01.bcnm final programme general information page 01-10.cdr

NuclearMedicineBecomes MoreIndividualized

ORGANIZED BY

THE HELLENIC SOCIETY

OF NUCLEAR MEDICINE AND

MOLECULAR IMAGING

th th17 -20 June, 2016, “Makedonia Palace” Hotel, Thessaloniki

Final Programme& Abstract book

www.bcnm2016.eu


th th17 -20 June, 2016“Makedonia Palace” Hotel Thessaloniki

ORGANIZED BY THE HELLENIC SOCIETY OF NUCLEAR MEDICINE AND MOLECULAR IMAGING

Table of Contents

F i n a l P r o g r a m m e & A b s t r a c t B o o k

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Welcome Message

Auspices

Committees

Organizers

General Information

Scientific Programme

Acknowledgments

Exhibition Plan

Oral Presentations

Poster Presentations

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Welcome Message


Dear Colleagues and Friends,

It is my pleasure to welcome you to the 5th Balkan Congress of Nuclear Medicine, which will be jointly held with the 13th National Congress of Nuclear Medicine, titled

“Nuclear Medicine becomes more individualized”

The basic goal of the Congresses is to update the developments in the field of nuclear medicine and to exchange opinions in topics concerning the diagnostic and therapeutic applications of radioisotopes. Entering the era of personalized medicine, molecular imaging lays the foundations so as to play a critical role in the upcoming advances. New radiopharmaceuticals, new hybrid imaging technologies, new therapeutic strategies and “in vivo” presence at medical decisions constitute the current reality and the future potentiality of nuclear medicine.

We are honored to welcome here in Thessaloniki, June 17-20 2016, all the lecturers and speakers, the auspices and authorities, the sponsors, and all the

th thparticipants and attendees at the 5 BCNM & 13 NCNM 2016 and all the parallel actions and sessions.

We are also honored to welcome all the patients'- relatives'-and friends' support organizations for their actions in general and contributions to the parallel sessions of the congresses.

Thessaloniki, an UNESCO World Heritage Site, with many Greek, Roman, Byzantine, Ottoman and Jewish monuments, founded around 315 BC by general Kassandros in order to honor his wife, princess Thessaloniki, is the largest city in Northern Greece and is considered the cultural capital of the country.

Let us share, with your contribution and active participation, the medical advances in nuclear Medicine for the well-being of the patients!

Enjoy your stay at the congresses and Thessaloniki!

Sincerely yours, Vassilios PrassopoulosPresident of 5th BCNM 2016 and 13nth NCNM 2016

Nuclear Medicine Physician,

Director of Nuclear Medicine & PET/CT Dpts.

HYGEIA SA

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Auspices


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Committees

President of the congresses: Prassopoulos Vassilios Athens

Organizing Committee: Dalianis Konstantinos Doumas ArgyrisGerasimou Georgios Iakovou IoannisNikaki Alexandra Papazisi Alexandra Pipikos Theodoros Vlachou Fani

AthensThessalonikiThessalonikiThessalonikiAthensThessalonikiAthensAthens

President: Gotzamani Psarrakou Anna Thessaloniki

Members: Apostolopoulos Dimitrios Artiko VeraA–zlem Atay Lutfiye Bochev PavelBuzumurga ClaudiaDražen HuićFotopoulos AndreasFrangos SavvasFranceschi MajaGaberscek SimonaGarcheva-Tsacheva Marina Girotto Neva Hadjiiska Valerija Hatice Erbas BelkisHojker Sergej Kučukalic ElmaNejra Latić KermoMititelu RalucaObradovic VladimirOzcan ZehraPrassopoulos Vassilios Rajkovaca Zvezdana Sobic Saranovic Dragana Titka Vladimir Ugrinska AnaZagar Ivana

PatraBelgradeAnkaraVarnaBrasovZagrebIoanninaNikosiaZagrebLjubljanaSofiaRijekaSofiaAnkaraLjubljanaSarajevoZenicaBucarestBelgradeIzmirAthensBanja LukaBelgrade TiranaSkopiaLjubljana

Committees of the 5th Balkan Congress & the 13nth National Congress of NuclearMedicine.

Scientific Committee of the 5th Balkan Congress of Nuclear Medicine


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Scientific Committee of the 13nth National Congress of Nuclear Medicine.

Awards Committee

President: Datseris Ioannis Athens

Members: Apostolopoulos Dimitrios Chatzipavlidou Vassiliki Iakovou Ioannis Notopoulos Athanassios

Patra Thessaloniki Thessaloniki Thessaloniki



Committees


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Congresses and event / activity organized



Organizers


Congress Communication & StrategyPeppermind Brand Communication

32, Kifissias AvenueAtrina Building - 15125 MarousiT +30 2107770656F +30 7770656

www.peppermind.gr [email protected]

Congress PCOGoldair Congress

1st km Paianias-Markopoulou Avenue190 02 Paiania-Greece P.O. Box 126T +30 210 32 74 570F +30 210 33 11 021

[email protected]

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General Information

Congress VenueMakedonia Palace2, Megalou Alexandrou Avenue, GR-54640, Thessaloniki, Greecewww.makedoniapalace.com

Official LanguageThe official language of the congress is English

Registration information

Registration CategoryOn Site

Registration Fee

Nuclear Physicians, Members of HSNM&MI Ä70,00

Nuclear Physicians Ä130,00

Other Specialties Ä30,00

Residents* Ä50,00

Students** Ä30,00

Technologists Ä50,00

Exhibitors Ä130,00

Accompanying Person Ä30,00

* An official letter from the Program Director is needed to obtain the resident's reduced fee** Student ID (or copy) should accompany the registration documents

Registration Fee IncludesFor Delegates, Residents, Nurses and Students:Access to Conference and Exhibition Hall Opening Ceremony & Welcome Reception Lunch and mid-session coffee as scheduled in the conference program Program, Certificate and other conference material Το register visit www.bncm2016.eu

BadgesBadges will be delivered to all registered delegates from the Congress Secretariat. For organizational and security reasons all delegates, are kindly requested to wear their badges during all congress scientific activities and social events. The badge allows to the scientific sessions, exhibition area, opening ceremony and welcome reception.


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General Information


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03

ScientificProgramme




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Friday 17 June, 2016Hall Aristotelis I

14:00Round Table Urology

Moderators: Charis Aidonopoulos Thessaloniki - Anna Psarrakou Thessaloniki

Clinical Dilemmas in Prostate CancerΙοannis Georgiopoulos Athens

Role of Hybrid Nuclear Medicine methods and PET/CT in Prostate CancerNikolaos Papathanasiou Athens

Renal transplantation- Radionuclide evaluationAthanassios Notopoulos Thessaloniki

Radionuclide treatment in osseous metastasisDimitrios Apostolopoulos Patra

Scholiast: Nikolaos Koliakos Thessaloniki

Round Table Oncology I

Moderators: Vassiliki Chatzipavlidou Thessaloniki - Irena Kostadinova, Sofia

Radionuclide detection of sentinel nodeSofia Koukouraki Heraklio

PET/CT in staging and treatment response in Lymphomas Pavel Bochev Varna

Breast malignancies: Is still any role of Nuclear Medicine?Fani Vlachou Athens

PET/CT in decision making of Lung cancerSofia Chatziioannou Athens

Coffee Break

16:00

18:00

18:30

20:30

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Friday 17 June, 2016Hall Aristotelis II

13:00-15:00Oral Presentations I OncologyChairpersons: Sofia Saranti Athens - Vladimir Titka Tirana

OP01HIGHLY SPECIFIC NUCLEAR MEDICINE METHOD FOR DIFFERENTIAL DIAGNOSIS OF ABDOMINAL TUMOR

1 2 3Todorovic - Tirnanic Mila , Cvetkovic Zorica , Suvajdžic - Vukovic Nada1Faculty of Medicine, University of Belgrade, Serbia and Center of Nuclear Medicine, Clinical Center of Serbia, Belgrade, Serbia2Department of Hematology, Clinical Hospital Center Zemun, Belgrade, Serbia3Faculty of Medicine, University of Belgrade, Serbia, and Clinic of Hematology, Clinical Center of Serbia, Belgrade, Serbia

OP02BREAST CANCER IMAGING WITH 18 F-FDG PET/CT: DO THE SIZE AND SUVMAX OF PRIMARY CANCER MASS AFFECT PET/CT PARAMETERS OF METASTATIC REGIONAL LYMPH NODES?

1 2 2Ayaz Sevin , Ayaz Umit Yasar , DOGen Mehmet Ercument1Mersin State Hospital Department of Nuclear Medicine2Mersin Women's and Children's Hospital Department of Radiology

OP04A FACTOR ANALYSIS OF SERUM MARKERS INDICATING TUMOR ACTIVITY, BONE METABOLISM AND OSTEOCLASTOGENESIS IN ADVANCED BREAST CANCER

1 1 2Notopoulos Athanasios , Likartsis Christodoulos , Notopoulos Panayiotis , Alevroudis 1 3 1 1Emmanouil , Psarras Kyriakos , Meristoudis Georgios , Thomopoulou Angeliki , Kotsira

1 1 4Matina , Zaromytidou Evangelia , Gotzamani - Psarrakou Anna

1 2 1 2Karageorgou Maria , RadoviC Magdalena , Tsoukalas Charalampos , AntiC Bratislav , 3 1 1 4Gazouli Maria , Paravatou - Petsotas Maria , Xanthopoulos Stavros , Calamiotou Maria ,

5 2 1Stamopoulos Dimosthenis , VranjeŠ - DuriC Sanja , Bouziotis Penelope

OP03FDG PET/CT IN THE MANAGEMENT OF LANGERHANS CELL HYSTIOCYTOSIS.

Bochev PavelNuclear medicine department St Marina hospital, Varna, Bulgaria

1Department of Nuclear Medicine, Hippokration General Hospital, Greece2Laboratory of Neuroinformatics, Technological Institute of Central Macedonia32rd Department of Propedeutic Surgery, Aristotelian University of Thessaloniki42nd Department of Nuclear Medicine, Aristotelian University of Thessaloniki

OP05FE3O4-DPD NANOPARTICLES LABELED WITH GALLIUM-68 AS POTENTIAL PET/MRI IMAGING AGENTS

1INRASTES, NCSR “Demokritos”, Athens, Greece2“Vinca” Institute of Nuclear Sciences, University of Belgrade, Belgrade, Serbia3School of Medicine, NKUA, Athens, Greece4Department of Solid State Physics, NKUA, Athens, Greece5Department of Solid State Physics, NKUA,INN, NCSR “Demokritos”, Athens, Greece

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OP06MATLAB IN VOXEL INTERNAL DOSIMETRY 111IN AND 177LU THERAPY

1 2 2 1 2Vamvakas Ioannis , Synefia Stella , Lyra Maria , Kostakis Vasilios , Ttofi Elena1Iaso Hospital, Athens 2Aretaieion Hospital, Athens

OP08METHOTREXATE LABELING WITH 99MTC – PRECLINICAL STUDIES

1 2 3 2Papachristou Maria , Bouziotis Penelope , Kastis George , Xanthopoulos Stavros , Datseris 1Ioannis

1Radiopharmacy, Nuclear Department – PET/CT, GHA «Evaggelismos»2Radiochemical Studies Laboratory, INRaSTES, NCSR “Demokritos”3Research Centre of Mathematics, Academy of Athens

OP09THE IMPACT OF 68GA-DOTATATE PET/CT IMAGING ON MANAGEMENT OF PATIENTS WITH NEUROENDOCRINE TUMOURS

1 1 2 1Skoura Evangelia , Michopoulou Sofia , Mohmaduvesh Mullan , Panagiotidis Emmanouil , 1 2 1 1Al Harbi Mohammed , Toumpanakis Christos , Almukhailed Omar , Kayani Irfan , Syed

1 3 3 2 1Rizwan , Navalkissoor Shaunak , Ell Peter J , Caplin Martyn E , Bomanji Jamshed1Nuclear Medicine Department, University College Hospital, London, United Kingdom2Neuroendocrine Tumour Unit, Royal Free Hospital, London, United Kingdom3Nuclear Medicine Department, Royal Free Hospital, London, United Kingdom

OP10COMPARISON OF 68GA-DOTATATE AND 18F-FDG PET/CT IN PATIENTS WITH NEUROENDOCRINE TUMORS

1 2 3Panagiotidis Emmanouil , Alshammari Alshaima , Michopoulou Sofia , Mohmaduvesh 3 2 2 1 2Mullan , Al - Harbi Mohammed , Berta Maria , Skoura Evangelia , Caplin Martyn ,

2 1Toumpanakis Christos , Bomanji Jamshed1 Nuclear Medicine Department, University College Hospital, London, United Kingdom2 Neuroendocrine Tumour Unit, Royal Free Hospital, London, United Kingdom3MSc4MD

