Abstract: Aim: was to develop a pharmacokinetic model and simulate the kinetics of radiopharmaceuticals in the human body for the functional study of the hepatobiliary system using the dynamic scintigraphy method. Materials and methods: the paper uses the method of compartmental modeling of drug pharmacokinetics (pharmacokinetic modeling) and results of dynamic scintigraphy of the hepatobiliary system of a patient with choledocholithiasis before and after endoscopic papillosphincterotomy to identify model parameters. Results: various methods of model parameters identification based on quantitative data of hepatobiliscintigraphy are proposed. Results of pharmacokinetic modeling for dynamic scintigraphy of the hepatobiliary system in cases of non-visualizing gallbladder (four-compartment model) and visualizing gallbladder with stimulation of its emptying (five-compartment model) are presented and analyzed. Conclusion: results of pharmacokinetic modeling presented in the article (calculated quantitative parameters and time activity curves) are in good agreement with the clinical data of dynamic scintigraphy of the hepatobiliary system in normal and pathological conditions. From the comparative analysis of model time activity curves for different zones of interest, the time of stimulation of gallbladder emptying is justified, which normally should be 35-40 min from the beginning of the study. References 1. National guide on radionuclide diagnostics. In 2 volumes. Vol. 2. (Ed. by Yu.B. Lishmanov, V.I. Chernov). Tomsk: STT, 2010; 418 [In Russ]. 2. Rassam F, Zhang T, Cieslak KP et al. Comparison between dynamic gadoxetate-enhanced MRI and 99mTc-mebrofenin hepatobiliary scintigraphy with SPECT for quantitative assessment of liver function. European Radiology. 2019; 29: 5063-5072. 3. Lambie H, Cook AM, Scarsbrook AF et al. Tc99m-hepatobiliary iminodiacetic acid (HIDA) scintigraphy in clinical practice. Clinical Radiology. 2011; 66: 1094-1105. 4. Gupta M, Choudhury PS, Singh S, Hazarika D. Liver functional volumetry by Tc99m mebrofenin hepatobiliary scintigraphy before major liver resection: A game changer. Indian Journal of Nuclear Medicine. 2018; 33: 277-283. 5. Sergienko VI, Dzhelliff R, Bondareva IB. Applied pharmacokinetics: main provisions and clinical application. М.: Izd-vo RAMN, 2003; 208 [In Russ]. 6. Bellman R. Mathematical methods in medicine. (Ed. by L.N. Belykh). M.: Mir, 1987; 200 [In Russ]. 7. Kotina ED. Program complex «Diagnostics» for processing radionuclide research. Vestnik of Saint Petersburg University. 2010; 2: 100-113 [In Russ]. 8. Matveev AV, Korneeva MYu. Features of modeling of kinetics of radiopharmaceuticals in functional research of the gepatobiliarny system. Herald of Omsk University. 2015; 3: 42-51 [In Russ]. 9. Yusupova AF, Valiullina NM, Odincova AH. Dynamic scintigraphy of the hepatobiliary system in the diagnosis of postcholecystectomy syndrome. Kazan Medical Journal. 2007; 88 (1): 44-46 [In Russ]. 10. Hazanov AI. Functional diagnostics of liver diseases, 2nd ed. М.: Medicina, 1988; 304 [In Russ]. 11. Matveev AV, Noskovec DYu. Pharmacokinetic modeling and dosimetric planning of radioiodine therapy of thyrotoxicosis. Herald of Omsk University. 2014; 4: 57-64 [In Russ]. 12. Huk R, Dzhivs TA. Direct search for solutions to numerical and statistical problems. М.: Mir, 1961; 219 [In Russ]. 13. Kudryashova NE. Radionuclide diagnostics in emergency conditions. Dr. med. sci. diss.. Moscow. 2009; 325 [In Russ]. 14. Kudryashova NE, Ermolov AS, Ivanov PA et al. Hepatobiliscintigraphy in the diagnosis of mechanical jaundice. Vestnik rentgenologii i radiologii. 2007; 3: 39-45 [In Russ]. 15. Rogal' ML, Novikov SV, Magomedbekov MM et al. Choice of surgical treatment tactics for patients with acute cholecystitis complicated by choledocholithiasis. Khirurgiya. Zhurnal imeni N.I. Pirogova. 2018; 4: 41-45 [In Russ]. 16. Hubutiya MSh, Kudryashova NE, Sinyakova OG et al. Use of radionuclide studies in the preparation of patients for liver transplantation and in the postoperative period. Transplantologiya. 2010; 1: 5-10 [In Russ].
