Radiology & Imaging
The Diverse Utility of Contrast Media Delivery and Dosing During Computed Tomography: An International Assessment of Knowledge and Practices
Background: Despite the escalated production rate the Iodinated Contrast Media (ICM) shortage continues and demand outweighs supply. Aim: The aim of this study is to investigate the knowledge and practice of ICM delivery in computed tomography (CT) among radiographers and radiologic technologists worldwide. Methods: An IRB-approved cross-sectional survey used Google Forms for data collection. It involved 94 CT radiographers from 27 countries and was divided into five sections. The first section gathered demographic information followed by sections on experience self-assessment of ICM reactions and delivery technique. The third section explored ICM knowledge and its relation to CT parameters. The fourth and fifth sections focus on practices during pulmonary angiography CT and renal CT scans. Data analysis involved descriptive statistics the Chi- Square test and ANOVA. Results: Knowledge was assessed with seven questions and a score of at least 3.5 was needed for categorization. The median score was two indicating low knowledge. Specifically 64.9% of the participants scored lower than the two scores. Years of experience are strongly correlated with the level of knowledge with 51.6% of radiographers having more than 10 years of experience demonstrating adequate knowledge. 41.7% of respondents demonstrated adequate knowledge when their duty was focused on CT. Furthermore wide practice variability exists in all CT pulmonary angiography protocols among radiographers with adequate and inadequate knowledge. Conclusion: Inexperienced individuals showed knowledge gaps leading to varied practices and highlighting the need for educational programs. The study underscores establishing standardized Protocols and Practice Guidelines (PPGs) for contrast media administration in Radiology Departments. Additionally it emphasizes the importance of regular training programs and international knowledge sharing. The potential for self-selection bias in the online survey sample is highlighted.
Optimal Indications of Radioimmunotherapy in Nuclear Medicine: A Mini-Review
Immunotherapy has emerged as a very considerable and potent therapeutic method in which immune inhibitors have gained a lot of attention in the curative field of various cancers. Under certain circumstances when radiotherapy is accompanied by immunotherapy the efficacy of the therapeutic procedure increases. Irradiated tumor cells follow a pathway called immunogenic cell death which targets tumor associated antigens. The application of radiolabeled antibodies under the concept of “radioimmunotherapy” (RIT) makes the synergistic targeted therapeutic effect possible. Since antibodies themselves are cytotoxic they can kill the cells that not only bind but are within the path length of their radiation emissions. RIT can be categorized as a substantial progress in nuclear medicine. The main concept of RIT includes targeting specified tumor-expressing antibodies. The mentioned purpose is achievable by formulation of radiolabeled antibodies which could be injected intravenously or directly into the tumor as well as compartmentally into a body cavity such as the peritoneum pleura or intrathecal space. RIT has demonstrated very optimistic therapeutic outcomes in radioresistant solid tumors. Wide ranges of efforts are accomplished in order to improve clinical trial accomplishments. In this review we intend to summarize the performed studies on RIT and their importance in medicine.
An 18F-MD-PSMA (Multi-dentate PMSA Imaging Agent) PET/CT in Prostate Cancer Relapse: Results of a Retrospective Trial
Purpose: This study aimed to evaluate the performance of 18F-MD-PSMA PET/CT in patients previously treated for prostate cancer by either surgery or therapy but later relapsed biochemically. Methods: This retrospective study enrolled 213 patients in sequence previously treated for prostate cancer by either surgery or therapy but later PSA relapsed. A total of 191 of these 213 patients were included in this analysis. All patients were biochemically relapsed after radical prostatectomy or therapy had 18F-MD-PSMA PET/CT scan within 1 week and were off hormonal therapy at the time of the scans. The new tracer was compared directly with 11C-choline in sensitivity. Results: In 3 patients a side-by-side comparison between 18F-MD-PSMA and 11C-choline was performed and it was found that the former was about 3 times more sensitive than the latter. The analysis of PET imaging using 18F-MD-PSMA in 191 relapsed patients showed that less than 10% of patients showed the disease limited in the prostate. Among the remote lesions the number in decreasing order was bone followed by lymph nodes and other organs. The maximal SUV in lesions in each patient followed an exponential decay with SUV inclined to the lower end. The Gleason score measured at the diagnosis showed no correlation with the average number of lesions in each patient the average maximal SUV values among this cohort of patients and the PSA values measured at the time of PET imaging. The number of lesions observed in each patient has no correlation with the PSA value measured at the time of PET imaging. When PSA value was measured as an independent biomarker at the time of PET imaging the positivity of PET imaging using 18F-MD-PSMA increased along with an increase in PSA value but with exceptions where PSMA expression was low or negative. From the PET imaging of this radioligand the majority of patients showed oligo-metastasis favoring using local therapy to manage the disease. Conclusion: An 18F-MD-PSMA as a radioligand was found to be superior to 11C-choline in the setting of patients with biochemical relapse after previous treatment. Its PET imaging results matched those of established PSMA radioligands but its chemical structure was found to have added features to conjugate with other functional molecules such as those with therapeutic properties. This radioligand lays the foundation for our further work.
