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Pascual TNB, Paez D, Iagaru A, Gnanasegaran G, Lee ST, Sathekge M, Buatti JM, Giammarile F, Al-Ibraheem A, Pardo MA, Baum RP, De Bari B, Ben-Haim S, Blay JY, Brink A, Estrada-Lobato E, Fanti S, Golubic AT, Hatazawa J, Israel O, Kiess A, Knoll P, Louw L, Mariani G, Mirzaei S, Orellana P, Prior JO, Urbain JL, Vichare S, Vinjamuri S, Virgolini I, Scott AM. Guiding principles on the education and practice of theranostics. Eur J Nucl Med Mol Imaging 2024; 51:2320-2331. [PMID: 38453729 PMCID: PMC11178594 DOI: 10.1007/s00259-024-06657-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/13/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE The recent development and approval of new diagnostic imaging and therapy approaches in the field of theranostics have revolutionised nuclear medicine practice. To ensure the provision of these new imaging and therapy approaches in a safe and high-quality manner, training of nuclear medicine physicians and qualified specialists is paramount. This is required for trainees who are learning theranostics practice, and for ensuring minimum standards for knowledge and competency in existing practising specialists. METHODS To address the need for a training curriculum in theranostics that would be utilised at a global level, a Consultancy Meeting was held at the IAEA in May 2023, with participation by experts in radiopharmaceutical therapy and theranostics including representatives of major international organisations relevant to theranostics practice. RESULTS Through extensive discussions and review of existing curriculum and guidelines, a harmonised training program for theranostics was developed, which aims to ensure safe and high quality theranostics practice in all countries. CONCLUSION The guiding principles for theranostics training outlined in this paper have immediate relevance for the safe and effective practice of theranostics.
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Affiliation(s)
| | - Diana Paez
- Division of Human Health, Department of Nuclear Science and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Andrei Iagaru
- Division of Nuclear Medicine and Molecular Imaging, Stanford University Medical Center, Stanford, CA, USA
| | - Gopi Gnanasegaran
- Department of Nuclear Medicine, Royal Free London NHS Foundation Trust, London, UK
| | - Sze Ting Lee
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia
- School of Cancer Medicine, La Trobe University, Melbourne, Australia
- School of Health and Biomedicine, Royal Melbourne Institute of Technology (RMIT) University, Melbourne, Australia
- Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Mike Sathekge
- Steve Biko Academic Hospital, Pretoria, South Africa
- University of Pretoria, Pretoria, South Africa
| | - John M Buatti
- Department of Radiation Oncology, Holden Comprehensive Cancer Center, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Francesco Giammarile
- Division of Human Health, Department of Nuclear Science and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Akram Al-Ibraheem
- Department of Nuclear Medicine, King Hussein Cancer Center (KHCC), Amman, Jordan
- School of Medicine, University of Jordan, Amman, Jordan
| | - Manuela Arevalo Pardo
- Division of Human Health, Department of Nuclear Science and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Richard P Baum
- Center for Advanced Radiomolecular Precision Oncology, Curanosticum Wiesbaden, FrankfurtWiesbaden, Germany
| | - Berardino De Bari
- Radiation Oncology Department, Réseau Hospitalier Neuchâtelois, La Chaux-de-Fonds, Switzerland
| | - Simona Ben-Haim
- Department of Biophysics and Nuclear Medicine, Hadassah University Hospital, Jerusalem, Israel
- Faculty of Medicine, Hebrew University, Jerusalem, Israel
- University College London, London, UK
| | - Jean-Yves Blay
- Department of Medicine, Centre Leon Berard, Lyon, France
- University Claude Bernard Lyon, Lyon, France
| | - Anita Brink
- Division of Human Health, Department of Nuclear Science and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Enrique Estrada-Lobato
- Division of Human Health, Department of Nuclear Science and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Stefano Fanti
- Nuclear Medicine Division, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Policlinico S.Orsola, Bologna, Italy
| | - Anja Tea Golubic
- Department of Nuclear Medicine and Radiation Protection, University Hospital Centre Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia
| | - Jun Hatazawa
- Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Ora Israel
- B. Rappaport School of Medicine, Israel Institute of Technology-Technion, Haifa, Israel
| | - Ana Kiess
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Peter Knoll
- Division of Human Health, Department of Nuclear Science and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Lizette Louw
- Center of Molecular Imaging and Theranostics, Johannesburg, South Africa
- University of the Witwatersrand, Johannesburg, South Africa
| | - Giuliano Mariani
- Regional Center of Nuclear Medicine, Department of Translational Research and Advanced Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Siroos Mirzaei
- Department of Nuclear Medicine With PET-Centre, Clinic Ottakring, Vienna, Austria
| | | | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | | | - Shrikant Vichare
- Division of Human Health, Department of Nuclear Science and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Sobhan Vinjamuri
- Nuclear Medicine Department, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Irene Virgolini
- Department of Nuclear Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Andrew M Scott
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia.
- Olivia Newton-John Cancer Research Institute, Melbourne, Australia.
- School of Cancer Medicine, La Trobe University, Melbourne, Australia.
- Faculty of Medicine, University of Melbourne, Melbourne, Australia.
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2
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Mokoala KMG, Ndlovu H, Lawal I, Sathekge MM. PET/CT and SPECT/CT for Infection in Joints and Bones: An Overview and Future Directions. Semin Nucl Med 2024; 54:394-408. [PMID: 38016897 DOI: 10.1053/j.semnuclmed.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/30/2023]
Abstract
Infections of the bones and joints, if misdiagnosed, may result in serious morbidity and even mortality. A prompt diagnosis followed by appropriate management may reduce the socioeconomic impact of bone and joint infections. Morphologic imaging such as ultrasound and plain radiographs form the first line investigations, however, in early infections findings may be negative or nonspecific. Nuclear medicine imaging techniques play a complementary role to morphologic imaging in the diagnosis of bone and joint infections. The availability of hybrid systems (SPECT/CT, SPECT/MRI, PET/CT or PET/MRI) offers improved specificity with ability to assess the extent of infection. Bone scans are useful as a gatekeeper wherein negative scans rule out sepsis with a good accuracy, however positive scans are nondiagnostic and more specific tracers should be considered. These include the use of labeled white blood cells and antigranulocyte antibodies. Various qualitative and quantitative interpretation criteria have been suggested to improve the specificity of the scans. PET has better image resolution and 18F-FDG is the major tracer for PET imaging with applications in oncology and inflammatory/infective disorders. It has demonstrated improved sensitivity over the SPECT based tracers, however, still suffers from lack of specificity. 18F-FDG PET has been used to monitor therapy in bone and joint infections. Other less studied, noncommercialized SPECT and PET tracers such as 111In-Biotin, 99mTc-Ubiquicidin, 18F-Na-Fluoride, 18F-labeled white blood cells and 124I-Fialuridine to name a few have shown great promise, however, their role in various bone and joint infections has not been established. Hybrid imaging with PET or PET/MRI offers huge potential for improving diagnostics in infections of the joints and bones.
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Affiliation(s)
- Kgomotso M G Mokoala
- University of Pretoria, Pretoria, Gauteng, South Africa; Nuclear Medicine Research Infrastructure (NuMeRI), Pretoria, Gauteng, South Africa
| | - Honest Ndlovu
- Nuclear Medicine Research Infrastructure (NuMeRI), Pretoria, Gauteng, South Africa
| | - Ismaheel Lawal
- University of Pretoria, Pretoria, Gauteng, South Africa; Emory University, Atlanta, Georgia, United States
| | - Mike Machaba Sathekge
- University of Pretoria, Pretoria, Gauteng, South Africa; Nuclear Medicine Research Infrastructure (NuMeRI), Pretoria, Gauteng, South Africa.
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3
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Fontes LF, Pujatti PB, da Silva JWE, Costa CH, Palhota C, de Oliveira AP, de Mello RCR. Radioiodine therapy during the COVID-19 pandemic in a public reference hospital in Brazil: an experience report. RADIATION PROTECTION DOSIMETRY 2023:7185625. [PMID: 37247636 DOI: 10.1093/rpd/ncad163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 04/04/2023] [Accepted: 05/03/2023] [Indexed: 05/31/2023]
Abstract
COVID-2019 has resulted in an emerging respiratory infection that has spread as a pandemic since January 2020. Nuclear Medicine Services and its workers experienced a dramatic change in their clinical routine. They were required to adjust protocols for this new health condition. Regarding radioiodine therapy (RIT), initial orientations were to postpone treatments. In Brazil, National Nuclear Energy Commission prepared guidelines. It authorized RIT to employ activities over 1850 MBq in an outpatient setting on an exceptional basis. This study reports the RIT experience of a Brazilian hospital during the COVID-19 pandemic, intending to evaluate the applicability of outpatient treatment employing over 1850 MBq of I-131 on a large scale. During referred period, 106 patients at our service had an indication for RIT, of which 58 agreed to participate in the research and provided informed consent. Majority of patients did not meet the minimum requirements for outpatient treatment using doses > 1850 MBq.
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Affiliation(s)
- Lídia F Fontes
- Nuclear Medicine Service, Cancer Hospital I, National Cancer Institute (INCA), Rio de Janeiro, RJ 20230-130, Brazil
- College of Pharmacy, Center for Pharmaceutical Care Studies, Federal University of Minas Gerais, Belo Horizonte, MG 31270-901, Brazil
| | - Priscilla B Pujatti
- Nuclear Medicine Service, Cancer Hospital I, National Cancer Institute (INCA), Rio de Janeiro, RJ 20230-130, Brazil
| | - Jorge W E da Silva
- Nuclear Medicine Service, Cancer Hospital I, National Cancer Institute (INCA), Rio de Janeiro, RJ 20230-130, Brazil
| | - Célia H Costa
- Nuclear Medicine Service, Cancer Hospital I, National Cancer Institute (INCA), Rio de Janeiro, RJ 20230-130, Brazil
| | - Cláudia Palhota
- Nuclear Medicine Service, Cancer Hospital I, National Cancer Institute (INCA), Rio de Janeiro, RJ 20230-130, Brazil
| | - Antônio P de Oliveira
- Nuclear Medicine Service, Cancer Hospital I, National Cancer Institute (INCA), Rio de Janeiro, RJ 20230-130, Brazil
| | - Rossana C R de Mello
- Nuclear Medicine Service, Cancer Hospital I, National Cancer Institute (INCA), Rio de Janeiro, RJ 20230-130, Brazil
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4
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Hage FG, Einstein AJ, Ananthasubramaniam K, Bourque JM, Case J, DePuey EG, Hendel RC, Henzlova MJ, Shah NR, Abbott BG, Al Jaroudi W, Better N, Doukky R, Duvall WL, Malhotra S, Pagnanelli R, Peix A, Reyes E, Saeed IM, Sanghani RM, Slomka PJ, Thompson RC, Veeranna V, Williams KA, Winchester DE. Quality metrics for single-photon emission computed tomography myocardial perfusion imaging: an ASNC information statement. J Nucl Cardiol 2023; 30:864-907. [PMID: 36607538 DOI: 10.1007/s12350-022-03162-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 11/17/2022] [Indexed: 01/07/2023]
Affiliation(s)
- Fadi G Hage
- Section of Cardiology, Birmingham VA Medical Center, Birmingham, AL, USA.
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, 446 GSB, 520 19Th Street South, Birmingham, AL, 35294, USA.
| | - Andrew J Einstein
- Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine and Department of Radiology, Columbia University Irving Medical Center and NewYork-Presbyterian Hospital, New York, NY, USA
| | | | - Jamieson M Bourque
- Department of Medicine (Cardiology), University of Virginia Health System, Charlottesville, VA, USA
- Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA, USA
| | - James Case
- Cardiovascular Imaging Technologies, Kansas City, MO, USA
| | - E Gordon DePuey
- Mount Sinai Morningside Hospital, New York, NY, USA
- Bay Ridge Medical Imaging, Brooklyn, NY, USA
| | - Robert C Hendel
- Department of Medicine, Division of Cardiology, Tulane University School of Medicine, New Orleans, LA, USA
| | | | - Nishant R Shah
- Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Brian G Abbott
- Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Wael Al Jaroudi
- Division of Cardiovascular Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Nathan Better
- Department of Nuclear Medicine and Cardiology, Royal Melbourne Hospital and University of Melbourne, Melbourne, Australia
| | - Rami Doukky
- Division of Cardiology, Cook County Health and Hospitals System, Chicago, IL, USA
| | - W Lane Duvall
- Heart and Vascular Institute, Hartford Hospital, Hartford, CT, USA
| | - Saurabh Malhotra
- Division of Cardiology, Cook County Health and Hospitals System, Chicago, IL, USA
| | | | - Amalia Peix
- Nuclear Medicine Department, Institute of Cardiology and Cardiovascular Surgery, La Habana, Cuba
| | - Eliana Reyes
- Nuclear Medicine Department, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Ibrahim M Saeed
- Virginia Heart, Falls Church, VA, USA
- INOVA Heart and Vascular Institute, Falls Church, VA, USA
- University of Missouri, Kansas City, MO, USA
| | - Rupa M Sanghani
- Division of Cardiology, Department of Medicine, Rush University Medical Center, Chicago, IL, USA
| | | | - Randall C Thompson
- Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Vikas Veeranna
- Division of Cardiology, Department of Medicine, New England Heart and Vascular Institute, Manchester, NH, USA
| | - Kim A Williams
- Department of Medicine, University of Louisville Department of Medicine, Louisville, KY, USA
| | - David E Winchester
- Malcom Randall VA Medical Center, Gainesville, FL, USA
- Division of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, FL, USA
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5
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Milà López M, Jiménez Heffernan A, Sánchez de Mora E, Fierro Alanis MP. [Nuclear Cardiology in the COVID-19 pandemic]. Rev Esp Med Nucl Imagen Mol 2023; 42:106-112. [PMID: 36683949 PMCID: PMC9841071 DOI: 10.1016/j.remn.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 01/08/2023] [Indexed: 01/18/2023]
Abstract
SARS-CoV-2 infection has a very important relationship with cardiovascular disease. Since the beginning of the pandemic, a close relationship has been observed between cardiovascular comorbidity and a worse prognosis in COVID-19 patients. The study of the pathophysiology of SARS-CoV-2 infection and cardiovascular disease suggests several concomitant hypotheses: direct myocardial damage by the virus, hypoxemia secondary to respiratory failure, inflammatory response to infection and/or thromboembolic phenomena. Cardiovascular damage can manifest in the acute phase of infection with acute myocardial infarction, myocarditis, arrhythmias..., during this phase Nuclear Cardiology procedures have not played a determining role in the diagnosis and management of these patients. On the other hand, in the subacute phase of the infection and in the post-acute COVID syndrome, Nuclear Cardiology seems to shed light on what happens in the cardiovascular system in this phase of the disease.The COVID-19 pandemic has represented a great challenge for health systems, with a significant reduction in non-urgent diagnostic procedures with the aim of reducing the risk of transmission to patients and health personnel. Nuclear Cardiology has not been an exception. In addition to the prioritization of urgent/non-deferrable procedures and general screening, hygiene and distance measures, the main organizations and scientific societies of Nuclear Medicine and Nuclear Cardiology released recommendations and guidelines for safe practice, introducing significant changes in myocardial perfusion SPECT protocols.
