Indian Journal of Nuclear Medicine最新文献

{"title":"A Review on the Usage of Bone Single-Photon Emission Computed Tomography/Computed Tomography in Detecting Skeletal Metastases in the Post-COVID-19 Era: Is it Time to Ditch Planar and Single-Photon Emission Computed Tomography only Gamma Camera Systems?","authors":"Subapriya Suppiah,&nbsp;Mohd Fazrin Mohd Rohani,&nbsp;Ahmad Zaid Zanial,&nbsp;Ahmad Danial Ahmad Shahrir,&nbsp;Khairul Aliff Khairuman,&nbsp;Sobhan Vinjamuri","doi":"10.4103/ijnm.ijnm_142_22","DOIUrl":"10.4103/ijnm.ijnm_142_22","url":null,"abstract":"<p><p>Planar whole-body bone scanning (WBS) is widely used to evaluate skeletal lesions seen in cancer and noncancer cases. Frequently, degenerative, or other benign bony changes may give rise to indeterminate lesions that mimic bone metastases. In the post-COVID-19 era, there is an evolutionary phase that puts importance on global development and adaptability, which encompasses to include nuclear medicine practices worldwide. Single-photon emission computed tomography/computed tomography (SPECT/CT) can be used to improve the characterization of these lesions and help to resolve the diagnostic conundrum while reducing the need for patients to undergo multiple different examinations at various imaging departments. The fusion of SPECT and CT allows morphological characterization of functional abnormality detected by focal tracer uptake on planar scintigraphy, which provides a one-stop center imaging in nuclear medicine departments. The objective of this study was to review the diagnostic accuracy of SPECT/CT in diagnosing bone metastases in a variety of oncology and nononcology cases and to determine the feasibility of performing bone SPECT/CT in all suspected cancer cases, including cases of bone infection instead of planar imaging alone. The utilization of hybrid SPECT/CT in indeterminate bone lesions detected on planar WBS can significantly increase the diagnostic confidence and accuracy of image interpretation. Recognition of patterns of disease identified using hybrid imaging can improve the management of patients with potentially lower costs in the long term. Currently, hybrid SPECT/CT machines are becoming a norm in nuclear medicine departments, thus potentially making single planar application machines obsolete in the near future. We hypothesize that in the interest of providing a meaningful interpretation of isotope bone scans, the default protocol should involve the option of acquiring SPECT/CT images rather than relying on whole-body scans only. Departments choosing to upgrade existing equipment or those choosing to invest in only one gamma camera should proactively opt for hybrid SPECT/CT systems.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"38 2","pages":"191-200"},"PeriodicalIF":0.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0d/3a/IJNM-38-191.PMC10348494.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9827887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Sentinel Lymph Node Drainage Mapping for Localization of Contralateral Lymph Node Metastasis in Locally Advanced Oral Squamous Cell Carcinoma - A Prospective Pilot Study.","authors":"Parneet Singh,&nbsp;Pallvi Kaul,&nbsp;Tejasvini Singhal,&nbsp;Amit Kumar,&nbsp;Pankaj Kumar Garg,&nbsp;Manishi L Narayan","doi":"10.4103/ijnm.ijnm_120_22","DOIUrl":"10.4103/ijnm.ijnm_120_22","url":null,"abstract":"<p><strong>Aim/background: </strong>Sentinel lymph node biopsy (SLNB) has become the standard of care for nodal staging in early-stage oral squamous cell carcinoma (OSCC) as an alternative to elective neck dissection. However, the role of sentinel lymph node (SLN) and lymphatic drainage mapping with image-guided surgery has not been studied in locally advanced OSCC. Therefore, this study was undertaken to evaluate the role of lymphatic drainage mapping in the identification of contralateral cervical lymph node metastasis in locally advanced OSCC (Stage III-IVb).</p><p><strong>Materials and methods: </strong>We have prospectively analyzed treatment-naïve patients of locally advanced, lateralized OSCC (<i>n</i> = 20). All patients underwent SLN imaging using peritumoral injection 0.5-1.0 mCi of 99 mTc-Sulfur colloid (Filtered) and intraoperative identification of contralateral neck nodes using a handheld gamma probe (Crystal Photonics).</p><p><strong>Results: </strong>A total of 20 patients (18 males and 2 females) with a median age of 52.5 (33-70 years) were included. Ipsilateral SLN was localized in 18 (90%) patients. Bilateral cervical nodes were visualized only in 7 (35%) patients on lymphoscintigraphy (LSG). Out of the seven patients, 5 patients underwent bilateral neck dissection and 2 patients had unilateral neck dissection with LSG-guided exploration of contralateral cervical node and intraoperative frozen section examination. Six out of these seven patients had one or other risk factor for contralateral metastasis (patients had either primary in the tongue, involvement of floor of mouth, or tumor thickness >3.75 mm). On postoperative HPE, only 1/20 (5%) patient showed metastasis in the contralateral cervical lymph node.