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Our study aimed to investigate the association between the characteristics of patients/images and complete remission of renal scarring shown in the first chronic phase Technetium-99m dimercaptosuccinic acid (DMSA) renal scintigraphy images in children with urinary tract infection (UTI). Fifty children, who underwent the chronic phase of DMSA scintigraphy more than twice following UTI diagnosis and had renal scarring in the first chronic phase DMSA renal scintigraphy, were enrolled. They were classified into 2 groups: with and without complete remission of renal scarring on the second chronic phase DMSA renal scintigraphy. Renal scarring was classified into 3 grades based on severity per the image findings. Seven cases had complete remission from renal scarring. There were significant differences in age and severity. Renal scarring might be completely reversed in young children without severe findings on DMSA renal scintigraphy. Additional chronic phase examination may aid in follow-up completion and patients' peace of mind. [ABSTRACT FROM AUTHOR]

Background: Parathyroid scan is an important imaging modality for localizing hyperfunctioning parathyroid tissue in patients with hyperparathyroidism. Unfortunately, whether early or delayed timing is the optimal protocol for [99mTc]Tc-MIBI SPECT/CT parathyroid remains under debate. This study aimed to evaluate the agreement and compare the confidence levels of physicians when interpreting early and delayed [99mTc]Tc-MIBI SPECT/CT parathyroid scans. Additionally, it sought to identify clinical factors that related to positive scan result. We conducted a prospective study where the early and delayed [99mTc]Tc-MIBI SPECT/CT was separately interpreted as either positive or negative. Furthermore, these interpretations were categorized based on whether they fell within more or less confidence levels of the readers and were correlated with clinical information. Results: We enrolled 39 patients with hyperparathyroidism with 158 possible locations of parathyroid glands. The per-location agreement between the early and delayed scans was moderate (concordant rate: 80.3%, Kappa = 0.558), and the per-patient agreement was slight (concordant rate: 71.8%, Kappa = 0.093). The confidence of interpretation was significantly higher for the delayed scans. Calcium supplementation, low serum parathyroid hormone levels, and low serum phosphate levels were associated with positive early scans. High calcium level and high parathyroid hormone levels were associated with positive delayed scans. Conclusions: Our study highlights the impact of the timing of SPECT/CT in [99mTc]Tc-MIBI parathyroid scans. The different confidence levels between early and delayed scans, along with clinical factors, imply that various factors affect parathyroid scan interpretation, and individualized scanning protocols adjusted for specific settings may be needed to optimize the successful localization of hyperfunctioning parathyroid tissue. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) is a major global health problem. Theragnostic is a term that refers to the integration of diagnostic and therapeutic modalities into a single system for personalized medicine. Theragnostic care in HCC involves the use of imaging techniques to diagnose the cancer and assess its characteristics, such as size, location, and extent of spread. Theragnostics involves the use of molecular and genetic tests to identify specific biomarkers that can help guide treatment decisions and, post-treatment, assess the dosimetry and localization of the treatment, thus guiding future treatment. This can be done through either positron emission tomography (PET) scanning or single photon emission tomography (SPECT) using radiolabeled tracers that target specific molecules expressed by HCC cells or radioembolization. This technique can help identify the location and extent of the cancer, as well as provide information on the tumor's metabolic activity and blood supply. In summary, theragnostics is an emerging field that holds promise for improving the diagnosis and treatment of HCC. By combining diagnostic and therapeutic modalities into a single system, theragnostics can help guide personalized treatment decisions and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Technetium-99 is a highly radioactive isotope with a long half-life that is common in nuclear waste. It volatizes at a low temperature, which poses a significant challenge to the clean-up and containment processes. Due to difficulties in purifying technetium compounds, their thermophysical properties have not been measured or calculated. Here, first principle methods are used along with the quasi quasi-harmonic harmonic approximation to compute the Debye temperature, volumetric thermal expansion coefficient, bulk modulus, and heat capacity of rutile TcO2 for temperatures ranging from 0 to 1500 K and applied pressures ranging from 0 to 255 GPa. The computed atomic structures agree well with the results from diffraction measurements. The computed thermophysical properties are in the neighborhood of other rutile metal oxides and, in particular, are within approximately 10–13% of rutile ReO2, which is frequently used as a substitute for TcO2 in experimental studies. [ABSTRACT FROM AUTHOR]

Background and Aim: Kidney dysfunction is reported in significant number of beta thalassemia major children. The aim of this study was to determine the prevalence of glomerular dysfunction in beta-thalassemia major children on regular blood transfusion (BT) and chelation therapy, and to find the correlation between glomerular filtration rate (GFR) estimated by Schwartz formula and Technetium 99m diethylenetriaminepentaacetic acid (99mTc-DTPA) renogram with ferritin level and cumulative transfusion load. Materials and Methods: An observational cross-sectional study conducted was done on 110 children diagnosed with beta-thalassemia major receiving regular BT and chelation therapy. Clinical examination, biochemical investigations (serum creatinine, ferritin) and DTPA renal scan were done. Estimated GFR calculation was done by Schwartz method and 99mTc-DTPA scan. The normal values of GFR were taken from the standard value as per KDIGO guidelines. P < 0.05 was considered statistically significant. Results: The prevalence of glomerular dysfunction by Schwartz formula and DTPA renogram was 44% and 24%, respectively. The GFR calculation (Schwartz formula and DTPA renogram) were weakly positively correlated (r = 0.126, P = 0.547). There was significant association between GFR Schwartz and duration of iron chelation, as children with abnormal GFR had significantly more duration of iron chelation >5 years (28% vs. 4%, P = 0.003). GFR (Schwartz formula and DTPA renogram) showed no association with cumulative transfusion load and disease duration (P > 0.05). GFR Schwartz formula and GFR-DTPA showed no correlation with serum ferritin with r = 0.179, (P = 0.392) and r = 0.278 (P = 0.178). Conclusion: There is a significant derangement in the renal function of children of beta-thalassemia major on chronic BT and iron chelation therapy. GFR holds a direct correlation with the increasing duration of iron chelation. [ABSTRACT FROM AUTHOR]

In this work, we have reviewed non-covalent interactions in technetium hexahalide compounds and obtained eight new compounds of the CatnTcHal6 type, where Cat = dimethylammonium, tetramethylammonium, caffeinium, benzothiazolium, nicotinamidium, and pyrazolium, and Hal = Cl, Br. SCXRD studies were carried out for new compounds. In some compounds, halide anions and/or crystallization water were present. In the compounds obtained, an essential influence on the formation of structures and crystal packing is exerted by the molecules of crystallization water and halide ions. Diethylammonium and nicotinamidium compounds, whose structures do not contain other ions and contain sufficiently strong non-covalent interactions, best bind hexahalotechnetates. π-Stacking interactions, anion–π interactions, and halogen bonds were found in the structures. The percentage contribution of the H⋯Hal/Hal⋯H interactions in the transition from fluorine to bromine in TcHal62− anions decreases, while the contribution of interactions of other types increases. The greatest variety of interactions in anions is observed for compounds of caffeinium and nicotinamidium with TcBr62−. The paper considers the processes of thermolysis of some new and previously known CatnTcHal6 compounds with various cations. It is shown that the thermal stability of the compounds is only due to the properties of the organic cation and does not depend on the nature of the halogen. The proposed stages of the process of thermolysis of the TcHal62− anion, accompanied by the reduction of technetium to metal, have been established. [ABSTRACT FROM AUTHOR]

