{"title":"Assessment of awareness and knowledge regarding nuclear medicine and appropriate use of Nuclear medicine modalities, among medical students and faculty members in two academic medical institutes in North India: A Cross sectional Study.","authors":"Nitin Gupta, Priya Sareen, Sudesh Kumar, Muninder Negi","doi":"10.22038/AOJNMB.2023.71375.1497","DOIUrl":"10.22038/AOJNMB.2023.71375.1497","url":null,"abstract":"<p><strong>Objectives: </strong>Despite significant progress in the field of nuclear medicine, basic nuclear medicine awareness and understanding among clinicians remains unsatisfactory, leading to under utilization of nuclear medicine modalities. To evaluate the awareness and knowledge regarding nuclear medicine and appropriate use of Nuclear medicine modalities, among medical students and faculty members.</p><p><strong>Method: </strong>In this descriptive cross sectional study, a self timer limited objective questionnaire based on Google forms was distributed to the study population and scores obtained by the participants were analyzed.</p><p><strong>Results: </strong>Percent scores range for intern, residency trainees, and senior resident/faculty groups for general awareness were 16-46%, 37-58% and 62-91% and for knowledge and appropriate use were 7-21%, 28-43%, and 35-85% respectively. Overall, 61% of the participants had poor awareness and knowledge regarding nuclear medicine modalities. None of the participants had received nuclear medicine exposure or education during their academics or training. Only 49% of the participants considered utilizing nuclear medicine modalities for their patient management.</p><p><strong>Conclusion: </strong>Undergraduate interns and residency trainees had a poor to fair level of awareness and knowledge regarding nuclear medicine. Hence creating more awareness in early stages of their career by incorporating Nuclear medicine basic education in medical undergraduate curriculum is required. The senior residents/faculty members had a moderate to good level of awareness and knowledge but still improvement in their knowledge would lead to a more appropriate and better utilization of nuclear medicine modalities for optimum patient management in a variety of clinical settings.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"12 1","pages":"73-85"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10757062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073268","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}
Kishin Tokuyama, Yusuke Inoue, Keiji Matsunaga, Yasunori Hamaguchi, Saori Sekimoto
{"title":"<sup>99m</sup>Tc-Sn-colloid SPECT/CT in thoracic splenosis after esophageal cancer surgery.","authors":"Kishin Tokuyama, Yusuke Inoue, Keiji Matsunaga, Yasunori Hamaguchi, Saori Sekimoto","doi":"10.22038/AOJNMB.2023.73907.1515","DOIUrl":"10.22038/AOJNMB.2023.73907.1515","url":null,"abstract":"<p><p>Splenosis occurs as a result of autotransplantation of splenic tissue following splenic injury or splenectomy. A 56-year-old man with esophageal cancer underwent thoracoscopic-assisted subtotal esophagectomy accompanied by three-field lymph node dissection, and retrosternal gastric tube reconstruction. The spleen was injured during the surgery and was removed. A retrosternal nodule of 12 mm in diameter was detected near the reconstructed gastric tube on computed tomography (CT) performed 3 years and 6 months postoperatively. Retrospectively, the nodule was observed in the same area on early postoperative CT and gradually increased in size. No accessory spleen was identified on the preoperative CT. Splenosis was suspected, and <sup>99m</sup>Tc-Sn-colloid single photon emission computed tomography (SPECT)/CT was performed. It revealed intense uptake in the retrosternal nodule, consistent with the diagnosis of thoracic splenosis. Subsequently, the patient has been under observation without treatment. <sup>99m</sup>Tc-labeled colloid SPECT/CT allowed confident diagnosis of thoracic splenosis following esophageal cancer surgery. This examination is considered valuable for the evaluation of ectopic splenic tissue.