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Best Practice & Research. Clinical... Sep 2023Neuroendocrine neoplasms are rare and heterogenous group of tumors with varying degrees of clinical presentations and involvement of multiple organ systems in the body.... (Review)
Review
Neuroendocrine neoplasms are rare and heterogenous group of tumors with varying degrees of clinical presentations and involvement of multiple organ systems in the body. In the modern clinical practice somatostatin receptor molecular imaging and targeted radioligand therapy plays a vital role in the diagnosis and management of the disease. Several new and promising radiotracers for NET imaging and theranostics, belonging to various groups and classes are being studied and investigated. This exponential growth of radiotracers poses concerns about the indication, clinical benefit, and safety profile of the agents. We discuss the basis behind these radiotracers clinical use, receptor targeting and intra and inter tumor heterogeneity. Furthermore, role of dual tracer imaging, combination therapy and potential applications of dosimetry in predicting treatment outcome and safety profile is reviewed. Individualized precision medicine with better tumor characterization, maximum therapeutic benefit and minimum toxicity is the way forward for future medicine.
Topics: Humans; Neuroendocrine Tumors; Radiopharmaceuticals; Positron-Emission Tomography; Positron Emission Tomography Computed Tomography; Receptors, Somatostatin
PubMed: 37468403
DOI: 10.1016/j.beem.2023.101797 -
Clinical Microbiology and Infection :... Mar 2024Fever of unknown origin (FUO) and inflammation of unknown origin (IUO) are diagnostic challenges that often require an extensive work-up. When first-line tests do not... (Review)
Review
BACKGROUND
Fever of unknown origin (FUO) and inflammation of unknown origin (IUO) are diagnostic challenges that often require an extensive work-up. When first-line tests do not provide any or only misleading clues, second-line investigations such as specialized imaging techniques are often warranted.
OBJECTIVES
To provide an overview of the diagnostic value of imaging techniques that are commonly used in patients with FUO/IUO.
SOURCES
MEDLINE database was searched to identify the most relevant studies, trials, reviews, or meta-analyses until 31 March 2023.
CONTENT
The most important types of second-line imaging tests for FUO and IUO are outlined, including [Ga]-citrate single-photon emission computed tomography/computed tomography (CT), labelled leukocyte imaging, [F]-fluorodeoxyglucose positron emission tomography CT ([F]-FDG-PET), and whole-body magnetic resonance imaging. This review summarizes the diagnostic yield, extends on potential future imaging techniques (pathogen-specific bacterial imaging and [F]-FDG-PET/magnetic resonance imaging), discusses cost-effectiveness, highlights practical implications and pitfalls, and addresses future perspectives. Where applicable, we provide additional data specifically for the infection subgroup.
IMPLICATIONS
Although many imaging examinations are proven to be useful in FUO and IUO, [F]-FDG-PET/CT is the preferred second-line test when available as it provides a high diagnostic yield in a presumably cost-effective way.
Topics: Humans; Positron Emission Tomography Computed Tomography; Fluorodeoxyglucose F18; Magnetic Resonance Imaging; Whole Body Imaging; Inflammation; Fever of Unknown Origin; Positron-Emission Tomography
PubMed: 37597617
DOI: 10.1016/j.cmi.2023.08.010 -
European Radiology Nov 2023To conduct a comprehensive bibliometric analysis of artificial intelligence (AI) and its subfields as well as radiomics in Radiology, Nuclear Medicine, and Medical...
OBJECTIVE
To conduct a comprehensive bibliometric analysis of artificial intelligence (AI) and its subfields as well as radiomics in Radiology, Nuclear Medicine, and Medical Imaging (RNMMI).
METHODS
Web of Science was queried for relevant publications in RNMMI and medicine along with their associated data from 2000 to 2021. Bibliometric techniques utilised were co-occurrence, co-authorship, citation burst, and thematic evolution analyses. Growth rate and doubling time were also estimated using log-linear regression analyses.