Background: The best way to assess renal cortical scarring is planar scintigraphy with 99mTc-dimercaptosuccinic acid (DMSA), while the value of single-photon emission computed tomography/computed tomography (SPECT/CT) is not well validated. The aim of the present study was to assess the value of planar, SPECT, and SPECT/CT scanning using 99mTc-DMSA in detecting renal cortical scarring. Methods: Patients with clinically suspected renal cortical scar were included in this prospective cohort. 99mTc-DMSA Planar images were obtained approximately 3–4 h after intravenous injection (IV) of 185 MBq of the tracer. SPECT/CT scans were obtained immediately after the planar ones. An expert nuclear medicine doctor who was unaware of the patient's clinical history or any previous imaging results analyzed the images. Each kidney was given a score of 0 for no obvious defects, 1 for equivocal lesions, 2 for a single defect, 3 for several defects, and 4 for non-visualized/non-functioning kidney (in CT images). The results of each method were then compared to each other. Results: One hundred eighty-six kidneys from ninety-three individuals were eligible for assessment. Planar scans detected 21 kidneys with equivocal lesions, 5 with single and 7 with multiple defects. SPECT scans detected 17 kidneys with single and 40 with multiple defects, while SPECT/CT scans revealed 5 with single and 11 with multiple defects. Only 5 of the 17 kidneys with single defects diagnosed by SPECT imaging had a scar in the SPECT/CT scans, whereas the remaining 12 had a solitary cortical cyst in the CT images. Only 11 of 40 kidneys with multiple defects on SPECT were shown to have a scar in the corresponding SPECT/CT images, whereas the rest matched to either hydro-nephrotic changes or multiple cortical cysts. Four kidneys with multiple defects on the SPECT/CT images were normal in the planar readings, were ascribed to an increase in renal background activity and a reduction in renal function. Conclusions: In cases with suspected renal cortical scar, 99mTc-DMSA SPECT/CT scanning outperformed both planar and SPECT imaging by reducing the number of false-positive SPECT readings and false-negative planar readings. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: To understand the fate of aerosols delivered by high-flow nasal cannula using continuous nebulization, an open-source anatomical model was developed and validated with a modified real-time gamma ratemeter technique. Mass balance defined circuit losses. Responsiveness to infusion rate and device technology were tested. METHODS: A nasal airway cast derived from a computed tomography scan was converted to a 3-dimensional-- printed head and face structure connected to a piston ventilator (breathing frequency 30 breaths/min, tidal volume 750 mL, duty cycle 0.50). For mass balance experiments, saline mixed with Technetium-99m was infused for 1 h. Aerosol delivery was measured using a gamma ratemeter oriented to an inhaled mass filter at the hypopharynx of the model. Background and dead-space effects were minimized. All components were imaged by scintigraphy. Continuous nebulization was tested at infusion rates of 10-40 mL/h with gas flow of 60 L/min using a breath-enhanced jet nebulizer (BEJN), and a vibrating mesh nebulizer. Drug delivery rates were defined by the slope of ratemeter counts/min (CPM/min) versus time (min). RESULTS: The major source of aerosol loss was at the nasal interface (~25%). Significant differences in deposition on circuit components were seen between nebulizers. The nebulizer residual was higher for BEJN (P = .006), and circuit losses, including the humidifier, were higher for vibrating mesh nebulizer (P = .006). There were no differences in delivery to the filter and head model. For 60 L/min gas flow, as infusion pump flow was increased, the rate of aerosol delivery (CPM/min) increased, for BEJN from 338 to 8,111; for vibrating mesh nebulizer, maximum delivery was 2,828. CONCLUSIONS: The model defined sites of aerosol losses during continuous nebulization and provided a realistic in vitro system for testing aerosol delivery during continuous nebulization. Real-time analysis can quantify effects of multiple changes in variables (nebulizer technology, infusion rate, gas flow, and ventilation) during a given experiment. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Investigación en Salud VIVE is the property of Revista de Investigacion en Salud VIVE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Speckle‐tracking‐derived strains in cardiac chambers may provide better solutions for transthyretin amyloid cardiomyopathy (ATTR‐CM) screening. This study aimed to evaluate the efficacy of biventricular strain measurements using speckle tracking for screening 99mTc‐pyrophosphate (99mTc‐PYP) scintigraphy‐positive cardiomyopathy, which is nearly equivalent to ATTR‐CM. Methods: We performed a retrospective analysis of transthoracic echocardiographic studies using vendor‐independent speckle tracking analysis in older patients (≥65 years) who underwent 99mTc‐PYP scintigraphy to evaluate the etiology of suspected ATTR‐CM in our institute between January 2019 and December 2022. Results: The entire cohort (n = 89) was divided into two subgroups positive 99mTc‐PYP scan results (n = 34) and negative 99mTc‐PYP scan results (n = 55). In the multivariate analysis, posterior wall thickness (p =.003, odds ratio [OR]:1.48, 95% confidence interval [CI]:1.14 –1.92), left ventricular longitudinal strain apical/basal ratio (LVLSapi/bas) (p =.015, OR: 2.78, 95% CI: 1.23–6.32, and right ventricular longitudinal strain (RVLS) (p =.003, OR: 1.15, 95% CI: 1.05 –1.26) were selected to be the most representative echocardiographic findings in 99mTc‐PYP positive cardiomyopathy. The receiver operating characteristic analysis indicated that posterior wall thickness (p <.0001, area under the curve [AUC]:.821, cut‐off value: 14.0 mm), LVLSapi/bas (p <.001, AUC:.802, cut‐off value: 2,16), and RVLS (p <.001, AUC:.791, cut‐off value: ‐18.7%) could significantly detect 99mTc‐PYP positive results with an excellent credibility. Echocardiographic score points calculated using the summary of these three parameters in each patient revealed that a 2‐point score had a fair sensitivity (85%) and an excellent specificity (93%), while a 1‐point score had an excellent sensitivity (91%) and a modest specificity (53%). Conclusion: Our proposed echocardiographic screening tool for 99mTc‐PYP scintigraphy‐positive cardiomyopathy may help clinicians manage patients with suspected ATTR‐CM. [ABSTRACT FROM AUTHOR]

Background: Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is characterized by immune system dysregulation after exposure to adjuvants, such as aluminum. Although cases of autoimmune thyroid diseases caused by ASIA have been reported, Graves' disease is one of the rarer diseases. There are some reports that vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cause ASIA. Here, we describe a case of Graves' disease following SARS-CoV-2 vaccination and a review of the literature. Case presentation: A 41-year-old woman was admitted to our hospital because of palpitations and fatigue. Two weeks after receiving the second SARS-CoV-2 vaccine (BNT162b2, Coronavirus Modified Uridine messenger RNA (mRNA) Vaccine, Pfizer), she developed fatigue and gradually worsened. On admission, she exhibited thyrotoxicosis (thyroid-stimulating hormone (TSH) < 0.01 mIU/L (0.08–0.54), free triiodothyronine (FT3) 33.2 pmol/L (3.8–6.3), and free thyroxine (FT4) 72.1 pmol/L (11.6–19.3)) and palpitations associated with atrial fibrillation. TSH receptor antibody (TRAb) was positive (TRAb 5.0 IU/L (< 2.0)), and 99mTc scintigraphy showed diffuse uptake in the thyroid gland, suggesting that the thyrotoxicosis in this case was caused by Graves' disease. Thiamazole was prescribed to correct her condition, and soon after this treatment was initiated, her symptoms and thyroid hormone levels were significantly reduced. Conclusions: This case report reinforces the potential correlation between ASIA affecting the thyroid and SARS-CoV-2 mRNA vaccines. The clinical course suggests that it is essential to consider the possibility of developing ASIA, such as Graves' disease, after exposure to the SARS-CoV-2 vaccine. [ABSTRACT FROM AUTHOR]

