Journal of Nuclear Medicine and Radiation Therapy最新文献

{"title":"Effect of patient bladder voiding on radiation dose rates measured around patients undergoing PET/CT imaging using 18F-FDG","authors":"K. Soliman, A. Alenezi","doi":"10.4172/2155-9619.1000272","DOIUrl":"https://doi.org/10.4172/2155-9619.1000272","url":null,"abstract":"Accurate dose rate estimates is important for radiation protection specialists conducting risk assessments and performing dose reconstruction in cases of accidental exposures. \u0000Objectives: The objectives of this work was to experimentally evaluate the bladder voiding factor effect on the dose rate measured from patients undergoing PET/CT imaging studies using 18F-FDG by directly measuring the dose rate immediately before and after voiding, and compare the results with the current scientific literature. \u0000Results: The bladder voiding effect had a dose rate reduction factor of about 12% between dose rates measured before and after voiding. This measured reduction factor agreed with the 15% reported by the AAPM Task Group 108. We have also measured dose rates at one meter from 50 patients and found an average dose rate per unit activity of 93.7 μSv/hr/GBq. Our dose rate results were in excellent agreement with the results of current published data (92 μSv/hr/GBq, AAPM Task Group 108). \u0000Conclusions: The presented data can be applied in radiation protection optimization procedures, especially for the protection of the care givers from patients undergoing 18F-FDG PET/CT imaging when they are considered as external radiation source or hazard to others. The provided information will benefit medical physicist working in nuclear medicine and radiation safety policy makers.","PeriodicalId":302578,"journal":{"name":"Journal of Nuclear Medicine and Radiation Therapy","volume":"116 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134266877","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":"Inhibition of the BER Factor APE1 Disrupts Repair of Double-Strand DNA Damage in Cells Treated with Low Dose-Rate, but Not High Dose-Rate XRadiation","authors":"A. McCluskey, M. Boyd","doi":"10.4172/2155-9619.1000269","DOIUrl":"https://doi.org/10.4172/2155-9619.1000269","url":null,"abstract":"Introduction: Radiotherapy is utilised in the treatment of many cancers, but its efficacy is limited by normal tissue toxicity and new radiotherapy techniques are thus urgently sought. The AP endonuclease APE1 is involved in repair of single strand DNA damage through the break excision repair (BER) pathway and altered levels of APE1 have been found in some cancers. In this study, we investigated the effects of APE1 inhibition, using the APE1-specific inhibitor CRT0044876 (CRT), in tumour cells following exposure to either high dose-rate (HDR) or low dose-rate (LDR) X-irradiation. \u0000Materials and Methods: Treatment efficacy was assessed by clonogenic assay followed by isobologram analysis to assess potential synergy. Cell cycle distribution was assessed by propidium iodide staining followed by flow cytometry. Induction of DNA damage and repair was assessed by single cell gel electrophoresis and by H2A.X phosphorylation. \u0000Results: In isobologram analysis of clonogenic assays, combinations of CRT and both HDR and LDR X-irradiation resulted in supra-additive levels of cytotoxicity. Cell cycle analysis showed that, while CRT had no effect on cell cycle distribution, HDR or LDR X-irradiation, and CRT-HDR or CRT-LDR combination treatment induced significant G2/M arrest. However, CRT-HDR combinations induced significantly less G2/M accumulation than HDR alone. Analysis of DNA damage indicated that treatment with HDR or LDR X-irradiation and CRT-HDR and CRT-LDR combinations induced significant double-strand DNA damage. Cells treated with CRT-HDR exhibited a significant reduction in γH2A.X foci 24 h after treatment compared to 1 h, suggesting induction of DNA repair mechanisms. However, in cells treated with CRT-LDR, there was no significant difference between H2A.X phosphorylation at 24 h compared to 1 h, suggesting disruption of dsDNA repair pathways. \u0000Conclusions: Pharmacological inhibition of APE1 enhances the cytotoxicity of high dose-rate and low dose-rate X-irradiation by different mechanisms.","PeriodicalId":302578,"journal":{"name":"Journal of Nuclear Medicine and Radiation Therapy","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131729335","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":"Dose Rate and Dose Painting","authors":"H. Abdollahi","doi":"10.4172/2155-9619.1000E114","DOIUrl":"https://doi.org/10.4172/2155-9619.1000E114","url":null,"abstract":"Tumor heterogeneity is one of the most important factors in tumor progression and recurrence after therapy. In this situation, delivery of a non-uniform dose would be optimum. Dose painting as a nonuniform