RESULTS
According to the number of publications, RNMMI (11,209; 19.8%) was the most prominent category in medicine (56,734). USA (44.6%) and China (23.1%) were the two most productive and collaborative countries. USA and Germany experienced the strongest citation bursts. Thematic evolution has recently exhibited a significant shift toward deep learning. In all analyses, the annual number of publications and citations demonstrated exponential growth, with deep learning-based publications exhibiting the most prominent growth pattern. Estimated continuous growth rate, annual growth rate, and doubling time of the AI and machine learning publications in RNMMI were 26.1% (95% confidence interval [CI], 12.0-40.2%), 29.8% (95% CI, 12.7-49.5%), and 2.7 years (95% CI, 1.7-5.8), respectively. In the sensitivity analysis using data from the last 5 and 10 years, these estimates ranged from 47.6 to 51.1%, 61.0 to 66.7%, and 1.4 to 1.5 years.
CONCLUSION
This study provides an overview of AI and radiomics research conducted mainly in RNMMI. These results may assist researchers, practitioners, policymakers, and organisations in gaining a better understanding of both the evolution of these fields and the importance of supporting (e.g., financial) these research activities.
KEY POINTS
• In terms of the number of publications on AI and ML, Radiology, Nuclear Medicine, and Medical Imaging was the most prominent category compared to the other categories related to medicine (e.g., Health Policy & Services, Surgery). • All evaluated analyses (i.e., AI, its subfields, and radiomics), based on the annual number of publications and citations, demonstrated exponential growth, with decreasing doubling time, which indicates increasing interest from researchers, journals, and, in turn, the medical imaging community. • The most prominent growth pattern was observed in deep learning-based publications. However, the further thematic analysis demonstrated that deep learning has been underdeveloped but highly relevant to the medical imaging community.
Topics: Humans; Nuclear Medicine; Artificial Intelligence; Radiography; Radionuclide Imaging; Bibliometrics
PubMed: 37314469
DOI: 10.1007/s00330-023-09772-0 -
Nuklearmedizin. Nuclear Medicine Oct 2023Machine learning (ML) is considered an important technology for future data analysis in health care. (Review)
Review
BACKGROUND
Machine learning (ML) is considered an important technology for future data analysis in health care.
METHODS
The inherently technology-driven fields of diagnostic radiology and nuclear medicine will both benefit from ML in terms of image acquisition and reconstruction. Within the next few years, this will lead to accelerated image acquisition, improved image quality, a reduction of motion artifacts and - for PET imaging - reduced radiation exposure and new approaches for attenuation correction. Furthermore, ML has the potential to support decision making by a combined analysis of data derived from different modalities, especially in oncology. In this context, we see great potential for ML in multiparametric hybrid imaging and the development of imaging biomarkers.
RESULTS AND CONCLUSION
In this review, we will describe the basics of ML, present approaches in hybrid imaging of MRI, CT, and PET, and discuss the specific challenges associated with it and the steps ahead to make ML a diagnostic and clinical tool in the future.
KEY POINTS
· ML provides a viable clinical solution for the reconstruction, processing, and analysis of hybrid imaging obtained from MRI, CT, and PET..
