Indian Journal of Nuclear Medicine最新文献

{"title":"Radiation Safety Assessment of 177Lu-DOTATATE Intra-arterial Peptide Receptor Therapy (PRRT).","authors":"Manoj Kumar Hariram Chauhan, Ashish Kumar Jha, Sneha Mithun, Rutuja Dasharath Parab, Pooja Dwivedi, Ameya D Puranik, Kunal Bharat Gala, Nitin Sudhakar Shetye, Suyash Kulkarni, Venkatesh Rangarajan","doi":"10.4103/ijnm.ijnm_88_23","DOIUrl":"10.4103/ijnm.ijnm_88_23","url":null,"abstract":"<p><strong>Objective: </strong>¹⁷⁷Lu-DOTATATE peptide receptor therapy (PRRT) is an established treatment for patients suffering from neuroendocrine tumors. In the last few years, intra-arterial PRRT is being considered for patients having liver metastatic disease predominantly. The aim of our study is to measure the radiation doses received by the treating intervention radiologists involved in intra-arterial PRRT treatment using ¹⁷⁷Lu-DOTATATE.</p><p><strong>Materials and methods: </strong>Radiation safety-related data of 31 patients who underwent 177Lu-DOTATATE intra-arterial PRRT treatment were used for this study. The exposure rate was measured at the hand and eye and chest level of treating intervention radiologists continuously from the beginning to the end of the administration. Exposure from the patient at the body surface (at the level of liver, thigh, and extremities) and 1 m from the body surface was measured just after the administration. The mean radiation exposure from the patient at the body surface and 1 m from the body was also calculated.</p><p><strong>Results: </strong>The mean administered activity was found to be 194 (±17) mCi. The mean radiation exposure at the surface at the level of the liver, thigh, and feet and at 1 m from the surface was found to be 100 (±25.11), 9 (±1.27), 5.6 (±0.52), and 5.3± (0.50) μSv/hr, respectively. The mean administration time was found to be 23 ± 5.6 min. The mean radiation dose to the hands, and eyes, of the treating intervention radiologist per procedure, was found to be 6.425 ± 2.75 μSv, 5.43 ± 1.76 μSv and 1-m exposure from the patient was found to be 5.3 ± 0.246 μSv, respectively.</p><p><strong>Conclusion: </strong>Our result shows that the radiation exposure from the patient postadministration is below the permissible limit of discharge. The radiation exposure to the intervention radiologist is also suggestive of a safe procedure to be performed by maintaining the radiation dose well within the permissible limit for radiation professionals.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"39 4","pages":"254-258"},"PeriodicalIF":0.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956494","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":"Optimizing Low-Dose [18F]FDG-PET/CT Scans: Ensuring Quality Amid Radiotracer Availability Challenges - Insights from a Peripheral Tertiary Care Center.","authors":"Sachin Tayal, Yash Jain, Sonali Thakur, Varun Shukla, Manikandan Marappagounder Venkatachalam, Ajay Kumar, Ritwik Sinha","doi":"10.4103/ijnm.ijnm_90_24","DOIUrl":"10.4103/ijnm.ijnm_90_24","url":null,"abstract":"<p><strong>Background: </strong>The introduction of positron emission tomography/computed tomography (PET/CT) has significantly advanced medical imaging. In oncology, ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) PET/CT is particularly crucial for staging, evaluating treatment response, monitoring follow-up, and planning radiotherapy. However, in resource limiting hospitals, the availability of fluorine-labeled ¹⁸F-FDG limits optimal scan acquisition. This study aims to determine the optimal dosage and acquisition time to maximize patient throughput during shortages.</p><p><strong>Aim and objective: </strong>To optimize low-dose ¹⁸F-FDG scan protocols while maintaining high image quality despite radiotracer availability challenges.</p><p><strong>Materials and methods: </strong>PET/CT scans were performed using GE's Discovery IQ 5-ring, 16-slice system within 40-60 minutes of intravenous ¹⁸F-FDG injection. The protocol was adjusted to a low-dose (0.05 mCi/kg of ¹⁸F-FDG), and the PET data acquisition time was increased to 3 min per bed position to ensure image quality.