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"12 1","pages":"61-64"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10757057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073266","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":"Physiological myocardial <sup>18</sup>F-FDG uptake pattern in oncologic PET/CT: comparison with findings in cardiac sarcoidosis.","authors":"Takashi Norikane, Yuka Yamamoto, Yasukage Takami, Katsuya Mitamura, Takuya Kobata, Yukito Maeda, Takahisa Noma, Yoshihiro Nishiyama","doi":"10.22038/AOJNMB.2023.70254.1490","DOIUrl":"10.22038/AOJNMB.2023.70254.1490","url":null,"abstract":"<p><strong>Objectives: </strong>Physiological myocardial <sup>18</sup>F-fluorodeoxyglucose (<sup>18</sup>F-FDG) uptake in oncologic positron emission tomography (PET)/computed tomography (CT) is commonly observed with multiple variations under clinical fasting conditions. The purpose of the present study was to evaluate physiological myocardial <sup>18</sup>F-FDG uptake pattern by comparing with the results in cardiac sarcoidosis.</p><p><strong>Methods: </strong>A total of 174 examinations in 174 patients without cardiac disease and 27 examinations in 17 patients with cardiac sarcoidosis were performed. The polar map images generated from <sup>18</sup>F-FDG PET/CT data were visually assessed as \"basal-ring,\" \"focal,\" and \"focal on diffuse\" patterns. Semi-quantitative analysis was also performed using the regional relative <sup>18</sup>F-FDG uptake (% uptake).</p><p><strong>Results: </strong>On visual analysis, the \"focal on diffuse\" pattern was the most common in both examinations (43% and 59%, respectively). The physiological % uptake in the lateral and basal septal walls tended to be higher. Subgroup analysis showed significantly higher uptake in the mid-wall and left circumflex territory. In cardiac sarcoidosis patients, there was a significant difference only between segments 2 and 15 (p=0.04). No significant differences were observed between the base-mid-apical territory and coronary artery branch territory.</p><p><strong>Conclusion: </strong>High <sup>18</sup>F-FDG uptake in the basal septal walls is likely to be observed as both physiological uptake in patients without cardiac disease and pathological uptake in patients with cardiac sarcoidosis.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"12 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10757061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073285","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}
Hemat Yaghoubi Mogadam, Mostafa Erfani, Mohammad Nikpassand, Masoud Mokhtary
{"title":"Evaluation of [<sup>99m</sup>Tc][Tc-HYNIC/EDDA]-Tyr as a target for metabolic tumor imaging in B16F10 melanoma tumor.","authors":"Hemat Yaghoubi Mogadam, Mostafa Erfani, Mohammad Nikpassand, Masoud Mokhtary","doi":"10.22038/AOJNMB.2021.60334.1420","DOIUrl":"https://doi.org/10.22038/AOJNMB.2021.60334.1420","url":null,"abstract":"<p><strong>Objectives: </strong>Clinical interest in metabolic imaging of cancer has been growing in recent years. The increase in protein metabolism of cancer cells is interesting target for metabolic tumor imaging, for which radiolabeled amino acids can be applied. The aim of this study was to evaluate a newly developed radiolabeled amino acid as an imaging protein metabolism in melanoma tumor.</p><p><strong>Methods: </strong>The radiolabeled tyrosine ([<sup>99m</sup>Tc][Tc-HYNIC/EDDA]-Tyr) was prepared and its biological properties was evaluated in B16F10 melanoma tumor. Moreover organs uptake and tumor accumulation were measured in mouse bearing B16F10 melanoma tumor.</p><p><strong>Results: </strong>Radiolabeled tyrosine was attached in B16F10 melanoma cells and showed the cell binding capacity of 13.82±0.73%. In animal study, the accumulation of radiolabeled tyrosine was observed in B16F10 melanoma tumor (2.15±0.09 %ID/g) after 30 min post injection, so that the uptake ratio of tumor to muscle was about 5.11. Through scintigraphy process the melanoma tumor clearly visualized in mice at 30 min post injection.</p><p><strong>Conclusion: </strong>These data suggest that the novel radiotracer ([<sup>99m</sup>Tc][Tc-HYNIC/EDDA]-Tyr) as an protein metabolism imaging agent, is able to transfer into melanoma cells and show great expectation for the clinical application in the imaging of melanoma tumors.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"10 2","pages":"100-108"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9205849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40479720","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":"Combination of compressed sensing-based iterative reconstruction and offset acquisition for I-123 FP-CIT SPECT: a simulation study.","authors":"Norikazu Matsutomo, Takeyuki Hashimoto, Mitsuha Fukami, Tomoaki Yamamoto","doi":"10.22038/AOJNMB.2021.59585.1417","DOIUrl":"https://doi.org/10.22038/AOJNMB.2021.59585.1417","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to validate undersampled single-photon emission computed tomography (SPECT) imaging using a combination of compressed sensing (CS) iterative reconstruction (CS-IR) and offset acquisition.