Nuclear_Medicine RSS : Gourt

Statewide :: Pennsylvania :: The Doctor Job

Looking for a job in a big city? Even if you've heard that a market is "saturated", wecan help! Many job openings for physicians may be hidden and unavailable unless you knowwhere to

Statewide :: Virginia :: The Doctor Job

Looking for a job in a big city? Even if you've heard that a market is "saturated", we can help! Many job openings for physicians may be hidden and unavailable unless you know where to look. An excellent

Statewide :: Texas :: The Doctor Job

Statewide :: Ohio :: The Doctor Job

Statewide :: New York :: The Doctor Job

Statewide :: New Jersey :: The Doctor Job

Statewide :: Maryland :: The Doctor Job

Statewide :: Indiana :: The Doctor Job

Statewide :: Illinois :: The Doctor Job

Statewide :: Georgia :: The Doctor Job

Statewide :: Florida :: The Doctor Job

Statewide :: District of Columbia :: The Doctor Job

Statewide :: Connecticut :: The Doctor Job

Statewide :: California :: The Doctor Job

Statewide :: Arizona :: The Doctor Job

Design and Optimization of Coin-Shaped Microreactor Chips for PET Radiopharmaceutical Synthesis.

Design and Optimization of Coin-Shaped Microreactor Chips for PET Radiopharmaceutical Synthesis. J Nucl Med. 2010 Feb;51(2):282-7 Authors: Elizarov AM, van Dam RM, Shin YS, Kolb HC, Padgett HC, Stout D, Shu J, Huang J, Daridon A, Heath JR An integrated elastomeric microfluidic device, with a footprint the size of a postage stamp, has been designed and optimized for multistep radiosynthesis of PET tracers. METHODS: The unique architecture of the device is centered around a 5-muL coin-shaped reactor, which yields reaction efficiency and speed from a combination of high reagent concentration, pressurized reactions, and rapid heat and mass transfer. Its novel features facilitate mixing, solvent exchange, and product collection. New mixing mechanisms assisted by vacuum, pressure, and chemical reactions are exploited. RESULTS: The architecture of the reported reactor is the first that has allowed batch-mode microfluidic devices to produce radiopharmaceuticals of sufficient quality and quantity to be validated by in vivo imaging. CONCLUSION: The reactor has the potential to produce multiple human doses of (18)F-FDG; the most impact, however, is expected in the synthesis of PET radiopharmaceuticals that can be made only with low yields by currently available equipment. PMID: 20124050 [PubMed - in process]

Annexin a5 uptake in ischemic myocardium: demonstration of reversible phosphatidylserine externalization and feasibility of radionuclide imaging.

Annexin a5 uptake in ischemic myocardium: demonstration of reversible phosphatidylserine externalization and feasibility of radionuclide imaging. J Nucl Med. 2010 Feb;51(2):259-67 Authors: Kenis H, Zandbergen HR, Hofstra L, Petrov AD, Dumont EA, Blankenberg FD, Haider N, Bitsch N, Gijbels M, Verjans JW, Narula N, Narula J, Reutelingsperger CP Ischemic insult to the myocardium is associated with cardiomyocyte apoptosis. Because apoptotic cell death is characterized by phosphatidylserine externalization on cell membrane and annexin-A5 (AA5) avidly binds to phosphatidylserine, we hypothesized that radiolabeled AA5 should be able to identify the regions of myocardial ischemia. METHODS: Models of brief myocardial ischemia by the occlusion of the coronary artery for 10 min (I-10) and reperfusion for 180 min (R-180) for the detection of phosphatidylserine exteriorization using (99m)Tc-labeled AA5 and gamma-imaging were produced in rabbits. (99m)Tc-AA5 uptake after brief ischemia was compared with an I-40/R-180 infarct model. Histologic characterization of both myocardial necrosis and apoptosis was performed in ischemia and infarct models. Phosphatidylserine exteriorization was also studied in a mouse model, and the dynamics and kinetics of phosphatidylserine exposure were assessed using unlabeled recombinant AA5 and AA5 labeled with biotin, Oregon Green, or Alexa 568. Appropriate controls were established. RESULTS: Phosphatidylserine exposure after ischemia in the rabbit heart could be detected by radionuclide imaging with (99m)Tc-AA5. Pathologic characterization of the explanted rabbit hearts did not show apoptosis or necrosis. Homogenization and ultracentrifugation of the ischemic myocardial tissue from rabbit hearts recovered two thirds of the radiolabeled AA5 from the cytoplasmic compartment. Murine experiments demonstrated that the cardiomyocytes expressed phosphatidylserine on their cell surface after an ischemic insult of 5 min. Phosphatidylserine exposure occurred continuously for at least 6 h after solitary ischemic insult. AA5 targeted the exposed phosphatidylserine on cardiomyocytes; AA5 was internalized into cytoplasmic vesicles within 10-30 min. Twenty-four hours after ischemia, cardiomyocytes with internalized AA5 had restored phosphatidylserine asymmetry of the sarcolemma, and no detectable phosphatidylserine remained on the cell surface. The preadministration of a pan-caspase inhibitor, zVAD-fmk, prevented phosphatidylserine exposure after ischemia. CONCLUSIONS: After a single episode of ischemia, cardiomyocytes express phosphatidylserine, which is amenable to targeting by AA5, for at least 6 h. Phosphatidylserine exposure is transient and internalized in cytoplasmic vesicles after AA5 binding, indicating the reversibility of the apoptotic process. PMID: 20124049 [PubMed - in process]

