World Journal of Nuclear Medicine

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ISSN / EISSN : 1450-1147 / 1607-3312
Published by: Georg Thieme Verlag KG (10.1055)
Total articles ≅ 651
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, Jay Suriar Rajasuriar
World Journal of Nuclear Medicine; https://doi.org/10.1055/s-0042-1750342

Abstract:
Positron emission tomography-computed tomography (PET-CT) has demonstrated its usefulness in evaluating nonspecific abdominal and inflammatory symptoms. We report a case of young woman with chronic right upper quadrant abdominal pain. Fluorine-18 fluorodeoxyglucose PET-CT showed subhepatic hypermetabolism. Subsequent diagnostic laparoscopy confirmed the uncommon diagnosis of Fitz-Hugh-Curtis syndrome.
, Marcel Baehr
World Journal of Nuclear Medicine, Volume 21, pp 062-064; https://doi.org/10.1055/s-0042-1744200

Abstract:
In the reported patient with advanced prostate cancer, a bone scan showed a false positive finding in thoracic vertebrae bone metastasis after external beam radiotherapy 2 months ago. An additional Tc-99m-prostate-specific membrane antigen scan showed a negative finding, although nonirradiated iliac bone metastasis was concordantly positive in both scans. The decrease in prostate-specific antigen-level from 156.6 ng/mL to 2.3 ng/mL indicates a strong effect of treatment, hence supporting false positivity in bone scan by flare phenomenon. The authors declare that no funding was applicable. The authors declare that no conflicts of interest/competing interests were applicable. The authors declare that no ethics approval was necessary. The authors declare that no consent to participate was necessary. The authors have consent of publication of their data. The used data and material are available and can be requested. The licenses of used software are available. * The two authors contributed equally to this article and share the first authorship. Publication Date: 11 March 2022 (online) © 2022. World Association of Radiopharmaceutical and Molecular Therapy (WARMTH). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
, Partha S. Choudhury, Parveen Jain, Manish Sharma, Venkata P. B. Koyyala, Sumit Goyal, Chaturbhuj Agarwal, Ankush Jajodia, Sunil Pasricha, Anurag Sharma, et al.
World Journal of Nuclear Medicine, Volume 21, pp 034-043; https://doi.org/10.1055/s-0042-1744201

Abstract:
Aims We compared the immune response evaluation criteria in solid tumors (iRECIST) with immune adaptive positron emission tomography response criteria in solid tumors (imPERCIST) in lung cancer patients treated with nivolumab. Materials and Methods Twenty lung cancer patients underwent fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) scan at baseline (PET-0), after four cycles (PET-1) and six to eight cycles (PET-2) of nivolumab were included. Kappa coefficient (k) was derived to see the level of agreement in two response criteria. Progression-free survival (PFS) curves were computed by the Kaplan–Meier method and compared with the Log Rank test. Univariate and multivariate regression for the percentage change in the sum of diameters (SoD), standard uptake value maximum (SUVmax), sum of metabolic tumor volume (SoMTV), and sum of total lesion glycolysis (SoTLG) was computed. A p-value less than 0.05 was considered significant. Results Kappa coefficient showed a substantial level of agreement (k 0.769) in two response criteria. Mean PFS in partial response, stable disease, and progressive disease (PD) patients in iRECIST and imPERCIST was 27.3, 17.7, 4.2, and 23.3, 18.8, 3.8 months, respectively. The Kaplan–Meier method with the log rank test showed a significant difference in PFS on intracomparison within both criteria; however, it was not significant on intercomparison. On univariate analysis, the percentage change in SoD, SoMTV, SoTLG was significant. However, on multivariate analysis, only percentage change in SoD was a significant predictor. Conclusions We concluded that imPERCIST was equally effective as currently recommended criteria iRECIST for response evaluation of nivolumab in lung cancer patients.
, Shekhar Pal, Nidhi Negi, Shweta Thaledi
World Journal of Nuclear Medicine, Volume 21, pp 083-084; https://doi.org/10.1055/s-0042-1744196

