Clinical PET-CT and Molecular Imaging (IPET 2015)
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Clinical Appropriateness Guidelines Positron Emission Testing, Other PET Applications, Including Oncologic Tumor Imaging Effective Date: April 21, 2014
Clinical Appropriateness Guidelines Positron Emission Testing, Other PET Applications, including Oncologic Tumor Imaging Effective Date: April 21, 2014 Proprietary and Confidential Date of Origin: 03/30/2005 Last reviewed: 11/14/2013 Last revised: 01/15/2013 Clinical Appropriateness Guidelines 8600 W Bryn Mawr Avenue South Tower - Suite 800 Chicago, IL 60631 P. 773.864.4600 Copyright © 2014. AIM Specialty Health. All Rights Reserved www.aimspecialtyhealth.com Table of Contents Administrative Guideline ..........................................................................................................3 Disclaimer ..............................................................................................................................................................3 Use of AIM’s Diagnostic Imaging Guidelines..........................................................................................................4 Multiple Simultaneous Imaging Requests ..............................................................................................................5 General Imaging Considerations ............................................................................................................................6 PET - Other PET Applications, Including Oncologic Tumor Imaging ......................................8 PET Bibliography ....................................................................................................................12 Table of Contents | Copyright © 2014. AIM Specialty Health. All Rights Reserved. -
Molecular Imaging – Introduction
MOLECULAR IMAGING – INTRODUCTION Author: Markus Rudin Affiliation: Institute for Biomedical Engineering, University and ETH Zurich, Institute for Pharmacology and Toxicology, University of Zurich, HCI-E488.2, ETH Zurich, CH-8093 Zurich, Switzerland, [email protected] Introduction The primary role of biomedical imaging is in diagnostics, i.e. the characterization of a disease phenotype based on morphological or physiological readouts. Image quality is rated based on two criteria: spatial resolution and contrast-to-noise ratio. Image contrast and thereby information can be enhanced by administration of labels that either enhance the contrast in the image or generate a signal that otherwise would not be detectable. When combining a signal generating moiety (a reporter group) with a target-specific carrier (receptor ligand, enzyme substrate, antibody, oligonucleotide, cell) highly specific information on targeted molecular interactions can be obtained. Such target-specific or molecular imaging approaches raised considerable interest both from a diagnostic and therapeutic point-of-view 1-3, and will become important tools for biomedical researchers. They provide temporo-spatial information on molecular processes in the intact organism, i.e. in the full biological context with all regulatory interactions in place. Molecular imaging techniques will therefore play a role for the validation for systems biological approaches. As for structural and functional imaging a primary application area of molecular imaging will be in diagnostics. Tissue/organ structure and function can be considered a phenotype of a molecular program. Being able to visualize and quantify these molecular processes will therefore provide early information on pathologies, eventually in a pre-morbid state. Molecular information will certainly enhance the accuracy of diagnosis allowing for better therapy planning for the individual patient (personalized medicine). -
Recent Advances in Radiological and Radionuclide Imaging and Therapy
European Journal of Endocrinology (2004) 151 15–27 ISSN 0804-4643 REVIEW Recent advances in radiological and radionuclide imaging and therapy of neuroendocrine tumours Gregory Kaltsas, Andrea Rockall1, Dimitrios Papadogias, Rodney Reznek1 and Ashley B Grossman Departments of Endocrinology and 1Academic Radiology, St Bartholomew’s Hospital, London ECIA 7BE, UK (Correspondence should be addressed to Ashley B Grossman, Department of Endocrinology, St Bartholomew’s Hospital, London EC1A 7BE, UK; Email: [email protected]) Abstract Neuroendocrine tumours (NETs) constitute a heterogeneous group of tumours that are able to express cell membrane neuroamine uptake mechanisms and/or specific receptors, such as