Abstract: Aim: was to estimate the functionality of the nanokoloid drug labeled with technetium-99m for scintigraphy and intraoperative detection of «sentinel» lymph nodes (SLN) in experimental animals. Materials and methods: the study was performed in 6 series of experiments, including 5 white male rats line «Wistar» weighing 300-350 g. Injection of radiopharmaceuticals (RPh) at a dose of 18-20 MBq were performed between the first and second fingers of the front paws of rats. Results: in scintigraphic studies STL noted that RPh «Nanocolloid, 99mTc-Al2O3» accumulation reaches a plateau at the node (10.2%) for 2 hour study and its percentage content is stored at this level until 24 h. Intraoperative study, in all cases it was possible to visualize the STL. Conclusions: results shows functional fitness RPh «Nanocolloids,99mTc-Al2O3» for scintigraphy and intraoperative detection of «sentinel» lymph nodes.
References 1. Semiglazov V.F. Novoe napravlenie v sberegatel'nom i organosohranjajushhem hirurgicheskom lechenii zlokachestvennyh opuholej. [A new trend in savings and organ-surgical treatment of malignant tumors]. Medicinskij vestnik 2009; 35 (504): 12-24 [In Russ]. 2. Abu-Rustum N.R., Knoury-Collado F., Gemignani M.L. Tehniques of sentinel lymph node identification for early-stage cervical and uterine cancer. Gynecol. Oncol. 2008; 111(2): 44-50. 3. Altgassen C., Hertel H. et al. Multicenter valida- cion study of the sentinentel lymph node concept in cervical cancer: AGO Study Group. J. Clin. Oncol. 2008; 26: 2943-2951. 4. Kuznecov V.V., Lebedev A.I., Morhov K.Ju., Gricaj A.N. Hirurgija invazivnogo raka shejki matki [Surgery is invasive cervical cancer]. Prakticheskaja onkologija. 2002; 3(3): 178-182 [In Russ]. 5. Hauspy J., Beiner M., Harley А. Sentinel Lymph Node in early stage cervical cancer. Gynecol. Oncol. 2008; l08 (1): 256-257. 6. Takeda N., Sakuragi N., Takeda M. et al. Multivariate analysis of histopathologic prognostic factors for invasive cervical cancer treated with radical hysterectomy and systematic retroperitoneal lymphadenectomy. Acta Obstet. Gynecol. Scand. 2002; 81: 1144-1151. 7. Seong S.J., Park H., Yang K.M. et al. Detection of sentinel lymph nodes in patients with early stage cervical cancer. J. Korean Med. Sci. 2007; 22 (1): 105-109. 8. Baggish M.S., Karram M.K. Atlas anatomii taza i ginekologicheskoj hirurgii [Atlas of pelvic anatomy and gynecologic surgery]. London: Izd-vo Elsevier Ltd. 2009; 1172 [In Russ]. 9. Lawrenz B., Jauckus J., Kupka M.S. et al. Fertility preservation in >1,000 patients: patient’s characteristics, spectrum, efficacy and risks of applied preservation techniques. Arch. Gynecol. Obstet. 2010; 283(3): 651-656. 10. Klinicheskaja onkoginekologija: Rukovodstvo dlja vrachej. (Pod red. V.P Kozachenko) [Clinical cancers: A Guide for Physicians. (Ed. V. Kozachenko)]. M.: Medicina, 2005; 431[In Russ]. 11. Abu-Rustum N.R., Neubauer N., Sonoda Y et al. Surgical and pathologic outcomes of fertility-sparing radical abdominal trachelectomy for FIGO stage IB1 cervical cancer. Gynecol. Oncol. 2008; 111(2): 261-264.
Possibilities of radionuclide diagnostics of diabetic foot syndrome (part 2)
DOI: https://doi.org/10.25512/DIR.2011.05.4.07
For quoting:
Zavadovskaya V.D., Zorkaltsev M.A., Kilina O.Yu., Kurazhov A.P., Shoulga O.S., Krasilnikova E.A., Ylbrekht A.A., Popov K.M. "Possibilities of radionuclide diagnostics of diabetic foot syndrome (part 2)". Journal Diagnostic & interventional radiology. 2011; 5(4); 31-36.
