bluuebunny/crossref_metadata_2025_split huggingface dataset:
57Co-Hematoporphyrin Accumulation by Experimental Tumors
Authors: Anghileri L. J. , Heidbreder M. , Mathes R. 
Published: March 2018

SummaryThe in vivo distribution of 57Co-hematoporphyrin in adenocarcinoma BW10232-bearing mice has been studied. Tumor-bearing and normal animals exhibit similar patterns of radioactivity accumulation. Twenty-four hours after the administration of the radiocompound the ratios tumor to blood and tumor to muscle indicate a potential value of this radioactive porphyrin for the detection of some types of tumor.
Malabsorption of Vitamin B12 in Homozygous ß-Thalassemia
Authors: Vlachos P. , Liakakos D. 
Published: March 2018

SummarySchilling tests were performed in ten children aged 5—12 years suffering from homozygous β-thalass-emia. 57Co labelled vitamin B12 values excreted in the urine have been found much lower than normal and remained low when the same procedure was repeated with the addition of intrinsic factor. The possible factors responsible for this malabsorption of vitamin B12 seemed to be liver damage and folic acid deficiency.
Platelets in cancer
Authors: Mammadova-Bach E. , Mangin P. , Lanza F. , Gachet C. 
Published: March 2018

SummaryPlatelets are well-known for their major role in primary hemostasis and thrombosis. Cancer patients frequently manifest thrombotic events and present abnormalities in blood coagulation which appear to be linked to altered platelet function and turnover. Moreover, numerous studies indicate an intimate cross-talk between platelets and tumor growth, angiogenesis and metastatic dissemination. Finally, several experimental data and clinical trials suggest possible benefits of anti-platelet drugs on some cancers. Here, we will review the current state of basic biological research regarding the role of platelets in cancer progression. We also critically review the possible clinical applicability of some anti-platelet therapies to limit tumor growth and prevent metastatic dissemination.
Radioimmunotherapy with yttrium-90 ibritumomab tiuxetan
Authors: Dietlein M. , Schnell R. , Pinkert J. , Eschner W. , Zimmermanns B. , Fischer T. , Engert A. , Schicha H. , Schomäcker K. 
Published: March 2018

Summary
90Y-ibritumomab tiuxetan (Zevalin®) is currently approved for radioimmunotherapy of patients with relapsed or refractory follicular non-Hodgkin’s lymphoma pretreated with rituximab. Future directions are the combined use of 90Y-ibritumomab tiuxetan as part of the initial treatment and as first-line multi-agent therapy of relapsed disease. Current studies investigate patients with other than follicular indolent histologies, e. g. diffuse large cell lymphoma. Labelling of 90Y ibritumomab tiuxetan is a safe procedure, the radiochemical purity is not disturbed by a higher room temperature or by metallic impurity. Quality control is recommended by thin layer chromatography (TLC), strips >15 cm are favourable. TLC cannot distinguish between the correctly radiolabelled antibodies and radiocolloid impurity. If necessary, additional HPLC should be performed. Radiocolloid impurities are absorbed to the solid phase and do not reach the eluate. If the radiochemical purity test is insufficient (<95%), the additional cleaning using EconoPac 10 DG columns (Biorad, Hercules, CA, USA) is a reliable procedure to reduce the percentage of free radionuclide. However, this procedure is not part of the approval.
Internal radionuclide therapy
Authors: Landmann M. , Wunderlich A. , Kull T. , Mottaghy F. M. , Reske S. N. , Glatting G. 
Published: March 2018

SummaryAim: Accurate dosimetry must be performed for each patient before therapy with unsealed radionuclides. Recently, the software tool ULMDOS was developed to facilitate planar dosimetric calculations and to support traceability and documentation as a prerequisite for good clinical practice. Here, the extended version of ULMDOS for processing of tomographic data is presented. Methods: ULMDOS is developed in IDL 6.1 (Interactive Data Language) under Windows XP/2000. Serial tomographic data can be loaded in an ECAT7 or DICOM format, and presented as maximum intensity projection. The definition of volumes of interest is supported by various tools (e.g., freehand, isocontour, polygon), region growing, and cluster analysis. Residence times are calculated from fits of the time activity data to exponential functions. Results, discussion: Quantitative 3-dimensional data allow performing a more individualized dosimetry, as problems due to organ overlay, insufficient attenuation and scatter correction in the planar approach can be avoided. For traceability, documentation, retrospective examination and later processing all data can be saved in binary or ASCII format. Dosimetric calculations can be conducted within a single environment, thus it spares the time-consuming transfer of data between different software tools.
FDG uptake after intraarterial chemotherapy in head and neck cancer
Authors: Kovács A. F. , Menzel C. , Engels K. , Kranert W. T. , Grünwald F. , Döbert N. 
Published: March 2018