The first consistent series of mononuclear 17‐electron complexes of three Group 7 elements has been isolated in crystalline form and studied by X‐ray diffraction and spectroscopic methods. The paramagnetic compounds have a composition of [M0(CO)(CNp‐F‐ArDArF2)4] (M=Mn, Tc, Re; ArDArF2=2,6‐(3,5‐(CF3)2C6H3)2C6H2F) and are stabilized by four sterically encumbering isocyanides, which prevent the metalloradicals from dimerization. They have a square pyramidal structure with the carbonyl ligands as apexes. The frozen‐solution EPR spectra of the rhenium and technetium compounds are clearly anisotropic with large 99Tc and 185,187Re hyperfine interactions for one component. High‐field EPR (Q band and W band) has been applied for the elucidation of the EPR parameters of the manganese(0) complex. [ABSTRACT FROM AUTHOR]

Simple Summary: Prostate and breast cancers are the most common malignancies. Accurate diagnosis and staging of diseases are important for the prognosis and determination of treatment tactics. The gastrin-releasing peptide receptor is overexpressed in over 80% of estrogen receptor-positive breast cancers and in up to 100% of primary prostate cancers, particularly in prostate cancers of lower grades and smaller sizes. Our group has developed an imaging agent [99mTc]Tc-maSSS-PEG2-RM26 suitable for the detection of gastrin-releasing peptide receptors' expression using SPECT. We aimed to perform a first-in-human study to test the safety of [99mTc]Tc-maSSS-PEG2-RM26 administration, to study its biological distribution in normal organs, and to evaluate the agent's targeting of receptors in tumors. This phase I study was performed in six prostate and seven breast cancer patients. Single injections of the new agent were well tolerated and a number of prostate and breast cancer primary tumors as well as metastases were visualized with SPECT/CT shortly after administration. The gastrin-releasing peptide receptor (GRPR) is overexpressed in prostate cancer (PCa) and in hormone-driven breast cancer (BCa). The aim of this phase I clinical trial was to evaluate safety, biodistribution, and dosimetry after the administration of the recently developed GRPR-targeting antagonistic bombesin analogue [99mTc]Tc-maSSS-PEG2-RM26 in PCa and BCa patients. Planar and whole-body SPECT/CT imaging was performed in six PCa patients and seven BCa patients 2, 4, 6, and 24 h post the intravenous administration of 40 µg of [99mTc]Tc-maSSS-PEG2-RM26 (600–700 MBq). No adverse events or pathological changes were observed. The rapid blood clearance of [99mTc]Tc-maSSS-PEG2-RM26 was observed with predominantly hepatobiliary excretion. The effective doses were 0.0053 ± 0.0007 for male patients and 0.008 ± 0.003 mSv/MBq for female patients. The accumulation of [99mTc]Tc-maSSS-PEG2-RM26 in tumors was observed in four out of six PCa and in seven out of seven BCa patients. In four BCa patients, a high uptake of the agent into the axillary lymph nodes was detected. Immunohistochemistry revealed positive GRPR expression in 60% of primary PCa, 71.4% of BCa tumors, and 50% of examined BCa lymph nodes. In conclusion, a single administration of [99mTc]Tc-maSSS-PEG2-RM26 was safe and well tolerated. [99mTc]Tc-maSSS-PEG2-RM26 SPECT may be useful for tumor detection in PCa and BCa patients, pending further studies. [ABSTRACT FROM AUTHOR]

Simple Summary: Non-small-cell lung cancer (NSCLC) represents approximately 80–85% of all lung cancers, and tumor resistance remains common and difficult to treat. Therefore, early detection of tumor resistance is of great significance for improving prognosis. Here, we developed a novel molecular imaging agent that could be used for imaging drug-resistant NSCLC, providing a noninvasive method for dynamically observing whether tumor resistance occurs during treatment. Background: N-cadherin is considered a characteristic protein of EMT and has been found to be closely related to tumor resistance. In this study, a novel molecular imaging probe, 99mTc-HYNIC-ADH-1, was developed, and its diagnostic value in monitoring drug resistance in NSCLC was preliminarily investigated. Methods: ADH-1 was labeled indirectly with 99mTc. Radiochemical purity and stability, partition coefficients and pharmacokinetics were evaluated. Additionally, the fluorescent probe of ADH-1 was synthesized to study tumor uptake in cells level and in vivo. Biodistribution analysis and small animal SPECT/CT were performed in PC9GR and PC9 tumor-bearing mice. Results: 99mTc-HYNIC-ADH-1 was highly stable (radiochemical purity ≥ 98% in PBS and serum after 24 h). A cell binding study and fluorescence imaging showed that the uptake was significantly higher in PC9GR cells (gefitinib-resistant) than in PC9 cells (nonresistant) (p < 0.05). Biodistribution analysis showed rapid blood clearance and significant uptake in the kidney and resistant tumor. Small animal SPECT/CT studies showed that uptake in PC9GR tumors (T/NT = 7.73 ± 0.54) was significantly higher than that in PC9 tumors (T/NT = 3.66 ± 0.78) at 1 h (p = 0.002). Conclusions: The 99mTc-HYNIC-ADH-1 molecular probe has a short synthesis time, high labeling rate, high radiochemical purity and good stability, does not require purification, is characterized by rapid blood clearance and is mainly excreted through the urinary system. 99mTc-HYNIC-ADH-1 is considered a promising probe for monitoring drug resistance in NSCLC. [ABSTRACT FROM AUTHOR]

36500325 4 Parra R.D., Grabowski S.J. Enhancing Effects of the Cyano Group on the C-X•••N Hydrogen or Halogen Bond in Complexes of X-Cyanomethanes with Trimethyl Amine: CH3-n(CN)nX•••NMe3, (n = 0-3; X = H, Cl, Br, I). In [[18]], a theoretical study demonstrated that non-covalent halogen---halogen interactions play crucial roles in the self-assembly of highly polarizable dichlorodiazadienes, and halogen bonding can dictate a packing preference in the solid state for this class of dichloro-substituted heterodienes, which may represent be convenient tools for a fine tuning of the properties of this novel class of dyes. The chalcogen---chalcogen bonding in molybdenum disulfide, molybdenum diselenide and molybdenum ditelluride dimers as prototypes for a basic understanding of the local interfacial chemical bonding environment in 2D layered transition metal dichalcogenides was discussed in [[7]]. A halogen-bonded 2D network, based on a diiminedibromido gold (III) complex and tribromide building blocks was analyzed in as an example of self-assembly of supramolecular architectures driven by -hole interactions [[28]]. [Extracted from the article]

