951 research outputs found

    Tocilizumab in MOG-antibody spectrum disorder: a case report

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    Background: Myelin oligodendrocyte glycoprotein antibody-related spectrum disorders (MOG-SD) are a heterogeneous group of inflammatory demyelinating diseases of the central nervous system, usually responsive to conventional immunosuppressive therapies. However, knowledge about treatment of non-responder patients is scarce. Methods: We report on a 20-year-old MOG-SD patient who experienced clinical deterioration despite rituximab-induced B-cell depletion. Results: Rescue therapy with tocilizumab (TCZ) prevented further relapses, with reduction of spinal-cord load on MRI, and a remarkable reduction of disability at the two-year follow-up. Conclusion: Our observations suggest that TCZ could induce clinico-radiologic improvements, which make it as an option for the treatment of MOG-SD

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

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    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

    188W/188Re Generator System and Its Therapeutic Applications

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    The188Re radioisotope represents a useful radioisotope for the preparation of radiopharmaceuticals for therapeutic applications, particularly because of its favorable nuclear properties. The nuclide decay pattern is through the emission of a principle beta particle having 2.12 MeV maximum energy, which is enough to penetrate and destroy abnormal tissues, and principle gamma rays (Eγ=155 keV), which can efficiently be used for imaging and calculations of radiation dose.188Re may be conveniently produced by188W/188Re generator systems. The challenges related to the double neutron capture reaction route to provide only modest yield of the parent188W radionuclide indeed have been one of the major issues about the use of188Re in nuclear medicine. Since the specific activity of188W used in the generator is relatively low (<185 GBq/g), the elutedRe188O4-can have a low radioactive concentration, often ineffective for radiopharmaceutical preparation. However, several efficient postelution concentration techniques have been developed, which yield clinically usefulRe188O4-solutions. This review summarizes the technologies developed for the preparation of188W/188Re generators, postelution concentration of the188Re perrhenate eluate, and a brief discussion of new chemical strategies available for the very high yield preparation of188Re radiopharmaceuticals

    Radioisotopic purity and imaging properties of cyclotron-produced 99mTc using direct 100Mo(p,2n) reaction

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    Evaluation of the radioisotopic purity of technetium-99m (99mTc) produced in GBq amounts by proton bombardment of enriched molibdenum-100 (100Mo) metallic targets at low proton energies (i.e. within 15\u201320 MeV) is conducted. This energy range was chosen since it is easily achievable by many conventional medical cyclotrons already available in the nuclear medicine departments of hospitals. The main motivation for such a study is in the framework of the research activities at the international level that have been conducted over the last few years to develop alternative production routes for the most widespread radioisotope used in medical imaging. The analysis of technetium isotopes and isomeric states (9xTc) present in the pertechnetate saline Na99mTcO4 solutions, obtained after the extraction/purification procedure, reveals radionuclidic purity levels basically in compliance with the limits recently issued by European Pharmacopoeia 9.3 (2018 Sodium pertechnetate (99mTc) injection 4801\u20133). Moreover, the impact of 9xTc contaminant nuclides on the final image quality is thoroughly evaluated, analyzing the emitted high-energy gamma rays and their influence on the image quality. The spatial resolution of images from cyclotron-produced 99mTc acquired with a mini-gamma camera was determined and compared with that obtained using technetium-99m solutions eluted from standard 99Mo/99mTc generators. The effect of the increased image background contribution due to Compton-scattered higher-energy gamma rays (E \u3b3 \u2009\u2009>\u2009\u2009200\u2009keV), which could cause image-contrast deterioration, was also studied. It is concluded that, due to the high radionuclidic purity of cyclotron-produced 99mTc using 100Mo(p,2n)99mTc reaction at a proton beam energy in the range 15.7\u201319.4 MeV, the resulting image properties are well comparable with those from the generator-eluted 99mTc

    Novel Tc-99m radiotracers for brain imaging

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    A novel class of Tc-99m complexes able to cross the blood brain barrier has been investigated and described here. These compounds are formed by reacting the bis-substituted nitrido precusors [99mTc(N)(PS)2] (PS = phosphino-thiol ligand) with triethylborane (BEt3) under strictly anhydrous conditions and using non-aqueous solvents. The molecular structure of these tracers was not fully established, but preliminary experimental evidence suggests that they result from the interaction of the Lewis base [99mTc(N)(PS)2] with the Lewis acid BEt3, which leads to the formation of the novel -B-NÂș Tc- adduct. After purification and recovery in a physiological solution, the new borane-nitrido Tc-99m derivatives were injected in rats for evaluating their in vivo biological behavior. Results showed a significant accumulation in brain tissue, thus indicating that these complexes are capable of penetrating the intact blood brain barrier. Uptake in the central nervous system was confirmed by imaging the distribution of activity on the integrated living animal using a YAP(S)SPECT small animal scanner

    Composite MRI measures and short-term disability in patients with clinically isolated syndrome suggestive of MS

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    The use of composite magnetic resonance imaging (MRI) measures has been suggested to better explain disability in patients with multiple sclerosis (MS). However, little is known about the utility of composite scores at the earliest stages of the disease

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

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    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
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