Nuclear medicine training and practice in Turkey

WOS: 000398888000019PubMed ID: 28138746Nuclear medicine applications in Turkey started in the early 1950s, grew as an independent medical discipline and finally were recognized by the Ministry of Health in 1973. Later on, the professional organization of nuclear medicine physicians and other related professionals including radiopharmacists and technologists under the Turkish Society of Nuclear Medicine were established in 1975. Recently after completing more than a half century in Turkey, nuclear medicine has proved to be a strong and evolving medical field with more than 600 physicians serving for the changing needs of clinical practice throughout these years. This article describes past and present facts in this field and attempts to provide insights into the future which hopefully will be brighter than before

Comparison of clinical and PET-derived prognostic factors in patients with non-Hodgkin lymphoma: a special emphasis on bone marrow involvement

tuncel, murat/0000-0003-2352-3587WOS: 000536763500008PubMed: 32209829Objective in patients with non-Hodgkin lymphoma (NHL), we investigated F-18 FDG PET/computed tomography (CT) parameters, clinical findings, laboratory parameters, and bone marrow involvement (BMI) status for predictive methods in progression-free survival (PFS) and overall survival (OS), and whether F-18 FDG PET/CT could take the place of bone marrow biopsy (BMB). Methods the performance of F-18 FDG PET/CT (BMPET) was evaluated. the prognostic value of maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), stage, international prognostic index (IPI) score, IPI risk, lactate dehydrogenase (LDH), B2 microglobulin, Ki67 proliferation index, and the presence of BMI was evaluated for OS and PFS. Kaplan-Meier curves were drawn for each designated cutoff value, and 5-year PFS and 7-year OS were evaluated using log-rank analysis. Results the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of BMPET and BMB to identify BMI were 69, 100, 86.1, 80, 100%, and 81.6, 100, 92.5, 89, 100%, respectively. the sensitivity, specificity, PPV, NPV, and accuracy of BMPET in patients with Ki67- proliferation index >25% were all 100%. BMPET, IPI risk, MTV, and LDH were found to be independent prognostic predictors for PFS, whereas BMPET, SUVmax, and MTV for OS. Five-year PFS analysis estimated as follows: BMPET (+) = 22%, BMPET (-) = 80%, LDH 437 (U/L) = 51%, MTV 56 (cm(3)) = 49%, low IPI risk = 87%, intermediate IPI risk = 69%, high IPI risk = 25%. Seven-year OS analysis was found as: SUVmax 17.6 = 48%, MTV 56 (cm(3)) = 45.8%, BMPET (-) = 72.5%, BMPET (+) = 42%. Conclusion in the Ki-67 proliferation index > 25% group, F-18 FDG PET/CT was able to differentiate BMI independently from NHL subgroups. We recommend using this method with large patient groups. MTV and BMPET were independent prognostic indicators for OS and PFS and may help to determine high-risk patients

A Gamma-Distribution Convolution Model of 99Mtc-Mibi Thyroid Time-Activity Curves

Background The convolution approach to thyroid time-activity curve (TAC) data fitting with a gamma distribution convolution (GDC) TAC model following bolus intravenous injection is presented and applied to 99mTc-MIBI data. The GDC model is a convolution of two gamma distribution functions that simultaneously models the distribution and washout kinetics of the radiotracer., The GDC model was fitted to thyroid region of interest (ROI) TAC data from 1 min per frame 99mTc-MIBI image series for 90 min; GDC models were generated for three patients having left and right thyroid lobe and total thyroid ROIs, and were contrasted with washout-only models, i.e., less complete models. GDC model accuracy was tested using 10 Monte Carlo simulations for each clinical ROI. Results The nine clinical GDC models, obtained from least counting error of counting, exhibited corrected (for 6 parameters) fit errors ranging from 0.998% to 1.82%. The range of all thyroid mean residence times (MRTs) was 212 to 699 min, which from noise injected simulations of each case had an average coefficient of variation of 0.7% and a not statistically significant accuracy error of 0.5% (p = 0.5, 2-sample paired t test). The slowest MRT value (699 min) was from a single thyroid lobe with a tissue diagnosed parathyroid adenoma also seen on scanning as retained marker. The two total thyroid ROIs without substantial pathology had MRT values of 278 and 350 min overlapping a published 99mTc-MIBI thyroid MRT value. One combined value and four unrelated washout-only models were tested and exhibited R-squared values for MRT with the GDC, i.e., a more complete concentration model, ranging from 0.0183 to 0.9395. Conclusions The GDC models had a small enough TAC noise-image misregistration (0.8%) that they have a plausible use as simulations of thyroid activity for querying performance of other models such as washout models, for altered ROI size, noise, administered dose, and image framing rates. Indeed, of the four washout-only models tested, no single model approached the apparent accuracy of the GDC model using only 90 min of data. Ninety minutes is a long gamma-camera acquisition time for a patient, but a short a time for most kinetic models. Consequently, the results should be regarded as preliminary.PubMedWoSScopu

Snmmi Procedure Standard/Eanm Practice Guideline For Diuretic Renal Scintigraphy In Adults With Suspected Upper Urinary Tract Obstruction 1.0

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Guidance Document For Structured Reporting Of Diuresis Renography

This Guidance Document for structured reporting of diuresis renography in adults was developed by the International Scientific Committee of Radionuclides in Nephro-urology (ISCORN; http://www.iscorn.org). ISCORN chose diuresis renography for its first structured report Guidance Document because suspected obstruction is the most common reason for referral, most radionuclide renal studies are conducted at institutions that perform Fewer than 3 studies per week, and a large percentage of studies are interpreted by physicians with limited training in nuclear medicine. Ten panelists were asked to categorize specific reporting elements as essential, recommended, optional (without sufficient data to support a higher ranking), and unnecessary (does not contribute to scan interpretation or quality assurance). The final document was developed through an iterative series of comments and questionnaires with a majority vote required to place an element in a specific category. The Guidance Document recommends a reporting structure organized into indications, clinical history, study procedure, findings and impression and specifies the elements considered essential or recommended in each category. The Guidance Document is not intended to be restrictive but, rather, to provide a basic structure and rationale so that the diuresis renography report will: (1) communicate the results to the referring physician in a clear and concise manner designed to optimize patient care; (2) contain the essential elements required to evaluate and interpret the study; (3) clearly document the technical components of the study necessary for accountability, quality assurance and reimbursement; and (4) encourage clinical research by facilitating better comparison and extrapolation of results between institutions. Semin Nucl Med 42:41-48 (C) 2012 Published by Elsevier Inc.Wo