Peptide Receptor Radionuclide Therapy and the Treatment of Gastroentero-pancreatic Neuroendocrine Tumors: Current Findings and Future Perspectives

Abstract

Purpose and Methods

Patients with inoperable and metastasized neuroendocrine tumors (NETs), particularly those with grades 1 and 2, usually receive treatment with somatostatin analogues (SSAs). Peptide receptor radionuclide therapy (PRRT) has gained momentum over the past two decades in patients who progress on SSAs. 177Lu-DOTATATE is currently the most widely used radiopeptide for PRRT. We reviewed the recent evidence on PRRT and the treatment of gastroentero-pancreatic neuroendocrine tumors (GEP-NETs).

Results

¹⁷⁷Lu-DOTATATE can be used as neoadjuvant treatment in patients with inoperable GEP-NETs, who might be candidate for surgery after treatment and as adjuvant therapy after surgical intervention. Combination treatments of PRRT with chemotherapy or targeted agents as well as combinations of radionuclides in patients with NETs have been explored over the last few years. The majority of patients with NETs experience partial response or have disease stabilization, a small percentage has complete response, while some 30% of patients, however, will have disease progression. The safety and efficacy of retreatment with extra cycles of PRRT as salvage therapy have been evaluated in small retrospective series.

Conclusion

Overall, there is evidence that disease control and quality of life improve significantly after 117Lu PRRT therapy. Clinical trials on this therapy are scarce, and there is a need for further studies to establish proper management guidelines.

from Imaging via alkiviadis.1961 on Inoreader https://ift.tt/2pSiDJo

Aims and scope/Editorial board

Publication date: March 2018
Source:Journal of Forensic Radiology and Imaging, Volume 12





from Imaging via alkiviadis.1961 on Inoreader https://ift.tt/2pOQJOY

Post-mortem computed tomography of cervical intervertebral separation: Retrospective review and comparison of the autopsy results of 57 separations

Publication date: March 2018
Source:Journal of Forensic Radiology and Imaging, Volume 12
Author(s): Seina Kudo, Yusuke Kawasumi, Akihito Usui, Makoto Arakawa, Naoto Yamagishi, Yui Igari, Masato Funayama, Tadashi Ishibashi
ObjectivesThe presence of an intervertebral separation indicates vertebral ligamentous injuries, and it is occasionally associated with fatal spinal cord injuries. However, it is often difficult to identify the separation using post-mortem computed tomography (CT). This study retrospectively evaluated the correlation between the post-mortem CT findings and autopsy results of cervical intervertebral separation.Materials and methodsForty-two subjects (8 females and 34 males) with cervical intervertebral separation were evaluated. The average age was 67 (range, 29–88) years. A radiologist retrospectively reviewed the cervical spines on axial, sagittal, and coronal CT images and determined whether intervertebral separations could be detected. The radiologist also classified the CT findings in cases with detectable separations.ResultsOf the 57 cervical intervertebral separations, 39 were detectable on the CT images. The CT findings were grouped into the following six categories: intervertebral gas (n = 19; 40.4%); forward intervertebral widening (n = 10; 21.3%); backward intervertebral widening (n = 1; 2.1%); anteroposterior misalignment (n = 6; 12.8%); spur fracture (n = 7; 14.9%); and hematoma in front of a vertebral body (n = 4; 8.5%). The sensitivity and specificity of intervertebral gas in the diagnosis of cervical intervertebral separation were 33.9% and 99.7%, respectively.ConclusionApproximately 70% of the cases with cervical intervertebral separations had various abnormal findings on CT imaging. The most common finding was intervertebral gas, but the sensitivity of intervertebral gas was not adequate.



from Imaging via alkiviadis.1961 on Inoreader https://ift.tt/2GhNVjz

Corrigendum to: Forensic 3D documentation of bodies: simple and fast procedure for combining CT scanning with external photogrammetry data. [Journal of Forensic Radiology and Imaging (2017) 47–51]

Publication date: March 2018
Source:Journal of Forensic Radiology and Imaging, Volume 12





from Imaging via alkiviadis.1961 on Inoreader https://ift.tt/2pLx2b4

Practice patterns of image guided particle therapy in Europe: A 2016 survey of the European Particle Therapy Network (EPTN)

Image guidance is critical in achieving accurate and precise radiation delivery in particle therapy, even more than in photon therapy. However, equipment, quality assurance procedures and clinical workflows for image-guided particle therapy (IGPT) may vary substantially between centres due to a lack of standardization. A survey was conducted to evaluate the current practice of IGPT in European particle therapy centres.

from Imaging via alkiviadis.1961 on Inoreader https://ift.tt/2Id7iev

Is accurate contouring of salivary and swallowing structures necessary to spare them in head and neck VMAT plans?

Current standards for organ-at-risk (OAR) contouring encourage anatomical accuracy which can be resource intensive. Certain OARs may be suitable for alternative delineation strategies. We investigated whether simplified salivary and swallowing structure contouring can still lead to good OAR sparing in automated head and neck cancer (HNC) plans.

from Imaging via alkiviadis.1961 on Inoreader https://ift.tt/2pP0ixi

Susceptibility-weighted magnetic resonance imaging of cerebrovascular sequelae after radiotherapy for pediatric brain tumors

Due to sensitive neuroimaging techniques, cerebrovascular complications such as cerebral microbleeds (CMB) and cerebral cavernous malformations (CCM) are increasingly recognized as considerable late effects after treatment for pediatric brain tumor. The aim of this study was to analyze CMB in a cohort of patients after cranial irradiation therapy for medulloblastoma or other pediatric brain tumors using susceptibility-weighted magnetic resonance imaging (SWI).

from Imaging via alkiviadis.1961 on Inoreader https://ift.tt/2GigtJW