somatostatin receptors, which can be of great value in the localization and treatment of these tumours. Scintigra- phy with 111In-pentetreotide has become one of the most important imaging investigations in the initial identification and staging of gastro-enteropancreatic (GEP) tumours, whereas helical computed tomography (CT), magnetic resonance imaging (MRI), endoscopic and/or peri-operative ultrason- ography are used for the precise localization of GEPs and in monitoring their response to treatment. Scintigraphy with 123I-MIBG (meta-iodobenzylguanidine) is sensitive in the identification of chromaf- fin cell tumours, although scintigraphy with 111In-pentetreotide may also have a role in the localiz- ation of malignant chromaffin cell tumours and medullary thyroid carcinoma; for further localization and monitoring of the response to treatment both CT and MRI are used with high diagnostic accu- racy. More recently, positron emission tomography (PET) scanning is being increasingly used for the localization of NETs, particularly when other imaging modalities have failed, although its precise role and utility remain to be defined. -
Advanced Ultrasound Technologies for Diagnosis and Therapy
Journal of Nuclear Medicine, published on March 1, 2018 as doi:10.2967/jnumed.117.200030 1 Advanced Ultrasound Technologies for Diagnosis and Therapy Anne Rix1, Wiltrud Lederle1, Benjamin Theek1, Twan Lammers1,2, Chrit Moonen3, Georg Schmitz4, Fabian Kiessling1* 1Institute for Experimental Molecular Imaging, RWTH-Aachen University, Aachen, Germany 2Department of Targeted Therapeutics, University of Twente, Enschede, The Netherlands 3Imaging Division, University Medical Center Utrecht, Utrecht, The Netherland 4Department of Medical Engineering, Ruhr-University Bochum, Bochum, Germany * Corresponding author: Fabian Kiessling MD, Institute for Experimental Molecular Imaging, University Aachen (RWTH), Forckenbeckstrasse 55, 52074 Aachen, Germany. Phone:+49-241- 8080116; fax:+49-241-8082442; e-mail: [email protected] First author: Anne Rix B.Sc., Institute for Experimental Molecular Imaging, University Aachen (RWTH), Forckenbeckstrasse 55, 52074 Aachen, Germany. Phone:+49-241-8080839; fax:+49- 241-8082442; e-mail: [email protected] Running title Advanced Ultrasound Imaging and Therapy 1 2 ABSTRACT Ultrasound is among the most rapidly advancing imaging techniques. Functional methods such as elastography have been clinically introduced, and tissue characterization is improved by contrast- enhanced scans. Here, novel super-resolution techniques provide unique morphological and functional insights into tissue vascularisation. Functional analyses are complemented with molecular ultrasound imaging, to visualize markers of inflammation and angiogenesis. The full potential of diagnostic ultrasound may become apparent by integrating these multiple imaging features in radiomics approaches. Emerging interest in ultrasound also results from its therapeutic potential. Various applications on tumor ablation with high intensity focused ultrasound (HIFU) are clinically evaluated and its performance strongly benefits from the integration into Magnetic Resonance Imaging (MRI). -
Impact of Preoperative Endoscopic Ultrasound in Surgical Oncology
REVIEW Impact of preoperative endoscopic ultrasound in surgical oncology Endoscopic ultrasound (EUS) has a strong impact on the imaging and staging of solid tumors within or in close proximity of the upper GI tract. Technological developments during the last two decades have increased the image quality and allowed very detailed visualization of local tumor spread and lymph node affection. Current indications for EUS of the upper GI tract encompass the differentiation between benign and malignant lesions, the staging of esophageal, gastric and pancreatic cancer, and the procurement of a biopsy specimen through fine-needle aspiration. Various technical innovations during the past two decades have increased the diagnostic quality and have simultaneously strengthened the role of EUS in the clinical setting. This article will give a compressed summary on the current state of EUS and possible further technical developments. 