Tc-99m-MIBI SPECT/CT imaging to diagnose secondary hyperparathyroidism after parathyroid forearm transplantation.

This article report a 40-year-old male patient who underwent total thyroidectomy and forearm auto-transplantation in another hospital for secondary hyperparathyroidism. After 4 years of follow-up, the level of parathyroid hormone continued to increase, and ultrasound showed nodules in the neck and right forearm, which were considered to be of parathyroid origin. Technetium 99m sestamibi single photon emission computed tomography and computed tomography (Tc-99m-MIBI SPECT/CT) imaging showed increased radioactive uptake in the submuscular soft tissue nodule of the right medial forearm, maximum standardized uptake value (SUVmax) is 0.98, which was identified as transplanted functioning parathyroid tissue. No parathyroid imaging activity was found in the neck. The patient then underwent partial removal of ectopic parathyroid tissue from the right forearm. Pathological examination confirmed parathyroid tissue, and removal was followed by a rapid decline in serum parathyroid hormone levels.

Advancing Alzheimer's research: Radiomics visualization of the default mode network in cerebral perfusion imaging.

OBJECTIVE: Alzheimer's disease, an irreversible neurological condition, demands timely diagnosis for effective clinical intervention. This study employs radiomics analysis to assess image features in default mode network cerebral perfusion imaging among individuals with cognitive impairment. METHODS: A radiomics analysis of cerebral perfusion imaging was conducted on 117 patients with cognitive impairment. They were divided into training and validation sets in a 7:3 ratio. Least Absolute Shrinkage and Selection Operator (LASSO) and Random Forest were employed to select and model image features, followed by logistic regression analysis of LASSO and Random Forest results. Diagnostic performance was assessed by calculating the area under the curve (AUC). RESULTS: In the training set, LASSO achieved AUC of 0.978, Random Forest had an AUC of 0.933. In the validation set, LASSO had AUC of 0.859, Random Forest had AUC of 0.986. By conducting Logistic Regression analysis in combination with LASSO and Random Forest, we identified a total of five radiomics features, with four related to morphology and one to textural features, originating from the medial prefrontal cortex and middle temporal gyrus. In the training set, Logistic Regression achieved AUC of 0.911, while in the validation set, it attained AUC of 0.925. CONCLUSION: The medial prefrontal cortex and middle temporal gyrus are the two brain regions within the default mode network that hold the highest significance for Alzheimer's disease diagnosis. Radiomics analysis contributes to the clinical assessment of Alzheimer's disease by delving into image data to extract deeper layers of information.

Diagnosis of thyroid disease using deep convolutional neural network models applied to thyroid scintigraphy images: a multicenter study.

Objectives: The aim of this study was to improve the diagnostic performance of nuclear medicine physicians using a deep convolutional neural network (DCNN) model and validate the results with two multicenter datasets for thyroid disease by analyzing clinical single-photon emission computed tomography (SPECT) image data. Methods: In this multicenter retrospective study, 3194 SPECT thyroid images were collected for model training (n=2067), internal validation (n=514) and external validation (n=613). First, four pretrained DCNN models (AlexNet, ShuffleNetV2, MobileNetV3 and ResNet-34) for were tested multiple medical image classification of thyroid disease types (i.e., Graves' disease, subacute thyroiditis, thyroid tumor and normal thyroid). The best performing model was then subjected to fivefold cross-validation to further assess its performance, and the diagnostic performance of this model was compared with that of junior and senior nuclear medicine physicians. Finally, class-specific attentional regions were visualized with attention heatmaps using gradient-weighted class activation mapping. Results: Each of the four pretrained neural networks attained an overall accuracy of more than 0.85 for the classification of SPECT thyroid images. The improved ResNet-34 model performed best, with an accuracy of 0.944. For the internal validation set, the ResNet-34 model showed higher accuracy (p < 0.001) when compared to that of the senior nuclear medicine physician, with an improvement of nearly 10%. Our model achieved an overall accuracy of 0.931 for the external dataset, a significantly higher accuracy than that of the senior physician (0.931 vs. 0.868, p < 0.001). Conclusion: The DCNN-based model performed well in terms of diagnosing thyroid scintillation images. The DCNN model showed higher sensitivity and greater specificity in identifying Graves' disease, subacute thyroiditis, and thyroid tumors compared to those of nuclear medicine physicians, illustrating the feasibility of deep learning models to improve the diagnostic efficiency for assisting clinicians.

