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Pharmaceutics Mar 2023Dendrimers are nanoscale-size polymers with a globular structure. They are composed of an internal core and branching dendrons with surface active groups which can be... (Review)
Review
BACKGROUND
Dendrimers are nanoscale-size polymers with a globular structure. They are composed of an internal core and branching dendrons with surface active groups which can be functionalized for medical applications. Different complexes have been developed for imaging and therapeutic purposes. This systematic review aims to summarize the development of newer dendrimers for oncological applications in nuclear medicine.
METHODS
An online literature search was conducted on Pubmed, Scopus, Medline, Cochrane Library, and Web Of Science databases selecting published studies from January 1999 to December 2022. The accepted studies considered the synthesis of dendrimer complexes for oncological nuclear medicine imaging and therapy.
RESULTS
111 articles were identified; 69 articles were excluded because they did not satisfy the selection criteria. Thus, nine duplicate records were removed. The remaining 33 articles were included and selected for quality assessment.
CONCLUSION
Nanomedicine has led researchers to create novel nanocarriers with high affinity for the target. Dendrimers represent feasible imaging probes and therapeutic agents since, through the functionalization of external chemical groups and thanks to the possibility to carry pharmaceuticals, it can be possible to exploit different therapeutic strategies and develop a useful weapon for oncological treatments.
PubMed: 36986728
DOI: 10.3390/pharmaceutics15030867 -
Annals of Oncology : Official Journal... Aug 2015Pulmonary carcinoids (PCs) are rare tumors. As there is a paucity of randomized studies, this expert consensus document represents an initiative by the European... (Review)
Review
Pulmonary neuroendocrine (carcinoid) tumors: European Neuroendocrine Tumor Society expert consensus and recommendations for best practice for typical and atypical pulmonary carcinoids.
BACKGROUND
Pulmonary carcinoids (PCs) are rare tumors. As there is a paucity of randomized studies, this expert consensus document represents an initiative by the European Neuroendocrine Tumor Society to provide guidance on their management.
PATIENTS AND METHODS
Bibliographical searches were carried out in PubMed for the terms 'pulmonary neuroendocrine tumors', 'bronchial neuroendocrine tumors', 'bronchial carcinoid tumors', 'pulmonary carcinoid', 'pulmonary typical/atypical carcinoid', and 'pulmonary carcinoid and diagnosis/treatment/epidemiology/prognosis'. A systematic review of the relevant literature was carried out, followed by expert review.
RESULTS
PCs are well-differentiated neuroendocrine tumors and include low- and intermediate-grade malignant tumors, i.e. typical (TC) and atypical carcinoid (AC), respectively. Contrast CT scan is the diagnostic gold standard for PCs, but pathology examination is mandatory for their correct classification. Somatostatin receptor imaging may visualize nearly 80% of the primary tumors and is most sensitive for metastatic disease. Plasma chromogranin A can be increased in PCs. Surgery is the treatment of choice for PCs with the aim of removing the tumor and preserving as much lung tissue as possible. Resection of metastases should be considered whenever possible with curative intent. Somatostatin analogs are the first-line treatment of carcinoid syndrome and may be considered as first-line systemic antiproliferative treatment in unresectable PCs, particularly of low-grade TC and AC. Locoregional or radiotargeted therapies should be considered for metastatic disease. Systemic chemotherapy is used for progressive PCs, although cytotoxic regimens have demonstrated limited effects with etoposide and platinum combination the most commonly used, however, temozolomide has shown most clinical benefit.
CONCLUSIONS
PCs are complex tumors which require a multidisciplinary approach and long-term follow-up.
Topics: Antineoplastic Combined Chemotherapy Protocols; Bronchoscopy; Carboplatin; Carcinoid Heart Disease; Carcinoid Tumor; Cisplatin; Dacarbazine; Etoposide; Europe; Humans; Lung Neoplasms; Pneumonectomy; Positron-Emission Tomography; Receptors, Somatostatin; Societies, Medical; Temozolomide; Tomography, X-Ray Computed; Ultrasonography
PubMed: 25646366
DOI: 10.1093/annonc/mdv041 -
Gland Surgery Dec 2021There are many studies on diagnostic imaging of thyroid nodules, among which radionuclide scanning imaging has been proven to be very effective in identifying malignant...
