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  • 1.
    Jokar, Narges
    et al.
    Bushehr Univ Med Sci, Persian Gulf Nucl Med Res Ctr, Dept Mol Imaging & Radionuclide Therapy, Bushehr Med Univ Hosp,Sch Med, Moalem St, Bushehr, Iran..
    Velikyan, Irina
    Uppsala University, Disciplinary Domain of Science and Technology, Chemistry, Department of Chemistry, Organic Chemistry. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Biomedical Radiation Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Radiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Medicinal Chemistry, Preclinical PET Platform. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Section of Nuclear Medicine and PET. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Endocrine Oncology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Medicinal Chemistry, Division of Molecular Imaging. Uppsala University, Disciplinary Domain of Science and Technology, Chemistry, Department of Biochemistry and Organic Chemistry, Organic Chemistry II. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Medicinal Chemistry, Preparative Medicinal Chemistry. Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Medicinal Chemistry, Translational PET Imaging.
    Ahmadzadehfar, Hojjat
    Klinikum Westfalen, Dept OlNucl Med, Dortmund, Germany..
    Rekabpour, Seyed Javad
    Salman Farsi Hosp, Dept Oncol, Bushehr, Iran..
    Jafari, Esmail
    Bushehr Univ Med Sci, Persian Gulf Nucl Med Res Ctr, Dept Mol Imaging & Radionuclide Therapy, Bushehr Med Univ Hosp,Sch Med, Moalem St, Bushehr, Iran..
    Ting, Hong Hoi
    Nanomab Technol Ltd, Shanghai, Peoples R China..
    Biersack, Hans-Juergen
    Univ Hosp Bonn, Dept Nucl Med, Bonn, Germany..
    Assadi, Majid
    Bushehr Univ Med Sci, Persian Gulf Nucl Med Res Ctr, Dept Mol Imaging & Radionuclide Therapy, Bushehr Med Univ Hosp,Sch Med, Moalem St, Bushehr, Iran..
    Theranostic Approach in Breast Cancer A Treasured Tailor for Future Oncology2021In: Clinical Nuclear Medicine, ISSN 0363-9762, E-ISSN 1536-0229, Vol. 46, no 8, p. E410-E420Article in journal (Refereed)
    Abstract [en]

    Breast cancer is the most frequent invasive malignancy and the second major cause of cancer death in female subjects mostly due to the considerable diagnostic delay and failure of therapeutic strategies. Thus, early diagnosis and possibility to monitor response to the treatment are of utmost importance. Identification of valid biomarkers, in particular new molecular therapeutic targets, that would allow screening, early patient identification, prediction of disease aggressiveness, and monitoring response to the therapeutic regimen has been in the focus of breast cancer research during recent decades. One of the intensively developing fields is nuclear medicine combining molecular diagnostic imaging and subsequent (radio)therapy in the light of theranostics. This review aimed to survey the current status of preclinical and clinical research using theranostic approach in breast cancer patients with potential to translate into conventional treatment strategies alone or in combination with other common treatments, especially in aggressive and resistant types of breast cancer. In addition, we present 5 patients with breast cancer who were refractory or relapsed after conventional therapy while presumably responded to the molecular radiotherapy with Lu-177-trastuzumab (Herceptin), Lu-177-DOTATATE, and Lu-177-FAPI-46.

  • 2.
    Rottenburger, Christof
    et al.
    Royal Free Hosp, Neuroendocrine Tumour Unit, London, England; Royal Free Hosp, Dept Nucl Med, London, England; Univ Basel Hosp, Clin Radiol & Nucl Med, Basel, Switzerland.
    Papantoniou, Dimitrios
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Royal Free Hosp, Neuroendocrine Tumour Unit, London, England; Ryhov Cty Hosp, Dept Oncol, Jönköping, Sweden.
    Mandair, Dalvinder
    Royal Free Hosp, Neuroendocrine Tumour Unit, London, England.
    Caplin, Martyn
    Royal Free Hosp, Neuroendocrine Tumour Unit, London, England.
    Navalkissoor, Shaunak
    Royal Free Hosp, Dept Nucl Med, London, England.
    A Case Series of Molecular Imaging of Glucagonoma After Initial Therapy—68Ga-DOTATATE PET/CT Reveals Similar Results as in Neuroendocrine Tumors of Other Origin in Follow-up and Re-evaluation2018In: Clinical Nuclear Medicine, ISSN 0363-9762, E-ISSN 1536-0229, Vol. 43, no 4, p. 252-255Article in journal (Other academic)
    Abstract [en]

    Glucagonoma is an extremely rare, glucagon-secreting neuroendocrine tumor of the pancreas. Only sparse data are available about the characteristics of this tumor in somatostatin receptor imaging and only for the situation of initial diagnosis. We present a series of 3 glucagonoma patients who underwent at least 1 68Ga-DOTATATE PET/CT scan. All patients were diagnosed by either histology and/or elevated serum levels of glucagon. The presented cases suggest that somatostatin receptor–based imaging can probably be used for re-evaluation of disease status in patients with glucagonoma in a similar way as it is already established for neuroendocrine tumors of other origin.

