ABSTRACT
BACKGROUND/AIM: Intraarterial Technetium-99m-Macroaggregated Albumin (99mTc-MAA) administration is an established method to predict particle distribution prior to radioembolization. This study aimed to analyse the impact of intraarterial administration of 99mTc-MAA on changes in liver-specific laboratory parameters and to assess whether such changes are associated with post-radioembolization hepatotoxicity. PATIENTS AND METHODS: A total of 202 patients treated with radioembolization received prior mapping angiography with 99mTc-MAA administration. All patients underwent clinical and laboratory examinations, including liver-specific parameters at certain times before and after mapping angiography/99mTc-MAA administration, as well as before radioembolization and during follow-up. RESULTS: Bilirubin increased temporarily after 99mTc-MAA administration (p<0.001), but was not clinically relevant, and returned close to the initial value before radioembolization. These changes showed no association with subsequent postradioembolic hepatotoxicity or shortened overall survival. CONCLUSION: 99mTc-MAA administration results in a significant, however, not clinically relevant transient increase in bilirubin levels, which does not provide a predictive value for subsequent radioembolization outcome or postradioembolic hepatotoxicity.
Subject(s)
Chemical and Drug Induced Liver Injury/diagnosis , Chemical and Drug Induced Liver Injury/etiology , Embolization, Therapeutic/adverse effects , Liver Neoplasms/complications , Liver Neoplasms/therapy , Radiopharmaceuticals/adverse effects , Technetium Tc 99m Aggregated Albumin/adverse effects , Adult , Aged , Aged, 80 and over , Computed Tomography Angiography , Disease Management , Embolization, Therapeutic/methods , Female , Humans , Liver Function Tests , Male , Middle Aged , Prognosis , Radiopharmaceuticals/administration & dosage , Retrospective Studies , Technetium Tc 99m Aggregated Albumin/administration & dosage , Treatment OutcomeABSTRACT
PURPOSE: Semiquantitative F-FET PET assessment using the tumor's SUV or tumor-to-background ratios (TBRs) can separate gliomas from peritumoral tissue or progression from pseudoprogression. This study investigated if point spread function (PSF) reconstruction of F-FET PET data affects SUV-based dignity assessment. MATERIALS AND METHODS: This study is a retrospective analysis of 87 glioma patients (female, 36; male, 51; age, 48 [13-81] years) undergoing F-FET PET/MRI for staging (n = 17) or restaging (n = 70). PET was reconstructed using ordered-subset expectation maximization with and without PSF. Lesions were delineated with semiautomated background-adapted thresholding relative to SUVmax; background was delineated contralaterally. Comparative measurements with a National Electrical Manufacturers Association International Electrotechnical Commission PET body phantom (sphere-to-background ratios, 8:1 and 4:1) were performed. RESULTS: PSF showed significantly higher tumor SUVmax (median difference, +0.1; interquartile range, 0.04-0.18), SUVmean (+0.05; 0.03-0.08), TBRmax|mean (+0.1; 0.04-0.2), and TBRmean|mean (+0.06; 0.03-0.09) than non-PSF (P < 0.001). Background SUVmean was unaffected. In patients and phantom, differences between PSF and non-PSF increased with TBR and decreased with lesion's PET volume. Differences only exceeded 0.2 SUV for SUVmax or 0.1 SUV for SUVmean if TBR was greater than 3 and lesion's PET volume was less than 10 mL (d = 27 mm). Dignity assessment by PSF and non-PSF was concordant in all patients examined for staging (cutoff, TBRmean|mean > 1.6; positive, 14; negative, 3) and restaging (cutoff, TBRmax|mean > 2.0; positive, 67; negative, 3). CONCLUSIONS: PSF increased tumor SUVmax and SUVmean compared with non-PSF F-FET PET/MRI data, especially in small lesions with high TBR (>3). However, dignity assessment using established TBR cutoffs was not affected.
Subject(s)
Glioma/diagnostic imaging , Image Processing, Computer-Assisted/methods , Magnetic Resonance Imaging , Multimodal Imaging , Positron-Emission Tomography , Tyrosine/analogs & derivatives , Adolescent , Adult , Aged , Aged, 80 and over , Biological Transport , Female , Glioma/metabolism , Humans , Male , Middle Aged , Phantoms, Imaging , Retrospective Studies , Tyrosine/metabolism , Young AdultABSTRACT
A focused low-intensity pulsed ultrasound (FLIPUS) was used to investigate the effects of stimulation period, acoustic intensity and donor age on the osteogenic differentiation potential of rat mesenchymal stromal cells (rMSCs). rMSCs from 3- and 12-mo-old female Sprague Drawly rats were isolated from bone marrow and stimulated 20 min/d with either 11.7 or 44.5 mW/cm2 (spatial average temporal average intensity) for 7 or 14 d. Osteogenic differentiation markers, i.e., Runt-related transcription factor 2 (RUNX2), osteocalcin (OCN) and degree of matrix calcification were analyzed. On day 7 of stimulation, OCN gene expression was enhanced 1.9-fold in cells from young rats when stimulated with low intensity. The low intensity also led to a 40% decrease in RUNX2 expression on day 7 in aged cells, whereas high intensity enhanced expression of RUNX2 on day 14. FLIPUS treatment with low intensity resulted in a 15% increase in extracellular matrix mineralization in young but not old rMSCs. These differences suggest the necessity of a donor-age related optimization of stimulation parameters.
