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Nuclear Medicine Review. Central & Eastern Europe

Ildikó Garai, Sandor Barna, Gabor Nagy, Attila Forgacs
Tektrotyd kit was developed by Polatom company for 99mTc labeling to make an alternative tracer of somatostatin receptor scintigraphy available. Since 2005, 99mTc-EDDA/HYNIC-Tyr3-Octreotide has been used in clinical imaging and achieved high impact in management of patients with neuroendocrine tumors. Knowing the limitations and pitfalls is essential to provide ac-curate diagnosis. Therefore, the potential pitfalls associated with the use of 99mTc-EDDA/HYNIC-TOC are reviewed on the basis of own experience. Data were analyzed of 310 patients who underwent somatostatin receptor scintigraphy with 99mTc-Tektrotyd...
2016: Nuclear Medicine Review. Central & Eastern Europe
Dorota Madrzak, Renata Mikołajczak, Grzegorz Kamiński
BACKGROUND: The aim of this study was the assessment of utility of somatostatin receptor scintigraphy (SRS) by SPECT imaging using 99mTc-EDDA/HYNIC-Tyr3-octreotide (99mTc-EDDA/HYNIC-TOC) in patients with neuroendocrine neoplasm (NEN) or suspected NEN, referred to Nuclear Medicine Dept. of Voivodship Specialty Center in Rzeszow. The selected group of patients was referred also to 68Ga PET/CT. The posed question was the ratio of patients for whom PET/CT with 68Ga would change their management...
2016: Nuclear Medicine Review. Central & Eastern Europe
Sonya Sergieva, Bozhil Robev, Milena Dimcheva, Albena Fakirova, Radka Hristoskova
Neuroendocrine tumors (NETs) of the thorax including bronchial and thymic tumors belong to foregut NETs. Limited loco-regional thoracic NETs can be resected with surgery, but in extensive metastatic disease the treatment is mainly palliative. A high incidence and density of somatostatin receptors (SSTR2, SSTR3, and SSTR5) are found in thoracic NETs. The purpose of this study was to evaluate the role of SPECT-CT somatostatin receptor scintigraphy (SRS) with 99mTc-Tektrotyd for imaging, staging and follow up of patients with bronchial and thymic neuroendocrine tumors...
2016: Nuclear Medicine Review. Central & Eastern Europe
Mate Trogrlic, Stanko Tezak
BACKGROUND: Aim of this study was to determine the value of technetium-99m-hydrazinonicotinyl-Tyr3-octreotide (99mTc-ED-DA/HYNIC-TOC) in patients with somatostatin receptor (SSR) positive tumors of head and neck region. MATERIAL AND METHODS: A total number of 16 patients were enrolled in this study. Planar whole body (WB) and single photon emission computed tomography (SPECT) images were acquired at 2 and 4 hours after the injection of approximately 670 MBq of 99mTc-EDDA/HYNIC-TOC...
2016: Nuclear Medicine Review. Central & Eastern Europe
Rafał Czepczyński, Maria Gryczyńska, Marek Ruchała
BACKGROUND: In majority of cases of differentiated thyroid carcinoma (DTC), the ablative radioiodine treatment shows high efficacy. In a small number of patients, mechanism of selective iodine uptake by the DTC cells is insufficient and alternative methods of diagnosis and treatment are needed. As demonstrated in vitro, DTC cells show expression of somatostatin recep-tors. Radiolabeled somatostatin analogs are widely used in the diagnosis of neuroendocrine tumors. The aim of the study was to evaluate the utility of peptide receptor scintigraphy with the use of 99mTc-EDDA/HYNIC-TOC in the diagnosis of DTC in patients with elevated thyroglobulin concentrations (Tg), negative WBS and no effect of the consecutive radioiodine therapies...
2016: Nuclear Medicine Review. Central & Eastern Europe
Renata Mikołajczak, Helmut R Maecke
The aim of this review is to summarize the developments and briefly characterize the somatostatin analogs which are currently used for somatostatin receptor imaging in clinical routine or in early phase clinical trials. Somatostatin (sst) receptor targeting with radiolabeled peptides has become an integral part in nuclear oncology during the last 20 years. This integration process has been initiated in Europe with the introduction to the market of 111In-DTPA-DPhe1-octreotide [111In-pentetreotide]. Introducing 99mTc in somatostatin receptor targeting radiopeptides resulted in much better image quality, higher sensitivity of tumor detection and lower mean effective dose for the examined patient...
2016: Nuclear Medicine Review. Central & Eastern Europe
Marta Opalińska, Alicja Hubalewska-Dydejczyk, Anna Sowa-Staszczak, Agnieszka Stefańska
Detection of neuroendocrine neoplasms (NENs) and monitoring of their response to therapy is still challenging due to huge heterogeneity of that group of tumors. Actually, NENs visualization is mainly based on molecular imaging while in the past it was relied on less effective structural imaging including CT and MRI. Molecular imaging techniques in combination with structural imaging (hybrid imaging), especially in patients with well-differentiated NENs, in addition to morphological provide the functional information about tumor which benefits in a more accurate patient management, including more sensitive visualization of primary tumors, more precise staging and better therapy follow-up...
