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"Production and quality control of [18F]-FDG in Iran "
"Jalilian AR,Afarideh H,Akbari BA,Shafiee M
Iranian Journal of Nuclear Medicine , 1999,
Abstract: The use of [18F]-2-FDG has been increasing in recent years. This agent was originally used for evaluation of CNS glucose uptake and pathologic conditions by positron emission tomography (PET). In view of increasing demand for this agent, its production has been started at cyclotron dept., Nuclear research center for agriculture & Medicine-Karaj Iran (NRCAM). In this paper, [18F]-FDG synthesis, quality control and other technical aspects are discussed.
Soft tissue sarcomas and 18F-FDG PET (Review article)
S. Izadyar
Iranian Journal of Nuclear Medicine , 2006,
Abstract: Soft tissue sarcomas are a heterogeneous group of tumors arising from mesenchymal origin.This varied tumor family encompasses over 80 different histologic subtypes, many with different treatment protocols and prognosis. In the past, given poor resolution of imaging techniques, many of patients presented at very advanced stages with large masses.Currently CT and MRI are the standard modalities used to investigate these patients, staging and also detecting metastatic lesions. By now studies have shown tha Positron Emission Tomography (PET) with synthetic glucose (deoxyglucose) labeled by fluorine-18 (18F - FDG PET) is effective in the detection of primary sarcoma masses and in differentiating between malignant and benign lesions.FDG- PET has been highly successful in grading, staging, biopsy guidance, therapeutic monitoring and also restaging ( local recurrence versus scar tissue ) of soft tissue sarcomas.
Abnormal 18F-FDG Uptake Detected with Positron Emission Tomography in a Patient with Breast Cancer: A Case of Sarcoidosis and Review of the Literature
Selmin Ataergin,Nuri Arslan,Ahmet Ozet,Mehmet Ali Ozguven
Case Reports in Medicine , 2009, DOI: 10.1155/2009/785047
Abstract: 18F-FDG PET is a useful and sensitive imaging method for a variety of malignancies, however, the specificity is low in active infections and inflammatory diseases. We describe a female patient with stage IIIA breast cancer in first complete remission with combination chemotherapy who developed nodular formations in the lung and axilla 12 years later. Imaging studies as well as FDG PET showed nodular lesions and increased metabolic activity which was interpreted as the progression of the primary disease. She was first given combination chemotherapy and hormonal therapy but was proven thereafter to have sarcoidosis by pathologic examination and was successfully treated with corticosteroid treatment.
The Role of 18F-FDG-Positron Emission Tomography/Computed Tomography in Staging Primary Breast Cancer  [cached]
Naoki Niikura, Naoto T. Ueno
Journal of Cancer , 2010,
Abstract: Despite Medicare approving the use of positron emission tomography/computed tomography (PET/CT) in staging primary breast cancer, little evidence is available to support the use of 18F-FDG-PET/CT for the detection of distant metastases in the initial staging of breast cancer. In this review of the literature listed in MEDLINE, we examine whether 18F-FDG-PET/CT may play a role in the initial staging of breast cancer. We discuss studies comparing PET/CT with conventional imaging for diagnosing distant metastases and axillary and extra-axillary lymph node metastases.
11C-choline vs. 18F-FDG PET/CT in assessing bone involvement in patients with multiple myeloma
Cristina Nanni, Elena Zamagni, Michele Cavo, Domenico Rubello, Paola Tacchetti, Cinzia Pettinato, Mohsen Farsad, Paolo Castellucci, Valentina Ambrosini, Gian Montini, Adil Al-Nahhas, Roberto Franchi, Stefano Fanti
World Journal of Surgical Oncology , 2007, DOI: 10.1186/1477-7819-5-68
Abstract: As MM bone lesions may present low 18F-FDG uptake; the aim of this study was to assess the possible added value and limitations of 11C-Choline to that of 18F-FDG PET/CT in patients affected with MM.Ten patients affected with MM underwent a standard 11C-Choline PET/CT and an 18F-FDG PET/CT within one week. The results of the two scans were compared in terms of number, sites and SUVmax of lesions.Four patients (40%) had a negative concordant 11C-Choline and 18F-FDG PET/CT scans. Two patients (20%) had a positive 11C-Choline and 18F-FDG PET/CT scans that identified the same number and sites of bone lesions. The remaining four patients (40%) had a positive 11C-Choline and 18F-FDG PET/CT scan, but the two exams identified different number of lesions. Choline showed a mean SUVmax of 5 while FDG showed a mean SUVmax of 3.8 (P = 0.042). Overall, 11C-Choline PET/CT scans detected 37 bone lesions and 18F-FDG PET/CT scans detected 22 bone lesions but the difference was not significant (P = 0.8).According to these preliminary data, 11C-Choline PET/CT appears to be more sensitive than 18F-FDG PET/CT for the detection of bony myelomatous lesions. If these data are confirmed in larger series of patients, 11C-Choline may be considered a more appropriate functional imaging in association with MRI for MM bone staging.Multiple myeloma (MM) is a B cell neoplasm involving bones in more than 80% of cases. Patients frequently present with a single or multiple lytic bone lesions causing bone pain, pathological fractures and hypercalcaemia [1-5]. Bone abnormalities (lytic or osteopenic) are one of the myeloma related organ dysfunction [6] and are responsible for low quality of life due to severe pain and high incidence of fractures, and this is particularly dangerous if located in the spine. The incidence of vertebral fractures can be reduced with bisphosphonates that are now available in the therapeutic armamentarium of MM.Bone lesions are usually evaluated with a spectrum of imaging techn
