Journal of nuclear medicine : official publication, Society of Nuclear Medicine
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The objective of this study was to assess the safety, dosimetry, and efficacy of the 177Lu-labeled somatostatin receptor (SSTR) antagonist DOTA-p-Cl-Phe-cyclo(d-Cys-Tyr-d-4-amino-Phe(carbamoyl)-Lys-Thr-Cys)d-Tyr-NH2 (177Lu-DOTA-LM3) in patients with metastatic neuroendocrine neoplasms (NENs). Methods: Fifty-one patients (aged 27-76 y; mean, 51.6 ± 13.9 y) with metastatic NENs underwent peptide receptor radionuclide therapy (PRRT) with 177Lu-DOTA-LM3 between August 2017 and December 2019. The median administered activity per cycle was 6.1 ± 0.88 GBq (range, 2.8-7.4 GBq). 68Ga-NODAGA-LM3 PET/CT was used for patient selection and follow-up after 177Lu-DOTA-LM3 PRRT. ⋯ Conclusion: The antagonist PRRT with 177Lu-DOTA-LM3 could be administered without severe adverse effects and was well tolerated by most patients, with thrombocytopenia occurring in only a few. No other severe adverse effects were observed; in particular, there was no nephrotoxicity. The SSTR antagonist 177Lu-DOTA-LM3 appears to be promising for PRRT, provides a favorable biodistribution and higher tumor radiation doses than SSTR agonists, and was effective in treating advanced metastatic NENs, especially in patients with low or no SSTR agonist binding, even achieving complete remission in some patients.
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A diverse health-care workforce is a necessary component of equitable care delivery to an increasingly diverse U. S. population. In nuclear medicine (NM), there is a paucity of data on the numbers of women and members of racial and ethnic groups that are underrepresented in medicine in the United States (URiMs). ⋯ S. grads. NM is included in the medical school curriculum at fewer than one third of academic centers with NM residency programs, typically toward the end of medical school. Increased and earlier exposure to NM, especially for women and URiMs, may improve recruitment and mitigate diversity gaps.
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Although the novel coronavirus disease 2019 (COVID-19) can present as non-specific clinical forms, subclinical cases represent an important route of transmission and a significant source of mortality, mainly in high-risk subpopulations such as cancer patients. A deeper knowledge about the shift in cellular metabolism of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected cells could provide new insights about its pathogenic and host response and help to diagnose pulmonary involvement. We explored the association between metabolic and structural changes of lung parenchyma in asymptomatic cancer patients with suspected COVID-19 pneumonia, as a potential added diagnostic value of fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET/CT) scans in this subpopulation. ⋯ Conclusion: In asymptomatic cancer patients, the metabolic activity in lung infiltrates is closely associated with several combined tomographic changes characteristic of COVID-19 pneumonia. Multimodal 18F-FDG PET/CT imaging could provide additional information during early diagnosis in selected predisposed patients during pandemic. The prognostic implications of simultaneous radiological and molecular findings in cancer and other high-risk subpopulations for COVID-19 pneumonia deserve further evaluation in prospective researches.
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Purpose: The aim of this study was to assess a) the impact of forced diuresis with early furosemide injection on the detection rate of local recurrence (LR) in prostate cancer (PC) patients with biochemical recurrence (BR) referred for 68Ga-labelled Glu-NH-CO-NH-Lys(Ahx)-HBED-CC (68Ga-PSMA-11) Positron Emission Tomography/Computed Tomography (PET/CT) and b) whether intravenous administration of furosemide shortly after tracer injection increases renal wash-out of 68Ga-PSMA-11 before it binds to the PSMA-receptor with possible influence on biodistribution and intensity of tracer uptake in organs with physiologic tracer accumulation. Materials and Methods: In a retrospective analysis two different groups with 220 prostate cancer patients each, referred for 68Ga-PSMA-11 PET/CT because of biochemical recurrence after primary therapy, were compared: patients of group one (median prostate specific antigen (PSA): 1.30 ng/ml) receiving no preparation prior to imaging, whereas patients in group two (median PSA: 0.82 ng/ml) were injected with 20 mg furosemide and 500 ml sodium chloride (NaCl 0.9%) immediately after tracer injection. Presence of local recurrence was assessed visually. ⋯ Apart from bladder activity, no significant reduction of tracer accumulation was found in the patient group receiving furosemide. Conclusion: Injection of 20 mg furosemide at the timepoint of radiotracer administration significantly increases the detection rate of local recurrence in prostate cancer patients with biochemical recurrence referred for 68Ga-PSMA-11 PET/CT. As intensity of 68Ga-PSMA-11-uptake in organs with physiologic uptake is not significantly reduced, a negative impact of early furosemide injection on targeting properties and biodistribution of 68Ga-PSMA-11 seems unlikely.
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Peptide receptor radionuclide therapy (PRRT) using radiolabeled somatostatin receptor (SSTR) analogs is a common approach in advanced neuroendocrine neoplasms. Recently, SSTR antagonists have shown promising results for imaging and therapy due to a higher number of binding sites than in commonly used agonists. We evaluated PRRT with SSTR agonist 177Lu-DOTATOC and antagonist 177Lu-DOTA-JR11 longitudinally in an orthotopic murine pancreatic neuroendocrine neoplasm model expressing human SSTR2. ⋯ These results were confirmed by 18F-FDG PET, revealing the least amount of viable tumor tissue in 177Lu-DOTA-JR11-treated animals, at 6.2% (IQR, 2%-23%). Conclusion: 177Lu-DOTA-JR11 showed a higher tumor-to-kidney ratio and a more pronounced cytotoxic effect than did 177Lu-DOTATOC. Additionally, tumor uptake was more stable over the course of 2 treatment cycles.