Radionuclide Imaging

放射性核素成像
  • 文章类型: Systematic Review
    背景:当前潜在活体供肾评估包括功能和解剖学评估。在某些情况下,建议使用闪烁显像,一些中心将此测试纳入捐赠者的方案。最近的研究主张避免这种测试,因为CT或MRI容积显示可以准确评估供体的肾功能。
    目的:总结捐献前和/或肾切除术后肾功能评估的影像学检查的科学依据。
    方法:本综述遵循了欧洲泌尿外科协会制定的指南,并遵循了PRISMA2020的建议。该协议于2022年12月10日在PROSPERO注册(ID:CRD42022379273)。
    结果:21项研究在经过全面筛选和资格评估后符合纳入标准。根据QUADAS-2,患者选择和流/定时域显示出主要的低偏倚风险。使用CT和闪烁显像术的分裂肾功能(SRF)之间的相关性从弱(r=0.21)到明显强(r=0.949)。Bland-Altman协议显示出中等到优异的结果,平均差异从-0.06%到1.76%。肾切除术后6个月或1年的分裂肾体积(CT)与估计的肾小球滤过率(eGFR)之间的相关性显示出中等相关性,系数范围从0.708到0.83。SRF(MRI)和肾闪烁显像之间的相关性报告为中度相关性,相关系数为0.58和0.84。MRI和闪烁显像显示出良好的一致性,观察到66%的一致性和±0.3%的平均差异。
    结论:尽管研究存在异质性,与闪烁显像相比,基于MRI或CT的肾功能测定似乎很有希望,具有良好的相关性和一致性。
    BACKGROUND: Current potential living kidney donor\'s assessment includes functional and anatomical evaluation. Scintigraphy is recommended in some cases and some centers include this test in the donor\'s protocol. Recent studies advocate for the avoidance of this test as CT or MRI volumetry showed to accurately assess donor\'s renal function.
    OBJECTIVE: To summarize scientific evidence on image tests for pre-donation and/or post-nephrectomy renal function evaluation.
    METHODS: This review followed the guidelines set by the European Association of Urology and adhered to PRISMA 2020 recommendations. The protocol was registered in PROSPERO on 10th December 2022 (ID: CRD42022379273).
    RESULTS: Twenty-one studies met the inclusion criteria after thorough screening and eligibility assessment. According to QUADAS-2, patient selection and flow/timing domains showed a predominant low risk of bias. The correlation between split renal function (SRF) using CT and scintigraphy varied from weak (r = 0.21) to remarkably strong (r = 0.949). Bland-Altman agreement demonstrated moderate to excellent results, with mean differences ranging from -0.06% to 1.76%. The correlation between split renal volume (CT) and estimated glomerular filtration rate (eGFR) at 6 months or 1 year after nephrectomy showed a moderate correlation, with coefficients ranging from 0.708 to 0.83. The correlation between SRF (MRI) and renal scintigraphy reported a moderate correlation, with correlation coefficients of 0.58 and 0.84. MRI and scintigraphy displayed a good agreement, with a 66% agreement observed and mean differences of ± 0.3%.
    CONCLUSIONS: Despite study heterogeneity, MRI or CT-based renal volumetry appears promising compared to scintigraphy, with favorable correlations and agreement.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    目的:本研究旨在对经验性高剂量放射性碘治疗甲状腺球蛋白(Tg)升高阴性碘闪烁显像(TENIS)综合征的分化型甲状腺癌患者的疗效进行系统评价和荟萃分析。
    方法:我们搜索了PubMed,EMBASE,和Cochrane图书馆,以确定直到2022年4月发表的相关研究。该系统评价是根据系统评价和荟萃分析的首选报告项目清单进行的,并在国际前瞻性系统评价登记册(PROSPERO)中注册。进行比例和比值比的荟萃分析,以评估经验性高剂量放射性碘治疗对TENIS综合征患者的有益效果。还根据微转移或大转移的存在进行亚组分析。
    结果:我们确定了14项研究,包括690例接受经验性高剂量放射性碘治疗的TENIS综合征患者。那些有微转移的患者在诊断性全身扫描中表现出以前未观察到的额外病变(prop=0.64,95%置信区间[CI],0.51-0.77),并且在经验性放射性碘治疗后血清Tg水平降低(prop=0.69;95%CI,0.52-0.84)。在大转移患者中未观察到此类发现。此外,我们发现,经验性放射性碘治疗组的血清Tg水平低于对照组(比值比=0.27;95%CI,0.09-0.87),这表明疾病进展的风险较低。
    结论:我们的研究结果表明,经验性高剂量放射性碘治疗可促进有益效果,可推荐用于TENIS综合征患者,特别是那些有微转移的。
    OBJECTIVE: This study aimed to perform a systematic review and meta-analysis on the efficacy of empirical high-dose radioiodine therapy in treating differentiated thyroid cancer patients with thyroglobulin (Tg)-elevated negative iodine scintigraphy (TENIS) syndrome.
