Brown fat uptake of 18F-FDG on dual time point PET/CT imaging.

The aim of this report was to assess the changes in the 18F-fluorodeoxyglucose (18F-FDG) uptake of brown fats on integrated positron emission tomography/computed tomography (PET/ CT) imaging. The patient presented with an enlargement of the neck lymph nodes, and was suspicious for tuberculous lymphadenitis. A whole body PET/CT imaging was performed, followed by a delayed imaging of the neck and thoracic regions. A visually increased 18F-FDG uptake was taken as a positive finding. A semi-quantitative evaluation was performed using a maximum standardised uptake value (SUVmax) with a cut-off value above 2.5. There were a number of 18F-FDG avid activity areas seen at the supraclavicular, mediastinal, paravertebral and perirenal regions. These are in keeping with the physiological 18F-FDG uptake in brown fat. The differences in SUVmax between the two scans ranged from -20 percent to +20 percent. Based on our observation, dual time point imaging may not be a reliable method for assessing the 18F-FDG uptake of brown fat

The comparison of serial SPECT-CT imaging to estimate absorbed dose to the organ at risk from peptide receptor radionuclide therapy dosimetry

Introduction: In Peptide Receptor Radionuclide Therapy (PRRT), the administration of radionuclide such as Lu-177 label with a pharmaceutical agent useful to destroy the lesion. The amount of Lu-177 radioactivity administered to the patients is still not standardize and generally not more than 7.4 GBq per session due to the patient’s safety issues. The first cycle of Lu-177 is an excellent technique to estimate radionuclide uptake for organs at risk. This study aims to simplify five SPECT-CT scanning points into less scanning points to estimate absorbed dose to the organ at risk. Methods: Ten patients who have neuroendocrine tumors enrolled in 177Lu-Dotatate therapy dosimetry. The serial SPECT-CT done after 2, 4, 24, 48 and 72 hours to acquired time disintegration for organ at risk. Partik’s categorical grading criteria is relevantly used in this study to convert the numeric value of Lin’s concordance coefficient into an ordinal scale. Results: Our current result demonstrated an excellent agreement between three and five scanning with LSA exponential fit method. These excellent results presented for kidney, liver and spleen. However, the bladder shows poor results due to the urinary system. Conclusion: Three data point of SPECT-CT images is the best option to estimate absorbed dose to the lesion and organ at risk for 177Lu-Dotatate dosimetry technique

PET-CT in esophageal cancer management: a cost effectiveness analysis study

The present investigation dealt with the assessment of clinicians perceived views on the impact of PET-CT in esophageal cancer management from practicality, clinical efficacy and cost –effectiveness point of views. Reviews on publication and retrospective data to develop and carry out a decision-making model-based economic evaluation to investigate the relative cost-effectiveness of PET/CT in esophageal cancer management staging compared with conventional pathway. Clinicians identified from patient medical records were included in the survey. Retrospective analysis of patient data from 2001-2008 was taken from esophageal cancer patient medical records and North West Cancer Intelligence Services (NWCIS) database. A decision tree was developed using TREEAGE software. The results of the cost-effectiveness analysis were presented in terms of the incremental cost-effectiveness ratios (I-CERs). PET compared with conventional work-up results for ICER for the strategy estimated at £28,460 per QALY; PET/CT compared with PET for ICER was £ 32,590 per QALY; and the ICER for PET/CT combined with conventional work-up versus PET/CT was £ 44,118. The package became more expensive with each additional diagnostic test added to PET and more effective in terms of QALYs gained. The conventional work-up was the preferred options as probabilistic sensitivity analysis showed at a willingness-to-pay threshold of £ 20,000 per QALY. Result of the current analysis suggested that the use of PET/CT in the diagnosis of esophageal cancer was unlikely to be cost-effective given the current willingness-to-pay thresholds that were accepted in the United Kingdom by decision-making bodies such as the National Institute for Health and Clinical Excellence

Assessing Idiopathic Scoliosis Knowledge Levels Among Malaysian Physiotherapists and Associating Their Clinical Experience

Physiotherapists play a significant role in the conservative management of idiopathic scoliosis (IS) patients. This study aimed to determine the level of knowledge on IS among practising physiotherapists and the association between years of clinical experience and the level of knowledge. A total of 63 physiotherapists responded to the International Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SORSOT) questionnaire. The findings demonstrated that the level of knowledge among the physiotherapists was poor, particularly regarding the prevalence, diagnosis, and treatment of IS. There was a significant association between years of clinical experience and the level of knowledge

Prenatal ultrasound heating impacts on fluctuations in haematological analysis of Oryctolagus cuniculus

Prenatal Ultrasound (US) is commonly used as a routine procedure on pregnant women. It is generally perceived as a safe procedure due to the use of non-ionizing radiation. However, the neurotoxicity of diagnostic prenatal US was detected to have a correlation with high susceptibility to early developing fetus. This research involved in vivo experimental model by using 3rd trimester pregnant Oryctolagus cuniculus and exposing them to US exposures for 30, 60, and 90 minutes at their gestational day (GD) 28-29. The output power and intensities, spatial peak temporal average intensity (ISPTA) of US were varied from 0.4 to 0.7 W and 0.13 to 0.19 W/cm2 respectively were tested initially in free-field, water. Haematological analysis was carried out to detect any changes in blood constituents. Statistically significant differences were detected in red blood cell (RBC) count (P<0.001), haemoglobin (Hb) concentration (P<0.001) and also platelet (PLT) count (P<0.001) in newborn of Oryctolagus cuniculus. These findings indicate the possibility of US heating in causing defects on studied animal

Quantifying the effects of iodine contrast media on standardised uptake values of FDG PET/CT images : an anthropomorphic phantom study.

