Advances in Radiotherapy & Nuclear Medicine最新文献

{"title":"18F-FDG PET/CT for the diagnosis and evaluation of antibiotic response in patients with left ventricular assistive device infection: A case report","authors":"Lijuan Di, Guangyu Zhao, Shanshi Li, Bo Zheng, Yan Fan","doi":"10.36922/arnm.3690","DOIUrl":"https://doi.org/10.36922/arnm.3690","url":null,"abstract":"The left ventricular assistive device (LVAD) is critical for end-stage heart failure patients. Centrifugal flow LVAD recipients have a 4-year survival rate of nearly 60%, with infection occurring in over 50% of patients within 2 years. Herein, we report a case of LVAD infection in a 60-year-old man. The patient presented with fever after 49 days following LVAD implantation. Culture of both blood and areas around the outflow cannula indicated an infection with Enterobacter cloacae and Staphylococcus aureus. After sequential treatment with meropenem and daptomycin, as well as abdominal incisional debridement, the patient’s symptoms of fever disappeared, but the inflammatory markers, such as the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level, remained abnormal. Five 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scans were performed to evaluate the infection. PET/CT revealed infected lesions around the lower segment of the outflow cannula with high FDG uptake. After continuous oral antibiotic treatment for more than 1 year, the infected areas with high FDG uptake around the outflow cannula gradually declined and eventually disappeared, consistent with the noted changes in both ESR and CRP levels in the serum. Multiple continuous 18F-FDG PET/CT scans can distinguish high FDG uptake areas of infection from sterile inflammatory areas, assisting in the accurate diagnosis of infection and evaluation of antibiotic treatment after LVAD implantation.","PeriodicalId":219217,"journal":{"name":"Advances in Radiotherapy & Nuclear Medicine","volume":"20 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141702398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State of the art in melanoma brain metastatic treatment and evidence of combined high-dose radiotherapy and immunotherapy approach","authors":"Silvia Comas Anton, G. Meca Santamaria, A. Mañes Garcia, Maria Gabriela Antelo Redondo","doi":"10.36922/arnm.3499","DOIUrl":"https://doi.org/10.36922/arnm.3499","url":null,"abstract":"Finding the perfect strategy to treat melanoma brain metastases (BMs) has become a real-world challenge. Despite the difference in response and survival from different primary tumors, multiple guidelines recommend a multidisciplinary approach to treating BM. Although these guidelines are not specific for melanoma BM, most subjects included in the studies on which the guidelines are based are patients with melanoma. One of the strategies for the treatment of melanoma BM that arouses the most interest is the concurrent use of stereotactic radiosurgery and immunotherapy. This strategy seems to be feasible and has shown to improve survival and local control in retrospective series and phase 1 and 2 prospective trials. Here, we present a review of the current recommendations for addressing melanoma BM and the evidence available about the strategy combining focal radiation and immune checkpoint inhibitors.","PeriodicalId":219217,"journal":{"name":"Advances in Radiotherapy & Nuclear Medicine","volume":"23 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141354665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of multidrug resistance in tumors using 99mTc-doxorubicin","authors":"B. Gutfilen, Sergio Augusto Lopes de Souza, Thiago Barboza, Bruna Fortunato Novis, Claudia Lopes Rodrigues Chagas, Maria Verônica Fonseca Torres de Oliveira, Vivian M. Rumjanek","doi":"10.36922/arnm.2822","DOIUrl":"https://doi.org/10.36922/arnm.2822","url":null,"abstract":"Doxorubicin (DOX) is a potent chemotherapeutic agent used as the first-choice drug in treating different types of cancer, such as leukemia, lymphoma, and breast cancer, among others. However, the development of multidrug resistance represents a significant obstacle to the successful treatment of tumors. In this study, we assessed whether labeled DOX could be uptaken by susceptible and multidrug-resistant cell lines and by tumors in vivo in animals. The efficiency of DOX labeling was maintained at around 90% in this work. To evaluate the effect of 99mTc-DOX on cells expressing active P-glycoprotein (Pgp), we utilized cultured human chronic myeloid leukemia K562 cells and the resistant counterpart Lucena 1 cells. Lucena 1 cell line showed overexpression