99m Tc-HYNIC-FAPI-46 SPECT/CT Uptake in Lactating Breasts

ABSTRACT

A 36-year-old woman with a history of medullary thyroid carcinoma was referred for 99m Tc-HYNIC-FAPI-46 scan. Her calcitonin levels gradually increased after external beam radiation therapy, whereas her CEA levels were stable. A few suspicious tumoral lymphadenopathies were localized to the superior mediastinum. Interestingly, bilateral physiologic breast uptake was noticed, which was presumed to be due to lactation in the past 18 months. To our knowledge, physiologic breast uptake in 99m Tc-HYNIC-FAPI imaging has not been previously reported.

Comparing infusion-related reactions of the first full dose (600 mg) biosimilar ocrelizumab administration with the standard divided protocol in multiple sclerosis patients: a randomized controlled trial study

BACKGROUND

Ocrelizumab is a humanized antiCD20, thought to be a highly effective disease-modifying therapy (DMT). Its most frequent adverse effects are infusion-related reactions (IRRs). To reduce these reactions, the first dose of ocrelizumab is administered as two 300 mg infusions separated by two weeks. However, in the phase II trial of ocrelizumab, severe IRRs were not significantly different between two doses of 600 mg dose (two separate 300 mg doses) and 2000 mg dose (two separate 1000 mg doses). We compared the IRRs in undivided full (one 600 mg) and divided (two 300 mg) doses of ocrelizumab which is the standard protocol.

METHODS

MS patients (relapsing or primary progressive MS) who are selected to receive ocrelizumab by neurologist or MS fellowship were enrolled in an open-label randomized controlled trial. Iranian biosimilar of the drug (Xacrel® by Cinnagen, approved by the Iranian Food and Drug Administration in 2021) was used. The participants received the first dose of ocrelizumab as either one 600 mg dose in one session or two 300 mg doses in two weeks apart. IRRs during or in the first 24 h after infusion were recorded.

RESULTS

Of 332 participants, 150 received two 300 mg doses, and 182 received one 600 mg dose (by random selection). Life-threatening adverse effects were not observed in both groups. Overnight admission or permanent drug discontinuation was not needed. Temporary drug discontinuation was significantly higher in the one 600 mg dose group (p-value < 0.001). During the infusions, malaise (p-value: 0.003), skin reactions (p-value: 0.04), throat swelling (p-value: 0.03), and dyspnea (p-value: 0.01) were significantly increased in the intervention group. However, in the first 24 h, there was no significant difference between two different treatment protocols (one 600 mg dose or two 300 mg doses) in the onset of IRRS (p-value: 0.12).

CONCLUSION

These findings suggest one 600 mg dose of ocrelizumab administration for the first dose is relatively safe. With some protocol modifications, it could lead to fewer patient referrals, saving time and cost and improvement the access for patients.

Interesting Findings in 68 Ga-FAPI-46 PET/CT Imaging in a Patient With Glioblastoma Multiforme

ABSTRACT

A 55-year-old disabled man with glioblastoma multiforme was referred to us for fibroblast activation protein inhibitor (FAPI) PET/CT imaging. 68 Ga-DOTA-FAPI-46 scan revealed uptake in the primary tumor and unexpected uptakes in soft tissue, especially in periarticular regions. These latter foci were compatible with calcifications on the CT. One in the breast was compatible with fibrotic tissue, but 2 other foci, in the rectus abdominis and gallbladder wall, could not be correlated with the CT findings. In Neurogenic heterotopic ossification, hypoxia-associated oxidative stress results in the metaplastic transformation of fibroblasts. Abnormal differentiation of fibroblasts in neurogenic heterotopic ossification before ossification could explain radiolabeled FAPI avidity in the mentioned areas.

Effect of Arch Size and Implant Angulations on the Accuracy of Implant Impressions

PURPOSE

To evaluate the effects of arch size and implant angulation on the accuracy of implant impressions.

MATERIALS AND METHODS

Four different resin models (small and large) of edentulous maxilla were fabricated and four implants were inserted (Blossom®, ø 4.75 × 10 mm) in each model. Implants were either parallel or angled 25° buccally. Forty working casts (small parallel, small angled, large parallel, and large angled) were fabricated in dental stone (n=10). For each implant, linear and angular displacements were measured using a coordinate-measuring machine (CMM) and mean values were analyzed by univariate analysis (α = 0.05).

RESULTS

Arch size did not affect the linear or angular displacement (P ⟩ .05). However, the implant angulation had a marked influence on the linear displacement (P ⟨ .05). The largest linear displacement occurred in implant no. 4 of angled small groups.

CONCLUSION

Regardless of arch size, linear and angular accuracy of implant impression varied with the implant angulation.

Feasibility and Therapeutic Potential of 177Lu-Fibroblast Activation Protein Inhibitor-46 for Patients With Relapsed or Refractory Cancers: A Preliminary Study

INTRODUCTION

Fibroblast activation protein (FAP) is a member of the serine protease family and has a high expression in the stroma of approximately 90% of epithelial malignancies. The present investigation aimed to assess the feasibility, safety, and dosimetry data of 177Lu-FAPI-46 in diverse malignancies.

