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Archive for the ‘PET’ Category

Have a brief insight over nuclear medicine, and about companies that cater to the sector with technology solutions and services!

Gamma Camera

Nuclear medicine is a medical specialty that deals with the utilization of radioactive substances for research, diagnosis/assessment, and treatment of various disorders; radioactive materials/radionuclides are used in for to image a patient, and to work on disease affected cells. Mostly, radionuclides comprise radioactive isotopes of subsequent: radium, uranium, lead, thorium, and polonium.

Radionuclide elements are merged with pharmaceutical compounds and related, for radio-pharmaceuticals that are used for therapeutic/diagnostic approaches, in care units, for administration to patients; properties of radiopharmaceuticals facilitate the specialty/nuclear medicine, with the ability for to image the degree of disorder in the body, on basis of physiology and cellular function; in comparison to other diagnostic approaches, nuclear medicine technology help more for early recognition of medical conditions and issues that the patients are affected with.

Healthcare organizations can now gain on the technology, through varied medical imaging systems, available in the healthcare domain, to redefine their care units, for better patient outcomes.

Get to benefit on subsequent and more, from varied companies, dealers and suppliers: cardiology imaging systems, multi-purpose gamma detectors/camera, hybrid imaging products (PET/CT, SPECT/CT etc.), software workflow solutions, and more!

If low budget dithers you for new and expensive gamma cameras and other nuclear medicine supplies, then get through MedicExchange for varied companies that are into used nuclear medicine equipment; get to utilize them for various refurbished medical equipment, for effective practice management.

Besides, nuclear medicine technology/technical students that are serious about a career in this sector can make optimal use of our catalog for varied online nuclear medicine programs and training sessions, available from hospitals/associations and universities.

For more on medical equipment solutions/services, and news and updates about the sector, stay tuned with MedicExchange!

For non–small cell lung cancer, early post RFA PET/CT is not required; six-month post RFA PET/CT findings mutually relate in a better way with clinical results at 1 year.

 

 

The medical research study was conducted by Don C. Yoo, Damian E. Dupuy, Shauna L. Hillman, Hiran C. Fernando, William S. Rilling, Jo-Anne O. Shepard and Barry A. Siegel from Department of Diagnostic Imaging, Warren Alpert Medical School, Rhode Island Hospital, Providence, RI; Mayo Clinic and Mayo Foundation, Rochester, MN; Department of Surgery, Boston University Medical Center, Boston, MA; Department of Radiology, Medical College of Wisconsin, Milwaukee, WI; Department of Radiology, Massachusetts General Hospital, Boston, MA; Mallinckrodt Institute of Radiology and Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO.

The research objective was to assess primary experience with 18F-FDG PET/CT post pulmonary RF ablation of stage IA non–small cell lung cancer, to ascertain if treatment success or residual disorder can be anticipated with early postablation PET.

About 30 patients with stage IA non–small cell lung cancer, with mean tumor size of 2.0 cm – of inoperable stage passed through computed tomography guided radiofrequency ablation (RFA), for over a time period of 33 months. PET/CT was executed subsequently: in two months prior, in a week and six months – after radiofrequency ablation (RFA), and metabolic response was classified and equated with clinical event rate.

Of results, early PET/CT images acquired within a week of radiofrequency ablation were appraisable for 26 patients; the event rate of patients with complete metabolic response (43%) with partial and no response/disease progression (67%) at early PET/CT were equated through; same was done also for event rate at 6-month PET/CT – patients with complete metabolic response had 0% event rate, while partial response/disease progression showed altogether event rate of 75%.

Conclusion: early post radiofrequency ablation PET/CT is not required and six-month post radiofrequency ablation PET/CT findings mutually relate in a better way with clinical results at 1 year.

The tumors were desolate and well restricted of patients with surgicopathologic staging of nerve sheath tumor of the cervical vagus, over MR and CT studies.

On magnetic resonance imaging, the tumors were heterogeneously bright on T2WI, with strong inhomogeneous postgadolinium enhancement.

 

The medical research study was conducted by Gopinathan Anil and Tiong-Yong Tan from Department of Radiology, Changi General Hospital, Singapore.

The study is available in American Journal of Roentgenology. Nerve sheath tumor is nervous system neoplasm – and emergence of it from the cervical vagus are uncommon. The research objective was to assess the role of Magnetic resonance imaging and Computed tomography in the diagnosis of these unusual neoplasms.

About 11 patients with surgicopathologic staging of nerve sheath tumor of the cervical vagus were selected had been referred to the institute from January 1999-2009, and their clinical data along with MR and CT studies were retroactively assessed. The tumors were appraised pertaining to: number, location, morphology, signal intensity/attenuation, patterns of mass effect and enhancement characteristics etc.