Abstract:
The world is in the midst of an ongoing coronavirus disease 2019 (COVID-19) pandemic caused by the emergence of a 2019-novel coronavirus (2019-nCOV) or severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), as it is now known.[1] The global health crisis caused due to the COVID-19 pandemic and the damage to health, wealth, and well-being have been enormous. The consequences of the same have been far reaching, particularly among the healthcare workers (HCW), who got infected and succumbed to COVID-19 globally. The overall global magnitude of COVID-19 among HCWs during the first wave was recently documented in a survey from 37 countries, wherein the authors have documented 2,736 HCW deaths.[2] The World Health Organization (WHO) Director General, Dr. Tedros Adhanom Ghebreyesus, also emphasized during the announcement of the WHO Health Worker Safety Charter September 17, 2020 that “thousands of health workers infected with COVID-19 have lost their lives worldwide.”[3] According to the WHO, 14% of the COVID-19 cases reported worldwide were among HCWs and in some low- and middle-income countries the number has been as high as 35%.[4] HCWs, particularly the doctors and nursing staff, are at highest risk of acquiring COVID-19 infection or spreading it to their patients. The situation turns out to be more challenging in low- and middle-income countries where the healthcare systems are already weak but overwhelmed and the HCWs are working under stressful conditions, sometimes even without proper personal protective equipment (PPE). A recent review published by Mhango et al identified lack of and/or inadequate PPE, exposure to infected patients, work overload, poor infection control practices, and pre-existing medical conditions as important risk factors for COVID-19 infection among HCWs.[5] The capability of SARS-CoV-2 to be transmitted from asymptomatic and presymptomatic individuals may also contribute to the increased risk among HCWs. Estimates based on pooled serological studies performed in different countries suggest that 7 to 8.7% of HCWs were infected by SARS-CoV-2.[6] Data available from various other studies also suggested that frontline HCWs had greater exposure to SARS-CoV-2 infection as compared with nonclinical staff.[7] [8] [9] As per the data available from Indian Medical Association, while 748 doctors died in the first wave of COVID-19 last year, 776 doctors have succumbed to COVID-19 during the second wave across India.[10] Moreover, the shortage of HCWs in India, with only one doctor for every 1,511 people and one nurse for every 670 people, which is well below the WHO's minimum norms, is another crucial challenge for the country.[11] As the highly effective and safe COVID-19 vaccines are now available and with the ongoing worldwide vaccination drive, not only the active cases of COVID-19 have declined but the number of patients seeking hospitalization has also decreased substantially. Mounting evidence suggests that the vaccines are associated with decreased asymptomatic infections and transmission of SARS-CoV-2.[12] Moreover, among those who have been vaccinated but still got infected, the severity of infection has been considerably low and the hope of the return of healthcare system to pre-COVID-19 era has grown stronger. As of now the pandemic is still rapidly increasing in some parts of the world and the protection of HCWs is imperative as they are at the forefront of fighting the pandemic. The formulation of effective and efficient occupational health policies for HCWs especially in the context of COVID-19 pandemic is the need of the hour. Mandatory COVID-19 vaccination for all the HCWs is one such important preventive measure, and if implemented it will not only be helpful to mitigate HCWs exposure risk to COVID-19 infection but will also ensure the safety of their patients, family members, and fellow HCWs. A study from United Kingdom reported a lower risk of COVID-19 infection among household contacts of vaccinated HCWs compared with household members of unvaccinated HCWs.[13] A recent report of COVID-19 outbreak in a skilled nursing facility attributed to an unvaccinated HCW underlines the risk unvaccinated HCWs can pose to their patients and other HCWs.[14] The recognition of HCW vaccination as an essential component of patient and HCW safety programs emerged during in mid-2000s with a focus on influenza vaccination. Mandatory influenza vaccination programs for HCWs have been associated with high vaccination rates and a significant decrease in healthcare associated influenza among hospitalized patients as well as among HCWs.[15] Similar policies can be adopted for formulating mandatory COVID-19 vaccination scheme for HCWs; however, there are several logistic concerns that need to be addressed. First, it is still unclear that any vaccine approved under Emergency Use Authorization by U.S. Food and Drug Administration can actually be mandated or not. Second, separate provisions be made for HCWs who cannot be vaccinated due to some contraindicated medical conditions. For instance, some individuals may develop allergic reactions after first dose of an mRNA vaccine and may not be able to receive second dose to achieve full immunity. Such individuals should be able to opt for other types of COVID-19 vaccines (vector vaccines or inactivated whole virus vaccine), so that the percentage of unvaccinated HCWs remains low. Third, alternative approaches for HCWs who refuse to get vaccinated should be included. Such HCWs should adhere to strict infection control measures like hygiene protocols, use of masks, and PPEs while working in healthcare facility and should undergo periodic testing for any asymptomatic infection while SARS-CoV-2 is still circulating. Moreover, an exemption to vaccination on religious or personal beliefs is another complicated situation, more so in Indian setting, and needs to be reviewed thoughtfully with a non-judgmental approach....
, Francis Hasford, Nozipho E. Nyakale, M. Mboyo-Di-Tamba Vangu, Bertus Oelofse, Hector M. Leboea
World Journal of Nuclear Medicine, Volume 21, pp 044-051; https://doi.org/10.1055/s-0042-1746173