Evaluation of a 64Cu-Labeled Cystine-Knot Peptide Based on Agouti-Related Protein for PET of Tumors Expressing {alpha}v{beta}3 Integrin.

Evaluation of a 64Cu-Labeled Cystine-Knot Peptide Based on Agouti-Related Protein for PET of Tumors Expressing {alpha}v{beta}3 Integrin. J Nucl Med. 2010 Feb;51(2):251-8 Authors: Jiang L, Kimura RH, Miao Z, Silverman AP, Ren G, Liu H, Li P, Gambhir SS, Cochran JR, Cheng Z Recently, a truncated form of the agouti-related protein (AgRP), a 4-kDa cystine-knot peptide of human origin, was used as a scaffold to engineer mutants that bound to alpha(v)beta(3) integrin with high affinity and specificity. In this study, we evaluated the potential of engineered integrin-binding AgRP peptides for use as cancer imaging agents in living subjects. METHODS: Engineered AgRP peptides were prepared by solid-phase peptide synthesis and were folded in vitro and purified by reversed-phase high-performance liquid chromatography. Competition assays were used to measure the relative binding affinities of engineered AgRP peptides for integrin receptors expressed on the surface of U87MG glioblastoma cells. The highest-affinity mutant, AgRP clone 7C, was site-specifically conjugated with 1,4,7,10-tetra-azacyclododecane-N,N',N''N'''-tetraacetic acid (DOTA). The resulting bioconjugate, DOTA-AgRP-7C, was radiolabeled with (64)Cu for biodistribution analysis and small-animal PET studies in mice bearing U87MG tumor xenografts. In addition to serum stability, the in vivo metabolic stability of (64)Cu-DOTA-AgRP-7C was assessed after injection and probe recovery from mouse kidney, liver, tumor, and urine. RESULTS: AgRP-7C and DOTA-AgRP-7C bound with high affinity to integrin receptors expressed on U87MG cells (half maximal inhibitory concentration values, 20 +/- 4 and 14 +/- 2 nM, respectively). DOTA-AgRP-7C was labeled with (64)Cu with high radiochemical purity (>99%). In biodistribution and small-animal PET studies, (64)Cu-DOTA-AgRP-7C displayed rapid blood clearance, good tumor uptake and retention (2.70 +/- 0.93 percentage injected dose per gram [%ID/g] and 2.37 +/- 1.04 %ID/g at 2 and 24 h, respectively), and high tumor-to-background tissue ratios. The integrin-binding specificity of (64)Cu-DOTA-AgRP-7C was confirmed in vitro and in vivo by showing that a large molar excess of the unlabeled peptidomimetic c(RGDyK) could block probe binding and tumor uptake. Serum stability and in vivo metabolite assays demonstrated that engineered AgRP peptides are sufficiently stable for in vivo molecular imaging applications. CONCLUSION: A radiolabeled version of the engineered AgRP peptide 7C showed promise as a PET agent for tumors that express the alpha(v)beta(3) integrin. Collectively, these results validate AgRP-based cystine-knot peptides for use in vivo as molecular imaging agents and provide support for the general use of AgRP as a scaffold to develop targeting peptides, and hence diagnostics, against other tumor receptors. PMID: 20124048 [PubMed - in process]

CT Hounsfield Units of Brown Adipose Tissue Increase with Activation: Preclinical and Clinical Studies.

