Quarterly Journal of Nuclear Medicine and Molecular Imaging

Single photon emission computed tomography (SPECT) has revolutionized delayed bone scan acquisitions and promises to bring the same benefits to early acquisitions, especially in areas of complex anatomy. To date, however, only a few studies have been published about the utility of blood pool SPECT. The accurate assessment of inflammatory processes can be an indisputable added value to the diagnosis. We present here a series of clinical cases illustrating the utility of blood pool SPECT in various clinical situations in rheumatology and orthopedics...

The use of alpha emitting radiotherapeutics is increasing, with further growth expected due to a number of clinical trials currently running involving new alpha emitters. However, literature concerning radiation safety aspects of alpha emitting radionuclides is limited and most of the available literature concerns 223 Ra. In general, the occupational exposure from alpha emitting radionuclides is expected to be low, as are doses to the public from external exposure. However, care must be taken to avoid skin contamination, inhalation, and ingestion...

No abstract text is available yet for this article.

BACKGROUND: Extremity exposure during the handling of unsealed radioactive sources is a matter of concern for nuclear medicine workers. Next to 99m Tc and 18 F, other radiopharmaceuticals have seen an increase in their use over the last decade. However, limited information on their impact on extremity dose is available. This study aimed to gain insight into the status of extremity exposure and dose monitoring in Europe. METHODS: A survey was conducted at the end of 2020 among the European Association of Nuclear Medicine community...

The recent development of radionuclide therapy and radioligand therapy has raised a call for achieving the highest quality standards, for either radiopharmacy or radiation protection. Novel radionuclides are now being used, either under the form of in-house production radiopharmaceuticals or available from companies. Over the last 20 years, they include radiolabeled microspheres for selective internal radiotherapy (SIRT), the introduction of the first commercially available alpha emitter radiopharmaceutical, 223 Ra, and the radiosynoviorthesis which is highly variable across Europe...

No abstract text is available yet for this article.

This overview describes the basic characteristics and chemistry, production and the clinical applications and use of radiopharmaceuticals pertaining to radiosynoviorthesis (RSO). In each of the case scenarios, the physical and clinical parameters that serve as determinants and govern the choice of a particular radionuclide employed for RSO are discussed. References have been drawn on the fundamentals of RSO where applicable, including a brief review of the principles and mechanism of action, the indication and efficacy of RSO in different disease conditions and suggestions set out by the current guideline recommendations...

BACKGROUND: The aim of this study was to assess the long-term anti-inflammatory effect and safety of 90-Yttrium and 166-Holmium radiosynoviorthesis (RSO) for treating chronic knee synovitis of various origins. METHODS: A total of 820 patients were included in this study and were followed up to 10 years after the procedure for objective and subjective changes in signs and symptoms of inflammation. RESULTS: Five years after RSO, excellent and good results were seen in 71% (95% CI 67-74%) of patients...

Radiosynoviorthesis (RSO) or radiation synovectomy has been practiced for more than half a century, but in many parts of the world, it is still relatively unknown and not used to its full potential in the standard care for chronic, persistent or recurrent synovitis. The working mechanism of RSO is simple yet elegant. Radiopharmaceutical particles are, after injection in the affected synovial joint, gobbled up by phagocytizing subsynovial inflammatory cells. As a consequence, the synovium will be irradiated locally resulting in synovial cell necrosis and inhibition of cell proliferation, which eventually leads to a decrease in the inflammatory response in the joint cavity...

BACKGROUND: The role of positron emission tomography / computed tomography (PET/CT) in hepatocellular carcinoma (HCC) management is not clearly defined. Our objective was to analyze the utility of dual-PET/CT (18F-FDG + 18F-Choline) imaging findings on the BCLC staging and treatment decision for HCC patients. METHODS: Between January 2011 and April 2019, 168 consecutive HCC patients with available baseline dual-PET/CT imaging data were retrospectively analyzed. To identify potential refinement criteria for surgically-treated patients, survival Kaplan-Meier curves of various standard-of-care and dual-PET/CT baseline parameters were estimated...

