Interim FDG-PET Scan in Hodgkin's Lymphoma: Hopes and Caveats

FDG-PET has recently emerged as an important tool for the management of Hodgkins lymphoma. Although its use for initial staging and response evaluation at the end of treatment is well established, the place of interim PET for response assessment and subsequent treatment tailoring is still quite controversial. The use of interim PET after a few cycles of chemotherapy may allow treatment reduction for good responders, leading to lesser treatment toxicities as well as early treatment adaptation for bad responders with a potential higher chance for cure. Interpretation of interim PET is a rapidly moving field. Actually, visual interpretation is preferred over quantitative interpretation in this situation. The notion of minimal residual uptake emerged for faint persisting FDG uptake, but has evolved during the recent years. Guidelines using mediastinum and liver as references have been proposed at the expert meeting in Deauville 2009. Actually, several trials are ongoing both for localised and advanced disease to evaluate the FDG-PET potential for early treatment monitoring and tailoring. Until the results of these prospective randomized trials become available, treatment changes according to the interim PET results should remain inappropriate and limited to well-conducted clinical trials

Reduction in camera-specific variability in [123I]FP-CIT SPECT outcome measures by image reconstruction optimized for multisite settings: impact on age-dependence of the specific binding ratio in the ENC-DAT database of healthy controls

Purpose Quantitative estimates of dopamine transporter availability, determined with [123I]FP-CIT SPECT, depend on the SPECT equipment, including both hardware and (reconstruction) software, which limits their use in multicentre research and clinical routine. This study tested a dedicated reconstruction algorithm for its ability to reduce camera-specific intersubject variability in [123I]FP-CIT SPECT. The secondary aim was to evaluate binding in whole brain (excluding striatum) as a reference for quantitative analysis. Methods Of 73 healthy subjects from the European Normal Control Database of [123I]FP-CIT recruited at six centres, 70 aged between 20 and 82 years were included. SPECT images were reconstructed using the QSPECT software package which provides fully automated detection of the outer contour of the head, camera-specific correction for scatter and septal penetration by transmission-dependent convolution subtraction, iterative OSEMreconstruction including attenuation correction, and camera-specific Bto kBq/ml^ calibration. LINK and HERMES reconstruction were used for head-to-head comparison. The specific striatal [123I]FP-CIT binding ratio (SBR) was computed using the Southampton method with binding in the whole brain, occipital cortex or cerebellum as the reference. The correlation between SBR and age was used as the primary quality measure. Results The fraction of SBR variability explained by age was highest (1) with QSPECT, independently of the reference region, and (2) with whole brain as the reference, independently of the reconstruction algorithm. Conclusion QSPECT reconstruction appears to be useful for reduction of camera-specific intersubject variability of [123I]FP-CIT SPECT in multisite and single-site multicamera settings. Whole brain excluding striatal binding as the reference provides more stable quantitative estimates than occipital or cerebellar binding

Antibody-functionalized polymer-coated gold nanoparticles targeting cancer cells: an in vitro and in vivo study

Gold nanoparticles ( 3c5 nm) coated with plasma-polymerized allylamine were produced through plasma vapor deposition and bioconjugated with a monoclonal antibody targeting the epidermal growth factor receptor. The resulting nanoconjugates displayed an antibody loading of about 1.7 nmol mg -1 and efficiently target epidermal growth factor receptor overexpressing cell lines, as ascertained by ELISA and Western blot assays. The in vitro targeting properties were also confirmed in vivo, where a similar biodistribution profile of what was experienced for the unconjugated antibody was observed. Thanks to the possibility of doping the gold nanoparticles with radionuclides during plasma vapor deposition, the proposed functionalization strategy represents a very suitable platform for the in vivo cancer targeting with nanosized multifunctional particles. This journal is \ua9 2012 The Royal Society of Chemistry

Expert consensus document:Cholangiocarcinoma: current knowledge and future perspectives consensus statement from the European Network for the Study of Cholangiocarcinoma (ENS-CCA)