SummaryAim: The intraarterial chemotherapy (i.a. CHT) using high dose cisplatin combined with systemic neutralization in patients with head and neck cancer (HNSCC) is used to reduce the tumor volume preoperatively. Aim of the study is the evaluation of the influence of i.a. CHT on the metabolism of fluor-18-deoxyglucose (FDG) in the primary and lymph nodes (LN). The value of FDG positron emission tomography (PET) preoperative and as follow-up method after i.a. CHT is examined. Patients, methods: Altogether 16 patients with HNSCC underwent two preoperative FDG PET examinations: the baseline examination one week before and the follow-up three weeks after i.a. CHT. The SUVmax values of the primary and the LN and LN metastases were evaluated and compared with each other and the histopathology. Results: The SUVmax value of the primary decreased after i.a. CHT significantly from a median (25th percentile/ 75th percentile) of 6.4 (4.1/ 7.8) to 3.6 (2.4/ 6.7) (p = 0.01). In 11 out of 16 patients cervical LN metastases were detected. The cervical LN metastases showed a decrease of the SUVmax value from 3.6 (2.3/ 4.8) in the pretreatment examination to 2.3 (1.7/ 3.6) after i.a. CHT (p = 0.008). Only in one patient with LN metastases the SUVmax of the nodes increased. The histopathologically measured size of the LN metastases ranged from 2 to 30 mm. Non malignant LN did not reveal a significant SUVmax decrease after i.a. CHT (p = 0.13). Conclusions: As expected, primaries of HNSCC showed a significant reduction of SUV after i.a. CHT. Compared to the primary the SUVmax decrease in LN metastases was less, but also significant. Since cytotoxic levels of cisplatin do not occur systemic, postinflammatory reactions of the LN or a lymphatic drainage of the chemotherapeutic drug into the LN could be an explanation. PET for staging of HNSCC must thus be performed prior to i.a. CHT.
Limitations of dual time point FDG-PET imaging in the evaluation of focal abdominal lesions
Authors: Hamscho N. , Menzel C. , Neuss L. , Kovács A. F. , Grünwald F. , Döbert N. 
Published: March 2018

Summary:Aim: For the evaluation of the diagnostic potential of dual time point FDG positron emission tomography (PET) in patients with suspicious focal abdominal up-take, dual time point PET imaging was compared with clinical findings. Patients, methods: In a prospective study, 56 patients exhibiting a solitary suspicious, intense abdominal FDG uptake, underwent dual time point PET imaging for staging or restaging of different malignant tumors, maximal standardized uptake value (SUVmax) measurements included. The first acquisition was started 64.8 ± 19.5, the second 211.3 ± 52.5 min after FDG injection. The final diagnosis based on CT or MRT imaging and a follow-up period of 12.6 ± 2.8 months. Additionally, colonoscopy was done in 6 patients. In another 6 patients histopathology was obtained from CT guided biopsy. Results: Malignant focal abdominal lesions with a SUVmax <2.5 (n = 4) showed an uptake increase of ≥30%. In the remaining malignant cases with an uptake of ≥2.5 (n = 11), up-take increased in 64% and decreased in 36%. Malignant lesions showing FDG uptake decrease (n = 4) had an initial SUVmax value ≥2.5 and remained with a SUVmax ≥2.5 in the second imaging. In benign lesions with an initial SUVmax ≥2.5 (n = 31), the uptake increased in 17 patients (55%) and decreased in 14 patients (45%). All lesions which changed configuration (33%) were confirmed as benign (n = 5). Conclusion: Using dual time point PET abdominal lesions show a very hetergenous uptake pattern regardless of their dignity. Malignancy can only be reliably excluded in lesions which change their configuration and in lesions with an initial SUVmax value <2.5 combined with an SUV decrease in the delayed imaging. Particularly abdominal lesions which show an initial SUVmax ≥2.5 combined with a SUV increase in the delayed imaging are suspicious for malignancy and need further clarification.
Confronting the practice of surgery on differentiated thyroid cancer with current guidelines in Germany
Authors: Wieler H. , Birtel S. , Ostwald-Lenz E. , Kaiser K. P. , Becker H. P. , Schwab R. 
Published: March 2018