Abstract: Purpose. Was to estimate the informative value of scintigraphy (SG) with labeled leukocytes (LL) in detection of osteomyelitis in patients with various forms of diabetic foot syndrome (DFS) Materials and methods. This study includes results of scintigraphy with labeled leukocytes of 39 patients with diabetes mellitus and with suspicion of osteomyelitis in diabetic foot. Results were compared with morphological study in 22 patients Results. SG with LL has high informative value rate in diagnostics of inflammatory process: sensitivity - 100%, specificity - 100% accuracy - 100%; and also high in the diagnostics of osteomyelitis: sensitivity - 100%, specificity - 64,7%, accuracy - 84,6%. Conclusions. LL CG is a highly effective method of identifying the presence of an inflammatory process. During high rate of sensitivity the level of specificity decreases in case of intraosseous inflammation. The reason of decreased specifity is in that SG has low resolution in differentiation of radiopharmaceutical accumulation in bones and soft tissues. References 1. Senneville E. et al. Needle puncture and transcutaneous bone biopsy cultures are inconsistent in patients with diabetes and suspected osteomyelitis of the foot. Clin. Infect. Dis. 2009; 48: 888-893. 2. Gil H.C. MR imaging of diabetic foot infection. H.C. Gil, W.B. Morrison. Semin. Musculoskelet. Radiol. 2004; 8(3): 189-198. 3. Craig J.G. et al. Osteomyelitis of the diabetic foot: MR imaging-pathologic correlation. Radiology. 1997; 203 (3): 849-855. 4. Vesco L. et al. The value of combined radionuclide and magnetic resonance imaging in the diagnosis and conservative management of minimal or localized osteomyelitis of the foot in diabetic patients. Metabolism. 1999; 48 (7): 922-927. 5. Hopfner S. et al. Preoperative imaging of Charcot neuroarthropathy. Does the additional application of (18) F-FDG-PET make sense? Nuklearmedizin. 2010; 45 (1):15-20. 6. Завадовская В.Д., Зоркальцев М.А., Килина О.Ю., Шульга О.С. Возможности радионуклидной диагностики синдрома диабетической стопы (часть 1). Диагностическая и интервенционная радиология. 2010; 4 (4): 31-40.
Abstract: Introduction. 199Tl-chloride scintigraphy is used to visualize tumors. In addition to typical imaging of the musculoskeletal malignancy, unusually types of malignant tumor visualization were revealed by studies of diagnostic potentialities of 199Tl-chloride scintigraphy, analogue of 201Tl-chloride scintigraphy. Aim. Was to study features of malignant tumor visualization of the musculoskeletal system with the help of 199Tl-chloride scintigraphy. Materials and methods. 85 patients with diseases of musculoskeletal system underwent 199Tl-chloride scintigraphy. 107 localizations of malignant tumors (n=57) and benign lesion (n=50) were investigated. During the research in 107 patients malignant tumors were detected, 50 patients had bening tumors. Results. Malignant tumors were visualized in 98.1%. Three types of malignant tumors' visualization were obtained - positive (82.4%) and rare negative (7.8%) and mixed (9.8%). Types of visualization were associated with tumor histological types, blood-flow, metabolism, and pharmacodynamic features of 199Tl-chloride. Negative and mixed visual types were high specific for primary and recurrent malignant tumors, but no metastasis. Conclusion. Accounting to negative and mixed visual types - 199Tl-chloride scintigraphy sensitivity increased to 98.1% without decreasing of specificity in detection of malignant tumors of musculoskeletal system.
Abstract: Good response to neoadjuvant chemotherapy is a favorable prognostic factor in patients with breast cancer. Early response evaluation might spare unnecessary chemotherapy in bad responders. Clinically mammography and ultrasound are used to evaluate response to treatment while being bac predictors of early response. MRI is getting wider acceptance but still lacks necessary accuracy to the absence of functional evaluation. Thus novel methods are being evaluated in early response prediction. Diffusion-weighted MRI, MR-spectroscopy, mammoscintigraphy PET as well as diffusion optic tomography are discussed in the review as potential ways to improve early prediction of response in breast cancer patients undergoing neoadjuvant chemotherapy. References 1. Davydov M.I., Aksel' E.M. Statistika zlokachestvennyh novoobrazovanij v Rossii i stranah SNG v 2012 g [Statistics of malignancies in Russian Federation and the CIS countries in 2012.]. Moskva, 2014;63-64 [In Russ]. 2. Montagna E., Bagnardi V., Rotmensz N. Pathological complete response after preoperative systemic therapy and outcome: relevance of clinical and biologic baseline features. Breast Cancer Res Treat. 2010;124(3):689-99. 