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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).
Cancer
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Elyce Cardonick, Charlotte Maggen, Puja Patel
The staging of lymphoma is based on history and physical examination, hematologic and biochemical testing, bone marrow biopsy, and radiologic imaging. Currently, women with stages I and II receive combination modality treatment, so full staging during pregnancy is unlikely to change the recommended treatment during the course of pregnancy and can be delayed to the postpartum period. Image staging in non-pregnant patients includes a chest x-ray and CT. In the pregnant woman, a two-view chest x-ray is suggested. A chest MRI can assess lymphadenopathy, and the information gained is comparable to a CT [59]. MRI can also evaluate the bone marrow and detect splenic involvement that may be undetectable with CT. Abdominal ultrasound can evaluate the spleen depending on size of gravid uterus. Diffusion weighted whole body MRI is a safer alternative during pregnancy [39]. After delivery a PET scan can be performed. Pet scan is avoided in pregnancy as fludeoxyglucose crosses the placenta and involves radiation as well.
Cervical Cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Georgios Imseeh, Alexandra Taylor
Response to radiotherapy is assessed with clinical examination and an MRI scan after 3 months (Figure 21.13). PET imaging may be useful if there are equivocal findings, as patients with a complete metabolic response have an excellent outlook.55 In the event of residual disease, surgery to obtain central clearance should be considered. There is no role for routine cytology in follow-up after radiotherapy.
Development and validation of an [18F]FDG-PET/CT radiomic model for predicting progression-free survival for patients with stage II – III thoracic esophageal squamous cell carcinoma who are treated with definitive chemoradiotherapy
Published in Acta Oncologica, 2023
Noriyoshi Takahashi, Shohei Tanaka, Rei Umezawa, Kentaro Takanami, Kazuya Takeda, Takaya Yamamoto, Yu Suzuki, Yoshiyuki Katsuta, Noriyuki Kadoya, Keiichi Jingu
[18F]FDG-PET/CT imaging was performed with two scanners (Biograph Duo LSO and Biograph 40; Siemens Medical Solution, Erlangen, Germany). The median period between [18F]FDG-PET/CT and the first day of radiation was 15 days (range, 1–45 days) in all patients. All patients fasted for 4 or more hours, and a blood glucose level < 200 mg/dL was required before [18F]FDG injection. Patients were injected with 3.7 MBq [18F]FDG/kg. Scanning began 60 min after [18F]FDG injection. A spiral CT scan was performed, followed by a collection of PET emission images from the distal femur to the top of the skull. The PET scanning time was 2 min per bed position with increments of 16.2 cm (3-dimensional mode); all patients were scanned in 8-bed positions. Our institution conforms to two sets of Japanese guidelines for the data acquisition protocol of oncology fluoro-D-glucose-positron emission tomography (FDG-PET)/computed tomography (CT) scans that established by the joint task force of the Japanese Society of Nuclear Medicine Technology and the Japanese Society of Nuclear Medicine. These guidelines aim to standardize PET image quality among facilities and different PET/CT scanner models. The details of the protocol for FDG-PET/CT image acquisition including reconstruction methods are shown in Supplementary 1. Moreover, based on the prior phantom experiment, the difference in the SUV of the same spherical target that was 2 cm or larger in diameter between the two PET/CT scanners was within 10%.
Digital PET/CT with 18F-FACBC in early castration-resistant prostate cancer: our preliminary results
Published in Expert Review of Medical Devices, 2022
Luca Filippi, Oreste Bagni, Orazio Schillaci
All the patients underwent PET/CT with 18F-FACBC according to present imaging guidelines [15]. All patients fasted for at least 4 hours before PET/CT scan and were asked to avoid any significant physical exercise 24 hours prior to the scan. Whole body PET/CT scan was performed, from the skull base to the proximal thigh, starting at 3–5 minutes after the intravenous (i.v.) injection of 370 MBq of 18F-FACBC. PET/CT scans were performed with a digital Biograph Vision PET/CT system (Siemens Healthcare; Erlangen, Germany). A CT scan from proximal thigh to skull base was performed with slice thickness of 1.0 mm, pitch factor 1, bone, and soft tissue reconstruction kernels and maximum of 120 keV and 90 mAs by applying CARE kV and CARE Dose. After CT scanning, a whole-body PET (proximal thigh to skull base) was acquired at 3–5 min post tracer administration in 3D (matrix: 440 × 440) with a zoom factor of 1.0. Digital PET was acquired on a Siemens Biograph Vision 450 with an axial FOV of 197 mm using continuous-bed motion (FlowMotion®) with a bed speed of 0.9 mm/s (equivalent to approximately 2 min/bed position). Reconstruction was conducted with a TrueX + TOF algorithm and Gauss-filtered to a transaxial resolution of 2 mm at FWHM (full width at half maximum). Attenuation correction was performed using the low-dose non-enhanced computed tomography data.
Brentuximab vedotin and bendamustine: an effective salvage therapy for relapsed or refractory Hodgkin lymphoma patients
Published in Journal of Chemotherapy, 2022
Bahar Uncu Ulu, Mehmet Sinan Dal, İpek Yönal Hindilerden, Olga Meltem Akay, Özgür Mehtap, Nurhilal Büyükkurt, Fehmi Hindilerden, Ahmet Kürşad Güneş, Tuğçe Nur Yiğenoğlu, Semih Başcı, Merih Kızıl Çakar, Didar Yanardağ Açık, Serdal Korkmaz, Turgay Ulaş, Gülsüm Özet, Burhan Ferhanoğlu, Meliha Nalçacı, Fevzi Altuntaş
Grade 3/4 haematological and non-haematological toxicities were defined according to the National Cancer Institute’s Common Terminology Criteria for Adverse Events (NCI-CTC) version 4.0. Hematological toxicities were evaluated in the first week of BvB treatment. On the first day of the treatment, 30 min before the onset of Bv, 8 mg dexamethasone and 45.5 mg pheniramine maleate were administered as pre-medications for the patients. No pre-medication was administered before B on the second day of treatment. Antiemetic treatment was administered in case of nausea symptoms. Neutropenic patients received growth factor support during treatment. The response evaluation was assessed using PET/CT. Response evaluation was performed after at least two cycles of combination treatment. This assessment was repeated every two cycles following more than two cycles of treatment. PET-CT scans were evaluated four to six weeks after treatment for response assessment according to the Deauville five-point scale [15].