Tolerability of PSMA radioligand therapy in metastatic prostate cancer patients with baseline mild to moderate leukopenia.

Background: Aim of this study was to analyze the safety of prostate-specific membrane antigen radioligand therapy (PSMA-RLT) in patients with metastatic castration-resistant prostate cancer (mCRPC) with preexisting mild to moderate leukopenia (CTCAE ≥ 1).

Results: Thirty-seven mCRPC patients with preexisting leukopenia (leukocyte count < 3.8 × 10/L) were included in this study.

Expanding the scope of PSMA-RLT: evaluating treatment in challenging mCRPC patients with poor performance status (ECOG 3).

Purpose: Given the increasing inclusion of ECOG 3 patients in oncology practice, data on this subgroup in the context of prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT) remain limited. This study evaluates the safety and outcome of PSMA-RLT in metastatic castration-resistant prostate cancer (mCRPC) patients with ECOG performance status 3.

Methods: In this analysis, a cohort of 18 mCRPC patients with ECOG performance status 3 who received PSMA-RLT was examined.

PSMA Radioligand Therapy in Advanced Age: Insights From an 85y+ mCRPC Patient Cohort.

Purpose: With increasing life expectancy, the number of older patients with metastatic castration-resistant prostate cancer (mCRPC) continues to rise, but this group is currently underrepresented in clinical trials. This study aims to assess the efficacy and safety of prostate-specific membrane antigen (PSMA) targeted radioligand therapy (RLT) in patients over 85 years old with mCRPC.

Materials And Methods: A retrospective analysis was conducted on 21 mCRPC patients aged 85 years or older receiving PSMA-RLT (range: 85-96 y).

Digitalization of Nuclear Medicine in Germany - Status Quo 2024.

Digitalization in the healthcare sector is becoming increasingly widespread. Yet, the degree of digitalization in nuclear medicine has not been systematically investigated. The "Digitalization and AI" working group of the German Society of Nuclear Medicine conducted a survey to assess the status quo of digitalization of the nuclear medicine health infrastructure in Germany.

[F]FDG PET/CT of Langerhans Cell Histiocytosis with Vertebra Plana.

We present an F-fluorodeoxyglucose ([F]FDG) positron emission tomography/computed tomography (PET/CT) scan of a 27 y/o patient with long-standing significant B symptoms, diffuse bone pain, increased inflammation parameters, and polydipsia revealing multiple FDG-avid osteolytic lesions of the axial skeleton including a vertebra plana of T7 and paraosseous soft tissue lesions. A CT-guided biopsy confirmed the diagnosis of Langerhans cell histiocytosis (LCH). This case highlights the importance of considering LCH in young patients with vertebral collapse and underscores the role of PET/CT imaging in establishing an accurate diagnosis.

Prediction of lesion-based response to PRRT using baseline somatostatin receptor PET.

Aim: The heterogeneous expression of somatostatin receptors in gastroenteropancreatic neuroendocrine tumors (GEP-NET) leads to significant intra-individual variability in tracer uptake during pre-therapeutic [Ga]Ga-DOTATOC PET/CT for patients receiving peptide receptor radionuclide therapy (PRRT). This study aims to evaluate the lesion-based relationship between receptor-mediated tracer uptake and the functional response to PRRT.

Methods: A retrospective analysis was conducted on 32 patients with metastatic GEP-NET (12 pancreatic and 20 non-pancreatic), all treated with [Lu]Lu-octreotate (4 cycles, with a mean of 7.

Radiomics for Predicting the Development of Brain Edema from Normal-Appearing Early Brain-CT After Cardiac Arrest and Return of Spontaneous Circulation.

Hypoxic-ischemic brain injury (HIBI) is a feared complication post-cardiac arrest (CA). The timing of brain imaging remains a topic of ongoing debate. Early computed tomography (CT) scans can reveal acute intracranial pathologies but may have limited predictive value due to delayed manifestation of HIBI-related changes.

225 Ac-PSMA-617 Augmentation After Insufficient Response Under 177 Lu-PSMA-617 Radioligand Therapy in mCRPC: Evaluation of Outcome and Safety From a Prospective Registry (REALITY Study).

Background: Even though the introduction of 177 Lu-PSMA-617 RLT represents a major milestone in the treatment of mCRPC, there are still patients who do not respond adequately to this therapy and for whom there are only limited options left. Augmenting 177 Lu-PSMA-617 RLT with the alpha-emitter 225 Ac-PSMA-617 may present an escalating treatment option to increase efficacy. In this study, we aim to evaluate outcome and safety of 225 Ac-PSMA-617 augmentation to 177 Lu-PSMA-617 RLT in patients who present insufficient response to monotherapy with 177 Lu-PSMA-617 RLT.

Diffuse Peritoneal Carcinomatosis of Prostate Cancer Unveiled by [89Zr]Zr-PSMA-617 PET/CT.