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Affiliation(s)
- M Milà López
- Servicio de Medicina Nuclear IDI, Hospital Universitario de Tarragona Joan XXIII, Tarragona, España
| | - A Jiménez Heffernan
- Servicio de Medicina Nuclear, Hospital Universitario Juan Ramón Jiménez, Huelva, España
| | - E Sánchez de Mora
- Servicio de Medicina Nuclear, Hospital Universitario Juan Ramón Jiménez, Huelva, España
| | - M P Fierro Alanis
- Servicio de Medicina Nuclear IDI, Hospital Universitario de Tarragona Joan XXIII, Tarragona, España
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6
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Milà López M, Jiménez Heffernan A, Sánchez de Mora E, Fierro Alanis MP. Nuclear Cardiology in the COVID-19 pandemic. Rev Esp Med Nucl Imagen Mol 2023; 42:106-112. [PMID: 36681148 PMCID: PMC9847316 DOI: 10.1016/j.remnie.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 01/08/2023] [Indexed: 01/19/2023]
Abstract
SARS-CoV-2 infection has a very important relationship with cardiovascular disease. Since the beginning of the pandemic, a close relationship has been observed between cardiovascular comorbidity and a worse prognosis in COVID-19 patients. The study of the pathophysiology of SARS-CoV-2 infection and cardiovascular disease suggests several concomitant hypotheses: direct myocardial damage by the virus, hypoxemia secondary to respiratory failure, inflammatory response to infection and/or thromboembolic phenomena. Cardiovascular damage can manifest in the acute phase of infection with acute myocardial infarction, myocarditis, arrhythmias…, during this phase Nuclear Cardiology procedures have not played a determining role in the diagnosis and management of these patients. On the other hand, in the subacute phase of the infection and in the post-acute COVID syndrome, Nuclear Cardiology seems to shed light on what happens in the cardiovascular system in this phase of the disease. The COVID-19 pandemic has represented a great challenge for health systems, with a significant reduction in non-urgent diagnostic procedures with the aim of reducing the risk of transmission to patients and health personnel. Nuclear Cardiology has not been an exception. In addition to the prioritization of urgent/non-deferrable procedures and general screening, hygiene and distance measures, the main organizations and scientific societies of Nuclear Medicine and Nuclear Cardiology released recommendations and guidelines for safe practice, introducing significant changes in myocardial perfusion SPECT protocols.
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Affiliation(s)
- Marta Milà López
- Servicio de Medicina Nuclear IDI, Hospital Universitario de Tarragona Joan XXIII, Tarragona, Spain.
| | | | - Elena Sánchez de Mora
- Servicio de Medicina Nuclear, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain
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7
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Myocardial perfusion imaging in the era of COVID-19: a systematic review. Clin Transl Imaging 2022; 11:165-197. [PMID: 36536657 PMCID: PMC9750842 DOI: 10.1007/s40336-022-00531-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/04/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE As COVID-19 was uncovered, it became evident that specific individuals could experience multi-organ complications for quite a while after infection. Among them, there were several cardiovascular complications. Myocardial perfusion imaging single photon emission computed tomography (MPI SPECT) can be utilized to detect and evaluate cardiac problems regardless of whether COVID caused them. By examining all publications relevant to the impacts of the pandemic on SPECT MPI imaging, we aimed to understand how the COVID pandemic affected different aspects of the MPI, how intense these effects were, and what the consequences were. METHOD On the 6th of June, 2022, a four-domain search strategy was developed and implemented by searching the following databases: PubMed, SCOPUS, EMBASE, Web of Science, and the Cochrane Central Register of Controlled Trials. The retrieved records have been put through two levels of screening. The search for forward and backward citations provided more results. RESULTS This study contained 32 papers, divided into the following three categories: 1. Case reports and series; 2. A comparison of the number of MPIs conducted before and after the pandemic; and 3. SPECT MPI findings. CONCLUSION We observed through the article review that CT scans performed in combination with MPI are crucial and should be interpreted within the context of COVID, especially during outbreaks. Moreover, we discovered that in the initial months of the pandemic, the number of SPECT MPIs performed globally decreased, with the fall being more significant in some countries, primarily in low- to middle-income regions. Lastly, we found that individuals with a history of COVID-19 may be more prone to having MPIs that demonstrate abnormalities, such as ischemia.
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8
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Jaroonvanichkul V, Leksuwankun S, Vachatimanont S. Simulated daily readout for maintaining nuclear medicine education in residency training amidst declining case volume: evidence from the COVID-19 pandemic. Nucl Med Commun 2022; 43:1136-1142. [PMID: 36164718 DOI: 10.1097/mnm.0000000000001617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Simulated daily readout (SDR) is a teaching initiative in radiology and nuclear medicine developed to simulate a resident's experience during periods of case volume reduction. SDR was employed by many training centers during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to evaluate the perception of radiology residents on the effectiveness of SDR. METHOD The SDR was conducted in the nuclear medicine rotations from 2019 to 2020 during the shutdown of the radionuclide imaging facilities using a combination of strategies including case selection, assignment, reporting and feedback. A brief 8-item questionnaire with Likert scale values was completed by radiology residents who participated in the SDR-based nuclear medicine rotations. RESULTS Thirty-five of 54 residents returned the questionnaire. The majority of residents affirmed the negative impact of the reduction in case volume on their training experiences and perceived that SDR could alleviate the effects. The SDR strategies perceived as more effective were targeted case selection, in-advanced assignment, verbal interpretation and reporting, and verbal feedback. CONCLUSION The radiology residents perceived the SDR as an effective tool to preserve their training experiences. The SDR has the potential to be a useful initiative when teaching centers face the threat of declining case volume.
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Affiliation(s)
| | | | - Sira Vachatimanont
- Division of Nuclear Medicine, Department of Radiology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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9
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Minamimoto R. Oncology and cardiology positron emission tomography/computed tomography faced with COVID-19: A review of available literature data. Front Med (Lausanne) 2022; 9:1052921. [DOI: 10.3389/fmed.2022.1052921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 10/07/2022] [Indexed: 01/18/2023] Open
Abstract
The COVID-19 pandemic has forced people to significantly change their lifestyles and attitudes, and has greatly burdened healthcare delivery systems worldwide. The redistribution of the medical delivery system to maintain normal medical care while responding generously to COVID-19 is a continuing challenge that weighs heavily on medical institutions. Among imaging modalities, chest X-rays and computed tomography (CT) examinations have clearly made a large contribution to treatment of COVID-19. In contrast, it is difficult to express the standpoint of nuclear medicine examinations in a straightforward manner, as the greatest emphasis in this modality has been on how necessary medical care can continue to be provided. Many clinical reports of nuclear medicine examinations related to COVID-19 have been published, and knowledge continues to accumulate. This review provides a summary of the current state of oncology and cardiology positron emission tomography (PET) examinations related to COVID-19, and includes preparation of the nuclear medicine department, trends in PET examinations, specific imaging findings on 18F-fluorodeoxyglucose (FDG) PET/CT, imaging of complications of COVID-19, PET tracers other than FDG, and the effects of vaccines on PET imaging findings.
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10
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Paez D, Marengo M, Bomanji J, Dondi M. Quality improvement initiative of the IAEA in nuclear medicine: a tool to assess staffing needs within the QUANUM framework. Nucl Med Commun 2022; 43:967-969. [PMID: 35582856 PMCID: PMC9371058 DOI: 10.1097/mnm.0000000000001584] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 04/04/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Diana Paez
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Application, International Atomic Energy Agency, Vienna, Austria
| | - Mario Marengo
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy
| | - Jamshed Bomanji
- Institute of Nuclear Medicine, University College London Hospital, London, UK
| | - Maurizio Dondi
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Application, International Atomic Energy Agency, Vienna, Austria
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11
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O' Doherty J, O' Doherty S, Abreu C, Aguiar A, Reilhac A, Robins E. Evolving operational guidance and experiences for radiology and nuclear medicine facilities in response to and beyond the COVID-19 pandemic. Br J Radiol 2022; 95:20200511. [PMID: 35930772 PMCID: PMC9815748 DOI: 10.1259/bjr.20200511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/07/2020] [Accepted: 08/13/2020] [Indexed: 01/13/2023] Open
Abstract
The resulting pandemic from the novel severe acute respiratory coronavirus 2, SARS-CoV-2 (COVID-19), continues to exert a strain on worldwide health services due to the incidence of hospitalization and mortality associated with infection. The aim of clinical services throughout the period of the pandemic and likely beyond to endemic infections as the situation stabilizes is to enhance safety aspects to mitigate transmission of COVID-19 while providing a high quality of service to all patients (COVID-19 positive and negative) while still upholding excellent medical standards. In order to achieve this, new strategies of clinical service operation are essential. Researchers have published peer-reviewed reference materials such as guidelines, experiences and advice to manage the resulting issues from the unpredictable challenges presented by the pandemic. There is a range of international guidance also from professional medical organizations, including best practice and advice in order to help imaging facilities adjust their standard operating procedures and workflows in line with infection control principles. This work provides a broad review of the main sources of advice and guidelines for radiology and nuclear medicine facilities during the pandemic, and also of rapidly emerging advice and local/national experiences as facilities begin to resume previously canceled non-urgent services as well as effects on imaging research.
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Affiliation(s)
- Jim O' Doherty
- Clinical Imaging Research Centre, National University of, Singapore 117599, Singapore
| | - Sophie O' Doherty
- Clinical Imaging Research Centre, National University of, Singapore 117599, Singapore
| | | | - Ana Aguiar
- Department of Nuclear Medicine and PET, Royal Marsden NHS Foundation Trust, SM2 5PT, Sutton, UK
| | - Anthonin Reilhac
- Clinical Imaging Research Centre, National University of, Singapore 117599, Singapore
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12
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Martini AL, Carli G, Kiferle L, Piersanti P, Palumbo P, Morbelli S, Calcagni ML, Perani D, Sestini S. Time-dependent recovery of brain hypometabolism in neuro-COVID-19 patients. Eur J Nucl Med Mol Imaging 2022; 50:90-102. [PMID: 35984451 PMCID: PMC9388976 DOI: 10.1007/s00259-022-05942-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/08/2022] [Indexed: 12/30/2022]
Abstract
Purpose We evaluated brain metabolic dysfunctions and associations with neurological and biological parameters in acute, subacute and chronic COVID-19 phases to provide deeper insights into the pathophysiology of the disease. Methods Twenty-six patients with neurological symptoms (neuro-COVID-19) and [18F]FDG-PET were included. Seven patients were acute (< 1 month (m) after onset), 12 subacute (4 ≥ 1-m, 4 ≥ 2-m and 4 ≥ 3-m) and 7 with neuro-post-COVID-19 (3 ≥ 5-m and 4 ≥ 7–9-m). One patient was evaluated longitudinally (acute and 5-m). Brain hypo- and hypermetabolism were analysed at single-subject and group levels. Correlations between severity/extent of brain hypo- and hypermetabolism and biological (oxygen saturation and C-reactive protein) and clinical variables (global cognition and Body Mass Index) were assessed. Results The “fronto-insular cortex” emerged as the hypometabolic hallmark of neuro-COVID-19. Acute patients showed the most severe hypometabolism affecting several cortical regions. Three-m and 5-m patients showed a progressive reduction of hypometabolism, with limited frontal clusters. After 7–9 months, no brain hypometabolism was detected. The patient evaluated longitudinally showed a diffuse brain hypometabolism in the acute phase, almost recovered after 5 months. Brain hypometabolism correlated with cognitive dysfunction, low blood saturation and high inflammatory status. Hypermetabolism in the brainstem, cerebellum, hippocampus and amygdala persisted over time and correlated with inflammation status. Conclusion Synergistic effects of systemic virus-mediated inflammation and transient hypoxia yield a dysfunction of the fronto-insular cortex, a signature of CNS involvement in neuro-COVID-19. This brain dysfunction is likely to be transient and almost reversible. The long-lasting brain hypermetabolism seems to reflect persistent inflammation processes. Supplementary Information The online version contains supplementary material available at 10.1007/s00259-022-05942-2.