</p><p><strong>Methods: </strong>Three types of numerical phantoms were used to evaluate image quality and quantification derived from CS with offset acquisition. SPECT images were reconstructed using filtered back-projection (FBP), maximum likelihood-expectation maximization (ML-EM), CS-IR, and CS-IR with offset acquisition. The efficacy of CS-IR with offset acquisition was examined in terms of spatial resolution, aspect ratio (ASR), activity concentration linearity, contrast, percent coefficient of variation (%CV), and specific binding ratio (SBR).</p><p><strong>Results: </strong>The full widths at half maximum remained unchanged as the number of projections decreased in CS-IR with offset acquisition. Changes in ASRs and linearities of count density were observed for ML-EM and CS-IR from undersampled projections. The %CV obtained by CS-IR with offset acquisition was substantially lower than that obtained by ML-EM and CS-IR. There were no significant differences between the %CVs obtained from 60 projections by CS-IR with offset acquisition and from 120 projections by FBP. Although the SBRs for CS-IR with offset acquisition tended to be slightly lower than for FBP, the SBRs for CS-IR with offset acquisition did not change with the number of projections.</p><p><strong>Conclusions: </strong>CS-IR with offset acquisition can provide good image quality and quantification compared with a commonly used SPECT reconstruction method, especially from undersampled projection data. Our proposed method could shorten overall SPECT acquisition times, which would benefit patients and enable quantification with dynamic SPECT acquisitions.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"10 2","pages":"117-125"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9205842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40593791","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":"A case report of differentiated thyroid cancer presenting as a renal mass.","authors":"Javaid Iqbal, Asif Jamal, Basit Iqbal","doi":"10.22038/AOJNMB.2021.60302.1422","DOIUrl":"https://doi.org/10.22038/AOJNMB.2021.60302.1422","url":null,"abstract":"<p><p>The kidney is an unconventional site for thyroid metastasis. As of the writing of this article, only about 30 cases have been reported. It presents like a renal mass. We are reporting a man with thyroid carcinoma presenting with distant metastasis to the kidney. He had complaints of abdominal pain and haematuria. Initial imaging suggested a left renal mass. A diagnosis of renal cell carcinoma was made and a nephrectomy was performed. Histopathology revealed it to be a metastasis from cancer of the thyroid gland. Subsequently, an ultrasound of the thyroid gland was performed, which showed a malignant appearing thyroid nodule. Correlative bone scan showed uptake at multiple skeletal sites. Total thyroidectomy was done and it was found to be papillary thyroid cancer. Subsequently, high dose radioactive iodine was administered. The patient was followed up and has recently found to have metastasis to the brain and is undergoing radiotherapy.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"10 2","pages":"147-150"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9205841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40593794","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}
Abdul Rahman Akkawi, Lynn Ezzeddine, Rita Chahinian, Firas Ershaid, Diala Merheb, Majd Mzeihem, Jean El-Cheikh, Mohamad Haidar
{"title":"Hepatic granuloma mimicking recurrent lymphoma on <sup>18</sup>F-FDG PET/CT in a patient with primary mediastinal diffuse large B-cell lymphoma.","authors":"Abdul Rahman Akkawi, Lynn Ezzeddine, Rita Chahinian, Firas Ershaid, Diala Merheb, Majd Mzeihem, Jean El-Cheikh, Mohamad Haidar","doi":"10.22038/AOJNMB.2021.56876.1396","DOIUrl":"https://doi.org/10.22038/AOJNMB.2021.56876.1396","url":null,"abstract":"<p><p><sup>18</sup>F-Flurodeoxyglucose (FDG) PET/CT has been considered the modality of choice in detecting, staging, restaging and following-up with lymphoma patients. However, it has an uncertain role in differentiating hepatic lymphomatous relapse from other granulomatous diseases such as in candidiasis or sarcoidosis. Therefore, it is important to correlate the imaging findings with other modalities such as ultrasound, CT scan, MRI, and histology to direct the diagnosis and treatment. We