Initial investigation of ¹?F-NaF PET/CT for identification of vertebral sites amenable to surgical revision after spinal fusion surgery.

By London Spine
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Initial investigation of ¹⁸F-NaF PET/CT for identification of vertebral sites amenable to surgical revision after spinal fusion surgery.

Eur J Nucl Med Mol Imaging. 2012 Nov;39(11):1737-44

Authors: Quon A, Dodd R, Iagaru A, de Abreu MR, Hennemann S, Alves Neto JM, Sprinz C

Abstract
PURPOSE: A pilot study was performed in patients with recurrent back pain after spinal fusion surgery to evaluate the ability of (18)F-NaF PET/CT imaging to correctly identify those requiring surgical intervention and to locate a site amenable to surgical intervention.
METHODS: In this prospective study 22 patients with recurrent back pain after spinal surgery and with equivocal findings on physical examination and CT were enrolled for evaluation with (18)F-NaF PET/CT. All PET/CT images were prospectively reviewed with the primary objective of identifying or ruling out the presence of lesions amenable to surgical intervention. The PET/CT results were then validated during surgical exploration or clinical follow-up of at least 15 months.
RESULTS: Abnormal (18)F-NaF foci were found in 16 of the 22 patients, and surgical intervention was recommended. These foci were located at various sites: screws, cages, rods, fixation hardware, and bone grafts. In 6 of the 22 patients no foci requiring surgical intervention were found. Validation of the results by surgery (15 patients) or on clinical follow-up (7 patients) showed that (18)F-NaF PET/CT correctly predicted the presence of an abnormality requiring surgical intervention in 15 of 16 patients and was falsely positive in 1 of 16.
CONCLUSION: In this initial investigation, (18)F-NaF PET/CT imaging showed potential utility for evaluation of recurrent symptoms after spinal fusion surgery by identifying those patients requiring surgical management.

PMID: 22895860 [PubMed – indexed for MEDLINE]

EANM guideline for radionuclide therapy with radium-223 of metastatic castration-resistant prostate cancer.

By London Spine
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EANM guideline for radionuclide therapy with radium-223 of metastatic castration-resistant prostate cancer.

Eur J Nucl Med Mol Imaging. 2017 Dec 12;:

Authors: Poeppel TD, Handkiewicz-Junak D, Andreeff M, Becherer A, Bockisch A, Fricke E, Geworski L, Heinzel A, Krause BJ, Krause T, Mitterhauser M, Sonnenschein W, Bodei L, Delgado-Bolton RC, Gabriel M

Abstract
Radium Ra-223 dichloride (radium-223, Xofigo®) is a targeted alpha therapy approved for the treatment of castration-resistant prostate cancer (CRPC) with symptomatic bone metastases and no known visceral metastatic disease. Radium-223 is the first targeted alpha therapy in this indication providing a new treatment option, with evidence of a significant survival benefit, both in overall survival and in the time to the first symptomatic skeletal-related event. The skeleton is the most common metastatic site in patients with advanced prostate cancer. Bone metastases are a clinically significant cause of morbidity and mortality, often resulting in bone pain, pathologic fracture, or spinal cord compression necessitating treatment. Radium-223 is selectively accumulated in the bone, specifically in areas of high bone turnover, by forming complexes with the mineral hydroxyapatite (the inorganic matrix of the bone). The alpha radiation generated during the radioactive decay of radium-223 produces a palliative anti-tumour effect on the bone metastases. The purpose of this guideline is to assist nuclear medicine specialists in evaluating patients who might be candidates for treatment using radium-223, planning and performing this treatment, understanding and evaluating its consequences, and improving patient management during therapy and follow-up.

PMID: 29234845 [PubMed – as supplied by publisher]