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Affiliation(s)
- Anna Lisa Martini
- Nuclear Medicine Unit, Department of Diagnostic Imaging, N.O.P. - S. Stefano, U.S.L. Toscana Centro, Prato, Italy
| | - Giulia Carli
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Lorenzo Kiferle
- Neurology Unit, N.O.P. - S. Stefano, U.S.L. Toscana Centro, Prato, Italy
| | - Patrizia Piersanti
- Neurology Unit, N.O.P. - S. Stefano, U.S.L. Toscana Centro, Prato, Italy
| | - Pasquale Palumbo
- Neurology Unit, N.O.P. - S. Stefano, U.S.L. Toscana Centro, Prato, Italy
| | - Silvia Morbelli
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | - Daniela Perani
- School of Psychology, Vita-Salute San Raffaele University, Milan, Italy.,In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Nuclear Medicine Unit, San Raffaele Hospital, Milan, Italy
| | - Stelvio Sestini
- Nuclear Medicine Unit, Department of Diagnostic Imaging, N.O.P. - S. Stefano, U.S.L. Toscana Centro, Prato, Italy.
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13
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Thompson RC, Phillips LM, Dilsizian V, Gutierrez DP, Einstein AJ, Crews SF, Skali H, Jih FKY, Dondi M, Gimelli A, Bateman TM, Al-Mallah MH, Ghesani M, Dorbala S, Calnon DA. Update on guidance and best practices for nuclear cardiology laboratories during the coronavirus disease 2019 (COVID-19) pandemic: Emphasis on transition to chronic endemic state. An information statement from ASNC, IAEA, and SNMMI. J Nucl Cardiol 2022; 29:2013-2018. [PMID: 35499661 PMCID: PMC9059683 DOI: 10.1007/s12350-022-02984-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 04/18/2022] [Indexed: 02/06/2023]
Affiliation(s)
- Randall C Thompson
- Department of Cardiology, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO, USA.
- American Society of Nuclear Cardiology (ASNC), Fairfax, VA, USA.
| | - Lawrence M Phillips
- Division of Cardiology, NYU Langone Medical Center, New York, NY, USA
- American Society of Nuclear Cardiology (ASNC), Fairfax, VA, USA
| | - Vasken Dilsizian
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- Society of Nuclear Medicine and Molecular Imaging (SNMMI), Reston, VA, USA
| | - Diana Paez Gutierrez
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
- International Atomic Energy Agency (IAEA), Vienna, Austria
| | - Andrew J Einstein
- Seymour, Paul, and Gloria Milstein Division of Cardiology, Department of Medicine, and Department of Radiology, Columbia University Irving Medical Center and NewYork-Presbyterian Hospital, New York, NY, USA
- American Society of Nuclear Cardiology (ASNC), Fairfax, VA, USA
| | - Suzanne F Crews
- Nuclear Cardiology, Northeast Georgia Health System, Gainesville, GA, USA
- American Society of Nuclear Cardiology (ASNC), Fairfax, VA, USA
| | - Hicham Skali
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Cardiovascular Division, Department of Medicine. Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- American Society of Nuclear Cardiology (ASNC), Fairfax, VA, USA
| | - Felix Keng Yung Jih
- National Heart Centre, Singapore, Singapore
- American Society of Nuclear Cardiology (ASNC), Fairfax, VA, USA
| | - Maurizio Dondi
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
- International Atomic Energy Agency (IAEA), Vienna, Austria
| | - Alessia Gimelli
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
- American Society of Nuclear Cardiology (ASNC), Fairfax, VA, USA
| | - Timothy M Bateman
- Department of Cardiology, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO, USA
- Society of Nuclear Medicine and Molecular Imaging (SNMMI), Reston, VA, USA
| | - Mouaz H Al-Mallah
- Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA
- American Society of Nuclear Cardiology (ASNC), Fairfax, VA, USA
| | - Munir Ghesani
- Icahn School of Medicine, Mount Sinai Hospital, New York, NY, USA
- Society of Nuclear Medicine and Molecular Imaging (SNMMI), Reston, VA, USA
| | - Sharmila Dorbala
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Cardiovascular Division, Department of Medicine. Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- American Society of Nuclear Cardiology (ASNC), Fairfax, VA, USA
| | - Dennis A Calnon
- OhioHealth Heart and Vascular Physicians, Columbus, OH, USA
- American Society of Nuclear Cardiology (ASNC), Fairfax, VA, USA
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14
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Minamimoto R, Hotta M, Okafuji T, Tsutui S, Tsukuda M, Nakayama H, Shida Y, Tajima T. Change in cancer diagnosis during the COVID-19 pandemic: Trends estimated from FDG-PET/CT. Glob Health Med 2022; 4:108-115. [PMID: 35586769 PMCID: PMC9066465 DOI: 10.35772/ghm.2022.01016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/22/2022] [Accepted: 03/28/2022] [Indexed: 04/29/2023]
Abstract
The aim of this study is to clarify changes in the circumstances of cancer diagnoses during the COVID-19 pandemic in Tokyo, Japan, estimated from [18F]-2-fluoro-2-deoxy-D-glucose (FDG) -positron emission tomography/ computed tomography (PET/CT) for cancer patients. Cancer diagnosis in pandemic status (PANS) was evaluated by retrospective review of the findings of FDG-PET/CT examinations performed between 11 March 2020 and 28 December 2021 for initial staging and restaging for malignancy. Evaluation of cancer diagnosis in pre-pandemic status (pPANS) was conducted similarly in FDG-PET/CT examinations performed between 4 January 2018 and 10 March 2020. Of these, patients with malignant lymphoma (ML), lung cancer, esophageal cancer, and colorectal cancer who had a pathologically proven diagnosis or clinical diagnosis following therapy of the disease were selected for analysis. Initial cancer staging was determined by the diagnostic report of FDG-PET/CT. Change in cancer stage and in the number of FDG-PET/CT examinations performed was evaluated between pPANS and PANS, and according to term of the pandemic and vaccination status. The COVID-19 epidemic influenced the number of cancer patients who underwent FDG-PET/CT. There was a marked decrease in the number of cancer patients receiving FDG-PET/CT in Terms 1-3 (March 2020 to February 2021), but it recovered in Terms 4-6 (March 2021 to December 2021). There was no significant difference between PANS and pPANS in terms of the initial stage of cancer, but Stage IV ML and Stage II esophageal cancer were more frequent in PANS. Initial staging of ML, lung cancer, and esophageal cancer revealed more advanced cancer stages in Terms 4-6 compared with Terms 1-3. The number of patients receiving FDG-PET/CT in Tokyo was influenced by the COVID-19 epidemic. Staging based on FDG-PET/CT shifted to more advanced cancer stage during the pandemic compared with pre-pandemic.
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Affiliation(s)
- Ryogo Minamimoto
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
- Address correspondence to:Ryogo Minamimoto, Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjyuku-ku, Tokyo 162-8655, Japan. E-mail:
| | - Masatoshi Hotta
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takashi Okafuji
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Soichiro Tsutui
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masaaki Tsukuda
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hidetsugu Nakayama
- Department of Radiation Oncology, National Cancer Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshitaka Shida
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tsuyoshi Tajima
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
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15
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[18F]FDG PET/CT in Short-Term Complications of COVID-19: Metabolic Markers of Persistent Inflammation and Impaired Respiratory Function. Diagnostics (Basel) 2022; 12:diagnostics12040835. [PMID: 35453883 PMCID: PMC9025979 DOI: 10.3390/diagnostics12040835] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 01/01/2023] Open
Abstract
SARS-CoV-2 virus infects organs other than the lung, such as mediastinal lymph nodes, spleen, and liver, but, to date, metabolic imaging studies obtained in short-term follow-ups of patients hospitalized with severe COVID-19 infection are rare. Our objective was to evaluate the usefulness of [18F]FDG-PET/CT in the short-term follow-up of patients admitted for COVID-19 pneumonia and to explore the association of the findings with clinical prognostic markers. The prospective study included 20 patients with COVID-19 pneumonia (November 2020–March 2021). Clinical and laboratory test findings were gathered at admission, 48–72 h post-admission, and 2–3 months post-discharge, when [18F]FDG-PET/CT and respiratory function tests were performed. Lung volumes, spirometry, lung diffusion capacity for carbon monoxide (DLCO), and respiratory muscle strength were measured. Volumetric [18F]FDG-PET/CT results were correlated with laboratory and respiratory parameters. Eleven [18F]FDG-PET/CT (55%) were positive, with hypermetabolic mediastinal lymphadenopathy in 90.9%. Mediastinal lesion’s SUVpeak was correlated with white cells’ count. Eleven (55%) patients had impaired respiratory function, including reduced DLCO (35%). SUVpeak was correlated with %predicted-DLCO. TLG was negatively correlated with %predicted-DLCO and TLC. In the short-term follow-up of patients hospitalized for COVID-19 pneumonia, [18F]FDG-PET/CT findings revealed significant detectable inflammation in lungs and mediastinal lymph nodes that correlated with pulmonary function impairment in more than half of the patients.
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16
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Abstract
Coronavirus disease 2019 (COVID-19) was first detected in China in late 2019 and rapidly spread to nearby Asian countries in early 2020. Outbreaks occurred differently in each country and affected nuclear medicine (NM) practice significantly even before the COVID-19 pandemic. The Asian NM community has worked together from the beginning of the pandemic. Fortunately, the Asian Regional Cooperative Council for Nuclear Medicine annual general meeting and Asia Nuclear Medicine Board examination was held in Manila from January 28 to February 2, 2020; these were the last face-to-face events of these organizations to date. Members shared information about COVID-19 at the conference, and through online means afterwards. Web-based surveys performed from March to April 2020 for the Asian Regional Cooperative Council for Nuclear Medicine and Asia Nuclear Medicine Board communities showed a significant reduction of NM practice and supply of radioisotopes (RI) at the beginning of the COVID-19 pandemic. A follow-up survey in March to April 2021 clearly showed the recovery of both NM practice and RI supplies. The pattern of recovery is variable according to institutions and countries. Herein, we have reported the case-in-point operational histories of four representative institutions in the East, Southeast, South, and West Asia. The second outbreak in India is ongoing on a worrisome scale. Various communications and educational sessions were actively performed online in the Asian NM community during the pandemic.
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Affiliation(s)
- Hee-Seung Henry Bom
- Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Hwasun, South Korea,Address reprint requests to: Hee-Seung Henry Bom, MD, PhD, FANMB, HFPSNM, Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, 322 Seoyangro, Hwasun, Jeonnam 58128, South Korea
| | - Thomas NB Pascual
- Philippine Nuclear Research Institute, Department of Science and Technology, Republic of the Philippines
| | - Partha S. Choudhury
- Department of Nuclear Medicine, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Akram Al-Ibraheem
- Department of Nuclear Medicine, King Hussein Cancer Center, Amman, Jordan
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17
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Padmanabhan A, Neeloth N, Rijju G. Positron-emission tomography–computed tomography appearance of COVID-19 infection. Lung India 2022; 39:199-200. [PMID: 35259806 PMCID: PMC9053932 DOI: 10.4103/lungindia.lungindia_471_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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18
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Paez D, Mikhail-Lette M, Gnanasegaran G, Dondi M, Estrada-Lobato E, Bomanji J, Vinjamuri S, El-Haj N, Morozova O, Alonso O, Pellet O, Orellana P, Navarro MC, Delgado Bolton RC, Giammarile F. Nuclear Medicine Departments in the Era of COVID-19. Semin Nucl Med 2022; 52:41-47. [PMID: 34243905 PMCID: PMC8216881 DOI: 10.1053/j.semnuclmed.2021.06.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
From the outset of the COVID-19 pandemic we, the nuclear medicine (NM) community, expediently mobilized to enable continuity of essential services to the best of our abilities. For example, we effectuated adapted guidelines for NM standard operating procedures (SOPs) and enacted heightened infection protection measures for staff, patients, and the public, alike. Challenges in radionuclide supply chains were identified and often met. NM procedural volumes declined globally and underwent restoration of varying degrees, contingent upon local contexts. Serial surveys have gauged and chronicled such geographical variance of the impact of COVID-19 on NM service delivery and, though it may be too early to fully understand the long-term consequences of reduced NM services, overall, we can certainly expect that this era adversely affected the management of many patients afflicted with non-communicable diseases. Today we are unquestionably better prepared to face unforeseen outbreaks, but a degree of uncertainty lingers. Which lessons learned will endure in the form of permanent NM pandemic preparedness procedures and protocols? In this spirit, the present manuscript presents a revision of prior recommendations issued mid-pandemic to NM centers, some of which may become mainstays in NM service delivery and implementation. Discussed herein are (1) comparative worldwide survey results of the measurable impact of COVID-19 on the practice of nuclear medicine (2) the definitions of a pandemic and its phases (3) relevant, recently developed or updated guidelines specific to nuclear medicine (4) incidental findings of COVID-19 on hybrid nuclear medicine studies performed primarily for oncologic indications and (5) how pertinent pedagogical methods for medical education, research, and development have been re-invented in a suddenly more virtual world. NM professionals shall indefinitely adopt many of the measures implemented during this pandemic, to enable continuity of essential services while preventing the spread of the virus. Which ones? Practices must remain ready for possible new peaks or variants of the roiling COVID-19 contagion and for the emergence of potential new pathogens that may incite future outbreaks or pandemics. Communications technologies are here to stay and will continue to be used in a broad spectrum of applications, from telemedicine to education, but how best? NM departments must align synergistically with these trends, considering what adaptations to a more virtual professional environment should not only last but be further innovated. The paper aims to provide recent history, analysis, and a springboard for continued constructive dialogue. To best navigate the future, NM must continue to learn from this crisis and must continue to bring new questions, evidence, ideas, and warranted systematic updates to the figurative table.