Non-FDG PET in the practice of oncology  [cached]
Caroli P,Nanni C,Rubello D,Alavi A
Indian Journal of Cancer , 2010,
Abstract: Fluoro-2-deoxy-d-glucose-positron emission tomography (FDG-PET) is utilized in more than 90% of cancers in staging, re-staging, assessing therapy response and during the follow-up. However, not all tumors show significant increase of metabolic activity on FDG-PET imaging. This is particularly true for prostate cancer, neuroendocrine tumors and hepatic tumors. In this review we have considered those already used for clinical applications such as 11C- and 18F-Choline, 11C-Methionine and 18F-FET, 18F-DOPA, 68Ga-DOTA-somatostatine analogues, 11C-Acetate and 18F-FLT. Choline presents a high affinity for malignant prostate tissue, even if low grade. Choline can be labeled with either 11C or 18F, the former being the preference due to lower urinary excretion and patients exposure. The latter is more useful for possible distribution to centers lacking in on-site cyclotron. Methionine is needed for protein synthesis and tumor cells require an external supply of methionine. These tracers have primarily been used for imaging of CNS neoplasms. The most appropriate indication is when conventional imaging procedures do not distinguish between edema, fibrosis or necrosis and disease relapse. In addition, the uptake of 11C-Methionine is proportional to the tumor grade and, therefore, the maximum small unilamellar vesicles (SUV) inside the brain mass before therapy is somehow considered a prognostic value. Neuroendocrine tumors (carcinoids, pheocromocytoma, neuroblastoma, medullary thyroid cancer, microcytoma, carotid glomus tumors, and melanoma) demonstrate an increased activity of L-DOPA decarboxylase, and hence they show a high uptake of 18FDOPA. For the study of NETs, 68Ga-DOTA-TOC/DOTA-NOC has been introduced as PET tracer. This compound for PET imaging has a high affinity for sst2 and sst5 and has been used in the detection of NETs in preliminary studies; 68Ga-DOTA-NOC PET is useful before metabolic radiotherapy in order to evaluate the biodistribution of the therapeutic compound; 18F-FLT is a specific marker of cell proliferation and the most important field of application of FLT is lung cancer. Other tracers are used in PET utilized as markers of hypoxia inside big neoplastic masses include 18F-MISO, 64Cu-ATSM, 18F-EF5, which highlight the presence of hypoxic areas are useful for patients that must be treated with radiotherapy.
Combined approach of perioperative 18F-FDG PET/CT imaging and intraoperative 18F-FDG handheld gamma probe detection for tumor localization and verification of complete tumor resection in breast cancer
Nathan C Hall, Stephen P Povoski, Douglas A Murrey, Michael V Knopp, Edward W Martin
World Journal of Surgical Oncology , 2007, DOI: 10.1186/1477-7819-5-143
Abstract: Two breast cancer patients were evaluated. 18F-FDG was administered and PET/CT was acquired immediately prior to surgery. Intraoperatively, tumors were localized and resected with the assistance of a handheld gamma probe. Resected tumors were scanned with specimen PET/CT prior to pathologic processing. Shortly after the surgical procedure, patients were re-imaged with PET/CT utilizing the same preoperatively administered 18F-FDG dose.One patient had primary carcinoma of breast and a metastatic axillary lymph node. The second patient had a solitary metastatic liver lesion. In both cases, preoperative PET/CT verified these findings and demonstrated no additional suspicious hypermetabolic lesions. Furthermore, intraoperative gamma probe detection, specimen PET/CT, and postoperative PET/CT verified complete resection of the hypermetabolic lesions.Immediate preoperative and postoperative PET/CT imaging, utilizing the same 18F-FDG injection dose, is feasible and image quality is acceptable. Such perioperative PET/CT imaging, along with intraoperative gamma probe detection and specimen PET/CT, can be used to verify complete tumor resection. This innovative approach demonstrates promise for assisting the oncologic surgeon in localizing and verifying resection of 18F-FDG positive tumors and may ultimately positively impact upon long-term patient outcomes.For many cancers, the risk of recurrence remains deceptively elevated despite presumption of complete resection at the time of initial surgical management. This implies that occult disease may remain undetected at the time of surgery and resultantly may not be resected by the standard surgical approaches. In this regard, diagnostic 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) imaging has become an established method for detecting sites of occult disease in oncology and is widely used in medical and surgical planning of cancer patients.Breast cancer remains the leading cause of ne