Imageological/Structural Study regarding the Improved Pharmacokinetics by 68Ga-Labeled PEGylated PSMA Multimer in Prostate Cancer.

PMSA (prostate-specific membrane antigen) is currently the most significant target for diagnosing and treating PCa (prostate cancer). Herein, we reported a series 68Ga/177Lu-labeled multimer PSMA tracer conjugating with PEG chain, including [68Ga]Ga-DOTA-(1P-PEG4), [68Ga]Ga-DOTA-(2P-PEG0), [68Ga]Ga-DOTA-(2P-PEG4), and [68Ga]Ga/[177Lu]Lu-DOTA-(2P-PEG4)2, which showed an advantage of a multivalent effect and PEGylation to achieve higher tumor accumulation and faster kidney clearance. To figure out how structural optimizations based on a PSMA multimer and PEGylation influence the probe's tumor-targeting ability, biodistribution, and metabolism, we examined PSMA molecular probes' affinities to PC-3 PIP (PSMA-highly-expressed PC-3 cell line), and conducted pharmacokinetics analysis, biodistribution detection, small animal PET/CT, and SPECT/CT imaging. The results showed that PEG4 and PSMA dimer optimizations enhanced the probes' tumor-targeting ability in PC-3 PIP tumor-bearing mice models. Compared with the PSMA monomer, the PEGylated PSMA dimer reduced the elimination half-life in the blood and increased uptake in the tumor, and the biodistribution results were consistent with PET/CT imaging results. [68Ga]Ga-DOTA-(2P-PEG4)2 exhibited higher tumor-to-organ ratios. When labeled by lutetium-177, relatively high accumulation of DOTA-(2P-PEG4)2 was still detected in PC-3 PIP tumor-bearing mice models after 48 h, indicating its prolonged tumor retention time. Given the superiority in imaging, simple synthetic processes, and structural stability, DOTA-(2P-PEG4)2 is expected to be a promising tumor-targeting diagnostic molecular probe in future clinical practice.

Corrigendum: Effect of 131 I with and without artificial liver support system in patients with Graves' disease and severe liver dysfunction: A retrospective study.

[This corrects the article DOI: 10.3389/fendo.2022.1034374.].

Effect of 131I with and without artificial liver support system in patients with Graves' disease and severe liver dysfunction: A retrospective study.

Objective: Treatment decision-making in Graves' disease (GD) with severe liver dysfunction (LD) is a clinical challenge. This research was carried out to evaluate the effect of radioiodine (131I) with or without an artificial liver support system (ALSS) in GD patients with severe LD. Methods: In total, 45 patients diagnosed with GD and severe LD were enrolled and allocated to two groups: patients treated with 131I alone (n=30) (Group A)and patients by a combination of 131I and ALSS (n=15)(Group B). Liver function, thyroid hormone concentrations, therapeutic efficacy, and the cost of treatment were compared between the two groups. Results: Thyroid hormone concentrations were lower 2 weeks after 131I treatment, but no deterioration in liver function was identified. There was no statistically significant difference in the treatment efficacy between the two groups. The hospital stay, total cost, and daily cost were lower in patients treated with 131I alone than in those treated with 131I and an ALSS (p<0.05). Conclusion: The key point of treating GD patients with severe LD is to control the GD.131I is recommended as an effective and safe and should be applied as soon as possible once the diagnosis is clarified; however, when used in combination with an ALSS, there was no substantial improvement in therapeutic efficacy.

Analysis of factors influencing the clinical outcome after surgery and 131I therapy in patients with moderate-risk thyroid papillary carcinoma.