</p><p><strong>Conclusion: </strong>Correct identification of metastatic disease in contralateral neck directly influences clinical management, as it can reduce contralateral neck failure rate and limit the morbidity associated with unnecessary contralateral neck dissection, and it is also crucial in radiotherapy planning in locally advanced OSCC. In the current study, lymphatic drainage mapping showed a metastatic rate of 5% in the contralateral neck nodes in locally advanced, lateralized OSCC. However, the role of SLNB and lymphatic drainage mapping in this subgroup of OSCC needs to be studied in larger population to validate these findings.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"38 2","pages":"125-133"},"PeriodicalIF":0.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d0/31/IJNM-38-125.PMC10348499.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9827893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artifactual Hot Spots on Technetium-99m Macroaggregated Albumin Perfusion Lung Scan.","authors":"Chaimae Sebbar,&nbsp;Soufiane Hiroual,&nbsp;Nathalie Kouassi,&nbsp;Mohamed Aziz Bsiss,&nbsp;Aboubaker Matrane","doi":"10.4103/ijnm.ijnm_182_22","DOIUrl":"10.4103/ijnm.ijnm_182_22","url":null,"abstract":"<p><p>A 40-year-old male patient with pulmonary tuberculosis was subjected to a perfusion lung scan to rule out pulmonary embolism. Administration of technetium-99m macroaggregated albumin through preexisting venous access resulted in multiple round hot spots in both pulmonary fields. This finding was interpreted as an artifact caused by injection through preexisting venous access.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"38 2","pages":"151-153"},"PeriodicalIF":0.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/46/93/IJNM-38-151.PMC10348493.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9827894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"¹⁸F-Labeled Fluoro-2-Deoxyglucose Positron Emission Tomography and Computed Tomography Findings in a Case of Atypical Presentation of Adult Cutaneous T-cell Lymphoma.","authors":"Sarin Krishna,&nbsp;Mudalsha Ravina,&nbsp;Yashwant Kashyap,&nbsp;Subhajit Dasgupta,&nbsp;Rutuja Kote","doi":"10.4103/ijnm.ijnm_128_22","DOIUrl":"10.4103/ijnm.ijnm_128_22","url":null,"abstract":"<p><p>Adult cutaneous T-cell lymphoma is an uncommon malignancy with poor prognosis and is usually seen in association with human T-cell lymphotropic virus type 1. We present the case of a 25-year-old female who gave a history of extensive whole-body polypoidal cutaneous and bilateral orbital and breast swellings. Biopsy was suggestive of cutaneous T-cell lymphoma and the patient was evaluated with ¹⁸F-labeled fluoro-2-deoxyglucose positron emission tomography and computed tomography for initial staging of the disease.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"38 2","pages":"167-169"},"PeriodicalIF":0.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a0/d3/IJNM-38-167.PMC10348491.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9879953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"99m-Tc TRODAT Single-Photon Emission Computerized Tomography Scan Image Compression using Singular Value Decomposition.","authors":"Jagrati Chaudhary,&nbsp;Anil Kumar Pandey,&nbsp;Angel Hemrom,&nbsp;Param Dev Sharma,&nbsp;Chetan Patel,&nbsp;Rakesh Kumar","doi":"10.4103/ijnm.ijnm_84_22","DOIUrl":"10.4103/ijnm.ijnm_84_22","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of the study was to compress 99m-Tc TRODAT single-photon emission computerized tomography (SPECT) scan image using Singular Value Decomposition (SVD) into an acceptable compressed image and then calculate the compression factor.</p><p><strong>Materials and methods: </strong>The SVD of every image from the image dataset of 2256 images (of forty-eight 99m-Tc TRODAT SPECT studies [48 studies X 47 trans-axial images = 2256 trans-axial images]) was computed and after truncating singular values smaller than a threshold, the compressed image was reconstructed. The SVD computation time and percentage compression achieved were calculated for each image. Two nuclear medicine physicians visually compared compressed image with its original image, and labeled it as either acceptable or unacceptable. Compressed image having loss of clinical details or presence of compression artifact was labeled unacceptable. The quality of compressed image was also assessed objectively using the following image quality metrics: Error, structural similarity (SSIM), brightness, global contrast factor (GCF), contrast per pixel (CPP), and blur. We also compared the TRODAT uptake in basal ganglia estimated from the compressed image and original image.