    METHODS: We searched PubMed, EMBASE, and the Cochrane Library to identify relevant studies published until April 2022. This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and registered in an international prospective register of systematic reviews (PROSPERO). Meta-analyses of proportions and odds ratios were performed to assess the beneficial effect of empirical high-dose radioiodine therapy in patients with TENIS syndrome. Subgroup analysis was also performed according to the presence of micrometastasis or macrometastasis.
    RESULTS: We identified 14 studies including 690 patients who received empirical high-dose radioiodine therapy for TENIS syndrome. Those who had micrometastasis exhibited additional lesions not previously observed on diagnostic whole-body scan (prop = 0.64, 95% confidence interval [CI], 0.51-0.77) and had reduced serum Tg levels (prop = 0.69; 95% CI, 0.52-0.84) after empirical radioiodine treatment. No such findings were observed among patients with macrometastasis. Moreover, we found that the empirical radioiodine treatment group had lower serum Tg levels than did controls (odds ratio = 0.27; 95% CI, 0.09-0.87), which suggests a lower risk of disease progression.
    CONCLUSIONS: Our findings indicate that empirical high-dose radioiodine therapy promoted beneficial effects and could be recommended for patients with TENIS syndrome, especially those with micrometastasis.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    本文介绍了包括射线照相术在内的现有成像技术的诊断效用的全面概述,计算机断层扫描,超声检查,磁共振成像(MRI),和放射性核素显像在最常见的骨科或肌肉骨骼感染的背景下。它还包括说明性图像,展示各种肌肉骨骼感染包括骨髓炎的重要发现,蜂窝织炎,化脓性关节炎,坏死性感染和假体周围关节感染及其相关并发症。
    This article presents a comprehensive overview of the diagnostic utility of existing imaging techniques including radiography, computed tomography, ultrasonography, magnetic resonance imaging (MRI), and radionuclide imaging in the context of the most common orthopaedic or musculoskeletal infections. It also includes illustrative images showcasing significant findings in various musculoskeletal infections including osteomyelitis, cellulitis, septic arthritis, necrotising infections and peri-prosthetic joint infections and their associated complications.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    全身磁共振成像(WB-MRI)巩固了其作为肿瘤诊断中关键工具的地位。它提供了无与伦比的软组织对比度分辨率和回避电离辐射的优势。本文就WB-MRI在肿瘤学中的多种应用作一综述。我们讨论了它在检测和诊断一系列癌症中的转化作用,强调多发性骨髓瘤和具有骨转移倾向的癌症。WB-MRI在单一扫描中涵盖整个身体的能力开创了癌症筛查的新范式,特别是对于患有遗传性癌症综合征或转移性疾病风险增加的个体。此外,它对临床景观的贡献,协助多灶性和全身性恶性肿瘤的整体管理,正在探索。文章强调了WB-MRI取得的技术进步,其无数的临床公用事业,以及整合到标准肿瘤护理中的挑战。实质上,这篇综述强调了WB-MRI的转化潜力,强调其作为塑造癌症诊断和治疗未来轨迹的基石模式的承诺。
    Whole-Body Magnetic Resonance Imaging (WB-MRI) has cemented its position as a pivotal tool in oncological diagnostics. It offers unparalleled soft tissue contrast resolution and the advantage of sidestepping ionizing radiation. This review explores the diverse applications of WB-MRI in oncology. We discuss its transformative role in detecting and diagnosing a spectrum of cancers, emphasizing conditions like multiple myeloma and cancers with a proclivity for bone metastases. WB-MRI\'s capability to encompass the entire body in a singular scan has ushered in novel paradigms in cancer screening, especially for individuals harboring hereditary cancer syndromes or at heightened risk for metastatic disease. Additionally, its contribution to the clinical landscape, aiding in the holistic management of multifocal and systemic malignancies, is explored. The article accentuates the technical strides achieved in WB-MRI, its myriad clinical utilities, and the challenges in integration into standard oncological care. In essence, this review underscores the transformative potential of WB-MRI, emphasizing its promise as a cornerstone modality in shaping the future trajectory of cancer diagnostics and treatment.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Meta-Analysis
    氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(PET/CT),核医学的主力,对肾细胞癌(RCC)的应用有限,特别是清晰的细胞变体。因此,已经尝试了各种其他示踪剂来评价RCC。放射性示踪剂的最有希望的靶标之一是在癌相关的新脉管系统中大量表达的前列腺特异性膜抗原(PSMA)。因此,我们试图回顾和分析PSMA靶向PET/CT在RCC评估中的作用。像PubMed这样的数据库,直到2023年9月30日,在RCC中搜索了EMBASE和SCOPUS在PSMA靶向PET/CT上发表的原始研究。使用经修订的诊断准确性研究质量评估工具-2(QUADAS-2)检查表评估纳入的研究。计算合并的敏感性和特异性,并用95%置信区间(95CI)表示。通过I平方指数评估研究中的异质性。PSMA靶向PET/CT检测局部疾病估计值的敏感性和特异性为87.2%(95CI:77-94%)和100%(95CI:92.9-100%),分别。局部复发性疾病检测的敏感性和特异性为100%(95CI:71.5-100%)和100%(95CI:89.4-100%),分别。联合检测转移性疾病的敏感性和特异性为92%(95CI:86.2-96%)和96.9%(95CI:83.8-99.9%),分别。PSMA靶向PET/CT检测透明细胞肾细胞癌(ccRCC)和非ccRCC的敏感性分别为94.7%(95CI:88-98.3%)和75%(95CI:35-96.8%),分别。PSMA靶向PET-CT对复发性RCC的检测显示出更好的诊断功效。虽然用于分级RCC,特异性较高,但敏感性较低。因此,它可以作为常规影像学评估RCC分期的非侵入性辅助工具,特别是清晰的细胞变体。
    Fluoro-deoxy glucose positron emission tomography/computed tomography (PET/CT), the workhorse of nuclear medicine, has limited utility for renal cell carcinoma (RCC), particularly clear cell variant. Thus, various other tracers have been tried for evaluation of RCC. One of the most promising targets for radiotracers is prostate-specific membrane antigen (PSMA) expressed in abundance in carcinoma-associated neo-vasculature. Thus, we tried to review and analyse the role of PSMA-targeted PET/CT in evaluation of RCC. Databases like PubMed, EMBASE and SCOPUS were searched for original studies published on PSMA-targeted PET/CT in RCC till 30 September 2023. Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) checklist was used to assess the included studies. Pooled sensitivity and specificity were calculated and represented with 95% confidence intervals (95%CI). Heterogeneity in the studies was assessed by I-square index. Pooled sensitivity and specificity of PSMA-targeted PET/CT for detection of local disease estimates were 87.2% (95%CI: 77-94%) and 100% (95%CI: 92.9-100%), respectively. Pooled sensitivity and specificity for detection of local recurrent disease are 100% (95%CI: 71.5-100%) and 100% (95%CI: 89.4-100%), respectively. Pooled sensitivity and specificity for detection of metastatic disease are 92% (95%CI: 86.2-96%) and 96.9% (95%CI: 83.8-99.9%), respectively. Pooled sensitivity of PSMA-targeted PET/CT for detection of clear cell renal cell carcinoma (ccRCC) and non-ccRCC are 94.7% (95%CI: 88-98.3%) and 75% (95%CI: 35-96.8%), respectively. PSMA-targeted PET-CT demonstrated better diagnostic efficacy for the detection of recurrent RCC. Whilst for staging RCC, it had higher specificity but lower sensitivity. Thus, it can serve as a non-invasive adjuvant tool to conventional imaging in the evaluation of staging of RCC, particularly clear cell variant.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Review
    暂无摘要。
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:以人为中心的护理(PCC)强调医疗保健专业人员需要优先考虑个人患者的需求,从而培养一个协作和强调的环境,使患者能够积极参与自己的护理。本文将探讨PCC在核医学(NM)中的应用目的,同时讨论在对成年患者进行诊断性NM检查期间可用于实施PCC的策略。
    方法:范围审查是根据JoannaBriggs研究所的方法进行的。搜索是在PubMed上进行的,Embase和Cinhal在2023年6月,包括英语学习,西班牙语,葡萄牙语和意大利语。研究方程结合了关键词和医学主题标题术语(MeSH),与以人为本的护理(PCC)相关,所有类型的核医学诊断检查。三位独立评论作者筛选了所有摘要和标题,所有符合条件的全文出版物都包括在本次范围审查中。
    结果:53篇文章,发表于1993年至2022年之间,符合本次范围审查的纳入标准。2015年发表了7篇文章,而所有纳入研究的56.6%在欧洲进行。大多数研究(n=39/53)只关注患者,确定的患者益处是:改善患者体验(67.9%),增加患者舒适度(13.2%),增加患者知识(5.7%),减少患者焦虑(9.4%)和减少等待/扫描时间(3.8%)。
    结论:范围审查发现缺乏调查在新墨西哥州使用以人为本的护理策略的研究。未来的研究将集中在使用国际调查来探索海外核医学部门的这一主题。
    结论:通过应用PCC原理,NM专业人员可以改善患者护理途径并提高患者满意度,导致增强的临床结果。
    BACKGROUND: Person-centred care (PCC) emphasises the need for the health care professional to prioritise individual patient needs, thereby fostering a collaborative and emphatic environment that empowers patients to actively participate in their own care. This article will explore the purpose of PCC in Nuclear Medicine (NM), while discussing strategies that may be used to implement PCC during diagnostic NM examinations performed on adult patients.