Noncovalent interactions involving metals as electron acceptors are continuously under investigation. The term "matere bond" has been proposed to identify noncovalent donor–acceptor interactions where elements of group 7 of the periodic table play the role of the electrophilic site. Most of the works on matere bonds involve rhenium atoms usually in +7 oxidation state. This work emphasizes for the first time their importance in technetium derivatives in several oxidation states (+7, +6, +5, and +3). The Cambridge Structural Database (CSD) in combination with density functional theory (DFT) calculations are used to demonstrate the structure directing role of matere bonds in X-ray structures, even involving anion⋯anion interactions. Further characterization of the matere bonds is provided using Molecular Electrostatic Potential (MEP) surface calculations, the "Quantum Theory of Atoms in Molecules" (QTAIM), and Natural Bond Orbital (NBO) analyses. It should be emphasized that some types of matere bonds reported herein have not been previously described in literature. [ABSTRACT FROM AUTHOR]

Organometallic approaches are of ongoing interest for the development of novel functional 99mTc radiopharmaceuticals, while the basic organotechnetium chemistry seems frequently to be little explored. Thus, structural and reactivity studies with the long-lived isotope 99Tc are of permanent interest as the foundation for further progress in the related radiopharmaceutical research with this artificial element. Particularly the knowledge about the organometallic chemistry of high-valent technetium compounds is scarcely developed. Here, phenylimido complexes of technetium(V) with different isocyanides are introduced. They have been synthesized by ligand-exchange procedures starting from [Tc(NPh)Cl3(PPh3)2]. Different reactivity patterns and products have been obtained depending on the steric and electronic properties of the individual ligands. This involves the formation of 1:1 and 1:2 exchange products of Tc(V) with the general formulae [Tc(NPh)Cl3(PPh3)(isocyanide)], cis- or trans-[Tc(NPh)Cl3(isocyanide)2], but also the reduction in the metal and the formation of cationic technetium(I) complex of the formula [Tc(isocyanide)6]+ when p-fluorophenyl isocyanide is used. The products have been studied by single-crystal X-ray diffraction and spectroscopic methods, including IR and multinuclear NMR spectroscopy. DFT calculations on the different isocyanides allow the prediction of their reactivity towards electron-rich and electron-deficient metal centers by means of the empirical SADAP parameter, which has been derived from the potential energy surface of the electron density on their potentially coordinating carbon atoms. [ABSTRACT FROM AUTHOR]

Amyloidosis is a collection of diseases caused by the misfolding of proteins that aggregate into insoluble amyloid fibrils and deposit in tissues. While these fibrils may aggregate to form insignificant localised deposits, they can also accumulate in multiple organs to the extent that amyloidosis can be an immediately life-threatening disease, requiring urgent treatment. Recent advances in diagnostic techniques and therapies are dramatically changing the disease landscape and patient prognosis. Delays in diagnosis and treatment remain the greatest challenge, necessitating physician awareness of the common clinical presentations that suggest amyloidosis. The most common types are transthyretin (ATTR) amyloidosis followed by immunoglobulin light-chain (AL) amyloidosis. While systemic AL amyloidosis was previously considered a death sentence with no effective therapies, significant improvement in patient survival has occurred over the past 2 decades, driven by greater understanding of the disease process, riskadapted adoption of myeloma therapies such as proteosome inhibitors (bortezomib) and monoclonal antibodies (daratumumab) and improved supportive care. ATTR amyloidosis is an underdiagnosed cause of heart failure. Technetium scintigraphy has made noninvasive diagnosis much easier, and ATTR is now recognised as the most common type of amyloidosis because of the increased identification of age-related ATTR. There are emerging ATTR treatments that slow disease progression, decrease patient hospitalisations and improve patient quality of life and survival. This review aims to update physicians on recent developments in amyloidosis diagnosis and management and to provide a diagnostic and treatment framework to improve the management of patients with all forms of amyloidosis. [ABSTRACT FROM AUTHOR]

Radioembolization is a well-established treatment for primary and metastatic liver cancer. There is increasing interest in personalized treatment planning supported by dosimetry, as it provides an opportunity to optimize dose delivery to tumor and minimize nontarget deposition, which demonstrably increases the efficacy and safety of this therapy. However, the optimal dosimetry procedure in the radioembolization setting is still evolving; existing data are limited as few trials have prospectively tailored dose based on personalized planning and predominantly semi-empirical methods are used for dose calculation. Since the pretreatment or "scout" procedure forms the basis of dosimetry calculations, an accurate and reliable technique is essential. 99m Tc-MAA SPECT constitutes the current accepted standard for pretreatment imaging; however, inconsistent patterns in published data raise the question whether this is the optimal agent. Alternative particles are now being introduced to the market, and early indications suggest use of an identical scout and treatment particle may be superior to the current standard. This review will undertake an evaluation of the increasingly refined dosimetric methods driving radioembolization practices, and a horizon scanning exercise identifying alternative scout particle solutions. Together these constitute a compelling vision for future treatment planning methods that prioritize individualized care. [ABSTRACT FROM AUTHOR]

Background: Triple therapy with inhaled corticosteroids/long-acting muscarinic antagonists/long-acting β2-agonists (ICS/LAMA/LABA) is recommended for patients with chronic obstructive pulmonary disease (COPD) with continued symptoms or exacerbations, despite treatment with LAMA/LABA or ICS/LABA. The pulmonary, extrathoracic, and regional lung deposition patterns of a radiolabeled ICS/LAMA/LABA triple fixed-dose combination budesonide/glycopyrrolate/formoterol fumarate (BGF 320/18/9.6 μg), delivered via a single Aerosphere metered dose inhaler (MDI) were previously assessed in healthy volunteers and showed good deposition to the central and peripheral airways (whole lung deposition: 37.7%). Here, we report the findings assessing BGF in patients with moderate-to-very severe COPD.Methods: This phase I, single-dose, open-label gamma scintigraphy imaging study (NCT03906045) was conducted in patients with moderate-to-very severe COPD. Patients received two actuations of BGF MDI (160/9/4.8 μg per actuation) radiolabeled with technetium‑99‑pertechnetate, not exceeding 5 MBq per actuation. Immediately following each inhalation, patients performed a breath-hold of up to 10 s, then exhaled into an exhalation filter. Gamma scintigraphy imaging of the anterior and posterior views of the lungs and stomach, and a lateral head and neck view, were performed immediately after exhalation. The primary objective of the study was to assess the pulmonary deposition of BGF. Secondary objectives assessed the deposited dose of radiolabeled BGF in the oropharyngeal and stomach regions, on the actuator, and on the exhalation filter in addition to regional airway deposition patterns in the lungs.Results: The mean BGF emitted dose deposited in the lungs was 32.1% (standard deviation [SD] 15.6) in patients with moderate-to-very severe COPD, 35.2% (SD 12.8) in patients with moderate COPD, and 28.7% (SD 18.4) in patients with severe/very severe COPD. Overall, the mean normalized outer/inner ratio was 0.55 (SD 0.19), while the standardized central/peripheral ratio was 2.21 (SD 1.64).Conclusions: Radiolabeled BGF 320/18/9.6 μg was efficiently delivered and deposited throughout the entire lung, including large and small airways, in patients with moderate-to-very severe COPD, with similar deposition in patients with moderate COPD and patients with severe/very severe COPD.Trial Registration: ClinicalTrials.gov, NCT03906045. Registered 8 April 2019, https://clinicaltrials.gov/ct2/show/NCT03906045. [ABSTRACT FROM AUTHOR]