OP11

18F-FDG-PET/CT IN RESTAGING TESTICULAR CANCER PATIENTS

Nikaki Alexandra, Efthymiadou Roxani, Vlachou Fani, Savvidou Despina, Pipikos Theodoros, Kechagias Dimitrios, Dalianis Konstantinos, Papoutsis Vasileios, Andreou Ioannis, Prassopoulos Vasileios

PET/CT Department, HYGEIA Hospital, Athens, Greece







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Invited Lectures Hosted by EANM

Chairpersons: Panagiotis Georgoulias Larissa - Marina Garcheva-Tsacheva Sofia

Anatomy Refresher and Cross-sectional Imaging: ThoraxAnatomy Refresher and Cross-sectional Imaging: Abdomen & PelvisCharlotte Fowler London

Hybrid imaging of musculoskeletal system Frederic Paycha Suresnes



16:00

17:00

17:00-18:00





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Saturday 18 June, 2016Hall Aristotelis I

09:00

11:00

11:00-11:30

Round Table Cardiology

Moderators: Maria Koutelou Athens - Dragana Sobic Saranovic Belgrad

The plane of Nuclear Cardiology in the diagnosis of coronary arteries diseaseClaudia Buzumurga Brasov

Value of viability assessment using SPECT and PET In patients with ischemic cardiomyopathyLuka Lezaic Ljubljana

Myocardial Innervation – role of PET and SPECT imagingMaria Koutelou Athens

Imaging cardiac sarcoidosis- the role of PET/CT in diagnosis and follow upDragana Sobic Saranovic Belgrade

Scholiast: Panagiotis Georgoulias Larissa

Invited Lecture

Chairpersons: Raluca Mititelu Bucarest - Vassilios Prassopoulos Athens

Imaging neurodegeneration: from metabolic patterns to individual diagnosisMarco Pagani Rome

Coffee Break

Light Lunch

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14:30-15:30

12:30 - 13:30







National Delegates Assembly

Round Table Neurology

Moderators: Vera Artico Belgrad - Andreas Fotopoulos Ioannina

Brain imaging of movement disordersGeorgios Gerasimou Thessaloniki

FDG PET/CT in the presurgical evaluation of epileptic patientsBelkis Erbas Ankara

Brain tumors evaluation PET and SPECT imagingSpyros Tsiouris Ioannina

Scholiast: Andreas Fotopoulos Ioannina

Invited Lecture Hosted by EANM

Chairperson: Pavlos Vasilakos Patra

PET/CT and PET/MRI molecular imaging for targeted therapy Roberto Delgado Bolton Madrid

Opening Ceremony – President's Reception

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17:00

17:30

21:00

15:30

17:00

14:30-15:30






Saturday 18 June, 2016Hall Aristotelis II

Oral Presentations II PediatricsChairperson: Athanasios Notopoulos Thessaloniki

OP12ADVANCED QUANTITATIVE ANALYSIS OF TC-99M MAG3 DIURETIC RENOGRAM IN CHILDREN WITH ANTENATALLY DETECTED RENAL PELVIC DILATATION

1 2 1 3Beatovic Slobodanka , Jankovic Milica , Sobic - Saranovic Dragana , Radulovic Marija , 1 1Blagic Miroslava4, Jaksic Emilija , Artiko Vera

1University of Belgrade Faculty of Medicine, Center for Nuclear Medicine, Clinical Center of Serbia, Belgrade, Serbia2University of Belgrade Faculty of Electrical Engineering, Belgrade, Serbia3Military Medical Academy, Institute of Nuclear Medicine, Belgrade, Serbia4Center for Nuclear Medicine, Clinical Center of Serbia, Belgrade, Serbia

OP13THORACIC ECTOPIC KIDNEY IN A CHILD

Titka Vladimir

OP14

VALIDATION OF NUMERICAL OUTPUTS OF IAEA SOFTWARE FOR RENOGRAM ANALYSIS IN PATIENTS WITH EQUIVOCALLY OBSTRUCTED UPPER URINARY TRACT

1 2 1 1Beatovic Slobodanka , Jankovic Milica , Sobic - Saranovic Dragana , Jaksic Emilija , Artiko 1Vear

OP15

DIAGNOSTIC PERFORMANCE OF IAEA SOFTWARE PACKAGE FOR ANALYSIS OF RENAL DYNAMIC SCINTIGRAPHY: RESULTS FOR PARAMETERS OF TC-MAG-3 RENOGRAM IN HEALTHY INDIVIDUALS

1 2 1 3Beatovic Slobodanka , Jankovic Milica , Sobic - Saranovic Dragana , Blagic Miroslava , 1 1Jaksic Emilija , Artiko Vera

1University of Belgrade Faculty of Medicine, Center for Nuclear Medicine, Clinical Center of Serbia, Belgrade, Serbia2University of Belgrade Faculty of Electrical Engineering, Belgrade, Serbia3Center for Nuclear Medicine, Clinical Center of Serbia, Belgrade, Serbia

OP16

INTER-RATER AGREEMENT IN THE ASSESSMENT OF RENAL LONG AXIS ANGLE WITH TC-99M DIMERCAPTOSUCCINIC ACID SCAN IN CHILDREN

Centre of Nuclear Medicine, HYGEA Hospital, Tirana, Albania

1University of Belgrade Faculty of Medicine, Center for Nuclear Medicine, Clinical Center of Serbia, Belgrade, Serbia2University of Belgrade Faculty of Electrical Engineering, Belgrade, Serbia

Likartsis Christodoulos, Alevroudis Emmanouil, Meristoudis Georgios, Tachtatzi Nikoleta, Zaromytidou Evangelia, Sakagiannis Georgios, Petrou Ioannis, Oikonomou Zoi, Kakatsiou Despoina, Psarouli Efthymia, Notopoulos AthanasiosNuclear Medicine Department of Hippokration GH, Thessaloniki, Greece

08:30-09:30

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OP17EVALUATION OF THE LEFT RENAL VEIN VARIATIONS IN PET/CT IMAGES: PRELIMINARY RESULTS

1 2 2Ayaz Sevin , Ayaz Umit Yasar , DOGen Mehmet Ercument1Mersin State Hospital Department of Nuclear Medicine2Mersin Women's and Children's Hospital Department of Radiology

Round Table Endocrinology

Moderators: Ioannis Koutsikos Athens - Pavel Bochev Varna

PET imaging in hyperparathyroidismLuka Lezaic Ljubljana

Implications of new ATA guidelines in the Management of DTC follow upIoannis Iakovou Thessaloniki

Newer Developments in the Imaging for NETs: From Bench to BedTheodosia Maina Athens

Invited Lecture Hosted by EANMRadio isotopic therapy in neuroendocrine tumorsVal Lewington London

Scholiast: Savvas Frangos Nikosia

Coffee Break

Light Lunch



11:00-11:30

17:30

14:30-15:30

19:30

19

Parallel action under the Congresses “Updates, Win battles, Enjoy the moments” Childhood cancer

Coordinator: Vassilios Prassopoulos, Athens

Speakers: Helen Dana, Athens

Maria Synodinou, Athens

Voula Minasidou, Thessaloniki

Stella Goumperi, Thessaloniki

Break:

On behalf of “Lampsi” Parents of Children with Neoplastic Diseases Society N. Greece

Speakers: Katerina Paraskevaidou, Thessaloniki

Eleni Tsagkalidou, Thessaloniki

Eleni Markouli, Thessaloniki

Music Concert



11:30 - 13:30

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Saturday 18 June, 2016Hall Alexandros II

Poster Walking Session

PP01LEFT VENTRICULAR QUANTITATIVE PARAMETERS OBTAINED USING GATED MYOCARDIAL PERFUSION SPECT: COMPARISON OF THREE SOFTWARE PACKAGES.

COMPARISON OF EARLY AND STANDARD POST-STRESS „GATED“ SPECT MIBI PROTOCOL IN PATIENTS WITH INTERMEDIATE DUKE TREADMILL SCORE

1 2 2Bojic Ljiljana , Sobic - Saranovic Dragana , Petrasinovic Zorica3, Artiko Vera , Obradovic 2Vladimir

PP03NON–INVASIVE EVALUATION OF THREE CORONARY HEART DISEASE WITH ECG-GATED SPECT - A CASE REPORT

1 2 2Chiriac Iulia Andreea , Mititelu Raluca Mihaela , Lepu? Mihaela Georgiana , Niculescu 2 2Olga , Mazilu Victor CÃtÃlin Victor CÃtÃlin

PP04BRAIN SPECT IN EVALUATION OF THE RENAL ARTERY SYMPATHETIC DENERVATION EFFECT ON THE CEREBRAL BLOOD FLOW LEVEL: CORRELATION WITH COGNITIVE FUNCTION IN PATIENTS WITH ARTERIAL HYPERTENSION RESISTANT

1 2 3 3 3Efimova Nataliya , Chernov V , Efimova I , Krivonogov N3, Saushkin V , Lichikaki V , 1 4Lishmanov Yu , Ryzhkova D

1Federal State Budgetary Scientific Institution «Research Institute for Сardiology», Tomsk, Russia, National Research Tomsk Polytechnic University, Tomsk, Russia2National Research Tomsk Polytechnic University, Tomsk, Russia3Federal State Budgetary Scientific Institution «Research Institute for Сardiology», Tomsk, Russia4Federal State Budgetary Institution «V. A. Almazov Federal North-West Medical Research Centre» of the Ministry of Health of the Russian Federation, St. Petersburg, Russia

Chairperson: Ioannis D. Asteriadis

Alexiou Sotiria, Georgoulias Panagiotis, Valotassiou Varvara, Tsougos Ioannis, Psimadas Dimitrios, Lakiotis Velissarios, Xanthopoulou Ioanna, Alexopoulos Dimitrios, Apostolopoulos Dimitrios, Vassilakos Pavlos

1Department of Nuclear medicine, Podgorica, Clinical Centre of Montenegro2Center of Nuclear medicine, Belgrade, Clinical Centre of Serbia3Clinic for Cardiology, Belgrade, Clinical Center of Serbia

1Department of Nuclear Medicine, Central Universitary Emergency Military Hospital “Dr Carol Davila”, Bucharest and Department of Nuclear Medicine and Radioiodotherapy, National Institute of Endocrinology “C. I. Parhon”, Bucharest, Romania2Department of Nuclear Medicine, Central Universitary Emergency Military Hospital “Dr Carol Davila”, Bucharest, Romania

PP02

14:30 - 15:30

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PP05MYOCARDIAL VIABILITY- THE VALUE OF TC-99M MIBI SPECT DURING NITRATE ADMINISTRATION IN ASSESSMENT OF VIABLE MYOCARDIUM IN PATIENTS WITH DILATED CARDIOMYOPATHY

Izic BelkisaUniversity Clinical Centre Tuzla, Radiology and Nuclear Medicine clinic, Bosnia and Herzegovina

PP06MYOCARDIAL STATUS IN FEMALE PATIENTS WITH NON-SPECIFIC CARDIAC COMPLAINTS EVALUATED WITH 99MTECHNETIUM-TETROFOSMIN MYOCARDIAL PERFUSION IMAGING

1 1 1Sioka Chrissa , Tsiouris Spyridon , Papadopoulos Athanasios , Kotrotsios Tzimis - 1 1 1 1Dimitrios , Nikos Vasileios , Papadimitropoulos Konstantinos , Sakellariou Konstantinos ,

1 1 1 1Exarhopoulos Thomas , Spiliotopoulou Maria , Xourgia Xanthi , Al - Boucharali Jihad , 2 1Lakkas Lampros , Pappas Konstantinos2, Fotopoulos Andreas

1Department of Nuclear Medicine, University Hospital of Ioannina, University of Ioannina School of Medicine, Ioannina, Greece2Department of Cardiology, University Hospital of Ioannina, University of Ioannina School of Medicine, Ioannina, Greece

PP07RELATIONSHIP OF MYOCARDIAL PERFUSION SCINTIGRAPHY SUMMED STRESS SCORE AND CORONARY ARTERY STENOSIS

1 1 2 1Stevic Milos , Vlajkovic Marina , Koracevic Goran , Rajic Milena1, Kojic Marko , Misic 1Ivana1, Ilic Slobodan

1Center of nuclear medicine, Clinical Center Nis, Serbia2Clinic for cardiovascular disease, Clinical center Nis, Serbia

PP08IS THERE A ROLE OF SERUM 25 HYDROXY-VITAMIN- D LEVELS IN PATIENTS WITH CORONARY ARTERY DISEASE. CORRELATION WITH SPECT MYOCARDIAL SCINTIGRAPHY

1 2 3 4Baloka Lukia , Karathanos Evangelos , Pavlidis Pavlos , Thomaidou - Ntanasel Antina , 2 3 2Zissimopoulou Orestia , Karakasi Valeria – Maria , Tsartsarakis Antonios , Sotiropoulou

5 2 1 5 2Rodoula , Tsaltabasidou Maria , Galiotou Maria , Barmpouti Vasiliki , Tzelepi Maria , 2Zissimopoulos Athanassios

1Molecular Biology and Genetics School, Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.2Nuclear Medicine Dept., Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.3Laboratory of Forensic Sciences, Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.4Cardiology Clinic, Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.5Medical School Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.