RGIE: A Gene Selection Method Related to Radiotherapy Resistance in Head and Neck Squamous Cell Carcinoma
Background: Head and Neck Squamous Cell Carcinoma (HNSCC) is a malignant tumor with a high degree of malignancy invasiveness and metastasis rate. Radiotherapy as an important adjuvant therapy for HNSCC can reduce the postoperative recurrence rate and improve the survival rate. Identifying the genes related to HNSCC radiotherapy resistance (HNSCC-RR) is helpful in the search for potential therapeutic targets. However identifying radiotherapy resistance-related genes from tens of thousands of genes is a challenging task. While interactions between genes are important for elucidating complex biological processes the large number of genes makes the computation of gene interactions infeasible. Methods: We propose a gene selection algorithm RGIE which is based on ReliefF Gene Network Inference with Ensemble of Trees (GENIE3) and Feature Elimination. ReliefF was used to select a feature subset that is discriminative for HNSCC-RR GENIE3 constructed a gene regulatory network based on this subset to analyze the regulatory relationship among genes and feature elimination was used to remove redundant and noisy features. Results: Nine genes (SPAG1 FIGN NUBPL CHMP5 TCF7L2 COQ10B BSDC1 ZFPM1 GRPEL1) were identified and used to identify HNSCC-RR which achieved performances of 0.9730 0.9679 0.9767 and 0.9885 in terms of accuracy precision recall and AUC respectively. Finally qRT-PCR validated the differential expression of the nine signature genes in cell lines (SCC9 SCC9-RR). Conclusion: RGIE is effective in screening genes related to HNSCC-RR. This approach may help guide clinical treatment modalities for patients and develop potential treatments.
Hypofractionated Radiation Therapy Suppresses Radioresistance in U87 Human Glioma Cells by Inhibiting Yap1 and Hsp90 Proteins
Background: Radiotherapy plays a vital role in the management of high-grade gliomas. However the radio resistance of glioma cells limits the effect of radiation and drives recurrence inside the irradiated tumor volume leading to poor outcomes for patients. Methods: High-grade glioma cell radioresistance significantly contributes to radiotherapy failure highlighting the importance of identifying predictive biomarkers for radioresistance. An increasing body of evidence complies with the Yes Associated Protein 1 (Yap-1) and heat shock protein 90 (Hsp90) as biomarkers for radioresistance in glioma cells. A number of studies suggest the potential of radioresistance-associated factors as biomarkers and/ or novel therapeutic targets in glioma cells. Thus it is essential for glioblastoma patients to identify robust druggable targets involved in radioresistance optimizing irradiation protocol and understanding their underlying molecular mechanisms. Results: Therefore in the present study we hypothesized that hypofractionated Gamma Knife radiation therapy (HF-GKRT) could target Yap-1 and Hsp90 and downregulate the mechanism of radioresistance in high-grade glioma cells. Conclusion: For this purpose expression levels of radioresistance markers Yap-1 and Hsp90 were evaluated after treatment with HF-GKRT and this was compared with single fraction Gamma Knife radiation therapy (SF-GKRT) in U87MG primary human glioblastoma cell line model. This would help design a novel radiation therapy regimen for glioblastoma patients by reducing the risk of radioresistance.