2016: Nuclear Medicine Review. Central & Eastern Europe
Jerzy Hankus, Romana Tomaszewska
Neuroendocrine neoplasms (NENs) show wide spectrum of clinical course - from benign biological potential to recurrences and rapidly progressive disease. Somatostatin analogs that bind to somatostatin receptor are part of the therapy; detection and evaluation of activation of somatostatin receptor subtypes are part of the process of new therapy induction. When using RT-PCR method and immunohistochemistry, it is possible to detect more than two SSTR subtypes in majority or all neuroendo-crine neoplasms regardless tumor origin...
2016: Nuclear Medicine Review. Central & Eastern Europe
Barbara Janota, Urszula Karczmarczyk, Ewa Laszuk, Piotr Garnuszek, Renata Mikołajczak
BACKGROUND: Preliminary clinical evaluation of 99mTc-EDDA/HYNIC-Met14-Exendin-4 showed that the complex offers new diagnostic possibilities for insulinoma and MTC. Exendin-4 contains methionine at position 14 in the amino acid chain, which may be oxidized to methionine sulfoxide and, from the pharmaceutical point of view, the oxidized moiety becomes an undesired impurity in the final radioactive preparation. Therefore, the aim of this study was to investigate the influence of commonly used methods to eliminate the effect of methionine oxidation in peptides, i...
2016: Nuclear Medicine Review. Central & Eastern Europe
Vera Artiko, Aida Afgan, Jelena Petrović, Branislava Radović, Nebojša Petrović, Marina Vlajković, Dragana Šobić-Šaranović, Vladimir Obradović
BACKGROUND: This paper is the short review of our preliminary results obtained with 99mTc-EDDA/HYNIC-TOC. MATERIAL AND METHODS: The total of 495 patients with different neuroendocrine tumors were investigated during last few years. RESULTS: There have been 334 true positive (TP), 73 true negative (TN), 6 false positive (FP) and 82 false negative findings (FN). Diagnosis was made according to SPECT findings in 122 patients (25%). The mean T/NT ratio for TP cases was significantly higher (p < 0...
2016: Nuclear Medicine Review. Central & Eastern Europe
Alicja Sałyga, Izabela Guzikowska-Ruszkowska, Rafał Czepczyński, Marek Ruchała
INTRODUCTION: The combination of positron emission tomography (PET) and magnetic resonance (MR) has become a subject of interest for researchers in the recent several years. Positron emission tomography in combination with magnetic resonance (PET/MR) is the most recent imaging technique classified in the so called hybrid systems category. AIM: This review briefly discusses the development history of PET/MR scanners, the principle of their operation, of tandem systems, as well as fully integrated devices...
2016: Nuclear Medicine Review. Central & Eastern Europe
Beata Ewa Chrapko, Marek Chrapko, Anna Nocuń, Bogusław Stefaniak, Tomasz Zubilewicz, Andrzej Drop
This review article discusses the utility of 18F-FDG PET/CT in diagnosis and management of vascular disease. We stress usefulness of this method in large vessel inflammation and infection. In our work we based on the literature analysis and clinical cases diagnosed in our institution by use of 18F-FDG PET/CT. The literature exploration was focusing on vascular inflammation and infections and 18-FDG PET. The search was performed on PubMed database and cross referencing. We present the practical review with several images of vascular diseases like: Takayasu arteritis, giant cell arteritis, vascular graft infections, abdominal aortic aneurysm infections and cases of aortitis and periaortitis...
2016: Nuclear Medicine Review. Central & Eastern Europe
Zhivka Dancheva, Pavel Bochev, Borislav Chaushev, Tsvetelina Yordanova, Aneliya Klisarova
BACKGROUND: Sarcomas comprise 1% of malignant tumors in adults but represent a significant diagnostic and therapeutic challenge. Molecular imaging with ¹⁸FDG PET/CT is a powerful modality in oncology. Its use for initial assessment, evaluation of response to therapy and recurrent disease in most tumors is essential for therapeutic decisions. Its indication in sarcomas is still controversial. One of the indications for PET/CT in sarcomas is detection of recurrences. Nowadays magnetic resonance tomography (MRT) has a crucial role in identification of local recurrences in soft tissue and bone sarcoma...
2016: Nuclear Medicine Review. Central & Eastern Europe
Nikolai Raikov, Boyan Nonchev, Borislav Chaushev, Diyana Vjagova, Svetoslav Todorov, Yana Bocheva, Daniela Malceva, Snejinka Vicheva, Asyia Raikova, Antoaneta Argatska, Miroslav Raikov
The main diagnostic tool for toxic adenomas (TA) is radionuclide imaging indicated in patients with evidence of thyroid nodules in combination with thyrotoxic syndrome. Thyroid ultrasound and fine-needle aspiration biopsy (FNAB) are widely used for the valuation of thyroid masses. There is no literature data concerning the utility of FNAB and related tests for the diagnosis of hyperfunctioning thyroid nodules. The purpose of this study is to determine the levels of free thyroxine (FT4) in the needle washout after FNAB of hot thyroid nodules...