    METHODS: The scoping review was conducted in accordance with the Joanna Briggs Institute methodology. The search was performed on PubMed, Embase and Cinhal in June 2023 and included studies in English, Spanish, Portuguese and Italian. The research equation combined keywords and Medical Subject Heading terms (MeSH) related to person-centred care (PCC), for all types of nuclear medicine diagnostic examinations performed. Three independent review authors screened all abstracts and titles, and all eligible full-text publications were included in this scoping review.
    RESULTS: Fifty-three articles, published between 1993 and 2022, met the inclusion criteria for this scoping review. Seven articles were published in 2015 while 56.6 % of all included studies were performed in Europe. Most studies (n = 39/53) focused on the patients only, with the identified patient benefits being: improve patient experience (67.9 %), increase patient comfort (13.2 %), increase patient knowledge (5.7 %), reduction of patient anxiety (9.4 %) and reduction of waiting/scan time (3.8 %).
    CONCLUSIONS: The scoping review identified a lack of research investigating the use of person-centred care strategies in NM. Future research will focus on using an international survey to explore this topic in nuclear medicine departments overseas.
    CONCLUSIONS: By applying PCC principles, the NM professional can improve the patient care pathway and increase patient satisfaction, leading to enhanced clinical outcomes.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Systematic Review
    骨扫描,反映感兴趣区域的血流和代谢活动,经常用于评估下颌生长障碍。摄取增加是非特异性发现,可能是多种原因导致的。放射性示踪剂吸收与生长活性之间的相关性尚未得到一致证明。这项研究的目的是评估平面骨骼闪烁显像(SS)的准确性,单光子发射计算机断层扫描(SPECT),与临床和影像学/断层摄影方法(参考标准)和组织学发现相比,用计算机断层扫描(CT)图像(SPECT/CT)检测异常下颌骨生长活动的SPECT。按照PRISMA指南进行了系统审查。灵敏度,特异性,并计算了平面SS的精度,SPECT,和SPECT/CT。与参考标准相比,SPECT/CT具有最好的诊断准确性(敏感性为76.5%,90.4%的特异性,83.2%的精度),其次是平面SS(灵敏度为81.8%,84.5%的特异性,83.0%的准确度)和SPECT(77.7%的灵敏度,72.4%的特异性,74.5%的准确率)。这项研究的结果表明,SPECT/CT具有最佳的临床相关性,但是证据的确定性很低。三种指标测试之间的敏感性和特异性差异无临床意义。这三个测试可能很有用,它们的诊断价值只有很小的差异。发现组织病理学作为参考标准不令人满意。
    Bone scans, reflecting blood flow and metabolic activity in a region of interest, are frequently used to evaluate mandibular growth disorders. Increased uptake is a non-specific finding and can occur as a result of multiple causes. The correlation between radioactive tracer uptake and growth activity has not been consistently demonstrated. The aim of this study was to assess the accuracy of planar skeletal scintigraphy (SS), single-photon emission computed tomography (SPECT), and SPECT with computed tomography (CT) images (SPECT/CT) in detecting abnormal mandibular growth activity compared to clinical and radiographic/tomographic methods (reference standard) and histologic findings. A systematic review was conducted following the PRISMA guidelines. Sensitivity, specificity, and accuracy were calculated for planar SS, SPECT, and SPECT/CT. Compared to the reference standard, SPECT/CT had the best diagnostic accuracy (76.5% sensitivity, 90.4% specificity, 83.2% accuracy), followed by planar SS (81.8% sensitivity, 84.5% specificity, 83.0% accuracy) and SPECT (77.7% sensitivity, 72.4% specificity, 74.5% accuracy). The results of this study indicate that SPECT/CT has the best clinical correlation, but the certainty of the evidence is low. The differences in sensitivity and specificity between the three index tests were not clinically significant. The three tests can be useful, with only a small difference in their diagnostic value. Histopathology was found not to be satisfactory as a reference standard.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Review