of Pgp that was not observed in K562. Our results suggested that the resistance to labeled or unlabeled DOX can be reversed by Pgp inhibition and can be easily detected. In conclusion, administering 99mTc-DOX into mice enables the differentiation between multidrug-resistant tumors in a non-invasive way and the evaluation of tumor resistance and possible chemosensitizers.","PeriodicalId":219217,"journal":{"name":"Advances in Radiotherapy & Nuclear Medicine","volume":"254 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140746258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gamma knife radiosurgery following whole-brain radiation","authors":"Natasha Mathur, Badal Juneja, A. Turtz, H. Goldman, Qianyi Xu, Dave Mulvihill, G. Kubicek","doi":"10.36922/arnm.2231","DOIUrl":"https://doi.org/10.36922/arnm.2231","url":null,"abstract":"In this study, we aimed to determine outcomes for patients requiring salvage stereotactic radiosurgery (SRS) who have progression of brain metastatic disease after initial treatment with whole-brain radiation (WBRT). This is a retrospective analysis of a prospective database of 112 patients who were treated with salvage SRS after experiencing failure following WBRT treatment with salvage SRS. Collectively, the patients had a median overall survival of 7 months after salvage SRS. Patients who had more than two brain metastases had a significantly shorter median survival but were not subjected to increased risk for distant brain failure. We also found that a short intervening time between WBRT and central nervous system (CNS) failure did not seem to worsen the nervous system control or reduce patient survival. Small cell lung cancer (SCLC) was associated with decreased overall survival and CNS control. In conclusion, SRS use following WBRT is safe and effective in the majority of patients. Patients with rapid failure after WBRT can be successfully salvaged with SRS. The findings also shed light on the overall poor outcomes, coupled with low median survival and high rates of CNS failure, in patients suffering multiple metastases stemming from SCLC.","PeriodicalId":219217,"journal":{"name":"Advances in Radiotherapy & Nuclear Medicine","volume":"40 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140371674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-sectional imaging in symmetrical bilateral extranodal recurrence of follicular lymphoma: A case report","authors":"C. Oliveti, B. Catalfamo, Annachiara Mollace, Claudia Italia Maria De Santis, Roberta Mancini, G. Cascini, Francesco Manti","doi":"10.36922/arnm.2828","DOIUrl":"https://doi.org/10.36922/arnm.2828","url":null,"abstract":"Follicular lymphoma (FL) constitutes nearly 30% of all lymphomas, making it the second most prevalent B-cell lymphoma. It exhibits an indolent course within the spectrum of non-Hodgkin lymphoma, with variable 5-year progression-free survival rates. Histologically graded 1–3, FL primarily affects bone marrow and lymphoid organs but may also involve extranodal tissues, such as bilateral muscle tissue. This report outlines the diagnostic challenges associated with disease recurrence in such unusual locations, emphasizing the need for vigilance among clinicians and radiologists. Through imaging and biopsy, we confirmed recurrence in the patient. The study highlights the role of 18F-FDG PET/CT in detecting uncommon FL sites and guiding treatment decisions while emphasizing the importance of multidisciplinary care for optimal patient management.","PeriodicalId":219217,"journal":{"name":"Advances in Radiotherapy & Nuclear Medicine","volume":"18 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140374405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood glucose level affects iodine-123 labeled MIBG uptake in the lung","authors":"Andreas Lim, M. Suh, Gi Jeong Cheon","doi":"10.36922/arnm.2506","DOIUrl":"https://doi.org/10.36922/arnm.2506","url":null,"abstract":"The aim of this study was to evaluate the correlation of blood glucose and the metaiodobenzylguanidine (MIBG) uptake in lung and compare the difference between the lung uptake of MIBG in diabetic and non-diabetic patients. Patients who underwent iodine-123 MIBG whole-body scan (WBS) in the Department of Nuclear Medicine Seoul National University Hospital between January 2014 and July 2022 were recruited and analyzed. Semi-quantitative analysis of the mean value of lung-to-mediastinum ratio (LMR) was performed. Correlation was analyzed with Pearson correlation test and mean difference was analyzed with independent t-test. There were 36 patients in diabetic group and 57 