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Affiliation(s)
- Diana Paez
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria,Address reprint requests to: Diana Paez, Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, PO Box 100, 1400 Vienna, Austria
| | - Miriam Mikhail-Lette
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | | | - Maurizio Dondi
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Enrique Estrada-Lobato
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Jamshed Bomanji
- Institute of Nuclear Medicine, University College London Hospital, London, United Kingdom
| | | | - Noura El-Haj
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Olga Morozova
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Omar Alonso
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Olivier Pellet
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Pilar Orellana
- Department of Nuclear Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Maria C. Navarro
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Roberto C. Delgado Bolton
- Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja (CIBIR), Logroño, La Rioja, Spain
| | - Francesco Giammarile
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
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19
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Kirienko M, Telo S, Hustinx R, Bomanji JB, Chiti A, Fanti S. The Impact of COVID-19 on Nuclear Medicine in Europe. Semin Nucl Med 2022; 52:17-24. [PMID: 34325819 PMCID: PMC8245351 DOI: 10.1053/j.semnuclmed.2021.06.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The COVID-19 pandemic has profoundly changed hospital activities, including nuclear medicine (NM) practice. This review aimed to determine and describe the impact of COVID-19 on NM in Europe and critically discuss actions and strategies applied to face the pandemic. A literature search for relevant articles was performed on PubMed, covering COVID-19 studies published up until January 21, 2021. The findings were summarized according to general and specific activities within the NM departments. The pandemic strongly challenged NM departments: a reduction in the workforce has been experienced in almost every center in Europe due to personnel diagnosed with COVID-19 and other reasons related to the coronavirus. NM departments introduced procedures to limit COVID-19 transmission, including environmental and personal hygiene, social distancing, rescheduling of non-high-priority procedures, the correct use of personal protective equipment, and prompt identification of suspect COVID-19 cases. A proportion of the departments experienced a delay in radiopharmaceuticals supply or technical assistance during the pandemic. Furthermore, the pandemic resulted in a significant reduction of diagnostic and therapeutic NM procedures, as well as a reduced level of care for patients affected by diseases other than COVID-19, such as cancer or acute cardiovascular disease. Telemedicine services have been set up to maintain medical assistance for patients. COVID-19 pandemic has reshaped human work resources, patient's diagnostic and therapeutic management, operative models, radiopharmaceutical supplies, teaching, training and research of NM departments. Limits of availability of resources emerged. Nonetheless, we have to provide continuity in care, especially for fragile patients, maintaining infection control measures. Challenges that have been faced should reshape our vision and get us prepared for the future.
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Affiliation(s)
- Margarita Kirienko
- Nuclear Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Silvi Telo
- Nuclear Medicine, DIMES, Alma Mater Studiorum University of Bologna, Bologna, Italy,Address reprint requests to Silvi Telo
| | | | | | - Arturo Chiti
- Department of Biomedical Sciences, Humanitas University, Milan, Italy,IRCCS Humanitas Research Hospital, Milan, Italy
| | - Stefano Fanti
- Nuclear Medicine, DIMES, Alma Mater Studiorum University of Bologna, Bologna, Italy,IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
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20
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Zamora E, Moadel RM, Song N, Zuckier LS. Remote Reading and Teaching of Nuclear Medicine in the Era of COVID-19. Semin Nucl Med 2022; 52:71-78. [PMID: 34301376 PMCID: PMC8293558 DOI: 10.1053/j.semnuclmed.2021.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Community SARS-CoV-2 has profoundly affected traditional elements of learning and teaching in nuclear medicine and diagnostic radiology departments. The response of the nuclear medicine community to the challenges imposed by the COVID-19 pandemic can be described in 3 phases: accommodation, consolidation and optimization, and a return towards normalcy. Adoption of virtual communication platforms has emerged as the crucial interim tool for preservation of trainee supervision and diagnostic imaging education. Development of supplemental teaching materials, refocusing research interests, and relaxation of requirements have all contributed toward stabilization of the residency programs. As we embark on a gradual return to normalcy, many of the virtual solutions that were employed have gained a degree of enduring popularity and may find a place in the postpandemic period.
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Affiliation(s)
| | | | | | - Lionel S. Zuckier
- Address reprint requests to Lionel S. Zuckier, MD, MBA, Division of Nuclear Medicine, Department of Radiology, Montefiore Medical Center, Bronx, NY 10467
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21
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Giammarile F, Delgado Bolton RC, El-Haj N, Mikhail M, Morozova O, Orellana P, Pellet O, Estrada Lobato E, Pynda Y, Paez D. Impact of COVID-19 on Nuclear Medicine Departments in Africa and Latin America. Semin Nucl Med 2022; 52:31-40. [PMID: 34243907 PMCID: PMC8639221 DOI: 10.1053/j.semnuclmed.2021.06.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The International Atomic Energy Agency (IAEA) conducted a survey to determine the impact of the COVID-19 pandemic on nuclear medicine services worldwide at two specific time-points: June and October 2020. In this paper, we describe the impact of COVID-19 on nuclear medicine departments in Africa (19 countries, 41 centers) and Latin America (15 countries, 83 centers) obtained from the survey. Respectively in Africa and Latin America, the volume of nuclear medicine procedures decreased by 69% and 79% in June 2020 and 44% and 67% in October 2020. Among the nuclear medicine procedures, oncological PET studies showed less of a decline in utilization compared to conventional nuclear medicine studies. A gradual trend towards a return to the pre-COVID-19 status of the supply chains of radioisotopes, generators, and other essential materials was evident. Overall, in 2020, the pandemic-related challenges resulted in significant decrease in nuclear medicine diagnostic and therapeutic procedures in Africa and Latin America. The impact was more pronounced in Latin America than in Africa. The current COVID-19 pandemic poses many challenges for the practice of nuclear medicine. If adequately prepared, departments can continue to deliver their essential services, while mitigating the risk for patients and staff. This requires adapting the SOPs, as quickly as possible, to meet the new requirements.
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Key Words
- covid-19, coronavirus disease 2019
- cnm, conventional nuclear medicine
- hic, high-income countries
- iaea, international atomic energy agency
- ipc, infection prevention and control
- iris, international research integration system
- lic, low-income countries
- lmic, lower-middle-income countries
- pet, positron emission tomography
- ppe, personal protective equipment
- umic, upper-middle-income countries
- who, world health organisation
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Affiliation(s)
- Francesco Giammarile
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria,Address reprint requests to Francesco Giammarile,PhD, MD, Nuclear Medicine and Diagnostic Imaging Section, International Atomic Energy Agency, Vienna, Austria
| | - Roberto C. Delgado Bolton
- Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja (CIBIR), Logroño, La Rioja, Spain
| | - Noura El-Haj
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Miriam Mikhail
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Olga Morozova
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Pilar Orellana
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Olivier Pellet
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | | | - Yaroslav Pynda
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Diana Paez
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
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22
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Maincent C, Perrin C, Chironi G, Baqué-Juston M, Berthier F, Paulmier B, Hugonnet F, Dittlot C, Farhad RL, Renvoise J, Serrano B, Nataf V, Mocquot F, Keita-Perse O, Claessens YE, Faraggi M. Microvascular injuries, secondary edema, and inconsistencies in lung vascularization between affected and nonaffected pulmonary segments of non-critically ill hospitalized COVID-19 patients presenting with clinical deterioration. Ther Adv Respir Dis 2022; 16:17534666221096040. [PMID: 35485327 PMCID: PMC9058452 DOI: 10.1177/17534666221096040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose: We aimed to better understand the pathophysiology of SARS-CoV-2 pneumonia in non-critically ill hospitalized patients secondarily presenting with clinical deterioration and increase in oxygen requirement without any identified worsening factors. Methods: We consecutively enrolled patients without clinical or biological evidence for superinfection, without left ventricular dysfunction and for whom a pulmonary embolism was discarded by computed tomography (CT) pulmonary angiography. We investigated lung ventilation and perfusion (LVP) by LVP scintigraphy, and, 24 h later, left and right ventricular function by Tc-99m-labeled albumin-gated blood-pool scintigraphy with late (60 mn) tomographic albumin images on the lungs to evaluate lung albumin retention that could indicate microvascular injuries with secondary edema. Results: We included 20 patients with confirmed SARS-CoV-2 pneumonia. All had CT evidence of organizing pneumonia and normal left ventricular ejection fraction. No patient demonstrated preserved ventilation with perfusion defect (mismatch), which may discard a distal lung thrombosis. Patterns of ventilation and perfusion were heterogeneous in seven patients (35%) with healthy lung segments presenting a relative paradoxical hypoperfusion and hypoventilation compared with segments with organizing pneumonia presenting a relative enhancement in perfusion and preserved ventilation. Lung albumin retention in area of organizing pneumonia was observed in 12 patients (60%), indicating microvascular injuries, increase in vessel permeability, and secondary edema. Conclusion: In hospitalized non-critically ill patients without evidence of superinfection, pulmonary embolism, or cardiac dysfunction, various types of damage may contribute to clinical deterioration including microvascular injuries and secondary edema, inconsistencies in lung segments vascularization suggesting a dysregulation of the balance in perfusion between segments affected by COVID-19 and others. Summary Statement Microvascular injuries and dysregulation of the balance in perfusion between segments affected by COVID-19 and others are present in non-critically ill patients without other known aggravating factors. Key Results In non-critically ill patients without evidence of superinfection, pulmonary embolism, macroscopic distal thrombosis or cardiac dysfunction, various types of damage may contribute to clinical deterioration including 1/ microvascular injuries and secondary edema, 2/ inconsistencies in lung segments vascularization with hypervascularization of consolidated segments contrasting with hypoperfusion of not affected segments, suggesting a dysregulation of the balance in perfusion between segments affected by COVID-19 and others.
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Affiliation(s)
- Cécile Maincent
- Pulmonary Department, Centre Hospitalier Princesse Grace, Monaco, Monaco
| | - Christophe Perrin
- Pulmonary Department, Centre Hospitalier Princesse Grace, Monaco, Monaco
| | - Gilles Chironi
- Check-up Unit, Centre Hospitalier Princesse Grace, Monaco, Monaco
| | - Marie Baqué-Juston
- Radiology Department, Centre Hospitalier Princesse Grace, Monaco, Monaco
| | - Frédéric Berthier
- Department of Biostatistics, Centre Hospitalier Princesse Grace, Monaco, Monaco
| | - Benoît Paulmier
- Nuclear Medicine Department, Centre Hospitalier Princesse Grace, Monaco, Monaco
| | - Florent Hugonnet
- Nuclear Medicine Department, Centre Hospitalier Princesse Grace, Monaco, Monaco
| | - Claire Dittlot
- Pulmonary Department, Centre Hospitalier Princesse Grace, Monaco, Monaco
| | - Ryan Lukas Farhad
- Pulmonary Department, Centre Hospitalier Princesse Grace, Monaco, Monaco
| | - Julien Renvoise
- Pulmonary Department, Centre Hospitalier Princesse Grace, Monaco, Monaco
| | - Benjamin Serrano
- Medical Physics Department, Centre Hospitalier Princesse Grace, Monaco, Monaco
| | - Valérie Nataf
- Nuclear Medicine Department, Centre Hospitalier Princesse Grace, Monaco, Monaco
| | - François Mocquot
- Nuclear Medicine Department, Centre Hospitalier Princesse Grace, Monaco, Monaco
| | - Olivia Keita-Perse
- Department of Infectious disease, Centre Hospitalier Princesse Grace, Monaco, Monaco
| | - Yann-Erik Claessens
- Department of Emergency Medicine, Centre Hospitalier Princesse Grace, Monaco, Monaco
| | - Marc Faraggi
- Nuclear Medicine Department, Centre Hospitalier Princesse Grace, Avenue Pasteur, BP 480, 98012 Monaco, Monaco
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23
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Giammarile F, Delgado Bolton RC, El-Haj N, Freudenberg LS, Herrmann K, Mikhail M, Morozova O, Orellana P, Pellet O, Estrada L E, Vinjamuri S, Gnanasegaran G, Pynda Y, Navarro-Marulanda MC, Choudhury PS, Paez D. Changes in the global impact of COVID-19 on nuclear medicine departments during 2020: an international follow-up survey. Eur J Nucl Med Mol Imaging 2021; 48:4318-4330. [PMID: 34148118 PMCID: PMC8214460 DOI: 10.1007/s00259-021-05444-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 05/31/2021] [Indexed: 12/14/2022]
Abstract
AIM As a follow-up to the international survey conducted by the International Atomic Energy Agency (IAEA) in April 2020, this survey aims to provide a situational snapshot of the COVID-19 impact on nuclear medicine services worldwide, 1 year later. The survey was designed to determine the impact of the pandemic at two specific time points: June and October 2020, and compare them to the previously collected data. MATERIALS AND METHODS A web-based questionnaire, in the same format as the April 2020 survey was disseminated to nuclear medicine facilities worldwide. Survey data was collected using a secure software platform hosted by the IAEA; it was made available for 6 weeks, from November 23 to December 31, 2020. RESULTS From 505 replies received from 96 countries, data was extracted from 355 questionnaires (of which 338 were fully completed). The responses came from centres across varying regions of the world and with heterogeneous income distributions. Regional differences and challenges across the world were identified and analysed. Globally, the volume of nuclear medicine procedures decreased by 73.3% in June 2020 and 56.9% in October 2020. Among the nuclear medicine procedures, oncological PET studies showed less of a decline in utilization compared to conventional nuclear medicine, particularly nuclear cardiology. The negative impact was also significantly less pronounced in high-income countries. A trend towards a gradual return to the pre-COVID-19 situation of the supply chains of radioisotopes, generators, and other essential materials was evident. CONCLUSION The year 2020 has a significant decrease in nuclear medicine diagnostic and therapeutic procedures as a result of the pandemic-related challenges. In June, the global decline recorded in the survey was greater than in October when the situation began to show improvement. However, the total number of procedures remained below those recorded in April 2020 and fell to less than half of the volumes normally carried out pre-pandemic.
