Therapeutic Radiometals: Global Trends Analysis of Scientific Literature (2008 -2018)

Background-aim: Academic journals have published a large number of papers in the therapeutic NM research field in the last 10 years. Despite this, a literature analysis has never been made before to point out the research interest in therapeutic radionuclides (RNs). For this reason, the present study has the aim to specifically analyze the research output on therapeutic radiometals from 2008 (January) to 2018 (October) with the aim to quantify and identify the global trend of scientific literature and emphasize the interdisciplinary nature of this research field. Methods: The data search has been targeted on conventional (I-131, Y-90, Lu-177, Re-188, Re-186, Sm-153, Sr-89, Er-186) and emergent (Cu-67, Sc-47, Ra-223, Ho-166, Tb-161, Tb-149, Pb-212/Bi-212, Ac225, Bi-213, At-211, Sn-117) RNs. Authors, starting from this time frame data, have been quantitatively first, and qualitatively after, analyzed and interpreted the scientific trend of this topic. Bibliometric data have been exported from Scopus database and elaborated with Excel. The number of article, article in press, note, short survey, review and letter, have been divided per year and RN with the aim to make perceptible the trend of the last decade. Data have been categorized also in terms of Journal Subject Areas in order to bring out the multidisciplinary nature of the research in this field. Finally, for each publication, authors country provenience have been extrapolated and elaborated to map the global researcher interest and involvement of human and financial resources. Results: A total of 12.717 publications have been analyzed. 81.3% of the publications regards conventional RNs while 18.7% regards emergent RNs. The most investigated therapeutic RNs are I-131, Y-90, Lu-177 among conventional, Ra-223, followed by Sn-117, Bi213 and Ac-225 among emergent RNs. From the analysis, it is evident the multidisciplinary contribution to this field but in particular, as expected, in the case of conventional RN most publications comes from preclinical and clinical fields while for the emergents the contribution is unbalanced for Physics, Engineering, Material Science fields mainly focused on emergent RNs production studies. From the geographical point of view we can see how almost half of the total works have been published by European in both conventional and Clin Transl Imaging (2019) 7 (Suppl 1):S1–S138 S127 123 emergent RNs categories. It is also evident the high collaboration grade between countries characteristics in line with the multidisciplinarity of this medical sector. Moreover, we extrapolated a countries top 20 for each category. On the podium for the conventional RNs are USA, Germany and China, while for emergent RNs are USA, Germany, United Kingdom. And much more. Conclusions: From this analysis arise that the success of NM has been intimately linked to the availability of new RNs and the radiopharmaceuticals field is constantly evolving thanks to the contribution of specialists coming from different disciplines and the collaboration between countries. In recent years the focus of the research shifted on the field of emergent therapeutic radioisotope production and application, such as Cu-67, Sc-47, for the interest in new treatment strategies such as the theranostics personalized approach. Alpha emitters, in particular Ra-223 and Ac-225 are also gaining attention in particular in USA and Germany. Instead, among conventional radionuclides the research on Lu-177 is constantly growing

Impact of imaging protocol on left ventricular ejection fraction using gated-SPECT myocardial perfusion imaging

10noopenopenMarcassa, C; Giubbini, R.; Acampa, W.; Cittanti, C.; Djepaxhija, O.; Gimelli, A.; Kokomani, A.; Medolago, G.; Milan, E.; Sciagrà, R.Marcassa, C; Giubbini, Raffaele; Acampa, W.; Cittanti, C.; Djepaxhija, O.; Gimelli, A.; Kokomani, A.; Medolago, Giuseppe; Milan, E.; Sciagrà, R

PET-Derived Radiomics and Artificial Intelligence in Breast Cancer: A Systematic Review

Breast cancer (BC) is a heterogeneous malignancy that still represents the second cause of cancer-related death among women worldwide. Due to the heterogeneity of BC, the correct identification of valuable biomarkers able to predict tumor biology and the best treatment approaches are still far from clear. Although molecular imaging with positron emission tomography/computed tomography (PET/CT) has improved the characterization of BC, these methods are not free from drawbacks. In recent years, radiomics and artificial intelligence (AI) have been playing an important role in the detection of several features normally unseen by the human eye in medical images. The present review provides a summary of the current status of radiomics and AI in different clinical settings of BC. A systematic search of PubMed, Web of Science and Scopus was conducted, including all articles published in English that explored radiomics and AI analyses of PET/CT images in BC. Several studies have demonstrated the potential role of such new features for the staging and prognosis as well as the assessment of biological characteristics. Radiomics and AI features appear to be promising in different clinical settings of BC, although larger prospective trials are needed to confirm and to standardize this evidence

Radioligand therapy (RLT) as neoadjuvant treatment for inoperable pancreatic neuroendocrine tumors: a literature review

In the last 10 years, several literature reports supported radioligand therapy (RLT) in neoadjuvant settings for pancreatic neuroendocrine tumors (PanNETs). Indeed, primary tumor shrinkage has been frequently reported following RLT in unresectable or borderline resectable PanNETs. Moreover, RLT-induced intratumoral modifications facilitate surgery, both on primary tumor and metastasis, having a great impact on progression free survival (PFS), overall survival (OS) and quality of life (QoL). However, prospective controlled investigations are necessary to confirm preliminary data and to define the best RLT scheme and the ideal patient that, in a multidisciplinary approach, should be referred to neoadjuvant RLT

PSMA PET/CT in Castration-Resistant Prostate Cancer: Myth or Reality?

Background: prostate-specific membrane antigen (PSMA) ligand PET has been recently incorporated into international guidelines for several different indications in prostate cancer (PCa) patients. However, there are still some open questions regarding the role of PSMA ligand PET in castration-resistant prostate cancer (CRPC). The aim of this work is to assess the clinical value of PSMA ligand PET/CT in patients with CRPC. Results: PSMA ligand PET has demonstrated higher detection rates in comparison to conventional imaging and allows for a significant reduction in the number of M0 CRPC patients. However, its real impact on patients’ prognosis is still an open question. Moreover, in CRPC patients, PSMA ligand PET presents some sensitivity and specificity limitations. Due to its heterogeneity, CRPC may present a mosaic of neoplastic clones, some of which could be PSMA−/FDG+, or vice versa. Likewise, unspecific bone uptake (UBU) and second primary neoplasms (SNPs) overexpressing PSMA in the neoangiogenic vessels represent potential specificity issues. Integrated multi-tracer imaging (PSMA ligand and [18F]FDG PET) together with a multidisciplinary discussion could allow for reaching the most accurate evaluation of each patient from a precision medicine point of view

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Scintigrafia surrenalica

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Integrazione della medicina nucleare nella diagnostica di laboratorio

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Terapia adiuvante. Feocromocitoma maligno e neuroblastomi

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