PATIENTS AND METHODS

Patients with advanced cancers with nonoperable tumors, or tumors refractory to conventional therapies, were enrolled. Treatment included escalating doses of 177Lu-FAPI-46 (1.85-4.44 GBq) per cycle using a combination of clinical and statistical expertise design, and intervals of 4 to 6 weeks were considered between the cycles. Biodistribution and dosimetry were examined by whole-body scans. We applied the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.03 to measure peptide-targeted radionuclide therapy (PTRT)-associated toxicity.

RESULTS

A total of 21 patients (11 females and 10 males) with a median age of 50 years (range, 6-79 years) were investigated. Of 21 participants, 18 cases were selected for PTRT. Overall, 36 PTRT cycles were performed. The median number of PTRT cycles and the median injected amount of activity in each cycle were 2 and 3.7 GBq, respectively. The dosimetric analysis revealed median absorbed doses of 0.026, 0.136, 0.886, and 0.02 with ranges of 0.023-0.034, 0.001-0.2, 0.076-1.39, and 0.002-0.2 mGy/MBq for the whole body, liver, kidneys, and spleen, respectively. The therapy was well tolerated in almost all patients.

CONCLUSIONS

The findings of this preliminary investigation might indicate the potential feasibility and safety of PTRT using 177Lu-FAPI-46 for different aggressive tumors. Moreover, the current study could be beneficial in determining the suitable amount of activity for a phase 2 study.

Effect of Arch Size and Implant Angulations on the Accuracy of Implant Impressions

PURPOSE

To evaluate the effects of arch size and implant angulation on the accuracy of implant impressions.

MATERIALS AND METHODS

Four different resin models (small and large) of edentulous maxilla were fabricated and four implants were inserted (Blossom®, ø 4.75 × 10 mm) in each model. Implants were either parallel or angled 25° buccally. Forty working casts (small parallel, small angled, large parallel, and large angled) were fabricated in dental stone (n=10). For each implant, linear and angular displacements were measured using a coordinate-measuring machine (CMM) and mean values were analyzed by univariate analysis (α = 0.05).

RESULTS

Arch size did not affect the linear or angular displacement (P ⟩ .05). However, the implant angulation had a marked influence on the linear displacement (P ⟨ .05). The largest linear displacement occurred in implant no. 4 of angled small groups.

CONCLUSION

Regardless of arch size, linear and angular accuracy of implant impression varied with the implant angulation.

Seasonal variation in the chemical composition, antioxidant activity, and total phenolic content of Artemisia absinthium essential oils

BACKGROUND

The genus Artemisia belonging to the Compositae (Asteraceae) family and many traditional uses from the Artemisia species were reported. Artemisia absinthium is one of the species in this genus and commonly used in the food industry in the preparation of aperitifs, bitters, and spirits.

OBJECTIVE

Evaluation of the effect of different harvesting stages on the composition of essential oil and antioxidant capacity of A. absinthium.

MATERIALS AND METHODS

Essential oils from the aerial parts of A. absinthium, collected in three stages (preflowering, flowering, and after-flowering) from plants grown in the North Khorasan province of Iran were obtained by steam distillation and the chemical composition of the oils was analyzed by gas chromatography-mass spectrometry and antioxidant activity and total phenolic content were determined by 2-diphenyl-1-picrylhydrazyl assay and Folin-Ciocalteu method.

RESULTS

Analysis of the isolated oils revealed the presence of 44 compounds, mainly alpha-pinene, sabinene, beta-pinene, alpha-phellandrene, p-cymene and chamazulene. Alpha-phellandrene, and chamazulene were major compounds in preflowering stage, but beta-pinene and alpha-phellandrene were major in flowering and past-flowering stages. Flowering stage had highest yield and after flowering stage had lowest yield. The essential oil of preflowering stage had the highest amount of antioxidant compound (chamazulene). Preflowering stage with highest amount of phenolic compounds had the strongest antioxidant activity with the lowest amount of EC50.

CONCLUSION

This study showed that the harvesting stage had significant effects on chemical composition and antioxidant properties of essential oils, and chamazulene is main compound for antioxidant activity in A. absinthium.

Dexamethasone levels in treated pregnant women and newborn infants

Dexamethasone concentration was measured in plasma and amniotic fluid by radioimmunoassay using a rabbit antiserum raised against DX-hemisuccinate-albumin. Recoveries of added tracers averaged 70% after paper chromatography. The within- and between-assay coefficients of variation averaged 10%. The lower limit of detection was 0.2 mug/dl when 0.4 ml of plasma was assayed. Ten healthy pregnant women at term had cesarean sections 8 to 11 hours following administration of 8 mg of DX orally. DX levels in maternal vein, in umbilical vein and artery, and in amniotic fluid averaged 2.2, 2.9, 2.6, and 2.5 mug/dl, respectively. Although cortisol levels were markedly suppressed, the total relative glucocorticoid activity in blood of fetuses treated with DX far exceeded that of the untreated group.