Topics: Image Processing, Computer-Assisted; Positron-Emission Tomography; Tomography, X-Ray Computed; Radionuclide Imaging; Machine Learning; Magnetic Resonance Imaging
PubMed: 37802058
DOI: 10.1055/a-2157-6670 -
European Heart Journal. Cardiovascular... Sep 2023Nuclear imaging techniques can detect and quantify pathophysiological processes underlying heart failure, complementing evaluation of cardiac structure and function with... (Review)
Review
Nuclear imaging techniques can detect and quantify pathophysiological processes underlying heart failure, complementing evaluation of cardiac structure and function with other imaging modalities. Combined imaging of myocardial perfusion and metabolism can identify left ventricle dysfunction caused by myocardial ischaemia that may be reversible after revascularization in the presence of viable myocardium. High sensitivity of nuclear imaging to detect targeted tracers has enabled assessment of various cellular and subcellular mechanisms of heart failure. Nuclear imaging of active inflammation and amyloid deposition is incorporated into clinical management algorithms of cardiac sarcoidosis and amyloidosis. Innervation imaging has well-documented prognostic value with respect to heart failure progression and arrhythmias. Emerging tracers specific for inflammation and myocardial fibrotic activity are in earlier stages of development but have demonstrated potential value in early characterization of the response to myocardial injury and prediction of adverse left ventricular remodelling. Early detection of disease activity is a key for transition from broad medical treatment of clinically overt heart failure towards a personalized approach aimed at supporting repair and preventing progressive failure. This review outlines the current status of nuclear imaging in phenotyping heart failure and combines it with discussion on novel developments.
Topics: Humans; Heart Failure; Heart; Cardiomyopathies; Positron-Emission Tomography; Tomography, Emission-Computed, Single-Photon; Inflammation; Perfusion
PubMed: 37294318
DOI: 10.1093/ehjci/jead128 -
The British Journal of Radiology Dec 2023Cardiovascular diseases (CVD) are the leading cause of death worldwide and have an increasing impact on society. Precision medicine, in which optimal care is identified... (Review)
Review
Cardiovascular diseases (CVD) are the leading cause of death worldwide and have an increasing impact on society. Precision medicine, in which optimal care is identified for an individual or a group of individuals rather than for the average population, might provide significant health benefits for this patient group and decrease CVD morbidity and mortality. Molecular imaging provides the opportunity to assess biological processes in individuals in addition to anatomical context provided by other imaging modalities and could prove to be essential in the implementation of precision medicine in CVD. New developments in single-photon emission computed tomography (SPECT) and positron emission tomography (PET) systems, combined with rapid innovations in promising and specific radiopharmaceuticals, provide an impressive improvement of diagnostic accuracy and therapy evaluation. This may result in improved health outcomes in CVD patients, thereby reducing societal impact. Furthermore, recent technical advances have led to new possibilities for accurate image quantification, dynamic imaging, and quantification of radiotracer kinetics. This potentially allows for better evaluation of disease activity over time and treatment response monitoring. However, the clinical implementation of these new methods has been slow. This review describes the recent advances in molecular imaging and the clinical value of quantitative PET and SPECT in various fields in cardiovascular molecular imaging, such as atherosclerosis, myocardial perfusion and ischemia, infiltrative cardiomyopathies, systemic vascular diseases, and infectious cardiovascular diseases. Moreover, the challenges that need to be overcome to achieve clinical translation are addressed, and future directions are provided.
Topics: Humans; Cardiovascular Diseases; Precision Medicine; Heart; Tomography, Emission-Computed, Single-Photon; Radiopharmaceuticals; Positron-Emission Tomography
PubMed: 37786997
DOI: 10.1259/bjr.20230704 -
AJR. American Journal of Roentgenology Sep 2023Neuroendocrine neoplasms (NENs) of the small bowel are typically slow-growing lesions that remain asymptomatic until reaching an advanced stage. Imaging modalities for... (Review)
Review
Neuroendocrine neoplasms (NENs) of the small bowel are typically slow-growing lesions that remain asymptomatic until reaching an advanced stage. Imaging modalities for lesion detection, staging, and follow-up in patients with known or suspected NEN include CT enterography, MR enterography, and PET/CT using a somatostatin receptor analog. FDG PET/CT may have a role in the evaluation of poorly differentiated NENs. Liver MRI, ideally with a hepatocyte-specific contrast agent, should be used in the evaluation of hepatic metastases. Imaging informs decisions regarding both surgical approaches and systematic therapy (specifically, peptide receptor radionuclide therapy). This Expert Panel Narrative Review describes the multimodality imaging features of small-bowel NENs; explores the optimal imaging modalities for their diagnosis, staging, and follow-up; and discusses how imaging may be used to guide therapy.