In Situ Photo Responsive Biodegradable Nanoparticle Forming Intrauterine Implant for Drug Delivery to Treat Ovarian Diseases: A Rationale-based Review
Ovarian disease constitutes various types of endocrine disorders such as polycystic ovarian syndrome (PCOS) ovarian cancer premature ovarian failure ovarian endometriosis and ovarian cysts. The prevalence of ovarian-related diseases is highly vulnerable in the world. The utility of various drug delivery systems for ovarian diseases has resulted in varied success. Moreover most of them lead to severe adverse effects and are incapable of ameliorating the signs and symptoms of the condition. Intrauterine devices (IUDs) have positioned themselves as a mechanism to deliver the drug for various ovarian-related diseases. Thereby avoiding various stability-related issues arising due to various physiological barriers of the female reproductive tract. However the use of intrauterine devices for drug delivery to the ovaries has not been fully explored. This is attributed to the fact that they cause cysts in the ovaries and skepticism among patients and physicians. Photo-sensitive devices are an appealing approach for managing disorders affecting the ovaries. Photo-sensitive in situ forming intrauterine implants (IUIs) have several advantages including simplicity in application reduced invasiveness as well as improved site-specific drug release control. Polymeric nanoparticles (PNPs) loaded with a drug may be a suitable choice to provide sustained release alter the pharmacokinetics and reduce the dose and dosing frequency. The current manuscript hypothesizes the utility of a PNP-loaded biodegradable photo-responsive intrauterine implantable device as an alternate novel strategy for ameliorating ovarian-related diseases.
177Lu-PSMA-617 Radioligand Treatment in Elderly Patients with Metastatic Castration-resistant Prostate Cancer: Therapeutic Efficacy and Safety Assessment
Objective: This study aimed to evaluate the therapeutic efficacy and safety of 177Lutetium-Prostate Specific Membrane Antigen (177Lu-PSMA-617) radioligand treatment (RLT) in metastatic castration-resistant prostate cancer (mCRPC) patients with aged older than 75 years. Methods: A total of 37 patients with mCRPC aged older than 75 years treated with 177Lu- PSMA-617 were included in this study. Pre-therapy and post-therapy biochemical metabolic and clinical response results and Hb TLC platelet serum creatinine and bilirubin levels were checked to evaluate the therapeutic efficacy and toxicity profile. The Common Terminology Criteria for Adverse Events was used for grading adverse events caused by 177Lu-PSMA-617 treatment. Results: The mean age of the patients included in the study was 79.8±2.9 (76-92). The number of 177Lu-PSMA-617 treatment cycles ranged from two to four and the mean administered radioactivity dose was 5.6±0.8 GBq per cycle. Partial biochemical response (PR) and partial metabolic response (PMR) were observed in 11 (29.7%) and 15 (40.6%) patients after treatment respectively. Although improvement in ECOG scores was observed in 5 (13.5%) patients after treatment it was not statistically significant. Grade 2 and 3 Hb toxicity was observed in 10 (27%) and 2 (5.4%) patients respectively. Grade 2 leukocytopenia in six patients Grade 1 thrombocytopenia in six patients and Grade 2 serum creatinine toxicity in five patients were seen after the treatment. On the other hand no patients developed liver toxicity and grade 3 or 4 leukocytopenia thrombocytopenia or creatinine toxicity. Conclusion: 177Lu-PSMA-617 treatment was a safe and effective treatment option for properly selected elderly mCRPC patients.
Theranostic and Combined Approaches Exploiting Multifunctional Gold Nanoclusters in Tumoral Ecosystems: A Paradigm Shift in Precision Oncology
Malignant tumors pose a significant threat to human life and well-being because of their rising occurrence and size. The current treatment methods and diagnostic techniques employed in clinical practice are inadequate for effectively treating tumors. Fluorescence photothermal effects radiosensitization and biocompatibility are only a few instances of the unique photonic and physicochemical properties exhibited. Gold nanoclusters (AuNCs) are nanomaterials that possess modest dimensions typically measuring approximately 3 nm and are composed of a limited number of particles. AuNCs have three primary functions in practical applications: serving as imaging agents drug transporters and therapeutic agents. This article discusses nanosystems. The text emphasizes the promise of AuNCs for tumor theranostic and combination treatment while also acknowledging any existing limitations. Lastly it is anticipated that the information presented here will serve as a valuable tool for researchers in this sector resulting in novel perspectives and ultimately a wider adoption of AuNCs in pharmaceuticals. This study focuses on the expansion of diagnostic applications in cancer therapy by utilizing AuNC-based devices made possible by the use of dynamic or passive tumor targeting techniques. The utilization of AuNCs has been thoroughly investigated for their prospective applicability as light-activated and radiation agents. Furthermore they have been investigated as nanocarriers for transporting anticancer drugs. The medications can either bind to the closure receptor or be linked to the AuNCs through various techniques showcasing their extensive potential for therapeutic applications.