Purpose: Generally, the prognosis for papillary thyroid cancer (PTC) is favorable. However, the moderate risk involved warrants further evaluation. Hence, we investigated the clinical outcomes in patients with moderate-risk PTC following surgery and the first 131I therapy, as well as the relevant factors that influence the therapeutic efficacy. Methods: Retrospective analyses of 175 patients with medium-risk PTC who visited the Second Affiliated Hospital of Chongqing Medical University from September 2017 to April 2019 were conducted. In according with the 2015 American Thyroid Association (ATA) guideline treatment response evaluation system, the patients were categorized into the following groups: excellent response (ER), indeterminate response (IDR), biochemical incomplete response (BIR), and structurally incomplete response (SIR), of which IDR, BIR, and SIR were collectively referred to as the NER group. To compare the general clinical features between the 2 groups of patients, 2 independent samples t-tests, χ2 test, and Mann-Whitney U-test were performed, followed by multivariate logistic regression analyses. With reference to the receiver operating characteristic (ROC) curve, the predicted value of ps-Tg to ER was evaluated, and the best cut-off value was determined. The subgroups with BRAFV600E test results were analyzed by χ2 test only. Results: The treatment responses of 123 patients were ER, while those of 52 patients were NER. The differences in the maximum tumor diameter (U = 2495.50), the amount of metastatic lymph nodes (U = 2313.50), the size of metastatic lymph node (U = 2113.50), the metastatic lymph node ratio (U = 2111.50), metastatic lymph node location (χ2 = 9.20), and ps-Tg level (U = 1011.00) were statistically significant. Multivariate regression analysis revealed that ps-Tg (OR = 1.209, 95% CI: 1.120-1.305) was an independent variable affecting ER. The cut-off value of ps-Tg for predicting ER was 6.915 ug/L, while its sensitivity and specificity were 69.2% and 89.4%, respectively. Conclusions: Patients with smaller tumor size, fewer lymph nodes, lower metastatic lymph node ratio, metastatic lymph nodes in the central region, smaller lymph node size, and ps-Tg <6.915 ug/L demonstrated better therapeutic effects after the initial treatment.

Dual-sonosensitizer loaded phase-transition nanoparticles with tumor-targeting for synergistically enhanced sonodynamic therapy.

Sonodynamic therapy (SDT) is a fast-growing therapy activated by using ultrasound to initiate a catalytic reaction of sensitizing agents and kill tumor cells through producing reactive oxygen species (ROS). Both sinoporphyrin sodium (DVDMS) and IR780 are preeminent sonosensitizers and have been used in SDT alone. In this study, tumor targeting multifunctional composite nanoparticles (DVDMS@IR780@PFP@PLGA, DIPP-NPs) were synthesized by encapsulating DVDMS, IR780 and perfluoropentane (PFP) to synergistically enhance SDT and achieve imaging of tumors. The loaded IR780 is regarded as a "navigator" to accurately identify and target tumor cells/tissues. DVDMS and IR780 not only can realize the directed SDT, but also can perform photoacoustic (PA) imaging. PFP plays its role in enhancing the ultrasound (US) imaging. Generally, DIPP-NPs not only have an obvious synergistic anti-tumor effect, but also are able to carry out dual-mode imaging, which paves a promising way for tumor therapy.

FDG PET/CT Findings of Multifocal Epithelioid Hemangioendotheliomas of the Bones.

Epithelioid hemangioendothelioma of the bones is very rare. We report a 78-year-old patient suffering from epithelioid hemangioendothelioma of multiple pelvic bones and the right femur. FDG PET/CT scan showed intense activity in mainly lytic lesions of these bones.

Primary pancreatic choriocarcinoma revealed on FDG PET/CT.

Choriocarcinoma is a cancer that usually occurs in the uterus during pregnancy. Extragonadal choriocarcinoma, although very rare, can occur. The diagnostic dilatation and curettage of the uterus in a 28-year-old woman who had vaginal bleeding and elevated human chorionic gonadotrophin level failed to identify any abnormality. FDG PET/CT revealed abnormal activity in the head of the pancreas. Pathological examination after partial pancreatectomy demonstrated primary choriocarcinoma in the pancreas.