Transarterial radioembolization of primary and secondary hepatic malignancies utilizing yttrium-90 microspheres is a commonly performed treatment by interventional radiologists. Traditionally performed as a two-part procedure, a diagnostic angiography is performed 1 to 3 weeks prior to treatment with the injection of technetium-99m-macroaggregated albumin followed by planar scintigraphy in the nuclear medicine department. Careful attention must be paid to the details during the diagnostic angiography to ensure the delivery of a safe and optimal dose to the diseased liver and to minimize radiation-induced damage to both unaffected liver and adjacent structures. In this article, we will review the steps and considerations that must be made during the angiography planning and discuss current and future areas of research. [ABSTRACT FROM AUTHOR]

The results of studies performed at the Khlopin Radium Institute in cooperation with other institutions from Russia and other countries, and also published data in the field of chemistry of higher technetium carbonyl compounds are summarized in the context of problems of nuclear medicine. Chemical problems that arise on the way of using higher technetium carbonyls in nuclear medicine and are associated with the synthesis conditions and reactivity of these complexes, and also the ways to solve these problems are analyzed. The major problems are the need for using high pressures in synthesis, the impossibility of direct replacement of halogen in pentacarbonyl halides (products directly obtained from pertechnetate ion) by other monodentate ligands, limited resistance of many higher technetium carbonyls to decarbonylation, and susceptibility of higher technetium carbonyls to nucleophilic reactions (including hydrolysis in alkaline media). The latter problem seems to be the most critical. The scientific outcome of the studies is outlined, and comparison with rhenium analogs is made. The complex [99mTcI(CO)5] shows promise for lung imaging; assumptions concerning the mechanism of its lung uptake are formulated. [ABSTRACT FROM AUTHOR]

We report a case of a 72-year-old man who was referred to our tertiary medical center for endoscopic ultrasound (EUS) evaluation for an incidental 2-cm mass in the tail of the pancreas seen on computed tomography (CT). On EUS, a 22 mm by 13 mm, well-defined hypoechoic mass was identified within the pancreatic tail, and a fine-needle biopsy was performed. Histopathology revealed benign pancreatic parenchyma and the presence of lymphocytes. A technetium-99m sulfur colloid scan was performed, which demonstrated uptake in the pancreatic tail lesion consistent with an intra-pancreatic splenule. This case demonstrates that a splenule or accessory splenic tissue should remain in the differential diagnosis of a pancreatic mass. An accurate diagnosis of pancreatic splenule can preclude surgical resection. [ABSTRACT FROM AUTHOR]

Permanganyl fluoride's existence at the stability threshold in the series of oxides and oxide fluorides of the late 3d transition metals is reflected by its experimentally challenging properties and by the difficulties posed in the theoretical description of its bonding characteristics. The history of this molecule is reviewed from early qualitative observations and the growing scattered information on its chemical and physical properties to the accurate determination and interpretation of its molecular structure and spectral features. The still problematic theoretical models for MnO4- and MnO3F are briefly presented in the broader context of the chemistry of elements in high oxidation states. Short biographies of the scientists engaged in these studies are offered. Related technetium and rhenium compounds are briefly considered for comparison. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to compare Tc-99m dimercaptosuccinic acid (99mTc-DMSA) renal cortical scintigraphy and Tc-99m diethylene triamine pentaacetic acid (99mTc-DTPA) and Tc-99m mercaptoacetyltriglycine (99mTc-MAG3) dynamic renal scintigraphy in the evaluation of relative renal function (RRF). Materials and Methods: Forty seven patients with renal cortical scintigraphy (with 99mTc-DMSA) and dynamic renal scintigraphy (with 99mTc-DTPA or 99mTc-MAG3) were included in this retrospective study. RRF obtained from 99mTc-DMSA, 99mTc-DTPA and 99mTc-MAG3 scintigraphies, clinical and demographic data were statistically analyzed. Results: There was a high correlation between 99mTc-DMSA renal cortical scintigraphy and dynamic renal scintigraphy (99mTc-DTPA or 99mTc-MAG3) in terms of RRF evaluation (r=0.981, p<0.001 and r=0.918, p=<0.001, respectively). While the Bland Altman plot showed an average difference of 3.30 between RRFs measured by 99mTc-DMSA and by 99mTc-DTPA, the difference between that with 99mTc-DMSA and 99mTc-MAG3 was 0.08. Conclusion: In conclusion, this study showed a high level of compliance between 99mTc-DMSA renal scintigraphy and dynamic renal scintigraphy (99mTc or 99mTc-MAG3) in the evaluation of RRF. Time loss, radiation exposed to the patients and economic losses are minimized with the use of a single method suitable for the purpose. [ABSTRACT FROM AUTHOR]

Introduction: Radioisotope methods have shown to be useful in the non-invasive diagnosis of thyroid nodules over the past years. The present prospective study aims to evaluate the efficacy of gamma imaging using single and dual tracer using Tc-99m pertechnetate and Tc-99m tetrofosmin for evaluation and management of thyroid nodules.Methods: Dynamic (perfusion) imaging was performed after injecting 148-185 MBq (4-5 mCi) of Tc-99m pertechnetate followed by static imaging. A second, dynamic (perfusion) imaging study within same week was performed with 296-370MBq (8-10mCi) of Tc-99m tetrofosmin on same group of patients followed by early and delayed images. Results of radionuclide perfusion scan from both studies were compared qualitatively with postsurgical histopathology or fine needle aspiration cytology (FNAC).Results: Total 65 nodules in 50 patients were included in the study. With single tracer, the specificity and accuracy of Tc-99m pertechnetate was 23% and 45% and for Tc-99m tetrofosmin scan was 40% and 49%. When dual tracers were evaluated for the same group of patients, the specificity was 56% and accuracy was 55%.Conclusion: Dual Tracer technique with Tc-99m pertechnetate and Tc-99m tetrofosmin could be helpful in selecting nodules need surgical intervention. This technique can be used for convenient and rapid diagnostic evaluation of thyroid nodules non-invasively. We suggest a combination of fine needle aspiration biopsy and dual use of Tc-99m-pertechnetate and Tc-99m-tetrofosmin as a routine diagnostic approach to thyroid nodules. [ABSTRACT FROM AUTHOR]

The paper presents the procedure for planning an experiment to create standard sets of reagents for a technetium-99m generator based on glucose derivatives. All stages are presented from researching the required quantities of a substance, a reducing agent, a stabilizer and auxiliary components to developing lyophilized kits and conducting quality control. The radiochemical purity of radiopharmaceuticals prepared on the basis of the developed kits ranged from 90.0 to 99.0%. We also showed the functional suitability of the developed preparations on C57B1/6j mice with an implanted malignant tumor - Lewis lung carcinoma. [ABSTRACT FROM AUTHOR]