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Affiliation(s)
- Francesco Giammarile
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, 1400, Vienna, Austria.
| | - Roberto C Delgado Bolton
- Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja (CIBIR), Logroño, La Rioja, Spain
| | - Noura El-Haj
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, 1400, Vienna, Austria
| | | | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen, Essen, Germany
| | - Miriam Mikhail
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, 1400, Vienna, Austria
| | - Olga Morozova
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, 1400, Vienna, Austria
| | - Pilar Orellana
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, 1400, Vienna, Austria
| | - Olivier Pellet
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, 1400, Vienna, Austria
| | - Enrique Estrada L
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, 1400, Vienna, Austria
| | - Sobhan Vinjamuri
- Nuclear Medicine Department, Liverpool University Hospitals, Liverpool, UK
| | | | - Yaroslav Pynda
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, 1400, Vienna, Austria
| | - Maria C Navarro-Marulanda
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, 1400, Vienna, Austria
| | - Partha S Choudhury
- Nuclear Medicine Department, Rajiv Gandhi Cancer Institute, Delhi, India
| | - Diana Paez
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, 1400, Vienna, Austria
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24
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Chhibber A, Kharat A, Kneale D, Welch V, Bangpan M, Chaiyakunapruk N. Assessment of health equity consideration in masking/PPE policies to contain COVID-19 using PROGRESS-plus framework: a systematic review. BMC Public Health 2021; 21:1682. [PMID: 34525995 PMCID: PMC8443429 DOI: 10.1186/s12889-021-11688-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/29/2021] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION There is increasing evidence that COVID-19 has unmasked the true magnitude of health inequity worldwide. Policies and guidance for containing the infection and reducing the COVID-19 related deaths have proven to be effective, however the extent to which health inequity factors were considered in these policies is rather unknown. The aim of this study is to measure the extent to which COVID-19 related policies reflect equity considerations by focusing on the global policy landscape around wearing masks and personal protection equipment (PPE). METHODS A systematic search for published documents on COVID-19 and masks/PPE was conducted across six databases: PubMed, EMBASE, CINAHL, ERIC, ASSIA and Psycinfo. Reviews, policy documents, briefs related to COVID-19 and masks/PPE were included in the review. To assess the extent of incorporation of equity in the policy documents, a guidance framework known as 'PROGRESS-Plus': Place of residence, Race/ethnicity, Occupation, Gender/sex, Religion, Education, Socioeconomic status, Social capital, Plus (age, disability etc.) was utilized. RESULTS This review included 212 policy documents. Out of 212 policy documents, 190 policy documents (89.62%) included at least one PROGRESS-plus component. Most of the policy documents (n = 163, 85.79%) focused on "occupation" component of the PROGRESS-plus followed by personal characteristics associated with discrimination (n = 4;2.11%), place of residence (n = 2;1.05%) and education (n = 1;0.53%). Subgroup analysis revealed that most of the policy documents (n = 176, 83.01%) were focused on "workers" such as healthcare workers, mortuary workers, school workers, transportation workers, essential workers etc. Of the remaining policy documents, most were targeted towards whole population (n = 30; 14.15%). Contrary to "worker focused" policy documents, most of the 'whole population focused' policy documents didn't have a PROGRESS-plus equity component rendering them equity limiting for the society. CONCLUSION Our review highlights even if policies considered health inequity during the design/implementation, this consideration was often one dimensional in nature. In addition, population wide policies should be carefully designed and implemented after identifying relevant equity related barriers in order to produce better outcomes for the whole society.
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Affiliation(s)
| | - Aditi Kharat
- School of Pharmacy, University of Utah, Salt Lake City, UT, USA
| | - Dylan Kneale
- The Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), UCL Social Research Institute, University College London, London, UK
| | - Vivian Welch
- Bruyere Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Mukdarut Bangpan
- The Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), UCL Social Research Institute, University College London, London, UK
| | - Nathorn Chaiyakunapruk
- School of Pharmacy, University of Utah, Salt Lake City, UT, USA.
- School of Pharmacy, Monash University, Subang Jaya, Malaysia.
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25
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Younis I, Longsheng C, Zulfiqar MI, Imran M, Shah SAA, Hussain M, Solangi YA. Regional disparities in Preventive measures of COVID-19 pandemic in China. A study from international students' prior knowledge, perception and vulnerabilities. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:40355-40370. [PMID: 33037960 PMCID: PMC7547302 DOI: 10.1007/s11356-020-10932-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 09/20/2020] [Indexed: 05/07/2023]
Abstract
The COVID-19 pandemic needs immediate solution before inflicting more devastation. So far, China has successfully controlled transmission of COVID-19 through implementing stringent preventive measures. In this study, we analyze the effectiveness of preventive measures taken in thirteen regions of China based on the feedback provided by 1135 international students studying in China. The study uses factor analysis combined with varimax rotation of variables. It was found that awareness raising and dispersing actionable knowledge regarding trust and adapting measures remained significantly important. Therefore, recognition of information gaps, improvements in the level of alertness, and development of preventive measures in each sector are imperative. The findings of this study revealed that trust, students' health, waste disposal, and the efforts of the Chinese government/international institute of education to prevent this pandemic were significantly and positively associated with preventive measures. The results showed that prior knowledge, global pandemics, and food and grocery purchases were firmly related to the preventive measures of COVID-19. Moreover, anxiety, transportation, and economic status were negatively related to the preventive measures. During this epidemic situation, international students suffered various types of mental stresses and anxiety, especially living in most affected regions of China. The study adopted a mixed (qualitative and quantitative) approach where the findings can act as a set of guidelines for governmental authorities in formulating, assisting in the preparation, instructing, and guiding policies to prevent and control the epidemic COVID-19 at national, local, and divisional levels.
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Affiliation(s)
- Ijaz Younis
- School of Economics and Management, Nanjing University of Science and Technology, Nanjing, 210094 People’s Republic of China
| | - Cheng Longsheng
- School of Economics and Management, Nanjing University of Science and Technology, Nanjing, 210094 People’s Republic of China
| | - Muhammad Imran Zulfiqar
- School of Economics and Management, Nanjing University of Science and Technology, Nanjing, 210094 People’s Republic of China
| | - Muhammad Imran
- School of Economics and Management, Nanjing University of Science and Technology, Nanjing, 210094 People’s Republic of China
| | - Syed Ahsan Ali Shah
- School of Economics and Management, Nanjing University of Science and Technology, Nanjing, 210094 People’s Republic of China
| | - Mudassar Hussain
- School of Economics and Management, Nanjing University of Science and Technology, Nanjing, 210094 People’s Republic of China
| | - Yasir Ahmed Solangi
- School of Economics and Management, Nanjing University of Science and Technology, Nanjing, 210094 People’s Republic of China
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26
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Moreira AP, Jamar F, Ozcan Z, Piciu D, Als C, Franceschi M, Trägårdh E, Zagar I, Sowa-Staszczak A, Cachin F, Bennink R, Forrer F, Adamsen TC, Fotopolous A, Kalnina M, Jensen LT, Mussalo H, Simanek M, Garcia-Cañamaque L, Nazarenko S, Mihailovic J, Bar-Sever Z, O'Connell M, Miladinova D, Graham R, Giubbini R, Kaliská L, Rozić D, Krause BJ, Gallowitsch HJ, Györke T, Sediene S, Rumyantsev P, Wadsak W, Kunikowska J. Impact of the COVID-19 pandemic on nuclear medicine departments in Europe. Eur J Nucl Med Mol Imaging 2021; 48:3361-3364. [PMID: 34328532 PMCID: PMC8322112 DOI: 10.1007/s00259-021-05484-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ana Paula Moreira
- Nuclear Medicine Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. .,Institute for Nuclear Sciences Applied To Health, University of Coimbra, Coimbra, Portugal.
| | - François Jamar
- Nuclear Medicine Department, Cliniques Universitaires St-Luc, Brussels, Belgium
| | - Zehra Ozcan
- Department of Nuclear Medicine, Ege University School of Medicine, Izmir, Turkey
| | - Doina Piciu
- University of Medicine and Pharmacy Iuliu Hațieganu Cluj-Napoca, Cluj-Napoca, Romania.,Nuclear Medicine Department, Institute of Oncology I. Chiricuta Cluj-Napoca, Cluj-Napoca, Romania
| | - Claudine Als
- Department of Nuclear Medicine, Hôpitaux Robert Schuman Zithaklinik, Luxembourg, Luxembourg
| | - Maja Franceschi
- Department of Oncology and Nuclear Medicine, Sestre Milosrdnice UHC, Zagreb, Croatia
| | - Elin Trägårdh
- Clinical Physiology and Nuclear Medicine, Skåne University Hospital and Lund University, Malmö, Sweden
| | - Ivana Zagar
- Department of Nuclear Medicine, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Anna Sowa-Staszczak
- Medical College, Endocrinology Department, Nuclear Medicine Unit, Jagiellonian University, Kraków, Poland
| | - Florent Cachin
- Nuclear Medicine, Jean Perrin Cancer Center, Clermont-Ferrand, France.,Medical Biophysics Department, Clermont Auvergne University, Clermont-Ferrand, France
| | - Roel Bennink
- Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Flavio Forrer
- Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Tom Christian Adamsen
- Centre for Nuclear Medicine, Department of Radiology, Haukeland University Hospital, Bergen, Norway.,Department of Chemistry, University of Bergen, Bergen, Norway
| | - Andreas Fotopolous
- Nuclear Medicine Department, University Hospital of Ioannina, Ioannina, Greece
| | - Marika Kalnina
- Pauls Stradins Clinical University Hospital, Riga, Latvia
| | | | - Hanna Mussalo
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Milan Simanek
- Department of Nuclear Medicine, Hospital Pelhřimov, Pelhřimov, Czech Republic
| | | | - Sergei Nazarenko
- Department of Health Technologies, Tallinn University of Technology, Tallinn, Estonia
| | - Jasna Mihailovic
- Department of Radiology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.,Centre of Nuclear Medicine, Oncology Institute of Vojvodina, Sremska, Kamenica, Serbia
| | - Zvi Bar-Sever
- Department of Nuclear Medicine, Schneider Children's Medical Center, Petah Tikva, Israel
| | - Martin O'Connell
- Mater University Hospital, University College Dublin, Dublin, Ireland
| | - Daniela Miladinova
- Institute of Pathophysiology and Nuclear Medicine, Faculty of Medicine, University Ss. Cyril and Methodius, Skopje, North Macedonia
| | - Richard Graham
- School of Radiology, Royal United Hospitals, Bath NHS Foundation Trust, Bath, UK
| | - Raffaele Giubbini
- Chair of Nuclear Medicine, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Lucia Kaliská
- Institute of Nuclear and Molecular Medicine, Banská Bystrica, Slovak Republic
| | - Damir Rozić
- Department of Nuclear Medicine, University Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Bernd J Krause
- Department of Nuclear Medicine, Rostock University Medical Centre, Rostock, Germany
| | - Hans-Jürgen Gallowitsch
- Department of Nuclear Medicine and Endocrinology, Klinikum Klagenfurt Am Wörthersee, Klagenfurt, Austria
| | - Tamás Györke
- Department of Nuclear Medicine/Semmelweis University, Medical Imaging Centre, Budapest, Hungary
| | | | - Pavel Rumyantsev
- SOGAZ International Medical Center, Saint-Petersburg, Russian Federation
| | - Wolfgang Wadsak
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Jolanta Kunikowska
- Nuclear Medicine Department, Medical University of Warsaw, Warsaw, Poland
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27
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Mahaletchumy T, Muhamad M, Mohammad Kazmin NE, Kori N, Periyasamy P. Pulmonary Embolism in an Asymptomatic COVID-19 Patient Detected on Ventilation/Perfusion SPECT/CT. Clin Nucl Med 2021; 46:e360-e362. [PMID: 33443945 DOI: 10.1097/rlu.0000000000003513] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
ABSTRACT Severe COVID-19 infection is associated with significant coagulopathy. We would like share a case of an asymptomatic 26-year-old man who tested positive for COVID-19 and had elevated d-dimer levels. Because of inconclusive CTPA findings, V/Q (ventilation/perfusion) SPECT/CT was performed, which confirmed the presence of pulmonary embolism. This case highlights the fact that pulmonary embolism should not be overlooked in a COVID-19 patient who has raised d-dimer levels, even in the absence of symptoms. It also highlights the importance of performing a V/Q study when CTPA results are inconclusive or when there are contraindications for iodinated contrast media.
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Affiliation(s)
| | | | | | - Najma Kori
- Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras
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28
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Vigne J, Peyronnet D, Leenhardt J, Dubegny C, Ardisson V, Pariscoat G, Bolot C, Rauscher A, Hallouard F, Clave-Darcissac C, Clotagatide A, Odouard E, Faivre-Chauvet A, Diehl J, Houdu B, Agostini D, Morello R. Quantitative impact of the first COVID-19 lockdown on nuclear medicine in France: the CORALINE study. Eur J Nucl Med Mol Imaging 2021; 48:4331-4338. [PMID: 34169368 PMCID: PMC8224993 DOI: 10.1007/s00259-021-05361-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/06/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE The coronavirus disease 2019 (COVID-19) pandemic reshaped the usual risk: benefit equilibrium that became a trade-off between the infection exposure risk for the patient (and for staff) and the risk associated with delaying or cancelling the nuclear medicine examination. This study aimed at quantifying the impact of the first COVID-19 lockdown in France on nuclear medicine examination volume together with volume of examination cancellation and non-attendance. METHODS We retrospectively assessed the volume of planned examinations from 1 month before to 1 month after the first lockdown in French high-volume nuclear medicine departments (NMD) sharing the same information management system including both university hospitals, UH (n = 7), and cancer centres, CC (n = 2). RESULTS The study enrolled 31,628 consecutive patients referred for a nuclear medicine examination performed or not (NMEP or NMEnP). The total volume of NMEP significantly dropped by 43.4% between the 4 weeks before and after the starting of the lockdown. The comparison of the percentage of NMEP and NMEnP between UH and CC is significantly different (p < 0.001). The percentage of NMEP during the study was 67.9% in UH vs 84.7% in CC. Percentages of NMEnP in UH and CC were due respectively to cancellation by the patient (14.9 vs 7.4%), cancellation by the NMD (9.5 vs 3.4%), cancellation by the referring physician (5.1 vs 4.4%) and non-attender patients (2.7 vs 0.2%). CONCLUSION The study underlines the public health issue caused by COVID-19 above the pandemic itself and should be useful in preparing for potential resource utilisation and staffing requirements.