1 KEYWORDS: 3D imaging elastosonography endoscopic ultrasound miniprobes Sascha S Chopra & oncologic surgery Michael Hünerbein† 1Department of General & Transplantation Surgery, Charité Campus Virchow-Clinic, Berlin, Conventional endoscopic ultrasound the so-called ‘miniprobes’ into the biliary system Germany Linear versus radial systems or the pancreatic duct in order to obtain high-res- †Author for correspondence: Department of Surgery & Surgical Endoscopic ultrasound (EUS) with flex- olution radial ultrasound images locally. Present Oncology, Helios Hospital Berlin, ible endoscopes is an important diagnostic and mini probes show a diameter of 2–3 mm and oper- 13122 Berlin, Germany Tel.: +49 309 417 1480 therapeutic tool, especially for the local staging ate with frequencies between 12 and 30 MHz. Fax: +49 309 417 1404 of gastrointestinal (GI) cancers, the differen- The main drawbacks of these devices are the lim- michael.huenerbein@ tiation between benign and malignant tumors, ited durability and the decreased depth of penetra- helios-kliniken.de and interventional procedures, such as biopsies tion (~2 cm). -
207/2015 3 Lääkeluettelon Aineet, Liite 1. Ämnena I Läkemedelsförteckningen, Bilaga 1
207/2015 3 LÄÄKELUETTELON AINEET, LIITE 1. ÄMNENA I LÄKEMEDELSFÖRTECKNINGEN, BILAGA 1. Latinankielinen nimi, Suomenkielinen nimi, Ruotsinkielinen nimi, Englanninkielinen nimi, Latinskt namn Finskt namn Svenskt namn Engelskt namn (N)-Hydroxy- (N)-Hydroksietyyli- (N)-Hydroxietyl- (N)-Hydroxyethyl- aethylprometazinum prometatsiini prometazin promethazine 2,4-Dichlorbenzyl- 2,4-Diklooribentsyyli- 2,4-Diklorbensylalkohol 2,4-Dichlorobenzyl alcoholum alkoholi alcohol 2-Isopropoxyphenyl-N- 2-Isopropoksifenyyli-N- 2-Isopropoxifenyl-N- 2-Isopropoxyphenyl-N- methylcarbamas metyylikarbamaatti metylkarbamat methylcarbamate 4-Dimethyl- ami- 4-Dimetyyliaminofenoli 4-Dimetylaminofenol 4-Dimethylaminophenol nophenolum Abacavirum Abakaviiri Abakavir Abacavir Abarelixum Abareliksi Abarelix Abarelix Abataceptum Abatasepti Abatacept Abatacept Abciximabum Absiksimabi Absiximab Abciximab Abirateronum Abirateroni Abirateron Abiraterone Acamprosatum Akamprosaatti Acamprosat Acamprosate Acarbosum Akarboosi Akarbos Acarbose Acebutololum Asebutololi Acebutolol Acebutolol Aceclofenacum Aseklofenaakki Aceklofenak Aceclofenac Acediasulfonum natricum Asediasulfoni natrium Acediasulfon natrium Acediasulfone sodium Acenocoumarolum Asenokumaroli Acenokumarol Acenocumarol Acepromazinum Asepromatsiini Acepromazin Acepromazine Acetarsolum Asetarsoli Acetarsol Acetarsol Acetazolamidum Asetatsoliamidi Acetazolamid Acetazolamide Acetohexamidum Asetoheksamidi Acetohexamid Acetohexamide Acetophenazinum Asetofenatsiini Acetofenazin Acetophenazine Acetphenolisatinum Asetofenoli-isatiini -
Immunoscintigraphy and Radioimmunotherapy in Cuba: Experiences with Labeled Monoclonal Antibodies for Cancer Diagnosis and Treatment (1993–2013)
Review Article Immunoscintigraphy and Radioimmunotherapy in Cuba: Experiences with Labeled Monoclonal Antibodies for Cancer Diagnosis and Treatment (1993–2013) Yamilé Peña MD PhD, Alejandro Perera PhD, Juan F. Batista MD ABSTRACT and therapeutic tools. The studies conducted demonstrated the good INTRODUCTION The availability of monoclonal antibodies in Cuba sensitivity and diagnostic precision of immunoscintigraphy for detect- has facilitated development and application of innovative techniques ing various types of tumors (head and neck, ovarian, colon, breast, (immunoscintigraphy and radioimmunotherapy) for cancer diagnosis lymphoma, brain). and treatment. Obtaining different radioimmune conjugates with radioactive isotopes OBJECTIVE Review immunoscintigraphy and radioimmunotherapy such as 99mTc and 188Re made it possible to administer radioimmuno- techniques and analyze their use in Cuba, based on the published lit- therapy to patients with several types of cancer (brain, lymphoma, erature. In this context, we describe the experience of Havana’s Clini- breast). The objective of 60% of the clinical trials was to determine cal Research Center with labeled monoclonal antibodies for cancer pharmacokinetics, internal dosimetry and adverse effects of mono- diagnosis and treatment during the period 1993–2013. clonal antibodies, as well as tumor response; there were few adverse effects, no damage to vital organs, and a positive tumor response in a EVIDENCE ACQUISITION Basic concepts concerning cancer and substantial percentage of patients. monoclonal antibodies were reviewed, as well as relevant inter- national and Cuban data. Forty-nine documents were reviewed, CONCLUSIONS Cuba has experience with production and radiola- among them 2 textbooks, 34 articles by Cuban authors and 13 by beling of monoclonal antibodies, which facilitates use of these agents. -
Chapter 12 Monographs of 99Mtc Pharmaceuticals 12
