Unexpected detection of abscessualized lung carcinoma on tc-99m-hmpao-labeled leukocytes scintigraphy misdiagnosed on chest computed tomography

Teknesyum-99m (Tc-99m)-heksametilpropilen amin oksim (HMPAO) işaretli lökosit sintigrafisi, kemik ve yumuşak dokudaki enfeksiyonları araştırmak ve teşhis etmek ve ayrıca gizli enfeksiyonu saptamak için iyi bir şekilde tasarlanmıştır. Yakın zamanda sağ akciğerde bronkopulmoner nöroendokrin tümörü teşhisi konan 71 yaşındaki bir kadın, son bir ay içinde geceleri üşüme ile ilişkili bilinmeyen kaynaklı aralıklı ateş nedeniyle sevk edildi. Toraks bilgisayarlı tomografisi (BT) taraması, üst vena kavanın trombotik yayılımını ve sağ akciğerin alt lobunun üst segmentindekarşılıklı atelektazisi olan katı patolojik dokuyu gösterdi. Bir kateter portu taşıyıcısı olduğundan, bu cihazın bir enfeksiyonundan şüpheleniliyordu. Bu nedenle, Tc-99m-HMPAO işaretli lökosit tek foton emisyonlu bilgisayarlı tomografi (SPECT) gerçekleştirildi ve eşleşen BT taraması ve Tc-99mHMPAO işaretli beyaz kan hücresi SPECT görüntü çiftleri birleştirildi. Bu yolla, artmış radyofarmasötik tutulumun, sağ akciğerin alt lobunda lokalize BT taraması ile tespit edilen yumuşak doku yoğunluğu kütlesine karşılık geldiği bulundu. Hibrid SPECT/BT füzyon görüntüleme, bilinen akciğer kanseri bölgesi ile uyumlu olarak lokalize edilmiş bir akciğer apsesinin varlığının teşhisi için çok önemliydi.Technetium-99m (Tc-99m)-hexamethylpropylene amine oxime (HMPAO)-labeled leukocytes scintigraphy is well established for investigating and diagnosing infections in bone and soft tissue, as well as for the detection of occult infection. A 71-year-old female who was recently diagnosed with bronchopulmonary neuroendocrine tumor of the right lung was referred for an intermittent fever of unknown origin associated with chill at night for the last month. Chest computed tomography (CT) scan showed a thrombotic widespread of the superior vena cava and a solid pathological tissue in the superior segment of the inferior lobe of the right lung with consensual atelectasis. Being a carrier of port-a-cath, an infection of this device was suspected. Therefore, Tc-99m-HMPAO-labeled leukocytes single-photon emission computed tomography (SPECT) was performed, and matching pairs of CT scan and Tc-99m-HMPAO-labeled white blood cell SPECT images were fused. Through this means, it was found that the area of the radiotracer increased uptake corresponded with the soft tissue density mass detected by CT scan localized at the inferior lobe of the right lung. The hybrid SPECT/CT fused imaging was crucial for diagnosis of the presence of a lung abscess localized in correspondence with the known lung cancer region

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

Prognostic and theranostic applications of positron emission tomography for a personalized approach to metastatic castration‐resistant prostate cancer

Metastatic castration‐resistant prostate cancer (mCRPC) represents a condition of pro-gressive disease in spite of androgen deprivation therapy (ADT), with a broad spectrum of mani-festations ranging from no symptoms to severe debilitation due to bone or visceral metastatization. The management of mCRPC has been profoundly modified by introducing novel therapeutic tools such as antiandrogen drugs (i.e., abiraterone acetate and enzalutamide), immunotherapy through sipuleucel‐T, and targeted alpha therapy (TAT). This variety of approaches calls for unmet need of biomarkers suitable for patients’ pre‐treatment selection and prognostic stratification. In this sce-nario, imaging with positron emission computed tomography (PET/CT) presents great and still unexplored potential to detect specific molecular and metabolic signatures, some of whom, such as the prostate specific membrane antigen (PSMA), can also be exploited as therapeutic targets, thus combining diagnosis and therapy in the so‐called “theranostic” approach. In this review, we per-formed a web‐based and desktop literature research to investigate the prognostic and theranostic potential of several PET imaging probes, such as18F‐FDG,18F‐choline and68Ga‐PSMA‐11, also covering the emerging tracers still in a pre‐clinical phase (e.g., PARP‐inhibitors’ analogs and the radioligands binding to gastrin releasing peptide receptors/GRPR), highlighting their potential for defining personalized care pathways in mCRPC

Administrative health claims and laboratory data to identified mCRPC or mCSPC patients: the way to go looks long but promising

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New frontiers in molecular imaging with superparamagnetic iron oxide nanoparticles (SPIONs): efficacy, toxicity, and future applications

Supermagnetic Iron Oxide Nanoparticles (SPIONs) are nanoparticles that have an iron oxide core and a functionalized shell. SPIONs have recently raised much interest in the scientific community, given their exciting potential diagnostic and theragnostic applications. The possibility to modify their surface and the characteristics of their core make SPIONs a specific contrast agent for magnetic resonance imaging but also an intriguing family of tracer for nuclear medicine. An example is 68Ga-radiolabeled bombesin-conjugated to superparamagnetic nanoparticles coated with trimethyl chitosan that is selective for the gastrin-releasing peptide receptors. These receptors are expressed by several human cancer cells such as breast and prostate neoplasia. Since the coating does not interfere with the properties of the molecules bounded to the shell, it has been proposed to link SPIONs with antibodies. SPIONs can be used also to monitor the biodistribution of mesenchymal stromal cells and take place in various applications. The aim of this review of literature is to analyze the diagnostic aspect of SPIONs in magnetic resonance imaging and in nuclear medicine, with a particular focus on sentinel lymph node applications. Moreover, it is taken into account the possible toxicity and the effects on human physiology to determine the SPIONs’ safety

99mTc-HMPAO brain SPECT in the monitoring of cerebral vasculitis therapy

tObjective: The central nervous system (CNS) may be involved in a variety of inflammatory diseases of theblood vessels, generally known as vasculitis. The clinical diagnosis of such involvement in early stagesis difficult, since a mild cognitive impairment can be the only symptom. It was hypothesized that brain-perfusion SPECT would be able to reveal CNS involvement and to monitor the course of the disease. Thepurpose of this study was assess if and when an improvement of cerebral perfusion can be registered bySPECT during the follow-up of these diseases.Material and methods: Eighteen patients affected by Systemic Lupus Erythematosus (SLE), 22 by undif-ferentiated vasculitis (UV), 5 by Behcet’s disease (BD) and 5 by primary Sjogren’s Syndrome (pSS) wereenrolled in this prospective study. A99mTc-HMPAO brain perfusion SPECT was performed before the treat-ment and was repeated during the follow-up at different time intervals. Image analysis was performedon 10 cerebral areas using a specific software.Results: In the SLE patients, no significant improvement of brain perfusion was found. On the contrary,in the UV the cerebral uptake of the tracer significantly improved from the twenty-fourth month (18/22patients). Patients with BD showed an improvement of scintigraphic findings (5/5 patients), while asimilar result was obtained only in 2 of the patients with pSS.Conclusions: In conclusion, brain SPECT seems to be able to monitor the disease in UV, indicating themoment when an improvement of the cerebral perfusion is achieved. In SLE patients this scintigraphictechnique did not show a significant improvement in CNS perfusion

Radium-223 treatment in mcrpc patient with polycythemia vera

There have been several studies on the clinical outcomes of Radium-223 treatment in patients with metastatic castration-resistant prostate cancer (mCRPC) who may have an increased risk of hematologic comorbidities. To the best of our knowledge, this is the first study to explore the potential bone marrow adverse effects (AEs) of Radium-223 administered with specific drugs used for hematologic conditions, such as polycythemia vera (PV). We report the case of a patient with mCRPC who was administered a combined treatment of Radium-223 and hydroxyurea for PV, aiming to support clinicians in predicting eventual AEs