124I PET: Pretherapeutic Staging, Detection of Recurrent Thyroid Cancer and Dosimetry

Radioiodine therapy (RIT) is an integral component in the treatment of differentiated thyroid cancer (DTC). Patients usually undergo RIT as initial therapy or later in the case of recurrent or persistent disease. The most important requirement for a successful RIT is the ability of metastases and thyroid (remnant) tissue to accumulate radioiodine. In order to calculate the achievable absorbed radiation dose for a lesion, volume and iodine kinetics in the lesion need to be determined. Pretherapeutic imaging and dosimetry with 124I PET provide the methodology to answer these questions

Experimental consolidation and absolute measurement of the nat C(p,x)11 C nuclear activation cross section at 100 MeV for particle therapy physics

The natC(p,x)11C reaction has been discussed in detail in the past [EXFOR database, Otuka et al. (Nuclear Data Sheets 120:272–276, 2014)]. However, measured activation cross sections by independent experiments are up to 15% apart. The aim of this study is to investigate underlying reasons for these observed discrepancies between different experiments and to determine a new consensus reference cross section at 100 MeV. Therefore, the experimental methods described in the two recent publications [Horst et al. (Phys Med Biol https://doi.org/10.1088/1361-6560/ab4511 [Titel anhand dieser DOI in Citavi-Projekt übernehmen] , 2019) and Bäcker et al. (Nuclear Instrum Methods Phys Res B 454:50–55, 2019)] are compared in detail and all experimental parameters are investigated for their impact on the results. For this purpose, a series of new experiments is performed. With the results of the experiments a new reference cross section of (68±3) mb is derived at (97±3) MeV proton energy. This value combined with the reliably measured excitation function could provide accurate cross section values for the energy region of proton therapy. Because of the well-known gamma-ray spectrometer used and the well-defined beam characteristics of the treatment machine at the proton therapy center, the experimental uncertainties on the absolute cross section could be reduced to 3%. Additionally, this setup is compared to the in-beam measurement setup from the second study presented in the literature (Horst et al. 2019). Another independent validation of the measurements is performed with a PET scanner

An international multi-center investigation on the accuracy of radionuclide calibrators in nuclear medicine theragnostics

Background: Personalized molecular radiotherapy based on theragnostics requires accurate quantification of the amount of radiopharmaceutical activity administered to patients both in diagnostic and therapeutic applications. This international multi-center study aims to investigate the clinical measurement accuracy of radionuclide calibrators for 7 radionuclides used in theragnostics: 99mTc, 111In, 123I, 124I, 131I, 177Lu, and 90Y. Methods: In total, 32 radionuclide calibrators from 8 hospitals located in the Netherlands, Belgium, and Germany were tested. For each radio

Metalloporphines: Dimers and Trimers

Procedures for the purification and subsequent crystallization of the slightly soluble four-coordinate metallporphines, the simplest possible porphyrin derivatives, are described. Crystals of the porphine derivatives of cobalt­(II), copper­(II), platinum­(II), and two polymorphs of zinc­(II) were obtained. Analysis of the crystal and molecular structures shows that all except the platinum­(II) derivative form an unusual trimeric species in the solid state. The isomorphous cobalt­(II), copper­(II), and one zinc­(II) polymorph pack in the unit cell to form dimers as well as the trimers. Interplanar spacings between porphine rings are similar in both the dimers and trimers and range between 3.24 and 3.37 Å. Porphine rings are strongly overlapped with lateral shifts between ring centers in both the dimers and trimers with values between 1.52 and 1.70 Å or in Category S as originally defined by Scheidt and Lee. Periodic trends in the M–N_p bond distances parallel those observed previously for tetraphenyl- and octaethyl­porphyrin derivatives

Dose-Response Relationship in Differentiated Thyroid Cancer Patients Undergoing Radioiodine Treatment Assessed by Means of I-124 PET/CT