Purpose. Technetium-99m diethylene triamine pentaacetic acid (Tc-99m DTPA) renal dynamic scintigraphy is a widely used imaging technique that evaluates renal function of patients with extrarenal abnormalities, but its clinical value in potentially offering us information on proliferation of liposarcoma has not yet been reported. Methods. We retrospectively reviewed 7 patients with histopathologically confirmed retroperitoneal liposarcoma who underwent Tc-99m DTPA renal dynamic scintigraphy. The clinical data, histopathological findings, Glomerular Filtration Rate (GFR), and Tc-99m DTPA uptake were recorded. Results. Dedifferentiated liposarcoma and well-differentiated liposarcoma showed dissimilar degrees of Tc-99m DTPA uptake, an observation that correlated with Ki-67 expression (p < 0.01). 4 of the 7 patients were diagnosed with dedifferentiated liposarcoma, showing a moderate uptake of Tc-99m DTPA and greater than 20% Ki-67 expression on histological slides. Meanwhile, the remaining 3 patients, diagnosed with well-differentiated liposarcoma, showed no uptake of Tc-99m DTPA and Ki-67 expression of less than 5%. Conclusions. This study suggests that Tc-99m DTPA renal dynamic scintigraphy provides diagnostic value in patients with retroperitoneal liposarcoma, not only in evaluating renal function but also in visualizing lesion-related radionuclide uptake, which may potentially offer further clinical insights into tumor proliferation and provide prognostic value for clinical outcomes in patients with retroperitoneal liposarcoma. [ABSTRACT FROM AUTHOR]

Objectives. This work aimed to study the efficacy of hybrid 99mTc-Pyrophosphate SPECT/CT for diagnosis of latent inflammatory processes in the myocardium of patients with atrial fibrillation (AF). Methods. The study comprised 34 patients aged 44 ± 9 years with AF of unknown etiology referred for radiofrequency ablation. The data were acquired using hybrid 99mTc-Pyrophosphate SPECT/CT. To evaluate and interpret the results of hybrid study and to determine localization of radiopharmaceutical accumulation, scintigraphic and CT images were fused. SPECT/CT results were compared with data of endomyocardial biopsy. Results. Sensitivity, specificity, and accuracy of 99mTc-Pyrophosphate SPECT/CT in diagnosing myocarditis were 91%, 100%, and 94%, respectively. Proposed diagnostic criteria for myocarditis comprised intensity of the radiopharmaceutical accumulation in the myocardium and the ratios of focus/lung, focus/vertebral column, and focus/LV pool. Minimum cutoff values for the histologically verified myocarditis were >1.47 for focus/lung index, >0.11 for focus/vertebral column ratio, and >1.26 for focus/lung index. Conclusions. SPECT/CT-based quantitative assessment of 99mTc-Pyrophosphate accumulation in the myocardium is a highly informative noninvasive method for diagnosis of inflammatory process in the heart in patients with AF of undefined etiology. [ABSTRACT FROM AUTHOR]

Differentiated thyroid carcinoma (DTC) is the most common endocrine malignancy. The study was performed to evaluate the factors that are likely to be responsible for the presence of remnant thyroid tissue. The data of 183 patients who underwent total thyroidectomy for DTC were retrospectively reviewed. The remnant thyroid tissue was determined by technetium-99 m pertechnetate (Tc-99 m) scintigraphy. The association of all possible factors (age, gender, size, multifocality, type, and characteristics of the tumor), extension of thyroidectomy, postoperative serum thyroglobulin (Tg), Tg antibody, and thyroid stimulating hormone levels with the presence of remnant tissue was evaluated. Remnant thyroid tissue was more common in patients with intermediate or high-risk features compared to low-risk group (p < 0.001) and in patients who underwent total thyroidectomy compared to patients with total thyroidectomy and central lymph node dissection (p = 0.009). Age, gender, and size, multifocality, type, and characteristics of the tumor were not found to be associated with the presence of remnant tissue. The extent of surgery is the single independent factor for the presence of remnant thyroid tissue after thyroidectomy (p < 0.001). The patients with intermediate and high-risk and extensive surgery were more likely to have remnant thyroid tissue after thyroidectomy for DTC. [ABSTRACT FROM AUTHOR]

BACKGROUND: Production of 99mTc from low specific activity (LSA) 99Mo obtained from 98Mo(n,γ)99Mo reaction in research reactor and 100Mo(γ,n)99Mo reaction in accelerator or directly from 100Mo(p,2n)99mTc nuclear reaction in cyclotron, has been explored [1]. The methyl ethyl ketone (MEK) based solvent extraction technique is a well-known method for the separation of 99mTc from low specific activity 99Mo. The 99Mo/99mTc autosolex generator [2], a computer controlled automated module, utilizes the conventional MEK solvent extraction method for extraction of 99mTc. Herein, we have validated the usage of autosolex by preparing quite a large number of pharmacopoeia grade 99mTcO4- (No. of batches: 97) using 7.40-27.5 GBq of LSA 99Mo-Sodium Molybdate (99MoO42-) solution (No. of batches: 31). To check the efficacy of 99mTcO4- towards radiolabeling, a wide range of 99mTc-radiopharmaceuticals (99mTc-RPs) including fourth generation 99mTc-radiopharmaceuticals has been evaluated. Finally, the clinical efficacy of these 99mTc-RPs has been evaluated. To make the autosolex generator more versatile, we have studied further some of the important issues relevant to autosolex generator viz. the functionality of conductivity detector with respect to the concentration of sodium hydroxide, purity of reagents/materials used and radiation dose outside the module. MATERIAL AND METHODS: The 99mTcO4- was extracted from the autosolex as described in the reported literature [2] using 7.40-27.5 GBq of LSA 99MoO42-. The 99mTc radiopharmaceuticals prepared from cold kits (99mTc-cold kits), obtained from our center, using standard procedures [3], subjected to required QC as per Indian Pharmacopeia monograph [4] and used in scintigraphic imaging in patients. The radiation exposure dose to the operator was compared between autosolex and manual MEK based solvent extraction generator. RESULTS: The extracted 99mTcO4- from autosolex is a clear and colorless solution with pH between 5.0 and 6.5. The elemental molybdenum (Mo) and aluminum (Al) content < 10 µg/mL, MEK levels < 0.1%, 99Mo breakthrough < 0.026% and radiochemical purity (RCP) > 98%. All the extracted 99mTcO4- batches complies sterility test, endotoxin limit (EL) < 5 EU/mL. The RCP of all the labeled 99mTc-RPs > 95%. The autosolex delivers much less radiation dose to the operator than the convention manually handled MEK based solvent extraction generator. CONCLUSIONS: Autosolex Generator was successfully validated to obtain pharmaceutical grade 99mTcO4- using LSA 99MoO42- up to a higher range of activity of 27.5 GBq and the generator is safe in radiological and pharmacological point of view. The work also confirms the suitability for the preparation of various types of 99mTc-RPs, especially using fourth generation 99mTc-RPs using autosolex generator and using these 99mTc-RPs for scintigraphic imaging in patients. [ABSTRACT FROM AUTHOR]

Objective This study aimed to calculate the baseline carbon inventory of Mercy Health, a provider of health and aged care services in Australia, across emission Scopes 1, 2 and 3. The carbon inventory has clarified the baseline environmental impact, identified carbon hotspots and will inform emissions reduction interventions and a decarbonisation trajectory. Methods A hybrid carbon footprinting methodology was devised. Established carbon footprinting standards provided methodological guidance. A consulting firm with health service carbon accounting experience provided expertise, rigour and objectivity to the work. Results In the 2020-21 financial year, the carbon footprint of Mercy Health was 102.96k tCO2-e. Scope 1 emissions accounted for 11.07% (11.40k tCO2-e), followed by Scope 2 with 29.80% (30.68k tCO2-e) and Scope 3 with 59.13% (60.88k tCO2-e). The largest carbon impost group was Building energy (42.01%; 43.25k tCO2-e), followed by Food and catering (9.42%; 9.70k tCO2-e) and Business services (7.74%; 7.97k tCO2-e). Mercy Health's Health Services, Aged Care and Support Services divisions contributed 49.16, 47.81 and 3.03% (50.61k, 49.23k and 3.12k tCO2-e) of total greenhouse gas emissions respectively. Conclusions Mercy Health's Health Services division and Aged Care division each comprised around half of total organisation carbon emissions. Building energy dominated emissions, particularly electricity. The study discovered meaningful differences in the composition of carbon emissions in operational divisions of the organisation, indicating tailored interventions will be required to meet carbon abatement targets. The study demonstrates the benefit of conducting carbon footprinting within individual organisations, and the importance of studies within the Australian context.