BACKGROUND: This study aimed to investigate parameters for medication-related osteonecrosis of jaw (MRONJ) patients using the bone SPECT/CT, especially bone mineral-based parameters. METHODS: Sixty-three patients with MRONJ (43 osteoporosis and 20 bone metastasises) underwent CT, MRI and SPECT/CT. A commercially available software automatically detected lesion area and calculated the quantitative SPECT/CT parameters as bone mineral-based standardized uptake value (SUV)...

BACKGROUND: Previous studies have shown that application of relatively low 131 I-Iodine activities can successfully be used to treat patients with Graves'disease (GD). We assessed treatment outcome in the long-term follow-up of our GD patients and influencing factors. METHODS: We evaluated 521 GD patients in this retrospective clinical single-center study. In all patients we performed scintigraphy and thyroid uptake measurement after 4 h and 24 h using 10 MBq 123 I and calculated administered activity using Marinellis' formula...

BACKGROUND: This study aimed to investigate improvements in 68Ga-FAPI PET/CT image quality due to using total variation regularized expectation maximization (TVR-EM) and ordered subset expectation maximization (OS-EM) reconstruction. METHODS: Data from a total of 24 patients were retrospectively analyzed in this study. Positron emission tomography (PET) images were reconstructed using OS-EM and TVR-EM for 2 and 3 minutes-per-bed (min/bed) acquisition. The SUVmean of a region-of-interest on the liver, image noise, signal-to-noise ratios (SNR), the SUVmax of the lesions and the tumour-to-background ratios (TBR) were measured and compared between the 2 methods...

No abstract text is available yet for this article.

Chronic synovitis is contributing to the development of arthropathy in haemophilia A and B. In most patients with severe and moderate haemophilia, during lifetime, joint damage progresses despite early prophylaxis and intense treatment with coagulation factor concentrates. Recurrent haemorrhages into the joints and subclinical bleeding lead to chronic inflammation of the synovium, neoangiogenesis and remodeling, sustaining a vicious circle of bleeding-remodelingbleeding and progression of osteochondral damage...

Surgical management for synovitis has undergone radical change in the last few years with the evolution of DMARDs and advanced Interventional Radiology techniques. Here we present areas where surgical therapy may still be the most effective option, either alone or in conjunction with non-surgical measures.

[18 F]fluorodeoxyglucose (FDG) PET/CT can be used to image the inflammation in rheumatoid arthritis. Specifically, the synovial metabolic activity can be evaluated visually and measured using standard uptake values. Fluorine-18-labeled Sodium fluoride (NaF) PET/CT can be used to determine synovial osteoblastic activity. Response assessment using FDG PET/CT is routine in many cancers and this is now an emerging technique for rheumatoid arthritis. Vasculitis in rheumatoid arthritis (RA) can be also studied with FDG PET/CT and aortic calcification with NaF PET/CT...

Advanced imaging techniques are needed to help clinicians in the diagnosis, in the choice of the right time for therapeutic interventions or for modifications and monitoring of treatment response in patients with autoimmune connective tissue diseases. Nuclear medicine imaging, especially PET/CT and PET/MRI, may play an important role in detecting disease activity, assessing early treatment response as well as in clarifying the complex mechanisms underlying systemic sclerosis, Sjögren's syndrome or systemic lupus erythematosus...

Large vessel vasculitides (LVV) are defined as chronic inflammatory disorders that affect the arteries with two major variants being distinguished: giant cell arteritis (GCA) and Takayasu's arteritis (TAK). These often present with nonspecific constitutional symptoms which makes an accurate diagnosis often challenging. Nevertheless, timely diagnosis is of utmost importance to initiate treatment and to avoid potential life-threatening complications. [18 F]FDG-PET/CT is nowadays widely accepted as useful tool to aid in the diagnosis of large vessel vasculitis...

Inflammatory bowel diseases (IBD), i.e. Crohn disease and ulcerative colitis, are autoimmune processes of undetermined origin characterized by the chronic inflammation of the digestive tract. There is no single gold-standard to diagnose IBD which is therefore carried out through the combination of endoscopy, biopsy, radiological and biological investigations; and the development of non-invasive technique allowing the assessment and monitoring of these diseases is necessary. In this state-of-the-art review of the literature, we present the results of PET imaging studies for the diagnosis and staging of IBD (suspected or known), response evaluation to treatment and evaluation of one the main complication, i...