The Efficacy of Radiolabeling the Albumin in Egg Whites with 99mTc-Sulfur Colloid.

In 2009, the Society of Nuclear Medicine and Molecular Imaging published a standardized protocol guideline for gastric emptying scintigraphy that contains specific instructions on the exact meal and preparation procedure. Previous research has shown that the standardized meal and proper preparation of the meal for gastric emptying scintigraphy are not being adopted by some facilities. This research explores the differences of radiolabeling in the method of preparation of 99mTc-sulfur colloid (SC)-radiolabeled eggs. Methods: Liquid egg whites were mixed with 99mTc-SC before cooking in conjunction with the standardized protocol. A second sample set was prepared by adding the 99mTc-SC to eggs after they were cooked. Each sample set was placed in a solution of HCl and pepsin to simulate gestation. Radiolabeling efficacy was tested on each sample set at 2 and 4 h after gestating in HCl and pepsin. Results: 99mTc-SC added to the liquid egg whites before microwave cooking yielded radiolabeling efficacy of 70% 99mTc-SC after 2 and 4 h of simulated gastric fluid gestation. In contrast, radiolabeling after cooking the egg whites yielded 50% radiolabeling after simulated gestation. Conclusion: The results from this experiment showed that the method of mixing the 99mTc-SC with liquid egg whites before microwave cooking has higher binding efficacy than when adding 99mTc-SC onto already cooked egg whites. These results highlight the importance of following the standardized protocol for the meal preparation of a gastric emptying study.

The Impact of the Coronavirus Disease 2019 Pandemic on the Clinical Environment.

The Nuclear Medicine Technology Certification Board performed an impact survey on the coronavirus disease 2019 pandemic to better assess the current state of nuclear medicine practice within the United States, as well as the perceptions and experiences of technologists working during the pandemic. Methods: A web-based automation platform was used to create, collect, and analyze the survey data. Results: The survey revealed many department protocol variations during the pandemic, a decrease in patient volume, and several other concerns and issues. Experiences regarding staffing and wage changes were varied. Conclusion: This research showed significant inconsistencies in practice and stresses to nuclear medicine technology during the pandemic, as well as concerns for the workforce pipeline. NMTCB decided to delay the JTA process and conduct additional research regarding the workforce.

Histology to 3D in vivo MR registration for volumetric evaluation of MRgFUS treatment assessment biomarkers.

Advances in imaging and early cancer detection have increased interest in magnetic resonance (MR) guided focused ultrasound (MRgFUS) technologies for cancer treatment. MRgFUS ablation treatments could reduce surgical risks, preserve organ tissue and function, and improve patient quality of life. However, surgical resection and histological analysis remain the gold standard to assess cancer treatment response. For non-invasive ablation therapies such as MRgFUS, the treatment response must be determined through MR imaging biomarkers. However, current MR biomarkers are inconclusive and have not been rigorously evaluated against histology via accurate registration. Existing registration methods rely on anatomical features to directly register in vivo MR and histology. For MRgFUS applications in anatomies such as liver, kidney, or breast, anatomical features that are not caused by the treatment are often insufficient to drive direct registration. We present a novel MR to histology registration workflow that utilizes intermediate imaging and does not rely on anatomical MR features being visible in histology. The presented workflow yields an overall registration accuracy of 1.00 ± 0.13 mm. The developed registration pipeline is used to evaluate a common MRgFUS treatment assessment biomarker against histology. Evaluating MR biomarkers against histology using this registration pipeline will facilitate validating novel MRgFUS biomarkers to improve treatment assessment without surgical intervention. While the presented registration technique has been evaluated in a MRgFUS ablation treatment model, this technique could be potentially applied in any tissue to evaluate a variety of therapeutic options.

Online Learning Strategies and Practical Tips for Nuclear Medicine Instructors.

As nuclear medicine instructors shift toward online learning, it is imperative to use instructional strategies that align with the program's theoretic foundation. Online learning does not require a complete course redesign, though attention should be paid to careful course design to support learning, promote student engagement, and facilitate competency development. Instructional strategies such as discussions, group projects, and gaming elements support the construction of knowledge and the development of self-efficacy and competency while keeping students engaged in the content. Intentional display and formatting such as content chunking and a variety of materials can also support student learning.

Authentic Leadership Theory and Practical Applications in Nuclear Medicine.

As the field of nuclear medicine continues to evolve, a need for new leaders will emerge and leadership development will become critical. "Authentic leadership" is an emerging leadership style rooted in humanism that can be used in conjunction with other leadership styles. Authentic leadership has positive implications for health-care settings, including improved patient care, job satisfaction, motivation, collaboration, and knowledge sharing. This article reviews the philosophic foundations of authentic leadership theory and key characteristics of an authentic leader in the context of nuclear medicine.

Validation of hybrid angular spectrum acoustic and thermal modelling in phantoms.