22ORGANIZED BY THE HELLENIC SOCIETY OF NUCLEAR MEDICINE AND MOLECULAR IMAGING



PP0925 HYDROXY-VITAMIN- D LEVELS AS PROGNOSTIC FACTOR IN PATIENTS WITH DIABETES MELLITUS AND MYOCARDIUM ISCHEMIA. CORRELATION WITH SPECT MYOCARDIAL SCINTIGRAPHY

1 2 3Baloka Lukia , Papanas Nicolaos , Karathanos Evangelos , Pavlidis Pavlos4, Thomaidou - 5 3 3 3Ntanasel Antina , Zissimopoulou Orestia , Tsartsarakis Antonios , Srataki Aphrodity ,

3 1 6 6 3Tsaltabasidou Maria , Darousi Smaro , Sotiropoulou Rodoula , Resta Ioanna , Arapi Maria , Pistola 3 7 3Anastasia , Lambropoulou Maria , Tzelepi Maria3, Zissimopoulos Athanassios

1Molecular Biology and Genetics School, Democritus University of Thrace, Medical School, University Hospital of Alexandroupolis Dragana, Greece.2Diabetes Center- Second Department of InternalMedicine, Democritus University of Thrace, Medical School, University Hospital of Alexandroupolis Dragana, Greece.3Nuclear Medicine Dept., Democritus University of Thrace, Medical School, University Hospital of Alexandroupolis Dragana, Greece.4Laboratory of Forensic Sciences, Democritus University of Thrace, Medical School, University Hospital of Alexandroupolis Dragana, Greece.5Cardiology Clinic, Democritus University of Thrace, Medical School, University Hospital of Alexandroupolis Dragana, Greece.6Medical School, Democritus University of Thrace, Medical School, University Hospital of Alexandroupolis Dragana, Greece.7Lab Histology-Embryology, Democritus University of Thrace, Medical School, University Hospital of Alexandroupolis Dragana, Greece.

PP10CONTRIBUTION OF WHOLE BODY SPECT/CT POST I131-THERAPY IMAGING TO THE DIAGNOSIS. WHAT HAS THE METHOD TO OFFER?

1 2 1 1 3Pipikos Theodoros , Koutsikos Ioannis , Vlachou Fani , Nikaki Alexandra , Dalianis Konstantinos , 1 1 1Papoutsis Vasileios , Tsiakas Evagelos , Papoutsani Despoina

1Nuclear Medicine department, Hygeia SA, Athens, Greece2Nuclear Medicine department, NIMITS Hospital, Athens, Greece

PP11THE DIAGNOSTIC SEQUELAE OF THE INCIDENTAL FINDING OF FOCAL ACTIVITY IN THE PROSTATE ON 18F-FDG PET/CT SCAN

Paschali Anna, Ahmed Haseeb, Szyszko Teresa, Cook Gary

PP12COMPARISON OF 67GA-CITRATE AND 99MTC-HMPAO LEUKOCYTES IN TECHNICAL MATTERS (RADIOLABELING, QUALITY CONTROL, INJECTED DOSES, PATIENT RADIATION EXPOSURE AND IMAGING PROTOCOLS)

Priftakis Dimitrios, Papachristou Maria, Xyrafi Eirini, Datseris Ioannis

3Medical Physics department, Hygeia SA, Athens, Greece

PET Imaging Centre (Kings College London), St Thomas' Hospital, London, UK

Nuclear Medicine Department – PET/CT , GHA “Evaggelismos”, Athens, Greece




PP13RADIONUCLIDE TREATMENT IN PROSTATE CANCER: IS THERE ANY CORRELATION OF FAVORABLE OUTCOME WITH PSA LEVELS AND SPREAD OF BONE DISEASE?

1 2 2 2 2Karanikiotis C , Doumas A. , Papanastasiou E , Gerasimou Georgios , Gerasimou Georgios , 2 2 2 2 2Liaros G , Gkirgkoudis M , Vasileiadis A , Spyroglou F , Gotzamani - Psarrakou A

1424 Military Hospital2AHEPA Hospital-2nd Laboratory of Nuclear Medicine

PP14SILENT MYOCARDIAL ISCHEMIA IMAGED WITH 99MTECHNETIUM-TETROFOSMIN MYOCARDIAL PERFUSION IMAGING IN PATIENTS WITH ISCHEMIC STROKE

1 1 1Sioka Chrissa , Fotopoulos Andreas , Spiliotopoulou Maria , Papadimitropoulos 1 1 1Konstantinos , Sakellariou Konstantinos , Kotrotsios Tzimis - Dimitrios , Nikos Vasileios1,

2 2 2 3 3Naka Katerina , Michalis Lampros , Behlioulis Aris , Markoula Sofia , Zouroudi Sofia , 3 3Kyritsis Athanasios , Giannopoulos Sotirios

PP15EARLY DIAGNOSIS OF ALZHEIMER'S DISEASE USING BRAIN PERFUSION SPECT WITH BRODMANN AREAS MAPPING

1 2 1Valotassiou Varvara , Papatriantafyllou John , Sifakis Nikolaos3, Tzavara Chara , Alexiou 1 1 1 1Sotiria , Psimadas Dimitris , Ziaka Anastasia , Baniora Eleni , Tsougos Ioannis1,

1Georgoulias Panagiotis

PP16THE FIRST EXPERIENCE OF USING A NEW RADIOPHARMACEUTICAL BASED ON THE 1-THIO-D-GLUCOSE LABELED WITH 99MTC FOR TUMOR IMAGING IN THE EXPERIMENT

1 2 1 2 1 2 , Zeltchan Roman , , Chernov Vladimir , , Medvedeva Anna1,2, Sinilkin Ivan , , Bragina Olga22 2 2 2 2Rogov Alexandr , Ilina Ekaterina , Stasyuk Elena , Skuridin Viktor , Efimova Natalya ,

2Dergilev Alexandr1Tomsk Cancer Research Institute, Tomsk, Russia2Tomsk Polytechnic University, Tomsk, Russia

1Department of Nuclear Medicine, University Hospital of Ioannina, University of Ioannina School of Medicine, Ioannina, Greece2Department of Cardiology, University Hospital of Ioannina, University of Ioannina School of Medicine, Ioannina, Greece3Department of Neurology, University Hospital of Ioannina, University of Ioannina School of Medicine, Ioannina, Greece

1Department of Nuclear Medicine, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece2Memory & Cognitive Disorders Clinic, Department of Neurology, “G. Gennimatas” Hospital, Athens, Greece3Department of Nuclear Medicine, “Alexandra” University Hospital, Athens, Greece




PP1799MTC-TETROFOSMIN UPTAKE CORRELATES WITH THE SENSITIVITY OF GLIOBLASTOMA CELL LINES TO TEMOZOLOMIDE

1 2 1 1Alexiou George , Xourgia Xanthi , Vartholomatos Evrysthenis , Gerogiannia Paraskevi , 3 2 1Kalef Ezra John , Fotopoulos Andreas , Kyritsis Athanasios

1Neurosurgical Institute, University of Ioannina, Ioannina, Greece2Department of Nuclear Medicine, University Hospital of Ioannina, Ioannina, Greece3Department of Medical Physics, University of Ioannina, Ioannina, Greece

PP18ROLE OF POSITRON EMISSION TOMOGRAPHY (PET/CT) IN IDENTIFYING UNKNOWN PRIMARY IN PATIENTS WITH LUNG METASTASIS.

1 2 2Barai Sukanta , Prasanth Arun , Gambhir Sanjay

PP19FLT-PET/CT IN METASTATIC BRAIN LESIONS

PP20DIFFERENT PATTERNS OF F18-FDG UPTAKE IN THE BOWEL IN PATIENTS UNDER ANTIDIABETIC METFORMINE MEDICATION

1 1 1 1 1Pipikos Theodoros , Eftymiadou Roxani , Vlachou Fani , Fillipi Vasiliki , Nikaki Alexandra , 1 2 1 1Kechagias Dimitrios , Dalianis Konstantinos , Merisoglou Sofia , Andreou Ioannis

PP21

1Sanjay Gandhi postgraduate Institute of Medical sciences, Lucknow,India2Department of Nuclear Medicine, SGPGIMS,Lucknow,India

1 1 2 1Nikaki Alexandra , Prassopoulos Vasileios , Tsougos Ioannis , Efthymiadou Roxani , 1 1 3 4Vlachou Fani , Filippi Vasiliki , Nomikos Panagiotis , Kosmidis Paris , Dalianis 5 1 6Konstantinos , Merisoglou Sofia , Georgoulias Panagiotis

1PET/CT department, Hygeia SA, Athens, Greece22Medical Physics Department , University of Thessaly, Larissa,Greece3Neurosurgery Clinic Hygeia SA, Athens,Greece52nd Internal Medicine - Oncology Clinic Hygeia SA, Athens,Greece4Medical Physics department, Hygeia SA, Athens, Greece6Department of Nuclear Medicine, University of Thessaly, Larissa, Greece

1PET/CT department, Hygeia SA, Athens, Greece2Medical Physics department, Hygeia SA, Athens, Greece

FLT-PET/CT IN INVESTIGATION OF RECURRENCE IN PRIMARY BRAIN TUMORS1 1 2 1Nikaki Alexandra , Eftymiadou Roxani , Tsougos Ioannis , Pipikos Theodoros , Filippi

1 3 4 1 1Vasiliki , Razi Evagelia , Dalianis Konstantinos , Papoutsis Vasileios , Andreou Ioannis , 1 5Prassopoulos Vasileios , Georgoulias Panagiotis

1PET/CT department, Hygeia SA, Athens, Greece2Medical Physics Department , University of Thessaly, Larissa,Greece3Pathology Oncology Clinic, Hygeia SA, Athens, Greece4Medical Physics Department, Hygeia SA, Athens, Greece5Department of Nuclear Medicine, University of Thessaly, Larissa, Greece




PP2218F-FDG-PET/CT IN RESTAGING TESTICULAR CANCER PATIENTS

Prassopoulos Vasileios, Andreou Ioannis, Papoutsis Vasileios, Nikaki Alexandra, Efthymiadou Roxani, Fani Vlachou, Despina Savvidou, Pipikos Theodoros, Kechagias Dimitrios, Dalianis Konstantinos

PP23LONG TERM, SINGLE CENTER, FOLLOW-UP OF WELL DIFFERENTIATED THYROID CARCINOMA

PopoviĆ Marina, TasiĆ Slobodan, KoljeviĆ MarkoviĆ Ana

Department of nuclear medicine, Institute of oncology and radiology of Serbia, Belgrade, Serbia

PP24TECHNETIUM-99M TETROFOSMIN SPECT FOR HEAD AND NECK TUMORS

1 1 1Sioka Chrissa , Exarchopoulos Thomas , Sakellariou Konstantinos , Papadimitropoulos 1 1 1 2Konstantinos , Nikos Vasileios , Kotrotsios Tzimis - Dimitrios , Ragos Vasileios ,

3 3 3Asimakopoulos Asimakis , Asimakopoulos Dimitrios , Exarchakos Georgios , Fotopoulos 1Andreas

PΡ25THE ROLE OF 68GA-DOTATATE PET/CT IMAGING IN THE DECISION OF PEPTIDE RECEPTOR RADIONUCLIDE THERAPY (PRRT) ADMINISTRATION


1 3 1 2 1Rizwan , Navalkissoor Shaunak , Ell Peter J , Caplin Martyn E , Bomanji Jamshed

PP2668GA-DOTATATE PET/CT VS PET/ MRI IN NEUROENDOCRINE TUMOURS: A COMPARATIVE STUDY

Alshammari Alshaima, Skoura Evangelia, Michopoulou Sofia, Fraioli Francesco, Syed Rizwan, Bomanji Jamshed

Nuclear medicine department, UCL hospital, London, UNITED KINGDOM


1Department of Nuclear Medicine, University Hospital of Ioannina, University of Ioannina School of Medicine, Ioannina, Greece2Department of Maxillofacial Surgery, University Hospital of Ioannina, University of Ioannina School of Medicine, Ioannina, Greece3Department of Ear Nose and Throat, University Hospital of Ioannina, University of Ioannina School of Medicine, Ioannina, Greece

1Nuclear Medicine Department, University College Hospital, London, United Kingdom2Neuroendocrine Tumour Unit, Royal Free Hospital, London, United Kingdom3Nuclear Medicine Department, Royal Free Hospital, London, United Kingdom




PP27CORRELATION OF [18F]FDG UPTAKE WITH CLINICAL AND LABORATORY PARAMETERS IN PATIENTS WITH LUNG CANCER

1 2 2 1Boudali Maria , Skoura Evangelia , Michopoulou Sofia , Datseris Ioannis E , Syrigos 3Konstantinos N

PP28THE CONTRIBUTION OF BRAIN SPECT AND ADVANCED MAGNETIC RESONANCE IMAGING IN THE DIFFERENTIAL DIAGNOSIS OF CEREBRAL TUMORS

1 2 3 4Tsitsia Vasiliki , Valotasiou Varvara , Fountas Konstantinos , Kapsalaki Eytychia , 4 2 1Fezoulidis Ioannis , Georgoulias Panagiotis , Tsougos Ioannis

PP29ROLE OF HYBRID NUCLEAR MEDICINE METHODS IN DETERMINING THERAPY APPROACH IN ONCOLOGICAL PATIENTS. CLINICAL CASES.