</p><p><strong>Results: </strong>Notable differences were observed in image quality scores based on varying acquisition times, with the extended acquisition time helping maintain diagnostic standards despite reduced tracer doses.</p><p><strong>Conclusion: </strong>The high sensitivity and long axial length of the PET/CT system (with five rings spanning 26 cm AFOV) can significantly alleviate the challenges faced by cyclotron-dependent centers. By leveraging the increased sensitivity, we successfully reduced the injected activity rather than the scan time to address the tracer shortage at our institute. This approach proved to be effective in maintaining image quality and patient care standards.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"39 4","pages":"292-298"},"PeriodicalIF":0.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956490","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":"Diagnostic Potential of 99mTc-macroaggregated Albumin Scintigraphy in the Diagnosis of Hepatopulmonary Syndrome: Insights from Two Case Studies and Critical Review of Literature.","authors":"Parneet Singh, Tejasvini Singhal, Pradeep Palanivel, Puneet Dhar, Manishi L Narayan","doi":"10.4103/ijnm.ijnm_18_23","DOIUrl":"10.4103/ijnm.ijnm_18_23","url":null,"abstract":"<p><p>Hepatopulmonary syndrome (HPS) is a rare pulmonary vascular complication of chronic liver disease characterized by dilatation of pulmonary capillaries leading to vascular shunting and systemic hypoxemia. Diagnosis of HPS requires documentation of intrapulmonary vasodilation (IPVD), the two most common imaging studies performed for the detection of IPVD include transthoracic contrast echocardiography (TTCE) and 99m-Tc-macroaggregated albumin scintigraphy (99mTc-MAA scan). TTCE has high sensitivity and thus, is the preferred initial investigation, while 99mTc-MAA scan is highly specific and plays an adjuvant role in diagnosis. 99mTc-MAA scan can, however, identify some cases of HPS not apparent on TTCE and can also quantify the shunt fraction. The current study describes the utility of 99mTc-MAA scan in the detection of IPVD in two suspected cases of HPS.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"39 4","pages":"304-308"},"PeriodicalIF":0.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956474","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":"GFR Estimation and Correlation for Oncology Patients by Two Methods, Gates Method and Dual Time Point Plasma Sampling Method.","authors":"Sachin Tayal, Varun Shukla, Manikandan Venkatachalam, Ajay Kumar, Uddeshya Narayan Jha","doi":"10.4103/ijnm.ijnm_2_24","DOIUrl":"10.4103/ijnm.ijnm_2_24","url":null,"abstract":"<p><strong>Background: </strong>With the increasing number of oncology cases and a parallel surge in chemotherapeutic drugs for treatment, the treating physicians conducts nephrotoxicity evaluation to provide a personalized dosing strategy. Of the various tests available, glomerular filtration rate (GFR) under gamma camera with help of Gates method has gained importance, being a good index of overall kidney functions. In addition to this, there has been an alternate and old method for GFR estimation: plasma sampling. We at our Institution conducted both the methods for better evaluation of GFR in cancer patient management.</p><p><strong>Aim: </strong>Comparison of Gates' camera based GFR based on kidney depth correction using Tonessen's method and CT based manual depth calculation with dual time point plasma sampling in cancer patients.</p><p><strong>Method: </strong>A retrospective study wherein patients' database were evaluated over a period of four months after approval from our Institutional Review Board. Thirty patients were included in the study. GFR was evaluated by two methods: Gates camera based and dual time plasma sampling method. Statistical analysis was done to help evaluate a correlation coefficient between the methods (Gates' method with and without CT based manual depth correction and dual time point plasma sampling).</p><p><strong>Results: </strong>Our study showed moderate correlation between Gates' camera based GFR and dual time plasma sampling method.