The purpose of this study is to investigate I-124 positron emission tomography (PET)/ultrasound (US) fusion imaging for function assessment of thyroid nodules. In 70 patients, 201 lesions were examined with conventional diagnostics (CD) (thyroid US, laboratory findings and Tc-99m pertechnetate scintigraphy), Tc-99m pertechnetate single photon emission computed tomography (SPECT) and I-124 PET/computed tomography (CT). Subsequently, US fusion imaging (SPECT/US and PET/US) was performed by three experienced investigators. Patients referred for thyroid diagnostics in a clinical routine setting were included in this study if CD produced equivocal results. PET/US was superior to CD and SPECT/US in 96% and 86%, respectively, and ambiguous findings in CD were clarified by PET/US in 96% of the 70 patients. Regarding nodule-based function assessment, 10% (66%), 39% (14%) and 71% (4%) of the 201 lesions were rated with absolute certainty (equivocal or uncertain) using CD, SPECT/US and PET/US, respectively (p < 0.001). PET/US has the potential to improve the function assessment of thyroid nodules in comparison to CD. [ABSTRACT FROM AUTHOR]

BACKGROUND: In GFR measurements with radiotracers, there is evidence that a two-compartment model is unable to describe the full plasma curve, including early time points, but analyses generally focus on two-compartment models. AIMS: To analyze both the mammillary and catenary three-compartment model and to determine empirical relations between model constants and the overall GFR and ECV (extra-cellular volume). MATERIAL AND METHODS: Mathematical analysis of the three-compartment model. Full-curve patient data from 32 adults and 7 children were used to relate model parameters to GFR and ECV. RESULTS: Model volumes were found to be roughly proportional to ECV. In both models, the central (plasma) volume was V1 = 0.24 x ECV and elimination rate from V1 was k10 = 4.2 x GFR/ECV. In the mammillary model, the two parallel volumes were V2 = 0.28 x ECV, V3 = 0.48 x ECV, and intercompartmental clearances were Cl12 [mL/min] = 0.0058 x ECV [mL], Cl13 = 0.042 x ECV. In the catenary model, the serial volumes were V2 = 0.60 x ECV, V3 = 0.16 x ECV, with clearances Cl12 = 0.048 x ECV, Cl23 = 0.0036 x ECV. CONCLUSION: Insight into the three-compartment model was achieved, and empirical relations to ECV and GFR/ECV were determined. [ABSTRACT FROM AUTHOR]

Heterotopic gastric mucosa (HGM) is defined as the presence of gastric mucosa outside of the stomach, which is documented by histologic finding. HGM is typically a solitary lesion; however, in our Case Report, the patient presented with multilocus HGM, an uncommon form in which the small bowel is extensively involved. We report a unique case of multilocus HGM mimicking very early--onset inflammatory bowel disease with recurrent gastrointestinal bleeding, chronic inflammation, and stricturing in a newborn patient. Histologic findings from the ileocecal specimen revealed multiple ulcers surrounded by chronic inflammation. Subsequently, a Technetium-99m pertechnetate scan demonstrated an increased tracer uptake in the remaining ileum. This radiologic finding, in combination with the discovery of gastric mucosa within the remainder of resected ileal specimen, led to the diagnosis of HGM. Omeprazole was initiated, and the patient is now asymptomatic without further gastrointestinal bleeding. Increased awareness of this rare disease and performing a Technetium-99m pertechnetate early can correctly diagnose HGM and prevent disease complication. [ABSTRACT FROM AUTHOR]

Background: The cingulate island score (CIScore), which indicates the Z‐score ratio of the posterior cingulate gyri to the medial occipital area, has been shown to be useful for differentiating dementia with Lewy bodies from Alzheimer's disease (AD). Our aim was to investigate associations between the clinical symptoms of AD and the CIScore as an index of the relative decrease in perfusion of the posterior cingulate gyri that occurs in the early stages of AD. Methods: Seventeen patients with early‐stage AD and 13 patients with amnesic mild cognitive impairment were examined. Z‐score maps of technetium‐99m ethyl cysteinate dimer single‐photon emission computed tomography images acquired from the patients were converted, and the CIScore was determined by using the easy Z‐score imaging system. The relationships between the CIScore and clinical symptom scores were tested. Results: A significant correlation was identified between the CIScore and the Neuropsychiatric Inventory Questionnaire score. No significant correlations were identified between the CIScore and other measures of cognitive function. Based on a CIScore of 0.39, we correctly differentiated patients with and without behavioural and psychological symptoms of dementia (BPSD), with a sensitivity of 72.2% and specificity of 75.0%. Discussion: Using technetium‐99m ethyl cysteinate dimer single‐photon emission computed tomography, we observed that decreased posterior cingulate gyri perfusion, relative to the medial occipital area, in prodromal and early AD was closely associated with behavioural and psychological symptoms of dementia. Therefore, our findings suggest that CIScore is not only useful for discriminating dementia with Lewy bodies from AD, but it can also be clinically used as a specific indicator of the vulnerability to behavioural and psychological symptoms of dementia in the early stages of AD. [ABSTRACT FROM AUTHOR]

Background: RANKL and RANK play an important role in jaw resorption during the development of the ameloblastomas. Therefore, the aim of this study was to explore the effect of 99 Tc-MDP on OPG/RANKL/RANK system on RAW264.7 and MC3T3-E1 cell lines in vitro and provide the theoretical basis for the clinical treatment of the jaw ameloblastoma.Methods: Different concentrations of 99 Tc-MDP were used to treat RAW264.7 and MC3T3-E1 cell lines. The cell proliferative inhibition rate was analyzed by CCK-8. Cell apoptosis and cell cycle were detected by flow cytometry. Western blot was used to detect the expression of OPG, RANKL, and RANK.Results: Treatment of RAW264.7 cell lines with different concentrations of 99 Tc-MDP had inhibitory effects and decreased the expression of RANK protein. The cell proliferation of 99 Tc-MDP on MC3T3-E1 cell lines was stronger at 48 hours than at 24 hours except for 100 μg/mL concentration group. Compared with the concentration of 0.01 μg/mL, the treatment of MC3T3-E1 cells with 100 μg/mL 99 Tc-MDP showed that the cell proliferative effect decreased at 24 hours and 48 hours (P < 0.05). After treatment with 0.01 μg/mL 99 Tc-MDP, the expression of OPG in MC3T3-E1 cells was significantly increased (P < 0.05). Compared with 0.01 μg/mL, the expression of RANKL was decreased after treatment with 100 μg/mL 99 Tc-MDP (P < 0.05).Conclusion: 99 Tc-MDP can induce apoptosis of RAW264.7 cells and inhibit the expression of RANK protein. The effect of 0.01 μg/mL of low concentration of 99 Tc-MDP can promote the proliferation of MC3T3-E1 cells and increase the expression of OPG and RANKL protein. 99 Tc-MDP may have adjuvant therapeutic effects on the treatment of jaw ameloblastoma. [ABSTRACT FROM AUTHOR]