CT Hounsfield Units of Brown Adipose Tissue Increase with Activation: Preclinical and Clinical Studies. J Nucl Med. 2010 Feb;51(2):246-50 Authors: Baba S, Jacene HA, Engles JM, Honda H, Wahl RL Brown adipose tissue (BAT) densities assessed as CT Hounsfield units (HUs) were evaluated in a rodent model and in patients to determine whether HUs changed in relation to BAT activity. METHODS: Serial (18)F-FDG PET/CT was performed on rats under both room temperature control conditions and after 4 h of cold-stimulation, which is known to activate BAT. The maximum standardized uptake values and CT HUs of BAT were measured, and tissues were examined in the laboratory. Image records from cancer patients who underwent PET/CT were reviewed, and 23 patients were identified who displayed both high and low (18)F-FDG uptake into BAT on serial (18)F-FDG PET/CT scans. The maximum standardized uptake values and CT HUs of BAT were compared in these scans. RESULTS: The mean (+/-SD) CT HUs of cold-activated BAT (-12.4 +/- 22.4) were significantly higher than those (-27.9 +/- 9.6) of the controls in the rat model. The CT HUs of BAT (-71.6 +/- 18.0) in the patients with high (18)F-FDG uptake were significantly higher than those (-104.4 +/- 16.8) of the patients with low (18)F-FDG uptake . A decrease in relative lipid content is seen in activated BAT in rats on histology. CONCLUSION: The CT HUs of BAT increased in activated conditions in both animals and patients, likely because of lipid consumption by activated BAT. PMID: 20124047 [PubMed - in process]

Improved quantification and normal limits for myocardial perfusion stress-rest change.

Improved quantification and normal limits for myocardial perfusion stress-rest change. J Nucl Med. 2010 Feb;51(2):204-9 Authors: Prasad M, Slomka PJ, Fish M, Kavanagh P, Gerlach J, Hayes S, Berman DS, Germano G We aimed to improve the quantification of myocardial perfusion stress-rest changes in myocardial perfusion SPECT (MPS) studies for the optimal automatic detection of ischemia and coronary artery disease (CAD). METHODS: Rest-stress (99m)Tc MPS studies (997 cases; 651 consecutive cases with correlating angiography and 346 cases with less than 5% likelihood (low likelihood [LLK]) of CAD) were analyzed. Normal limits for stress-rest changes were derived from additional LLK patients (40 women, 40 men). We computed the global stress-rest change (C-SR) by integrating direct stress-rest changes for each polar map pixel. Additionally, stress-rest change and total perfusion deficit (TPD) at stress were combined in 1 variable (C-TPD) for the optimal detection of CAD. RESULTS: The area under the receiver-operating-characteristic curve (AUC) for C-SR (0.92) was larger than that for stress TPD-rest TPD (0.88) for the identification of stenosis of 70% or more (P < 0.0001). AUC (0.94) and sensitivity (90%) for C-TPD were higher than those for stress TPD (0.91 and 83%, respectively) (P < 0.0001), whereas specificity remained the same (81%). CONCLUSION: C-SR and C-TPD provide higher diagnostic performance than difference between stress and rest TPD or stress hypoperfusion analysis. PMID: 20124046 [PubMed - in process]

Chest CT and Whole-Body 18F-FDG PET Are Cost-Effective in Screening for Distant Metastases in Head and Neck Cancer Patients.

