Résumé
Annually, the incidence of brain tumors has slightly increased and also the patient prognosis is still disappointing, especially for high-grade neoplasms. So, researchers seek methods to improve therapeutic index as a critical aim of treatment. One of these new challenging methods is radioimmunotherapy (RIT) that involves recruiting a coupling of radionuclide component with monoclonal antibody (mAb) which are targeted against cell surface tumor–related antigens or antigens of cells within the tumor microenvironment. In the context of cancer care, precision medicine is exemplified by RIT; precision medicine can offer a tailored treatment to meet the needs for treatment of brain tumors. This review aims to discuss the molecular targets used in radioimmunotherapy of brain tumors, available and future radioimmunopharmaceutics, clinical trials of radioimmunotherapy in brain neoplasms, and eventually, conclusion and future perspective of application of radioimmunotherapy in neurooncology cancer care.
Résumé
Annually, the incidence of brain tumors has slightly increased and also the patient prognosis is still disappointing, especially for high-grade neoplasms. So, researchers seek methods to improve therapeutic index as a critical aim of treatment. One of these new challenging methods is radioimmunotherapy (RIT) that involves recruiting a coupling of radionuclide component with monoclonal antibody (mAb) which are targeted against cell surface tumor–related antigens or antigens of cells within the tumor microenvironment. In the context of cancer care, precision medicine is exemplified by RIT; precision medicine can offer a tailored treatment to meet the needs for treatment of brain tumors. This review aims to discuss the molecular targets used in radioimmunotherapy of brain tumors, available and future radioimmunopharmaceutics, clinical trials of radioimmunotherapy in brain neoplasms, and eventually, conclusion and future perspective of application of radioimmunotherapy in neurooncology cancer care.
Sujets)
Humains , Tumeurs du cerveau , Encéphale , Incidence , Médecine de précision , Pronostic , Radioimmunothérapie , Microenvironnement tumoralRésumé
Introduction: Left ventricular ejection fraction [LVEF] is considered to be the single most important prognostic factor in patients with previous myocardial infarction. LVEF is not improved in all patients after coronary artery bypass grafting [CABG]. This study aimed to assess the possibility of prediction of LVEF changes after CABG using myocardial perfusion gated signle photon emission computed tomography [GSPECT]
Materials and Methods: Overall, 48 patients with mean LVEF of 30.2% [ +/- 4.7] underwent Echocardiography and GSPECT after injection of Tc-99m-MIBI at rest. Myocardial uptake was evaluated in 17 myocardial segments and was compared with age and gender matched normal data pool. The risks and benefits of CABG were explained to the patients and 16 cases [15 male and 1 female] with the mean age of 61.1 years [ +/- 10.8] accepted to undergo off-pump CABG. All the patients were followed-up for at least six months and echocardiography and GSPECT were repeated at the end of follow up
Results: The mean LVEF was increased from of 31.1% [ +/- 3.5] to 34.5% [ +/- 3.6] after surgery [P<0.001]. Delta LVEF was defined as ?LVEF=LVEF [before CABG] -LVEF [after CABG]. ?LVEF was within the range of 0-8% with the mean of 3.4% [ +/- 2.5]. The number of non-viable myocardial segments was not significantly different between patients with ?LVEF ? 5% and those with smaller changes. Myocardial perfusion was estimated for all segments, and the mean global uptake was defined by adding the mean uptake in all segments, divided by 17. The mean global uptake was 53.1% in our patients. Regression analysis revealed that ?LVEF after CABG can be predicted reliably using the following formula: ?LVEF= -33.8 + [0.77 × mean global uptake] [P<0.01]
Conclusion: Our study showed that change of LVEF after CABG can be predicted reliably using mean global uptake in preoperative myocardial perfusion SPECT at rest
Résumé
Appendicitis is one of the most common surgical emergencies. In spite of the relatively high rate of negative appendectomy, as a result of miss diagnosis, uncertainty of diagnosis still continues to challenge physicians. The objective of this prospective study was to investigate the role of [99m]Tc-Ubiquicidin [UBI] scintigraphy in the diagnosis of acute appendicitis and to compare [99m]Tc-UBI scintigraphy with [99m]Tc-IgG scintigraphy. Twelve patients with right lower quadrant pain and suspicious of acute appendicitis were referred to the nuclear medicine imaging center. Radionuclide imaging was performed with [99m]Tc-UBI in 8 and [99m]Tc-IgG in 4 patients. Ultrasonography, Alvarado scoring and histopathological examinations were also performed as additional diagnostic tests. Reports from [99m]Tc-IgG and [99m]Tc-UBI scintigraphies of all patients were negative. This study may conclude that [99m]Tc-IgG scintigraphy and [99m]Tc-UBI scintigraphy in the detection of appendicitis do not have adequate efficacy. However, in order to better evaluate [99m]Tc-IgG and [99m]Tc-UBI scintigraphy, a comprehensive study on a large number of patients with clinical suspicious of acute appendicitis would be more helpful