"An Integrated Approach using YOLOv8 and ResNet, SeResNet & Vision Transformer (ViT) Algorithms based on ROI Fracture Prediction in X-ray Images of the Elbow"
In this study we harnessed three cutting-edge algorithms' capabilities to refine the elbow fracture prediction process through X-ray image analysis. Employing the YOLOv8 (You only look once) algorithm we first identified Regions of Interest (ROI) within the X-ray images significantly augmenting fracture prediction accuracy.
Subsequently we integrated and compared the ResNet the SeResNet (Squeeze-and-Excitation Residual Network) ViT (Vision Transformer) algorithms to refine our predictive capabilities. Furthermore to ensure optimal precision we implemented a series of meticulous refinements. This included recalibrating ROI regions to enable finer-grained identification of diagnostically significant areas within the X-ray images. Additionally advanced image enhancement techniques were applied to optimize the X-ray images' visual quality and structural clarity.
These methodological enhancements synergistically contributed to a substantial improvement in the overall accuracy of our fracture predictions. The dataset utilized for training testing & validation and comprehensive evaluation exclusively comprised elbow X-ray images where predicting the fracture with three algorithms: Resnet50; accuracy 0.97 precision 1 recall 0.95 SeResnet50; accuracy 0.97 precision 1 recall 0.95 & ViT-B-16 with high accuracy of 0.99 precision same as the other two algorithms with a recall of 0.95.
This approach has the potential to increase the precision of diagnoses lessen the burden of radiologists easily integrate into current medical imaging systems and assist clinical decision-making all of which could lead to better patient care and health outcomes overall.
Whether the Liver-to-Portal Vein Ratio is Applicable for Evaluating the European Society of Gastrointestinal and Abdominal Radiology Hepatobiliary Phase in Gd-EOB-DTPA-Enhanced MRI?
This study aimed to verify whether the Liver-to-portal Ratio (LPR) can assess the adequacy of the Hepatobiliary Phase (HBP) for patients with different liver functions.
A total of 125 patients were prospectively enrolled in the study and graded into the non-cirrhosis group (45) Child-Pugh A group (40) and Child-Pugh B/C group (40). The LPR on HBP was calculated after eight HBPs were obtained within 5-40 minutes. The adequate HBP was determined according to the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus statement. The differences in LPR and lesions’ conspicuity between 10-min HBP and adequate HBP were analyzed by paired t-test and Wilcoxon signed-rank test respectively. The chi-square test was used to test the difference in proportion with LPR larger than 1.462 between 10-min HBP and adequate HBP.
The differences in LPR and lesions’ conspicuity between 10-min HBP and adequate HBP were significant in Child-Pugh A and Child-Pugh B/C groups (P < 0.05) except for the non-cirrhosis group (P > 0.05). The differences in proportion with LPR larger than 1.462 between 10-min HBP and adequate HBP were not statistically significant in all groups (all P > 0.05).
The adequate HBP obtained according to the 2016 ESGAR consensus statement could provide larger LPR and better lesions’ conspicuity than 10-min HBP especially for cirrhotic patients; however the efficacy of using an LPR cutoff of 1.462 as the standard of the adequate HBP may be compromised in patients with cirrhosis.
Prenatal Three-Dimensional Ultrasound Diagnosis of Dural Sinus Arteriovenous Malformation: An Unusual Case Report
Dural sinus arteriovenous malformation is an uncommon intracranial vascular malformation. The affected cases may suffer from severe neurological injury. Prenatal ultrasound has been used to diagnose fetal intracranial vascular abnormality but prenatal three-dimensional (3D) ultrasound presents a very rare anomaly; an arteriovenous malformation of the dural sinus has not been reported.