patients in non-diabetic group with mean age of 56 ± 14.1 and 52 ± 14.6 years, respectively. The mean 24-h LMRs in diabetic and non-diabetic groups were 1.38 ± 0.20 and 1.17 ± 0.14, respectively. Fasting glucose showed a mean value of 136 ± 37.7 and 96 ± 8.2 mg/dL, respectively. There was a significant positive correlation in diabetic (r = 0.397; P = 0.016) and non-diabetic groups (r = 0.579; P <0.001) with significant mean difference (0.21; P <0.001). In conclusion, lung uptake of MIBG is positively correlated with blood sugar level, with diabetic patients displaying higher lung uptake of MIBG compared with non-diabetic patients. In addition, higher lung uptake of MIBG is evident in patients with higher fasting glucose level and even in non-diabetic patients. Thus, in the situations where MIBG therapy is required, the radiation dose to the lungs must be carefully adjusted for patients with high blood sugar level.","PeriodicalId":219217,"journal":{"name":"Advances in Radiotherapy &amp; Nuclear Medicine","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140374069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"18F-FDG positron emission tomography-computed tomography and Richter transformation: A retrospective study with a cohort of 12 consecutive patients","authors":"Salah Oueriagli Nabih, Chaymae Bensaid, Meryem Aboussabr, O. Sahel, Y. Benameur, A. Doudouh","doi":"10.36922/arnm.2431","DOIUrl":"https://doi.org/10.36922/arnm.2431","url":null,"abstract":"Richter transformation (RT) refers to a transformational process of chronic lymphocytic leukemia (CLL) into a more aggressive form. CLL is considered an indolent lymphoma with no avidity to 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). RT transforms CLL into a diffuse large B-cell lymphoma, Hodgkin’s lymphoma, or prolymphocytic leukemia, and the lymphoid tissue becomes highly FDG avid. The main value of 18F-FDG PET/CT in CLL patients lies in its ability to exclude RT with high negative predictive value and identify sites of increased 18F-FDG uptake that is suitable for biopsy. In our retrospective analysis, we examined 12 patients suspected of RT, who were included in our study between November 2018 and December 2022. 18F-FDG PET/CT was considered for patients with enlarged lymph node, fever, and elevated lactate dehydrogenase levels. A cutoff standardized uptake value (SUVmax) = 5 was chosen empirically based on our institutional practice. Extranodal disease was suspected if abnormal 18F-FDG uptake was observed in the liver, spleen, bone marrow, or another organ. In this study, the specificity of 18F-FDG PET/CT was 44.5%, with positive and negative predictive values of 37.5% and 100%, respectively. Frequencies of cases with increased uptake of 18F-FDG in the “only nodal sites” and “nodal and extranodal sites,” relative to positive biopsies, were 20% and 66%, respectively.","PeriodicalId":219217,"journal":{"name":"Advances in Radiotherapy &amp; Nuclear Medicine","volume":"1 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140374504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the adequacy of a 5-mm planning target volume margin for 4D-CT scan-based image-guided radiotherapy for locally advanced carcinoma of the lung","authors":"Animesh Saha, Aditi Mishra, Shreya Manna, Ajay Banik, Suchanda Goswami, J. Bhattacharya, Tanmoy Mukhopadhay, P. Soren, Sayantan Mondal, Saptaswa Chattopadhyay, Biplab Sarkar, Suvra Biswal, Kiruba George, Mousin Gazi, Sandipan Roy Chowdhury","doi":"10.36922/arnm.2784","DOIUrl":"https://doi.org/10.36922/arnm.2784","url":null,"abstract":"In developed nations, 4D-computed tomography (4D-CT)-based image-guided radiotherapy (IGRT) has become the standard for treating lung carcinoma patients, with the primary goal of achieving disease cure. However, its usage in India remains limited. Here, we compared target volume delineation for radical radiation planning in patients with locally advanced lung carcinoma using helical free-breathing CT (FBCT) and 4D-CT. In addition, we assessed the adequacy of a 5-mm planning target volume (PTV) margin with 4D-CT planning. Fifty patients with locally advanced lung cancer were enrolled in the study. Each patient underwent contouring based on 4D-CT to generate an internal target volume, and a 5-mm PTV margin (PTV_4D) was added for radical radiation. Subsequently, each patient underwent two intensity-modulated radiation therapy (IMRT) plans with comparable planning and optimization parameters. One plan was based on the FBCT-based volume (PTV_3D), while the other was based on the 4D-CT-based volume (PTV_4D). PTV, organ at risk (OAR) dose, and PTV coverage by 95% of the prescribed dose (PTVD 95_3D vs. PTVD 95_4D) were compared between the two schemes. Results revealed that 4D-CT-based planning reduced PTV (mean PTV volume: 539 cc vs. 782 cc) and lowered OAR doses (mean lung dose: 13 Gy vs. 15 Gy; mean esophagus dose: 18.5 Gy vs. 21.15 Gy; mean spinal cord max dose: 35.59 Gy vs. 37.39 Gy). At 3 months after treatment imaging, 40% of the patients showed a complete response, 48% showed a partial response, 4% showed stable disease, and 8% showed progressive disease. In conclusion, 4D-CT-based radiation planning for locally advanced lung carcinoma with a reduced PTV margin of 5 mm can dramatically decrease the PTV and OAR doses without sacrificing PTV coverage compared to FBCT-based planning. However, daily online image guidance or at least a well-defined offline image guidance protocol is recommended when employing such a small PTV margin.","PeriodicalId":219217,"journal":{"name":"Advances in Radiotherapy &amp; Nuclear Medicine","volume":"14 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140374573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive analysis of myelosuppression of pediatric patients receiving radiotherapy","authors":"Yijie Sun, Hongjia Liu, Chenguang Li, Yubin Li, Huamu Xie, Yibao Zhang","doi":"10.36922/arnm.2519","DOIUrl":"https://doi.org/10.36922/arnm.2519","url":null,"abstract":"Pediatric oncology management necessitates distinct strategies for radiotherapy due to the heightened sensitivity of pediatric bone marrow to radiation exposure compared to adults. Therefore, this study aimed to compare the risk of radiation-induced myelosuppression between pediatric and adult patients by analyzing the correlations between gender, age, active marrow distribution, and radiation-induced myelosuppression. The medical records of 49 pediatric patients aged <15 years were retrospectively analyzed. Subgroup analyses based on sex and age were conducted to compare this pediatric patient data with data from adult patients reported in the literature. The observed rate of radiation-induced myelosuppression in the pediatric group was 59.18%, which was approximately twice the rate for the adult group (34%) reported in literature. Notably, the rates of leukopenia and granulocytopenia were observed in 53% and 45% of patients suffering from radiation-induced myelosuppression, respectively, compared to rates of thrombocytopenia and hemoglobinopenia observed in only 10% of patients, indicating that white blood cells and granulocytes are more sensitive indicators of radiation-induced myelosuppression. Our findings revealed that pediatric patients receiving radiotherapy in the head-and-neck regions face a higher risk of radiation-induced myelosuppression than adult patients due to the changes in active bone marrow during childhood development. Therefore, careful consideration of radiation-induced myelosuppression is essential during protocol optimization for pediatric patients receiving radiotherapy outside the pelvic region.","PeriodicalId":219217,"journal":{"name":"Advances in Radiotherapy &amp; Nuclear Medicine","volume":"101 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140379543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary syphilis: An unusual cause of osteolytic lesion diagnosed by 99mTc-MDP SPECT and presenting features","authors":"Xia Lu, Chifeng Xu, Haizhong Zhou, Qin Xiao, Huiying He","doi":"10.36922/arnm.2204","DOIUrl":"https://doi.org/10.36922/arnm.2204","url":null,"abstract":"Herein, we present the case of a 68-year-old woman complaining of pain of the right knee, which was initially misdiagnosed by plain radiography as fracture on inner right tibia plateau but was finally clarified as osteolytic lesion secondary to syphilis affecting the whole right knee. The final diagnosis was made based on the valuable findings from bone scanning, which allows for imaging of abnormalities with much larger extent, a scale that is out of the examination capacity of plain radiography. Bone scanning was employed in this case, coupled with the use of 99mTc-MDP, to assess abnormal bone metabolism at the whole right knee next to the tibia plateau. The imaging results illustrated the diverse features of bone involvement of secondary syphilis, including periostitis, osteolysis as well as osteomyelitis, occurring together or in isolation.","PeriodicalId":219217,"journal":{"name":"Advances in Radiotherapy &amp; Nuclear Medicine","volume":"55 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140378174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}