150 research outputs found
Multimodality treatment in hormone-refractory prostate cancer patients with bone metastases
We agree with the interesting points made by Koutsikos et
al. They confirm the feasibility of the combined use of
bone-seeking radiopharmaceuticals and bisphosphonates
and highlight the potential benefit of this combined
treatment. We would like to stress the importance to study
multimodality treatment strategies in well-designed clinical
trials. These trials should evaluate the multidimensional
character of pain, as well as survival, and they should
incorporate imaging modalities for response stratification ..
Combined use of zoledronic acid and 153Sm-EDTMP in hormone-refractory prostate cancer patients with bone metastases
Purpose: 153Sm-ethylenediaminetetramethylenephosphonic
acid (EDTMP; Quadramet®) is indicated for the treatment of
painful bone metastases, whereas zoledronic acid (Zometa®)
is indicated for the prevention of skeletal complications.
Because of the different therapeutic effects, combining the
treatments may be beneficial. Both, however, accumulate in
areas with increased osteoblastic activity. Possible drug
interactions were investigated.
Methods: Patients with hormone-refractory prostate cancer
were treated with 18.5 MBq/kg 153Sm-EDTMP in weeks 1
and 3 and with 37 MBq/kg in week 15. Treatment with 4 mg
zoledronic acid began in week 3 and continued every
4 weeks through week 23. In weeks 3 and 15, zoledronic
acid was administered 2 days before 153Sm-EDTMP
treatment. Urine was collected 48 h after injection of
153Sm-EDTMP, and whole-body images were obtained 6,
24 and 48 h post-injection. The effect of zoledronic acid on
total bone uptake of 153Sm-EDTMP was measured indirectly
by the cumulative activity excreted in the urine in weeks 1, 3
and 15. Biodistribution, safety, tolerability and effect on
prostate-specific antigen level were also studied.
Results: The urinary excretion in week 3 divided by the
urinary excretion in week 1 (baseline) times 100% was
mean 98.4±11.6% (median 96.2%). From week 1 to 15,
after four zoledronic acid treatments, the mean ratio was
101.9±10.7% (median 101.8%). Bioequivalence could be
concluded by using a two-sample t test for both perprotocol
(n=13) and full-analysis sets (n=18). Toxicity was
comparable to of monotherapy with 153Sm-EDTMP.
Conclusion: Zoledronic acid treatment does not influence
153Sm-EDTMP skeletal uptake. Combined treatment is
feasible and safe
Normal imaging findings after aortic valve implantation on 18F-Fluorodeoxyglucose positron emission tomography with computed tomography
Background: To determine the normal perivalvular 18F-Fluorodeoxyglucose (18F-FDG) uptake on positron emission tomography (PET) with computed tomography (CT) within one year after aortic prosthetic heart valve (PHV) implantation. Methods: Patients with uncomplicated aortic PHV implantation were prospectively included and underwent 18F-FDG PET/CT at either 5 (± 1) weeks (group 1), 12 (± 2) weeks (group 2) or 52 (± 8) weeks (group 3) after implantation. 18F-FDG uptake around the PHV was scored qualitatively (none/low/intermediate/high) and quantitatively by measuring the maximum Standardized Uptake Value (SUVmax) and target to background ratio (SUVratio). Results: In total, 37 patients (group 1: n = 12, group 2: n = 12, group 3: n = 13) (mean age 66 ± 8 years) were prospectively included. Perivalvular 18F-FDG uptake was low (8/12 (67%)) and intermediate (4/12 (33%)) in group 1, low (7/12 (58%)) and intermediate (5/12 (42%)) in group 2, and low (8/13 (62%)) and intermediate (5/13 (38%)) in group 3 (P = 0.91). SUVmax was 4.1 ± 0.7, 4.6 ± 0.9 and 3.8 ± 0.7 (mean ± SD, P = 0.08), and SUVratio was 2.0 [1.9 to 2.2], 2.0 [1.8 to 2.6], and 1.9 [1.7 to 2.0] (median [IQR], P = 0.81) for groups 1, 2, and 3, respectively. Conclusion: Non-infected aortic PHV have similar low to intermediate perivalvular 18F-FDG uptake with similar SUVmax and SUVratio at 5, 12, and 52 weeks after implantation
Human monoclonal antibodies against Staphylococcus aureus surface antigens recognize in vitro and in vivo biofilm
Implant-associated Staphylococcus aureus infections are difficult to treat because
of biofilm formation. Bacteria in a biofilm are often insensitive to antibiotics and host immunity.
Monoclonal antibodies (mAbs) could provide an alternative approach to improve the diagnosis
and potential treatment of biofilm-related infections. Here, we show that mAbs targeting common
surface components of S. aureus can recognize clinically relevant biofilm types. The mAbs were
also shown to bind a collection of clinical isolates derived from different biofilm-associated infections (endocarditis, prosthetic joint, catheter). We identify two groups of antibodies: one group
that uniquely binds S. aureus in biofilm state and one that recognizes S. aureus in both biofilm and
planktonic state. Furthermore, we show that a mAb recognizing wall teichoic acid (clone 4497)
specifically localizes to a subcutaneously implanted pre-colonized catheter in mice. In conclusion,
we demonstrate the capacity of several human mAbs to detect S. aureus biofilms in vitro and in vivo
The Efficacy of Coil Embolization to Obtain Intrahepatic Redistribution in Radioembolization: Qualitative and Quantitative Analyses
Purpose: To evaluate the efficacy of coil embolization to obtain intrahepatic redistribution in patients undergoing radioembolization. Materials and Method: All patients treated with radioembolization at our institute were retrospectively analyzed, and all cases in which a tumor-feeding vessel was coil-embolized were selected. Two nuclear medicine physicians visually assessed the effect of redistribution. Furthermore, the redistribution of microspheres was measured by quantifying the activity distributed to the coil-embolized (dependent) segment relative to the other (non-dependent) segments and to the tumor(s) in that segment. Quantitative analysis was performed on post-treatment 90Y-PET and 166Ho-SPECT using Simplicit90Y software. Lesion response was measured according to RECIST 1.1 criteria at 3 months post-treatment. Results: Out of 37 cases, 32 were suitable for quantitative analysis and 37 for qualitative analysis. In the qualitative analysis, redistribution was deemed successful in 69% of cases. The quantitative analysis showed that the median ratio of the activity to the dependent embolized segments and the non-dependent segments was 0.88 (range 0.26–2.05) and 0.80 (range 0.19–1.62) for tumors in dependent segments compared with tumors in non-dependent segments. Using a cutoff ratio of 0.7 (30% lower activity concentration in comparison with the rest of the liver), 57% of cases were successful. At 3 months post-treatment, 6% of dependent tumors had partial response, 20% progressive disease, and 74% stable disease. In non-dependent tumors, this was, respectively, 16%, 20%, and 64%. Conclusion: Coil embolization of hepatic arteries to induce redistribution of microspheres has a limited success rate. Qualitative assessment tends to overrate redistribution
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