3. Bonnefoi H., Litiere S., Piccart M. Pathological complete response after neoadjuvant chemotherapy is an independent predictive factor irrespective of simplified breast cancer intrinsic subtypes: a landmark and two-step approach analyses from the EORTC 10994/BIG 1-00 phase III trial. Ann Oncol. 2014 Jun;25(6):1128-36. 4. Semiglazov V.F., Paltuev R.M., Semiglazova TJu. i dr. Klinicheskie rekomendacii po diagnostike i lecheniju raka molochnoj zhelezy [Clinical guidelines for the diagnosis and treatment of breast cancer.]. SPb.: ABS-press. 2013; 234 [In Russ]. 5. Schmitt E.L., Threatt B.A. Effective breast cancer detection with filmscreen mammography. Canad. Ass. Radiol. 1985;36(4):303-307. 6. Mistry K.A., Thakur M.H., Kembhavi S.A. The effect of chemotherapy on the mammographic appearance of breast cancer and correlation with histopathology. Brit. J. Radiol. 2016; 89:1057-1063. 7. Helvie M.A., Joynt L.K., Cody R.L. et al. Locally advanced breast carcinoma: accuracy of mammography versus clinical examination in the prediction of residual disease after chemotherapy. Radiology. 1996;198:327-332. 8. Komjahov A.V.. Ocenka jeffektivnosti neoad’juvantnoj sistemnoj terapii raka molochnoj zhelezy s pomoshhju magnitno-rezonansnoj tomografii i sonografii [Evaluation of the effectiveness of neoadjuvant systemic therapy for breast cancer using magnetic resonance imaging and sonography.]. Avtoreferat. Diss. kand. med. nauk SPb. 2016; 13-15 [In Russ]. 9. Gazhonova V.E., Efremova M.P., Dorohova E.A. Sovremennye metody neinvazivnoj luchevoj diagnostiki raka molochnoj zhelezy [Modern non-invasive methods of radiation diagnosis of breast cancer.]. RMZh. 2016;5:321-324 [In Russ]. 10. Meladze N.V., Ternovoj S.K., Abduraimov A.B. 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Assessment of therapeutic response of locally advanced breast cancer (LABC) patients undergoing neoadjuvant chemotherapy (NACT) monitored using sequential magnetic resonance spectroscopic imaging. NMR Biomed. 2010;23(3):233-41. 15. Jonathan K.P, Begley L., Thomas W. In vivo proton magnetic resonance spectroscopy of breast cancer: a review of the literature. Breast Cancer Research. 2012; 14:207. 16. Bammer R. Basic principles of diffusion-weighted imaging. Eur Radiol. 2003;45:169-184. 17. Kwee T., Takahara T., Ochiai R. et al. Whole-body diffusion weighted magnetic resonance imaging. Eur Radiol. 2009;70: 409-417. 18. Smirnova N.A., Nazarov A.A., Del'gadil'o-Kuznecov L.Je. Radionuklidnye metody v diagnostike i lechenii raka molochnoj zhelezy [Radionuclide methods in the diagnosis and treatment of breast cancer.]. Vestnik RUDN. 2005;(29)1: 45-50 [In Russ]. 19. Brjanceva Zh.V. Avtoreferat. Diss. kand. med. nauk. Rol’ mammoscintigrafii v ocenke jeffektivnosti neoad’juvantnogo lechenija raka molochnoj zhelezy [Mammoscintigraphy role in assessing the effectiveness of neoadjuvant treatment of breast cancer.]. SPb. 2015;3-4 [In Russ]. 20. Qiufang Liu, Chen Wang, Panli Li. The Role of 18F- FDG PET/CT and MRI in Assessing Pathological Complete Response to Neoadjuvant Chemotherapy in Patients with Breast Cancer: A Systematic Review and Meta-Analysis. Biomed Res Int. 2016;2016:10. 21. Tromberg B.J., Zhang Z., Leproux A. Predicting Responses to Neoadjuvant Chemotherapy in Breast Cancer: ACRIN 6691 Trial of Diffuse Optical Spectroscopic Imaging. Сancer Research. 2016;5933. 22. Baek H.M., Chen J.H, Nie K. Predicting Pathologic Response to Neoadjuvant Chemotherapy in Breast Cancer by Using MR Imaging and Quantitative 1H MR Spectroscopy. Radiology. 2009 Jun; 251(3):653-662. 23. Bufi E., Belli P, Matteo M. 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Role of the Apparent Diffusion Coefficient in the Prediction of Response to Neoadjuvant Chemotherapy in Patients With Locally Advanced Breast Cancer. Clin Breast Cancer. 2015 0ct;15(5):370-80. 28. Leong K.M., Lau P., Ramadan S. Utilisation of MR spectroscopy and diffusion weighted imaging in predicting and monitoring of breast cancer response to chemotherapy. J Med Imaging Radiat Oncol. 2015 Jun;59(3):268-77. 29. Novikov S.N., Kanaev S.V., Petr K.V. Technetium-99m methoxyisobutylisonitrile scintimammography for monitoring and early prediction of breast cancer response to neoadjuvant chemotherapy. Nucl Med Commun. 2015 Aug; 36(8):795-801. 30. Trehan R., Seam R.K., Gupta M.K. Role of scintimammography in assessing the response of neoadjuvant chemotherapy in locally advanced breast cancer. World J Nucl Med. 2014 Sep;13(3):163-9. 31. Schaafsma B.E., van de Giessen M., Charehbili A. Optical mammography using diffuse optical spectroscopy for monitoring tumor response to neoadjuvant chemotherapy in women with locally advanced breast cancer. Clin Cancer Res. 2015 Feb; 21(3):5