dose distribution is a feasible strategy in radiation oncology. It requires imaging biomarkers to determine treatment sites which should receive higher doses. There are two main strategies for dose painting: by numbers (DPBN) and by contours (DPBC). In DPBC, tumour sub volumes receive a boosted dose, whilst DPBN is a voxel based issue and each voxel of tumour volume receives an individual dose prescription [1]. Based on molecular imaging data, dose painting involves four distinct steps including: “determination of the correlation between the underlying tumour biology and molecular imaging; determination of dose prescription function based on molecular imaging data; planning of the treatment and dose delivery; and assessment of the clinical outcomes in comparison with standard treatments” [2]. Molecular imaging (more PET) plays a rigorous role to find more accurate target volume, called biological target volume (BTV). Bentzen et al. mentioned there are three evidence based causes of treatment failure in radiation oncology including tumor burden, tumor cell proliferation, and hypoxia. They concluded that molecular imaging of those phenotypes using specific PET tracer can lead to find ideal painted dose distribution [3]. In the other hand, by introduction of cancer stem cells (CSCs) hypothesis and their highly radiation resistance, the mentioned triplet treatment failure (tumor burden, proliferation, and hypoxia) can be correlated to CSCs. Also, the main heterogeneity of tumors is due to CSCs theoretically. Multiple studies have shown that CSCs are highly radioresistance because they are hypoxic, have strong DNA repair and radical scavenging systems and they repopulate by a fast manner [4].","PeriodicalId":302578,"journal":{"name":"Journal of Nuclear Medicine and Radiation Therapy","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131563023","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":"99mTc MDP and 67Gallium Dual Isotope Imaging in the Evaluation of Sternal Osteomyelitis and Wound Dehiscence","authors":"P. Shanmugasundaram, S. Padma","doi":"10.4172/2155-9619.1000266","DOIUrl":"https://doi.org/10.4172/2155-9619.1000266","url":null,"abstract":"Sternal infections are a major cause of morbidity and mortality in patients undergoing cardiac surgery. They occur in 1% to 3% of patients who undergo open-heart surgery and carry a moderately high mortality rate. Sternal infections can range from minor, superficial infections to open mediastinitis with invasion of the sternum, heart, and great vessels. Infection can lead to partial or complete separation of bony sternum thus compounding the problem. Identifying osteomyelitis (OM) is a challenge to the surgeons especially in the postoperative setting. Although clinically presence of fever and leukocytosis along with sternal wound dehiscence suggests deep infection. Localization and ascertaining the extent of sternal infection is difficult. Treatment entails surgical debridement with closed irrigation, open-wound packing, or muscle or omental flap procedures, as well as antibiotic therapy. In sternal OM, delineation of sinus tracts into the various planes of anterior mediastinal tissues is essential to achieve proper surgical drainage and antibiotic cover. This is exclusively achieved by Gallium infection imaging and additional use of SPECTCT (Single photon emission computed tomography). Only when the postoperative site is devoid of residual infection, thoracic and trunk reconstruction can be performed to provide stability to sternal dehiscence.","PeriodicalId":302578,"journal":{"name":"Journal of Nuclear Medicine and Radiation Therapy","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121094600","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":"Accumulated Dose of Intensity-Modulated Radiotherapy for Head and Neck Cancer Using Deformable Registration of Two Sets of Computed Tomography Images","authors":"S. Tsudou, H. Takegawa, Y. Ueda, M. Miyazaki, R. Nakashima, M. Suga, H. Numasaki, M. Takashina, M. Koizumi, T. Teshima, K. Nishiyama","doi":"10.4172/2155-9619.1000264","DOIUrl":"https://doi.org/10.4172/2155-9619.1000264","url":null,"abstract":"Purpose: The aim of this study was, using deformable image registration (DIR), to evaluate alteration of dose distribution caused by patient’s anatomical structure changes during a two-phase intensity-modulated radiotherapy (IMRT). \u0000Methods: IMRT consisted of an initial plan delivering 53 Gy to gross tumor volume (GTV) and 45 Gy to elective volumes and a boost plan delivering 16.96 Gy to GTV. The subjects were 10 patients with head and neck cancer who underwent computed tomography (CT) scans twice (first CT before treatment and second CT before boost). A sum of the initial and the boost plans for the first CT was Original total plan. Using DIR, the original boost and a modified new