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Affiliation(s)
- Jonathan Vigne
- Department of Nuclear Medicine, CHU de Caen Normandie, Normandie Université, UNICAEN, 14000, Caen, France. .,Department of Pharmacy, CHU de Caen Normandie, Normandie Université, UNICAEN, 14000, Caen, France. .,Normandie Université, UNICAEN, INSERM U1237, PhIND, Institut Blood and Brain @ Caen-Normandie, Centre Cyceron, 14000, Caen, France.
| | - Damien Peyronnet
- Department of Nuclear Medicine, CHU de Caen Normandie, Normandie Université, UNICAEN, 14000, Caen, France.,Department of Pharmacy, CHU de Caen Normandie, Normandie Université, UNICAEN, 14000, Caen, France
| | - Julien Leenhardt
- Nuclear Medicine Department, Grenoble-Alpes University Hospital, Grenoble, France.,Radiopharmaceutiques Biocliniques, UMR UGA-INSERM U1039, Grenoble, France
| | - Constance Dubegny
- Radiopharmacy, Nuclear Medicine Department, CHU de Nantes, 44000, Nantes, France
| | - Valérie Ardisson
- Department of Pharmacy, Centre de lutte contre le cancer Eugène Marquis, 35000, Rennes, France
| | - Guillaume Pariscoat
- Department of Nuclear Medicine, CHU Bichat, Assistance Publique Hôpitaux de Paris, 75018, Paris, France
| | - Claire Bolot
- Radiopharmacy Unit, Pharmacy Department, Groupement Hospitalier Est, Hospices Civils de Lyon, 59 boulevard Pinel, 69677, Bron Cedex, France
| | - Aurore Rauscher
- Radiopharmacy, Nuclear Medicine Department, ICO Nantes-Angers, 44800, Saint-Herblain, France
| | - François Hallouard
- Radiopharmacy Unit, Pharmacy Department, Groupement Hospitalier Sud, Hospices Civils de Lyon, 165 Chemin du Grand Revoyet, 69310, Pierre-Bénite, France
| | - Caroline Clave-Darcissac
- Radiopharmacy Unit, Pharmacy Department, Groupement Hospitalier Sud, Hospices Civils de Lyon, 165 Chemin du Grand Revoyet, 69310, Pierre-Bénite, France
| | - Anthony Clotagatide
- Department of Pharmacy, CHU de Saint-Etienne, Hôpital Nord, 42055, Saint-Etienne, France.,Department of Nuclear Medicine, CHU de Saint-Etienne, 42055, Saint-Etienne, France
| | - Emmanuel Odouard
- Department of Pharmacy, CHU de Saint-Etienne, Hôpital Nord, 42055, Saint-Etienne, France.,Department of Nuclear Medicine, CHU de Saint-Etienne, 42055, Saint-Etienne, France
| | - Alain Faivre-Chauvet
- Radiopharmacy, Nuclear Medicine Department, CHU de Nantes, 44000, Nantes, France
| | - Justine Diehl
- Biostatistic and Clinical Research, CHU de Caen Normandie, Normandie Université, UNICAEN, 14000, Caen, France
| | - Benjamin Houdu
- Department of Nuclear Medicine, CHU de Caen Normandie, Normandie Université, UNICAEN, 14000, Caen, France
| | - Denis Agostini
- Department of Nuclear Medicine, CHU de Caen Normandie, Normandie Université, UNICAEN, 14000, Caen, France
| | - Rémy Morello
- Biostatistic and Clinical Research, CHU de Caen Normandie, Normandie Université, UNICAEN, 14000, Caen, France
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29
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Wakfie-Corieh CG, Ferrando-Castagnetto F, Blanes Garcia AM, Garcia-Esquinas MG, Ortega Candil A, Rodriguez Rey C, Cabrera Martin MN, Delgado Cano A, Carreras Delgado JL. Incidental findings suggestive of COVID-19 pneumonia in oncological patients undergoing 18F-FDG PET/CT studies: association between metabolic and structural lung changes. J Nucl Med 2021; 63:274-279. [PMID: 34088776 PMCID: PMC8805775 DOI: 10.2967/jnumed.121.261915] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/05/2021] [Indexed: 11/16/2022] Open
Abstract
Although the novel coronavirus disease 2019 (COVID-19) can present as non-specific clinical forms, subclinical cases represent an important route of transmission and a significant source of mortality, mainly in high-risk subpopulations such as cancer patients. A deeper knowledge about the shift in cellular metabolism of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected cells could provide new insights about its pathogenic and host response and help to diagnose pulmonary involvement. We explored the association between metabolic and structural changes of lung parenchyma in asymptomatic cancer patients with suspected COVID-19 pneumonia, as a potential added diagnostic value of fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET/CT) scans in this subpopulation. Methods: Within the period of February 19 and May 29, 2020 18F-FDG PET/CT studies were reviewed to identify those cancer patients with suggestive incidental findings of COVID-19 pneumonia. PET studies were interpreted through qualitative (visual) and semiquantitative analysis (measurement of maximum standardized uptake value, SUVmax) evaluating lung findings. Several characteristic signs of COVID-19 pneumonia on computed tomography (CT) were described as COVID-19 Reporting and Data System (CO-RADS) categories (1-6). After comparing SUVmax values of pulmonary infiltrates among different CO-RADS categories, we explored the best potential cut-off values of pulmonary SUVmax against CO-RADS categories as "gold standard" result to discard the diagnosis of COVID-19 pneumonia. Results: CT signs classified as CO-RADS category 5 or 6 were found in 16/41 (39%) oncological patients derived to multimodal PET/CT imaging. SUVmax was higher in patients with CO-RADS 5 and 6 vs. 4 (6.17±0.82 vs. 3.78±0.50, P = 0.04) and vs. 2 and 3 categories (3.59±0.41, P = 0.01). A specificity of 93.8% (IC 95%: 71.7-99.7%) and an accuracy of 92.9% were obtained when combining a CO-RADS score 5-6 with a SUVmax of 2.45 in pulmonary infiltrates. Conclusion: In asymptomatic cancer patients, the metabolic activity in lung infiltrates is closely associated with several combined tomographic changes characteristic of COVID-19 pneumonia. Multimodal 18F-FDG PET/CT imaging could provide additional information during early diagnosis in selected predisposed patients during pandemic. The prognostic implications of simultaneous radiological and molecular findings in cancer and other high-risk subpopulations for COVID-19 pneumonia deserve further evaluation in prospective researches.
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Delgado Bolton RC, Calapaquí Terán AK, Erba PA, Giammarile F. Medical imaging in times of pandemic: focus on the cornerstones of successful imaging. Eur J Nucl Med Mol Imaging 2021; 48:1724-1725. [PMID: 33770202 PMCID: PMC7994349 DOI: 10.1007/s00259-021-05331-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Roberto C Delgado Bolton
- Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja (CIBIR), Logroño, La Rioja, Spain.
| | | | - Paola A Erba
- Regional Center of Nuclear Medicine, Department of Translational Research and Advanced Technologies in Medicine, University of Pisa, Pisa, Italy
- Medical Imaging Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Francesco Giammarile
- Nuclear Medicine and Diagnostic Imaging Section, International Atomic Energy Agency (IAEA), Vienna, Austria
- Department of Nuclear Medicine, Centre Léon Bérard, Lyon, France
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Positron emission tomography in the COVID-19 pandemic era. Eur J Nucl Med Mol Imaging 2021; 48:3903-3917. [PMID: 34013405 PMCID: PMC8134823 DOI: 10.1007/s00259-021-05347-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 03/29/2021] [Indexed: 12/24/2022]
Abstract
Coronavirus disease 2019 (COVID-19) has become a major public health problem worldwide since its outbreak in 2019. Currently, the spread of COVID-19 is far from over, and various complications have roused increasing awareness of the public, calling for novel techniques to aid at diagnosis and treatment. Based on the principle of molecular imaging, positron emission tomography (PET) is expected to offer pathophysiological alternations of COVID-19 in the molecular/cellular perspectives and facilitate the clinical management of patients. A number of PET-related cases and research have been reported on COVID-19 over the past one year. This article reviews the current studies of PET in the diagnosis and treatment of COVID-19, and discusses potential applications of PET in the development of management strategy for COVID-19 patients in the pandemic era.
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Juengling FD, Maldonado A, Wuest F, Schindler TH. Identify. Quantify. Predict. Why Immunologists Should Widely Use Molecular Imaging for Coronavirus Disease 2019. Front Immunol 2021; 12:568959. [PMID: 34054793 PMCID: PMC8155634 DOI: 10.3389/fimmu.2021.568959] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 04/16/2021] [Indexed: 01/18/2023] Open
Abstract
Molecular imaging using PET/CT or PET/MRI has evolved from an experimental imaging modality at its inception in 1972 to an integral component of diagnostic procedures in oncology, and, to lesser extent, in cardiology and neurology, by successfully offering in-vivo imaging and quantitation of key pathophysiological targets or molecular signatures, such as glucose metabolism in cancerous disease. Apart from metabolism probes, novel radiolabeled peptide and antibody PET tracers, including radiolabeled monoclonal antibodies (mAbs) have entered the clinical arena, providing the in-vivo capability to collect target-specific quantitative in-vivo data on cellular and molecular pathomechanisms on a whole-body scale, and eventually, extract imaging biomarkers possibly serving as prognostic indicators. The success of molecular imaging in mapping disease severity on a whole-body scale, and directing targeted therapies in oncology possibly could translate to the management of Coronavirus Disease 2019 (COVID-19), by identifying, localizing, and quantifying involvement of different immune mediated responses to the infection with SARS-COV2 during the course of acute infection and possible, chronic courses with long-term effects on specific organs. The authors summarize current knowledge for medical imaging in COVID-19 in general with a focus on molecular imaging technology and provide a perspective for immunologists interested in molecular imaging research using validated and immediately available molecular probes, as well as possible future targets, highlighting key targets for tailored treatment approaches as brought up by key opinion leaders.
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Affiliation(s)
- Freimut D. Juengling
- Medical Faculty, University Bern, Bern, Switzerland
- Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Antonio Maldonado
- Department of Nuclear Medicine and Molecular Imaging, Quironsalud Madrid University Hospital, Madrid, Spain
| | - Frank Wuest
- Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Thomas H. Schindler
- Mallinckrodt Institute of Radiology, Division of Nuclear Medicine, Washington University School of Medicine, Saint Louis, MO, United States
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Nawwar AA, Searle J, Green C, Lyburn ID. Infection Control of COVID-19: Surgical Mask-Related Facial Cutaneous Artifact on FDG PET/CT. Clin Nucl Med 2021; 46:e221-e223. [PMID: 33234928 DOI: 10.1097/rlu.0000000000003424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT In accordance with published international COVID-19 pandemic guidance (American College of Nuclear Medicine, British Nuclear Medicine Society, and European Association of Nuclear Medicine), the use of face masks has become an essential part of infection control for both patients and staff. A 56-year-old man with mantle cell lymphoma underwent staging FDG PET/CT, which demonstrated avid lymphadenopathy below the diaphragm and an unusual diffuse FDG uptake projected over the face, raising the suspicion of cutaneous lymphomatous involvement. On reflection of the clinical scenario and scanning conditions, cutaneous involvement was discounted; the pattern of uptake and lack of CT correlate were supportive of a cutaneous artifact related to the presence of the patient's mask.
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Coronavirus (COVID-19) pandemic mediated changing trends in nuclear medicine education and training: time to change and scintillate. Eur J Nucl Med Mol Imaging 2021; 49:427-435. [PMID: 33661327 PMCID: PMC7930105 DOI: 10.1007/s00259-021-05241-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Dizdarevic S, Abdulla M, Sewedy T, Weston C, Oxley C, Croasdale J, Redman S, Vinjamuri S, Mayes C, Flux G, Ward M, Graham R, Buscombe J. Impact of COVID-19 on nuclear medicine in the UK. Nucl Med Commun 2021; 42:138-149. [PMID: 33346606 DOI: 10.1097/mnm.0000000000001357] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE COVID-19 brought about unprecedented challenges to healthcare, with nuclear medicine (NM) being no exception. The British Nuclear Medicine Society (BNMS) COVID-19 survey assessed the impact of the first wave of pandemic on NM services in the UK. With COVID-19 resurge compounded by seasonal winter pressures, we reflect and share lessons learnt from the first wave of pandemic to guide future strategy. METHODS A questionnaire consisting of 34 questions was sent out to all BNMS members over 2 weeks in May 2020, to evaluate the impact of 'lockdown'. RESULTS One hundred thirty-eight members (92 sites) from a multidisciplinary background responded. There was a 65% reduction across all services; 97.6% of respondents reported some reduction in diagnostic procedures and 71.3% reduction in therapies; 85% worked with a reduced workforce. The North East of England, Greater London and South East and Wessex were most affected by staff absences. The North East reported the highest number of COVID-19 positive staff; London reported the greatest lack of testing. The reported time required to clear the backlog was 1-12 months. Seventy-one percent of participants used BNMS COVID-19 guidance. CONCLUSION The first wave caused a major disruption of NM service delivery and impacted on the workforce. The departmental strategies should tailor services to evolving local and regional differences in prevalence of COVID-19. A blanket shutdown of services with a 'one size fits all' strategy would likely have a severe impact on future delivery of NM and health services in general. Timely testing of staff and patients remains of paramount importance.