Chapter 12 Monographs of 99mTc Pharmaceuticals 12 12.1 99mTc-Pertechnetate I. Zolle and P.O. Bremer Chemical name Chemical structure Sodium pertechnetate Sodium pertechnetate 99mTc injection (fission) (Ph. Eur.) Technetium Tc 99m pertechnetate injection (USP) 99m ± Pertechnetate anion ( TcO4) 99mTc(VII)-Na-pertechnetate Physical characteristics Commercial products Ec=140.5 keV (IT) 99Mo/99mTc generator: T1/2 =6.02 h GE Healthcare Bristol-Myers Squibb Mallinckrodt/Tyco Preparation Sodium pertechnetate 99mTc is eluted from an approved 99Mo/99mTc generator with ster- ile, isotonic saline. Generator systems differ; therefore, elution should be performed ac- cording to the manual provided by the manufacturer. Aseptic conditions have to be maintained throughout the operation, keeping the elution needle sterile. The total eluted activity and volume are recorded at the time of elution. The resulting 99mTc ac- tivity concentration depends on the elution volume. Sodium pertechnetate 99mTc is a clear, colorless solution for intravenous injection. The pH value is 4.0±8.0 (Ph. Eur.). Description of Eluate 99mTc eluate is described in the European Pharmacopeia in two specific monographs de- pending on the method of preparation of the parent radionuclide 99Mo, which is generally isolated from fission products (Monograph 124) (Council of Europe 2005a), or produced by neutron activation of metallic 98Mo-oxide (Monograph 283) (Council of Europe 2005b). Sodium pertechnetate 99mTc injection solution satisfies the general requirements of parenteral preparations stated in the European Pharmacopeia (Council of Europe 2004). The specific activity of 99mTc-pertechnetate is not stated in the Pharmacopeia; however, it is recommended that the eluate is obtained from a generator that is eluted regularly, 174 12.1 99mTc-Pertechnetate every 24 h. -
Clinical Applications of SPECT/CT: New Hybrid Nuclear Medicine Imaging System
IAEA-TECDOC-1597 Clinical Applications of SPECT/CT: New Hybrid Nuclear Medicine Imaging System August 2008 IAEA-TECDOC-1597 Clinical Applications of SPECT/CT: New Hybrid Nuclear Medicine Imaging System August 2008 The originating Section of this publication in the IAEA was: Nuclear Medicine Section International Atomic Energy Agency Wagramer Strasse 5 P.O. Box 100 A-1400 Vienna, Austria CLINICAL APPLICATIONS OF SPECT/CT: NEW HYBRID NUCLEAR MEDICINE IMAGING SYSTEM IAEA, VIENNA, 2008 IAEA-TECDOC-1597 ISBN 978-92-0-107108-8 ISSN 1011–4289 © IAEA, 2008 Printed by the IAEA in Austria August 2008 FOREWORD Interest in multimodality imaging shows no sign of subsiding. New tracers are spreading out the spectrum of clinical applications and innovative technological solutions are preparing the way for yet more modality marriages: hybrid imaging. Single photon emission computed tomography (SPECT) has enabled the evaluation of disease processes based on functional and metabolic information of organs and cells. Integration of X ray computed tomography (CT) into SPECT has recently emerged as a brilliant diagnostic tool in medical imaging, where anatomical details may delineate functional and metabolic information. SPECT/CT has proven to be valuable in oncology. For example, in the case of a patient with metastatic thyroid cancer, neither SPECT nor CT alone could identify the site of malignancy. SPECT/CT, a hybrid image, precisely identified where the surgeon should operate. However SPECT/CT is not just advantageous in oncology. It may also be used as a one-stop- shop for various diseases. Clinical applications with SPECT/CT have started and expanded in developed countries. -
Molecular Imaging Tutorial
This tutorial will define what is currently considered molecular imaging. It will provide history and an overview, discuss the goals and the advantages of molecular imaging. It will clarify what is and is not molecular imaging, and give examples of different imaging case studies. It will also discuss MRI, Optical Imaging, SPECT and PET imaging, and how they relate to molecular imaging. Molecular Imaging: Definition, Overview and Goals • Definition as published in Eur J Nucl Med: Molecular imaging has its roots in nuclear medicine and in many ways is a direct extension of this discipline. Nuclear Medicine has always focused on patient management through the use of injected radiolabeled tracers in conjunction with imaging technology. • Definition as published in Genes & Dev: Molecular imaging is the visual representation, characterization, and quantification of biological processes at the cellular and subcellular levels within intact living organisms. The images obtained reflect cellular and molecular pathways and in vivo mechanisms of disease present within the natural