Outcomes of Gamma Knife Radiosurgery for Drug-Resistant Primary Trigeminal Neuralgia.

Objective: To evaluate the result of gamma knife radiosurgery (GKRS) for drug-resistant primary trigeminal neuralgia (TN). Methods: Patients who were diagnosed with drug-resistant primary TN were treated with GKRS at the Nuclear Medicine and Oncology Center, Bach Mai Hospital from January 2015 to June 2020. Using the pain rating scale of the Barrow Neurological Institute (BNI), follow-ups and evaluations were conducted at 1 month, 3 months, 6 months, and 9 month, and 1, 2 years, 3 years, and 5 years after radiosurgery. Comparisons of pain levels was performed before and after radiosurgery according to the BNI scale. Results: From January 2015 to June 2020, 33 patients were treated with GKS. There were 23 female patients and 10 male patients; the average age was 61.9. The average onset time of disease was 4.42 years. Among all patients, 84.8% of patients were relieved from pain and 78.8% were pain-free without medication. The mean time for pain relief was 3 months and was not related to the dose of GKS (<80 Gy and ≥80 Gy). The efficacy of pain relief is not related to blood vessel contact with the trigeminal nerve, the dose of GKS, and the onset of disease. The rate of recurrence after the first pain relief was low (14.3%). Conclusions: Gamma knife is an effective method for the treatment of primary drug-resistant TN, especially in elderly patients with underlying medical conditions. The analgesic effect does not depend on the presence of nerve-vascular conflict.

Efforts in the Formation and Development of Nuclear Medicine in Vietnam / 대한핵의학회잡지

The foundations of nuclear medicine in Vietnam were established from 1970. Until now, after 48 years of development, in Vietnam, we have some basic equipment including 31 SPECT, 4 SPECT/CT machines, 11 PET/CT scanners, five cyclotrons, and one nuclear reactor.Many nuclearmedicine techniques in diagnosis and treatment have been routinely performed at provincial and central level health facilities such as tumor scintigraphy, thyroid scintigraphy, bone scintigraphy, kidney scintigraphy, cardiac scintigraphy, and radio-isotope therapy with I-131 and P-32. Selective internal radiation therapy with Y-90 microsphere and I-125 radioactive seed implantation has been also successfully applied in some big hospitals. However, there are still many difficulties for Vietnam as the lack of new widely used radioisotopes such as Ga-67, Cu-64, Samarium-153, and Lutetium-177 and the lack of nuclear medicine specialists. In the future, we are putting our efforts on the applications of new isotopes in diagnosis and treatment of cancers (theranostic) like Ga-68-DOTATATE, Lutetium-177-DOTATATE, Ga-68-PSMA, and Lutetium-177-PSMA, equipping modern nuclear medicine diagnostic tools, strengthening the human resources training in nuclear medicine. At the same time, we are trying our best to strengthen the cooperation with international nuclear medicine societies in over the world.

Efforts in the Formation and Development of Nuclear Medicine in Vietnam / 대한핵의학회잡지

The foundations of nuclear medicine in Vietnam were established from 1970. Until now, after 48 years of development, in Vietnam, we have some basic equipment including 31 SPECT, 4 SPECT/CT machines, 11 PET/CT scanners, five cyclotrons, and one nuclear reactor.Many nuclearmedicine techniques in diagnosis and treatment have been routinely performed at provincial and central level health facilities such as tumor scintigraphy, thyroid scintigraphy, bone scintigraphy, kidney scintigraphy, cardiac scintigraphy, and radio-isotope therapy with I-131 and P-32. Selective internal radiation therapy with Y-90 microsphere and I-125 radioactive seed implantation has been also successfully applied in some big hospitals. However, there are still many difficulties for Vietnam as the lack of new widely used radioisotopes such as Ga-67, Cu-64, Samarium-153, and Lutetium-177 and the lack of nuclear medicine specialists. In the future, we are putting our efforts on the applications of new isotopes in diagnosis and treatment of cancers (theranostic) like Ga-68-DOTATATE, Lutetium-177-DOTATATE, Ga-68-PSMA, and Lutetium-177-PSMA, equipping modern nuclear medicine diagnostic tools, strengthening the human resources training in nuclear medicine. At the same time, we are trying our best to strengthen the cooperation with international nuclear medicine societies in over the world.