Synthesis, quality control and dosimetry of the radiopharmaceutical 18F-sodium fluoride produced at the Center for Development of Nuclear Technology - CDTN
Silveira, Marina Bicalho;Soares, Marcella Araugio;Valente, Eduardo Sarmento;Waquil, Samira Soares;Ferreira, Andréa Vidal;Santos, Raquel Gouvêa dos;Silva, Juliana Batista da;
Brazilian Journal of Pharmaceutical Sciences , 2010, DOI: 10.1590/S1984-82502010000300021
Abstract: 18f-sodium fluoride (na18f) is a radiopharmaceutical used for diagnosis in nuclear medicine by positron emission tomography (pet) imaging. bone scintigraphy is normally performed using 99mtc-mdp. however, 18f pet scans promise high quality imaging with increased resolution and improved sensitivity and specificity. in order to make available a tool for more specific studies of tumors and non-oncological diseases of bone tissue, the uppr/cdtn team undertook the production and quality control of na18f injectable solution with the physical-chemical, microbiological and biological characteristics recommended in the u.s. pharmacopeia. na18f radiochemical purity was 96.7 ± 1.3 %, with rf= 0.026 ± 0.006. the product presented a ph of 5.3 ± 0.6, half life of 109.0 ± 0.8 minutes, endotoxin limit < 5.0 eu.ml-1 and no microbial contaminants. the biodistribution of na18f was similar to that described in the literature, with a clearance of 0.19 ml.min-1 and distribution volume of 18.76 ml. the highest bone concentration (5.0 ± 0.5 %id.g-1) was observed 20 minutes after injection. na18f produced at the uppr presented all the quality assurance requirements of the u.s. pharmacopeia and can be safely used for clinical bone imaging.
Leading role of 18F-FDG-PET imaging in early diagnosis of Alzheimer’s disease: an overview
Cason E, Treglia G, Fagioli G
Research and Reports in Nuclear Medicine , 2011, DOI: http://dx.doi.org/10.2147/RRNM.S16142
Abstract: ding role of 18F-FDG-PET imaging in early diagnosis of Alzheimer’s disease: an overview Review (3059) Total Article Views Authors: Cason E, Treglia G, Fagioli G Published Date June 2011 Volume 2011:1 Pages 11 - 19 DOI: http://dx.doi.org/10.2147/RRNM.S16142 Ernesto Cason1, Giorgio Treglia2, Giorgio Fagioli1 1Unit of Nuclear Medicine, Maggiore Hospital of Bologna, Bologna, Italy; 2Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Rome, Italy Abstract: Early detection of Alzheimer’s disease (AD) is important to reveal preclinical pathological alterations, to monitor disease progression, and to evaluate response to therapy. The study of cerebral glucose metabolism through 18F-fluoro-deoxy-glucose positron emission tomography (FDG-PET) plays a leading role in early detection of AD because the decrease of cerebral glucose metabolism largely precedes the onset of AD symptoms. This technique demonstrated high sensitivity in early diagnosis of AD, allowing a qualitative and quantitative estimate of cerebral glucose metabolism. Furthermore FDG-PET imaging may help to discriminate the subjects of a high-risk population (like patients with mild cognitive impairment) who more probably will develop AD: an early stage of AD generally shows hypometabolism of medial temporal lobes and parietotemporal posterior cortices; other cerebral cortices are later involved. The combination of FDG-PET with other biomarkers, such as genotype, cerebrospinal fluid markers, and amyloid plaque imaging, may increase the preclinical diagnostic accuracy and offer promising approaches to assess individual prognosis in AD patients.
Lista de recomenda??es do Exame PET/CT com 18F-FDG em Oncologia: consenso entre a Sociedade Brasileira de Cancerologia e a Sociedade Brasileira de Biologia, Medicina Nuclear e Imagem Molecular
Soares Junior, José;Fonseca, Roberto Porto;Cerci, Juliano Julio;Buchpiguel, Carlos Alberto;Cunha, Marcelo Livorsi da;Mamed, Marcelo;Almeida, Sérgio Altino de;
Radiologia Brasileira , 2010, DOI: 10.1590/S0100-39842010000400010
Abstract: the authors present a list of recommendations on the utilization of 18f-fdg pet/ct in oncology for the diagnosis, staging and detection of cancer, as well as in the follow-up of the disease progression and possible recurrence. the recommendations were based on the analysis of controlled studies and a systematic review of the literature including both retrospective and prospective studies regarding the clinical usefulness and the impact of 18f-fdg pet/ct on the management of cancer patients. 18f-fdg pet/ct should be utilized as a supplement to other conventional imaging methods such as computed tomography and magnetic resonance imaging. positive results suggesting changes in the clinical management should be confirmed by histopathological studies. 18f-fdg pet should be utilized in the diagnosis and appropriate clinical management of cancer involving the respiratory system, head and neck, digestive system, breast, genital organs, thyroid, central nervous system, besides melanomas, lymphomas and occult primary tumors.
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