China
Africa
Explore chapters and articles related to this topic
Image Acquisition Protocols
Published in Michael Ljungberg, Handbook of Nuclear Medicine and Molecular Imaging for Physicists, 2022
As discussed, it is possible to reduce the FOV used by the system by applying a digital zoom during the acquisition. Conversely, it is possible to increase the field of view by moving the detector or patient during an acquisition. This type of acquisition protocol is generally referred to as whole-body imaging, as it is commonly used to image along the entire length of the patient. A clinical example where this is most common is for bone imaging, particularly for oncology where potential sites of disease can appear in any number of places within the skeletal anatomy. Typical imaging methods and patient preparation are summarized in Table 15.5.
Lymphoscintigraphy
Published in Michael Ljungberg, Handbook of Nuclear Medicine and Molecular Imaging for Physicists, 2022
Rimma Axelsson, Maria Holstensson, Ulrika Estenberg
Imaging is recommended before surgery for all types of cancers. Sentinel node detection could be performed as a one- or two-day procedure depending on the surgical facility’s occupancy/schedule. SLNs are generally visualized within 1–2h after injection, and the patient should be operated upon within 2–30h after the injection of the tracer. Dynamic imaging is recommended for detection of SLNs in patients with malignant melanoma and in patients with tumours in the head and neck regions. Early (20 min after injection) and delayed (1–3 h after injection) static planar imaging as well as whole-body acquisition protocols are applied (whole-body imaging is essential for patients with malignant melanoma). However, neither planar imaging nor whole-body scanning provide the exact anatomical localization of SLNs. Therefore, in complex anatomical regions such as head and neck, tomographic gamma camera imaging fused with x-ray CT (SPECT/CT) is applied when the SLN is visible in the planar images in order to provide an anatomical road map for surgeons. The CT is usually acquired using a low-dose protocol without the use of a contrast agent. In patients with malignant melanoma or tumours in the head and neck regions, a higher overall SLN detection rate and better detection of SLNs located next to the injection site have been reported on SPECT/CT compared to on planar imaging [36, 37]. Utilizing SPECT/CT not only provides an anatomical localization of SLNs, but has also been shown to identify SLNs and clarify ambiguous SLNs on planar images. The region containing SLN should be marked on the skin using a permanent marker.
Assessment of response to treatment
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Lawrence H Schwartz, Binsheng Zhao, Marius E Mayerhoefer
A general principle to follow in imaging of response assessment is that the subsequent follow-up examinations should be performed with the same modality and the same imaging protocol. This enables comparison of the size and number of lesions, as well other, more recently introduced, metabolic and functional parameters. The introduction of new modalities or imaging of new body parts should be performed if there are equivocal features on initial imaging or if new clinical symptoms are present. Generally, there is now a trend towards whole-body imaging in cancer that provides all necessary information for patient management in a single examination. Increasingly, radiologists participate in clinical investigations or clinical trials involving novel imaging or therapeutic agents to assess their efficacy. General guidelines regarding good clinical practice are appropriate in these research investigations, as well as for those undertaken in routine clinical practice and, at present, the greatest difference lies in the degree of quantification of imaging findings between research and clinical studies, as well as the documentation of the findings. Ultimately, accurate interpretation of the imaging findings and individual patient care are paramount, whether involving a routine case or a clinical research investigation.
Primary cardiac lymphoma: the management and outcome of a single-centre cohort of 22 patients
Published in Acta Oncologica, 2021
Xiao-Juan Wei, Hui Yuan, Pek-Lan Khong, Fen Zhang, Peng-Jun Liao, Xin-Miao Jiang, Ling Huang, Han-Guo Guo, Fei-Li Chen, Si-Chu Liu, Yan-Ying Huang, Shu-Xia Wang, Wen-Yu Li
Whole-body imaging was performed to evaluate disease characteristics and determine the optimal biopsy route. Whole-body 18-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) combined with contrast-enhanced CT (CECT) was the imaging modality of choice, but for patients with limited economic resources whole-body CECT was also accepted (see Document S1 for a description of the imaging techniques). Bulky disease was defined as the largest dimension ≥7.5 cm of a cardiac tumour. If imaging revealed extracardiac involvement, biopsy was performed at the least invasive site. Peripheral lymph node or mass biopsy was the priority, followed by cytological investigation of pleural or pericardial effusion, and intrathoracic or intra-abdominal biopsy (mediastinoscopy or CT-guided fine needle aspiration biopsy [CT-FNAB]). For patients presenting with only intrapericardial lesions, we attempted transjugular endocardial biopsy, endobronchial ultrasonography-guided fine-needle aspiration biopsy (EBUS-FNAB), or video-assisted thoracic surgery (VATS), depending on the lesion location. Cardiotomy was the final option. All histological samples were reviewed by an experienced pathologist (F Z) as previously described [13].
Cemiplimab for locally advanced cutaneous squamous cell carcinoma: safety, efficacy, and position in therapy panel
Published in Expert Review of Anticancer Therapy, 2021
Eve Lebas, Nathalie Marchal, Andrée Rorive, Arjen F Nikkels
The cornerstone study revealed that using cemiplimab at 3 mg/kg every 2 weeks for expansion cohorts of patients suffering from lacSCC and/or mcSCC in a phase 1 trial, a response rate of 50%, observed after 2 months of treatment (13 of 26 patients, 95% confidence interval (CI), 30 to 70)(NCT02383212) [32]. Efficacy was evaluated using whole-body imaging techniques according to RECIST 1.1. In a pivotal phase 2 study with a median follow-up of 7.9 months it was demonstrated that 3 mg/kg of cemiplimab every 2 weeks for a cohort of patients with mcSCC provided a response rate of 47% (28 of 59 patients; 95% CI, 34 to 61) [32]. Among the 28 responding patients the DOR was longer than half a year in 57% of the patients, and 82% of the responding patients continued to have a response and to receive cemiplimab at the time of data cutoff [33].
64Cu-ATSM and 99mTc(CO)3-DCM20 potential in the early detection of rheumatoid arthritis
Published in Modern Rheumatology, 2021
Trang Thuy Dam, Hirofumi Hanaoka, Takahito Nakajima, Aiko Yamaguchi, Koichi Okamura, Hirotaka Chikuda, Yoshito Tsushima
To date, anatomical imaging techniques like US and MRI can detect early structural damages of RA joint such as synovitis, bone erosions, and osteitis. Although those techniques are useful for RA diagnosis, they still lack the potential to provide information on the early-phase of RA, in which cellular and molecular changes precede anatomic alterations. A promising approach to enable early diagnosis is molecular imaging that can visualize certain biological processes at the molecular and cellular levels. Nuclear medicine plays a role in molecular imaging. Our results thus may allow for detection of early bio-physiological changes prior to the appearance of anatomic lesions in RA by using 99mTc(CO)3-DCM20 and 64Cu-ATSM. In addition, PET or planar imaging with these tracers enable whole body imaging in contrast to US and MRI.