This study aimed to emphasize the diagnostic value of 3D ultrasound in the fetus with dural sinus arteriovenous malformation.
A 38-year-old woman was referred for targeted fetal ultrasonography at 37 weeks of gestation due to an ultrasound that showed a cystic lesion in the posterior cranial fossa. The fetus demonstrated obvious dilatation of the torcular herophili bilateral transverse sinuses and bilateral sigmoid sinuses appearing as a novel bull's horn sign on 3D ultrasound. After birth cerebral angiography confirmed the diagnosis of dural arteriovenous fistula (DAVF) in the occipital sinus region.
3D ultrasound is an appealing method for prenatal diagnosis of dural sinus arteriovenous malformation.
Muscle CT Radiomics is Feasible in the Identification of Gout
The aim of this study was to investigate the feasibility of muscle CT radiomics in identifying gout.
A total of 30 gout patients and 20 non-gout cases with CT examinations of ankles were analyzed by using the methods of CT radiomics. CT radiomics features of the soleus muscle were extracted using the software of a 3D slicer and then gout cases and non-gout cases were compared. The radiomics features that were significantly different between the two groups were then processed with machine learning methods. Receiver operating characteristic curve analysis was used to evaluate the diagnostic performance.
Five CT radiomics features were significantly different between gout cases and non-gout cases (P < 0.05). In the logic regression the AUC sensitivity specificity and accuracy were 0.738 77% (46/60) 70% (28/40) and 74% (74/100) respectively. In the Random forest Xgboost and support vector machine analysis the accuracy was 0.901 0.833 and 0.875 respectively.
From this study it can be concluded that muscle CT radiomics is feasible in identifying gout.
Performance of Iron Phosphate Glass Containing Various Heavy Metal Oxides for Particulate Nuclear Radiation Shielding
Background: Employees may be exposed to different kinds of ionizing radiation at work. When ionizing radiation interacts with human cells it can cause damage to the cells and genetic material. Therefore one of the scientists' primary objectives has always been to create the best radiation-shielding materials. Glass could offer promising shielding material resulting from the high flexibility of composition simplicity of production and good thermal stability. Materials and Methods: The melt-quenching technique was used to create a glass having the following formula: 50% P2O5+20% Na2O+20% Fe2O3+10% X where X = As2O3 SrO BaO CdO and Sb2O3 mol %. The impact of the different heavy metal additions on the structure of the glass networks was studied using FTIR spectroscopy. Glass's ability to attenuate neutrons and/or charged particles has been theoretically investigated. The performance of the developed glass as a shield was examined by a comparison against commercial glass (RS 253 G18) ordinary concrete (OC) and water (H2O). Results: For charged particle radiations (Electrons Protons and Alpha) the shielding parameters like the mass stopping power the projected range and the effective atomic number were evaluated where S5/Sb glass achieves the best performance. In the case of Neutrons the results values reveal that S3/Ba glass ( ΣR = 0.105) is the best-modified glass for neutron shielding. Conclusion: Among all the investigated glasses S5/Sb glass composition has a smaller range and provides superior protection against charged particles. In contrast the S3/Ba glass composition is a superior choice for shielding against neutron radiation.
