The quarterly journal of nuclear medicine : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR)最新文献

{"title":"On the development of rational standards for nuclear response evaluation.","authors":"G R Laking,&nbsp;P M Price","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>Small variations in test protocols can disproportionately affect the sensitivity and specificity of response evaluation in nuclear medicine. Although use of standardised methods can remedy this, standards must be shown to add value. We think a concept of \"societal efficacy\" is the benchmark criterion for value of medical interventions. This paper gives an overview of literature on nuclear response evaluation, and promotes a decision-analytic approach to the synthesis of standards.</p><p><strong>Methods: </strong>A Medline search using the OVID database, 1966-January 2002. Reports were organised in relation to mode of treatment and timing of follow-up evaluation. Protocols of multimodality treatment were classified according to the treatment with the greatest tissue-inflammatory potential. The database will be made available on-line at the Website of the European Organisation for the Research and Treatment of Cancer (EORTC) Functional Imaging Group (http://www.eortc.be).</p><p><strong>Results: </strong>Two hundred and twelve reports could be classified as primary studies in humans. 125 were formal \"before-and-after\" studies of response to anticancer therapy. More than 60 reported the use of serial positron emission tomography (PET) with fluorodeoxyglucose (FDG).</p><p><strong>Conclusion: </strong>Descriptive reports of the accuracy and applications of new diagnostic technologies need to be linked to an expectation of improved research or clinical outcomes. To manage the large volume of information will require a trans-disciplinary perspective and use of advanced decision-analytic</p><p><strong>Methods: </strong>At stake is the possibility of an \"industrial\" upscaling of one of nuclear oncology' strongest applications.</p>","PeriodicalId":79384,"journal":{"name":"The quarterly journal of nuclear medicine : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR)","volume":"47 1","pages":"3-7"},"PeriodicalIF":0.0,"publicationDate":"2003-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22359165","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":"MIBI as prognostic factor in breast cancer.","authors":"S Del Vecchio,&nbsp;A Zannetti,&nbsp;L Aloj,&nbsp;M Salvatore","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Evaluation of treatment response is of primary importance in the management of patients with cancer. Both positron- and g-emitting compounds have been used to monitor changes in tumor metabolism or viability after therapy. The use of (99m)Tc-labeled lipophilic cations raised the possibility to predict the tumor response to treatment and to identify patients who will become refractory to subsequent therapy. In particular, many studies have shown the prognostic value of (99m)Tc-MIBI scan in different types of malignancy including breast and lung cancer, lymphoma and sarcoma. The ability of (99m)Tc-MIBI to interact with P-glycoprotein, allowing the functional assessment of the multidrug resistant phenotype, is one of the mechanisms underlying its prognostic value. Additional mechanisms of cell resistance, mainly involving alterations of apoptosis, may affect (99m)Tc-MIBI uptake in tumors. Therefore, either an enhanced tracer clearance or a reduced early uptake of (99m)Tc-MIBI indicate a poor response to therapy. In both cases, (99m)Tc-MIBI scan may ensure that the further management strategy will be effective in individual cancer patients.</p>","PeriodicalId":79384,"journal":{"name":"The quarterly journal of nuclear medicine : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR)","volume":"47 1","pages":"46-50"},"PeriodicalIF":0.0,"publicationDate":"2003-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22357782","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":"PET-FDG as predictor of therapy response in patients with colorectal carcinoma.","authors":"A Dimitrakopoulou-Strauss,&nbsp;L G Strauss,&nbsp;J Rudi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>The purpose of this study was to evaluate the prognostic value of quantitative dynamic FDG PET studies in patients with metastastic colorectal cancer receiving FOLFOX (fluorouracil, folinic acid and oxaliplatin) chemotherapy.</p><p><strong>Methods: </strong>The evaluation includes 28 patients with 55 metastases from primary colorectal cancer. Reference for the FDG studies was the clinical response data, according to the WHO classification. Three response groups were defined: progressive disease (PD), stable disease (SD) and partial response (PR). The FDG studies were accomplished as dynamic series for 60 min. The evaluation of the FDG kinetics was performed using the SUV, and fractal dimension (FD) of the time activity curves based on the box counting procedure (parameter for the inhomogeneity of the tumors).</p><p><strong>Results: </strong>The median SUV as measured in the tumor lesions prior to onset to FOLFOX was 3.15, in comparison with 2.68 SUV after the first cycle and 2.61 SUV after the second cycle. Discriminant analysis (DA) was used for the classification of the data into the 3 categories. Both parameters SUV and FD provided 2 of the 3 \"predicted\" categories, namely PD and SD. It was possible to correctly classify PR in only 10% of the patients, using the FD of both studies. Generally, DA inclined to misclassify the data towards PD. Even the first PET study was predictive with respect to therapy outcome (96% for PD and 47% for SD using only the baseline SUV). Metastases with a baseline SUV lower than 4.6 did not respond to FOLFOX chemotherapy. The combination of SUV and FD of the first study lead to a correct classification of 93% of PD and 60% of SD. Best results were obtained for the FD of the initial PET study (90% for PD and 75% for SD) as well as for the FD of both studies (77% for PD, 73% for SD, 10% for PR).