present a case of a 33-year-old woman with large B-cell lymphoma in complete remission following treatment presenting with neutropenic fever following her final cycle of chemotherapy. Ultrasound of the abdomen and enhanced CT scan of the abdomen and pelvis were negative. The FDG PET/CT scan showed multiple FDG-avid hypodense hepatic lesions that were suggestive either of lymphoproliferative involvement or nonmalignant process. However, MRI of the abdomen performed four days later was suggestive of an infectious process, rather than a lymphoproliferative disorder. A subsequent CT-guided biopsy of a hepatic lesion showed granulomatous inflammation, with no evidence of malignancy or Tuberculosis. The patient was started on Caspofungin followed by Fluconazole. After 5 weeks, the clinical condition resolved, and the subsequent FDG PET/CT showed complete resolution of the FDG-avid multiple hepatic lesions.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"10 1","pages":"47-52"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8742851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39863843","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}
Ali Mohamedkhair, Akram Al-Ibraheem, Ahmed Saad Abdlkadir, Omar Jaber
{"title":"Challenging Results on FDG PET/CT in a Patient with Uncontrolled Celiac Disease and small bowel adenocarcinoma.","authors":"Ali Mohamedkhair, Akram Al-Ibraheem, Ahmed Saad Abdlkadir, Omar Jaber","doi":"10.22038/AOJNMB.2022.61853.1437","DOIUrl":"https://doi.org/10.22038/AOJNMB.2022.61853.1437","url":null,"abstract":"<p><p>Celiac disease (CD) is a chronic immune-mediated enteropathy that is caused by both environmental (gluten) and genetic (human leukocyte antigen (HLA) and non-HLA genes) factors. Patients may be asymptomatic or exhibit atypical symptoms, necessitating a high index of suspicion for proper diagnosis. The evaluation of CD patients with <sup>18</sup>F-FDG PET/CT imaging can be difficult, owing to the fact that this disease is inflammatory in nature. Typical <sup>18</sup>F-FDG PET/CT gastrointestinal manifestations of celiac disease include increased multifocal or diffuse bowel uptake, whereas single short segmental uptake is rarely encountered; thus, awareness of this wide range of findings is important to guide physicians through proper management and outcome. We report a case of small intestine adenocarcinoma and known CD complaining of recent episodes of diarrhea and weight loss that had a suspicious small bowel wall thickening that corresponds to a short segmental hypermetabolic process on FDG PET/CT follow-up scan. The patient was then referred to the gastroenterology department and underwent a colonoscopy, a biopsy was taken that revealed CD and was negative for malignancy. Furthermore, 6 months later the abovementioned segmental FDG activity was completely resolved without any treatment received at the given time.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"10 2","pages":"155-160"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9205848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40479722","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}
Kosuke Yamashita, Noriaki Miyaji, Kazuki Motegi, Takashi Terauchi, Shigeki Ito
{"title":"Development of a new quantification method using partial volume effect correction for individual energy peaks in <sup>111</sup>In-pentetreotide SPECT/CT.","authors":"Kosuke Yamashita, Noriaki Miyaji, Kazuki Motegi, Takashi Terauchi, Shigeki Ito","doi":"10.22038/AOJNMB.2022.61394.1430","DOIUrl":"https://doi.org/10.22038/AOJNMB.2022.61394.1430","url":null,"abstract":"<p><strong>Objectives: </strong>Somatostatin receptor scintigraphy (SRS) using <sup>111</sup>In-pentetreotide has no established quantification method. The purpose of this study was to develop a new quantitative method to correct the partial volume effect (PVE) for individual energy peaks in <sup>111</sup>In-pentetreotide single-photon emission computed tomography (SPECT).</p><p><strong>Methods: </strong>Phantom experiments were performed to construct a new quantitative method. In the phantom experiments, a NEMA IEC body phantom was used. Acquisition was performed using two energy peaks (171 keV and 245 keV) on the SPECT/CT system. The volume of interest was set at each hot sphere and lung insert in the SPECT images of each energy peak, and the recovery coefficient (RC) was calculated to understand the PVE. A new quantitative index, the indium uptake index (IUI), was calculated using the RC to correct the PVE. The quantitative accuracy of the IUI in the hot sphere was confirmed. Case studies were performed to clarify the quantitative accuracy. In a case study, the relationship between the IUI and the Krenning score, which is used as a visual assessment, was evaluated for each lesion.