Hepatopulmonary Shunt Ratio Verification Model for Transarterial Radioembolization
Introduction: The most important toxicity of transarterial radioembolization therapy applied in liver malignancies is radiation pneumonitis and fibrosis due to hepatopulmonary shunt of Yttrium-90 (90Y) microspheres. Currently Technetium-99m macroaggregated albumin (99mTc-MAA) scintigraphic images are used to estimate lung shunt fraction (LSF) before treatment. The aim of this study was to create a phantom to calculate exact LFS rates according to 99mTc activities in the phantom and to compare these rates with LSF values calculated from scintigraphic images. Materials and Methods: A 3D-printed lung and liver phantom containing two liver tumors was developed from Polylactic Acid (PLA) material which is similar to the normal-sized human body in terms of texture and density. Actual %LSFs were calculated by filling phantoms and tumors with 99mTc radionuclide. After the phantoms were placed in the water tank made of plexiglass material planar SPECT and SPECT/CT images were obtained. The actual LSF ratio calculated from the activity amounts filled into the phantom was used for the verification of the quantification of scintigraphic images and the results obtained by the Simplicity90YTM method. Results: In our experimental model LSFs calculated from 99mTc activities filled into the lungs normal liver small tumor and large tumor were found to be 0% 6.2% 10.8% and 16.9%. According to these actual LSF values LSF values were calculated from planar SPECT/CT (without attenuation correction) and SPECT/CT (with both attenuation and scatter correction) scintigraphic images of the phantom. In each scintigraphy doses were calculated for lung small tumor large tumor normal liver and Simplicity90YTM. The doses calculated from planar and SPECT/CT (NoAC+NoSC) images were found to be higher than the actual doses. The doses calculated from SPECT/CT (with AC+with SC) images and Simplicity90YTM were found to be closer to the real dose values. Conclusion: LSF is critical in dosimetry calculations of 90Y microsphere therapy. The newly introduced hepatopulmonary shunt phantom in this study is suitable for LSF verification for all models/brands of SPECT and SPECT/CT devices.
The Radioprotective Effect of LBP on Neurogenesis and Cognition after Acute Radiation Exposure
Background: Radiation exposure has been linked to the development of brain damage and cognitive impairment but the protective effect and mechanism of Lycium barbarum pills (LBP) on radiation-induced neurological damage remains to be clarified. Methods: Behavioral tests and immunohistochemical studies were conducted to evaluate the protective effects of LBP extract (10 g/kg orally daily for 4 weeks) against radiation-induced damage on neurogenesis and cognitive function in Balb/c mice exposed to 5.5 Gy X-ray acute radiation. Results: The results showed that the LBP extract significantly improved body weight loss locomotor activity and spatial learning and memory. Immunohistochemical tests revealed that the LBP extract prevented the loss of proliferating cells newly generated neurons and interneurons especially in the subgranular area of the dentate gyrus. Conclusion: The findings suggest that LBP is a potential neuroprotective drug for mitigating radiation-induced neuropsychological disorders.
Development and Validation of a Nomogram for Predicting Breast Malignancy in Male Patients Based on Clinical and Ultrasound Features
Objective: This study aimed to construct a nomogram based on clinical and ultrasound (US) features to predict breast malignancy in males. Methods: The medical records between August 2021 and February 2023 were retrospectively collected from the database. Patients included in this study were randomly divided into training and validation sets in a 7:3 ratio. The models for predicting the risk of malignancy in male patients with breast lesions were virtualized by the nomograms. Results: Among the 71 enrolled patients 50 were grouped into the training set while 21 were grouped into the validation set. After the multivariate analysis was done pain BI-RADS category and elastography score were identified as the predictors for malignancy risk and were selected to generate the nomogram. The C-index was 0.931 for the model. Concordance between predictions and observations was detected by calibration curves and was found to be good in this study. The model achieved a net benefit across all threshold probabilities which was shown by the decision curve analysis (DCA) curve. Conclusion: We successfully constructed a nomogram to evaluate the risk of breast malignancy in males using clinical and US features including pain BI-RADS category and elastography score which yielded good predictive performance.