</p><p><strong>Conclusion: </strong>Quantitative, dynamic FDG-PET should be used preferentially for monitoring patients with metastatic colorectal cancer receiving chemotherapy. Even the first FDG study prior to onset to chemotherapy is predictive for the therapy outcome.</p>","PeriodicalId":79384,"journal":{"name":"The quarterly journal of nuclear medicine : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR)","volume":"47 1","pages":"8-13"},"PeriodicalIF":0.0,"publicationDate":"2003-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22359166","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":"Prognostic value of FDG-PET in malignant lymphoma.","authors":"A Becherer,&nbsp;U Jaeger,&nbsp;M Szabo,&nbsp;K Kletter","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Lymphomas have represented an indication for nuclear medicine investigations for 30 years. Gallium-67 scintigraphy has been shown to be a valuable complementary method in Hodgkin's disease and non-Hodgkin lymphoma for detecting viable residual lesions after chemotherapy and for diagnosis of a relapse. Thallium-201 is of interest in differentiating cerebral lymphomas from infectious lesions in AIDS patients but less useful in extra-cerebral lymphomas. PET with fluorine-18-FDG is more accurate than 67Ga in lymphoma. In patients with a positive PET scan after chemotherapy an early relapse occurs in up to 100%, while more than 80% of patients with a negative PET will have a long-term remission. Most studies show that FDG-PET is significantly correlated with patient outcome whereas there is much weaker or even no correlation for CT. The main reason is that PET is not bound to morphological criteria like lymph node size while CT is often not able to differentiate between residual tumour and post-therapeutic fibrosis. Therefore, based on a considerable number of clinical studies, FDG-PET gains increasing significance for staging, restaging and therapy monitoring in malignant lymphomas.</p>","PeriodicalId":79384,"journal":{"name":"The quarterly journal of nuclear medicine : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR)","volume":"47 1","pages":"14-21"},"PeriodicalIF":0.0,"publicationDate":"2003-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22359167","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":"Urinary tract infection and other pediatric considerations.","authors":"M A Rossleigh","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Urinary tract infection in childhood can lead to chronic sequelae, particularly in the presence of vesico-ureteric reflux or obstruction. The renal complications of acute pyelonephritis or residual chronic renal cortical scarring are most accurately evaluated with scintigraphy using (99m)Tc dimercaptosuccinic acid. The diagnosis of renal obstruction can be problematic, particularly in infants and children. Diuresis renography is an established tool in diagnosing and assessing the severity of obstruction. However the methodology for performing diuresis renography is a very controversial area in paediatric nuclear medicine, due to the lack of a gold standard. The surgical management of neonatal hydronephrosis is similarly controversial.</p>","PeriodicalId":79384,"journal":{"name":"The quarterly journal of nuclear medicine : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR)","volume":"46 4","pages":"304-10"},"PeriodicalIF":0.0,"publicationDate":"2002-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22093185","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":"Renovascular hypertension: nuclear medicine techniques.","authors":"A Taylor","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Angiotensin converting enzyme inhibition (ACEI) renography is the only imaging examination that tests directly for the presence of renovascular hypertension (RVH); other imaging examinations test for the presence of renal artery stenosis (RAS). The goals of ACEI renography are two-fold: 1) to detect those patients with hypertension who have renal artery stenosis as the cause of their hypertension and who would benefit from revascularization, and 2) to determine which hypertensive patients do not have renovascular hypertension and obviate the expense and risk of angiography and, potentially, revascularization. This review summarizes general components of renal scintigraphy (pretest voiding, hydration, patient position, relative uptake, time to peak height of the renogram curve, 20 min/max ratio, postvoid images, quality control) as well as those components specific to ACEI renography (choice of radiopharmaceutical, choice of ACE inhibitor, angiotensin II receptor blockers, diuretics, parenchymal mean transit time, monitoring of blood pressure, 1 versus 2 day protocols and omission of the baseline study). ACEI renography is highly accurate in patients with suspected RVH who have normal or near normal renal function. In this patient population, the sensitivity and specificity of ACEI renography for renovascular hypertension exceed 90%; angiography as an initial approach is not cost effective. Data from 10 studies evaluating cure or improvement in blood pressure in 291 patients undergoing revascularization showed the mean positive predictive value of ACEI renography to be 92%. When azotemic patients present with suspected RVH, as many as 50% of patients may have an intermediate probability ACEI renogram and the sensitivity of detecting RVH falls to approximately 80% even when intermediate and high probability tests are combined.