We report an interesting case of a 64-year-old man with a history of radical prostatectomy for prostate cancer. The patient presented with steady increasing prostate-specific antigen levels, but with negative findings on previous multiple conventional prostate-specific membrane antigen (PSMA) PET/CT (with [68Ga]Ga-PSMA-11) and [18F]FDG PET/CT. A recently introduced PSMA tracer using long-lived 89Zr (half-life 3.

Safety of PSMA radioligand therapy in mCRPC patients with preexisting moderate to severe thrombocytopenia.

Purpose: Aim of this study was to analyze the safety of prostate-specific membrane antigen radioligand therapy (PSMA-RLT) in patients with metastatic castration-resistant prostate cancer (mCRPC) with preexisting moderate to severe thrombocytopenia (CTCAE ≥ 2).

Materials And Methods: Seventeen mCRPC patients with preexisting thrombocytopenia (platelet count < 75 × 10/L) were included in this study. Patients received a median of 3 cycles of [Lu]Lu-PSMA-617 (range 1-6).

Outcome and Renal Safety of PSMA-Targeted Radioligand Therapy in mCRPC Patients With Preexisting Impaired Renal Function.

Purpose: This study aims to evaluate the outcome and renal safety of prostate-specific membrane antigen (PSMA)-radioligand therapy (RLT) in patients with metastatic castration-resistant prostate carcinoma (mCRPC) and preexisting renal impairment.

Methods: Ninety-four patients with preexisting renal impairment were included in this retrospective analysis. Inclusion criterion was a glomerular filtration rate (GFR) of ≤60 mL/min (equivalent to Common Terminology Criteria of Adverse Events [CTCAE] ≥2).

Analysis of Molecular Imaging Biomarkers Derived from [F]FDG PET/CT in mCRPC: Whole-Body Total Lesion Glycolysis (TLG) Predicts Overall Survival in Patients Undergoing [Ac]Ac-PSMA-617-Augmented [Lu]Lu-PSMA-617 Radioligand Therapy.

The augmentation of [Lu]Lu-PSMA-617 radioligand therapy by alpha emitting [Ac]Ac-PSMA-617, known as the tandem therapy concept, is a promising escalating treatment option in advanced mCRPC. In this study, we evaluated the value of [F]FDG PET/CT-derived molecular imaging biomarkers for predicting response and outcome to PSMA tandem RLT in = 33 patients with insufficient response on [Lu]Lu-PSMA-617 monotherapy. Six different molecular imaging parameters at baseline, i.

[Zr]Zr-PSMA-617 PET/CT in a Patient with Biochemical Recurrence of Prostate Cancer and Prior Indetermined Findings on [F]PSMA-1007 Imaging.

We report a case of a 79-year-old male patient with a history of radical prostatectomy for prostate cancer. The patient presented with biochemical reoccurrence; however, previous conventional PSMA PET/CT using [F]PSMA-1007 showed two indetermined findings with low uptake in the right iliac lymph nodes. Further MRI evaluation provided no additional information.

Ectopic Cushing Syndrome Localized by 68 Ga-DOTA-LM3 PET/CT.

A 53-year-old woman presented with signs of Cushing syndrome with challenges in diagnosis and localization. A novel somatostatin receptor (SSTR)-targeted PET/CT with 68 Ga-DOTA-LM3, an SSTR antagonist, revealed a suspicious focal finding in the pancreatic head, proven to be ectopic Cushing syndrome after surgical resection. This interesting image clearly shows the potential of PET imaging with SSTR antagonists as 68 Ga-DOTA-LM3 in the diagnosis of ectopic Cushing syndrome.

Analysis of Molecular Imaging and Laboratory Baseline Biomarkers in PSMA-RLT: Whole-Body Total Lesion PSMA (TLP) Predicts Overall Survival.

The aim of this retrospective study was to identify pre-therapeutic predictive laboratory and molecular imaging biomarkers for response and overall survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT). Pre-therapeutic laboratory and [Ga]Ga-PSMA-11 PET/CT data of = 102 mCRPC patients receiving [Lu]Lu-PSMA-617 RLT within a prospective registry (REALITY Study, NCT04833517) were analyzed including laboratory parameters such as alkaline phosphatase (ALP), prostate-specific antigen (PSA), gamma glutamyl transferase (GGT), glutamate oxaloacetate transaminase (GOT), glutamate pyruvate transaminase (GPT), neuron specific enolase (NSE), hemoglobin (Hb), and imaging parameters such as maximum standardized uptake value of the tumor lesions (SUV), the mean standardized uptake value of all tumor lesions (SUV), the whole-body molecular tumor volume (MTV), and the whole-body total lesion PSMA (TLP). Mann-Whitney U test, univariate and multivariable Cox-regression were performed to test for association of the parameters with response and OS.

Puncture Cube Patient-Mounted Navigation System versus Freehand Method for CT-Guided Needle Placement: Study on a Neoprene Covered Elliptical Cylinder Gelatin Phantom.