Abstract:
Introduction The functionality of radionuclide dose calibrator and nuclear medicine imaging systems hasa direct effect on the accuracy and preciseness of internal dosimetry evaluations. Our study, therefore, aimed to critically appraise the radionuclide calibrators and gamma cameras prior to Lutetium-177 (177Lu) internal dosimetry in a developing country. Materials and Methods Two radionuclide calibrators' and three gamma cameras at two South African hospitals were critically appraised in preparation for internal dosimetry of 177Lu. The radionuclide calibrators' accuracy, linearity, and sample volume abilities were appraised. For the three gamma cameras, the uniformity, energy resolution, center of rotation, and collimator sensitivity were appraised. These appraisals were performed between the years 2014 and 2019. Results The radionuclide calibrators' constancy, accuracy, linearity, and sample volume were within ± 5%. We also integrated a 177Lu calibration factor into one radionuclide calibrator's library. The three gamma cameras' uniformity was within 2 to 5%, energy resolution within 11%, center of rotation within 2 mm, and the sensitivity recorded for all low energy high resolution collimator. Conclusion Our radionuclide calibrators passed the critical appraisal and may be confidently used for assaying 177Lu. All three cameras also passed critical appraisal and may be used to assess organ absorbed dose. Sefako Makgatho Health Sciences University Research Ethics Committee approved this study, SMUREC Ethics Reference Number: SMUREC//M/114/2018: PG University of Kwazulu-Natal Biomedical Research Ethics Committee approved this study, BREC Ethics Reference Number: BE693/18. Publication Date: 30 April 2022 (online) © 2022. World Association of Radiopharmaceutical and Molecular Therapy (WARMTH). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
, Pandurangan Basumani, Anand Kothandaraman, Ravi Ramakrishnan
World Journal of Nuclear Medicine, Volume 21, pp 069-072; https://doi.org/10.1055/s-0042-1746176

Abstract:
Tuberculous involvement of the spine (tuberculosis [TB] spine) can cause severe morbidity unless detected and treated early. Apart from the constitutional symptoms, it can present with back pain, kyphosis, gait abnormality, and paraplegia secondary to the bone or spinal cord involvement. There had been instances of TB spine presenting directly as abdominal pain due to psoas abscesses. Herein, we report a very rare clinical manifestation of TB spine as referred pain in the right upper abdominal quadrant due to right epidural phlegmon associated with T7 vertebra, detected by positron emission tomography.
Domnique S. Newallo, Michara Chataigne, Saima Muzahir
World Journal of Nuclear Medicine, Volume 21, pp 065-068; https://doi.org/10.1055/s-0042-1748030

Abstract:
Peritoneal scintigraphy, although rarely used, plays a vital role in the diagnosis of peritoneal dialysis catheter complications. Reported complications include spontaneous hydrothorax secondary to a pleuroperitoneal fistula, which requires the abandonment of peritoneal dialysis, given that a delay in diagnosis can lead to worsening clinical status. Previously reported peritoneal scintigraphy protocols recommended intraperitoneal instillation of radiotracer and moderate-to-large volumes of dialysate or sterile saline ranging from 350 to 2,000 mL. However, smaller volumes, in conjunction with the use of single-photon emission computed tomography/computed tomography, are not verified in patients receiving peritoneal scintigraphy imaging.
Pramit Kumar, Parneet Singh, Hardik Veerwal, Bina Ravi,
World Journal of Nuclear Medicine, Volume 21, pp 028-033; https://doi.org/10.1055/s-0042-1744198