</p><p><strong>Conclusion: </strong>One need to understand the limitation of each method and see if the renal depth corrections can be done with the help of CT or lateral images of NM for near accurate GFR and in case of selecting dual plasma sampling, errors to be minimized in pipetting and sample counting. Hence, it will be better to use both the methods for coming to a conclusion.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"39 4","pages":"259-264"},"PeriodicalIF":0.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956479","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":"Abscopal Effect Demonstrated on [18F]FDG PET/CT in a Case of Renal Cell Carcinoma Postnephrectomy.","authors":"Sambit Sagar, Dikhra Khan, Nivedita Kundu, Shamim Ahmed Shamim, Rakesh Kumar","doi":"10.4103/ijnm.ijnm_30_23","DOIUrl":"10.4103/ijnm.ijnm_30_23","url":null,"abstract":"<p><p>Renal cell carcinoma accounts for 3% of all malignancies with many of them presenting with metastasis at the time of presentation. The abscopal effect, a phenomenon characterized by systemic bystander effects on nontargeted lesions due to local therapy, has been extensively studied in the context of radiotherapy and immunotherapy. However, documentation of the abscopal effect following surgery remains limited. We present a case of a 67-year-old Indian male diagnosed with clear cell renal cell carcinoma (RCC), who underwent left radical nephrectomy. Baseline staging and postnephrectomy follow-up scans with fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET-CT) revealed an FDG-avid primary lesion in the left kidney with metastasis to the left lung. Surprisingly, the follow-up FDG PET-CT scan demonstrated the resolution of the left lung metastasis, indicating the occurrence of the abscopal effect resulting from the local nephrectomy. This rare clinical observation highlights the potential of surgery to induce immunogenic tumor neoantigens release and inflammatory factors, leading to systemic antitumor effects. While the abscopal effect has been extensively studied in the context of radiotherapy and immunotherapy, there is a scarcity of studies reporting nephrectomy promoting such systemic effects. The combination of radiotherapy and immunotherapy has shown promising results in enhancing tumor immunosuppression and facilitating the abscopal effect. We report a case of RCC with lung metastasis showing abscopal effect with resolution of lung nodule postnephrectomy on 18-F-FDG PET-CT.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"39 4","pages":"320-322"},"PeriodicalIF":0.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956310","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":"Rare Primary Pericardial Mesothelioma on an [18F]FDG PET/CT Scan and Its Postchemotherapy Response Evaluation.","authors":"Hemant Rathore","doi":"10.4103/ijnm.ijnm_43_24","DOIUrl":"10.4103/ijnm.ijnm_43_24","url":null,"abstract":"<p><p>Primary pericardial mesothelioma is a highly aggressive and rare neoplasm that arises from the pericardial mesothelial cell and has a poor prognosis. The diagnosis is usually established by histological and immunohistochemical studies. Malignant mesothelioma most frequently occurs from the pleura (90%), less frequently from the peritoneum and pericardium (6%-10%), and very rarely from the tunica vaginalis in the testis. Most of the patients were retrospectively diagnosed after surgery or an autopsy due to the absence of specific clinical manifestations. We present a case study of a 65-year-old female with primary pericardial mesotheliomas who was investigated with 18F-fluorodeoxyglucose positron emission tomography with computed tomography (FDG PET/CT) scan for biopsy and staging, which shows significant resolution of disease on postchemotherapy response evaluation and underwent pericardiectomy with a progression-free survival of over 12 months.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"39 4","pages":"313-315"},"PeriodicalIF":0.