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Affiliation(s)
- Sabina Dizdarevic
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
- Brighton and Sussex Medical School, Brighton, UK
| | - Mahdi Abdulla
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
| | - Taha Sewedy
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
| | - Charlotte Weston
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
| | - Caroline Oxley
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
| | - Jilly Croasdale
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
| | - Stewart Redman
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
| | - Sobhan Vinjamuri
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
| | - Christopher Mayes
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
| | - Glen Flux
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
| | - Mike Ward
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
| | - Richard Graham
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
| | - John Buscombe
- British Nuclear Medicine Society
- Barts Health NHS Trust, London, UK
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Morón S, González E, Rojas J. 68Ga-DOTANOC PET/CT With Lung Involvement in the Era of COVID-19 Pandemic. Clin Nucl Med 2021; 46:166-167. [PMID: 33234942 PMCID: PMC7780932 DOI: 10.1097/rlu.0000000000003473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/05/2020] [Indexed: 01/20/2023]
Abstract
ABSTRACT Patient was a 55-year-old man with history of pancreas neuroendocrine tumor grade 2, Ki-67 index 10%. He was treated with surgical resection. 68Ga-DOTANOC PET/CT was performed as part of follow-up of known disease. The images showed opacities in both lungs' parenchyma with moderate uptake of radiotracer and mediastinal lymph nodes with high uptake suggestive of infection. Two weeks before a high-resolution CT was performed, these findings in the lungs were not present. The patient was asymptomatic and was referred to the emergency department for reverse transcriptase-polymerase chain reaction COVID-19 test, and the result was positive.
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Casali M, Lauri C, Altini C, Bertagna F, Cassarino G, Cistaro A, Erba AP, Ferrari C, Mainolfi CG, Palucci A, Prandini N, Baldari S, Bartoli F, Bartolomei M, D’Antonio A, Dondi F, Gandolfo P, Giordano A, Laudicella R, Massollo M, Nieri A, Piccardo A, Vendramin L, Muratore F, Lavelli V, Albano D, Burroni L, Cuocolo A, Evangelista L, Lazzeri E, Quartuccio N, Rossi B, Rubini G, Sollini M, Versari A, Signore A. State of the art of 18F-FDG PET/CT application in inflammation and infection: a guide for image acquisition and interpretation. Clin Transl Imaging 2021; 9:299-339. [PMID: 34277510 PMCID: PMC8271312 DOI: 10.1007/s40336-021-00445-w] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 06/19/2021] [Indexed: 02/06/2023]
Abstract
AIM The diagnosis, severity and extent of a sterile inflammation or a septic infection could be challenging since there is not one single test able to achieve an accurate diagnosis. The clinical use of 18F-fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) imaging in the assessment of inflammation and infection is increasing worldwide. The purpose of this paper is to achieve an Italian consensus document on [18F]FDG PET/CT or PET/MRI in inflammatory and infectious diseases, such as osteomyelitis (OM), prosthetic joint infections (PJI), infective endocarditis (IE), prosthetic valve endocarditis (PVE), cardiac implantable electronic device infections (CIEDI), systemic and cardiac sarcoidosis (SS/CS), diabetic foot (DF), fungal infections (FI), tuberculosis (TBC), fever and inflammation of unknown origin (FUO/IUO), pediatric infections (PI), inflammatory bowel diseases (IBD), spine infections (SI), vascular graft infections (VGI), large vessel vasculitis (LVV), retroperitoneal fibrosis (RF) and COVID-19 infections. METHODS In September 2020, the inflammatory and infectious diseases focus group (IIFG) of the Italian Association of Nuclear Medicine (AIMN) proposed to realize a procedural paper about the clinical applications of [18F]FDG PET/CT or PET/MRI in inflammatory and infectious diseases. The project was carried out thanks to the collaboration of 13 Italian nuclear medicine centers, with a consolidate experience in this field. With the endorsement of AIMN, IIFG contacted each center, and the pediatric diseases focus group (PDFC). IIFG provided for each team involved, a draft with essential information regarding the execution of [18F]FDG PET/CT or PET/MRI scan (i.e., indications, patient preparation, standard or specific acquisition modalities, interpretation criteria, reporting methods, pitfalls and artifacts), by limiting the literature research to the last 20 years. Moreover, some clinical cases were required from each center, to underline the teaching points. Time for the collection of each report was from October to December 2020. RESULTS Overall, we summarized 291 scientific papers and guidelines published between 1998 and 2021. Papers were divided in several sub-topics and summarized in the following paragraphs: clinical indications, image interpretation criteria, future perspectivess and new trends (for each single disease), while patient preparation, image acquisition, possible pitfalls and reporting modalities were described afterwards. Moreover, a specific section was dedicated to pediatric and PET/MRI indications. A collection of images was described for each indication. CONCLUSIONS Currently, [18F]FDG PET/CT in oncology is globally accepted and standardized in main diagnostic algorithms for neoplasms. In recent years, the ever-closer collaboration among different European associations has tried to overcome the absence of a standardization also in the field of inflammation and infections. The collaboration of several nuclear medicine centers with a long experience in this field, as well as among different AIMN focus groups represents a further attempt in this direction. We hope that this document will be the basis for a "common nuclear physicians' language" throughout all the country. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40336-021-00445-w.
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Affiliation(s)
- Massimiliano Casali
- Nuclear Medicine Unit, Azienda Unità Sanitaria Locale IRCCS, Reggio Emilia, Italy
| | - Chiara Lauri
- grid.7841.aNuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Corinna Altini
- grid.7644.10000 0001 0120 3326Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Francesco Bertagna
- grid.412725.7Nuclear Medicine, University of Brescia and Spedali Civili di Brescia, Brescia, Italy
| | - Gianluca Cassarino
- grid.5608.b0000 0004 1757 3470Nuclear Medicine Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| | | | - Anna Paola Erba
- grid.5395.a0000 0004 1757 3729Regional Center of Nuclear Medicine, Department of Translational Research and Advanced Technologies in Medicine, University of Pisa, Pisa, Italy
| | - Cristina Ferrari
- grid.7644.10000 0001 0120 3326Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Ciro Gabriele Mainolfi
- grid.4691.a0000 0001 0790 385XDepartment of Advanced Biomedical Sciences, University “Federico II”, Naples, Italy
| | - Andrea Palucci
- grid.415845.9Department of Nuclear Medicine, “Ospedali Riuniti di Torrette” Hospital, Ancona, Italy
| | - Napoleone Prandini
- grid.418324.80000 0004 1781 8749Nuclear Medicine Unit, Department of Diagnostic Imaging, Centro Diagnostico Italiano, Milan, Italy
| | - Sergio Baldari
- grid.10438.3e0000 0001 2178 8421Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and of Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Francesco Bartoli
- grid.5395.a0000 0004 1757 3729Regional Center of Nuclear Medicine, Department of Translational Research and Advanced Technologies in Medicine, University of Pisa, Pisa, Italy
| | - Mirco Bartolomei
- grid.416315.4Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy
| | - Adriana D’Antonio
- grid.4691.a0000 0001 0790 385XDepartment of Advanced Biomedical Sciences, University “Federico II”, Naples, Italy
| | - Francesco Dondi
- grid.412725.7Nuclear Medicine, University of Brescia and Spedali Civili di Brescia, Brescia, Italy
| | - Patrizia Gandolfo
- grid.418324.80000 0004 1781 8749Nuclear Medicine Unit, Department of Diagnostic Imaging, Centro Diagnostico Italiano, Milan, Italy
| | - Alessia Giordano
- grid.4691.a0000 0001 0790 385XDepartment of Advanced Biomedical Sciences, University “Federico II”, Naples, Italy
| | - Riccardo Laudicella
- grid.10438.3e0000 0001 2178 8421Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and of Morpho-Functional Imaging, University of Messina, Messina, Italy
| | | | - Alberto Nieri
- grid.416315.4Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy
| | | | - Laura Vendramin
- grid.5608.b0000 0004 1757 3470Nuclear Medicine Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Francesco Muratore
- Rheumatology Unit, Azienda Unità Sanitaria Locale IRCCS, Reggio Emilia, Italy
| | - Valentina Lavelli
- grid.7644.10000 0001 0120 3326Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Domenico Albano
- grid.412725.7Nuclear Medicine, University of Brescia and Spedali Civili di Brescia, Brescia, Italy
| | - Luca Burroni
- grid.415845.9Department of Nuclear Medicine, “Ospedali Riuniti di Torrette” Hospital, Ancona, Italy
| | - Alberto Cuocolo
- grid.4691.a0000 0001 0790 385XDepartment of Advanced Biomedical Sciences, University “Federico II”, Naples, Italy
| | - Laura Evangelista
- grid.5608.b0000 0004 1757 3470Nuclear Medicine Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Elena Lazzeri
- grid.5395.a0000 0004 1757 3729Regional Center of Nuclear Medicine, Department of Translational Research and Advanced Technologies in Medicine, University of Pisa, Pisa, Italy
| | - Natale Quartuccio
- grid.419995.9Nuclear Medicine Unit, A.R.N.A.S. Civico di Cristina and Benfratelli Hospitals, Palermo, Italy
| | - Brunella Rossi
- Nuclear Medicine Unit, Department of Services, ASUR MARCHE-AV5, Ascoli Piceno, Italy
| | - Giuseppe Rubini
- grid.7644.10000 0001 0120 3326Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Martina Sollini
- grid.417728.f0000 0004 1756 8807Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
| | - Annibale Versari
- Nuclear Medicine Unit, Azienda Unità Sanitaria Locale IRCCS, Reggio Emilia, Italy
| | - Alberto Signore
- grid.7841.aNuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, “Sapienza” University of Rome, Rome, Italy
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Katal S, Azam S, Bombardieri E, Picchio M, Gholamrezanezhad A. Reopening the country: Recommendations for nuclear medicine departments. World J Nucl Med 2021; 20:1-6. [PMID: 33850483 PMCID: PMC8034797 DOI: 10.4103/wjnm.wjnm_73_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/07/2020] [Accepted: 07/24/2020] [Indexed: 12/15/2022] Open
Abstract
The best practices for nuclear medicine departments to operate safely during the COVID-19 pandemic have been debated in the literature recently. However, as many governments have started to ease restrictions in activity due to COVID-19, a set of guidelines is needed to resume routine patient care throughout the world. The nonessential or elective procedures which were previously postponed or canceled during the COVID-19 pandemic will gradually restart in the following weeks despite the continued risks. In this paper, we aim to review some of the most effective general precautions to restart the regular nuclear medicine operations safely.
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Affiliation(s)
- Sanaz Katal
- Department of Nuclear Medicine/PET-CT, Shiraz, Kowsar Hospital, Iran
| | - Saif Azam
- Department of Diagnostic Radiology, Keck School of Medicine, University of Southern California, USA
| | | | - Maria Picchio
- Vita-Salute San Raffaele University, Nuclear Medicine Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Ali Gholamrezanezhad
- Department of Diagnostic Radiology, Keck School of Medicine, University of Southern California, USA
- Address for correspondence: Dr. Ali Gholamrezanezhad, Department of Diagnostic Radiology, Keck School of Medicine, University of Southern California, 1520 San Pablo Street, Los Angles, California, USA. E-mail:
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Abbasi F, Gholamrezanezhad A, Jokar N, Assadi M. A Path to New Normal of Nuclear Medicine Facilities: Considerations for Reopening. ASIA OCEANIA JOURNAL OF NUCLEAR MEDICINE & BIOLOGY 2021; 9:80-85. [PMID: 33392356 PMCID: PMC7701226 DOI: 10.22038/aojnmb.2020.16887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 09/05/2020] [Accepted: 09/08/2020] [Indexed: 11/06/2022]
Abstract
The stormy clouds of the coronavirus disease 2019 outbreak caused a rapidly spreading epidemic still hanging over the sphere. Any steps to transition toward a new normal should be guided by health authorities, together with economic and societal considerations. There are various items mainly falling into three classifications, including patient worry, clinical demand, and economic recession. Social distancing, lay-offs, and decreased number of patients with health insurance may lead to a prolonged period to retrieve normalcy. To return to a new normal, an individualized management model should be developed for each laboratory based on staff, instruments, services, crowding, physical space, hospital base unit, or outpatient clinic. Continuous training of different occupational staffs is among the key parameters in maintaining this readiness. The proposed response model should have internal and systemic integrity as well as coherence among the included items in two intra- and inter-unit management categories, namely thinking globally and acting locally.
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Affiliation(s)
- Farhad Abbasi
- Department of Infectious Diseases, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Ali Gholamrezanezhad
- Department of Diagnostic Radiology, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Narges Jokar
- Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Majid Assadi
- Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
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Carrio I, Essler M, Freudenberg LS, Herrmann K. "COVID-19 Pandemic as stimulator to Re-Establish Nuclear Medicine as Clinical Specialty" based on a report of Prof. Dr. Ignasi Carrio. Nuklearmedizin 2020; 59:405-408. [PMID: 33336349 DOI: 10.1055/a-1286-4946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kaushik A, Patel S, Dubey K. COVID-19 and nuclear cardiology: Introducing the "forward" virtual visit. J Card Surg 2020; 36:783. [PMID: 33284490 DOI: 10.1111/jocs.15236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Atul Kaushik
- Department of Cardiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Surendra Patel
- Department of Trauma and Emergency Cardiothoracic Surgery, All India Institute of Medical Sciences, Jodhpur, India
| | - Kalika Dubey
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Jodhpur, India
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Grellier JF, Lussato D, Guernou M, Queneau M, Bonardel G. Images of COVID-19 Infection Cases in Asymptomatic or Paucisymptomatic Patients With Neoplastic Diseases on 18F-FDG PET/CT. Clin Nucl Med 2020; 45:965-966. [PMID: 32804760 DOI: 10.1097/rlu.0000000000003255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We describe the results of F-FDG PET/CT of 3 patients referred to our institution during the single day of Monday, March 23, 2020, for an initial assessment of cancer extension or for the therapeutic evaluation of chemotherapy of neoplastic pathology, with no obvious infectious or respiratory symptoms at the time of examination. A retrospective review of the recent clinical history of patients in association with the typical pulmonary images on CT scan suggested the diagnosis of COVID-19. The characteristic aspects of COVID-19 infection should be recognized on F-FDG PET/CT, even if patients are asymptomatic or minimally symptomatic.