boost plan were recalculated on the second CT and summed with the initial plan to create total plans: DIR plan and modified DIR plan. \u0000Results: Mean dose (Dmean) of the ipsilateral and contralateral parotids were increased by 8.0% (P<0.01) and 6.8% (P<0.05) in DIR plan compared with Original total plan. Compared with DIR plan, modified DIR plan reduced Dmean of the ipsilateral parotid (P<0.01). Dose to 95% of the volume (D95) to clinical target volume for GTV (CTV1) of DIR plan was significantly higher than that of Original total plan (P<0.01) and modified DIR plan (P<0.01). \u0000Conclusions: Dose summation using DIR demonstrated that the body shrinking during IMRT significantly increased the doses of both parotids and CTV1. Modified DIR plan compensated the increases in doses of the ipsilateral parotid and CTV1.","PeriodicalId":302578,"journal":{"name":"Journal of Nuclear Medicine and Radiation Therapy","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125869558","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":"Incidental Detection of Pigmented Villonodular Synovitis by 18FDG PETCT Imaging in a Case of Poorly Differentiated Thyroid Carcinoma","authors":"Manjit Sarma, C. Borde, S. Padma, P. Shanmugasundaram","doi":"10.4172/2155-9619.1000267","DOIUrl":"https://doi.org/10.4172/2155-9619.1000267","url":null,"abstract":"We report the incidental identification of an unsuspected Pigmented Villonodular Synovitis (PVNS) in a patient of known thyroid malignancy (poorly differentiated thyroid carcinoma, PDTC) who underwent whole body 18 Fluorine Flurodeoxyglucose Positron Emission Tomography Computed Tomography (18F FDG PET CT). FDG PET CT showed a FDG avid enhancing lesion in the subscapularis muscle near coracoid process of left scapula. A subsequent MRI showed a lesion anterior to the left glenoid in close proximity to the subcapsularis tendon suggestive of PNVS arising from the subcapsular bursa. This case highlights the non oncological utility of FDG PETCT in musculoskeletal disorders like PVNS.","PeriodicalId":302578,"journal":{"name":"Journal of Nuclear Medicine and Radiation Therapy","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122299529","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":"Assessment of Brain Tumor Displacements after Skull-based Registration: A CT/MRI Fusion Study","authors":"Qianyi Xu, G. Hanna, Y. Zhai, S. Asbell, J. Fan, T. Lacouture, Y. Chen, L. Kim, G. Kubicek","doi":"10.4172/2155-9619.1000265","DOIUrl":"https://doi.org/10.4172/2155-9619.1000265","url":null,"abstract":"Purpose: To assess brain tumor displacements between skull based and soft-tissue based matching during CTMRI fusion for a total of 35 brain lesions. Methods: Twenty-five patients who underwent CT and MRI scans in the same day were retrospectively recruited into the study. Semi-automatic skull based fusion was first performed and reviewed on a Treatment Planning System (TPS). A secondary fine-tuning of the fusion was then performed, if mismatch was observed in the tumor or neighboring soft-tissue, using nearby visible soft-tissue, such as gyri, sulci, and fissures. Two physicists fine-tuned the secondary fusion until the best match could be agreed upon. The resulting rotations and translations between the two fusions were recorded, which indicated local displacements between skull based and soft-tissue based matching. We further created a PTV by expanding a 2 mm margin around the GTV after skull-based fusion, and then evaluated the coverage of the GTV within the PTV after fine tuning with soft-tissue based fusion. Results: In 29 of the 35 lesions, minor to no mismatch was found between the soft-tissue and skull based fusions. The corresponding translational and rotational shifts were 0.05 ± 0.63 mm (LR), 0.01 ± 0.79 mm (AP), 0.37 ± 1.01 mm (SI); -0.15 ± 0.67° (pitch), -0.19 ± 0.34° (yaw), and -0.12 ± 0.49° (roll). Thus the GTV, after soft-tissue based fusion, was 100% covered by the PTV. However, in the remaining 6 lesions in the study, noticeable displacements were observed between the skull and soft-tissue based fusions. Excluding an outlier lesion, the mean translational and rotational shifts for 5 of the 6 remaining lesions were 0.90 ± 2.15 mm (LR), 1.50 ± 2.27 mm (AP), -1.01 ± 1.83 mm (SI); -1.42 ± 3.12°(pitch), 0.02 ± 0.83°(yaw), and -0.17 ± 0.68°(roll). For the outlier lesion, the GTV was nearly missed by the PTV, and for the rest of the 5 lesions, the mean coverage of the GTV was 98.9% within the PTV. Conclusion: In a small portion of lesions, our study showed noticeable brain tumor displacement with typical patient setup in CT and MRI scans when using skull based fusion in comparison with soft-tissue fusion. Careful review of the skull based fusion is recommended by examining the match with nearby soft-tissue and/or tumors. If fusion deviations are found, it is also