BACKGROUND
There are many studies on diagnostic imaging of thyroid nodules, among which radionuclide scanning imaging has been proven to be very effective in identifying malignant lesions of thyroid nodules and is now widely used in the clinical detection of thyroid nodules.
METHODS
Studies on radionuclide imaging in the diagnosis of thyroid nodules were searched in multiple Chinese and English databases, including PubMed, Web of Science, Embase, and The Cochrane Library as of July 1, 2021. The search terms included "clinical experiment", "thyroid nodule", "radionuclide imaging", "thyroid mass", "thyroid masses", "postoperative pathology", and "histopathology". The basic information and evaluation indicators in the literature were screened and extracted. Subsequently, meta-analysis was performed using RevMan 5.3 and Stata 13 software provided by the Cochrane system. In addition, forest plots and summary receiver operating characteristic (SROC) curves were drawn.
RESULTS
Seven randomized controlled trails (RCTs) were included in this study. The radionuclide imaging of thyroid nodule showed the area under SROC curve of 0.38. The combined diagnostic sensitivity and specificity were 0.66 [95% confidence interval (CI): 0.46, 0.89] and 0.36 (95% CI: 0.21, 0.59), respectively. The combined positive likelihood ratio (LR) and negative LR were 0.66 (95% CI: 0.53, 0.87) and 0.67 (95% CI: 0.43, 0.95), respectively. In addition, the combined diagnostic odds ratio (OR) was 4.45 (95% CI: 0.25, 10.57).
DISCUSSION
In this study, meta-analysis was used to confirm the application value of radionuclide imaging in the diagnosis of thyroid nodules. In the future, the value of radionuclide imaging in the diagnosis of thyroid nodules should be compared with other imaging detection methods.
PubMed: 35070895
DOI: 10.21037/gs-21-766 -
European Heart Journal Sep 2018To determine the ranges of pre-test probability (PTP) of coronary artery disease (CAD) in which stress electrocardiogram (ECG), stress echocardiography, coronary... (Meta-Analysis)
Meta-Analysis
The performance of non-invasive tests to rule-in and rule-out significant coronary artery stenosis in patients with stable angina: a meta-analysis focused on post-test disease probability.
AIMS
To determine the ranges of pre-test probability (PTP) of coronary artery disease (CAD) in which stress electrocardiogram (ECG), stress echocardiography, coronary computed tomography angiography (CCTA), single-photon emission computed tomography (SPECT), positron emission tomography (PET), and cardiac magnetic resonance (CMR) can reclassify patients into a post-test probability that defines (>85%) or excludes (<15%) anatomically (defined by visual evaluation of invasive coronary angiography [ICA]) and functionally (defined by a fractional flow reserve [FFR] ≤0.8) significant CAD.
METHODS AND RESULTS
A broad search in electronic databases until August 2017 was performed. Studies on the aforementioned techniques in >100 patients with stable CAD that utilized either ICA or ICA with FFR measurement as reference, were included. Study-level data was pooled using a hierarchical bivariate random-effects model and likelihood ratios were obtained for each technique. The PTP ranges for each technique to rule-in or rule-out significant CAD were defined. A total of 28 664 patients from 132 studies that used ICA as reference and 4131 from 23 studies using FFR, were analysed. Stress ECG can rule-in and rule-out anatomically significant CAD only when PTP is ≥80% (76-83) and ≤19% (15-25), respectively. Coronary computed tomography angiography is able to rule-in anatomic CAD at a PTP ≥58% (45-70) and rule-out at a PTP ≤80% (65-94). The corresponding PTP values for functionally significant CAD were ≥75% (67-83) and ≤57% (40-72) for CCTA, and ≥71% (59-81) and ≤27 (24-31) for ICA, demonstrating poorer performance of anatomic imaging against FFR. In contrast, functional imaging techniques (PET, stress CMR, and SPECT) are able to rule-in functionally significant CAD when PTP is ≥46-59% and rule-out when PTP is ≤34-57%.