Chest CT and Whole-Body 18F-FDG PET Are Cost-Effective in Screening for Distant Metastases in Head and Neck Cancer Patients. J Nucl Med. 2010 Feb;51(2):176-82 Authors: Uyl-de Groot CA, Senft A, de Bree R, Leemans CR, Hoekstra OS The aim of the study was to define the cost-effectiveness of whole-body (18)F-FDG PET, as compared with chest CT, in screening for distant metastases in patients with head and neck squamous cell carcinoma (HNSCC). METHODS: In a multicenter prospective study, 145 consecutive patients with high risk factors for distant metastases and scheduled for extensive treatment underwent chest CT and whole-body (18)F-FDG PET for screening of distant metastases. The cost data of 80 patients in whom distant metastases developed or who had a follow-up of at least 12 mo were analyzed. Cost-effectiveness analysis, including sensitivity analysis, was performed to compare the results of (18)F-FDG PET, CT, and a combination of CT and (18)F-FDG PET (CT + (18)F-FDG PET). RESULTS: Pretreatment screening identified distant metastases in 21% of patients. (18)F-FDG PET had a higher sensitivity (53% vs. 37%) and positive predictive value (80% vs. 75%) than did CT. CT + (18)F-FDG PET had the highest sensitivity (63%). The average costs in the CT, (18)F-FDG PET, and CT + (18)F-FDG PET groups amounted to euro38,558 ( approximately $57,705), euro38,355 ( approximately $57,402), and euro37,954 ( approximately $56,801), respectively, in the first year after screening. CT + (18)F-FDG PET resulted in savings between euro203 ( approximately $303) and euro604 ( approximately $903). Sensitivity analysis showed that the dominance of CT + (18)F-FDG PET was robust. CONCLUSION: In HNSCC patients with risk factors, pretreatment screening for distant metastases by chest CT is improved by (18)F-FDG PET. The combination of (18)F-FDG PET with CT is the most effective, without leading to additional costs. PMID: 20124045 [PubMed - in process]

Sino-american conference planned.

Sino-american conference planned. J Nucl Med. 2010 Feb;51(2):22N Authors: PMID: 20124044 [PubMed - in process]

From the SNM Radiopharmaceutical Sciences Council.

From the SNM Radiopharmaceutical Sciences Council. J Nucl Med. 2010 Feb;51(2):21N Authors: Adam MJ PMID: 20124043 [PubMed - in process]

From the american college of nuclear medicine.

From the american college of nuclear medicine. J Nucl Med. 2010 Feb;51(2):21N-2N Authors: Harolds JA PMID: 20124042 [PubMed - in process]

From the SNM Nuclear Oncology Council.

From the SNM Nuclear Oncology Council. J Nucl Med. 2010 Feb;51(2):20N-1N Authors: Karam M PMID: 20124041 [PubMed - in process]

From the SNM Cardiovascular Council.

From the SNM Cardiovascular Council. J Nucl Med. 2010 Feb;51(2):19N Authors: Bengel FM PMID: 20124040 [PubMed - in process]

From the SNM Gastrointestinal Council.

From the SNM Gastrointestinal Council. J Nucl Med. 2010 Feb;51(2):19N-20N Authors: Tulchinsky M PMID: 20124039 [PubMed - in process]

From the SNM Brain Imaging Council.

From the SNM Brain Imaging Council. J Nucl Med. 2010 Feb;51(2):18N Authors: Bohnen NI PMID: 20124038 [PubMed - in process]

From the SNM PET Center of Excellence.

From the SNM PET Center of Excellence. J Nucl Med. 2010 Feb;51(2):17N Authors: Segall GM PMID: 20124037 [PubMed - in process]

From the SNM Academic Council.

From the SNM Academic Council. J Nucl Med. 2010 Feb;51(2):17N-8N Authors: Greenspan BS PMID: 20124036 [PubMed - in process]

From the SNM Molecular Imaging Center of Excellence.

From the SNM Molecular Imaging Center of Excellence. J Nucl Med. 2010 Feb;51(2):16N Authors: Vanbrocklin H PMID: 20124035 [PubMed - in process]

Raising awareness of the need for domestic isotope supply.

Raising awareness of the need for domestic isotope supply. J Nucl Med. 2010 Feb;51(2):15N Authors: Nielsen CJ PMID: 20124034 [PubMed - in process]

SNM Enjoys Smooth Operations.

SNM Enjoys Smooth Operations. J Nucl Med. 2010 Feb;51(2):15N-6N Authors: Pappas V PMID: 20124033 [PubMed - in process]

Education, Reimbursement, Research: Tenets of SNM's Success.

Education, Reimbursement, Research: Tenets of SNM's Success. J Nucl Med. 2010 Feb;51(2):14N Authors: Graham MM PMID: 20124032 [PubMed - in process]

The state of nuclear medicine, 2010.

The state of nuclear medicine, 2010. J Nucl Med. 2010 Feb;51(2):13N-4N Authors: Nagle C, Knight N PMID: 20124031 [PubMed - in process]

(124)I-iodopyridopyrimidinone for PET of Abl kinase-expressing tumors in vivo.