PP30CHANGES IN THE MANAGEMENT OF SELECTED PATIENTS WITH SECONDARY PULMONARY LESIONS ACCORDING TO THE EARLY EFFECT OF CHEMOTHERAPY, EVALUATED BY 18F-FDG PET/CT.CLINICAL CASES.

Garcheva Marina1, Hadzhiyska V.1, Minchev Zv. Sofia1

PP31CLINICAL IMPORTANCE OF BONE MARROW 18F-FDG UPTAKE AFTER TREATMENT IN LYMPHOMA PATIENTS

1Evangelismos General Hospital, Athens, GREECE2UCLH, London, UNITED KINGDOM3Oncology Unit GPP, University of Athens, School of Medicine, Athens, GREECE

1Department of Medical Physics, University of Thessaly, Greece2Nuclear Medicine Department, University of Thessaly, Greece3Neurosurgery Department, University of Thessaly, Greece4Radiology Department, University of Thessaly, Greece

Demirev A., Hadzhiiska V, Garcheva Marina

Garcheva Marina, Hadzhiiska V, Nikolova P.



Sunday 19 June, 2016Hall Aristotelis I

09:00Round Table Oncology II

Moderators: Michael Souvatzoglou Athens - Dragi Stanimirovic Sarajevo

PET/CT in Head and Neck cancerEvangelia Skoura Athens

The Role of the hybrid imaging methods in cutaneous melanoma and Merkel cell CarcinomaIrena Kostadinova Sofia

Nuclear medicine techniques in multiple myelomaRaluca Mititelu Bucarest

PET/CT in tumors of hepatobiliary systemVera Artico, Belgrad

Round Table Radiotherapy

Moderators: Erasmia Trivizaki Athens - Pinar Kiratli Ankara

Toxic Adenoma Treatment with I-131Dragi Stanimirovic Sarajevo

PET/CT in Radiation Oncology treatment planning Roberto Delgado Bolton Madrid

Radioembolization in Hepatic tumorsThe role of SIRT with Y – 90 microspheres radioembolization for the treatment of cancers with liver involvementAthanasios Karabeazis London

Coffee Break

Light Lunch

28

12:00

14:00

11:30-12:00

14:30-15:30




15:30Inflammation and Infection Session

Moderator:

Role of PET/CT in Extrapulmonary tuberculosisDragana Sobic Saranovic Belgrade

Cell labeling – current status and future trendsAljaz Socan Ljubljana

The role of Nuclear Medicine in diabetic footMichael Souvatzoglou, Athens

Invited Lecture

Chair: Ioannis Datseris Athens

PET/CT in inflammation and infectionJamshed Bomanji London

Session Hosted by the Greek Atomic Energy Commission

Moderators: Stavroula Vogiatzi Athens - Andreas Fotopoulos Ioannina

Luka Lezaic Ljubljana

Coffee Break

18:00

18:30-20:00

18:00-18:30

29






Sunday 19 June, 2016Hall Aristotelis II

Oral Presentations III

OΡ19DATSCAN SPECT IMAGING IN DIFFERENTIAL DIAGNOSIS OF PARKINSONISM

1 2 2 2 2Brajkovic Leposava , Kostic Vladimir , Svetel Marina , Stefanova Elka , Petrovic Igor , Sobic 1- Saranovic Dragana

1Center for Nuclear medicine2Clinic for Neurology

OP20HOW FDG-PET HELPED US AFTER 100+ EPILEPSY OPERATIONS?

1 2 2 1Brajkovic Leposava , Sokic Dragoslav , Vojvodic Nikola , Jesic Ana , Sobic - Saranovic 1 3 1Dragana , Bascarevic Vladimir , Artiko Vera

1Center for Nuclear medicine, Serbia2Clinic for Neurology, Serbia3Clinic for neurosurgery, Serbia

OΡ21THE CLINICAL IMPACT OF RCBF-SPECT STUDY IN MILD COGNITIVE IMPAIRMENT

1 1 2 1Moralidis Efstratios , Doumas Argyrios , Ioannidis Panagiotis , Gerasimou Georgios , 2 1 2 1Maiovis Pantelis , Gotzamani - Psarrakou Anna , Karakostas Dimitrios , Spyroglou Foteini ,

1 1Liaros Georgios , Vasilliadis Apostolos1Lab of Nuclear Medicine22nd Neurological Clinic, AHEPA University Hospital, Thessaloniki, Greece

OP22ATTENUATION CORRECTION EÍ BRAIN DATSCAN (I-123 IOFLUPANE ) SPECT STUDIES. IS THERE ANY NEED FOR LOW DOSE CT BASED ATTENUATION CORRECTION METHOD?

1 1 1 2Pipikos Theodoros , Vlachou Fani , Nikaki Alexandra , Dalianis Konstantinos , Papoutsani 1 1 1Despoina , Tsiakas Evagelos , Papoutsis Vasileios

1Nuclear Medicine department, Hygeia SA, Athens, Greece2Medical Physics department, Hygeia SA, Athens, Greece

OP23OVERVIEW OF RADIOPHARMACIST'S EDUCATION IN BALKAN COUNTRIES: IS IT INDIVIDUAL STRUGGLE OR WELL-DEFINED SYLLABUS?

1 2StankoviC Aljoša , RajkovaCa Zvezdana1Radiopharmacy2Nuclear Medicine

OP24A SYSTEMATIC REVIEW ON THE INFORMATION SEEKING BEHAVIOUR OF NUCLEAR PHYSICIANS: THE ROLE OF ONLINE INFORMATION LITERACY

1 2 3 4Persakis Evangelos , Kostagiolas Petros , Datseris Ioannis , Niakas Dimitrios1Department of Nuclear Medicine - PET/CT, Evaggelismos General Hospital, Athens, Greece & Department of Archives, Library Science and Museology, Faculty of Information Sciences and Informatics, Ionian University, Corfu, Greece

Chairperson: Aljaz Socan Ljubjana

30

09:00-10:00


14:30-15:30

18:00-18:30

20:00

2Department of Archives, Library Science and Museology, Faculty of Information Sciences and Informatics, Ionian University, Corfu, Greece3Department of Nuclear Medicine – PET/CT, Evaggelismos General Hospital, Athens, Greece4School of Social Science, Hellenic Open University, Patras, Greece

Fundamentals of nuclear medicine brain imaging Nick Gulliver London

What are the required skills for the contemporary nuclear medicine technologistsNick Gulliver London

Disaparteness of the PET/CT imaging from a technologist's point of view

Claudiu Pe?tean Napoca

DG PET/CT artifacts: the role of technologists in top quality PET/CT hybrid imaging

Claudiu Pe?tean Napoca

Scholiast: Nick Gulliver London

General Assembly HSNM

Technologists' Session Moderators: Alexandra Papazisi Thessaloniki - Claudiu Pe?tean Napoca

Light Lunch

Coffee Break

Sunday 19 June, 2016Hall Aristotelis II


12:30 - 14:30


Sunday 19 June, 2016Hall Alexandros II

Poster Walking Session

Chairperson: Efrosyni - Vasiliki Kitsou Athens

PP32THE EFFICACY OF SPECT WITH 199TL FOR BREAST, LARYNGEAL AND LARYNGOPHARYNGEAL CANCER DETECTION

1,2 1,2 1,2 1,2Medvedeva Anna , Zelchan Roman , Chernov Vladimir , Sinilkin Ivan , Slonimskaya 2, 2, 1, , 1,2Elena Belevich Yuliya Chijevskaya Svetlana 2 Choynzonov Evgenii

1Tomsk Cancer Research Institute, Tomsk, Russia2Tomsk Polytechnic University, Tomsk, Russia

PP33THE COMBINATION OF 123I-FP-CIT-SPECT-DATSCAN AND CARDIAC 123-I-MIBG SCAN IN DIAGNOSIS OF PARKINSONIAN SYNDROMES: SIX YEARS EXPERIENCE

1 1 2 1Papadaki Emmanouela , Stathaki Maria , Spanaki Kleanthi , Koukouraki Sophia , 1 1 1 1Bourogianni Olga , Galanopoulos Konstantinos , Alefantinou Marina , Tsaroucha Angeliki

1Nuclear Medicine Dept, Heraklion University Hospital, Crete, Greece

2Department of Neurology, Heraklion University Hospital, Crete, Greece

PP34FALSE POSITIVE RADIOIODINE UPTAKE IN WHOLE BODY SCINTIGRAPHY: PHYSIOLOGIC OR PATHOLOGIC UNEXPECTED FINDINGS.

1 1 1Papadaki Emmanouela , Bourogianni Olga , Galanopoulos Konstantinos , Alefantinou 1 1 1Marina , Stathaki Maria , Koukouraki Sophia

1Nuclear Medicine Department, Heraklion University Hospital, Crete, Greece

PP35SERUM CGRP UPREGULATION IN PATIENTS WITH MIXED IN SITU AND INVASIVE DUCTAL BREAST CARCINOMA (DCIS+IDC): CORRELATED WITH MAMMOGRAPHIC BREAST DENSITY AND CELL PROLIFERATION INDEX Ki67?

1 1 2 1Papantoniou Vassilios , Valsamaki Pipitsa , Marinopoulos Spyridon , Skiadaresi Chaido , 1 1 1 2Delichas Zisis , Papantoniou Ioannis , Tsiouma Maria , Dimitrakakis Konstantinos ,

2Loutradis Dimitrios1Nuclear Medicine Department, University General Hospital “Alexandra”, Athens, Greece2Obstetrics and Gynecology Department, University General Hospital “Alexandra”, Athens, Greece

PP36SERUM CGRP UPREGULATION IN PATIENTS WITH MIXED IN SITU AND INVASIVE DUCTAL BREAST CARCINOMA (DCIS+IDC): CORRELATED WITH MAMMOGRAPHIC BREAST DENSITY AND CELL PROLIFERATION INDEX Ki67?




14:30-15:30


PP3799MTC-PYP MYOCARDIAL SCINTIGRAPHY: REPLACING ENDOMYOCARDIAL BIOPSY OR MASS SPECTROSCOPY IN PATIENTS WITH CARDIAC AMYLOIDOSIS OF UKNOWN ORIGIN?

1 2 3 1Valsamaki Pipitsa , Kastritis Eustathios , Tsiouris Spyridon , Skiadaresi Chaido , Delichas 1 1 1 1Zisis , Papantoniou Ioannis , Tsiouma Maria , Athanasoulis Theodoros , Fotopoulos

3 2 1Andreas , Dimopoulos Meletios Athanasios , Papantoniou Vassilios1Nuclear Medicine Department, University General Hospital Alexandra , Athens, Greece2Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece3Nuclear Medicine Department, University Hospital of Ioannina, Ioannina, Greece

PP38EVALUATION OF SERUM 25 HYDROXY-VITAMIN- D LEVELS IN PATIENTS WITH DIABETES MELLITUS

1 2 2 3Tsigalou Christina , Papazoglou Dimitrios , Papanas Nicolaos , Patsiamanidi Maria , 4 4 4 5Zissimopoulou Orestia , Pistola Anastasia , Tsartsarakis Antonios , Katsimbri Maria ,

6 7 sLambropoulou Maria , Giorgos Vasilis , Zissimopoulos Athanassio 41Biopathology Lab, Democritus University of Thrace, Medical School University Hospital of Alexandroupolis Dragana, Greece.2Diabetes Center- Second Department of Internal Medicine, Democritus University of Thrace, Medical School University Hospital of Alexandroupolis Dragana, Greece.3Ophalmology Clinic, Democritus University of Thrace, Medical School University Hospital of Alexandroupolis Dragana, Greece.4Nuclear Medicine Dept., Democritus University of Thrace, Medical School University Hospital of Alexandroupolis Dragana, Greece.5Molecular Biology and Genetics School, Democritus University of Thrace, Medical School University Hospital of Alexandroupolis Dragana, Greece.6Lab Histology-Embryology, Democritus University of Thrace, Medical School University Hospital of Alexandroupolis Dragana, Greece.7Medical School, Democritus University of Thrace, Medical School University Hospital of Alexandroupolis Dragana, Greece.