CONCLUSION
The various diagnostic modalities have different optimal performance ranges for the detection of anatomically and functionally significant CAD. Stress ECG appears to have very limited diagnostic power. The selection of a diagnostic technique for any given patient to rule-in or rule-out CAD should be based on the optimal PTP range for each test and on the assumed reference standard.
Topics: Angina, Stable; Computed Tomography Angiography; Coronary Angiography; Coronary Stenosis; Echocardiography, Stress; Electrocardiography; Humans; Magnetic Resonance Angiography; Positron-Emission Tomography; Probability; Single Photon Emission Computed Tomography Computed Tomography
PubMed: 29850808
DOI: 10.1093/eurheartj/ehy267 -
Theranostics 2023Recent studies suggest that Ga-FAPI PET/CT demonstrated superiority over F-FDG PET/CT in the evaluation of various cancer types, especially in gastric cancer (GC). By... (Meta-Analysis)
Meta-Analysis
Recent studies suggest that Ga-FAPI PET/CT demonstrated superiority over F-FDG PET/CT in the evaluation of various cancer types, especially in gastric cancer (GC). By comprehensively reviewing and analysing the differences between Ga-FAPI and F-FDG in GC, some evidence is provided to foster the broader clinical application of FAPI PET imaging. In this review, studies published up to July 3, 2023, that employed radionuclide labelled FAPI as a diagnostic radiotracer for PET in GC were analysed. These studies were sourced from both the PubMed and Web of Science databases. Our statistical analysis involved a bivariate meta-analysis of the diagnostic data and a meta-analysis of the quantitative metrics. These were performed using R language. The meta-analysis included 14 studies, with 527 patients, of which 358 were diagnosed with GC. Overall, Ga-FAPI showed higher pooled sensitivity (0.84 [95% CI 0.67-0.94] 0.46 [95% CI 0.32-0.60]), specificity (0.91 [95% CI 0.76-0.98] 0.88 [95% CI 0.74-0.96]) and area under the curve (AUC) (0.92 [95% CI 0.77-0.98] 0.52 [95% CI 0.38-0.86]) than F-FDG. The evidence showed superior pooled sensitivities of Ga-FAPI PET over F-FDG for primary tumours, local recurrence, lymph node metastases, distant metastases, and peritoneal metastases. Furthermore, Ga-FAPI PET provided higher maximum standardized uptake value (SUVmax) and tumour-to-background ratios (TBR). For bone metastases, while Ga-FAPI PET demonstrated slightly lower patient-based pooled sensitivity (0.93 1.00), it significantly outperformed F-FDG in the lesion-based analysis (0.95 0.65). However, SUVmax (mean difference [MD] 1.79 [95% CI -3.87-7.45]) and TBR (MD 5.01 [95% CI -0.78-10.80]) of bone metastases showed no significant difference between Ga-FAPI PET/CT and F-FDG PET/CT. Compared with F-FDG, Ga-FAPI PET imaging showed improved diagnostic accuracy in the evaluation of GC. It can be effectively applied to the early diagnosis, initial staging, and detection of recurrence/metastases of GC. Ga-FAPI may have the potential of replacing F-FDG in GC in future applications.
Topics: Humans; Stomach Neoplasms; Positron Emission Tomography Computed Tomography; Fluorodeoxyglucose F18; Gallium Radioisotopes; Positron-Emission Tomography
PubMed: 37649615
DOI: 10.7150/thno.88335 -
European Annals of Otorhinolaryngology,... Sep 2017To review the optimal techniques for localization and characterization of neck paragangliomas (PGL). (Review)
Review
OBJECTIVE
To review the optimal techniques for localization and characterization of neck paragangliomas (PGL).
MATERIAL AND METHODS
Systematic review of the literature from the PubMed/Medline database.