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956512","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":"Disseminated Multiple Organ Lymphoma Presented as Vulvar Lesion Diagnosed by [18F]FDG PET/CT.","authors":"Zehra Pınar Koç, Pınar Pelin Özcan, Tolgay Tuyan İlhan, Mehmet Yaldız","doi":"10.4103/ijnm.ijnm_37_21","DOIUrl":"10.4103/ijnm.ijnm_37_21","url":null,"abstract":"<p><p>We would like to present a 49-year-old female patient who was presented with a vulva lesion and palpable inguinal lymph nodes who were diagnosed with disseminated multiorgan involvement of high grade diffuse large B-cell lymphoma. The ¹⁸F-fluorodeoxyglucose positron emission tomography computerized tomography imaging showed multiple cervical, axillary, and abdominal lymph nodes, pulmonary nodules as well as gross hypermetabolic vulvar lesion.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"39 4","pages":"318-319"},"PeriodicalIF":0.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956475","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":"Carcinoma Breast Presenting with Concurrent Extensive Lymph Nodal Sarcoidosis.","authors":"Siddharth Sharma, Vijay Singh, Sanjay Gambhir, Manish Ora","doi":"10.4103/ijnm.ijnm_66_23","DOIUrl":"10.4103/ijnm.ijnm_66_23","url":null,"abstract":"<p><p>Sarcoidosis is a systemic disease characterized by noncaseating granulomas involving any organ. Concurrent carcinoma breast with sarcoidosis is a rare occurrence. A 51-year-old female presented with right breast lump and was diagnosed with infiltrating ductal carcinoma with lymph nodal (LN) metastases (estrogen receptor, progesterone receptor positive, and HER2neu negative). Baseline fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) scan revealed breast mass with multiple LNs. Biopsy of iliac and internal mammary LNs indicated granulomatous lymphadenitis. A possible diagnosis of sarcoidosis was considered. End of chemotherapy (4 EC, 12 paclitaxel), FDG PET/CT revealed a complete metabolic response in breast mass. Most lymph nodes were resolved. Modified radical mastectomy specimen was negative for breast malignancy with granulomatous lymphadenitis in LNs.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"39 4","pages":"323-324"},"PeriodicalIF":0.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956471","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":"Lithium-induced Thyroiditis in a Patient with Bipolar Affective Disorder: A Rare Presentation.","authors":"Abhilash Selvaratnam, Ramya Subramani, Nikhil Kumar Gupta, Vijay Singh, Vivek Kumar Saini","doi":"10.4103/ijnm.ijnm_48_24","DOIUrl":"10.4103/ijnm.ijnm_48_24","url":null,"abstract":"<p><p>Lithium is used in the treatment of bipolar disorder to manage and stabilize mood, proving effective in addressing both manic and depressive phases. In these patients, the use of lithium is associated with various thyroid disorders, such as goiter and hypothyroidism; thyrotoxicosis is a rare presentation. In this case report, we demonstrated lithium-induced thyroiditis on thyroid scintigraphy.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"39 4","pages":"316-317"},"PeriodicalIF":0.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956482","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]FDG PET/CT in Necrotizing Fasciitis: A Case Series Investigating the Clinical Utility in a Challenging and Rare Condition.","authors":"Parth Baberwal, Priyanka Verma, Pravin Shinde, Sandip Basu","doi":"10.4103/ijnm.ijnm_7_24","DOIUrl":"10.4103/ijnm.ijnm_7_24","url":null,"abstract":"<p><p>Necrotizing fasciitis is a deadly yet rare soft tissue and skin infection that is usually diagnosed clinically. At times, clinical signs may betray the underlying etiology and masquerade as cellulitis in the early course of the disease. We report four cases with clinical suspicion of necrotizing fasciitis, some after the failure of therapy for cellulitis who underwent 18-F fluorodeoxyglucose positron emission tomography-computed tomography (18-F FDG PET/CT) showing the extent of the disease, showing subclinical sites of involvement in patients with necrotizing fasciitis on baseline scan as well as its role in assessing response to treatment using 18-F FDG PET/CT.</p>","PeriodicalId":45830,"journal":{"name":"Indian Journal of Nuclear Medicine","volume":"39 4","pages":"299-303"},"PeriodicalIF":0.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956289","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}