</p>","PeriodicalId":79384,"journal":{"name":"The quarterly journal of nuclear medicine : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR)","volume":"46 4","pages":"268-82"},"PeriodicalIF":0.0,"publicationDate":"2002-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22092621","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":"The basics of renal imaging and function studies.","authors":"E Durand,&nbsp;A Prigent","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Many radiotracers are available for kidney studies. They are classified into glomerular tracers (DTPA, EDTA), tubular tracers (OIH, MAG3) and cortical tracers (DMSA, GHA). Renal function is best assessed by glomerular filtration rate. Camera studies provide a relative function assessment, whereas clearance techniques provide a precise and reliable assessment of absolute renal function. The combination of both therefore gives a comprehensive study of glomerular function. Attempts to assess absolute function from camera studies only resulted in gross inaccuracy. Tubular tracers have a higher extraction rate. This could be used to estimate renal plasma flow (by assessing the effective renal plasma flow), or to determine relative function when renal function is low, or to study the urine flow in the urinary tract. Cortical tracers provide a high imaging quality. They are more adapted to infection assessment and relative function measurements. This paper reviews the most commonly used tracers and their relationship with renal physiology. Techniques for camera static and dynamic studies and plasma and urinary clearances are detailed. Procedures follow the recommendations of the most recent international consensus conferences on the topics.</p>","PeriodicalId":79384,"journal":{"name":"The quarterly journal of nuclear medicine : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR)","volume":"46 4","pages":"249-67"},"PeriodicalIF":0.0,"publicationDate":"2002-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22092620","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":"Investigation of brain tumours with (99m)Tc-MIBI SPET.","authors":"S Baldari,&nbsp;G Restifo Pecorella,&nbsp;S Cosentino,&nbsp;F Minutoli","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aim of this paper is to give the reader an updated overview of (99m)Tc-MIBI SPET applications in investigating brain tumours. Elements determining MIBI uptake at the level of the brain are first mentioned. (99m)Tc-MIBI SPET features in different malignant and benign brain lesions (low and high grade gliomas, glioblastoma multiforme, metastasis, lymphoma, meningioma, neuroma, radiation necrosis and other rarer brain lesions) are reviewed. The ability of 99mTc-MIBI SPET, alone or in combination with other radiotracers, in the differential diagnosis of brain lesions is discussed. We outline (99m)Tc-MIBI SPET value in determining brain tumours grading and in distinguishing tumour recurrence from radiation necrosis. Clinical applications of 99mTc-MIBI in the management of AIDS patients, where discrimination between lymphoma and several different lesions only on the basis of CT or MRI findings is often impossible, are reported. In addition the relationships among (99m)Tc-MIBI SPET, P-glycoprotein (MDR-1 gene product) expression in brain neoplasms and chemotherapy response are mentioned.</p>","PeriodicalId":79384,"journal":{"name":"The quarterly journal of nuclear medicine : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR)","volume":"46 4","pages":"336-45"},"PeriodicalIF":0.0,"publicationDate":"2002-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22093190","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":"6th National Congress of the Italian Association of Nuclear Medicine. Genoa, Italy, 15-19 November 2002. Abstracts.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79384,"journal":{"name":"The quarterly journal of nuclear medicine : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR)","volume":"46 4 Suppl 1","pages":"1-130"},"PeriodicalIF":0.0,"publicationDate":"2002-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22186328","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":"Renovascular hypertension. Radiographic methods.","authors":"E L Loney,&nbsp;J Farrant,&nbsp;A Watkinson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In recent years the choice of radiographic methods available in the investigation of renovascular hypertension has increased significantly. It can be difficult for the clinician to decide which patients will benefit from screening and which modality to choose. This article seeks to address some of these issues. The role of the plain radiograph and intravenous urogram are briefly mentioned. Doppler ultrasound, MR, CT and conventional arteriography are discussed in detail. Their advantages and pitfalls are reviewed. In our institution ultrasound to document renal size and gadolinium-enhanced 3-D MRA are our recommended first-line investigations unless MRA is contraindicated. Digital subtraction arteriography is reserved for the small subgroup in which MRA fails to obtain an answer, for whatever reason.</p>","PeriodicalId":79384,"journal":{"name":"The quarterly journal of nuclear medicine : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR)","volume":"46 4","pages":"283-94"},"PeriodicalIF":0.0,"publicationDate":"2002-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22093183","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}