Summary:Aim: For the surgical therapy of differentiated thyroid cancer precise guidelines are applied by the German medical societies. In a retrospective multicenter study, we investigated the following issues: Are the current guidelines respected?. Is there a difference concerning the surgical radicalism and the outcome?. Does the perioperative morbidity increase with the higher radicalism of the procedure?. Patients, methods: Data gained from 102 patients from 17 regional referral hospitals who underwent surgery for thyroid cancer and a following radioiodine treatment (mean follow up: 42.7 [24-79] months) were analyzed. At least 71 criterias were analyzed in a SPSS file. Results: 46.1% of carcinomas were incidentally detected during goiter surgery. The thyroid cancer (papillary n = 78; follicular n = 24) occurred in 87% unilateral and in 13% bilateral. Papillary carcinomas <1 cm were detected in 25 cases; in five of these cases (20%) contralateral carcinomas <1 cm were found. There were significant differences concerning the surgical radicalism: a range from hemithyroidectomy to radical thyroidectomy with lateral neck dissection. Analysis of the histopathologic reports revealed that lymph node dissection was not performed according to guidelines in 55% of all patients. The perioperative morbidity was lower in departments with a high case load. The postoperative dysfunction of the recurrent laryngeal nerve (mean: 7.9% total / 4.9% nerves at risk) variated highly, depending on differences in radicalism and hospitals. Up to now these variations in surgical treatment have shown no differences in their outcome and survival rates, when followed by radioiodine therapy. Conclusion: Current surgical regimes did not follow the guidelines in more than 50% of all cases. This low acceptance has to be discussed. The actual discussion about principles of treatment regarding, the socalled papillary microcarcinomas (old term) has to be respected within the current guidelines.
The incidentaloma of the thyroid
Authors: Kobe C. , Schmidt M. , Schicha H. , Dietlein M. 
Published: March 2018

Summary:The incidentally detected thyroid nodule using sonography is described as incidentaloma; the most nodules have a diameter up to 1.5 cm. Sonography will detect thyroid nodules in more than 20% of the population in Germany. Epidemiological studies investigating the prevalence of malignancy in such incidentalomas are missing. The incidence of differentiated thyroid cancer is about 3 per 100,000 people and year. However, several monocentric studies have shown a prevalence of malignancy of up to 10% of the thyroid nodules in selected patients’ group. The histology did not found microcarcinomas only, but also small cancer with infiltration of the thyroid capsule, lymph node metastasis or multifocal spread. The studies were not designed for outcome measurement after early and incidental detection of small thyroid cancers. Hypoechogenity, ill defined borders, central hypervascularization or microcalcifications were used as combined criteria for risk stratification. The second method for risk stratification is scintigraphy and further tests are warranted for hypofunctioning nodule ≥1 cm. Additionally, the family history, patient’s age <20 years, former radiation of the neck, and measurement of calcitonin should be regarded. Without such a risk stratification selection for fine needle aspiration is impossible. Fine needle aspiration of non-palpable incidentalomas led to non-representative or unequivocal cytological findings in up to 40%. Because better outcome of incidentally detected small thyroid carcinomas is not proved and because sonography, scintigraphy and fine needle aspiration remain imprecise regarding dignity of incidentalomas, fine needle aspiration is not the standard for small, non-palpable thyroid nodules. Conclusion: For management of incidentaloma, sonographically unsuspicious, scintigraphically indifferent (nodules ≥1 cm) and without any risk factors in patients’ history, wait and see is justified when patient is informed about the problem.
Introduction of a quality management system compliant with DIN EN ISO 9001:2000 into a university department of nuclear medicine
Authors: Paschen U. , Kröger S. , Bohuslavizki K. H. , Clausen M. , Jansen-Schmidt V. 
Published: March 2018