RESULTS
Neck PGL are hypervascular tumours essentially arising from paraganglionic tissue situated at the carotid bifurcation (carotid body) and along the vagus nerve. Morphological and functional imaging are indicated to confirm the diagnosis, identify multifocal disease and for local and regional staging. MR angiography is the noninvasive technique of choice. CT scan and especially CT angiography are excellent alternatives for diagnosis and staging. Conventional arteriography remains useful preoperatively for embolization and occlusion tests. Functional imaging allows localization and characterization of PGLs. Somatostatin receptor scintigraphy (SRS) was the reference imaging technique for staging of sporadic PGLs. The indications for PET imaging have been extended over recent years in parallel with the development of new tracers such as [F]-FDOPA PET or Gallium-labelled DOTA peptides. Gallium-labelled DOTA peptides has become the first-line imaging modality in the evaluation of cervical PGLs, regardless of the genetic background.
CONCLUSION
Morphological and functional imaging is essential for the staging of neck PGL.
Topics: Computed Tomography Angiography; Head and Neck Neoplasms; Humans; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Neoplasm Staging; Paraganglioma; Positron-Emission Tomography; Predictive Value of Tests; Radiopharmaceuticals; Sensitivity and Specificity; Tomography, X-Ray Computed
PubMed: 27887852
DOI: 10.1016/j.anorl.2016.10.003 -
International Journal of Molecular... Apr 2021Molecular imaging of pathologic lesions can improve efficient detection of cancer and cardiovascular diseases. A shared pathophysiological feature is angiogenesis, the...
Molecular imaging of pathologic lesions can improve efficient detection of cancer and cardiovascular diseases. A shared pathophysiological feature is angiogenesis, the formation of new blood vessels. Endoglin (CD105) is a coreceptor for ligands of the Transforming Growth Factor-β (TGF-β) family and is highly expressed on angiogenic endothelial cells. Therefore, endoglin-based imaging has been explored to visualize lesions of the aforementioned diseases. This systematic review highlights the progress in endoglin-based imaging of cancer, atherosclerosis, myocardial infarction, and aortic aneurysm, focusing on positron emission tomography (PET), single-photon emission computed tomography (SPECT), magnetic resonance imaging (MRI), near-infrared fluorescence (NIRF) imaging, and ultrasound imaging. PubMed was searched combining the following subjects and their respective synonyms or relevant subterms: "Endoglin", "Imaging/Image-guided surgery". In total, 59 papers were found eligible to be included: 58 reporting about preclinical animal or in vitro models and one ex vivo study in human organs. In addition to exact data extraction of imaging modality type, tumor or cardiovascular disease model, and tracer (class), outcomes were described via a narrative synthesis. Collectively, the data identify endoglin as a suitable target for intraoperative and diagnostic imaging of the neovasculature in tumors, whereas for cardiovascular diseases, the evidence remains scarce but promising.
Topics: Animals; Cardiovascular Diseases; Endoglin; Humans; Magnetic Resonance Imaging; Neoplasms; Optical Imaging; Positron-Emission Tomography; Surgery, Computer-Assisted; Tomography, Emission-Computed, Single-Photon; Ultrasonography
PubMed: 33946583
DOI: 10.3390/ijms22094804 -
The British Journal of Radiology Dec 2017The aim of this study was to systematically review the literature to synthesize and summarize the evidence surrounding the clinical utility of positron emission... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The aim of this study was to systematically review the literature to synthesize and summarize the evidence surrounding the clinical utility of positron emission tomography (PET) imaging in patients with anal canal cancer.
METHODS
The literature was searched using MEDLINE, EMBASE and Cochrane Database of Systematic Reviews databases. Studies comparing PET or PET/CT with conventional imaging in the staging, response evaluation and follow-up of anal canal cancer were deemed eligible for inclusion.
RESULTS
17 studies met the inclusion criteria. For the detection of primary tumour in situ, the pooled sensitivity was 99% for PET or PET/CT and 67% for CT. For the detection of inguinal lymph nodes, PET/CT had an overall sensitivity of 93% and specificity of 76%. PET or PET/CT upstaged 5.1 to 37.5% of patients and downstaged 8.2 to 26.7% of patients. Treatment plans were modified in 12.5 to 59.3% of patients, which consisted mainly of radiotherapy dose or field changes. Complete response on PET or PET/CT is a good prognostic factor for overall and progression-free survival.