2016: Nuclear Medicine Review. Central & Eastern Europe
Daniela Chroustová, Jirí Trnka, Veřa Šírová, Ivana Urbanová, Jan Langer, Jozef Kubinyi
BACKGROUND: Validation of the 99mTc-DMSA planar scintigraphy accuracy for split renal function assessment and comparison with evaluation based on SPECT imaging both with and without CT attenuation correction. MATERIALS AND METHODS: For split renal function assessment two methods were used: A) planar scintigraphy based on anterior and posterior projections using correction for kidney depth calculated by the geometric mean; B) semi-quantitative evaluation based on SPECT (B1) and attenuation-corrected SPECT/CT (B2) images using locally developed software for kidney segmentation and voxel-based analysis...
2016: Nuclear Medicine Review. Central & Eastern Europe
Małgorzata Natalia Mojsak, Saeid Abdelrazek, Piotr Szumowski, Franciszek Rogowski, Monika Sykała, Jerzy Kostecki, Agnieszka Kociura-Sawicka, Dorota Jurgilewicz, Janusz Myśliwiec
BACKGROUND: Radioiodine therapy (RIT) in patients with large nontoxic multinodular goiter (MNG) recently becomes more common method in comparison to surgery (especially in elderly patients and with contraindications because of severe chronic diseases other systems). Repeatedly low thyroid radioactive iodine uptake (RAIU) decreases effectiveness of RIT or makes it impossible. The recombinant human thyrotropin can increase RAIU and improve the results of RIT. THE AIM OF THE STUDY: was to assess the influence of a single very low dose (0...
2016: Nuclear Medicine Review. Central & Eastern Europe
Małgorzata Iwona Kobylecka, Adam Bajera, Katarzyna Fronczewska-Wieniawska, Joanna Mączewska, Maria Teresa Płazińska, Leszek Królicki
There is no controversy in the published literature that sensitivity and specificity of parathyroid scintigraphy is superior to other imaging techniques. However no uniform protocol has been established for scintigraphy. In order to analyze parathyroid scintigraphic images in the Department of Nuclear Medicine at the Medical University of Warsaw we have developed a program that allows qualitative and quantitative evaluation of recorded images and motion artifacts correction. This program offers a uniform procedure of analysis of parathyroid imaging results in diagnostic centers, accelerates the analysis of parathyroid tests performed with use of single radioactive tracer, that require the acquisition of consecutive images of the patient, without altering his body position between successive stages of registration...
2016: Nuclear Medicine Review. Central & Eastern Europe
Bartosz Szymanowski, Renata Duchnowska, Marek Bilski, Grażyna Łapińska, Beata Hryciuk, Grzegorz Kamiński, Cezary Szczylik
We are reporting a case of a 55-year-old woman who was diagnosed as having a non-functioning pancreatic neuroendocrine neoplasm (NF-PNEN), the World Health Organization (WHO) low grade (G1) with liver metastases. In the staging process the positron emission tomography - computed tomography with Fluorine-18-Fluorodeoxyglucose (F-FDG PET-CT) and spiral CT then the gallium-DOTA-octreotate positron emission tomography - computer tomography (⁶⁸Ga-DOTATATE PET-CT) shown difference in burden of disease. In first line therapy, everolimus (Afinitor®, Novartis Pharma GmbH, Germany) at the oral dose of 10 mg once daily and octreotide long-acting release (Sandostatin LAR®) 30 mg i...
2016: Nuclear Medicine Review. Central & Eastern Europe
Ewa Witkowska-Patena, Andrzej Mazurek, Mirosław Dziuk
A 29-year-old patient after blunt chest trauma with right lung atelectasis and pulmonary empyema was referred for lung ventilation and perfusion scintigraphy before right-sided pneumonectomy. Radionuclide imaging revealed severely reduced perfusion and lack of ventilation in the collapsed right lung. Additionally, it showed a matching lobar perfusion-ventilation defect in the lower left lobe, which, apart from consolidation area in posterior basal segment, appeared normal in computed tomography. A normal perfusion and ventilation pattern was observed in the upper left lobe...
2016: Nuclear Medicine Review. Central & Eastern Europe
Aleksandra Joanna Pyzik, Beata Matyjaszek-Matuszek, Agnieszka Zwolak, Beata Chrapko, Dawid Pyzik, Katarzyna Strawa-Zakościelna
Parathyroid cancer is a rare disorder of unclear etiology that is difficult to diagnose and treat. It is most often diagnosed incidentally based on multi-organ non-specific symptoms of hypercalcemia as a consequence of parathyroid hormone oversecretion. We present a case of a male with primary hyperparathyroidism who was diagnosed with parathyroid cancer ectopically located in the mediastinum only after the third surgery. However, due to chronic hypercalcemia, problems with localization and a bad clinical condition, the patient was not able to undergo a radical resection and one year after the first pathological fracture died...
2016: Nuclear Medicine Review. Central & Eastern Europe
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