  • 3. Sandqvist, Patricia
    et al.
    Nilsson, Inga-Lena
    Grybäck, Per
    Sanchez-Crespo, Alejandro
    Sundin, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Multiphase Iodine Contrast-Enhanced SPECT/CT Outperforms Nonenhanced SPECT/CT for Preoperative Localization of Small Parathyroid Adenomas2019In: Clinical Nuclear Medicine, ISSN 0363-9762, E-ISSN 1536-0229, Vol. 44, no 12, p. 929-935Article in journal (Refereed)
    Abstract [en]

    Purpose

    The aim of this study was to assess the value of intravenously contrast-enhanced CT in conjunction with 99mTc-MIBI SPECT for preoperative localization of parathyroid adenoma.

    Methods

    One hundred ninety-two patients with primary hyperparathyroidism were enrolled in the study between May 2015 and May 2017. The patients underwent a preoperative “one-stop shop” examination with 99mTc-MIBI SPECT/CT by using dual time-point (10 and 90 minutes) protocol and both nonenhanced CT and contrast-enhanced CT acquisition in the arterial and venous phase, 35 and 75 seconds, respectively, after contrast medium injection start. For 149 patients, the imaging results could be correlated to those at surgery and histopathology.

    Results

    The median adenoma weight was 330 mg. The addition of contrast-enhanced CT increased the sensitivity from 81.1% to 89.9% (P = 0.003). The specificity of nonenhanced SPECT/CT was similar to contrast-enhanced CT (96.1% vs 97.9%; P = 0.077). For patients with uniglandular disease (n = 140, 94.0%), the sensitivity increased from 86.4% to 93.6% (P = 0.021) and the specificity from 96.2% to 97.9% (P = 0.118) by adding contrast-enhanced CT. In patients with multiglandular disease (n = 9, 6.0%), adding contrast-enhanced CT improved detection sensitivity from 42.1% to 63.2%. However, these patients were few and significance was not reached (P = 0.125).

    Conclusions

    In this cohort, with generally small parathyroid adenomas, the sensitivity in preoperative localization was greatly improved by adding contrast-enhanced CT to 99mTc-MIBI SPECT/CT.

  • 4.
    Sandqvist, Patricia
    et al.
    Karolinska Univ Hosp, Dept Med Radiat Phys & Nucl Med, Stockholm, Sweden.; Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden.
    Nilsson, Inga-Lena
    Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden.; Karolinska Univ Hosp, Dept Endocrine Surg, Stockholm, Sweden.
    Grybäck, Per
    Karolinska Univ Hosp, Dept Med Radiat Phys & Nucl Med, Stockholm, Sweden.; Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden.
    Sanchez-Crespo, Alejandro
    Karolinska Univ Hosp, Dept Med Radiat Phys & Nucl Med, Stockholm, Sweden.
    Sundin, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    SPECT/CT's Advantage for Preoperative Localization of Small Parathyroid Adenomas in Primary Hyperparathyroidism2017In: Clinical Nuclear Medicine, ISSN 0363-9762, E-ISSN 1536-0229, Vol. 42, no 2, p. 109-114Article in journal (Refereed)
    Abstract [en]

    PURPOSES: The aims of this study were to assess the performance of Tc-sestamibi SPECT/CT, with diagnostic CT quality, compared with SPECT alone for preoperative localization of parathyroid adenomas and to assess the influence of adenoma weight on the correct adenoma lateralization with SPECT/CT and with SPECT alone.

    METHODS: Two hundred forty-nine consecutive patients, biochemically diagnosed with primary hyperparathyroidism, were examined with a combined SPECT/CT scanner. Subsequently, 200 patients with confirmed histopathology and biochemical cure after parathyroidectomy were included in this study (16 with multiglandular disease). For each patient, the SPECT-alone data were analyzed first. Thereafter, the CT information was added, and a new evaluation was performed with the combined data. In addition, for each patient, the diagnostic confidence with each method was graded on a scale based on the presence of different image features. The preoperative diagnostic findings were then compared with the surgical and histopathologic reports.