PP39EVALUATION OF FOOD ALLERGY TESTING IN INFANTS AND CHILDREN BY DETECTION OF SERUM ALLERGENS USING RAST TEST

1 2 3 4Tsigalou Christina , Damianidou Sofia , Tsalkidis Angelos , Sotiropoulou Rodoula , 2 5 6 7Theocharis Gerasimos , Pistola Anastasia , Lambropoulou Maria , Christofis Christos ,

5Zissimopoulos Athanassios1Biopathology Lab., Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.2Molecular Biology and Genetics School, Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.3Pediatrics Clinic, Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.4Medical School, Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.5Nuclear Medicine Dept., Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.6Lab Histology-Embryology, Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.7Department of Anaesthesiology, Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.


ORGANIZED BY THE HELLENIC SOCIETY OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 33ORGANIZED BY THE HELLENIC SOCIETY OF NUCLEAR MEDICINE AND MOLECULAR IMAGING

PP40THE LEVELS OF SERUM 25 HYDROXY-VITAMIN- D IN PEDIATRIC PATIENTS WITH BRONCHIAL ASTHMA

1 2 2 3Maziotis Evangelos , Tsalkidis Angelos , Parashakis Emmanouel , Zissimopoulou Orestia , 1 3 4 1 5Benti Daphni , Pistola Anastasia , Christofis Christos , Bilali Anna , Maridaki Zinovia ,

3Zissimopoulos Athanassios1Molecular Biology and Genetics School, Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.2Pediatrics Clinic, Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.3Nuclear Medicine Dept., Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.4Department of Anaesthesiology, Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.5Medical School, Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.

PP41TOWARDS OPTIMIZATION OF PROTECTION IN PET/CT IMAGING: ROLE OF TECHNOLOGY IN PATIENT DOSE MANAGEMENT

1 2 3Antic Vojislav , Ciraj - Bjelac Olivera , Haglund Joulie1Center for Nuclear Medicine, University Clinical Centre of Serbia, Belgrade, Serbia2Vinča Institute of Nuclear Sciences, University of Belgrade, Mike Petrovica Alasa 12-14, Belgrade, Serbia and School of Electrical Engineering, University of Belgrade, Bulevar kralja Aleksandra 73, Belgrade, Serbia3Medical physicist, Gothenburg, Sweden

PΡ42MEDICAL WORKERS OPERATING IN NUCLEAR MEDICINE VS PET/CT: RADIATION EXPOSURE COMPARISON

1 1 2 2Dalianis Konstantinos , Kollias George , Pipikos Theodoros , Prassopoulos Vasileios , 2Efthimiadoy Roxani

1Medical Physics Department, Hygeia Hospital, Greece2PET/CT Department, Hygeia Hospital, Greece

PP43A HIGH SENSITIVITY GAMMA IMAGING PROBE FOR SENTINEL LYMPH NODE DETECTION

1 2 2 2Georgiou Maria , Fysikopoulos Eleftherios , Lamproy Efthimis , Loudos Georgios , 3Gewrgoulias Panagiotis

1Department of Nuclear medicine, Medicine School, University of Thessaly, Greece and Department of Biomedical Engineering, Technological Educational Institute of Athens, Greece2Department of Biomedical Engineering, Technological Educational Institute of Athens, Greece3Department of Nuclear medicine, Medicine School, University of Thessaly, Greece



PP44QUANTITATIVE ASSESSMENT OF 32P COLLOID IN THE BRAIN CANCERS USING PLANAR IMAGES AND A NEW SKULL PHANTOM

1 2 2Poorbaygi Hosein , Babaee Maryam , Sardari Dariuosh , Shahzadi Sohrab3, Amoui 3Mahasti

1Nuclear Science and Technology Research Institute, Tehran, Iran2Islamic Azad University, Science and Research branch, Tehran, Iran3Department of Nuclear medicine, Shohada-e-Tajrish center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

PP45A VOXEL-BASED ANALYTICAL DOSE CALCULATION ALGORITHM

1 1 1 1Spirou Spiridon V. , Kostou Theodora , Papadimitroulas Panagiotis , Loudos George1Department of Biomedical Engineering, Technological Educational Institute of Athens, Greece

PP46MANAGEMENT OF IN VIVO RADIOISOTOPES AND RADIOPHARMACEUTICALS [IMPORT-USE-HANDLING-REJECTION] FROM A3 LABORATORY – HOSPITAL EXPERIENCE

1 1 1 1Datseris Ioannis , Moraitis Nikos , Ntonas Christos , Xirafi Eirini1, Papachristou Maria1Radiopharmacy, Nuclear Medicine Department – PET/CT, GHA “Evaggelismos”

PP47FEATURES OF PRODUCTION OF HIGHLY ACTIVE GENERATORS OF TECHNETIUM-99м ON THE BASIS OF THE ENRICHED MOLYBDENUM-98.

1 1 1 1 1Ilina Ekaterina , Skuridin Victor , Stasyuk Elena , Nesterov Evgeniy , Rogov Aleksander , 1 1Sadkin Vladimir , Larionova Lyudmila

1National Research Tomsk Polytechnic University, Russia

PP48RECEIVING NEW RADIOPHARMACEUTICAL BASED ON FATTY ACID MARKED TECHNETIUM-99M

1 1 1 1 2Ilina Ekaterina , Scuridin Victor , Stasyuk Elena , Nesterov Evgeniy , Sazonova Svetlana , 1 1 1Sadkin Vladimir , Larionova Lyudmila , Rogov Aleksander

1National Research Tomsk Polytechnic University, Russia2National Research Tomsk Polytechnic University, Tomsk cancer research institute, Russia

PΡ49SYNTHESIS AND CHARACTERIZATION OF NEW RE AND 99MTC “2+1” MIXED LIGAND COMPLEXES CARRYING 3-BROMOANILINOQUINAZOLINE AS PHARMACOPHORE

1 1 1 1Lazopoulos Aristotelis , Kiritsis Christos , Shegani Antonio , Papasavva Aphrodite , Panagiotopoulou Angeliki2, Pelecanou Maria2, Papadopoulos Minas1, Pirmettis Ioannis11INRASTES, NCSR “Demokritos”, Athens, Greece2IB-A, NCSR “Demokritos”, Athens, Greece





PP50ACUTE AND CHRONIC TOXICITY OF 199TL-DIETHYLDITHIOCARBAMATE

1 1 1 1 2Maslov Leonid , Lishmanov Yury , Efimova Natalia , Naryzhnaya Natalia , Ryzhkova Dariya1Research Institute of Cardiology, Tomsk, Russia2Northwestern Federal Medical Research Center, St. Petersburg, Russia

PP5168GA RADIOLABELING OF CHELATED AND CHELATOR-FREE MAGNETIC NANOPARTICLES; IN VITRO AND IN VIVO EVALUATION

1 2 2Papadopoulou Sofia , Tsoukalas Charalampos , Karageorgou Maria , Paravatou - Petsotas 2 3 4 5 5Maria , Gazouli Maria , Bakandritsos Aristides , Meristoudi Anastasia , Pispas Stergios ,

1 1 2Tsitsilonis Ourania , Stravopodis Dimitrios , Bouziotis Penelope1Faculty of Biology, National and Kapodistrian University of Athens, Athens, Greece2Institute of Nuclear and Radiological Sciences and Technology, Energy and Safety (INRaSTES), National Center for Scientific Research Demokritos, Aghia Paraskevi Athens, Greece3Department of Basic Medical Sciences, School of Medicine, University of Athens, Athens, Greece4Materials Science Department, University of Patras, Patra, Greece5Theoretical and Physical Chemistry Institute, National Hellenic Research Foundation, Athens, Greece.

PP52SYNTHESIS AND BIODISTRIBUTION STUDIES OF 68GA LABELED FITC FLUOROPHORE MANNOSYLATED DEXTRAN FOR SENTINEL LYMPH NODE DETECTION

1 1 1 1Papasavva Aphroditi , Shegani Antonio , Kiritsis Christos , Kontogeorgaki Sofia , 1 1 1Karachaliou Chrysa - Euaggelia , Tsoukalas Charalampos , Bouziotis Pinelopi , Pelecanou

2 1 1 1Maria , Papadopoulos Minas , Pirmettis Ioannis , Papasavva Aphroditi1INRASTES, NCSR “Demokritos”, Athens, Greece2IB-A, NCSR “Demokritos”, Athens, Greece

PP53SYNTHESIS AND CHARACTERIZATION OF NEW RE AND TC TRICARBONYL DITHIOCARBAMATE COMPLEXES

1 1 1 1Papadopoulos Ioannis , Ischyropoulou Myrto , Shegani Antonio , Kiritsis Christos , 2 2 , 1Raptopoulou Catherine , Psycharis Vassilis , Pelecanou Maria3 Pirmettis Ioannis ,

1Papadopoulos Minas1INRASTES, NCSR “Demokritos”, Athens, Greece2DMS, NCSR “Demokritos”, Athens, Greece3IB-A, NCSR “Demokritos”, Athens, Greece

PP54IMPACT OF 99MTC-LABELLING ON BINDING AND VIABILITY OF HUMAN ADIPOSE TISSUE-DERIVED CELLS IN VITRO AND ON THE CELL-TRACKING PROPERTIES USING SPECT IN VIVO

1 1 2 3Fragogeorgi Eirini , Efthimiadou Eleni , Rosenblat Gennady , Georgioy Maria , Daich 4 5 1 1 6Julian , Laurent Sophie , Bouziotis Penelope , Kordas George , Velez Marisela , Muller

5 2 1Robert , Meretzki Shai , Loudos George1National Center for Scientific Research – NCSR “DEMOKRITOS” 2BonusBioGroup Ltd.



3BioEmission Technology Solutions4Bioimag Soluciones de Contraste, S.L.5University of Mons6Bioimag Soluciones de Contraste, S.L AND Catalysis and Oil-chemistry Institute (C.S.I.C.)

PΡ55ATYPICAL SUBACUTE THYROIDITIS SCINTIGRAPHICALY PRESENTED AS TOXIC ADENOMA – CASE REPORT

1 2 3 1 1AleksiĆ Željka , AleksiĆ Aleksandar , RistoviĆ Nenad , MiliĆeviĆ Mirjana , JoliĆ Bojana , 2JoliĆ Aleksandar

1Health center Zajecar, Nuclear medicine department, Zajecar, Serbia 2Health center Zajecar, Internal medicine department, Zajecar, Serbia3Health center Zajecar Department for infectious disesases, Zajecar, Serbia

PP56BAD CHOICES OR GOOD SURVIVAL - A CASE REPORT OF THYROID CARCINOMAChiriac Iulia Andreea1, Purice Mariana 1, Voicu Gabriela 1, Goldstein Andrei Liviu 11Department of Nuclear Medicine and Radioiodotherapy, National Institute of Endocrinology “C. I. Parhon”, Bucharest, Romania

PΡ57CORRELATION OF 99MTC-MIBI SCAN WITH HISTOPATHOLOGIC DIAGNOSIS IN PATIENTS WITH “COLD“ THYROID NODULES

1 1 1 1 1 1Kojić Marko , Vlajković Marina , Rajić Milena , Mišić Ivana , Stević Milos , Ilić Slobodan , 1 2Kojić Ljiljana , Karanikolić Aleksandar

1Department of Nuclear Medicine, Clinical Center Niš, Serbia2Surgical Clinic, Clinical Center Niš, Serbia

PP58TRACER UPTAKE UNRELATED TO THYROID CANCER ON RADIOIODINE WHOLE BODY SCAN

1 1 1 1Koutsikos Ioannis , Sarris Konstantinos , Papachristou Aristidis , Christodoulou Sotiris , 1Koutoulakos Antonis

1Biomedicine group

PP59POSTPROCEDURALLY HYPOTHYROIDISM IN PATIENTS TREATED WITH RADIOIODINE FOR AUTOIMUNE HYPERTHYROIDISM

1 1 2Milicevic Mirjana , Aleksic Zeljka , Aleksic Aleksandar1Health Centre Zajecar, Department of Nuclear Medicine, Serbia2Health Centre Zajecar, Internal Medicine Department, Serbia

PP60SERUM CGRP: A NOVEL BIOMARKER AT THE ENDS OF A SPECTRUM POSTULATING THE INVERSE INCIDENCE OF ALZHEIMER'S DISEASE VERSUS MIXED DCIS+IDC?