In focused ultrasound (FUS) thermal ablation of diseased tissue, acoustic beam and thermal simulations enable treatment planning and optimization. In this study, a treatment-planning methodology that uses the hybrid angular spectrum (HAS) method and the Pennes' bioheat equation (PBHE) is experimentally validated in homogeneous tissue-mimicking phantoms. Simulated three-dimensional temperature profiles are compared to volumetric MR thermometry imaging (MRTI) of FUS sonications in the phantoms, whose acoustic and thermal properties are independently measured. Additionally, Monte Carlo (MC) uncertainty analysis is performed to quantify the effect of tissue property uncertainties on simulation results. The mean error between simulated and experimental spatiotemporal peak temperature rise was +0.33°C (+6.9%). Despite this error, the experimental temperature rise fell within the expected uncertainty of the simulation, as determined by the MC analysis. The average errors of the simulated transverse and longitudinal full width half maximum (FWHM) of the profiles were -1.9% and 7.5%, respectively. A linear regression and local sensitivity analysis revealed that simulated temperature amplitude is more sensitive to uncertainties in simulation inputs than in the profile width and shape. Acoustic power, acoustic attenuation and thermal conductivity had the greatest impact on peak temperature rise uncertainty; thermal conductivity and volumetric heat capacity had the greatest impact on FWHM uncertainty. This study validates that using the HAS and PBHE method can adequately predict temperature profiles from single sonications in homogeneous media. Further, it informs the need to accurately measure or predict patient-specific properties for improved treatment planning of ablative FUS surgeries.

Development and validation of a MRgHIFU non-invasive tissue acoustic property estimation technique.

MR-guided high-intensity focussed ultrasound (MRgHIFU) non-invasive ablative surgeries have advanced into clinical trials for treating many pathologies and cancers. A remaining challenge of these surgeries is accurately planning and monitoring tissue heating in the face of patient-specific and dynamic acoustic properties of tissues. Currently, non-invasive measurements of acoustic properties have not been implemented in MRgHIFU treatment planning and monitoring procedures. This methods-driven study presents a technique using MR temperature imaging (MRTI) during low-temperature HIFU sonications to non-invasively estimate sample-specific acoustic absorption and speed of sound values in tissue-mimicking phantoms. Using measured thermal properties, specific absorption rate (SAR) patterns are calculated from the MRTI data and compared to simulated SAR patterns iteratively generated via the Hybrid Angular Spectrum (HAS) method. Once the error between the simulated and measured patterns is minimised, the estimated acoustic property values are compared to the true phantom values obtained via an independent technique. The estimated values are then used to simulate temperature profiles in the phantoms, and compared to experimental temperature profiles. This study demonstrates that trends in acoustic absorption and speed of sound can be non-invasively estimated with average errors of 21% and 1%, respectively. Additionally, temperature predictions using the estimated properties on average match within 1.2 °C of the experimental peak temperature rises in the phantoms. The positive results achieved in tissue-mimicking phantoms presented in this study indicate that this technique may be extended to in vivo applications, improving HIFU sonication temperature rise predictions and treatment assessment.

Patterning N-type and S-type neuroblastoma cells with Pluronic F108 and ECM proteins.

Influencing cell shape using micropatterned substrates affects cell behaviors, such as proliferation and apoptosis. Cell shape may also affect these behaviors in human neuroblastoma (NBL) cancer, but to date, no substrate design has effectively patterned multiple clinically important human NBL lines. In this study, we investigated whether Pluronic F108 was an effective antiadhesive coating for human NBL cells and whether it would localize three NBL lines to adhesive regions of tissue culture plastic or collagen I on substrate patterns. The adhesion and patterning of an S-type line, SH-EP, and two N-type lines, SH-SY5Y and IMR-32, were tested. In adhesion assays, F108 deterred NBL adhesion equally as well as two antiadhesive organofunctional silanes and far better than bovine serum albumin. Patterned stripes of F108 restricted all three human NBL lines to adhesive stripes of tissue culture plastic. We then investigated four schemes of applying collagen and F108 to different regions of a substrate. Contact with collagen obliterates the ability of F108 to deter NBL adhesion, limiting how both materials can be applied to substrates to produce high fidelity NBL patterning. This patterned substrate design should facilitate investigations of the role of cell shape in NBL cell behavior.

The design of electrospun PLLA nanofiber scaffolds compatible with serum-free growth of primary motor and sensory neurons.

Aligned electrospun nanofibers direct neurite growth and may prove effective for repair throughout the nervous system. Applying nanofiber scaffolds to different nervous system regions will require prior in vitro testing of scaffold designs with specific neuronal and glial cell types. This would be best accomplished using primary neurons in serum-free media; however, such growth on nanofiber substrates has not yet been achieved. Here we report the development of poly(L-lactic acid) (PLLA) nanofiber substrates that support serum-free growth of primary motor and sensory neurons at low plating densities. In our study, we first compared materials used to anchor fibers to glass to keep cells submerged and maintain fiber alignment. We found that poly(lactic-co-glycolic acid) (PLGA) anchors fibers to glass and is less toxic to primary neurons than bandage and glue used in other studies. We then designed a substrate produced by electrospinning PLLA nanofibers directly on cover slips pre-coated with PLGA. This substrate retains fiber alignment even when the fiber bundle detaches from the cover slip and keeps cells in the same focal plane. To see if increasing wettability improves motor neuron survival, some fibers were plasma etched before cell plating. Survival on etched fibers was reduced at the lower plating density. Finally, the alignment of neurons grown on this substrate was equal to nanofiber alignment and surpassed the alignment of neurites from explants tested in a previous study. This substrate should facilitate investigating the behavior of many neuronal types on electrospun fibers in serum-free conditions.