recommended to consider adding a margin to the GTV to account for such variations, since such variations could potentially affect target localization accuracy at the time of treatment.","PeriodicalId":302578,"journal":{"name":"Journal of Nuclear Medicine and Radiation Therapy","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116247404","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":"Total Eclipse of FDG-PET Scan Caused by Hyperphysiological FDG Uptake of Masticatory Muscles Due to Chewing","authors":"K. Okuyucu, H. San, A. O. Karacalioglu, O. Emer, S. Ince","doi":"10.4172/2155-9619.1000268","DOIUrl":"https://doi.org/10.4172/2155-9619.1000268","url":null,"abstract":"In routine oncological 18F-fluorodeoxyglucose positron emission tomography (FDG-PET/CT) scan, the patients rest in a quite, dimly lit room for 60 minutes after intravenous (IV) injection of FDG and they are instructed not to move during this time (uptake phase) before FDG-PET/CT scanning to prevent and decrease unwanted FDG accumulations on muscle traces caused by muscle movements. In conditions of patient inconsistency, undesirable activities can be seen and reach high levels making difficult or even impossible to interpret the images. Different muscle groups form various physiological or over- physiological uptake patterns depending on their specific motion. Herein we represent a good didactic example to this phenomenon.","PeriodicalId":302578,"journal":{"name":"Journal of Nuclear Medicine and Radiation Therapy","volume":"121 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121364926","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":"A Case Report of a Metastatic Adenocarcinoma of Lung with Dual Positivity for EGFR Mutation and ALK Fusion","authors":"M. Kamath, K. Lokesh, Govind Babu, K. Lakshmaiah, MC SureshBabu, U. Amirtham","doi":"10.4172/2155-9619.1000262","DOIUrl":"https://doi.org/10.4172/2155-9619.1000262","url":null,"abstract":"Non-small cell lung cancer ranks among the most lethal cancers worldwide. The rate of epidermal growth factor receptor (EGFR) mutations and echinoderm microtubuleassociated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) gene fusion is the most common in younger age, non-smoking Asian adenocarcinoma lung cancer patients. EGFR mutations and ALK gene rearrangements are known to be mutually exclusive and as mutual causes of resistance to EGFR-tyrosine kinase inhibitors (TKIs) or ALK-TKIs. However, rarely such co-alterations do co-exist in some clinical cases. Here we report a 62 year old male, heavy smoker with cough, hemoptysis and fatigue. Histopathological examination of bronchoscopic guided biopsy showed adenocarcinoma histology. Staging evaluation, he was found to have stage IV disease on positron emission tomography-computed tomography scan. The biopsy blocks tested positive for both EGFR mutation and ALK fusion. Patient was initiated on tablet Gefitinib 250 mg once daily. To the best of our knowledge, there has been no report of dual EGFR mutation and ALK fusion positivity from India.","PeriodicalId":302578,"journal":{"name":"Journal of Nuclear Medicine and Radiation Therapy","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129734369","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":"HDR Brachitherapy for Basal Cell Carcinoma","authors":"Lancellotta, M. Lupattelli, C. Zucchetti, S. Saccia, A. Cavalli, C. Aristei","doi":"10.4172/2155-9619.1000260","DOIUrl":"https://doi.org/10.4172/2155-9619.1000260","url":null,"abstract":"Aim: to evaluate tumor control, toxicity and cosmesis in patients with relapse of basal cell carcinoma (BSC) who underwent high-dose-rate brachytherapy (HDR-BT)using a regimen of hypofractionation. \u0000Case presentation: A 93-year-old male, Karnosky Performace Status 90%, was diagnosed to have a relapse of BSC. A biopsy confirmed a relapse of BSC. The patient underwent HDR-BT with 192 Ir. The prescription dose of 50 Gy in 20 fractions of 2.5 Gy was delivered daily. The Common Terminology Criteria for Adverse Events (CTCA v4.0) toxicity scale was used to asses acute toxicity and the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC) scale was used to asses late toxicity related to cosmesis. The treatment was well tolerated. Clinically, the lesion completely regressed. The skin acute toxicity was grade 2 CTCA v4.0 and late toxicity grade 1EORTC. When the patient was consulted about his cosmetic result, he was satisfied. At the median follow-up of 7 months, the patient was alive and disease-free. \u0000Conclusion: the HDR-BT can be an effective and safe treatment option for selected elderly patients with relapse skin cancer.","PeriodicalId":302578,"journal":{"name":"Journal of Nuclear Medicine and Radiation Therapy","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117263819","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}