About the results, the tumors were desolate and well restricted. On computed tomography – 2 tumors were predominantly isodense, 8 were hypodense with poor enhancement; one had manifold cystic regions with enhancing solid components. On magnetic resonance imaging, the tumors in a heterogenous manner were bright on T2WI, with strong inhomogeneous postgadolinium enhancement. Subsequent were observed in some of patients: split fat sign, fascicular, entering and exiting nerve, hyperintense rim sign etc.

The common carotid artery was found anteriorly displaced in eight of the patients; except for a patient with posterolateral displacement, it maintained a neutral position for 2 of the patients. With exclusion of two, than other patients – the tumor acted as separation in between internal jugular vein and carotid artery.

Note: The spectrum of MRI and CT characteristics and patterns of mass effect of nerve sheath tumor of the cervical vagus were put forward as conclusion, along with observations for which we direct you more through http://www.ajronline.org

The combination of CT histogram analysis and SUV remarkably enhances the PET/CT diagnostic precision for distinguishing adrenal lesions, and considerably decreases the number of false positive cases.

The medical research study was conducted by Marzio Perri, Paola Erba, Duccio Volterrani, Federica Guidoccio, Elena Lazzeri, Davide Caramella and Giuliano Mariani from the Regional Center of Nuclear Medicine and Division of Radiology, University of Pisa Medical School, Pisa, Italy.

The study is available in American Journal of Roentgenology, and the research objective was to decide on the diagnostic performance of 18F-FDG PET/CT for distinguishing adrenal masses in cancer patients, merging CT histogram analysis and standardized uptake value (SUV).

Through FDG PET/CT about 93 cancer patients (men and women, with age group of 38-84 years) with 117 adrenal masses were assessed. Based on size change/histopathologic analysis – 42 were malignant, though on base of constancy for 6 months, 75 were benign.

For each adrenal lesion, subsequent were calculated: mean attenuation value, size, percentage of negative pixels on CT histogram analysis, SUVmax and average SUV.

By calculation of SUV ratios of adrenal lesion to liver, adrenal lesion to aorta and adrenal lesion to spleen, FDG uptake was equated with radioactivity of the liver, aorta and spleen, and through ROC curve analysis and independent T tests, PET/CT value was estimated.

About the results, statistically significant deviation was established amongst malignant and benign masses, in – attenuation value, size, percentage of negative pixels, and SUV. With SUVmax greater than 2.8 in all cases, malignant lesions demonstrated FDG activity higher than that in aorta, liver and spleen, while lesions with a percentage of negative pixels higher than 10% were benign, in case of CT histogram analysis.

The incorporated CT histogram analysis and SUV gave 97.3% specificity, 100% sensitivity, 100% negative predictive value, and 95.7% positive predictive value. The same (CT histogram analysis and SUV) at receiving operating characteristic analysis was more precise than simple SUVmax analysis and the mix of attenuation value and SUVmax.

Conclusion: The mix of CT histogram analysis and SUV remarkably enhances the PET/CT diagnostic precision for distinguishing adrenal lesions, ensuing to considerable decrease in the number of false positive cases.

FDA approved first Mobile Radiology App for iPhone®/iPad®, for clinicians and radiologists in remote locations.

Mobile MIM is effective for results of MRI, CT, and PET on mobile devices for diagnosis.

• It is applicable for other modalities as well, viz. fluoroscopy, angiography, ultrasound etc.
• Due to small size, it is not application friendly to Radiographs, for to attain resolution/contrast required to view an X-Ray.
• The portable device extends forth multi touch user interface with medical grade displays.

*(News Courtesy: RSNA)*

It took about 2 years for Food and Drug Administration (FDA) to approve mobile diagnostic radiology application for iPhone®/iPad®, for radiologists, away from clinical workstations.

Mobile radiology app facilitates radiology images taken in care units to be compacted for ensured network transfer, to be sent through portable wireless devices. Though individual facilities have built up similar application for their utility, FDA has not yet sanctioned those, aimed for primary diagnosing, rather secondary viewing. The commendation of Mobile MIM from FDA has opened new avenues to similar devices from other companies, in the market.

FDA examined Mobile MIM’s operation on various devices, measured resolution, luminance noise versus international guidelines and standards. FDA ascertained that Mobile MIM allows for enough resolution quality to be utilized for medical diagnostics, when a full workstation is unavailable.

Though the application will be useful for remote reference/consultation, the technology will be particularly good for getting at subspecialty expertise, not other than available. The resident can confer with radiology on call professional, at any location.

But, some problems could not be kept off with of Mobile MIM, as for physicians that make remote diagnosis from a state in which they are not licensed to – it can bring up grave legal issues.

As per medical research study put forward at the Cancer Imaging and Radiation Therapy Symposium in Atlanta:

In comparison to lone CT scan, the aggregation of Computerized Tomography Scan (CT) with 18F-FDG PET (Fluorodeoxyglucose Positron Emission Tomography) images ensued into more outlined tumors, and likely dissimilar cancer therapy options, in head and neck cancer patients.