Related Articles (124)I-iodopyridopyrimidinone for PET of Abl kinase-expressing tumors in vivo. J Nucl Med. 2010 Jan;51(1):121-9 Authors: Doubrovin M, Kochetkova T, Santos E, Veach DR, Smith-Jones P, Pillarsetty N, Balatoni J, Bornmann W, Gelovani J, Larson SM Because of the recent development of an iodopyridopyrimidinone Abl protein kinase inhibitor (PKI), (124)I-SKI-212230 ((124)I-SKI230), we investigated the feasibility of a PET-based molecular imaging method for the direct visualization of Abl kinase expression and PKI treatment. METHODS: In vitro pharmacokinetic properties, including specific and nonspecific binding of (124)I-SKI230 to its Abl kinase target and interaction with other PKIs, were assessed in cell-free medium and chronic myelogenous leukemia (CML) cells overexpressing BCR-Abl (K562), in comparison with BT-474 cells that are low in Abl expression. In a xenograft tumor model, we assessed the in vivo pharmacokinetics of (124)I-SKI230 using PET and postmortem tissue sampling. We also tested a paradigm of (124)I-SKI230 PET after treatment of the animal with a dose of Abl-specific PKI for the monitoring of the tumor response. RESULTS: In vitro studies confirmed that SKI230 binds to Abl kinase with nanomolar affinity, that selective uptake occurs in cell lines known to express Abl kinase, that RNAi knock-down supports specificity of cellular uptake due to Abl kinase, and that imatinib, an archetype Abl PKI, completely displaces SKI230. With SKI230, we obtained successful in vivo PET of Abl-expressing human tumors in a nude rat. We were also able to demonstrate evidence of substrate inhibition of in vivo radiotracer uptake in the xenograft tumor after treatment of the animal as a model of PKI treatment monitoring. CONCLUSION: These results support the hypothesis that molecular imaging using PET will be useful for the study of in vivo pharmacodynamics of Abl PKI molecular therapy in humans. PMID: 20048131 [PubMed - indexed for MEDLINE]

(18)F-FDG avidity in lymphoma readdressed: a study of 766 patients.

Related Articles (18)F-FDG avidity in lymphoma readdressed: a study of 766 patients. J Nucl Med. 2010 Jan;51(1):25-30 Authors: Weiler-Sagie M, Bushelev O, Epelbaum R, Dann EJ, Haim N, Avivi I, Ben-Barak A, Ben-Arie Y, Bar-Shalom R, Israel O PET/CT with (18)F-FDG is an important noninvasive diagnostic tool for management of patients with lymphoma, and its use may surpass current guideline recommendations. The aim of the present study is to enlarge the growing body of evidence concerning (18)F-FDG avidity of lymphoma to provide a basis for future guidelines. METHODS: The reports from (18)F-FDG PET/CT studies performed in a single center for staging of 1,093 patients with newly diagnosed Hodgkin disease and non-Hodgkin lymphoma between 2001 and 2008 were reviewed for the presence of (18)F-FDG avidity. Of these patients, 766 patients with a histopathologic diagnosis verified according to the World Health Organization classification were included in the final analysis. (18)F-FDG avidity was defined as the presence of at least 1 focus of (18)F-FDG uptake reported as a disease site. Nonavidity was defined as disease proven by clinical examination, conventional imaging modalities, and histopathology with no (18)F-FDG uptake in any of the involved sites. RESULTS: At least one (18)F-FDG-avid lymphoma site was reported for 718 patient studies (94%). Forty-eight patients (6%) had lymphoma not avid for (18)F-FDG. (18)F-FDG avidity was found in all patients (100%) with Hodgkin disease (n = 233), Burkitt lymphoma (n = 18), mantle cell lymphoma (n = 14), nodal marginal zone lymphoma (n = 8), and lymphoblastic lymphoma (n = 6). An (18)F-FDG avidity of 97% was found in patients with diffuse large B-cell lymphoma (216/222), 95% for follicular lymphoma (133/140), 85% for T-cell lymphoma (34/40), 83% for small lymphocytic lymphoma (24/29), and 55% for extranodal marginal zone lymphoma (29/53). CONCLUSION: The present study indicated that with the exception of extranodal marginal zone lymphoma and small lymphocytic lymphoma, most lymphoma subtypes have high (18)F-FDG avidity. The cumulating evidence consistently showing high (18)F-FDG avidity in the potentially curable Burkitt, natural killer/T-cell, and anaplastic large T-cell lymphoma subtypes justifies further investigations of the utility of (18)F-FDG PET in these diseases at presentation. PMID: 20009002 [PubMed - indexed for MEDLINE]

Innovations in radiotherapy planning of head and neck cancers: role of PET.