Objective: Negative 99mTc-pertechnetate uptake of the thyroid bed indicates the absence or a small volume of remnant thyroid tissue (RTT) after total thyroidectomy (TT). The aim of this study is to evaluate the predictive value of negative 99mTc-pertechnetate scintigraphy for excellent response (ER) to radioactive iodine therapy (RIT) in low- to intermediate-risk differentiated thyroid cancer (DTC) patients.Patients: One-hundred and eighty-nine low- to intermediate-risk DTC patients who underwent TT, RIT with a single dose of 30 mCi and suppressive therapy with thyroid-stimulating hormone (TSH) from July 2015 to February 2016 in our hospital were retrospectively evaluated. 99mTc-pertechnetate thyroid scintigraphy was performed just before RIT and images were reported dichotomously as negative or positive. The response of patients was assessed for 23.2 ± 3.8 months after RIT and dichotomized as excellent response (ER) or non-excellent response (NER). 99mTc-pertechnetate uptake, age at diagnosis, gender, multifocality, T stage, N stage, preablative stimulated thyroglobulin (ps-Tg), and TSH were explored as potential predictors for ER.Results: 80.68% (71/88) of patients with negative 99mTc-pertechnetate uptake achieved ER. When patients were evaluated according to different ps-Tg levels, we found that 94.83% (55/58) of patients with ps-Tg < 1 ng/ml and negative 99mTc-pertechnetate uptake achieved ER. Multivariate Cox regression analysis revealed that ps-Tg (P = 0.0001) and 99mTc-pertechnetate uptake (P = 0.0473) were independent predictors for ER.Conclusions: In addition to ps-Tg, negative 99mTc-pertechnetate uptake is also a significant independent predictor for an excellent response in low- to intermediate-risk patients. It may be possible to omit RIT in patients with ps-Tg < 1 ng/ml and concurrent negative 99mTc-pertechnetate uptake. [ABSTRACT FROM AUTHOR]

The clinical applications of the quantitative single photon emission computed tomography (SPECT)/computed tomography (CT) are being expanded to a variety of fields of nuclear medicine. However, clinical application of quantitative SPECT/CT for the evaluation of Graves' disease (GD) still needs further investigation. Our aim was to investigate the feasibility of standard uptake value (SUV) of the thyroid for the clinical diagnosis and evaluation of GD. In this prospective multicenter study, 116 patients diagnosed with GD (Graves group) and 74 healthy volunteers (control group) were enrolled from 8 different hospitals. All patients underwent technetium pertechnetate (TcO99m4-) SPECT/CT imaging with Q.Metrix quantitative software and 24-hour thyroid radioactive iodine uptake (24h-RAIU) test. The SUVmax and SUVmean in Graves group were significantly higher than those of control group (P<0.01). Cut-off values of SUVmax and SUVmean to predict GD were 231.425 and 116.66 by ROC curves, respectively. The SUVmax and SUVmean in Graves patients were significantly related to serum thyroxine level with correlation coefficient of 0.493 and 0.512 for FT3 and 0.449 and 0.464 for FT4, respectively (all P<0.01). Additionally, the SUVmax and SUVmean in GD positively correlated with 24h-RAIU with a coefficient of 0.832 and 0.830, respectively (P<0.01). The volumes determined by Q.Metrix (35.65 ± 20.56ml) of 72 subjects also positively correlated with that from ultrasound (36.67 ± 21.00ml) with a coefficient of 0.927 (P<0.01). SUV measurements derived from thyroid SPECT/CT may be useful for the clinical diagnosis and evaluation of GD. [ABSTRACT FROM AUTHOR]

Highlights • Di- t -BuDB18C6 has been used for separation of technetium from alkaline LLW. • Solvent constituted as 0.2 M di- t -BuDB18C6 + 50% isodecyl alcohol/ n -dodecane. • Direct extraction of technetium from LLW without any feed adjustment. • Ion-pair complex formation as: Crown ether. Na+·TcO 4 −. • Quantitative stripping of technetium extract with de-ionized water. Abstract Di- tert -butyldibenzo-18-crown-6 ether (CE) dissolved in a mixture of isodecyl alcohol and n -dodecane has been investigated for separation of technetium from alkaline low level waste (LLW). Technetium present as TcO 4 − pairs with sodium ion-crown ether complex formed due to high sodium nitrate concentration in the waste solution results in extraction of TcO 4 − by ion-pair formation of the kind Na+·CE·TcO 4 −. Stoichiometry of the extracted complex as determined by slope analysis of log–log plot of technetium distribution ratio (D Tc) vs. the CE concentration suggests a combining ratio of 1 TcO 4 − to 1 CE. Extraction of TcO 4 − was examined from aqueous phase with varying NaNO 3 and NaOH concentrations. D Tc was found to increase with increase in Na+ concentration having NO 3 − or OH− as counter ions, however, above 5 M concentrations of them, D Tc remained constant for NaOH while it decreases for NaNO 3 due to a strong competitive extraction of NO 3 − ion compared to OH−. Quantitative stripping of TcO 4 − was achieved in three consecutive contact of loaded organic with deionized water. [ABSTRACT FROM AUTHOR]

Background. Graves’ ophthalmopathy (GO) is a complicated autoimmune disease. Various therapies have been used to manage GO; however the optimum therapy is not clear. Glucocorticoids (GCs) therapy is the mainstay of treatment especially for active moderate to severe patients, which needs evidence-based support. Method. We searched all the randomized controlled trials (RCTs) involving corticosteroid treatment for patients diagnosed with GO from EMBASE, Medline, and the Cochrane library and then conducted a system review and meta-analysis. The electronic search covered the period from April 1966 to March 2018. Result. Twenty-nine trials were included. GCs were proved to be beneficial for GO patients [response rate, risk ratio (RR) = 1.72, 95% confidence interval (CI): 1.28~2.31, P=0.0003], and intravenous corticosteroids worked significantly better than oral corticosteroids as ever reported. When compared with the single treatment of GCs, the combination of radiotherapy and GCs showed similar effects on response rate (RR=1.25, 95%CI: 0.91~1.73). A study proved the advantage of mycophenolate mofetil over GCs in three outcomes (response rate, RR=0.74, 95%CI: 0.63~0.88). Additional treatments such as technetium-99 methylene diphosphate (99Tc-MDP) or cyclosporine enhanced the effect of GCs on proptosis reduction, respectively (P<0.00001 and P=0.02). Conclusion. Our meta-analysis confirmed the effects of GCs in the management of GO and intravenous GCs are proved to be better than oral GCs as ever reported. Combination of radiotherapy and GCs did not enhance the effects of GCs. However, if proptosis is the main issue, combination of 99Tc-MDP or cyclosporine with GCs may be taken into consideration. The reported advantages of mycophenolate mofetil over GCs are noteworthy and need more RCTs to confirm. [ABSTRACT FROM AUTHOR]