This study aimed to quantify the amount of change in Standardised Uptake Values (SUVs) of PET/CT images by simulating the set-up as closely as possible to the actual patient scanning. The experiments were conducted using an anthropomorphic phantom, which contained an amount of radioactivity in the form of Fluorodeoxyglucose (FDG) in a primary plastic test tube and one litre saline bags, including the insertion of bony structures and another two test tubes containing different concentrations of iodine contrast media. Standard scanning protocols were employed for the PET/CT image acquisition. The highest absolute differences in the SUVmax and SUVmean values of the saline bags were found to be about 0.2 and 0.4, respectively. The primary test tube showed the largest change of 1.5 in both SUVs; SUV max and SUVmean. However, none of these changes were found to be statistically significant. The clinical literature also contains no evidence to suggest that the changes of this magnitude would change the final diagnosis. Based on these preliminary data, we propose that iodine contrast media can be used during the CT scan of PET/CT imaging, without significantly affecting the diagnostic quality of this integrated imaging modality

Ergonomic Intervention Practice at the Workplace in Asian boundary: A systematic review

Work-related musculoskeletal disorders (WRMSDs) are considered occupational diseases that can cause extreme discomfort and impairment. Due to the high prevalence of WRMSDs in Asia, ergonomic intervention has become particularly important and received growing interest among scholars. This review aims to classify ergonomic intervention practices for better musculoskeletal health at workplaces in Asian countries. PRISMA was chosen to review 22 recently published ergonomic intervention studies obtained from the Scopus and WoS databases. The findings revealed three main approaches for ergonomic intervention: application of devices or tools (seven articles), administrative approach (seven articles), and a combination of both (eight articles).

Evaluation of healthcare science student learning styles based VARK analysis technique

This study aimed to evaluate the learning styles among healthcare students and to study the relationship with their academic achievement. This cross-sectional study was conducted among 137 healthcare students from six different courses. Data was collected using a self-administered questionnaire and developed based on the original visual, aural/auditory, read/write, and kinesthetic (VARK) assessment. The questionnaire was divided into two sections: the demographic status and the learning style perspective. A total of 119 respondents (86.8%) has chosen unimodal as their learning styles, while the rest of the 18 respondents (13.2%) choose multimodal as their preferred learning method. Among the unimodal learning styles, visual (32%) and reading (26%) were most preferred among respondents. The auditory and kinesthetic methods of learning were less and accounted for 10% to 20%. Notably, in multimodal learning styles preferences, 4% of students prefer a combination learning style of visual and kinesthetic methods. There was no significant relationship between learning styles and academic achievement using Pearson’s Chi-square test (p>0.05). Hence, both were independent of one another. Hence, some of the dominant learning styles needed to be considered based on their future profession

Structural, mechanical, and dielectric properties of polydimethylsiloxane and silicone elastomer for the fabrication of clinical-grade kidney phantom

This study aimed to introduce an alternative, inexpensive, and straightforward polymer with specific mechanical and dielectric properties suitable for the fabrication of a clinical-grade kidney phantom. Two polymer-based phantom materials, polydimethylsiloxane (PDMS) and silicone elastomer (SE), were investigated for their capability to meet the requirements. The concentration ratios of base to curing agent (B/C) were 9.5/1.5, 19/3, 10/1, 20/2, 10.5/0.5, and 21/1 for PDMS and 4.5/5.5, 10/12, 5/5, 11/11, 5.5/4.5, and 12/10 for SE. All samples were mixed, degassed, and poured into Petri dishes and small beakers. The polymer was cured under room temperature for 2 h and then demolded from the hard mold. The air bubbles produced were removed using a vacuum desiccator for 30 min. All samples underwent mechanical testing (tensile strength and elastic modulus), and their dielectric properties were measured using a dielectric probe kit equipped with 85071E materials measurement software. The radiation attenuation properties were also measured using PhyX-Zetra for PDMS phantoms with the chemical formula C2H6OSi. Small changes in base and cross-linker play an essential role in modifying the elastic modulus and tensile strength. The effective atomic number of PDMS showed a similar pattern with human kidney tissue at the intermediate energy level of 1.50 × 10−1 to 1 MeV. Therefore, PDMS can potentially be used to mimic the human kidney in terms of tensile strength, flexibility, the acceptable real part of the complex dielectric constant ε′r, and conductivity, which allows it to be used as a stable kidney phantom for medical imaging purposes

Proton magnetic resonance spectroscopy (¹H-MRS) of human skeletal muscle at 1.5 Tesla: potential applications in exercise - a pilot study

This research study aimed to evaluate metabolites in human skeletal muscles pre- and post-exercise non-invasively via proton magnetic resonance spectroscopy (¹H-MRS). The upper legs of 6 lightly active male subjects underwent imaging pre- and post-exercise via 1.5 T MRI (TR/TE = 3500ms/100ms, FOV = 20cm, slice thickness = 6mm) and ¹H-MRS (TR/TE = 2000ms/31ms, VOI = 20mm x 20mm x 35mm). The researchers measured the pre- and post-exercise metabolic readings (NAA, CHO, and Cr metabolites) for the vastus lateralis and semitendinosus muscles. A paired t-test was performed. In the vastus lateralis muscle, NAA, CHO, and Cr metabolites values decreased with no significant difference after the exercise. Similarly, in the semitendinosus muscle, NAA, CHO, and Cr metabolites values were also decreased with CHO (p<0.02) and Cr (p<0.01) showed the significant difference after the exercise. Evaluating human skeletal muscles via ¹H-MRS at 1.5 T is feasible