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Affiliation(s)
- Jean-François Grellier
- From the Department of Nuclear Medicine, Centre Cardiologique du Nord, Saint-Denis, France
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Hospital radiopharmacy in Argentina during the COVID-19 pandemic. Criteria and fundamentals for the organization of work. Rev Esp Med Nucl Imagen Mol 2020. [PMCID: PMC7572134 DOI: 10.1016/j.remnie.2020.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This publication presents criteria and bases for the work organization in the safe practice of Hospital Radiopharmacy, in order to minimize the risk of viral transmission during the COVID-19 pandemic, in a reference facility of the National Energy Commission Atomic of Argentina, while continuing to perform essential services for the health system. For this purpose, documents from the National Energy Commission Atomic, IAEA, WHO and other scientific publications were consulted as reference. These recommendations are under constant review and are permanently updated. Within this framework, the present model of work organization for this essential activity is proposed, including general and specific recommendations and its epidemiological and immunological basis.
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Morbelli S, Ekmekcioglu O, Barthel H, Albert NL, Boellaard R, Cecchin D, Guedj E, Lammertsma AA, Law I, Penuelas I, Semah F, Traub-Weidinger T, van de Giessen E, Varrone A, Garibotto V. COVID-19 and the brain: impact on nuclear medicine in neurology. Eur J Nucl Med Mol Imaging 2020; 47:2487-2492. [PMID: 32700058 PMCID: PMC7375837 DOI: 10.1007/s00259-020-04965-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Silvia Morbelli
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy. .,Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Department of Health Sciences(DISSAL), University of Genoa, Genoa, Italy.
| | - Ozgul Ekmekcioglu
- Department of Nuclear Medicine, Sisli Etfal Education and Research Hospital, Istanbul, Turkey
| | - Henryk Barthel
- Department of Nuclear Medicine, Leipzig University, Leipzig, Germany
| | - Nathalie L Albert
- Department of Nuclear Medicine, Ludwig Maximilians-University of Munich, Munich, Germany
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, De Boelelaan, 1117, Amsterdam, Netherlands
| | - Diego Cecchin
- Nuclear Medicine Unit, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Eric Guedj
- APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, Nuclear Medicine Department, Aix Marseille Univ, Marseille, France
| | - Adriaan A Lammertsma
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, De Boelelaan, 1117, Amsterdam, Netherlands
| | - Ian Law
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ivan Penuelas
- Department of Nuclear Medicine, Clinica Universidad de Navarra, IdiSNA, University of Navarra, Pamplona, Spain
| | - Franck Semah
- Nuclear Medicine Department, University Hospital, Lille, France
| | - Tatjana Traub-Weidinger
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Elsmarieke van de Giessen
- Radiology and Nuclear Medicine, Amsterdam UMC, Location AMC, Meibergdreef 9, Amsterdam, The Netherlands
| | - Andrea Varrone
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Valentina Garibotto
- NIMTLab, Faculty of Medicine, Geneva University, Geneva, Switzerland.,Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospitals, Geneva, Switzerland
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Skali H, Murthy VL, Paez D, Choi EM, Keng FYJ, Iain MA, Al-Mallah M, Campisi R, Bateman TM, Carrio I, Beanlands R, Calnon DA, Dilsizian V, Dondi M, Gimelli A, Pagnanelli R, Polk DM, Soman P, Einstein AJ, Dorbala S, Thompson RC. Guidance and best practices for reestablishment of non-emergent care in nuclear cardiology laboratories during the coronavirus disease 2019 (COVID-19) pandemic: An information statement from ASNC, IAEA, and SNMMI : Endorsed by the Infectious Diseases Society of America. J Nucl Cardiol 2020; 27:1855-1862. [PMID: 32710257 PMCID: PMC7379750 DOI: 10.1007/s12350-020-02203-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 05/14/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Hicham Skali
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Venkatesh L Murthy
- Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI, USA
| | - Diana Paez
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | | | | | - McGhie A Iain
- Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Mouaz Al-Mallah
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA
| | - Roxana Campisi
- Departments of Nuclear Medicine and Cardiovascular Imaging, Diagnostico Maipu, Department of Nuclear Medicine, Instituto Argentino de Diagnostico y Tratamiento, Buenos Aires, Argentina
| | - Timothy M Bateman
- Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO, USA
| | | | - Rob Beanlands
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | | | - Vasken Dilsizian
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Maurizio Dondi
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | | | - Robert Pagnanelli
- Department of Radiology, Duke University Health System, Durham, NC, USA
| | - Donna M Polk
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Prem Soman
- Division of Cardiology, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Andrew J Einstein
- Department of Medicine, Cardiology Division, and Department of Radiology, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, NY, USA
| | - Sharmila Dorbala
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Randall C Thompson
- Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO, USA.
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COVID-19 en la biopsia selectiva de ganglio centinela: el invitado inesperado. REVISTA DE SENOLOGÍA Y PATOLOGÍA MAMARIA 2020. [PMCID: PMC7831987 DOI: 10.1016/j.senol.2020.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objetivo Describir las medidas adoptadas dentro del plan de contingencia del COVID-19 respecto a la biopsia selectiva de ganglio centinela (BSGC) y analizar su impacto sobre la actividad asistencial. Metodología Estudio cualitativo, descriptivo y retrospectivo de BSGC realizadas durante el período del 14/03 al 11/05 de 2020. Análisis de las medidas tomadas para minimizar las probabilidades de contagio y resultados de PCR de pacientes y personal. Comparativa de casos con los realizados en el mismo período de 2019. Actividad diaria de linfogammagrafía y de cirugía radioguiada (CRG) por indicación médica. Cálculo numérico y porcentual de CRG por hospital y recursos humanos diarios de medicina nuclear requeridos. Resultados Se realizaron 42 intervenciones con BSGC, un 31,1% menos que en 2019. La indicación médica de cáncer de mama experimentó el mayor descenso de actividad (n = 18, 41,9%). Del total de CRG, Hospital Clínic realizó el 45,2%, Hospital Maternitat el 31,0%, Hospital Plató el 16,7% y Hospital Sant Joan de Déu el 7,1% restante. En relación con los recursos humanos, la planificación inicial se cumplió en un 77% de los días. El total de los controles PCR a pacientes (n = 42) y personal de CRG (n = 9) dio resultado negativo. Conclusiones El COVID-19 influyó negativamente en la actividad asistencial de la BSGC del Hospital Clínic, pero fue compensado por una planificación acertada, basada en el análisis previo de los procesos del procedimiento, que permitió adaptar los recursos de material y personal a las circunstancias cambiantes, otorgándole una flexibilidad que posibilitó el cumplimiento de la programación establecida.
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Mirzaei S, Farhan C, Karolyi M. 18F-prostate-specific membrane antigen positron emission tomography computed tomography incidental finding in a patient after COVID-19 infection. World J Nucl Med 2020; 19:455-456. [PMID: 33623525 PMCID: PMC7875034 DOI: 10.4103/wjnm.wjnm_110_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/08/2020] [Accepted: 08/23/2020] [Indexed: 11/13/2022] Open
Abstract
The COVID-19 pandemic has now reached most countries. However, the referred patients to a nuclear medicine department will be primarily the asymptomatic ones. We report the case of a patient (84-year-old male) who was sent for18F-prostate-specific membrane antigen positron emission tomography computed tomography (PSMA PET-CT) with suspicion of recurrent disease after prostate cancer and total prostatectomy 2 years prior to the examination. He suffered from COVID-19 pneumonia 4 weeks prior to PET-CT examination. The18F-PSMA PET-CT revealed moderate elevated uptake in the area of previous pneumonia in the right lung. The radiological findings showed ground glass changes in this area indicating possible residual inflammatory disease even weeks after infection.
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Affiliation(s)
- Siroos Mirzaei
- Department of Nuclear Medicine with PET-Center, Klinik Ottakring, Vienna, Austria
| | - Cherin Farhan
- Department of Nuclear Medicine with PET-Center, Klinik Ottakring, Vienna, Austria
| | - Mario Karolyi
- Department for Infectious Diseases and Tropical Medicine, Klinik Favoriten (KFJ), Vienna, Austria
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Sadri K, Dabbagh VR, Forghani MN, Asadi M, Sadeghi R. Lymphoscintigraphy in the Time of COVID-19: Effect of Molybdenum-99 Shortage on Feasibility of Sentinel Node Mapping. Lymphat Res Biol 2020; 19:134-140. [PMID: 32986489 DOI: 10.1089/lrb.2020.0063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Background: In the current study, we reported our experience on sentinel node mapping of breast cancer patients during the extreme shortage of Mo99-Tc99m generators using Tc-99m phytate. Methods and Results: During the period from March 7, 2019, to April 18, 2020, due to disruption of molybdenum supply chain, we used low specific activity Tc-99m pertechnetate elute (0.5-2 mCi of 99mTcO4 in 5 mL) for each kit preparation. Two or three intradermal periareolar injections were done for each patient (0.02-0.1 mCi/0.2 mL for each injection). Immediately following injection, dynamic lymphoscintigraphy was done. Surgery was done the same day of injection and the axillary sentinel node was sought using a gamma probe. Overall, 35 patients were included in the study. The specific activity of the Tc-99m elute (in 5 mL) used for kit preparation was 2 mCi/10 mg in four, 1.5 mCi/10 mg in eight, 1.25 mCi/10 mg in eight, 1 mCi/10 mg in three, 0.75 mCi/10 mg in five, and 0.5 mCi/10 mg of 99mTc-Phytate in seven patients. For the first four groups of patients, we used two 0.2 mL injections, while in the latter two groups, three 0.2 mL injections were used. At least one sentinel node was detected in all patients but three in whom axilla was involved. Conclusion: Sentinel node biopsy can be achieved with low specific activity of Tc-99m elute at the time of Mo99-Tc-99m generator shortage. If special personal protection is used, sentinel node mapping can be done in nuclear medicine departments with excellent results despite the COVID-19 pandemic and disruption of generator shipment.
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Affiliation(s)
- Kayvan Sadri
- Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vahid Reza Dabbagh
- Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mahdi Asadi
- Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ramin Sadeghi
- Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Accidental diagnosis of COVID-19 pneumonia after 18F FDG PET/CT: a case series. Clin Transl Imaging 2020; 8:393-400. [PMID: 32989417 PMCID: PMC7512221 DOI: 10.1007/s40336-020-00388-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/11/2020] [Indexed: 12/15/2022]
Abstract
Purpose The aim of this case series is to illustrate possible [18F]-FDG uptake patterns associated to COVID-19. Methods Retrospective assessment of all Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scans performed for any clinical / oncological reason from 1st April 2020 to 30th April 2020. Results of PCR testing for SARS-CoV-2 were retrieved for all patients with lung consolidations and/or peripheral ground glass opacities characterized by increased metabolism to evaluate any possible association with the viral infection. Results Seven (4%) out of 172 FDG-PET scans were included. Six out of seven patients (85%) had positive RT-PCR for SARS-CoV-2, while one patient (15%) had possible (not PCR confirmed) COVID-19 pneumonia. Conclusion Suspicious accidental COVID-19 findings in Nuclear Medicine Department need to be reported and appropriately evaluated to implement proper supportive treatment and infection control measures.
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Klain M, Nappi C, Maurea S, De Risi M, Volpe F, Caiazzo E, Piscopo L, Manganelli M, Schlumberger M, Cuocolo A. Management of differentiated thyroid cancer through nuclear medicine facilities during Covid-19 emergency: the telemedicine challenge. Eur J Nucl Med Mol Imaging 2020; 48:831-836. [PMID: 32965559 PMCID: PMC7509822 DOI: 10.1007/s00259-020-05041-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 09/13/2020] [Indexed: 02/07/2023]
Abstract
Purpose To investigate whether a telemedicine service (TMS) carried out during the Covid-19 pandemic impacted on management of patients with differentiated thyroid cancer (DTC). Methods We retrospectively reviewed the number and the findings of outpatient visits in DTC subjects referred between March 11, 2020, and May 31, 2020, during the Covid-19 pandemic at the Radiometabolic Unit of the University of Naples Federico II. Office visits scheduled in March and May 2020 were converted in teleconsultation reaching all patients planned for an in-ward access to advise them to use the TMS for all clinical necessity. The number and the findings of DTC patients evaluated by in-ward access in the corresponding period of 2019 were also assessed for direct comparison. Results The number of outpatient visits performed by TMS during the pandemic (n = 445) and by in-ward access in the corresponding period of 2019 (n = 525) was comparable with only 15% of outpatient evaluations missed. Conclusions Our findings demonstrate the utility of telemedicine tools to avoid the potential negative impact of interruption or postponement of diagnostic and/or therapeutic procedures. Therefore, investments in medical network system development, including the implementation of telehealth approaches, should be encouraged at national and international levels.
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Affiliation(s)
- Michele Klain
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Simone Maurea
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Marina De Risi
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Fabio Volpe
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Elisa Caiazzo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Leandra Piscopo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | | | - Martin Schlumberger
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.
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