CONCLUSIONS
PET/CT seems to add value to conventional imaging in the initial staging of patients with T2-4 disease but further high-quality research is required to validate this. There is insufficient evidence at this time to recommend a routine use of PET/CT in the assessment of treatment response or follow-up. Advances in knowledge: PET/CT appears to alter the disease stage and management in a meaningful number of patients to justify its use as part of staging investigations in locally advanced cases.
Topics: Anal Canal; Anus Neoplasms; Humans; Positron-Emission Tomography
PubMed: 28972796
DOI: 10.1259/bjr.20170370 -
Osteoarthritis and Cartilage Oct 2014The aim of this review is to describe imaging techniques for evaluation of non-osteochondral structures such as the synovium, menisci in the knee, labrum in the hip,... (Review)
Review
OBJECTIVE
The aim of this review is to describe imaging techniques for evaluation of non-osteochondral structures such as the synovium, menisci in the knee, labrum in the hip, ligaments and muscles and to review the literature from recent clinical and epidemiological studies of OA.
METHODS
This is a non-systematic narrative review of published literature on imaging of non-osteochondral tissues in OA. PubMed and MEDLINE search for articles published up to 2014, using the keywords osteoarthritis, synovitis, meniscus, labrum, ligaments, plica, muscles, magnetic resonance imaging (MRI), ultrasound, computed tomography (CT), scintigraphy, and positron emission tomography (PET).
RESULTS
Published literature showed imaging of non-osteochondral tissues in OA relies primarily on MRI and ultrasound. The use of semiquantitative and quantitative imaging biomarkers of non-osteochondral tissues in clinical and epidemiological OA studies is reported. We highlight studies that have compared both imaging methodologies directly, and those that have established a relationship between imaging biomarkers and clinical outcomes. We provide recommendations as to which imaging protocols should be used to assess disease-specific changes regarding synovium, meniscus in the knee, labrum in the hip, and ligaments, and highlight potential pitfalls in their usage.
CONCLUSION
MRI and ultrasound are currently the most useful imaging modalities for evaluation of non-osteochondral tissues in OA. MRI evaluation of any tissue needs to be performed using appropriate MR pulse sequences. Ultrasound may be particularly useful for evaluation of small joints of the hand. Nuclear medicine and CT play a limited role in imaging of non-osteochondral tissues in OA.
Topics: Diagnostic Imaging; Humans; Ligaments; Magnetic Resonance Imaging; Menisci, Tibial; Muscle, Skeletal; Osteoarthritis, Hip; Osteoarthritis, Knee; Positron-Emission Tomography; Radionuclide Imaging; Synovial Membrane; Tomography, X-Ray Computed; Ultrasonography
PubMed: 25278069
DOI: 10.1016/j.joca.2014.05.001 -
European Journal of Medicinal Chemistry Jan 2024Prostate specific membrane antigen (PSMA) has been the subject of several studies in recent decades as a promising molecular target for prostate cancer (PCa), in fact it... (Review)
Review
Prostate specific membrane antigen (PSMA) has been the subject of several studies in recent decades as a promising molecular target for prostate cancer (PCa), in fact it is considered an excellent molecular target for both PCa imaging (both for staging and follow-up), by means of PET/CT and for radioligand therapy. Its interesting molecular features have enabled the development of a new diagnostic and therapeutic approach for PCa, called "theranostics." Considering the abundance of PSMA-based probes that have appeared so far in the literature, the present work focuses the attention on radiopharmaceuticals with increasing clinical application, highlighting advantages and disadvantages in terms of different metabolization and excretion processes, pharmacokinetic, binding affinity and variable internalization rate, tumor-to-background ratio, residence times and toxicity profile.
Topics: Male; Humans; Positron Emission Tomography Computed Tomography; Prostatic Neoplasms; Radiopharmaceuticals; Precision Medicine; Gallium Radioisotopes
PubMed: 37992520
DOI: 10.1016/j.ejmech.2023.115966