Hell J Nucl Med
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To determine whether a pregnancy-adapted clinical and D-dimer-based algorithm, termed the "YEARS algorithm," can reduce the need for radiological imaging, including lung scintigraphy in pregnant women with suspected pulmonary embolism (PE). ⋯ The pregnancy-adapted YEARS algorithm can safely rule out PE in about one-third of pregnant women with suspected PE without the need for radiological imaging.
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"...but why think? Why not try the experiment?..." John Hunter (1728-1793), in a letter to Edward Jenner. August 2nd, 1775. When Galen of Pergamum (2nd c. ⋯ Pandits foresee that the world will be different after the end of this pandemic. Perhaps human ingenuity will seek new investigative methods that will render the randomised clinical trial obsolete, both, on methodological and ethical grounds. Until then and even if we have to accept the scientific supremacy of the randomised study in the evaluation of novel therapies, the ethical considerations in the unprecedented circumstances of a relentless pandemic demand a more humane approach, befitting the beneficent precepts of the Hippocratic tradition.
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The coronavirus COVID-19 pandemic is the defining global health crisis of our time. Health care systems globally are amid an unprecedented challenge. Since its emergence in December 2019 in Wuhan, China, the virus has spread to 185 countries worldwide, with more than 2.63 million cases confirmed and more than 183 thousand related deaths (as of 23/04/2020). ⋯ The interim Editor in Chief of the current issue, would like to express her gratitude to Professor Emeritus Philip Grammaticos for his contribution to the global scientific community as well as to the incoming Editor in Chief Konstantinos Anagnostopoulos, MD, PhD, FRCP, FESC for accepting this new role. We wholeheartedly welcome the new Editor in Chief and the new members of the Editorial Board, wishing them an active, attentive and successful mandate. Hellenic Journal of Nuclear Medicine will remain true to the set principles, values and past and prepared to cope with future challenges in the scientific and clinical setting.
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Observational Study
Glial and neuroaxonal biomarkers in a multiple sclerosis (MS) cohort.
The desire to treat patients with MS early and to target the correct therapy to patients is hampered by a lack of useful prognostic biomarkers that can predict disease progression, severity, and responses to treatment. In addition, clinical trials of new drugs require biomarkers that can predict response to therapy over the course of a few years trial. These biomarkers need to be rapid, relatively inexpensive, and have the potential to be uniformly administered across multiple centres and clinicians. To date, there have been many studies into potential biomarkers for MS. Only serial Magnetic Resonance Imaging (MRI) have emerged as having clinical utility in longitudinal or prospective studies. Small cohort, cross-sectional studies and moderate cohort longitudinal studies have provided a panel of possible biomarkers for MS. Neurofilament light (NfL-l) protein is the light subunit of a structural component in the neuronal axons and increased levels in the cerebrospinal fluid (CSF) reflect axonal degeneration. Tau protein is a microtubule binding protein that contributes to the stability of microtubules. The binding of tau to microtubules is reduced by increases in the phosphorylation state of tau. Hyperphosphorylation of tau disrupts microtubules and leads to degeneration of neurons. Detection of NfL-l protein, tau and phospho tau protein in the CSF in considered to reflect the degree of axonal damage in the central nervous system. Glial fibrillary acidic protein (GFAP) is secreted from astrocytic and is a well-established marker of reactive astrogliosis. Extensive astrocytosis leads to the formation of the astroglial scar, that plays a role in the progression of disease. ⋯ 87 MS patients (aged 41.1±11.96) enrolled in the study and 21 controls (aged 44.17±12.8). The female/male ratio was 8 females/12 males in the controls and 64 females/20 males in the patients' group. From the patients' cohort 86% (75 patients) were relapsing forms and 14% (12 patients) were progressive forms of the disease. From the total sample 60 patients had disease duration more than a year and 48 less or equal to 1 year. 31 (28.9%) patients had received prior corticosteroid course and 15 patients (13.9%) had prior statin use. In the MS cohort 31 patients (28.7%) had received previous first line disease modifying treatment. The EDSS that showed mild disability without effect of mobility on grades below 4, affected the majority of the sample with EDSS 1-3 in 70% of the patients. 27% of the patients had EDSS scale score 3.5-6.
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Attenuation correction (AC) of positron emission tomography (PET) data poses a challenge when no transmission data or computed tomography (CT) data are available, e.g. in stand alone PET scanners or PET/magnetic resonance imaging (MRI). In these cases, external imaging data or morphological imaging data are normally used for the generation of attenuation maps. Newly introduced machine learning methods however may allow for direct estimation of attenuation maps from non attenuation-corrected PET data (PETNAC). Our purpose was thus to establish and evaluate a method for independent AC of brain fluorine-18-fluorodeoxyglucose (18F-FDG) PET images only based on PETNAC using Generative Adversarial Networks (GAN). ⋯ Independent AC of brain 18F-FDG PET is feasible with high accuracy using the proposed, easy to implement deep learning framework. Further evaluation in clinical cohorts will be necessary to assess the clinical performance of this method.