    暂无摘要。
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Meta-Analysis
    目的:通过无创方式检测下消化道出血(LGIB)对于LGIB的成功治疗非常重要。红细胞闪烁显像和CT在检测LGIB和通过定位出血部位指导患者管理方面具有作用。然而,只有少数研究评估了RBC闪烁显像和CT在LGIB诊断中的作用.进行了这项系统评价,以评估RBC闪烁显像和CT在临床或生化发现可疑LGIB的患者中检测LGIB的诊断性能。
    方法:本系统综述遵循PRISMA指南。在PubMed中搜索,Scopus,Embase是使用相关关键词进行的,和截至2022年4月30日发表的文章都包括在内。使用内窥镜或手术结果作为参考标准,提取真假阳性和真假阴性的数量。诊断测试准确性的汇总估计-包括灵敏度,特异性,正似然比,负似然比,和总结ROC(SROC)曲线-使用双变量随机效应荟萃分析生成。
    结果:包括171例患者的三项研究纳入了系统评价和荟萃分析。汇集的敏感性,特异性,正似然比,使用RBC闪烁显像检测LGIB的阴性似然比为0.787(95%CI,0.643-0.893),0.289(95%CI,0.164-0.443),分别为1.214(95%CI,0.923-1.597)和0.576(95%CI,0.296-1.121)。SROC曲线下面积为0.73。汇集的敏感性,特异性,正似然比,使用CT检测LGIB的阴性似然比为0.931(95%CI,0.772-0.992),0.870(95%CI,0.737-0.951),6.085(95%CI,0.840-44.097),分别为0.126(95%CI,0.006-2.509)。SROC曲线下面积为0.095。
    结论:红细胞闪烁显像具有良好的整体敏感性,CTA具有极好的敏感性特异性,在临床或生化结果可疑的患者中,LGIB检测的阳性和阴性似然比。可以在算法上使用CTA和RBC闪烁显像来排除对LGIB部位没有定位的患者,从而帮助这些患者避免内窥镜检查或手术探查等侵入性程序。
    OBJECTIVE: Detection of lower gastrointestinal bleeding (LGIB) through noninvasive modalities is very important in the successful management of LGIB. RBC scintigraphy and CT have a role in the detection of LGIB and guiding the management of patient by localization of the bleeding site. However, only a small number of studies have evaluated the role of RBC scintigraphy and CT in the diagnosis of LGIB. This systematic review was conducted to evaluate the diagnostic performance of RBC scintigraphy and CT in the detection of LGIB in patients with clinical or biochemical findings suspicious of LGIB.
    METHODS: This systematic review followed PRISMA guidelines. Searches in PubMed, Scopus, and Embase were conducted using relevant keywords, and articles published through 30 April 2022, were included. Using endoscopy or surgical outcomes as the reference standard, the numbers of true and false positives and true and false negatives were extracted. Pooled estimates of diagnostic test accuracy - including sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and summary ROC (SROC) curve - were generated using bivariate random-effects meta-analysis.
    RESULTS: Three studies comprising 171 patients were included in the systematic review and meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio for the detection of LGIB using RBC scintigraphy were 0.787 (95% CI, 0.643-0.893), 0.289 (95% CI, 0.164-0.443), 1.214 (95% CI, 0.923-1.597) and 0.576 (95% CI, 0.296-1.121) respectively. The area under the SROC curve was 0.73. The pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio for the detection of LGIB using CT were 0.931 (95% CI, 0.772-0.992), 0.870 (95% CI, 0.737-0.951), 6.085 (95% CI, 0.840-44.097), 0.126 (95% CI, 0.006-2.509) respectively. The area under the SROC curve was 0.095.
    CONCLUSIONS: RBC scintigraphy has overall good sensitivity and CTA has excellent sensitivity specificity, positive and negative likelihood ratio in the detection of LGIB in patients with clinical or biochemical findings suspicious for LGIB.CTA along with RBC scintigraphy can be used algorithmically to rule out patients who do not have a localization for the site of LGIB thereby helping these patients to avoid invasive procedures like endoscopy or surgical explorations.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

公众号