SummaryIn 1995, the management of the University Clinic Hamburg-Eppendorf proposed to establish a total quality assurance (QA) system. A revised QA-system has been introduced stepwise in the department of nuclear medicine since 1997, and certification was achieved in accordance with DIN EN ISO 9001:2000 on February 14,2001.The QA-handbook is devided into two parts. The first part contains operational (diagnostic and therapeutic) procedures in so-called standard operating procedures (SOP). They describe the indication of procedures as well as the competences and time necessary in a standardized manner. Up to now, more than 70 SOPs have been written as a collaborative approach between technicians and physicians during daily clinical routine after analysing and discussing the procedures. Thus, the results were more clearly defined processes and more satisfied employees.The second part consists of general rules and directions concerning the security of work and equipment as well as radialion protection tasks, hygiene etc. as it is required by the law. This part was written predominantly by the management of the department of nuclear-medicine and the QA-coordinator. Detailed information for the patients, documentation of the work-flows as well as the medical report was adapted to the QM-system. Although in the introduction phase of a QA-system a vast amount of time is necessary, some months later a surplus for the clinical workday will become available. The well defined relations of competences and procedures will result in a gain of time, a reduction of costs and a help to ensure the legal demands. Last but not least, the QA-system simply helps to build up confidence and acceptance both by the patients and the referring physicians.
Guidelines on radioiodine therapy for differentiated thyroid carcinoma
Authors: Pixberg M. K. , Dörr U. , Dietlein M. , Schlemmer H. , Grimm J. , Zajic T. , Nestle U. , Ladner S. , Sepehr-Rezai S. , Rosenbaum S. , Puskás C. , Fostitsch P. , Heinecke A. , Schuck A. , Willich N. , Schmid K. W. , Dralle H. , Schober O. , Biermann M. ,   for the MSDS study group
Published: March 2018

SummaryAim: For the examination of the impact on clinical practice of the guidelines for differentiated thyroid carcinoma (DTC), treatment data from the ongoing Multicenter Study Differentiated Thyroid Carcinoma (MSDS) were analyzed. Patients, methods: Patients were randomized to adjuvant external beam radiotherapy (RTx) or no RTx in addition to standard therapy in TNM stages pT4 pN0/1/x M0/x (UICC, 5th ed. 1997). All patients were to receive the same treatment regimen consisting of thyroidectomy, ablative radioiodine therapy (RIT), and a diagnostic 131I whole-body scintigraphy (WBS) 3-4 months after RIT. Results: Of 339 eligible patients enrolled between January 2000 and March 2004, 273 could be analyzed. Guideline recommendations by the German Society for Nuclear Medicine from 1999 and 1992 were complied with within 28% and 82% with regard to the interval between surgery and RIT (4 vs. 4–6 weeks), in 33% and 84% with regard to 131I activity for RIT (1-3 vs. 1-4 GBq; ± 10%), and in 16% and 60% with regard to 131I activity for WBS (15319-300 vs. 15319-400 MBq; ± 10%). Conclusions: The 1999 guideline revision appears to have had little impact on clinical practice. Further follow-up will reveal if guideline compliance had an effect on outcomes.
Nuclear Medicine
Authors: Jigalin A. , Lerch H. 
Published: March 2018

SummaryAim, method: The scientific publications in the 2003 and 2004 issues of the journal Nuklearmedizin were analyzed retrospectively with regard to the proportion of medical technology research. Results: Out of a total of 73 articles examined, 9 (12%) were classified as medical technology research, that is, 8/15 of the original papers (16%) and one of the case reports (5%). Of these 9 articles, 44% (4/9) focused on the combination of molecular and morphological imaging with direct technical appliance or information technology solutions. Conclusion: Medical technology research is limited in the journal’s catchment area. The reason for this is related to the interdependency between divergent development dynamics in the medical technology industry’s locations, the many years that the area of scintigraphic technology has been underrepresented, research policy particularly in discrepancies in the promotion of molecular imaging and a policy in which health is not perceived as a predominantly good and positive oeconomic factor, but more as a curb to oeconomic development.
Lymph node staging in extracranial head and neck cancer with FDG PET – appropriate uptake period and size-dependence of the results
Authors: Klenzner Th. , Krause Th. , Mix M. , Ross U. H. , Moser E. , Nitzsche E. U. , Brink I. 
Published: March 2018