</p><p><strong>Results: </strong>Nuclear Medicine Physician labeled each image acceptable, as they found compressed image identical to its original image. The values of brightness, GCF, CPP, and blur metrics show that compressed images are less noisy, brighter, and sharper than its original image. The median values of error (0.0006) and SSIM (0.93) indicate that the compressed images were approximately identical to its original image. In 39 out of 48 studies, the percentage difference in TRODAT uptake (in basal ganglia from compressed and original image) was negligible (approximately equal to zero). In remaining 9 studies, the maximum percentage difference was 13%. The SVD computation time and percentage compression achieved for a TRODAT study were 0.17398 s and up to 54.61%, respectively.</p><p><strong>Conclusions: </strong>The compression factor up to 54.61% was achieved during 99m-Tc TRODAT SPECT scan image compression using SVD, for an acceptable compressed image.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"38 2","pages":"103-109"},"PeriodicalIF":0.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1c/ac/IJNM-38-103.PMC10348500.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9879955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent Renal Cell Carcinoma Presenting as Port-Site Metastases, Detected on ¹⁸F-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography.","authors":"Ralph Emerson,&nbsp;Parneet Singh,&nbsp;Girish Kumar Parida,&nbsp;Pramit Kumar,&nbsp;Kanhaiyalal Agrawal","doi":"10.4103/ijnm.ijnm_168_22","DOIUrl":"10.4103/ijnm.ijnm_168_22","url":null,"abstract":"<p><p>The incidence of port-site metastases (PSMs) varies with the tumor type with adenocarcinoma having a high incidence. However, it is rarely seen in urological malignancies and more so in renal cell carcinoma (RCC). We hereby describe one such case of PSM after laparoscopic radical nephrectomy for RCC, which was detected on ¹⁸F-fluorodeoxyglucose positron emission tomography-computed tomography.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"38 2","pages":"174-176"},"PeriodicalIF":0.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/01/89/IJNM-38-174.PMC10348512.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9825418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial Recognition: A Temporal Tale of Multiple Window Spatial Registration.","authors":"R L Vijayaraghavan,&nbsp;S Koilraj,&nbsp;Eileen Cynthia Kanakaraj","doi":"10.4103/ijnm.ijnm_145_22","DOIUrl":"10.4103/ijnm.ijnm_145_22","url":null,"abstract":"<p><strong>Purpose: </strong>The performance ability of position logic circuitry of gamma-camera to superimpose the X-Y gains obtained from different pulse height analyzers is multiple window spatial registration (MWSR). This study was conducted to evaluate the feasibility of dual-tracer method using ^99mTc and ¹³¹I to assess MWSR.</p><p><strong>Materials and methods: </strong>The procedure was carried out on a dual-head gamma-camera with rectangular NaI (Tl) crystal using a point source containing ^99mTc pertechnetate and ¹³¹I-NaI. Pixel coordinates, full width at half-maximum of point spread function at 364 keV and 140 keV, and pixels with maximum count of images for dual detectors were analyzed and compared.</p><p><strong>Results: </strong>The experiment demonstrated an excellent correlation between the X and Y coordinates identified on 364 keV and 140 keV images (Spearman's coefficient of rank correlation: 0.9, <i>P</i> < 0.0001). Intraclass correlation of studies performed on two separate occasions showed a good correlation (k = 0.87) demonstrating the reproducibility of the procedure.</p><p><strong>Conclusion: </strong>Dual-tracer method for evaluation of MWSR is a reproducible, accurate, and logical alternative to the routine National Electrical Manufacturers Association procedure.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"38 2","pages":"134-139"},"PeriodicalIF":0.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1d/6a/IJNM-38-134.PMC10348501.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9827888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of (F-18) Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Prediction of Response to Neoadjuvant Therapy in Esophageal Cancer: Correlation with Pathological Response and Survival.","authors":"Javier J Robles Barba,&nbsp;Aida Sabaté Llobera,&nbsp;Cristina Gámez Cenzano,&nbsp;Juan J Martin Marcuartu,&nbsp;Natalia Romero Martínez,&nbsp;Maria J Paules Villar,&nbsp;Carla Bettonica Larrañaga,&nbsp;Anna Boladeras Inglada,&nbsp;Mariona Calvo Campos,&nbsp;Albert Font Pous,&nbsp;Maica Galán Guzmán,&nbsp;Montserrat Cortés Romera","doi":"10.4103/ijnm.ijnm_12_22","DOIUrl":"10.4103/ijnm.ijnm_12_22","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to assess the correlation between metabolic response with fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) and pathological response in patients with locally advanced esophageal cancer treated with neoadjuvant chemoradiotherapy and to study FDG-PET parameters for the prediction of pathological response and outcome.