The research was led by Homan Dehnad, MD, Utrecht University Medical Center in Utrecht, Netherlands.

The conference was supported by Radiological Society of North America (RSNA) and the American Society for Radiation Oncology (ASTRO).

Medical researchers attempted to ascertain the implication of combination of CT and FDG-PET for deciding tumor delineation and therapy for head and neck cancer patients.

CT scan is standard method for determination of tumor delineation prior adjudicating head and neck cancer treatment, normally through intensity modulated radiation treatment. FDG PET utilizes radioactive products, in combination with sugar, and can generate more outlined tumors.

For the trial study, about 327 patients were treated with Intensity-Modulated Radiation Therapy (IMRT) for head neck cancer.

On grounds of the aggregated approach of CT scan and FDG PET, researchers detected shift in the characterization of the tumor in a patient, out of 3 patients. This resulted into change and adjustment of treatment for 10% of patients, and 33% of patients, respectively.

In about 17% of the patients, the primary tumor was not seeable on CAT scans alone, for the most part due to dental implants.

Researchers anticipated for enhanced delineation of the tumor, though they never looked forward to it to have drastic influence on cancer treatment options for the patients. They urged for requirement of multi-imaged facilities for every committed institute that dealt with head and neck cancer (Oncology).

Conclusion: The combination FDG PET CT scan is significant for tumor characterization in primary radiotherapy for head and neck cancer.

PET scan demonstrated well, in comparison to TTE/TEE and multislice CT for infectious endocarditis.

• Infectious Endocarditis can be analyzed, once the accretion of FDG is observed on a PET scan in suspected region.
• PET scan discovered out FDG accumulation in region of prosthetic blood vessel of the right ventricular outflow tract.

The medical research was conducted by Tsuneaki Kenzaka, MD, Miho Shimoshikiryo, MD, Akihito Kitao, MD, Kazuomi Kario, MD, and Masayoshi Hashimoto, MD. The clinical trial is available in the Journal of Nuclear Cardiology.

The analysis of infectious endocarditis is characteristically based on clinical presentation, blood cultures and echocardiogram findings. Echocardiography is fundamental in the analysis/management of patients with infectious endocarditis.

Medical researches elaborated a medical case of infectious endocarditis, which could not be analyzed through Transthoracic Echocardiography (TTE) and Transesophageal Echocardiogram (TEE). The 35-year-old patient who had been suffering from high fever for more than 2 weeks had a significant medical history of tetralogy of fallot. On examination, no abnormal findings were observed in the blood and urine tests, except for increased white blood cells.

CAT scans with contrast medium and otherwise of the chest, abdomen and head did not divulge cause for the febricity. His medical history and current illness pointed out to infectious endocarditis. Due to artifact, the pulmonary valves could not be envisioned by. Streptococcus Viridans was recognized out in blood cultures, and valve repair was adjudicated for infectious endocarditis.

64-slice CTA was carried out to identify out infectious focal areas, researchers found low-density region in the valves, but could not differentiate it out from fuzzy artifact image in the simulated blood vessel site of the right ventricular outflow tract (RVOT).

PET scan then was adjudicated as a substitute for the procedure. The scan was acquired after instilling the patient with 18F-FDG (4 MBq/kg). Positron emission tomography apparently divulged out the localized accretion of FDG in the contrived blood vessel site of the RVOT. The second scan was carried out after treatment phase of six weeks. It did not show any accretion of FDG in the fraction of the artificial blood vessel.

Except for heparin administration, the second PET scan was administered as per the standard protocol. The patient recuperated with the treatment schedule, as the accumulation vanished after the treatment.

Conclusion: PET scan is effective in treating grave medical cases of infective endocarditis.

PET is an ideal tool for measurement of coronary endothelial dysfunction. Therefore, a finding of endothelial dysfunction may guide interventions for preventing the development of future cardiovascular events.

These findings are mentioned in a recent article available online in the Journal of Nuclear Cardiology. The lead authors of the article titled, ‘Assessment of coronary endothelial function using PET‘, are Keiichiro Yoshinaga MD, PhD, FACC, Osamu Manabe MD, PhD and Nagara Tamaki MD, PhD

Coronary endothelial dysfunction is the most basic irregularity in the evolution of coronary artery diseases. The most common cause is atherosclerosis. It is also seen in septic shock, high blood pressure/hypertension, diabetes etc.

Various coronary risk factors unfavorably affect endothelial cells. Endothelial function testing/detection can provide timely medical interventions to put off cardiovascular disorders, in future.

Myocardial perfusion imaging (coronary perfusion) is a feasible option. The measurement of myocardial blood flow through PET scans facilitate for assessment of endothelial function.

