The relation between cardiac 123I-mIBG scintigraphy and functional response 1 year after CRT implantation

Cardiac resynchronization therapy (CRT) is a disease-modifying therapy in patients with chronic heart failure (CHF). Current guidelines ascribe CRT eligibility on three parameters only: left ventricular ejection fraction (LVEF), QRS duration, and New York Heart Association (NYHA) functional class. However, one-third of CHF patients does not benefit from CRT. This study evaluated whether 123I-meta-iodobenzylguanidine (123I-mIBG) assessed cardiac sympathetic activity could optimize CRT patient selection

Comparison of the imaging performances for recently developed monolithic scintillators: CRY018 and CRY019 for dual isotope gamma ray imaging applications

The growing interest for new scintillation crystals with outstanding imaging performances (i.e. resolution and efficiency) has suggested the study of recently discovered scintillators named CRY018 and CRY019. The crystals under investigation are monolithic and have shown enhanced characteristics both for gamma ray spectrometry and for Nuclear Medicine imaging applications such as the dual isotope imaging. Moreover, the non-hygroscopic nature and the absence of afterglow make these scintillators even more attractive for the potential improvement in a wide range of applications. These scintillation crystals show a high energy resolution in the energy range involved in Nuclear Medicine, allowing the discrimination between very close energy values. Moreover, in order to prove their suitability of being powerful imaging systems, the imaging performances like the position linearity and the intrinsic spatial resolution have been evaluated obtaining satisfactory results thanks to the implementation of an optimized algorithm for the images reconstruction. © 2017 IOP Publishing Ltd and Sissa Medialab srl

Role of PET gamma detection in radioguided surgery: a systematic review

Purpose This systematic review aimed to collect published studies concerning intraoperative gamma detection of positronemitting tracers for radioguided surgery (RGS) applications. Methods A systematic literature search of studies published until October 2022 was performed in Pubmed, Web Of Science, Central (Cochrane Library) and Scopus databases, including the following keywords: “Positron Emission Tomography” OR “PET” AND “Gamma” OR “γ” AND “Probe” AND “Radioguided Surgery” OR “RGS”. The included studies had to concern RGS procedures performed in at least 3 patients, regardless of the administered radiopharmaceutical and the field of application. Results Among to the 17 selected studies, all published between 2000 and 2022, only 2 investigations were conducted with gallium-68 (68Ga)-labeled somatostatin analogues, with fluorine-18-fluoro-2-deoxyglucose ([ 18F]FDG) being the most commonly used agent for RGS applications. Almost all studies were performed in oncologic patients, with only one paper also including inflammatory and infectious findings. The analysis showed that the largest part of procedures was performed through the intraoperative use of conventional gamma probes, not specifically designed for the detection of annihilation photons (n = 9), followed by PET gamma probes (n = 5) and with only three studies involving electronic collimation. Conclusions Regardless of the intraoperative devices, RGS with positron emitters seems to lead to significant improvements in surgeons’ ability to obtain a complete resection of tumors, even if the nature of photons resulting from positron–electron collision still remains extremely challenging and requires further technical advances

18F-fluorodeoxyglucose (18F-FDG) functionalized gold nanoparticles (GNPs) for plasmonic photothermal ablation of cancer. A review

The meeting and merging between innovative nanotechnological systems, such as nanoparticles, and the persistent need to outperform diagnostic-therapeutic approaches to fighting cancer are revolutionizing the medical research scenario, leading us into the world of nanomedicine. Photothermal therapy (PTT) is a non-invasive thermo-ablative treatment in which cellular hyperthermia is generated through the interaction of near-infrared light with light-to-heat converter entities, such as gold nanoparticles (GNPs). GNPs have great potential to improve recovery time, cure complexity, and time spent on the treatment of specific types of cancer. The development of gold nanostructures for photothermal efficacy and target selectivity ensures effective and deep tissue-penetrating PTT with fewer worries about adverse effects from nonspecific distributions. Regardless of the thriving research recorded in the last decade regarding the multiple biomedical applications of nanoparticles and, in particular, their conjugation with drugs, few works have been completed regarding the possibility of combining GNPs with the cancer-targeted pharmaceutical fluorodeoxyglucose (FDG). This review aims to provide an actual scenario on the application of functionalized GNP-mediated PTT for cancer ablation purposes, regarding the opportunity given by the 18F-fluorodeoxyglucose (18F-FDG) functionalization

Innovative LuYAP:Ce array for PET imaging

We present an imaging characterization of a 10 x 10 LuYAP array (2 x 2 x 10 mm3 pixels) with an innovative dielectric coating insulation (0.015 mm thick), in view of its possible use in a gamma camera for imaging positron emission tomography (PET) or in similar applications, e.g. as γ-prompt detector in hadron therapy. The particular assembly of this array was realized in order to obtain a packing fraction of 98%, improving detection efficiency and light collection. For imaging purpose, the array has been coupled with a selected Hamamatsu H10966-100 Multi Anode Photomultiplier read out by a customized 64 independent channels electronics. This tube presents a superbialkali photocathode with 38% of quantum efficiency, permitting to enhance energy resolution and consequently image quality. A pixel identification of about 0.5 mm at 662 keV was obtained, highlighting the potentiality of this detector in PET application

Somatostatin receptor PET/CT imaging for the detection and staging of pancreatic NET. A systematic review and meta-analysis

We investigated the diagnostic performance of Somatostatin Receptor Positron Emission Tomography/Computed Tomography (SSR-PET/CT) for the detection of primary lesion and initial staging of pancreatic neuroendocrine tumors (pNETs). A comprehensive literature search up to January 2020 was performed selecting studies in presence of: sample size ≥10 patients; index test (i.e., 68Ga-DOTATOC or 68Ga-DOTANOC or 68Ga-DOTATATE PET/CT); and outcomes (i.e., detection rate (DR), true positive, true negative, false positive, and false-negative). The methodological quality was evaluated with QUADAS-2. Pooled DR and pooled sensitivity and specificity for the identification of the primary tumor were assessed by a patient-based and a lesion-based analysis. Thirty-eight studies were selected for the qualitative analysis, while 18 papers were included in the meta-analysis. The number of pNET patients ranged from 10 to 142, for a total of 1143 subjects. At patient-based analysis, the pooled sensitivity and specificity for the assessment of primary pNET were 79.6% (95% confidence interval (95%CI): 71–87%) and 95% (95%CI: 75–100%) with a heterogeneity of 59.6% and 51.5%, respectively. Pooled DR for the primary lesion was 81% (95%CI: 65–90%) and 92% (95%CI: 80–97%), respectively, at patient-based and lesion-based analysis. In conclusion, SSR-PET/CT has high DR and diagnostic performances for primary lesion and initial staging of pNETs

International impact of COVID-19 on the diagnosis of heart disease

Background: The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified. Objectives: The study sought to assess COVID-19's impact on global cardiovascular diagnostic procedural volumes and safety practices. Methods: The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained. Results: Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoracic echocardiography decreased by 59%, transesophageal echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p < 0.001 for each procedure). In multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower–middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and telehealth. Conclusions: COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world's economically challenged. Further study of cardiovascular outcomes and COVID-19–related changes in care delivery is warranted

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