“One Method to Label Them All”: A Single Fully Automated Protocol for GMP-Compliant 68Ga Radiolabeling of PSMA-11, Transposable to PSMA-I&T and PSMA-617
Background: Prostate-specific membrane antigen (PSMA) is an ideal target for molecular imaging and targeted radionuclide therapy in prostate cancer. Consequently various PSMA ligands were developed. Some of these molecules are functionalized with a chelator that can host radiometals such as 68Ga for PET imaging. The 68Ga radiolabeling step benefits from process automation making it more robust and reducing radiation exposure. Objective: To design a single automated radiolabeling protocol for the GMP-compliant preparation of [68Ga]Ga-PSMA-11 transposable to the production of [68Ga]Ga-PSMA-617 and [68Ga]Ga-PSMA-I Methods: A GAIA® synthesis module and a GALLIAD® generator were used. Radio-TLC and radio-HPLC methods were validated for radiochemical purity (RCP) determination. Three [68Ga]Ga-PSMA-11 validation batches were produced and thoroughly tested for appearance and pH radionuclide identity and purity RCP stability residual solvent and sterility. Minimal modifications were made to the reagents and disposables for optimal application to other PSMA ligands. Results: [68Ga]Ga-PSMA-11 for clinical application was produced in 27 min. The 3 validation batches met the quality criteria expected by the European Pharmacopoeia to allow routine production. For optimal transposition to PSMA-617 the solid phase extraction cartridge was changed to improve purification of the radiolabeled product. For application to PSMA-I the buffer solution initially used was replaced by HEPES 2.7 M to achieve good radiochemical yields. Residual HEPES content was checked in the final product and was below the Ph. Eur. threshold. Conclusion: A single automated radiolabeling method on the GAIA® module was developed and implemented for 68Ga radiolabeling of 3 PSMA ligands with slight adjustments for each molecule.
An In-depth Analysis of the Adverse Effects of Ionizing Radiation Exposure on Cardiac Catheterization Staffs
Diagnostic and interventional angiograms are instrumental in the multidisciplinary approach to CAD management enabling accurate diagnosis and effective targeted treatments that significantly enhance patient care and cardiovascular outcomes. However cath lab staff including interventional cardiologists is consistently exposed to ionizing radiation which poses inherent health risks. Radiation exposure in the cath lab primarily results from the use of fluoroscopy and cineangiography during diagnostic and interventional procedures. Understanding these risks and implementing effective radiation protection measurements are imperative to ensure the well-being of healthcare professionals while delivering high-quality cardiac care. Prolonged and repeated exposure can lead to both deterministic and stochastic effects. Deterministic effects such as skin erythema and tissue damage are more likely to occur at high radiation doses. Interventional cardiologists and staff may experience these effects when safety measures are not rigorously followed. In fact while ionizing radiation is essential in the practice of radiation cardiology ward cath lab staff faces inherent risks from radiation exposure. Stochastic effects on the other hand are characterized by a probabilistic relationship between radiation exposure and the likelihood of harm. These effects include the increased risk of cancer particularly for those with long-term exposure. Interventional cardiologists due to their frequent presence in the cath lab face a higher lifetime cumulative radiation dose potentially elevating their cancer risk. Protective measures including the use of lead aprons thyroid shields and radiation monitoring devices play a crucial role in reducing radiation exposure for cath lab personnel. Adherence to strict dose optimization protocols such as minimizing fluoroscopy time and maximizing distance from the radiation source is also essential in mitigating these risks. Ongoing research and advancements in radiation safety technology are essential in further for minimizing the adverse effects of ionizing radiation in the cath lab.
Impact of Radiation Therapy on Serum Humanin and MOTS-c Levels in Patients with Lung or Breast Cancer
Background: Lung and breast cancer are the most frequent causes of death from cancer globally. The objectives of this research were to evaluate the serum mitochondrial open reading frame of the 12S rRNA-c (MOTS-c) and humanin levels in lung or breast cancer patients and investigate the impacts of radiation therapy on the circulating levels of these peptides. Methods: 35 lung cancer patients 34 breast cancer patients and healthy volunteers as a control group were recruited in this prospective observatory research. Lung cancer patients with stage IIIA/IIIB were treated with paclitaxel-based chemotherapy plus radiotherapy (2 Gy per day 30 times 60 Gy total dose). Breast cancer stage IIA/IIB patients were treated with postoperative locoregional radiation therapy (2 Gy per day 25 times 50 Gy total dose). The ELISA method was used to detect serum humanin and MOTS-c levels during before and after radiotherapy. Results: We observed marked elevations in circulating MOTS-c but not humanin levels in patients with lung cancer (P < 0.001). Radiation therapy led to a marked augmentation in MOTS-c levels in these patients (P < 0.001). On the other hand there was a marked decline in humanin but not MOTS-c levels in breast cancer patients (P < 0.001). Conclusion: Our research has shown for the first time that increased MOTS-c and decreased humanin levels play a role in lung cancer and breast cancer respectively. Additionally radiotherapy modifies MOTS-c levels in patients with lung but not breast cancer.