Related Articles Innovations in radiotherapy planning of head and neck cancers: role of PET. J Nucl Med. 2010 Jan;51(1):66-76 Authors: Troost EG, Schinagl DA, Bussink J, Boerman OC, van der Kogel AJ, Oyen WJ, Kaanders JH Modern radiotherapy techniques heavily rely on high-quality medical imaging. PET provides biologic information about the tumor, complementary to anatomic imaging. Integrated PET/CT has found its way into the practice of radiation oncology, and (18)F-FDG PET is being introduced for radiotherapy planning. The functional information possibly augments accurate delineation and treatment of the tumor and its extensions while reducing the dose to surrounding healthy tissues. In addition to (18)F-FDG, other PET tracers are available for imaging specific biologic tumor characteristics determining radiation resistance. For head and neck cancer, the potential gains of PET are increasingly being recognized. This review describes the current role of PET and perspectives on its future use for selection and delineation of radiotherapy target volumes and for biologic characterization of this tumor entity. Furthermore, the potential role of PET for early response monitoring, treatment modification, and patient selection is addressed in this review. PMID: 20009000 [PubMed - indexed for MEDLINE]

Nuclear myocardial perfusion imaging with a cadmium-zinc-telluride detector technique: optimized protocol for scan time reduction.

Related Articles Nuclear myocardial perfusion imaging with a cadmium-zinc-telluride detector technique: optimized protocol for scan time reduction. J Nucl Med. 2010 Jan;51(1):46-51 Authors: Herzog BA, Buechel RR, Katz R, Brueckner M, Husmann L, Burger IA, Pazhenkottil AP, Valenta I, Gaemperli O, Treyer V, Kaufmann PA We aimed at establishing the optimal scan time for nuclear myocardial perfusion imaging (MPI) on an ultrafast cardiac gamma-camera using a novel cadmium-zinc-telluride (CZT) solid-state detector technology. METHODS: Twenty patients (17 male; BMI range, 21.7-35.5 kg/m(2)) underwent 1-d (99m)Tc-tetrofosmin adenosine stress and rest MPI protocols, each with a 15-min acquisition on a standard dual-detector SPECT camera. All scans were immediately repeated on an ultrafast CZT camera over a 6-min acquisition time and reconstructed from list-mode raw data to obtain scan durations of 1 min, 2 min, etc., up to a maximum of 6 min. For each of the scan durations, the segmental tracer uptake value (percentage of maximum myocardial uptake) from the CZT camera was compared by intraclass correlation with standard SPECT camera data using a 20-segment model, and clinical agreement was assessed per coronary territory. Scan durations above which no further relevant improvement in uptake correlation was found were defined as minimal required scan times, for which Bland-Altman limits of agreement were calculated. RESULTS: Minimal required scan times were 3 min for low dose (r = 0.81; P < 0.001; Bland-Altman, -11.4% to 12.2%) and 2 min for high dose (r = 0.80; P < 0.001; Bland-Altman, -7.6% to 12.9%), yielding a clinical agreement of 95% and 97%, respectively. CONCLUSION: We have established the minimal scan time for a CZT solid-state detector system, which allows 1-d stress/rest MPI with a substantially reduced acquisition time resulting in excellent agreement with regard to uptake and clinical findings, compared with MPI from a standard dual-head SPECT gamma-camera. PMID: 20008999 [PubMed - indexed for MEDLINE]

Dopamine cell implantation in Parkinson's disease: long-term clinical and (18)F-FDOPA PET outcomes.

