Multi-time-point kidney dosimetry for 177Lu-DOTATATE peptide receptor radionuclide therapy (PRRT) is resource-intensive, and delayed-phase imaging is infeasible where PRRT is delivered during a short hospitalization. We evaluated a single-time-point (STP) method using a cohort-specific half-life fraction (HLF) correction at 4–120 h post-injection. We retrospectively analyzed 17 patients (34 kidneys) after a first 177Lu-DOTATATE cycle (October 2021–January 2024). Reference doses came from a 4-time-point (4TP) SPECT/CT protocol at 4, 24, 72 and 120 h. STP doses were compared with the reference by mean percent error (MPE), root mean square error (RMSE), Bland–Altman analysis and the Friedman test with Holm post-hoc correction. Four-fold cross-validation, with the HLF re-derived from training folds only, was applied at 4 and 24 h. The mean 4TP dose was 3120.5 ± 1015.7 mGy. STP (4 h) gave 3307.6 ± 1131.7 mGy (not significantly different), whereas 24, 72 and 120 h significantly overestimated it. The whole-cohort MPE was 8.3 ± 31.1
Amyloid positron emission tomography (PET) and plasma biomarkers are clinically established; however, their topographical relationship with regional tau burden remains unclear. We investigated whether amyloid PET and plasma biomarkers are associated with regional tau pathology, measured using second-generation tracer florzolotau (18F) PET, across the Alzheimer’s disease (AD) continuum. This cross-sectional study enrolled participants who underwent biomarker assessment between September 2018 and May 2022. The primary outcome was the voxel-wise spatial correlation of florzolotau (18F) standardised uptake value ratio with amyloid PET centiloid and plasma biomarkers, assessed using age- and sex-adjusted whole-brain and region-of-interest (ROI) linear regression analyses, including multivariate models adjusted for amyloid PET centiloid. The study included 92 individuals (mean age, 71 [standard deviation, 8.8] years; 46 men), comprising 40 amyloid-negative healthy controls, 10 patients with preclinical AD, 21 with mild cognitive impairment due to AD, and 21 with AD dementia. In initial analyses, regional tau uptake correlated widely with plasma amyloid-beta 42/40 (Aβ42/40) ratio, p-tau, and glial fibrillary acidic protein (GFAP). However, following multivariate adjustment for global amyloid burden, correlations for Aβ42/40 and GFAP were completely abolished. In contrast, plasma p-tau217, p-tau181, and neurofilament light chain (NfL) maintained significant amyloid-independent correlations with temporoparietal tau uptake, with p-tau217 uniquely retaining robust and extensive associations across the cortex. Plasma p-tau217 is strongly associated with the spatial distribution and severity of tau burden independent of global amyloid burden. Measuring plasma p-tau217 holds significant potential for patient stratification and monitoring in the era of disease-modifying therapies. UMIN Clinical Trials Registry (UMIN000032027), registered 31 March 2018, prospectively registered (URL https//center6.umin.ac.jp/cgiopenbin/ctr_e/ctr_view.cgi? recptno=UMIN000032027). Japan Registry of Clinical Trials (jRCTs031180225), prospectively registered (URL https//jrct.niph.go.jp/enlatestdetail/jRCTs031180225).
To evaluate whether serial quantitative computed tomography (CT) volume change is associated with mortality, acute exacerbation, and concurrent pulmonary function decline in fibrotic interstitial lung disease. This retrospective single-center study included 102 participants who underwent surgical lung biopsy and paired CT between October 2018 and August 2023. A deep learning-based quantitative CT system measured fibrotic lesion and normal-lung volumes. Spearman correlations compared CT measures. Cox models assessed baseline volumes and annualized changes; linear models assessed concurrent pulmonary function change. Median age was 65 years [interquartile range, 56–69]; 68 participants were men. During median 4.82 years of follow-up, 12 deaths and 15 acute exacerbations occurred. Fibrotic lesion and normal-lung volumes were inversely correlated at baseline and follow-up, as were their annualized changes (ρ = −0.53, − 0.60, and − 0.56, respectively). Annualized fibrotic lesion volume increase (hazard ratio per 100 mL/year, 1.40; 95
Recent advances in diagnostic imaging have significantly impacted surgical planning and options. In breast reconstruction using abdominal flaps, a method employing flaps from the lower abdomen allows for a high-quality reconstruction with a morphology and texture resembling those of the contralateral breast. Understanding microvascular patterns is crucial in this surgery to prevent volume deficiencies and contribute to successful tissue transplantation while maintaining the softness of the tissue. While the location and number of "perforators"—arteriovenous bundles penetrating the anterior sheath of the rectus abdominis—have traditionally been the focus, recent studies have further emphasized the importance of selecting appropriate perforating vessels to maintain the vascular network within the superficial adipose tissue and subcutaneous tissue and to elevate a high-quality flap with extensive and stable blood flow. Clinical studies using contrast-enhanced CT have drawn attention to the midline-crossing arterial network, demonstrating its relationship with a wide range of hemodynamic areas. Preoperatively, clearly identifying the blood vessels linking the left and right sides of the abdominal midline provides valuable information for planning free DIEP flaps for breast reconstruction, ensuring stable blood flow to the flap. However, clear visualization with contrast-enhanced CT requires high volumes of contrast agents, and color Doppler ultrasound has difficulty visualizing horizontally; therefore, a non-invasive and superior imaging method is required. Photoacoustic imaging can comprehensively and noninvasively visualize the subcutaneous vascular network and is attracting attention as a new preoperative examination technique. We conducted clinical research using newly developed medical photoacoustic imaging and reported the results and future challenges in several publications. We have also recently reported the impact of abdominal surgical scars on the midline-crossing artery. This review summarizes the current trends in preoperative vascular studies for breast reconstruction using abdominal flaps and discusses the current state of evolving photoacoustic imaging technology.
To evaluate whether anatomical volume-of-interest (VOI) thresholds derived from a SINPHONI-2 reference cohort could provide standardized component-wise quantification of disproportionately enlarged subarachnoid-space hydrocephalus (DESH) in a separate clinical cohort. Thresholds were derived from 61 SINPHONI-2 cases using a prespecified mildest-case rule and applied without re-optimization to 33 participants with probable idiopathic normal pressure hydrocephalus (iNPH), 26 with Alzheimer disease, 18 with progressive supranuclear palsy, and 20 normal controls. DESH metric-S summed binary positivity for ventriculomegaly, Sylvian fissure enlargement, and tight high-convexity and medial sulci; DESH metric-I was defined as (Sylvian fissure volume + lateral ventricular volume)/high-convexity and medial sulcal volume. Evans index and callosal angle were evaluated as conventional imaging measures. For iNPH versus pooled non-iNPH, DESH metric-S had an area under the curve (AUC) of 0.958 (95
