Potential Clinical Impact of LAFOV PET/CT: A Systematic Evaluation of Image Quality and Lesion Detection.

We performed a systematic evaluation of the diagnostic performance of LAFOV PET/CT with increasing acquisition time. The first 100 oncologic adult patients referred for 3 MBq/kg 2-[18F]fluoro-2-deoxy-D-glucose PET/CT on the Siemens Biograph Vision Quadra were included. A standard imaging protocol of 10 min was used and scans were reconstructed at 30 s, 60 s, 90 s, 180 s, 300 s, and 600 s. Paired comparisons of quantitative image noise, qualitative image quality, lesion detection, and lesion classification were performed. Image noise (n = 50, 34 women) was acceptable according to the current standard of care (coefficient-of-varianceref < 0.15) after 90 s and improved significantly with increasing acquisition time (PB < 0.001). The same was seen in observer rankings (PB < 0.001). Lesion detection (n = 100, 74 women) improved significantly from 30 s to 90 s (PB < 0.001), 90 s to 180 s (PB = 0.001), and 90 s to 300 s (PB = 0.002), while lesion classification improved from 90 s to 180 s (PB < 0.001), 180 s to 300 s (PB = 0.021), and 90 s to 300 s (PB < 0.001). We observed improved image quality, lesion detection, and lesion classification with increasing acquisition time while maintaining a total scan time of less than 5 min, which demonstrates a potential clinical benefit. Based on these results we recommend a standard imaging acquisition protocol for LAFOV PET/CT of minimum 180 s to maximum 300 s after injection of 3 MBq/kg 2-[18F]fluoro-2-deoxy-D-glucose.

[Research training is inadequate among future medical doctors]. / Forskningstræning er utilstrækkeligblandt kommende læger.

This questionnaire survey investigated interest and activity in pregraduate research among 643 medical students at the Faculty of Health and Medical Sciences at the University of Copenhagen. We find, that although the students show great interest and motivation for research, very few have actual research experience. The students described suboptimal research training, lack of tutoring and facilitation as well as of career counselling. Also, conditions for pregraduate research activities are unequal among the faculties of health sciences in Denmark.

First experiences from Copenhagen with paediatric single photon emission computed tomography/computed tomography.

OBJECTIVE: This study evaluates the diagnostic value of single photon emission computed tomographic (SPECT)/multislice computed tomographic (MSCT) fusion images compared with planar scintigraphy in children. METHODS: Fifteen children [eight girls, mean age 13 years (range 2-17 years)] who were examined in the SPECT/16-MSCT scanner at the Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet were included. The studies and clinical indications were eight Tc-hydroxymethane diphosphonate bone scintigraphies (three bone abnormalities, three osteomyelitis, two bone tumours), one bone scintigraphy combined with In-labelled leukocyte study (osteomyelitis), three I-meta-iodobenzylguanidine scintigraphies (neuroblastoma), three In-octreotide scintigraphies (two carcinoid tumours, one Langerhans cell histiocytosis) and one Tc-dimercaptosuccinic acid scintigraphy (suspected renal transplant infarction). At the evaluation of the planar scans, the decision to perform a SPECT/16-MSCT scan was taken. A specialist in nuclear medicine read the SPECT scans and the CT scans were, if performed as high resolution or when in doubt, read by the specialist in radiology, followed by a simultaneous reading. We categorized the additional information gained from the SPECT/MSCT scan into three groups: (i) structural information gained from the CT scan, (ii) additional nuclear medicine information gained from the SPECT scan and (iii) information used for biopsy guidance. Use of a CT scan of diagnostic quality was only allowed (n = 1) after referral from the clinicians, and read in collaboration with the specialist in radiology. RESULTS: Fourteen of the 15 planar scans gained additional structural information from SPECT/CT. Twelve of 15 planar scans gained additional nuclear medicine information. Six studies gained specific information for biopsy guidance. CONCLUSION: SPECT/CT provided additional information in all cases. SPECT/CT in children seems to be a most valuable tool and it increases the certainty of the diagnostic work-up.

Fourteen-year-old girl with endobronchial carcinoid tumour presenting with asthma and lobar emphysema.

INTRODUCTION: Bronchial carcinoid tumours seldom occur in children, and represent a rare cause of pulmonary obstruction. Because of low clinical suspicion and the variable ways of presentation, diagnosis may be delayed. OBJECTIVES: We report on a patient with this tumour. It is hoped that increased awareness of the tumour can lead to earlier diagnosis. METHODS: Report of a case. RESULTS: This case describes a 14-year-old previously healthy girl, presenting with asthma-like symptoms throughout 2 years, decreased lung function and emphysema in left lower lobe on chest x-ray. Computerized tomography (CT) showed an intraluminal process in the left main bronchus and emphysema in both the upper and lower left lobe and showed no signs of metastasis or spread to lung tissue. Bronchoscopy showed an inflammatory polyp. Surgical resection demonstrated a typical carcinoid tumour. Later control biopsy revealed no persisting malignant tissue. The asthma symptoms returned and a new bronchoscopy showed scarring and narrowing of the left bronchus. Treatment comprised of dilatation by bronchoscopy plus daily combination corticosteroids and beta-2-agonist inhalation and the symptoms improved. No signs of relapse 16 months postdiagnosis. CONCLUSIONS: The case clearly shows the delay, which is common in the diagnosis of children with bronchial carcinoid tumours. Symptoms of the obstructive nature of the tumour are variable and might present as emphysema seen on x-ray and CT. Carcinoid tumour should be considered in children with longstanding pulmonary symptoms with no response to conventional treatment. Prognosis is good but long-term follow up is needed.