1 1 2 1Papantoniou Vassilios , Valsamaki Pipitsa , Marinopoulos Spyridon , Skiadaresi Chaido , 1 1 1 3Delichas Zisis , Papantoniou Ioannis , Tsiouma Maria , Papadimitriou Alexandros ,

2 4Loutradis Dimitrios , Papageorgiou Sokratis1Nuclear Medicine Department, University General Hospital “Alexandra”, Athens, Greece2Obstetrics and Gynecology Department, University General Hospital “Alexandra”, Athens, Greece3Neurology Department, Henry Dunant Clinic, Athens, Greece4Neurology Department, University General Hospital “Attikon”, Athens, Greece




Monday 20 June, 2016Hall Aristotelis I

Round Table Pediatrics

Moderators: Dimitrios Koliouskas Thessaloniki Athanasios Zissimopoulos Alexandroupoli

Role of Nuclear Medicine (PET/CT) in Pediatric Lymphoma and Sarcoma patientsPina Kiratly Ankara

Neonatal hydronephrosis: Pitfalls and interesting cases Erbas Belkis Ankara

Radionuclide reflux and Scar imagingPepi Vonorta Athens

Neuroblastoma and others solid tumors in children Radionuclide diagnosis and treatmentEleni Dana Athens

Scholiast: Dimitrios Koliouskas Thessaloniki

Round Table

Moderators: Argyrios Doumas Thessaloniki - Erbas Belkis Ankara

Young nuclea medicine doctors in Balkan Countries. After the speciality what?Argyrios Doumas Thessaloniki

Crossing the quality chasm in nuclear medicine practice and patients' lifeEvanthia Giannoula Thessaloniki

Problems in radiopharmaceutical: Price heterogenity and financial difficultiesErbas Belkis Ankara

Coffee Break

“Communicating with all the Balkan Nuclear Medicine Societies. Common problems seeking common solutions”

Closing Ceremony

11:30-12:00

09:00

12:00

11:30

14:00

14:00


Oral Presentations IV

OP25FEASIBILITY OF DEDICATED MOUSE IMAGING USING “a -EYE”, A NEW, LOW COST BENCHTOP SCINTIGRAPHIC CAMERA

1 1 2Georgiou Maria , Papadimitroulas Panagiotis , Fysikopoulos Eleftherios , Mikropoulos 2 2Konstantinos , Loudos George

1Bioemission Technology Solutions, Athens, Greece2Technological Educational Institute of Athens, Athens, Greece

OΡ26PERFORFORMANCE EVLUATION OF A HYBRID PRECLINICAL PET/SPECT/X-RAY PROTOTYPE

1 2 3 3Rouchota Maria Tina , Georgiou Maria , Fragogeorgi Eirini , Fysikopoylos Eleftherios , 3 2 1Mikropoulos Konstantinos , Papadimitroulas Panagiotis , Kagadis George , Loudos

3Georgios1University of Patras, Rion, Patras, Greece2Bioemission Technology Solutions, Athens, Greece3Technological Educational Institute of Athens, Athens, Greece

OΡ27DOSIMETRIC EVALUATION TO MEDICAL WORKERS OPERATING IN A PET/CT DEPARTMENT AFTER THE USE OF DYNAMIC TECHNIQUES

1 1 2 2Dalianis Konstantinos , Kollias George , Efthimiadou Roxani , Prassopoulos Vasileios1Medical Physics Department, Hygeia Hospital, Greece2PET/CT Department, Hygeia Hospital, Greece

OΡ28FIRST STEPS TOWARDS THE STANDARDIZATION OF MULTI-CENTRE PET/CT SCANNING PARAMETERS ON A NATIONAL LEVEL: POTENTIAL FOR A PILOT STUDY IN GREECE

1 2 3 4Theodorakis Lampros , Loudos Georgios , Prassopoulos Vasilios , Kappas Constantinos , 4 1Tsougos Ioannis , Georgoulias Panagiotis

OP29ESTIMATION OF COLLECTIVE EFFECTIVE DOSE TO THE POPULATION FROM NUCLEAR MEDICINE PROCEDURES

Vogiatzi Stavroula, Liossis Alexandros, Lamprinakou Martha, Hourdakis Constantinos

Chairperson: Michael Souvatzoglou Athens

1Department of Nuclear Medicine, Faculty of Medicine, University of Thessaly, Biopolis, Larissa,

Greece2Department of Biomedical Engineering, Technological Educational institute of Athens, Egaleo, Athens, Greece3PET/CT Department, Hygeia Hospital, Marousi, Athens, Greece4Medical Physics Department, Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece

Greek Atomic Energy Commission, Agia Paraskevi, Greece


Monday 20 June, 2016Hall Aristotelis II

08:30-09:30






OP30ESTIMATION OF THE COLLECTIVE EFFECTIVE DOSE TO THE GREEK POPULATION FROM MEDICAL EXPOSURES

Nikolaou Magda, Vogiatzi Stavroula, Kalathaki Maria, Simantirakis Georgios, Koukorava Christina, Economides Sotirios, Hourdakis Konstantinos, Kamenopoulou Vassiliki


OP31RESIDUAL ACTIVITIES OF COMMONLY USED 99MTC-LABELLED RADIOPHARMACEUTICALS.

Stavrou Petros, Papachristou M., Persakis E, Kouvelis K., Datseris E.

Evaggelismos General Hospital, Department of Nuclear Medicine & PET/CT, Athens, Greece

OP32THE DIAGNOSTIC BENEFITS OF QUANTIFICATION APLYED IN DYNAMIC PARATHYROID SCINTIGRAPHY

Koljevic AnaInstitute of Oncology and Radiology of Serbia


Monday 20 June, 2016Hall Aristotelis II






ORGANIZED BY THE HELLENIC SOCIETY OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 42

11:30

12:30

Satellite Symposium Hosted by GE Healthcare

DaTSCAN™ (123I ioflupane): Supporting early diagnosis

When even the best face uncertainty:A Neurologist's diagnostic dilemma in ParkinsonsGeorgios A. Tagaris Athens

Nuclear Medicine in collaboration with Neurology: How DaTSCAN increases confidenceJan Lepej Kosice

Shades of Grey instead of Black & White: DaTQUANT™ to quantify, to verify

Satellite Lecture Hosted by NOVAHEALTH and IASON

PET/CT imaging of glioblastoma: 18F-FET got a Marketing AuthorizationMarina Hodolic, Graz

Satellite Lecture Hosted by Siemens

Chair: Dimitrios Apostolopolos, Patra

Konstantinos A. Antoniou, Athens

Chair: Sofia Koukouraki, Heraclion

Siemens Molecular Imaging – New technologies in nuclear medicineChristian Brueckner, Erlangen

13:30-14:00

14:00-14:30







Lecture Hosted by Sanofi-Genzyme

Chairpersons: Ioannis Iakovou Thessaloniki - Savvas Frangos Nikosia

Well Differentiated Thyroid Cancer: Ablation and stimulation. From theory to practiceIoannis Koutsikos Athens

Satellite Lecture Hosted by Specialty Therapeutics

Hall Amfitrion IΙ


Workshop Hosted by GE Healthcare

Latest clinical practices from the experts in PET for oncology Session

Hosted by: Jakub Siennicki Clinical Education Leader, GE Healthcare

Improving PET/CT in prostate cancer: what does the oncologist need?

Heikki Minn, Turku

Adopting 68Ga-PSMA: what are the benefits, pre requisites and reading

recommendations?

Stefano Fanti, Bologna

Multimodality imaging applications in radiation treatment planningArturo Chiti, Milan

Implementing new hybrid imaging techniques: why full competency in both radiology & nuclear medicine is keyKatrine Riklund, Umea

Chair: Vassilios Prassopoulos Athens

Regadenoson: A selective coronary vasodilator for use as a pharmacological stress agent for radionuclide MPIMaria Koutelou, Athens


19:30 - 20:00

10:00 - 11:00

11:00-11:30









Exhibition Plan


1. IBA

2. Monrol

3. Novahealth

4. Alliance

5. Polatom

6. Mediray

7. Pharmaten

8. Raymed

9. Viokosmos

10. Viokosmos

11. Specialty

12. Radiomedical

13. Lynax

14. Aenorasis

15. GE Healthcare




47

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Oral Presentations


OΡ01

HIGHLY SPECIFIC NUCLEAR MEDICINE METHOD FOR DIFFERENTIAL DIAGNOSIS OF ABDOMINAL TUMOR

1 2 3Todorovic - Tirnanic Mila , Cvetkovic Zorica , Suvajdžic - Vuković Nada1Faculty of Medicine, University of Belgrade, Serbia and Center of Nuclear Medicine, Clinical Center of Serbia, Belgrade, Serbia2Department of Hematology, Clinical Hospital Center Zemun, Belgrade, Serbia3Faculty of Medicine, University of Belgrade, Serbia, and Clinic of Hematology, Clinical Center of Serbia, Belgrade, Serbia

Purpose: In the era of PET/CT and MRI there is still a problem of inadequate specificity. In a female patient with chronic lymphocytic leukemia (CLL) and left nephrectomy (with splenectomy) performed because of the renal cell carcinoma (RCC), eleven years later CT revealed hyperdense masses in the left hypochondrium highly suggestive of RCC recurrence. The purpose was to make differential diagnosis between RCC recurrence and other possible pathology.Method – Material: A 68-year-old female was diagnosed with chronic lymphocytic

3leukemia stage 0 according to Rai. She had isolated lymphocytosis of 11000/mm and an HLA-DR, CD19, CD20, CD5, CD23 positive lymphocytic clone in peripheral blood. A lobulated mass with well defined margins measuring 50×62.5×62 mm was found at the lower pole of the left kidney incidentally by CT scan. She consequently underwent left radical nephrectomy showing RCC with no lymph node involvement (pT2N0M0). Splenectomy was performed due to accidental intraoperative injury. She was regularly monitored afterwards for both malignancies with no adjuvant treatment. Eleven years later, a routine abdominal CT was performed, revealing a newly occurring hyperdense mass measuring 30×20 mm surrounded by a few smaller lymph nodes (up to 1 cm) in the left renal space, highly suggestive of RCC recurrence. Another 20 mm hyperdense formation was registered below it, at its left side. In order to make differential diagnosis, selective scintigraphy of the splenic tissue was performed.

oResults: Technetium-99m in vitro labeled (596 MBq), heat-denatured (at 49,5 C during 20 minutes) red blood cell (596 MBq) were intravenously injected. One hour thereafter, large field of view gamma camera equipped with low energy high resolution collimator was used for planar and SPECT images. They showed accumulation of damaged RBC in the two masses described at CT, as well as in one additional 1 cm large lesion, medially located.

OP02BREAST CANCER IMAGING WITH 18 F-FDG PET/CT: DO THE SIZE AND SUVMAX OF PRIMARY CANCER MASS AFFECT PET/CT PARAMETERS OF METASTATIC REGIONAL LYMPH NODES?

1 2 2Ayaz Sevin , Ayaz Umit Yaşar , DOGen Mehmet Ercument1Mersin State Hospital Department of Nuclear Medicine2Mersin Women's and Children's Hospital Department of Radiology

Purpose: We aimed to evaluate the PET/CT features related to primary tumour and locoregional metastatic lymph nodes (LNs) for breast cancer at the time of diagnosis and to establish relationships between several parameters from PET/CT.Method-Material: Our study was conducted between years 2014–2015 and 23 women (mean age; 48.66±12.23 y) with known primary invasive ductal carcinoma were included. They underwent PET/CT imaging for the initial tumour staging and had no evidence of distant metastates. The patients were divided into two groups. LABC (locally advanced breast cancer) group included 17 patients with ipsilateral axillary lymph node (LN) metastasis demonstrable on FDG-PET/CT. Non-LABC group consisted of six LN negative patients without a demonstrable LN metastasis. PET/CT parameters including tumour size, axillary LN size, SUV of ipsilateral axillary LNs (SUV -LN), SUV of primary max max max

tumour (SUV -T) and NT ratios (SUV -LN/SUV -T) were compared between the groups. max max max

Correlations, including between tumour size and SUV -T within each group, between max

PET/CT parameters above-mentioned in LABC were evaluated statistically.

48




Oral Presentations


Results: Mean tumour size in non-LABC and LABC groups were 26.41±11.60 mm and 34.52±21.24 mm, respectively (p<0.05). Mean axillary LN size in non-LABC and LABC groups were 9.71±0.78 mm and 16.71±8.57 mm, respectively (p<0.05). Mean axillary SUVmax-LN in non-LABC and LABC groups were 0.82±0.17 and 6.06±4.74, respectively (p<0.05). Mean SUV -T in non-LABC and LABC max

groups were 5.07±2.54 and 7.53±5.28, respectively (p<0.05). Mean NT ratios in non-LABC and LABC groups were 184±0.057 and 0.918±0.605, respectively (p<0.05). The correlations between tumour size and SUV -T within non-LABC group (r=0.644, p=0.005) and within LABC group max

(r=0.658, p=0.004) were significant. In LABC group, significant correlation between size and SUVmax

of metastatic axillary LNs (r=0.773, p=0.000) was found. In LABC group we found other significant correlations, including the correlation between tumour size and metastatic axillary LN size (r=0.772, p=0.000), correlation between SUV -T and metastatic axillary LN size (r=0.682, p=0.003), max

correlation between SUV -T and SUV -LN (r=0.833, p=0.000), correlation between tumour size max max

and SUV -LN (r=0.519, p=0.033).max

Conclusion: We found significant correlations between PET/CT parameters of the primary tumour and those of metastatic axillary LNs. Patients with LN metastases had relatively larger primary tumours and higher SUV . max

FDG PET/CT IN THE MANAGEMENT OF LANGERHANS CELL HYSTIOCYTOSIS.