Résumé
In this report, the preliminary results of the experimental evaluation of the Performance of HiReSPECT scanner have been illustrated. In order to assess the capability of the scanner in both planar and tomographic modes, three rats were injected with 99mTc, 99mTc-DMSA, and 99mTc-MDP for thyroid scan, kidney scan and bone scan respectively in order to perform planar imaging. In addition, two rats were injected with 99mTc-MIBI and 99mTc-DMSA to perform cardiac and kidney tomographic imaging, respectively. Tomographic and planar scans of the rat organs showed that radioactive distribution in cardiac, kidney, bone and thyroid images exhibited detailed physiologic information of the imaged organs. Due to high resolution performance of the scanner, thyroid lobes are well depicted and distinguished from each other. Results of the evaluation of the planar and tomographic images indicated that HiReSPECT has appropriate imaging capability as an imaging system in biomedical research
Résumé
The aim of present study was to estimate effective dose from most common procedures performed in nuclear medicine departments of Golestan province. Data of nuclear medicine procedures performed in 2 nuclear medicine departments in Golestan province were collected during 4 years. Effective dose, collective effective dose and effective dose per examination were calculated using standard dosimetry tables. Based on the data of this study, results of 10437 nuclear medicine procedures performed during 4 years have lead to 3.97 mSv as average effective dose per examination and 10.37 human-Sv as mean collective effective dose. It was also revealed that Tc-99m was the main source of effective dose [98.3%], bone scan was the most common procedure [25.9%] and cardiac scan [MIBI-rest] has the highest collective effective dose [33.5%] during 4 years. Beside the cardiac scan which was the most common nuclear medicine procedure and the main contributor of effective dose in patients, due to geographical condition of the northeast of Iran, bone scan was the highest performed nuclear medicine examination in the Golestan province
Sujets)
Dose de rayonnementRésumé
Sternal non-union is a severe complication of sternotomy closure following open heart surgeries. Healing problems typically occur in 0.3% to 5% of patients. Technetium-99m methylene diphosphonate [[99m]Tc-MDP] bone scintigraphy has been used to assess bone nonunion to predict the healing response for proper management. In this report, we present the case of a marked sternal nonunion following coronary artery bypass graft [CABG], using radionuclide bone scintigraphy
Sujets)
Humains , Mâle , Sternum/imagerie diagnostique , Os et tissu osseux/imagerie diagnostique , Médronate de technétium (99mTc) , Cicatrisation de plaie , Pontage aortocoronarienRésumé
The principle of cancer immunotherapy includes various methods of manipulations to influence immune responses against tumors in both humans and animals. This advanced technology of hybridoma production provided the necessary skills to efficiently produce highly specific monoclonal antibodies [mAb]. Radioactively-tagged antibodies which are applied in radioimmunotherapy [RIT], can target adjacent cells and may not require immune function. This study highlights the mechanism and the effect of action of radioimmunotherapic agents, especially two applied agents including [90]Yibritumomab tiuxetan and [131]I-tositumomab that are approved by Food and Drug Administration [FDA] for treatment of some cancers
Sujets)
Humains , Anticorps monoclonaux , Radio-isotopes de l'yttrium , Tumeurs/thérapieRésumé
Percutaneous transluminal coronary angioplasty [PTCA] is an effective method for revascularizing of stenotic coronary vessels. Lack of response to this treatment, either in symptomatic or asymptomatic patients, is usually due to incomplete revascularization, restenosis, and/or irreversibility of myocardial perfusion. Introduction of a noninvasive method with high predictive value for diagnosis of reversibility in ischemic myocardium is of high importance to determine the patients who will benefit from PTCA. Sixty patients with one or two vessel disease, who were candidates for PTCA and had a successful PTCA [proved by post-revascularization angiography], enrolled the study. For all patients myocardial perfusion within 6 months after PTCA. The predictive values of pre-PTCA scan for the diagnosis of reversibility and prediction of perfusion improvement after PTCA were evaluated. Perfusion improvement after PTCA was noted in 52 of 60 patients [86.7%]. The positive predictive value of pre-intervention MPI for diagnosis of reversibility was 94.3% and the corresponding negative predictive value was 71.4%. Myocardial perfusion imaging may play an important role for accurate prediction of perfusion improvement after percutaneous transluminal coronary angioplasty