Clinical value of a combined multi-phase contrast enhanced DOPA-PET/CT in neuroendocrine tumours with emphasis on the diagnostic CT component

Objective: To assess the clinical value of multi-phase, contrast-enhanced DOPA-PET/CT with emphasis on the diagnostic CT component in patients with neuroendocrine tumours (NET). Methods: Sixty-five patients with NET underwent DOPA-cePET/CT. The DOPA-PET, multi-phase CT and combined DOPA cePET/CT data were evaluated and diagnostic accuracies compared. The value of ceCT in DOPA cePET/CT concerning lesion detection and therapeutic impact was evaluated. Sensitivities, specificities and accuracies were calculated. Histopathology and clinical follow-up served as the standard of reference. Differences were tested for statistical significance by McNemar's test. Results: In 40 patients metastatic and/or primary tumour lesions were detected. Lesion-based analysis for the DOPA-PET showed sensitivity, specificity and accuracy of 66%, 100% and 67%, for the ceCT data 85%, 71% and 85%, and for the combined DOPA cePET/CT data 97%, 71% and 96%. DOPA cePET/CT was significantly more accurate compared with dual-phase CT (p < 0.05) and PET alone (p < 0.05). Additional lesion detection was based on ceCT in 12 patients; three patients underwent significant therapeutic changes based on the ceCT findings. Conclusion: DOPA cePET/CT was significantly more accurate than DOPA-PET alone and ceCT alone. The CT component itself had a diagnostic impact in a small percentage but contributed to the therapeutic strategies in selected patient

Therapeutic impact of [18F]fluoride positron-emission tomography/computed tomography on patients with unclear foot pain

Purpose: To evaluate the therapeutic impact of [18F]fluoride positron-emission tomography/computed tomography ([18F]fluoride PET/CT) imaging on patients with unclear foot pain. Methods: Twenty-eight patients were prospectively included in this study. Therapeutic management was defined by two experienced dedicated foot surgeons before and after [18F]fluoride PET/CT imaging. Twenty-six patients underwent cross-sectional imaging [CT, magnetic resonance (MR)] prior to PET/CT. A retrospective analysis of the magnetic resonance imaging (MRI) diagnoses was performed when a therapy change occurred after PET/CT imaging. Results: In 13/28 (46%) patients therapeutic management was changed due to PET/CT results. Management changes occurred in patients with the following diagnoses: os trigonum syndrome; sinus tarsi syndrome; os tibiale externum syndrome; osteoarthritis of several joints; non-consolidated fragments; calcaneo-navicular coalition; plantar fasciitis; insertional tendinopathy; suggestion of periostitis; neoarticulations between metatarsal bones. Os trigonum, os tibiale externum, subtalar osteoarthritis and plantar fasciitis were only seen to be active on PET/CT images but not on MR images. Conclusion: [18F]fluoride PET/CT has a substantial therapeutic impact on management in patients with unclear foot pai

18F-Fluoride PET/CT for detection of sacroiliitis in ankylosing spondylitis

Purpose: The aim of this study was to evaluate the performance of 18F-fluoride-PET/CT (PET/CT) for the diagnosis of sacroiliac joint (SIJ) arthritis in patients with active ankylosing spondylitis (AS). Methods: Included in the study were 15 patients with AS according to the modified New York criteria (AS group) and with active disease and 13 patients with mechanical low back pain (MLBP; control group) who were investigated with whole-body 18F-fluoride PET/CT. The ratio of the uptake in the SIJ and that in the sacrum (SIJ/S) was calculated for every joint. Results: The mean SIJ/S ratio of 30 quantified joints in the AS group was 1.66 (range 1.10-3.07) with PET/CT, and the mean SIJ/S ratio of 26 quantified joints in the MLBP group was 1.12 (range 0.71-1.52). The area under the receiver operating characteristic curve for SIJ arthritis was 0.84. With plain radiography as a the gold standard and taking an SIJ/S ratio of >1.3 as the threshold, the sensitivity, specificity and accuracy on a per patient basis were 80%, 77% and 79%, respectively. On a per SIJ basis, the greatest sensitivity (94%) was found in grade 3 sacroiliitis (n = 16). Conclusion: Our results suggest that quantitative 18F-fluoride PET/CT may play a role in the diagnosis of sacroiliitis in active AS and is an alternative to conventional bone scintigraphy in times of molybdenum shortag

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Neuro-cognitive mechanisms of conscious and unconscious visual perception: From a plethora of phenomena to general principles

Psychological and neuroscience approaches have promoted much progress in elucidating the cognitive and neural mechanisms that underlie phenomenal visual awareness during the last decades. In this article, we provide an overview of the latest research investigating important phenomena in conscious and unconscious vision. We identify general principles to characterize conscious and unconscious visual perception, which may serve as important building blocks for a unified model to explain the plethora of findings. We argue that in particular the integration of principles from both conscious and unconscious vision is advantageous and provides critical constraints for developing adequate theoretical models. Based on the principles identified in our review, we outline essential components of a unified model of conscious and unconscious visual perception. We propose that awareness refers to consolidated visual representations, which are accessible to the entire brain and therefore globally available. However, visual awareness not only depends on consolidation within the visual system, but is additionally the result of a post-sensory gating process, which is mediated by higher-level cognitive control mechanisms. We further propose that amplification of visual representations by attentional sensitization is not exclusive to the domain of conscious perception, but also applies to visual stimuli, which remain unconscious. Conscious and unconscious processing modes are highly interdependent with influences in both directions. We therefore argue that exactly this interdependence renders a unified model of conscious and unconscious visual perception valuable. Computational modeling jointly with focused experimental research could lead to a better understanding of the plethora of empirical phenomena in consciousness research

Identification, characterization and suppression of side-products formed during the synthesis of high dose (68)Ga-DOTA-TATE

In the course of the establishment of (68)Ga-DOTA-TATE production for clinical use a shoulder comprising presumably several impurities was observed in the chromatogram of the analytical radio-HPLC. LC-MS/MS results support the hypothesis that some of these radioimpurities are radiolytic oxidation by-products of (68)Ga-DOTA-TATE. A new HPLC method was developed for quality control of (68)Ga-DOTA-TATE. Significant improvement on the radiochemical purity of (68)Ga-DOTA-TATE was achieved by the addition of ascorbic acid or ethanol to the reaction mixture

Additional file 1: of A new two-strip TLC method for the quality control of technetium-99m mercaptoacetyl-triglycine (99mTc-MAG3)

ESM_1. (XLSX 47 kb

Transporters involved in the hepatic uptake of (99m)Tc-mebrofenin and indocyanine green

The transporter specificity of (99m)Tc-mebrofenin and ICG partially overlaps as both compounds are transported by OATP1B3. (99m)Tc-mebrofenin is also taken up by OATP1B1, whereas ICG is additionally transported by NTCP