Purpose Lung cancer surgery outcomes depend heavily on preoperative pulmonary reserve, with forced expiratory volume in 1 second (FEV1) being a critical preoperative evaluation factor. Our study investigates the discrepancies between predicted and long-term actual postoperative lung function, focusing on clinical factors affecting these outcomes. Methods This retrospective observational study encompassed lung cancer patients who underwent preoperative lung perfusion SPECT/CT between 2015 and 2021. We evaluated preoperative and postoperative pulmonary function tests, considering factors such as surgery type, resected volume, and patient history including tuberculosis. Predicted postoperative lung function was calculated using SPECT/CT imaging. Results From 216 patients (men:women, 150:66; age, 67.9 ± 8.7 years), predicted postoperative FEV1% (ppoFEV1%) showed significant correlation with actual postoperative FEV1% ( r = 0.667; P < 0.001). Paired t test revealed that ppoFEV1% was significantly lower compared with actual postoperative FEV1% ( P < 0.001). The study identified video-assisted thoracic surgery (VATS) (odds ratio [OR], 3.90; 95% confidence interval [CI], 1.98–7.69; P < 0.001) and higher percentage of resected volume (OR per 1% increase, 1.05; 95% CI, 1.01–1.09; P = 0.014) as significant predictors of postsurgical lung function improvement. Conversely, for the decline in lung function postsurgery, significant predictors included lower percentage of resected lung volume (OR per 1% increase, 0.92; 95% CI, 0.86–0.98; P = 0.011), higher preoperative FEV1% (OR, 1.03; 95% CI, 1.01–1.07; P = 0.009), and the presence of tuberculosis (OR, 5.19; 95% CI, 1.48–18.15; P = 0.010). Additionally, in a subgroup of patients with borderline lung function, VATS was related with improvement. Conclusions Our findings demonstrate that in more than half of the patients, actual postsurgical lung function exceeded predicted values, particularly following VATS and with higher volume of lung resection. It also identifies lower resected lung volume, higher preoperative FEV1%, and tuberculosis as factors associated with a postsurgical decline in lung function. The study underscores the need for precise preoperative lung function assessment and tailored postoperative management, with particular attention to patients with relevant clinical factors. Future research should focus on validation of clinical factors and exploring tailored approaches to lung cancer surgery and recovery.
68Ga-NOTA Glu-Urea-Lys (NGUL) is a novel prostate-specific membrane antigen (PSMA)–targeting tracer used for PET/CT imaging. This study aimed to compare performance in the detection of primary and metastatic lesions and to compare biodistribution between 68Ga-NGUL and 68Ga-PSMA-11 in the same patients with prostate cancer. Methods: Eleven patients with metastatic prostate cancer were prospectively recruited. The quantitative tracer uptake was determined in normal organs and in primary and metastatic lesions. Results:68Ga-NGUL showed significantly lower normal-organ uptake and rapid urinary clearance. The number and sites of detected PSMA-positive primary and metastatic lesions were identical, and no significant quantitative uptake difference was observed. 68Ga-NGUL showed a relatively lower tumor-to-background ratio than 68Ga-PSMA-11. Conclusion: In a head-to-head comparison with 68Ga-PSMA-11, 68Ga-NGUL showed lower uptake in normal organs and similar performance in detecting PSMA-avid primary and metastatic lesions. 68Ga-NGUL could be a valuable option for PSMA imaging.
Ga-NGUL is a novel prostate-specific membrane antigen (PSMA)-targeting tracer based on Glu-Urea-Lys derivatives conjugated to a 1,4,7-triazacyclononane-
Exosomes have played fundamental roles in conveying specific biomolecules to the relevant target cells. The plausible nontoxicity of exosomes and their inherent biological roles as endogenous nanocarriers in cell–cell communication brings the promise of using exosomes as drug delivery vehicles in vivo in animals and even in clinical situations. Despite vigorous exosome research in progress on their biogenesis and biological significance, in vivo imaging and investigation of in vivo distribution of exosomes and/or their clearance has lagged, hampering the verification of possible clinical translation. In vivo molecular imaging of exosomes helps us to understand in vivo behavior of exosomes after systemic or local administration by visualizing the location, distribution, and excretion pattern over time in live animals and possibly in humans. Especially, in vivo radionuclide imaging has provided quantitative and tomographic information to better understand in vivo characteristics of exosomes. In this chapter, we have summarized the current progress in in vivo imaging of exosomes in animal models and highlighted their labeling methods and the successful examples of image-based elucidation of biological and physiological roles of exosomes.
1408 Introduction: Basal/acetazolamide brain perfusion SPECT has been used routinely to evaluate functional hemodynamics in patients with carotid artery stenosis. To detect any decrease on vascular perfusion, nuclear medicine physician rely principally on visual analysis. However, optimizing perceptual expertise on basal/acetazolamide brain perfusion SPECT require time and experience. Recently, a 3D CNN-based interpretation model for brain perfusion SPECT images has been developed. This research aim to compare the diagnosis accuracy of interpreting brain perfusion SPECT images with and without 3D CNN-based score.
Materials and Methods: One hundred and five cases (43.2 ± 12.3 years) with basal/acetazolamide brain perfusion SPECT were retrospectively collected. Perfusion score were generated from 3D CNN model for each image. Each of image read by 2 nuclear medicine physician novice to brain perfusion SPECT (experience less than 7 months) with and without score from 3D CNN model for each vessel territory. Agreement between novice readers and expert reading for each vessel territory were examined.
Results: Analysis between novice reader 1 and expert readers showed improvement with 3D CNN-based score from slight into strong agreement for Basal R-ACA, L-ACA,R-ICA, and Diamox R-ACA (K= 0.08 to 0.873, 0.194 vs 0.817, 0.161 vs 0.912, 0.161 vs 0.912), Fair to strong agreement for Basal R-MCA, L-ICA and Diamox L-ACA (K=0.264 vs 0.887, 0.342 vs 0.724, 0.256 vs 0.914), moderate to strong agreement for Diamox R-MCA, L-MCA and L-ICA (K=0.457 vs 0.955,0.382 vs 0.921, 0.559vs. 0.954) and slight to strong agreement for L-MCA (K = 0.193 vs 0.554). Analysis between novice reader 2 and expert readers showed improvement with 3D CNN based score form moderate to strong agreement for all of vessel region (K=0.512 - 0.734 vs 0.923 - 0.912).
Conclusions: 3D CNN-based scores may aid physicians to detect the abnormality of basal perfusion and vascular reserve per artery territories especially physicians who have insufficient experience in reading brain perfusion SPECT.
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