The dose response relationship in a fixed-aCtivity approach generally applied in the treatment of differentiated thyroid cancer was assessed using I-124 PET/CT. Methods: Pretherapeutic I-124 PET/CT images of 47 patients scheduled for radioiodine therapy were retrospectively analyzed. I-124 PET/CT images were acquired 24 and 96 h after oral administration of approximately 28 MBq of I-124-sodium iodide. Lesions were identified as thyroid remnants or metastases (lymph node, lung, bone). After a neoteric segmentation technique allowing accurate volume estimation down to the I-124 PET spatial resolution of 0.15 mL was applied, lesions were divided into a known-volume group and a small-volume group. For the known-volume group, average lesion-absorbed dose (AD) values were calculated, whereas for the small-volume group a minimum lesion AD was estimated. Lesion response was determined on the basis of I-124 PET/CT and I-131 SPECT/CT follow-up images. A lesion not detectable on any of the follow-up images was considered a completely responding lesion. Differences in lesion AD estimations between completely and incompletely responding lesions were evaluated by Mann Whitney U test. Moreover, receiver-operating-characteristic curves were used to test the performance of pretherapeutic I-124 PET/CT lesion AD for prediction of complete lesion response. Results: In the approach of fixed radioiodine activity (3.0 +/- 1.0 GBq), 89% of thyroid remnants and 69% of metastases responded completely. Except for the small-volume groups, the lesion AD of completely responding lesions was significantly higher than that of incompletely responding lesions. Using receiver-operating-characteristic curve analysis, it was shown that for the known-volume group, pretherapeutic I-124 PET/CT lesion dosimetry can be used as a prognostic tool to predict lesion-based I-131 therapy response with an area under the curve of 0.76 for remnants and 0.97 for metastases. The corresponding lesion AD threshold value maximizing correct complete response prediction was 90 Gy for remnants and 40 Gy for metastases. Conclusion: In a fixed-activity approach, a statistically significant dose response relationship for both thyroid remnants and metastases using pretherapeutic I-124 PET/CT lesion dosimetry was found. The findings may be useful in patient management

Teacher evaluation in the Kingdom of Saudi Arabia's (KSA) schools - moving forward

The aim of this optimization study was to minimize the acquisition time of 68Ga-HBED-CC-PSMA positron emission tomography/magnetic resonance imaging (PET/MRI) in patients with local and metastatic prostate cancer (PCa) to obtain a sufficient image quality and quantification accuracy without any appreciable loss.Twenty patients with PCa were administered intravenously with the 68Ga-HBED-CC-PSMA ligand (mean activity 99 MBq/patient, range 76-148 MBq) and subsequently underwent PET/MRI at, on average, 168 min (range 77-320 min) after injection. PET and MR imaging data were acquired simultaneously. PET acquisition was performed in list mode and PET images were reconstructed at different time intervals (1, 2, 4, 6, 8, and 10 min). Data were analyzed regarding radiotracer uptake in tumors and muscle tissue and PET image quality. Tumor uptake was quantified in terms of the maximum and mean standardized uptake value (SUVmax, SUVmean) within a spherical volume of interest (VOI). Reference VOIs were drawn in the gluteus maximus muscle on the right side. PET image quality was evaluated by experienced nuclear physicians/radiologists using a five-point ordinal scale from 5-1 (excellent-insufficient).Lesion detectability linearly increased with increasing acquisition times, reaching its maximum at PET acquisition times of 4 min. At this image acquisition time, tumor lesions in 19/20 (95%) patients were detected. PET image quality showed a positive correlation with increasing acquisition time, reaching a plateau at 4-6 min image acquisition. Both SUVmax and SUVmean correlated inversely with acquisition time and reached a plateau at acquisition times after 4 min.In the applied image acquisition settings, the optimal acquisition time of 68Ga-PSMA-ligand PET/MRI in patients with local and metastatic PCa was identified to be 4 min per bed position. At this acquisition time, PET image quality and lesion detectability reach a maximum while SUVmax and SUVmean do not change significantly beyond this time point