Related Articles Dopamine cell implantation in Parkinson's disease: long-term clinical and (18)F-FDOPA PET outcomes. J Nucl Med. 2010 Jan;51(1):7-15 Authors: Ma Y, Tang C, Chaly T, Greene P, Breeze R, Fahn S, Freed C, Dhawan V, Eidelberg D We have previously reported the results of a 1-y double-blind, placebo-controlled study of embryonic dopamine cell implantation for Parkinson's disease. At the end of the blinded phase, we found a significant increase in putamen uptake on (18)F-fluorodopa ((18)F-FDOPA) PET reflecting the viability of the grafts. Nonetheless, clinical improvement was significant only in younger (age < or = 60 y) transplant recipients, as indicated by a reduction in Unified Parkinson's Disease Rating Scale (UPDRS) motor scores. METHODS: We now report long-term clinical and PET outcomes from 33 of the original trial participants who were followed for 2 y after transplantation and 15 of these subjects who were followed for 2 additional years. Longitudinal changes in UPDRS motor ratings and caudate and putamen (18)F-FDOPA uptake were assessed with repeated-measures ANOVA. Relationships between these changes over time were evaluated by the analysis of within-subject correlations. RESULTS: We found that UPDRS motor ratings declined over time after transplantation (P < 0.001). Clinical improvement at 1 y was relatively better for the younger transplant recipients and for men, but these age and sex differences were not evident at longer-term follow-up. Significant increases in putamen (18)F-FDOPA uptake were evident at all posttransplantation time points (P < 0.001) and were not influenced by either age or sex. Posttransplantation changes in putamen PET signal and clinical outcome were significantly intercorrelated (P < 0.02) over the course of the study. Image analysis at the voxel level revealed significant bilateral increases in (18)F-FDOPA uptake at 1 y (P < 0.001) in the posterior putamen engraftment sites. PET signal in this region increased further at 2 and 4 y after engraftment. Concurrently, this analysis disclosed progressive declines in radiotracer uptake in the nonengrafted caudate and ventrorostral putamen. Clinical improvement after transplantation correlated with the retention of PET signal in this region at the preoperative baseline. CONCLUSION: These results suggest that clinical benefit and graft viability are sustained up to 4 y after transplantation. Moreover, the dependence of clinical (but not imaging) outcomes on subject age and sex at 1 y may not persist over the long term. Last, the imaging changes reliably correlate with clinical outcome over the entire posttransplantation time course. PMID: 20008998 [PubMed - indexed for MEDLINE]

PET and PET/CT reports: observations from the National Oncologic PET Registry.

Related Articles PET and PET/CT reports: observations from the National Oncologic PET Registry. J Nucl Med. 2010 Jan;51(1):158-63 Authors: Coleman RE, Hillner BE, Shields AF, Duan F, Merlino DA, Hanna LG, Stine SH, Siegel BA Our objective was to identify core elements for inclusion in oncologic PET reports and to evaluate a sample of reports in the National Oncologic PET Registry database. METHODS: A list of desirable elements in PET reports was compiled from American College of Radiology and Society of Nuclear Medicine guidelines. A training set of 20 randomly selected reports was evaluated by the 4-physician panel, and the results were used to formulate a consensus approach for assessing report content and quality. Each reviewer then scored 65 randomly selected reports-20 common to all reviewers. The scores were tabulated, and interrater variability was measured for the common cases. RESULTS: Each report was assessed for 34 elements-21 primary and 11 additional questions related to 6 of these primary elements. Among the common cases, there was strong (> or = 0.70) interrater agreement for 30 of 34 elements. Among the unique cases, only 9 elements were included in more than 90% of the reports. Several important elements were not included in more than 40% of the reports: the reason for the study, a description of treatment history, a statement about comparison to other imaging, and time from radiopharmaceutical injection to imaging. CONCLUSION: Essential elements that should be included in oncologic PET reports were missing from many reports. These deficiencies may render the reports less helpful to referring physicians, may lead to misdiagnoses, and may cause coding and billing errors. Interpreting physicians should audit their reports to ascertain that they include appropriate elements necessary for billing compliance and for effective communications with referring physicians. PMID: 20008997 [PubMed - indexed for MEDLINE]

The PET/CT report: the most important part of the study.

Related Articles The PET/CT report: the most important part of the study. J Nucl Med. 2010 Jan;51(1):5-6 Authors: Graham MM PMID: 20008996 [PubMed - indexed for MEDLINE]

Radioisotopic imaging of neuroinflammation.

