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Chan SH, Huang CK, Luzhbin D, Hou PN, Chang YT, Wu J. Meta-analysis of the effectiveness of heparin in suppressing physiological myocardial FDG uptake in PET/CT. J Nucl Cardiol 2023; 30:2454-2463. [PMID: 37258954 DOI: 10.1007/s12350-023-03296-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 05/02/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND The present meta-analysis aims to investigate the effectiveness of heparin administration in suppressing physiological myocardial 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET)/computed tomography (CT), as its role in this regard has not been well investigated. METHODS PRISMA guidelines were used to interrogate the PubMed, Embase, Cochrane library, Web of Knowledge, and www.clinicaltrail.gov databases from the earliest records to March 2023. The final analysis included five randomized controlled trials (RCTs). Meta-analysis was conducted to compare the effectiveness of unfractionated heparin (UFH) administration versus non-UFH administration, and subgroup analysis based on fixed and variable fasting durations was conducted. Effect sizes were pooled using a random-effects model, and the pooled odds ratios (ORs) were calculated. RESULTS Five eligible RCTs with a total of 910 patients (550 with heparin, 360 without heparin) were included. The forest plot analysis initially indicated no significant difference in the suppression of myocardial FDG uptake between the UFH and non-UFH groups (OR 2.279, 95% CI 0.593 to 8.755, p = 0.23), with a high degree of statistical heterogeneity (I2 = 91.16%). Further subgroup analysis showed that the fixed fasting duration group with UFH administration had statistically significant suppression of myocardial FDG uptake (OR 4.452, 95% CI 1.221 to 16.233, p = 0.024), while the varying fasting duration group did not show a significant effect. CONCLUSIONS According to the findings of our meta-analysis, we suggest that intravenous administration of UFH can be considered as a supplementary approach to suppress myocardial FDG uptake.
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Affiliation(s)
- Shan-Ho Chan
- Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Cheng-Kai Huang
- Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
- Department of Nuclear Medicine, Cheng-Ching General Hospital, Chung-Kang Branch, Taichung, Taiwan
| | - Dmytro Luzhbin
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | - Po-Nien Hou
- Department of Nuclear Medicine, Chang-Bing Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Yu-Ting Chang
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, No.155, Sec.2, Linong Street, Taipei, 11221, Taiwan
| | - Jay Wu
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, No.155, Sec.2, Linong Street, Taipei, 11221, Taiwan.
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Hung SY, Luzhbin D, Chang SJ, Chao MM, Wu J. Assessing body dose rate constant and effective body absorption factor in Taiwanese reference phantoms. Radiat Prot Dosimetry 2023:7152944. [PMID: 37148237 DOI: 10.1093/rpd/ncad145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 04/06/2023] [Accepted: 04/12/2023] [Indexed: 05/08/2023]
Abstract
The self-attenuation of a patient's body is an important factor in nuclear medicine for designing radiation shielding. Taiwanese reference man (TRM) and Taiwanese reference woman (TRW) were constructed to simulate the body dose rate constant and the effective body absorption factor for 18F-FDG, 131I-NaI and 99mTc-MIBI using the Monte Carlo technique. For TRM, the maximum body dose rate constants for 18F-FDG, 131I-NaI and 99mTc-MIBI were 1.26 × 10-1, 4.89 × 10-2 and 1.76 × 10-2 mSv-m2/GBq-h, respectively, at heights of 110, 110 and 100 cm. For TRW, the results were 1.23 × 10-1, 4.75 × 10-2 and 1.68 × 10-2 mSv-m2/GBq-h at heights of 100, 100 and 90 cm. The effective body absorption factors were 32.6, 36.7 and 46.2% for TRM and 34.2, 38.5 and 48.6% for TRW. Regional reference phantoms along with the derived body dose rate constant and effective body absorption factor should be used for determining regulatory secondary standards in nuclear medicine.
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Affiliation(s)
- Shih-Yen Hung
- Department of Radiology, Chi Mei Medical Center, Liouying, Tainan 73657, Taiwan
- Department of Medical Imaging and Radiological Science, Central Taiwan University of Science and Technology, Taichung 40601, Taiwan
| | - Dmytro Luzhbin
- Institute of Statistical Science, Academia Sinica, Taipei 11529, Taiwan
| | - Shu-Jun Chang
- Health Physics Division, Institute of Nuclear Energy Research, Taoyuan 325207, Taiwan
| | - Max Min Chao
- Department of Radiology, Chi Mei Medical Center, Liouying, Tainan 73657, Taiwan
- Department of Medical Imaging and Radiological Science, Central Taiwan University of Science and Technology, Taichung 40601, Taiwan
| | - Jay Wu
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
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Huang CK, Hou PN, Luzhbin D, Yang CW, Chang YT, Wu J. Effective suppression of myocardial glucose uptake using predesigned low-carbohydrate boxed meals. J Nucl Cardiol 2023; 30:484-494. [PMID: 35918591 DOI: 10.1007/s12350-022-03076-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/22/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND Dietary preparation protocols are an effective means to suppress physiological myocardial 18F-fluorodeoxyglucose (FDG) uptake. This study aimed to investigate the efficacy of various carbohydrate-restricted diets using predesigned boxed meals. METHODS The patients were divided into four groups to undergo different preparatory protocols as follows: a minimum 15-hour fast alone, two meals of high-fat, low-carbohydrate diet (HFLCD), two meals of high-animal-protein, low-carbohydrate diet (HAPLCD), and two meals of high-plant-based-protein, low-carbohydrate diet (HPPLCD). Boxed meals were prepared to meet the required carbohydrate restrictions. Myocardial SUVmax and SUVmean were measured and the suppression rate was analyzed. RESULTS The average myocardial SUVmax of fast alone, HFLCD, HAPLCD, and HPPLCD were 8.26 ± 5.85, 2.21 ± 1.50, 2.34 ± 1.88, and 4.10 ± 3.61, respectively, and the suppression rates were 36.6%, 93.3%, 93.3%, and 70%, respectively. The effectiveness of HFLCD, HAPLCD, and HPPLCD was all statistically superior to that of a 15-hour fast alone. SUVmax of HFLCD and HAPLCD showed no significant differences (p = 1), whereas HFLCD and HPPLCD had significant differences (p = .046). CONCLUSIONS Using the predesigned boxed meals based on carbohydrate restriction, HFLCD, HAPLCD, and HPPLCD can be administered to patients with different dietary needs while providing a substantial reduction in physiological myocardial FDG uptake.