Nuclear medicine department St Marina hospital, Varna, Bulgaria

Langerhans cell hystiocytosis (LCH) is a rare disease, characterized by accumulation of clonal dendritic cells in various organs. LCH is heterogeneous in presentation and extremely variable as a natural course of the disease, ranging from self limiting to life-threatening cases. Diagnosis in hystopathological, based on both routine staining and immunohystochemistry (CD1a and/or Langerin is required for definite diagnosis). Bones, skin and pituitary are most affected but any organ or system could be involved. Initial evaluation includes wide range of imaging and laboratory studies and organ involvement is not obligatory defined by imaging. Treatment ranges with localization and extent of the disease, but in multisystem involvement (MS-LCH) systemic treatment is the current standard. The role of FDG PET in LHC is mostly in discriminating single system disease (SS-LCH) from MS-LCH and defining multiple site SS-LCH cases. Attempts have been made to establish a role in treatment response monitoring.Aim of the study: To initiate a single institution database of LHC patients, assessed by FDG PET/CT and define basic patterns of FDG avid pathology.Materials and methods. A total of 8 patients were enrolled aged from 2 to 26 years. 6 patients were initially presented as SS-LCH (one lung, one pituitary and 4 bone) and 2 as MS-LCH. All patient underwent FDG PET/CT (in three patients follow up PET was performed) None had systemic treatment before PET/CT. Results: FDG PET results were positive in 7 patients and negative in one (completely resected primary bone site). Scan results altered staging in two patients from SS to MS-LHC and in two patients from SS-single site to SS-multiple sites LHC. Lesions, affecting stage were confirmed by MRI or biopsy or follow up. Great challenge was faced in one patient where an obvious liver lesion disappeared without treatment and in one patient, where existing FDG positive bone lesions “migrated” without treatment (although completely resolved after tretment)Conclusion: Attempts to use imaging and FDG PET/CT in particular in a general oncologic manner (staging/treatment response/restaging) should be revised or at least used with caution, due to unpredictable behavior of LHC even in untreated patients.

0.

OΡ03

Bochev Pavel

49




Oral Presentations


OP04

1Notopoulos Athanasios

A FACTOR ANALYSIS OF SERUM MARKERS INDICATING TUMOR ACTIVITY, BONE METABOLISM AND OSTEOCLASTOGENESIS IN ADVANCED BREAST CANCER

1 2, Likartsis Christodoulos , Notopoulos Panayiotis , Alevroudis Emmanouil1 3 1 1 1, Psarras Kyriakos , Meristoudis Georgios , Thomopoulou Angeliki , Kotsira Matina , Zaromytidou

1 4Evangelia , Gotzamani - Psarrakou Anna1Department of Nuclear Medicine, Hippokration General Hospital, Greece2Laboratory of Neuroinformatics, Technological Institute of Central Macedonia32rd Department of Propedeutic Surgery, Aristotelian University of Thessaloniki42nd Department of Nuclear Medicine, Aristotelian University of Thessaloniki

Aim: To evaluate the relative usefulness of a panel of 14 bone metabolism markers and 5 tumor markers for the early and reliable assessment of treatment efficacy in breast cancer patients with bone metastases (BC+BM).Patients: A total of 424 women were divided into the following 4 groups: 1) Group A: 153 BC+BM patients (36.08%). 2) Group B: 77 BC patients (18.16%) diagnosed at initial levels without skeletal complications. 3) Group C: 72 patients (16.98%) suffering from benign breast diseases under follow-up. 4) Group D: 122 healthy controls (28.77% of total).Method: The serum level of all markers has been determined in all women at their enrollment in the study, one month later, and after six months. We created a conventional “scan score” based on the number, size and metabolic activity of BM in the initial bone scintigraphy. Levels of OPG, RANKL, CA 27.29, TRAP-5b, BAP, and OPN were examined by ELISA. The other substances (CEA, CA 15-3, TPA, CYFRA 21-1, ICTP, PICP, PINP, PIIINP, PTHrP, IGF-1, CT, OC) were assayed by radiometric (RIA, IRMA) methods.Statistics: Basic demographic characteristics and the level of markers in the serum were compared using two sided Student's t test for unpaired observations. Similar comparisons were carried out among the subgroups of group A, which were identified either on the basis of the scan score (S1, S2 and S3) or of the outcome of the disease (A1-recession or stability, A2-deterioration). Due to the large number of interdependent variables, we then proceeded on the technique of factor analysis.Results: Initial scan score S1 was observed in 81 (52.94%) patients, while S2 was observed in 49 (32.03%) patients and S3 in the remaining 23 (15.03%) patients of group A. Among tumor markers, CA 27.29 and CYFRA 21-1 had comparatively the best performance in reflecting the presence of BM at initial presentation, while CEA correlated satisfactorily with scan score. CA15-3 and TPA were reliable predictors of therapeutic response. Skeletal involvement appeared to be associated with significantly elevated levels of 10 out of 14 markers of bone metabolism. OPG/RANKL, TRAP and IGF1 correlated more satisfactorily with scan score, while TRAP, ICTP, OPG/RANKL, PINP and CT showed significant efficacy in predicting therapeutic response.Conclusion: After collating the information resulting from the various combinations of the 19 markers studied, it appears that: a) A set of biomarkers comprising TRAP, IGF-1, RANKL and CA 27.29 has been shown to be the most sensitive approach to detect the presence of BM in BC patients, followed by another set of biomarkers consisting of ICTP, CA 15-3 and PINP. b) OPG/RANKL ratio, TRAP and IGF1 better reflect the extent and severity of skeletal involvement. c) ICTP, TRAP, OPG/RANKL and CA 15-3 exhibit greater predictive strength as they had significantly lower levels in all measurements in patients with remission or stabilization of the disease. d) On the base of the well-established clinicopathological parameters, more accurately refining BC subgroups should be defined.

50




Oral Presentations


FE3O4-DPD NANOPARTICLES LABELED WITH GALLIUM-68 AS POTENTIAL PET/MRI IMAGING AGENTS

2 1 2RadoviC Magdalena , Tsoukalas Charalampos , AntiC Bratislav , 3 1 1 4Gazouli Maria , Paravatou - Petsotas Maria , Xanthopoulos Stavros , Calamiotou Maria ,

5 2 1Stamopoulos Dimosthenis , VranjeŠ - DuriC Sanja , Bouziotis Penelope1INRASTES, NCSR “Demokritos”, Athens, Greece2“Vinča” Institute of Nuclear Sciences, University of Belgrade, Belgrade, Serbia3School of Medicine, NKUA, Athens, Greece4Department of Solid State Physics, NKUA, Athens, Greece5Department of Solid State Physics, NKUA,INN, NCSR “Demokritos”, Athens, Greece

Purpose Dual-modality contrast agents, such as radiolabeled nanoparticles, are promising candidates for a number of diagnostic applications, since they combine the advantages of two different imaging modalities, namely SPECT or PET with MR imaging. The benefit of such a combination is to more accurately interpret disease and abnormalities in vivo, by exploiting the advantages of each imaging technique, i.e. high sensitivity for SPECT/PET, high resolution anatomical information for MRI. The aim of the present study is to evaluate the efficacy of 68Ga-labeled Fe3O4 superparamagnetic iron oxide nanoparticles (SPIONs) coated with DPD phosphonate, as potential PET/MRI imaging agents. Materials and methods SPIONs coated with biocompatible DPD-phosphonate were radiolabeled with positron-emitting Gallium-68 to quantify the accumulation of the nanoparticles in vivo. In vitro studies in PBS, saline and human serum, were performed to evaluate their stability in vivo. In vivo biodistribution study was performed in 9 healthy mice at 30, 60 and 120 min post-injection.Results 68Ga-Fe3O4-DPD SPIONs presented high radiolabeling yield (95%) and proved stable in vitro. The ex vivo biodistribution study in healthy mice showed significant liver and spleen uptake at all examined time points, with lower uptake (<4% ID/g) in all other organs. A significant fraction of radiolabeled nanoparticles presented in bones (6.9% ID/g at 120min) is indicative of high affinity of phosphonate to bone tissue. The biodistribution profiles between 68Ga-Fe3O4-DPD SPIONs and free 68Ga-acetate were also compared, indicating a different pharmacokinetic behavior for 68Ga-acetate, with negligible uptake in all organs, and excretion via the kidneys.Conclusion 68Ga-Fe3O4-DPD SPIONs demonstrated high radiolabeling efficiency and in vitro stability and satisfactory in vivo behavior. Cytotoxicity studies to explore the potential toxic effects of the nanoparticles, as well as biodistribution studies in tumor models, are in progress.

MATLAB IN VOXEL INTERNAL DOSIMETRY 111IN AND 177LU THERAPY2 2 1 2 Synefia Stella , Lyra Maria , Kostakis Vasilios , Ttofi Elena

1Iaso Hospital, Athens 2aretaieion Hospital, Athens

Purpose. The aim of this study is to develop, by MATLAB code, an algorithm that calculates absorbed dose at every voxel of quantitative SPECT scintigraphy image and

111 177establishes a general internal dosimetry protocol for therapy by radionuclides In or Lu. 111 177Method-Material. SPECT scintigraphy images of known In or Lu activities contained in

a cylindrical phantom with 30 cm radius filled with water were obtained. The algorithm that calculates absorbed dose at every voxel of the scintigraphy image was developed by MATLAB. The scintigraphy images were converted to 3-dimensional matrices. Every element of the matrix was assigned with the respective counts. The matrix was multiplied with the conversion factor and the new elements represented the activity at every voxel. A cumulative activity matrix was calculated from activity matrices that were obtained at different time points. The absorbed dose at every voxel of the cumulative activity matrix was computed with the convolution method. A 3-dimensional convolution matrix with size

OP05

1Karageorgou Maria ,

OΡ06

1Vamvakas Ioannis ,

51




Oral Presentations


5x5x5 was created. The elements of this matrix are numerical factors that convert cumulative activity to absorbed dose. The values of these factors were determined from

111 177G.Sgouros et.al for In and Lanconelli et.al for Lu published data. Convolution between the cumulative activity matrix and the convolution matrix gives a new matrix with numeric elements that represent absorbed dose at every voxel.

111Results. SPECT scintigraphy images were obtained for 4425.2MBq In activity. A cumulative activity of 61.95GBq*h was calculated and the voxel convolution method showed that mean absorbed dose was 176.3Gy. Maximum dose of 763.5Gy was calculated

177for the central voxel in the activity. Similarly, Lu cumulative activity calculated as 205 GBq*s, mean absorbed dose of 16.4Gy and maximum dose 34.1Gy in central voxel of distribution.Conclusions. Voxel internal dosimetry can be performed accurately by the use of MATLAB.

111 177The method has been applied to In and Lu patient specific radionuclide therapies.

METHOTREXATE LABELING WITH 99MTC – PRECLINICAL STUDIES2 3 2 Bouziotis Penelope , Kastis George , Xanthopoulos Stavros , Datseris

1Ioannis1Radiopharmacy, Nuclear Department – PET/CT, GHA «Evaggelismos»2Radiochemical Studies Laboratory, INRaSTES, NCSR “Demokritos”3Research Centre of Mathematics, Academy of Athens

Purpose Methotrexate (MTX) is a structural analogue of folic acid and one of the most 1widely used antimetabolites in cancer chemotherapy. At low doses (up to 25 mg/ml) it is

also part of the established treatment of many autoimmune disorders, like Rheumatoid 2Arthritis (RA) where it has nowadays became the standard of care.

The present paper has two targets:a) Oncology: accumulation of drug in breast Ca and in skeletical lesions.b) Rheumatology: i) find the “plateau” of therapeutic dosage, ii) imaging inflammatory site of rheumatoid or/and arthritis in general, in bones and mainly in joints.

