68Ga-PSMA ligand PET/CT integrating indocyanine green-guided salvage lymph node dissection for lymph node metastasis after radical prostatectomy / 亚洲男科学杂志(英文版)

To efficiently remove all recurrent lymph nodes (rLNs) and minimize complications, we developed a combination approach that consisted of 68Gallium prostate-specific membrane antigen (PSMA) ligand positron emission tomography (PET)/computed tomography (CT) and integrated indocyanine green (ICG)-guided salvage lymph node dissection (sLND) for rLNs after radical prostatectomy (RP). Nineteen patients were enrolled to receive such treatment. 68Ga-PSMA ligand PET/CT was used to identify rLNs, and 5 mg of ICG was injected into the space between the rectum and bladder before surgery. Fluorescent laparoscopy was used to perform sLND. While extensive LN dissection was performed at level I, another 5 mg of ICG was injected via the intravenous route to intensify the fluorescent signal, and laparoscopy was introduced to intensively target stained LNs along levels I and II, specifically around suspicious LNs, with 68Ga-PSMA ligand PET/CT. Next, both lateral peritonea were exposed longitudinally to facilitate the removal of fluorescently stained LNs at levels III and IV. In total, pathological analysis confirmed that 42 nodes were rLNs. Among 145 positive LNs stained with ICG, 24 suspicious LNs identified with 68Ga-PSMA ligand PET/CT were included. The sensitivity and specificity of 68Ga-PSMA ligand PET/CT for detecting rLNs were 42.9% and 96.6%, respectively. For ICG, the sensitivity was 92.8% and the specificity was 39.1%. At a median follow-up of 15 (interquartile range [IQR]: 6-31) months, 15 patients experienced complete biochemical remission (BR, prostate-specific antigen [PSA] <0.2 ng ml-1), and 4 patients had a decline in the PSA level, but it remained >0.2 ng ml-1. Therefore, 68Ga-PSMA ligand PET/CT integrating ICG-guided sLND provides efficient sLND with few complications for patients with rLNs after RP.

Preparation and biodistribution of [67Ga]-labeledoxytocin for SPECT purposes

Oxytocin [OT] is a paracrine hormone with various biological activities and many sex organs in both sexes, as well as many tumor cells have shown to have related receptors. In this study the development of a receptor imaging tracer for possible tumor imaging has been described. OT was successively labeled with [67Ga]-gallium chloride after conjugation with freshly prepared cyclic DTPA-dianhydride. The best results of the conjugation were obtained by the addition of 1 ml of a OT pharmaceutical solution [2 mg/ml, in phosphate buffer, pH=8] to a glass tube pre-coated with DTPA-dianhydride [0.02 mg] at 25°C with continuous mild stirring for 30 min. Radiochemical purity [RCP] of the labeled compound was determined, using RTLC and ITLC followed by stability tests and animal biodistribution studies. Radiolabeling took about 60 minutes with a RCP higher than 98% at optimized conditions [specific activity = 1000 Ci/mM, labeling efficiency 80%]. The stability of the tracer at room temperature was significant, up to an hour. Preliminary in vivo studies in normal female rat model showed ovary/blood and ovary/muscle ratio uptake of the tracer in 60 minutes to be 4.53 and 9.18, respectively. The result was consistent with the reported OT receptor distribution in normal female mammals. The radiolabeled oxytocin, prepared in this study, was a possible fast acting tracer for OT receptor imaging; studies however, more studies are required to determine the best imaging conditions especially in larger mammal animals

Enfermedad pulmonar intersticial nuevos conceptos sobre fisiopatologia y manejo / Intersticial lung disease new concepts about patophysiology and management

Las enfermedades pulmonares intersticiales conforman un grupo heterogeneo de entidades con patrones comunes clinicos, radiologicos , funcionales, y de deterioro pulmonar hacia la fibrosis. La causa principal es la produccion de alveolitis y solo quien presente cambios minimos respondera al tratamiento con esteroides. La biopsia pulmonar, el lavado broncoalveolar y las pruebas funcionales son utiles para clasificar el grado de la enfermedad. Se han adicionado recientemente los estudios con Galio 67 y el histoquimico del colageno. La respuesta a los esteroides parece ser la unica prueba terapeutica util hasta el momento