Cholangiocarcinoma (CCA) is a heterogeneous group of malignancies with features of biliary tract differentiation. CCA is the second most common primary liver tumour and the incidence is increasing worldwide. CCA has high mortality owing to its aggressiveness, late diagnosis and refractory nature. In May 2015, the "European Network for the Study of Cholangiocarcinoma" (ENS-CCA: www.enscca.org or www.cholangiocarcinoma.eu) was created to promote and boost international research collaboration on the study of CCA at basic, translational and clinical level. In this Consensus Statement, we aim to provide valuable information on classifications, pathological features, risk factors, cells of origin, genetic and epigenetic modifications and current therapies available for this cancer. Moreover, future directions on basic and clinical investigations and plans for the ENS-CCA are highlighted

Guidelines for brain radionuclide imaging - Perfusion Single Photon Computed Tomography (SPECT) using Tc-99m radiopharmaceuticals and brain metabolism Positron Emission Tomography (PET) using F-18 fluorodeoxyglucose

The purpose of these guidelines is to assist nuclear medicine practitioners in recommending, performing, interpreting, and reporting the results of brain perfusion SPECT studies using Tc-99m radiopharmaceuticals and brain metabolism PET studies using F-18 fluorodeoxyglucose (FDG). These guidelines have been adapted and extended from those produced by the Society, of Nuclear Medicine (Juni et al., 1998) and the European Association of Nuclear Medicine by, a Belgian group of experts in the field trained in neurology and/or nuclear medicine. Some indications are not universally approved (e.g. brain death), but largely, supported by the literature. They, have been included in these guidelines in order to provide recommendations and a standardised protoco

Monte Carlo Calculation of Radioimmunotherapy with 90Y-, 177Lu-, 131I-, 124I-, and 188Re-Nanoobjects: Choice of the Best Radionuclide for Solid Tumour Treatment by Using TCP and NTCP Concepts

Radioimmunotherapy has shown that the use of monoclonal antibodies combined with a radioisotope like 131I or 90Y still remains ineffective for solid and radioresistant tumour treatment. Previous simulations have revealed that an increase in the number of 90Y labelled to each antibody or nanoobject could be a solution to improve treatment output. It now seems important to assess the treatment output and toxicity when radionuclides such as 90Y, 177Lu, 131I, 124I, and 188Re are used. Tumour control probability (TCP) and normal tissue complication probability (NTCP) curves versus the number of radionuclides per nanoobject were computed with MCNPX to evaluate treatment efficacy for solid tumours and to predict the incidence of surrounding side effects. Analyses were carried out for two solid tumour sizes of 0.5 and 1.0 cm radius and for nanoobject (i.e., a radiolabelled antibody) distributed uniformly or nonuniformly throughout a solid tumour (e.g., Non-small-cell-lung cancer (NSCLC)). 90Y and 188Re are the best candidates for solid tumour treatment when only one radionuclide is coupled to one carrier. Furthermore, regardless of the radionuclide properties, high values of TCP can be reached without toxicity if the number of radionuclides per nanoobject increases

Guidelines for brain radionuclide imaging: perfusion single photon computed tomography (SPECT) using 99mTc radiopharmaceuticals and brain metabolism positron emission tomography (PET) using 18F fluorodeoxyglucose

The purpose of these guidelines is to assist nuclear medicine practitioners in recommending, performing, interpreting, and reporting the results of brain perfusion SPECT studies using Tc-99m radiopharmaceuticals and brain metabolism PET studies using F-18 fluorodeoxyglucose (FDG). These guidelines have been adapted and extended from those produced by the Society, of Nuclear Medicine (Juni et al., 1998) and the European Association of Nuclear Medicine by, a Belgian group of experts in the field trained in neurology and/or nuclear medicine. Some indications are not universally approved (e.g. brain death), but largely, supported by the literature. They, have been included in these guidelines in order to provide recommendations and a standardised protocol