A quick glance at selected topics in this issue.

"A quick glance at selected topics in this issue" aims to highlight contents of the Journal and provide a quick review to the readers.

Population-Based Study on Patterns of Cardiac Stress Testing After Percutaneous Coronary Intervention.

BACKGROUND: The appropriate use criteria considers cardiac stress testing within 2 years after percutaneous coronary intervention (PCI) to be rarely appropriate, unless prompted by symptoms or change in clinical status. Little is known about the patterns of cardiac stress testing after PCI in the single-payer Canadian healthcare system, where mechanisms for reimbursement are different from the United States. METHODS AND RESULTS: Frequency and timing of cardiac stress testing within 2 years of PCI performed between April 2004 and March 2013 in Ontario, Canada, was determined from linked provincial databases. Subsequent rates of coronary angiography and revascularization after stress testing were ascertained. Of the 112 691 patients with PCI, 67 442 (59.8%) underwent at least 1 stress test, with 38 267 (34.0%) undergoing repeat stress testing (ie, >1 stress test) within 2 years. Patients who underwent stress testing were younger, had less medical comorbidities, were more likely to reside in urban areas, and had higher incomes. Spikes in incidence of repeat stress testing were observed at 3 to 4 months, 6 to 7 months, and 12 to 13 months after the prior stress test. Of those tested, only 5.9% underwent subsequent coronary angiography, and only 3.1% underwent repeat revascularization within 60 days of stress testing. CONCLUSIONS: More than half of all patients undergo cardiac stress testing within 2 years of PCI, with one third undergoing repeat stress tests. Only 1 of 30 tested patients underwent repeat revascularization. These findings reinforce the appropriate use criteria recommendations against routine stress testing after PCI. Further work is needed to aid with the selection of patients most likely to benefit from stress testing after PCI.

Multi-modality imaging: Bird's eye view from the 2016 American Heart Association Scientific Sessions.

This review summarizes key imaging studies that were presented in the American Heart Association Scientific Sessions 2016 related to the fields of nuclear cardiology, cardiac computed tomography, cardiac magnetic resonance, and echocardiography. This bird's eye view will inform readers about multiple studies from these different modalities. We hope that this general overview will be useful for those that did not attend the conference as well as to those that did since it is often difficult to get exposure to many abstracts at large meetings. The review, therefore, aims to help readers stay updated on the newest imaging studies presented at the meeting.

A quick glance at selected topics in this issue.

"A quick glance at selected topics in this issue" aims to highlight selected articles and provide a quick review to the readers.

Introduction of nuclear medicine research in Japan.

There were many interesting presentations of unique studies at the Annual Meeting of the Japanese Society of Nuclear Medicine, although there were fewer attendees from Europe than expected. These presentations included research on diseases that are more frequent in Japan and Asia than in Europe, synthesis of original radiopharmaceuticals, and development of imaging devices and methods with novel ideas especially by Japanese manufacturers. In this review, we introduce recent nuclear medicine research conducted in Japan in the five categories of Oncology, Neurology, Cardiology, Radiopharmaceuticals and Technology. It is our hope that this article will encourage the participation of researchers from all over the world, in particular from Europe, in scientific meetings on nuclear medicine held in Japan.

¿Pancreatitis autoinmune o cáncer de páncreas? / Autoimmune pancreatitis or pancreatic cancer?

No disponible

Bone scintigraphy as cornerstone in the diagnosis of Erdheim-Chester disease / Papel crucial de la gammagrafía ósea en el diagnóstico de la enfermedad de Erdheim–Chester

The Erdheim-Chester disease (ECD) is an extremely rare form of non-Langerhans cell histiocytosis. The main difficulty for its diagnosis lies in the wide variety of non-specific symptoms and signs that can occur in the disease process, leading, therefore, to there being no clear-cut algorithm as a guide for an optimal biopsy to confirm the diagnosis. An 81-year-old male with history of diabetes insipidus was admitted due to non-specific respiratory signs. Imaging techniques revealed osteoblastic lesions in the lumbar spine. Whole-body bone-scintigraphy (BS) was performed, in which lesions involving the axial and appendicular skeleton, with different rates of osteoblastic activity, were observed. This highlighted a symmetrical severely intense uptake in the knees, leading to an accurate biopsy specimen that enabled making the definitive diagnosis. BS is a widely available, safe, and inexpensive technique that shows a characteristic pattern of uptake for ECD, thus its use is highly recommended for screening and guiding biopsy if clinical suspicion exists. Furthermore, when the scintigraphy pattern is incidentally observed, biopsy of increased uptake areas (tibia preferably) is mandatory in order to rule out the disease (AU)

La enfermedad de Erdheim-Chester es una histiocitosis no-Larngerhans extremadamente rara. La dificultad en su diagnóstico se debe a los signos y síntomas inespecíficos que presenta, que conlleva la ausencia de un claro algoritmo diagnóstico. Reportamos el caso de un varón de 81 años con diabetes insipidus en estudio por síntomas respiratorios inespecíficos. Lesiones osteoblásticas en la columna fueron referidas en técnicas radiológicas. Mediante gammagrafía ósea (GO) se observaron lesiones osteoblásticas con diferente actividad metabólica en esqueleto axial y apendicular, destacando una actividad muy elevada y simétrica en rodillas, cuya biopsia permitió el diagnóstico definitivo. La GO es una técnica disponible, segura y barata que muestra un patrón característico, por lo que recomendamos su realización como screening y guía para toma de biopsia. Ante el hallazgo incidental de dicho patrón debería realizarse biopsia (AU)

Nuclear and optical dual-labelled imaging agents. Design and challenges.