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Affiliation(s)
- Cheng-Kai Huang
- Department of Nuclear Medicine, Chung-Kang Branch, Cheng-Ching General Hospital, Taichung, Taiwan
- Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Po-Nien Hou
- Department of Nuclear Medicine, Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Dmytro Luzhbin
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | - Chao-Wei Yang
- Department of Nuclear Medicine, Chung-Kang Branch, Cheng-Ching General Hospital, Taichung, Taiwan
| | - Yu-Ting Chang
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Taipei, 11221, Taiwan
| | - Jay Wu
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Taipei, 11221, Taiwan.
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Abstract
Metal implants often produce severe artifacts in the reconstructed computed tomography (CT) images, causing information and image detail loss and making the CT images diagnostically unusable. In order to eliminate the metal artifacts and enhance the diagnostic value of the reconstructed CT images, a post-processing metal artifact reduction algorithm, based on a tissue-class model segmented by thresholding and k-means clustering with spatial information, is proposed. The image inpainting technique is incorporated into the algorithm to improve the segmentation accuracy for CT images severely corrupted by metal artifacts. A study of a water phantom and of two sets of clinical CT images was performed to test the algorithm performance. The proposed method effectively eliminates typical metal artifacts, restores the average CT numbers of different tissues to the proper levels, and preserves the edge and contrast information, thus allowing the accurate reconstruction of the tissue attenuation map. The quality of the artifact-corrected CT images allows them to be subsequently used in other clinical applications, such as three-dimensional rendering, dose estimation for radiotherapy, attenuation correction for PET and SPECT, etc. The algorithm does not rely on the use of the raw sinogram and so is not limited by the proprietary format restrictions.
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Affiliation(s)
- Dmytro Luzhbin
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei, Taiwan, 11221, Republic of China
| | - Jay Wu
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei, Taiwan, 11221, Republic of China.
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Chao KH, Huang CK, Luzhbin D, Wu J. Four patients with gastrointestinal bleeding identified by a modified in vivo technique with labeled red blood cells sedimentation. Hell J Nucl Med 2017; 20:86-88. [PMID: 28315915 DOI: 10.1967/s002449910513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 02/08/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Gastrointestinal bleeding scintigraphy (GIBS) offers the advantage of continuous monitoring of patients to localize the site of gastrointestinal bleeding. In this study, a modified in vivo labeling method with sedimentation of the labeled red blood cells (RBC) was applied to remove free technetium-99m (99mTc) and increase labeling efficiency. PATIENTS AND METHODS Four patients were studied. A modified in vivo RBC labeling method was used. After 10 minutes of RBC sedimentation, patients' blood plasma in the upper part of the syringe was removed, and the erythrocytes labeled with 99mTc were re-administered to the patient. Serial dynamic scintiphotos were taken during the first 60 minutes. Delayed static images were acquired up to 22 hours after injection. RESULTS The labeling efficiency of 99mTc-RBC increased up to 93%. GIBS can be performed after 20 hours post-injection and provide accurate diagnosis of gastrointestinal bleeding. No false positive findings due to free 99mTc accumulation were observed for the four patients. CONCLUSION The modified in vivo method with sedimentation is a simple and effective way to increase the labeling efficiency and thus the diagnosis for the detection of gastrointestinal bleeding.
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Affiliation(s)
- Kang-Hung Chao
- Department of Nuclear Medicine, Chung-Kang Branch, Cheng-Ching General Hospital, Taichung, Taiwan.
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Liao GJ, Chien FT, Luzhbin D, Chen YL. Entropic attraction: Polymer compaction and expansion induced by nano-particles in confinement. J Chem Phys 2015; 142:174904. [DOI: 10.1063/1.4919650] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Affiliation(s)
- Guo-Jun Liao
- Department of Physics, National Taiwan University, Taipei, Taiwan
| | - Fan-Tso Chien
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - Dmytro Luzhbin
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - Yeng-Long Chen
- Department of Physics, National Taiwan University, Taipei, Taiwan
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
- Department of Chemical Engineering, National Tsing-Hua University, Hsinchu, Taiwan
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