Abstract:
Objective Lymphedema of the upper limb is the most common complication in patients with breast cancer, who require axillary lymph node (LN) dissection. Proposition of identifying upper limb draining LN and preserving it, during axillary dissection can reduce significant postoperative morbidity, but it has the risk of inadequate oncological resection. This study was planned to find out metastatic rate in axillary reverse mapping (ARM) nodes in our population. Materials and Methods Lymphoscintigraphy (LSG) was performed using intradermal injection of 99mTc Sulfur Colloid into ipsilateral second and third interdigital web spaces of hand in patients with breast cancer. Planar, single-photon emission computed tomography-computed tomography images were acquired followed by intraoperative localization of arm draining LNs using Gamma Probe. All identified ARM nodes were dissected and sent for histopathological examination to confirm metastatic involvement. Results Twenty eligible patients were prospectively analyzed. The identification rate of arm draining LN with LSG was 90% (18/20). Among 14 eligible patients included in the study, ARM node metastasis was seen in two patients. A total of 64 ARM nodes were dissected from 14 patients, 4/64 nodes (2 patients) were positive for metastases (6.25%). Of the six patients excluded from the study, in 1 patient ARM node could not be identified on Gamma Probe, in two cases, it could not be retrieved surgically, in next two cases ARM could not be identified on LSG and remaining one case was removed because of previous surgical intervention. Conclusion In the current study, LSG showed the identification rate of 90% for ARM nodes in patients with carcinoma breast and metastatic involvement was seen in 6.25% (4/64) of these nodes in 2/14 (14.2%) patients, which is in agreement with previously published data. Oncological safety of preserving ARM nodes needs to be evaluated in the larger population. Publication Date: 13 April 2022 (online) © 2022. World Association of Radiopharmaceutical and Molecular Therapy (WARMTH). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
Abhishek Purkayastha, Virender Suhag, Sachin Taneja, Azhar Husain
World Journal of Nuclear Medicine, Volume 21, pp 076-079; https://doi.org/10.1055/s-0042-1748155

Abstract:
Carcinoma penis is a rare malignancy accounting 0.5 to 1% cases in the developed countries with a slightly higher incidence in the developing nations. Slow locoregional progression is characteristic of penile carcinoma and distant metastases are very uncommon. We hereby report a case of highly aggressive squamous cell penile carcinoma in a 46-year-old male with fulminant upfront distant dissemination to left supraclavicular lymph nodes without involving the inguinal and pelvic nodes detected by whole-body 18F-fluorodeoxyglucose positron emission tomography scan. The scan also detected lytic destructive lesion involving the pelvic and adjacent bones with infiltration of skeletal muscles. He was treated with palliative radiotherapy to the weight-bearing sites followed by systemic chemotherapy. A thorough review of literature reveals that our case may be one of the rarest cases ever reported in world literature where an asymptomatic penile carcinoma presents with upfront supraclavicular lymph node metastasis bypassing the inguinal, pelvic, and retroperitoneal lymph node chains. Purkayastha Abhishek conceptualized, designed and prepared the manuscript. Purkayastha Abhishek and Suhag Virender were involved in definition of intellectual content and literature search. Purkayastha Abhishek, Suhag Virender, and Taneja Sachin contributed substantially in clinical studies, data analysis, and statistical analysis. Purkayastha Abhishek, Suhag Virender, and Husain Azhar helped in data acquisition. Purkayastha Abhishek, Suhag Virender, Taneja Sachin, and Husain Azhar were involved in manuscript editing and review. Purkayastha Abhishek, Suhag Virender, Taneja Sachin, and Husain Azhar provided guarantee. The manuscript has been read and approved by all the authors, the requirements for authorship have been met, and each author believes that the manuscript represents honest work. Written informed consent to publication was obtained from the patient. Publication Date: 30 April 2022 (online) © 2022. World Association of Radiopharmaceutical and Molecular Therapy (WARMTH). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
Habibollah Dadgar, Nasim Norouzbeigi, Narges Jokar, Jafar Zareizadeh, Ali Gholamrezanezhad, Hojjat Ahmadzadehfar, Moloud Abbaszadeh,
World Journal of Nuclear Medicine, Volume 21, pp 001-008; https://doi.org/10.1055/s-0042-1748154

Abstract:
Bone is a common metastasis site in several malignancies, most importantly prostate and breast cancers. Given the significance of the early and accurate diagnosis of bone metastases for preliminary staging, treatment planning and monitoring, restaging, and survival prediction in patients with malignancy, it is critical to compare and contrast the strengths and weaknesses of imaging modalities. Although technetium-99m-labeled diphosphonates [99mTc-MDP] scintigraphy has been used for assessing skeletal involvement, there is a renewed interest in fluorine-18-labeled sodium fluoride [18F-NaF] bone imaging with positron emission tomography or positron emission tomography/computed tomography, since this approach provides essential advantages in bone metastases evaluation. This review study aimed to discuss the basic and technical aspects of 18F-NaF imaging and its mechanism of action, and compare this modality with the 99mTc-MDP bone scan and 18F-fluorodeoxyglucose using current evidence from the pertinent literature and case examples of the center in the study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The Institutional Review Board of Razavi Hospital approved all case reports. Publication Date: 30 April 2022 (online) © 2022. World Association of Radiopharmaceutical and Molecular Therapy (WARMTH). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
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