PET imaging/myocardial blood flow with sympathetic stress levels have been put on various patients with coronary risk factors. It was found useful in assessment of risk of coronary heart disease.

The authors opine that endothelial evaluation using PET can be used to study the pathophysiology of cardiovascular disease as well as in evaluation of the treatment. This can help in the development and testing of new treatment approaches for cardiac disease.

The authors recommend further development of this method as a research tool in cardiac disease management.

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Whole body PET MRI might substitute integrated PET CT scanning, as MR outmatches CT, for complementary examination in PET indication. The subject is discussed in a recent editorial published in the ‘European Journal of Nuclear Medicine and Molecular Imaging’, titled ‘Whole-body hybrid PET/MRI: ready for clinical use?‘

Combined PET/CT facilitates precise tumor staging, and evaluates radiation oncology response to the therapy and is superior in comparison to stand-alone PET or CT. The advance PET technology (PET/CT) alleviates for PET imaging of the trunk/body (head to mid-thigh) with isotropic resolution in 10 min and lesser than that.

The incorporation of high-end Multidetector CT (in dual modality) provides for contrast-enhanced CT evaluations. It augments the clinical significance of incorporated PET/CT imaging protocols.

MR imaging studies aid for soft tissue analysis/cephalometric analysis, cancer detection, tissue characterization, functional imaging etc. Patients often undergo MRI scans, other than a PET/CT study, for detection and staging of cancers. This is done for soft tissue analysis/morphological information, when stand-alone computed tomography is unable to provide information with.

Combined PET/MR examinations may potentially become significant than PET/CT imaging. MR outmatches CT, for complementary examination in PET indications. It is now proposed that whole body MR imaging might substitute PET/CT.

MRI machines detect area of restricted diffusion (diffusion weighted MRI). It provides information about injuries to parts of the nervous system, with high sensitivity. The feasibility of PET/MRI is more to be seen.

In a recent medical research study conducted by Mayo Clinic, Scottsdale healthcare and the Translational Genomics Research Institute – the team worked on willingness of patients to go for multiple tests/examinations for cancer new treatments, to receive advance experimental treatment in clinical trials, which paved the way to personalized medicine, where specific treatment methods are prescribed generally concerned with the genetic makeup (DNA) of the cancerous tumors of the patients. The clinical trials studies (Oncology) done by Mayo Clinic were comprised of about 61 patients that had 39 men and 22 women with advanced malignancy.

It is one of rare studies (cancer clinical trial) of its kind, where the patients were urged for their preferred tests/examinations and diagnostic/medical imaging studies that they would be keen to go through, to partake in clinical studies for cancer. They were even checked on for their perception on those invasive tests and studies performed on them. The subsequent study on willingness of patients for to go through Pharmacokinetic and Pharmacodynamic examinations in the premature phase (oncology clinical trials) will hit the publishing corner by the American Cancer Society (cancer edition), by July 2011. To comprehend some more about the cancer (of its molecular aspects), medical research team requires for to go for tumor specimens, and diagnostic images gathered from various imaging modalities (Radiology), viz. MRI, CT, PET etc., where the clinical trials of premature-phase include medical analyses of Pharmacodynamics and Pharmacokinetics, to evaluate on the effects of drug on the body and vice versa.

The study (clinical trials for cancer) was conducted for to examine out willingness of patients for to go through those and was even decided up for to gauge their tolerance levels on respective tests and examinations at clinical research center. The outcome was astonishing, as patients showed their willingness to go through extra/additional examinations for to partake in clinical studies, and the research team considered the study crucial for generation of vital information, gathered on from patients, for increased level of targeted therapy.

The in general tendency/willingness of patients to go through study-required tests/examinations were high, as they showed willingness for all sort of tests/examinations: diagnostic imaging (Ultrasound, X-Rays, PET, CT scans etc.), blood-urine, but most of them did not show their interest for MRI and skin/tumor biopsies, with only few exceptions that went through one-and-two tumor biopsy specimens. Research team considered this a vital thing, as it paved them a direction for to fabricate clinical studies for to ask patients to go for additional tumor diagnostic test/biopsies, but on the same the team even understands that they need to cautiously judge of total biopsies that were being requested, and of the molecular tests/examinations they decide to carry on with the tumor specimen. The clinical research study even threw light on previous negative experiences and hassles the patients had on more insidious/invasive tests (skin biopsies etc.) as the patients were found not willing to undergo such tests/examinations again; on the other, there were some patients that had insurance coverage and other benefits, which extended over their readiness for such tests/examinations.

Research team believes the results would serve well for further expedition over to fabricate patient-friendly biomarkers for cancer clinical studies, to go up for similar type of patient-specific medical research/study to educate and communicate over patients about treatment, to attain objectives of clinical research.