</p><p><strong>Results: </strong>The obtained RCs showed that the energy peak at 171 keV was faster in recovering the effect of PVE than that at 245 keV. The IUI in the 17-mm-diameter hot sphere was overestimated by 4.8% and 8.3% at 171 keV and 245 keV, respectively, compared to the actual IUIs. The relationship between IUI and Krenning score was rs=0.773 (<i>p</i><0.005) at sum, rs=0.739 (<i>p</i><0.005) at 171 keV, and rs=0.773 (<i>p</i><0.005) at 245 keV.</p><p><strong>Conclusion: </strong>We have developed a new quantification method for <sup>111</sup>In-pentetreotide SPECT/CT using RC-based PVE correction for an individual energy peak of 171 keV. The quantitative accuracy of this method was high even for accumulations of less than 20 mm, and it showed a good relationship with the Krenning score; therefore, the clinical usefulness of IUI was demonstrated.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"10 2","pages":"126-137"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9205847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40479723","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":"A method to prevail false positive responses due to excess cations and viscous nature of Radiopharmaceuticals in Limulus Amebocyte Lysate Gel Clot test.","authors":"Arpit Mitra, Sangita Lad, Sudeep Sahu, Savita Kulkarni","doi":"10.22038/AOJNMB.2021.59607.1416","DOIUrl":"https://doi.org/10.22038/AOJNMB.2021.59607.1416","url":null,"abstract":"<p><strong>Objectives: </strong>Bacterial endotoxin test (BET) for detection and quantification of endotoxin in radiopharmaceuticals (RPs), used for therapy or diagnosis, is prerequisite to administration in patients. Out of the two established methods used for this purpose (Kinetic Chromogenic Assay: KCM and Gel Clot Bacterial Endotoxin Test: GC-BET), GC-BET is recommended by pharmacopeias to evaluate the interferences exhibited during the assay due to presence of various ingredients in samples. In the present study, the influence of excess of cations in [<sup>177</sup>Lu]Lu-DOTATATE, used for Peptide Receptor Radionuclide Therapy (PRRT), were studied and a protocol to negate the enhancement observed was developed. Additionally, a protocol for carrying out GC-BET for extremely viscous [<sup>131</sup>I]I-Lipiodol was standardized.</p><p><strong>Methods: </strong>GC-BET was performed for [<sup>177</sup>Lu]Lu-DOTATATE and [<sup>131</sup>I]I-Lipiodol at maximum valid dilution (MVD), using LRW as a diluent. To negate the false positivity observed in case of [<sup>177</sup>Lu]Lu-DOTATATE, various concentrations of calcium chloride (CaCl<sub>2</sub>) were added and evaluated for the reversal of the interference observed initially. To prevail the difficulty in performing GC-BET for [<sup>131</sup>I]I-Lipiodol various modification in the protocols like orbital vortexing at different rpm and time intervals were performed. KCM assays were also performed for studied RPs at MVD.</p><p><strong>Results: </strong>It was observed that at MVD, [<sup>177</sup>Lu]Lu-DOTATATE exhibited false positivity in GC-BET. However, all the individual reagents used in labeling of [<sup>177</sup>Lu]Lu-DOTATATE did not show any false positivity. Finally, performing the assay with an addition of 2mM CaCl<sub>2</sub> (final concentration) nullified the false positivity. Further, intricacy in performing GC-BET for [<sup>131</sup>I]I-Lipiodol due to its viscosity was resolved by orbital vortexing at 3000 rpm for 5 minutes.</p><p><strong>Conclusions: </strong>Our study proved that false positivity was observed in GC-BET for [<sup>177</sup>Lu]Lu-DOTATATE due to the presence excess M<sup>3+</sup> ions. Further, our study is the first of its kind which demonstrated methods for negating these false positive results by using modified protocol and hypothesizing the reason behind the enhancement. Additionally, ours is the first study which proved that a simple step of vortexing the viscous RPs like [<sup>131</sup>I]I-Lipiodol can resolved the problems encountered during performing GC-BET due to viscosity of RPs.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"10 2","pages":"109-116"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9205850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40593793","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}