Related Articles Radioisotopic imaging of neuroinflammation. J Nucl Med. 2010 Jan;51(1):1-4 Authors: Winkeler A, Boisgard R, Martin A, Tavitian B Inflammatory responses are closely associated with many neurologic disorders and influence their outcome. In vivo imaging can document events accompanying neuroinflammation, such as changes in blood flow, vascular permeability, tightness of the blood-to-brain barrier, local metabolic activity, and expression of specific molecular targets. Here, we briefly review current methods for imaging neuroinflammation, with special emphasis on nuclear imaging techniques. PMID: 20008995 [PubMed - indexed for MEDLINE]

Diagnosis of cirrhotic portal hypertension and compensatory circulation using transsplenic portal scintigraphy with (99m)Tc-phytate.

Related Articles Diagnosis of cirrhotic portal hypertension and compensatory circulation using transsplenic portal scintigraphy with (99m)Tc-phytate. J Nucl Med. 2010 Jan;51(1):52-6 Authors: Gao L, Yang F, Ren C, Han J, Zhao Y, Li H Our objective was to investigate the diagnostic value and clinical significance of transsplenic portal scintigraphy in cirrhotic portal hypertension and compensatory circulation. METHODS: Transsplenic portal scintigraphy, ultrasound, and gastroscopy were performed on 50 patients with cirrhotic portal hypertension and on 10 controls. According to the Child-Pugh classification, 15 patients with cirrhosis were Child A, 19 were Child B, and 16 were Child C. RESULTS: In the control group, the splenoportal vein was shaped like the letter S, and the portosystemic shunt index was 0.19 +/- 0.07. Portal hypertension portosystemic shunts were of 3 types: intrahepatic (13 patients; index, 0.52 +/- 0.19), compensatory (31 patients; index, 0.64 +/- 0.28); and completely extrahepatic (6 patients; index, 0.91 +/- 0.03). Collateral vessels were uphill, downhill, or complex. The portosystemic shunt index increased as cirrhosis and esophageal varices increased. There was statistical significance among groups (P < 0.05 or < 0.01). CONCLUSION: Transsplenic portal scintigraphy was sensitive for detecting the number and location of shunts and will allow for improved surgical planning. PMID: 20008994 [PubMed - indexed for MEDLINE]

Implementation of an automated respiratory amplitude gating technique for PET/CT: clinical evaluation.

Related Articles Implementation of an automated respiratory amplitude gating technique for PET/CT: clinical evaluation. J Nucl Med. 2010 Jan;51(1):16-24 Authors: Chang G, Chang T, Pan T, Clark JW, Mawlawi OR Amplitude gating techniques have recently been shown to be better at suppressing respiratory motion artifacts than phase gating. However, most commercial PET/CT scanners are equipped with phase gating capabilities only. The objective of this article was to propose and evaluate using patient studies an automated respiratory amplitude gating technique that could be implemented on current whole-body PET/CT scanners. A primary design feature of the proposed technique is to automatically match the respiratory amplitude captured during the CT scan with a corresponding amplitude during the PET scan. METHODS: The proposed amplitude gating technique consists of a CT scan, followed by a list-mode PET scan. The CT scan was acquired while the patient's respiratory motion was recorded by a monitoring device that determined the respiratory motion amplitude captured during the CT scan. A program was designed to inject triggers into the PET list stream whenever the patient's respiration crossed a preset amplitude range determined by the captured amplitude during CT. To implement this proposed amplitude gating technique in whole-body PET/CT, a PET-first protocol was necessary to minimize the respiratory baseline drift between the CT and PET scans. In this implementation, a regular PET scan was first acquired over the patient's whole body but excluding the bed position that covered the lesion of interest. The whole-body CT scan was then acquired, followed by a list-mode PET acquisition over the bed position that covered the area of interest (lesion). The proposed amplitude gating technique was tested using 13 patients with 21 lung or thoracic tumors. RESULTS: In the patient studies, the gated images-when compared with the ungated images-showed statistically significant improvements, with an average 27% and 28% increase in maximum and mean standardized uptake value, respectively, for all lesions. Furthermore, the tumors in the gated images showed better contrast using visual inspection and line profiles. CONCLUSION: The implementation of the proposed respiratory amplitude gating technique on current PET/CT scanners is feasible, and amplitude-matched CT and PET data can be automatically generated using our proposed procedures without requiring patients to hold their breath or increase their radiation exposure. PMID: 20008993 [PubMed - indexed for MEDLINE]