Summary
Aim: Identification of a rationale for the appropriate uptake period for static clinical extracranial head and neck PET imaging and evaluation of the diagnostic accuracy of such an optimized FDG PET approach for lymph node staging in the head and neck region. Methods: In a subset of 5 patients, kinetic tumour studies were performed in order to identify the cellular activity plateau phase of FDG accumulation for head and neck cancer. Seventy-eight consecutive patients (11 women, 67 men; mean age ± SD: 55 ± 11 years; range, 36-78 years), presenting with histologically proven squamous cell carcinoma and sonographically detected lymph nodes in 86 neck sides, underwent clinically indicated FDG PET imaging. PET results were compared to those derived from histological examinations and follow-up imaging results after 6 months in order to calculate sensitivity and specificity for lymph node staging. Results: FDG kinetics in head and neck cancer indicate that the cellular activity plateau of FDG accumulation is reached after an uptake period of 90 min. Using this protocol metastatic involvement of neck sides with lymph nodes less than 1 cm in diameter was correctly identified with a sensitivity of 71.4% and a specificity of 92.3%. Sensitivity increased with the lymph node diameter (1.1-1.5 cm 83.3%, 1.6-2.0 cm 100%, > 2 cm 88.9%). Conclusion: The appropriate uptake period for static clinical extracranial head and neck PET imaging that allows measurements in the activity plateau phase is about 90 min. FDG PET may add some significant information regarding metastatic spread into regional lymph nodes.
Radioiodination of monoclonal antibodies, proteins and peptides for diagnosis and therapy
Authors: Gotthardt M. , Becker W. , Béhé M. , Behr Th. M. 
Published: March 2018

SummarySimple and reliable methodologies for radioiodination of proteins and peptides are described. The labeling systems are easy to assemble, capable of radioiodinating any protein or, with slight modifications, also peptide (molecular mass 1000-300,000) from kBq to GBq levels of activity for use in diagnosis and/or therapy. Furthermore, the procedures are feasible in any nuclear medicine department. Gigabecquerel amounts of activity can be handled safely. The most favored iodination methodology relies on the Iodogen system, a mild oxidating agent without reducing agents. Thus, protein degradation is minimized. Labeling yields are between 60 and 90%, and immunoreactivities remain ≥ 85%. Other radioiodination methods (chloramine-T, Bolton-Hunter) are described and briefly discussed.
Diagnostik und Therapie der auditorischen Neuropathie
Authors: Ptok Martin 
Published: March 2018

ZusammenfassungDie auditorische Neuropathie (AN) zeichnet sich durch nachweisbare evozierbare otoakustische Emissionen (EOAE) und nicht ableitbare bzw. nur mit erhöhten Schwellen ableitbare auditorisch evozierte Hirnstammpotenziale aus. Als Ursache mus eine Funktionsstörung der inneren Haarzellen und/oder eine Störung der neuronalen Reizweiterleitung bei intakten äußeren Haarzellen angenommen werden.Betroffene Patienten verhalten sich in schweren Fällen wie Schwerhörige mit einer hochgradigen kochleären Schwerhörigkeit, in milderen Fällen kann das Tonschwellenaudiogramm weitgehend normal sein, das Sprachverständnis ist meistens jedoch deutlich eingeschränkt.Die auditorische Neuropathie scheint häufiger zu sein als noch vor einiger Zeit angenommen. Bei anamnestisch zu vermutender Schwerhörigkeit, insbesondere bei Kindern mit einem Sprachentwicklungsrückstand – gerade, wenn ein Sprachaudiogramm noch nicht durchführbar erscheint – gutem Tonschwellenaudiogramm und nachweisbaren EOAE ist die auditorische Neuropathie immer diffenzialdiagnostisch zu berücksichtigen.
Aktuelles zum Morbus Perthes
Authors: Westhoff Bettina , Krauspe Rüdiger 
Published: March 2018

ZusammenfassungBeim Morbus Perthes, der juvenilen Hüftkopfnekrose, kommt es zur Verminderung oder Unterbrechung der Blutversorgung der Epiphyse des Femurkopfes. Über die Ätiologie besteht bislang keine Einigkeit, systemische wie lokale Faktoren werden diskutiert. Die Erkrankung verläuft in verschiedenen Stadien. Die Diagnose kann in der Regel mittels konventioneller Röntgenaufnahmen gestellt werden. Das heute allgemein anerkannte therapeutische Prinzip besteht in dem Erhalt des Containments. Dies kann in Abhängigkeit von dem Schweregrad durch konservative Maßnahmen, häufig aber nur durch operative Eingriffe, erzielt werden. Die Langzeitprognose ist im Wesentlichen abhängig von der Sphärizität und Kongruenz zwischen Hüftkopf und Pfanne nach Ausheilung.