    RESULTS: The distribution of adenoma weights showed a peak at 210 mg, with a median at 338 mg. The sensitivity and specificity (multiglandular disease included) for correct classification of adenomas were significantly higher for SPECT/CT, 83% and 96%, respectively, than for SPECT alone, 80% and 93% (P < 0.01). Below 210 mg, the differences between SPECT/CT and SPECT alone in accurate adenoma lateralization were more prominent. Sixty-seven percent of all adenomas were graded with the highest confidence score with SPECT/CT compared with 53% with SPECT.

    CONCLUSIONS: SPECT/CT yields fewer false-positive findings than SPECT alone. The advantage of SPECT/CT over SPECT alone was most apparent for correct lateralization of small adenomas (<210 mg).

  • 5.
    Sundin, Anders
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology. Univ Uppsala Hosp, Dept Radiol, Uppsala, Sweden.
    Uhlén, Natalja
    Karolinska Inst, Div Radiog, Dept Clin Sci Intervent & Technol, Stockholm, Sweden; Karolinska Univ Hosp, Dept Radiol, Huddinge, Sweden.
    Axelsson, Rimma
    Karolinska Univ Hosp, Dept Radiol, Huddinge, Sweden; Karolinska Inst, Div Med Imaging & Technol, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.
    18F-FDG PET/CT Diagnosis of Bronchopulmonary Carcinoids Versus Pulmonary Hamartomas: Reply.2017In: Clinical Nuclear Medicine, ISSN 0363-9762, E-ISSN 1536-0229, Vol. 42, no 1, p. 81-82Article in journal (Refereed)
  • 6.
    Uhlen, Natalja
    et al.
    Dept Clin Sci Intervent & Technol, Div Radiog, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Radiol, Huddinge, Sweden..
    Grundberg, Oscar
    Karolinska Univ Hosp, Div Resp Med & Allergol, Dept Med, SE-14186 Stockholm, Sweden..
    Jacobsson, Hans
    Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Radiol, SE-14186 Stockholm, Sweden..
    Sundin, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology. Univ Uppsala Hosp, Dept Radiol, Uppsala, Sweden.
    Dobra, Katalin
    Karolinska Inst, Dept Lab Med, Div Pathol, Stockholm, Sweden..
    Sanchez-Crespo, Alejandro
    Karolinska Univ Hosp, Dept Nucl Med, SE-14186 Stockholm, Sweden..
    Axelsson, Rimma
    Karolinska Univ Hosp, Dept Radiol, Huddinge, Sweden.;Karolinska Inst, Dept Clin Sci Intervent & Technol, Div Med Imaging & Technol, Stockholm, Sweden..
    Kolbeck, Karl-Gustaf
    Karolinska Univ Hosp, Div Resp Med & Allergol, Dept Med, SE-14186 Stockholm, Sweden..
    18F-FDG PET/CT Diagnosis of Bronchopulmonary Carcinoids Versus Pulmonary Hamartomas2016In: Clinical Nuclear Medicine, ISSN 0363-9762, E-ISSN 1536-0229, Vol. 41, no 4, p. 263-267Article in journal (Refereed)
    Abstract [en]

    Purpose Radiological characterization of pulmonary tumors may be difficult and invasive. Needle biopsy may produce false-negative results. F-18-FDG PET/CT is an established noninvasive procedure for lung tumor characterization and staging. This study was aimed at differentiating bronchopulmonary carcinoids from hamartomas and typical from atypical bronchopulmonary carcinoids by means of F-18-FDG PET/CT. Patients and Methods In a retrospective analysis of 118 patients, with surgically resected pulmonary carcinoid tumors and hamartomas, 87 of those selected had also undergone F-18-FDG PET/CT preoperatively and constituted the study population. To better assess the tracer accumulation, especially in small lesions, the F-18-FDG uptake (SUV) in the tumors was corrected for partial volume effect by applying recovery coefficients corresponding to the respective various specific tumor volumes, as extrapolated from those obtained from experiments in a NEMA phantom. Results The SUVmax was higher in the pulmonary carcinoids (mean, 3.9) than in the hamartomas (mean, 1.4; P <= 0.00001) and higher in the subgroup of peripheral carcinoids than in hamartomas (P <= 0.00001). The SUVmax was similar for the atypical and typical carcinoids, 5.0 and 3.8, respectively, because of the large variation in the data (P = 0.11). Conclusions Using PET measurements of the F-18-FDG uptake (SUVmax) in the tumors, corrected for partial volume effects, it was possible to differentiate the carcinoids from the hamartomas, but the clinically more aggressive atypical carcinoids could not be differentiated from the typical carcinoids.

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