physiological environment. • Definition according to the American College of Radiology: Molecular imaging is the spatially localized and/or temporally resolved sensing of molecular and cellular processes in vivo. Overview of Molecular Imaging • Development of the first microscope in the late sixteenth century led to a keen interest in observations of structure of tissues and organs. This interest in organ structure and function has driven advances in biology ever since. • Molecular imaging originated from the field of radiopharmacology due to the need to better understand the fundamental molecular pathways inside organisms in a noninvasive manner. Molecular imaging unites molecular biology and in vivo imaging and enables the visualization of cellular function and the follow-up of the molecular process in living organisms without perturbing them. -
Yale New Haven Health- Nuclear Medicine Octreotide Imaging Exam
Yale New Haven Hospital Department of Radiology and Biomedical Imaging NewHaven Nuclear Medicine- Octreotide Scan Health Pre-exam Information and Instructions Thank you for choosing Yale New Haven Hospital We are looking forward to providing you with exceptional care. Your doctor has ordered an Octreotide scan. This is an imaging test that is used for localization of primary and metastatic neuroendocrine tumors bearing somatostatin receptors. This exam consists of 3 appointments over two days. Yale New Haven Hospital Preparation for this Exam: Before Arriving for Your Exam Please arrive 15 minutes early to check in. Children accompanying patients during visits: o Unfortunately, we cannot routinely supervise your children during your imaging study. We believe that you are best served when we can provide 100% of our attention to you. Therefore, we encourage you to make childcare arrangements or to bring a responsible adult with you to supervise your children. There are no pre-exam instructions. The injection for this exam is specifically ordered for you and is very expensive, if you are unable to keep your appointment or have any questions, please call us at 203-688-1011 option 7. Wear loose comfortable clothing, since you will need to lie still for a period of time. We want to make your waiting time as pleasant as possible. Consider bringing your favorite magazine, book or music player to help you pass the time. Please leave your jewelry and valuables at home. After Arriving Upon arrival, a technologist will explain your procedure and answer any questions you may have. ATTENTION Females (ages 10 to 55) To ensure Radiation Safety, the following is YNHH Policy on pregnancy test for this Radiology exam. -
Quo Vadis Molecular Imaging?
Journal of Nuclear Medicine, published on August 28, 2020 as doi:10.2967/jnumed.120.241984 Quo Vadis Molecular Imaging? Jan Grimm1,2*, Fabian Kiessling3,4*, Bernd J. Pichler5,6* (*authors contributed equally and are listed in alphabetical order) 1Molecular Pharmacology Program & Department of Radiology Memorial Sloan-Kettering Cancer Center, New York, NY, USA 2Pharmacology Program & Department of Radiology, Weil Cornell Medical College, New York, NY, USA 3Institute for Experimental Molecular Imaging, University Hospital Aachen, RWTH Aachen University, Center for Biohybrid Medical Systems (CBMS), Forckenbeckstr. 55, 52074 Aachen, Germany 4Fraunhofer Institute for Digital Medicine, MEVIS, Am Fallturm 1, 28359 Bremen, Germany 5Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University, Tuebingen, Germany 6Cluster of Excellence iFIT (EXC 2180) "Image-Guided and Functionally Instructed Tumor Therapies", University of Tübingen, Germany Corresponding authors: Jan Grimm: Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA; phone: +1-646-888-3191; [email protected] Fabian Kiessling: Institute for Experimental Molecular Imaging, RWTH Aachen University, Forckenbeckstrasse 55, D-52074 Aachen; phone: +49-241-8080116; fax: +49-241-803380116; [email protected] Bernd Pichler: Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Röntgenweg 13, 72076 Tübingen, Germany, phone: +49-7071-29- 83427; [email protected] 1 Abstract Molecular Imaging (MI) yields important insights into relevant biological signatures at an organ-specific and systemic level, which is not achievable with conventional imaging methods and thus provides an essential link between preclinical and clinical research. In this context, new diagnostic probes and imaging methods, revealing comprehensive functional and molecular information, are being provided by MI research, several of which have found their way into clinical application.