</p><p><strong>Methods: </strong>Twenty-five patients with locally advanced esophageal cancer underwent two FDG-PET/CT scans for initial staging and after neoadjuvant chemoradiotherapy. FDG uptake in the primary tumor was calculated in both scans (SUVmax, SULpeak, and TLG). Metabolic response was assessed according to the reduction of PET parameters: complete response (mCR = 100%), partial response (mPR ≥50%), and no response (mNR ≤50%). Pathological response was also classified as complete (pCR), partial (pPR), or no response (pNR). Patients were followed up (range, 8-99 months) determining free-disease interval (FDI) and overall survival (OS).</p><p><strong>Results: </strong>Two patients were excluded due to exitus for nonesophageal-related causes. The metabolic response was observed in 18/23 remaining patients (3mCR, 15 mPR), of which 12/18 patients showed a pathological response (3 pCR, 9 pPR). A major discrepancy was observed in 2 mNR patients who achieved pPR. FDI and OS were longer in patients with metabolic response than nonresponders, but no statistical difference was found. No significant correlation was found between PET parameters and pathological response, FDI, and OS.</p><p><strong>Conclusions: </strong>FDG-PET/CT is a useful technique to assess response to neoadjuvant chemoradiotherapy in esophageal cancer. Although in this preliminary study, no correlation between metabolic and pathologic response was found and no statistical differences between responders and nonresponders were observed, a tendency of longer FDI and OS was apparently found in responders patients.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"38 2","pages":"97-102"},"PeriodicalIF":0.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/12/bb/IJNM-38-97.PMC10348503.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9827891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of ¹⁸F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Cardiac Infections.","authors":"Jasim Jaleel,&nbsp;Prateek Kaushik,&nbsp;Chetan Patel,&nbsp;Khangembam Bangkim Chandra,&nbsp;Satyavir Yadav,&nbsp;Deepti Siddharthan","doi":"10.4103/ijnm.ijnm_113_22","DOIUrl":"10.4103/ijnm.ijnm_113_22","url":null,"abstract":"<p><p>Diagnosis of cardiac infections, which includes infective endocarditis (IE) and cardiac device infections, despite having a high death rate, is still challenging. Frequently used modalities such as echocardiography, computed tomography (CT), and magnetic resonance imaging cannot confirm the presence of an active infection or extracardiac findings. Taking these things to consideration, newer guidelines have suggested the inclusion of ¹⁸F fluorodeoxyglucose positron emission tomography/CT (¹⁸F FDG PET/CT) in the workup of patients with suspected prosthetic valve IE. In this pictorial essay, we are demonstrating the utility of ¹⁸F-FDG PET/CT in varied cases of IE, cardiac implantable electronic devices, and coronary stent infection and how they helped in solving diagnostic dilemmas.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"38 2","pages":"140-144"},"PeriodicalIF":0.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/83/fd/IJNM-38-140.PMC10348497.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9825419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combining Immunotherapy with Transarterial Radioembolization.","authors":"Zeynep Ceren Balaban Genc,&nbsp;Efe Soydemır,&nbsp;Seval Ay Ersoy,&nbsp;Tunc Ones","doi":"10.4103/ijnm.ijnm_180_22","DOIUrl":"10.4103/ijnm.ijnm_180_22","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) has a high mortality rate due to the diagnosis of patients at advanced stages and ineffective systemic therapies. Immunotherapy is considered a new treatment option for unresectable HCC alternatives to the limitations of conventional cytotoxic chemotherapy. In this case report, we reported that transarterial radioembolization and immunotherapy such as atezolizumab and bevacizumab can be used together in a manner effectively in the management of HCC treatment.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"38 2","pages":"145-147"},"PeriodicalIF":0.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6a/ec/IJNM-38-145.PMC10348490.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9825423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}