Over the last two decades, molecular imaging has been established as a valuable technology, aiming at visualization and characterization of biochemical processes on a molecular level in isolated cells, tissues and higher organisms. Within the wide scope of the various imaging techniques, dual-labelled modalities for nuclear (PET, SPECT) and near-infrared fluorescence (NIRF) imaging show promise owing to their comparable detection sensitivity. Novel materials offer excellent prospects for the development of new non-invasive strategies of early diagnosis and efficient monitoring of therapeutic treatments. In the field of cancer medicine, the combination of different imaging techniques such as PET/SPECT and OI for tracking down tumours and metastases, and subsequent image-guided surgery for tumour resection is particularly attractive. This review focuses on the development of promising dual-labelled agents to be applied in bimodal nuclear/optical imaging, combining radionuclides and fluorescent dyes. The discussion encompasses modular ligands as well as nanoscale systems, including antibodies and their fragments.

An endless research for 2016.

In a moment of reflection of the past year of 2015, as to what we have achieved in medical research and what we need to do in the future we realize that although we have performed an enormous progress in medical research in the past we still have to do much more. In nuclear medicine there are many problems to solve like, how can we differentiate between infection, inflammation and cancer or between lymphomas and adenocarcinomas. In bone scans we need to differentiate traumatic lesions acute or chronic and lesions from another origin. Dosimetry and radiation burden is another problem. In HJNM we have previously published related papers. Not to mention radiation sickness due to modern atomic or hydrogen bombs. Labeling antibodies and genetic material is another issue. Additionally, in general medical knowledge is still unable to solve many unknown, difficult or tragic problems of our lives, like cancer, some viral infections, research in immunology, collagen diseases, genetics, radiation treatment, psychological disorders, anesthetics, the Hayflick phenomenon, hypertension, asthma, the function of the gastrointestinal tract, infectious diseases, physical exercise, all of which are briefly mentioned. We hope that even under the present financial problems and considering that almost 90% of medical truth is still unknown, our research in 2016 will be very important. In this paper we also discuss means for a more genuine and effective research.

Interventional Molecular Imaging.

Although molecular imaging has had a dramatic impact on diagnostic imaging, it has only recently begun to be integrated into interventional procedures. Its significant impact is attributed to its ability to provide noninvasive, physiologic information that supplements conventional morphologic imaging. The four major interventional opportunities for molecular imaging are, first, to provide guidance to localize a target; second, to provide tissue analysis to confirm that the target has been reached; third, to provide in-room, posttherapy assessment; and fourth, to deliver targeted therapeutics. With improved understanding and application of(18)F-FDG, as well as the addition of new molecular probes beyond(18)F-FDG, the future holds significant promise for the expansion of molecular imaging into the realm of interventional procedures.

Hipotensión intracraneal idiopática asociada a disrafismo espinal oculto / Idiopathic intracranial hypotension associated with occult spinal dysraphism

No disponible

[Radionuclide therapy and diagnostics in urology]. / Nuklearmedizinische Therapie und Diagnostik in der Urologie.

In recent years there has been methodological improvement in established nuclear medicine procedures, such as renal and skeletal scintigraphy and new very specific probes for treatment and diagnosis of urological diseases have been introduced into the clinical routine. New diagnostic methods, such as positron emission tomography (PET) using prostate-specific membrane antigen (PSMA) ligands for highly accurate tumor localization in recurrent prostate cancer have become available in many centers. The very high and selective accumulation of these PSMA ligands in tumor tissue has shown promising therapeutic results. Moreover, since 2013 a new radiopharmaceutical agent, radium-223 dichloride, has been approved for treatment of symptomatic bone metastases of prostate cancer. Better knowledge of indications, benefits and limitations of these procedures will help clinicians to adequately introduce them into patient management. This article summarizes the state of the art in established nuclear medicine procedures for urological disorders and also reports on new diagnostic and therapeutic possibilities.

Current status of nuclear cardiology in Japan: Ongoing efforts to improve clinical standards and to establish evidence.

Nuclear cardiology imaging tests are widely performed in Japan as clinical practice. The Japanese nuclear cardiology community has developed new diagnostic imaging tests using (123)I-beta-methyl-p-iodophenyl-pentadecanoic acid, (123)I-metaiodobenzylguanidine, and (18)F-fluorodeoxyglucose PET for detecting cardiac involvement in sarcoidosis. These tests have become popular worldwide. The Japanese Circulation Society and the Japanese Society of Nuclear Cardiology have published clinical imaging guidelines showing indications and standards for the new imaging tests. JSNC is currently striving to improve the standard of clinical practice and is promoting research activities.