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Medical and Biological Applications of Low Energy Accelerators
Published in Vlado Valković, Low Energy Particle Accelerator-Based Technologies and Their Applications, 2022
PET is a diagnostic imaging procedure used regularly to acquire essential clinical information. The PET-CT hybrid, which consists of two scanning machines: PET scanner and an X-ray CT. At present, these represent the technological hierarchy of Nuclear Medicine, occupying an important position in diagnostics. In fact, PET-CT has the capability to evaluate diseases through a simultaneous functional and morphostructural analysis. This allows for an earlier diagnosis of the disease state, which is crucial for obtaining the required information to provide a more reliable prognosis and therapy. Presently, the most frequently used PET radiotracer fluorodeoxyglucose (18FDG) has a major role in oncology. Useful information is being regularly obtained by using both 18FDG and a selection of radiotracer compounds to evaluate some of the most important biological processes (Kitson et al. 2009).
Methods and Equipment for Quality Control of Radiopharmaceuticals
Published in Michael Ljungberg, Handbook of Nuclear Medicine and Molecular Imaging for Physicists, 2022
Rolf Zijlma, Danique Giesen, Yvette Kruiter, Philip H. Elsinga, Gert Luurtsema
After production of a radiopharmaceutical, a quality control procedure (QC) is required in order to assess whether the prepared radiopharmaceutical meets the predefined quality standards. The purpose of performing quality control analysis is (1) to assure that the radiopharmaceutical can safely be administered to a patient, and (2) to assure that the intended PET scan will supply the correct information to the physician. In this chapter quality control methods will be described, including the equipment used and the rationale for the QC methods. To show practical examples, the radiopharmaceutical [18F]fluorodeoxyglucose is taken as a representative example. FDG is the most-often used radiopharmaceutical; this “workhorse” of PET, is used for molecular imaging of patients in the field of cardiology, neurology, inflammation, and oncology [1, 2]. In addition, some additional methods that are not applicable for FDG, but which are crucial for other radiopharmaceuticals will be described briefly.
Nuclear Medicine Imaging and Therapy
Published in Debbie Peet, Emma Chung, Practical Medical Physics, 2021
David Towey, Lisa Rowley, Debbie Peet
The most common application for PET-CT within the UK is 18F – fluorodeoxyglucose (FDG) imaging for cancer diagnosis, staging, management and assessing treatment response. FDG is a glucose analogue, taken up by metabolically active tumours. As the heart and brain are also highly metabolically active, the patient is asked to rest in a warm room following administration of FDG to prevent brown fat and muscle uptake and enable metabolically active tumours to be clearly visualised.
Positive association between cerebral grey matter metabolism and dopamine D2/D3 receptor availability in healthy and schizophrenia subjects: An 18F-fluorodeoxyglucose and 18F-fallypride positron emission tomography study
Published in The World Journal of Biological Psychiatry, 2020
Serge A. Mitelman, Monte S. Buchsbaum, Bradley T. Christian, Brian M. Merrill, Bradley R. Buchsbaum, Jogeshwar Mukherjee, Douglas S. Lehrer
FDG images were normalised by dividing each voxel by mean values of the whole brain, masked with MNI brain and using slices above MNI z = −53 (see image alignment in a typical subject with schizophrenia in Figure 1). A restricted vertical range was chosen to minimise errors in the brain extraction routine at low slice levels. These relative 18F-fluorodeoxyglucose metabolic rates were used in all analyses. For analyses of 42 Brodmann areas, gyri, hippocampus, insula, and subcortical structures, FDG uptake and 18F-fallypride BPND values were obtained using AFNI regions of interest (Cox 1996). Subcortical structures included the amygdala, cerebellar subregions (tonsil, culmen, declive, tuber and pyramid of the vermis, dentate and fastigial nuclei), basal ganglia associated structures (head, body and tail of the caudate nucleus, putamen, lateral globus pallidus, medial globus pallidus, red nucleus, substantia nigra, claustrum), hypothalamus and mamillary bodies, thalamic nuclei (pulvinar, ventral anterior, lateral dorsal, ventral lateral, ventral posteromedial, lateral posterior, ventral posterolateral, mediodorsal as well as anterior and midline nuclear groups).
A case of TAFRO syndrome, a variant of multicentric Castleman’s disease, successfully treated with corticosteroid and cyclosporine A
Published in Modern Rheumatology, 2019
Naruhiko Takasawa, Yukio Sekiguchi, Tsuneyuki Takahashi, Akira Muryoi, Jo Satoh, Takeshi Sasaki
A 46-year-old woman was admitted to NTT East Tohoku Hospital because of chest pain, back pain, and slight fever. She was complaining of fatigue. Her body temperature ranged from 37°C to 38°C, and cervical lymphadenopathy was detected. No rale was detected, and the abdomen was soft with no tenderness. The results of laboratory tests are shown in Table 1. The white blood cell count and CRP level were high; liver dysfunction, with marked elevation of ALP and γ-glutamyl transferase, and hypoalbuminemia were detected. Cytomegalovirus antigenemia and β-glucan assays yielded negative results. Titers of autoantibodies, including anti-mitochondrial and anti-smooth muscle antibodies, were within the normal range, except for the anti-SS-A antibody. Schirmer test and fluorescein staining test results were positive. Chest radiography showed bilateral pleural effusion, and computed tomographic (CT) scanning of the chest and abdomen revealed hepatosplenomegaly, bilateral pleural effusion, and ascites (Figure 1). Positron emission tomography/computed tomography revealed abnormal accumulation of fluorodeoxyglucose in cervical, mediastinal, and retroperitoneal lymph nodes (Figure 2).
Isotoxic investigation of 18F-FDG PET/CT-guided dose escalation with intensity-modulated radiotherapy for LA-NSCLC
Published in International Journal of Radiation Biology, 2021
Yan Shao, Hua Chen, Hao Wang, Aihui Feng, Ying Huang, Qing Kong, Zhiyong Xu
Recently, PET/CT has been widely used in clinical. By selecting an appropriate positron emission tomography tracer, it is possible to image biological processes such as glycolysis metabolism and hypoxia (Krengli et al. 2010; Nishikawa et al. 2017). 18F fluorodeoxyglucose (FDG) is commonly used for tumor glucose metabolism. Some researchers (Maeseneer et al. 2010; Calais et al. 2015; Shusharina et al. 2015) had reported that volumes of local relapse are correlated with high uptake regions on pretreatment images and are stable over time for 18F-FDG PET/CT. Thus, a higher dose to the area with high FDG uptake may be beneficial to improve LC. Several articles (Xu et al. 2017; Ji et al. 2014; Ma et al. 2018) had already investigated the feasibility of using SIB-IMRT to treat NSCLC and dosimetric differences between SIB-IMRT and conventional radiotherapy treatment plannings under the guidance of PET/CT were also evaluated (Lievens et al. 2011; Li et al. 2018; Warren et al. 2014; Shao et al. 2019). Both SIB-IMRT and conventional radiotherapy treatment plannings are IMRT plans. Li et al. (2018) delivered three different doses to the hypoxic subarea and compared the dosimetric differences of target and OARs between SIB-IMRT and conventional radiotherapy. It was found that SIB-IMRT under the guidance of PET/CT could increase the target dose without increasing the dose to OARs. On this basis, we investigated the treatment plan with the highest target dose in isotoxic radiotherapy and compared the differences of dosimetric and biological parameters of target and OARs between the plan and conventional radiotherapy plans.