Topics: Humans; Positron Emission Tomography Computed Tomography; Intestinal Neoplasms; Positron-Emission Tomography; Somatostatin; Radionuclide Imaging; Neuroendocrine Tumors
PubMed: 36752369
DOI: 10.2214/AJR.22.28877 -
PET Clinics Apr 2024The clinical landscape of lymphomas has changed dramatically over the last 2 decades, including significant progress made in the understanding and utilization of... (Review)
Review
The clinical landscape of lymphomas has changed dramatically over the last 2 decades, including significant progress made in the understanding and utilization of imaging modalities and the available treatment options for both indolent and aggressive lymphomas. Since the introduction of hybrid PET/CT scanners in 2001, the indications of 18F-fluorodeoxyglucose (FDG) PET/CT in the management of lymphomas have grown rapidly. In today's clinical practice, FDG PET/CT is used in successful management of the vast majority patients with lymphomas.
Topics: Humans; Positron Emission Tomography Computed Tomography; Fluorodeoxyglucose F18; Lymphoma; Positron-Emission Tomography
PubMed: 38403384
DOI: 10.1016/j.cpet.2023.12.014 -
The Journal of Infectious Diseases Oct 2023Invasive fungal infections have become a major challenge for public health, mainly due to the growing numbers of immunocompromised patients, with high morbidity and... (Review)
Review
Invasive fungal infections have become a major challenge for public health, mainly due to the growing numbers of immunocompromised patients, with high morbidity and mortality. Currently, conventional imaging modalities such as computed tomography and magnetic resonance imaging contribute largely to the noninvasive diagnosis and treatment evaluation of those infections. These techniques, however, often fall short when a fast, noninvasive and specific diagnosis of fungal infection is necessary. Molecular imaging, especially using nuclear medicine-based techniques, aims to develop fungal-specific radiotracers that can be tested in preclinical models and eventually translated to human applications. In the last few decades, multiple radioligands have been developed and tested as potential fungal-specific tracers. These include radiolabeled peptides, antifungal drugs, siderophores, fungal-specific antibodies, and sugars. In this review, we provide an overview of the pros and cons of the available radiotracers. We also address the future prospects of fungal-specific imaging.
Topics: Humans; Positron-Emission Tomography; Mycoses; Antifungal Agents; Tomography, X-Ray Computed; Invasive Fungal Infections; Antibodies, Fungal
PubMed: 37788500
DOI: 10.1093/infdis/jiad067 -
The Journal of Infectious Diseases Oct 2023Central nervous system (CNS) infections can lead to high mortality and severe morbidity. Diagnosis, monitoring, and assessing response to therapy of CNS infections is... (Review)
Review
Central nervous system (CNS) infections can lead to high mortality and severe morbidity. Diagnosis, monitoring, and assessing response to therapy of CNS infections is particularly challenging with traditional tools, such as microbiology, due to the dangers associated with invasive CNS procedures (ie, biopsy or surgical resection) to obtain tissues. Molecular imaging techniques like positron emission tomography (PET) and single-photon emission computed tomography (SPECT) imaging have long been used to complement anatomic imaging such as computed tomography (CT) and magnetic resonance imaging (MRI), for in vivo evaluation of disease pathophysiology, progression, and treatment response. In this review, we detail the use of molecular imaging to delineate host-pathogen interactions, elucidate antimicrobial pharmacokinetics, and monitor treatment response. We also discuss the utility of pathogen-specific radiotracers to accurately diagnose CNS infections and strategies to develop radiotracers that would cross the blood-brain barrier.
Topics: Humans; Tomography, Emission-Computed, Single-Photon; Positron-Emission Tomography; Tomography, X-Ray Computed; Blood-Brain Barrier; Central Nervous System Infections
PubMed: 37788502
DOI: 10.1093/infdis/jiad223