Purpose: The study aims to show how the "Puncture Cube" (PC) (Medical Templates, Egg, Switzerland) compares to the freehand method (FHM) for CT-guided punctures.

Methods: The PC is a patient-mounted disassemblable cube consisting of an upper and lower template with multiple holes each to predefine puncture trajectory. A total of 80 punctures (FHM in-plane, FHM off-plane, PC in-plane, PC off-plane) was performed by 4 radiologists on a target 9.

CT angiography of the lower limbs: combining small field of view with large matrix size and iterative reconstruction further improves image quality of below-the-knee arteries.

Background: Image quality and diagnostic accuracy in computed tomography angiography (CTA) reach their limits in imaging of below-the-knee vessels.

Purpose: To evaluate whether image quality in CTA of lower limbs is further improvable by combining side-separate reconstruction with a larger matrix size and whether resulting noise can be compromised with iterative reconstruction (IR).

Material And Methods: From CTA of the lower extremities of 26 patients (5 women, 21 men; mean age = 68.

Histopathological Confirmed Polycythemia Vera with Transformation to Myelofibrosis Depicted on [F]FDG PET/CT.

We present a case of a 59-year-old male diagnosed with polycythemia vera (PV) for many years, who presented with a relatively abrupt onset of heavy constitutional symptoms, including fatigue, night sweats, and a 10% weight loss over 6 weeks. Despite the known initial diagnosis of PV, the presence of profound B-symptoms prompted further investigation. A positron emission tomography/computed tomography (PET/CT) scan with F-Fluorodeoxyglucose ([F]FDG) was performed to exclude malignant diseases.

ChatGPT: Evaluating answers on contrast media related questions and finetuning by providing the model with the ESUR guideline on contrast agents.

Objective: This study aimed to assess the feasibility of GPT-4 for answering questions related to contrast media with and without the context of the European Society of Urogenital Radiology (ESUR) guideline on contrast agents. The overarching goal was to determine whether contextual enrichment by providing guideline information improves answers of GPT-4 for clinical decision-making in radiology.

Methods: A set of 64 questions, based on the ESUR guideline on contrast agents mirroring pertinent sections, was developed and posed to GPT-4 both directly and after providing the guideline using a plugin.

Retrospective evaluation of interventional radiological treatments for chronic mesenteric ischemia in Germany based on a four-year period of the DeGIR Registry: comparison of outcomes with international quality standards.

Purpose: Endovascular treatment has emerged as the gold standard for managing chronic mesenteric ischemia (CMI) resulting from arterial stenosis or occlusion. This study aimed to assess the efficacy and complication rates of continuous interventional radiology treatment for CMI in Germany between 2018 and 2021, comparing these findings with international quality standards.

Materials And Methods: Data for CMI therapy with stenting and percutaneous transluminal angioplasty (PTA) was obtained from the quality management system of the German Interventional Radiological Society (DeGIR).

Assessment of Efficacy and Complications of Endovascular Interventions for Critical Limb Ischemia in Germany: A Nationwide Study.

Purpose: Endovascular interventional radiological procedures have become the mainstay for the treatment of critical limb ischemia (CLI) due to arterial stenosis or occlusion. Open surgical or endovascular procedures, such as percutaneous transluminal angioplasty (PTA) or stenting can be used as a treatment strategy. The aim is to evaluate the success and major complication rates of interventional radiology treatments for CLI in Germany in 2021, and to compare these results with internationally published data.

Prevalence of burnout among German radiologists: a call to action.

Objectives: In the presence of escalating global concerns regarding physician burnout, this study aims to analyze the prevalence and associated factors of burnout among radiologists in Germany.

Methods: A comprehensive online survey, inclusive of 73 targeted questions including a German-modified version of the Maslach Burnout Inventory, was distributed among all members of the German Radiological Society and the German Interventional Radiological Society between May and August 2023. The survey encompassed aspects of employment, workload, well-being, and coping mechanisms.

Feasibility of GPT-3 and GPT-4 for in-Depth Patient Education Prior to Interventional Radiological Procedures: A Comparative Analysis.

Purpose: This study explores the utility of the large language models, GPT-3 and GPT-4, for in-depth patient education prior to interventional radiology procedures. Further, differences in answer accuracy between the models were assessed.

Materials And Methods: A total of 133 questions related to three specific interventional radiology procedures (Port implantation, PTA and TACE) covering general information as well as preparation details, risks and complications and post procedural aftercare were compiled.

Feasibility of the chick chorioallantoic membrane model for preclinical studies on tumor radiofrequency ablation.

Background: We evaluated the feasibility of a chick chorioallantoic membrane (CAM) tumor model for preclinical research on tumor radiofrequency ablation (RFA).

Methods: Fertilized chicken eggs were incubated and divided into five cohorts: RFA for 30 s (n = 5), RFA for 60 s (n = 5), RFA for 120 s (n = 4), sham (n = 8), and controls (n = 6). Xenografting using pancreatic neuroendocrine tumor cells of the BON-1 cell line was performed on embryonic day (ED) 8.