99mMethods - Results On microscopic level, the labelling of MTX with Tc was accomplished 3via Tc-glucoheptonate. The yields were 95-98%. For the radiochemical control TLC and

HPLC were used. The compound was stable in vitro up to 6 h at RT, as well as in the presence of serum. Ex vivo animal experiments were performed in Swiss Albino mice (n = 3 animals per time-point). The animals were injected with 700 i Ci radiotracer and sacrificed at 2 and 24 h post-injection. Apart from the kidneys, no major uptake in all analyzed tissues is observed (≤ 1.5 % ID/g from 2 h p.i.). The bone to blood ratio significantly increased from 2 to 24 h (0.93 and 14.8 respectively), thus leading to a pronounced differentiation between bone and non-osseous tissue. In vivo planar scintigraphy was performed with a small Anger-type camera on 2 Swiss mice injected with 700 i Ci radiotracer, at 2 and 24 hours p.i.. The images illustrate increased uptake of the tracer at the bones at both 2h and 24h post injection. The increased uptake is more evident at the spinal cord and knee joints.Conclusion The preclinical studies show that the compound accumulates in the spinal cord, in the joints and bones. The results are promising and in the future the labeling method will be transferred into macroscopic level in order for the compound to be identified by spectroscopic methods (NMR, MS, Crystalography ). Biodistribution and imaging studies in pathological breast cancer models are in progress.

OP08

1Papachristou Maria ,

52




Oral Presentations


OΡ09

1Skoura Evangelia

OΡ10

1Panagiotidis Emmanouil ,

THE IMPACT OF 68GA-DOTATATE PET/CT IMAGING ON MANAGEMENT OF PATIENTS WITH NEUROENDOCRINE TUMOURS

1 2 1, Michopoulou Sofia , Mohmaduvesh Mullan , Panagiotidis Emmanouil , 1 2 1 1Al Harbi Mohammed , Toumpanakis Christos , Almukhailed Omar , Kayani Irfan , Syed


68Purpose: Ga-DOTATATE PET/CT scan is a widely accepted method for imaging of neuroendocrine tumours (NETs). This cross-sectional study was performed to review the

68first 8 years of patient data from a large Ga-DOTATATE PET/CT database in order to establish the impact of the modality on patient treatment and survival.Method - Material: Demographic data, clinical outcome, survival, and change in

68management after Ga-DOTATATE PET/CT were evaluated.68Results: Between May 2005 and August 2013, 1258 Ga-DOTATATE PET/CT scans were

performed in 728 patients with confirmed or suspected NETs. In most patients the primary site was located in the midgut 26.4%. Analysis of NET grading in patients with known histopathological data revealed that 35.7% had NET grade G1, 12.2% G2 and 8.7% G3. The

68most common indications for Ga-DOTATATE PET/CT were follow-up (24.4%) and initial 68tumour staging (23.4%). Of the 1258 Ga-DOTATATE PET/CT scans completed, 75.7% were

positive and 24.3% negative; there were 14 false positive and 29 false negative scans. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 97%, 95.1%, 96.6%, 98.5% and 90.4%, respectively. In 40.9% of patients, the treatment plan was changed after the scans, owing mainly to new, unexpected findings. Statistically significant differences in survival were shown between patients with G1, G2 and G3 grade tumours (p<0.0001), and also between patients with bone metastasis versus patients with soft tissue metastasis (p<0.0001).

68Conclusion: Ga-DOTATATE PET/CT scan is safe and influences management in a large proportion of patients. Prognosis was dependent on tumour grade, and the presence of bone metastasis was associated with worse overall survival.

COMPARISON OF 68GA-DOTATATE AND 18F-FDG PET/CT IN PATIENTS WITH NEUROENDOCRINE TUMORS

2 3 Alshammari Alshaima , Michopoulou Sofia , Mohmaduvesh 3 2 2 1 2Mullan , Al - Harbi Mohammed , Berta Maria , Skoura Evangelia , Caplin Martyn ,

2 1Toumpanakis Christos , Bomanji Jamshed1 Nuclear Medicine Department, University College Hospital, London, United Kingdom2 Neuroendocrine Tumour Unit, Royal Free Hospital, London, United Kingdom3MSc4MD

Purpose: The objective of this study is to determine the clinical impact of 68Ga-DOTATATE (Ga) and 18F-fluorodeoxyglucose (FDG) in the management of patients with Neuroendocrine tumors (NET). Our second aim was to investigate the role of SUV max for both tracers as a prognostic indicator for patients with NET.Methods: This is a retrospective study of 120 patients (pts) with histologically proven NET that underwent both Ga and FDG PET/CT. PET/CT results and SUV values were compared with prognostic factors such as: pathological grading (G1, G2, G3), and proliferation index (Ki). The clinical impact of PET/CT findings in regards to the tracers influence on clinical management was recorded. All pts were followed up and differences in survival rates were calculated using Kaplan-Meier analysis.

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Results: The combination of Ga and FDG PET/CT had an impact in therapy modification in 49 (41%) pts. In 8 (7%) pts the decision was made based on FDG findings, in 20 (17%) pts on both radiotracers' findings and in 20 (17%) pts on Ga alone. The most frequent impact on management that was mainly based on only FDG findings was the initiation or continuation of chemotherapy in 7 (6%) pts. The most common treatment plan made due to Ga findings was initiation of PRRT in 12 (10%) pts. Only in one out of 34 pts with G1 tumors and in 4 out of 27 pts with G2 tumors, the management change was based on FDG results. Using on way ANOVA test, there was significant differences for Ga SUV max values, being higher for G1 and lower for G3 tumors (p=0.036). However, no significant difference for FDG derived SUV results between different tumor grades was detected. Bonferroni correction did not show any significant difference in SUV max for tumors with ki<5% and ki>5%, for either tracer. There was no association regarding SUV max values and patients' survival.Conclusion: Our initial data showed that, though 68 Ga SUV max values correlated with tumour grade, it could not predict patients' prognosis. There is no clinical impact of 18F-FDG PET/CT in G1 NET and moderate impact in G2 NET tumors. We propose that in NET with G1 and G2 grades, the use of 18F-FDG PET/CT should be limited and tailored to individual patient.

Purpose: Endometrial cancer is a common gynecologic malignancy with good prognosis at early stages, but poorer at metastatic disease or recurrence. Accurate staging during the course of disease is very important. In this retrospective study, we evaluated the role of 18F-FDG-PET/CT in restaging patients with endometrial cancer after therapy.Method-Material: 40 PET/CT examinations of patients with endometrial cancer were retrospectively reviewed. All patients had received the appropriate treatment according to the disease and were referred for PET/CT examination for restaging after treatment. All of the patients had undergone CT examination. Comparison between the results of the two imaging modalities occurred.Results: PET and CT were both positive in 15/40 cases; in 3/15 cases, PET revealed more metastatic lesions concerning lymph nodes and osseous disease; PET did not show hypermetabolism in small pulmonary nodules in 3/15 cases and in one small liver metastatic lesion in 1/15 case. In 2/40 cases CT was positive revealing pulmonary nodules but PET was negative. In 8/40 cases both CT and PET were negative. In 5/40 cases CT was negative, while PET was positive (lymph nodes, peritoneal implantations, osseous metastasis, and local disease). In 10 cases CT was without alterations compared to previous examination or equivocal. Of those, PET was positive in 4 (lymph node in 3, local disease in 1), negative in 5 and equivocal in 1.Conclusion: As a whole body imaging modality, PET/CT is helpful in restaging patients with endometrial cancer, adding the metabolic information to anatomic one. Although attention should be paid in characterization of small pulmonary nodules and small liver lesions, PET/CT is valuable in determining lymph nodes, peritoneal implantations, local disease and osseous metastasis.

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18F-FDG-PET/CT IN RESTAGING TESTICULAR CANCER PATIENTS

Nikaki Alexandra, Efthymiadou Roxani, Vlachou Fani, Savvidou Despina, Pipikos Theodoros, Kechagias Dimitrios, Dalianis Konstantinos, Papoutsis Vasileios, Andreou Ioannis, Prassopoulos Vasileios


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ADVANCED QUANTITATIVE ANALYSIS OF TC-99M MAG3 DIURETIC RENOGRAM IN CHILDREN WITH ANTENATALLY DETECTED RENAL PELVIC DILATATION

2 1 3, Jankovic Milica , Sobic - Saranovic Dragana , Radulovic Marija , 4 1 1Blagic Miroslava , Jaksic Emilija , Artiko Vera

1University of Belgrade Faculty of Medicine, Center for Nuclear Medicine, Clinical Center of Serbia, Belgrade, Serbia2University of Belgrade Faculty of Electrical Engineering, Belgrade, Serbia3Military Medical Academy, Institute of Nuclear Medicine, Belgrade, Serbia4Center for Nuclear Medicine, Clinical Center of Serbia, Belgrade, Serbia

Introduction: Hydronephrosis (HN) caused by pelviureteric junction (PUJ) obstruction is among most common abnormalities detected by antenatal ultrasound screening. It requires careful conservative follow-up in which diuretic renography plays important role.Aims of this study in children were: a) to calculate, by means of the International Atomic

99mEnergy Agency (IAEA) software, the values of Tc MAG parameters in normal kidneys, 3

obstructed kidneys and hypotonic unobstructed kidneys and b) to assess the accuracy of the obtained parameters by comparing with the values published by other authors.Patients and methods: 62 children (median age: 16 months) with HN attributed to pelviureteric junction (PUJ) stenosis were included into study. 130 renograms were analyzed. 22-minutes acquisition with 132 10-sec images was applied. Furosemide was administered after 2min (F+2). Post-void image was acquired at 60min. Two observers analyzed each study and classified kidneys into three categories. Group 1: 84 kidneys contralateral to hydronephrotic kidney, without structural abnormality on previous diagnostics; group 2: 30 hypotonic non-obstructed kidneys; group 3: 16 obstructed kidneys. Parameters analyzed were: output efficiency (OE), normalized residual activity at 20min (NORA ) and on post-micturition acquisition (NORA ).20 PM

Results were presented as mean±SD. For group 1 they were: OE: 95±1.5%; NORA : 20

0.25±0.06; NORA : 0.02±0.007. Results for group 2: OE: 87±7.8%; NORA : 0.57±0.19; PM 20

NORA : 0.03±0.02. For group 3: OE: 56±9.6%; NORA : 2.16±0.33; NORA : 0.27±0.13. PM 20 PM

Linear regression analysis showed significant inverse linear correlation between NORA 20

and ROE (R = - 0.982; y = 99.6 – 21.1x) at 0.01 level. ROC analysis revealed cutoff values of 20

predicting obstruction at 71%, 1.62 and 0.11 for OE, NORA and NORA respectively.20 PM,

Conclusion: The overall results provided evidence of excellent agreement of obtained results with previously reported values of the quantitative parameters of renal washout. OE and NORA are sensitive parameters of drainage through collecting system. They help to distinguish between obstruction and non obstructive dilatation and to decide about surgical or conservative treatment of children with HN.

THORACIC ECTOPIC KIDNEY IN A CHILD

Titka Vladimir

Centre of Nuclear Medicine, HYGEA Hospital, Tirana, Albania

Thoracic kidney is a rare type of renal ectopic. It accounts for less than 5% of renal ectopic. Most cases are asymptomatic and discovered as incidental. Not many cases have been reported in the world either. Between 1940 and 2003 only 200 cases had been reported in the world. The case which is being referred to is of the thoracic ectopic kidney in 5 years old girl, asymptomatic .Her sister had suffered from renal pathology, due to this family's case, the girl had done ECO examinations which did not apparently reveal the left kidney. For this reason, a scintigraphy examination was recommended to the girl.

99mIn examination with Tc-DMSA accomplished in the Centre of Nuclear Medicine of our hospital, renal ectopi was revealed on the level of left hemi thorax. In Intravenous pyelography (IVP) and thoraco-abdominal computed tomography (CT), the renal ectopic was confirmed on the left hemi thorax level and anatomic reports were defined too.

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VALIDATION OF NUMERICAL OUTPUTS OF IAEA SOFTWARE FOR RENOGRAM ANALYSIS IN PATIENTS WITH EQUIVOCALLY OBSTRUCTED UPPER URINARY TRACT

2 1 1 Jankovic Milica , Sobic - Saranovic Dragana , Jaksic Emilija , Artiko 1Vear

1University of Belgrade Faculty of Medicine, Center for Nuclear Medicine, Clinical Center of Serbia, Belgrade, Serbia2University of Belgrade Faculty of Electrical Engineering, Belgrade, Serbia

Introduction: Advanced parameters of diuresis renography - output efficiency (OE) and normalized residual activity (NORA) help to distinguish between obstructed and non-obstructed kidneys. Unfortunately, algorithm for their calculation is not widely available. Non-commercial software developed by International Atomic Energy Agency (IAEA) enables this comprehensive analysis, but it is not yet validated against any commercial software.Aim of this study was to validate reliability of numerical outputs of IAEA software by comparing with values reported in literature and to determine significance of OE and NORA in the assessment of equivocally obstructed urinary tract.Subjects and methods: 183 patients with suspected obstruction (mean age: 51.8 years)

99munderwent Tc DTPA dynamic scintigraphy with furosemide stimulation at 20 minute. 323 kidneys were investigated. 40-min acquisition with 240 10-sec images was applied. Post-void image was acquired at 50 minute. Studies were analyzed by two observers and, according to assessment of images and renograms, kidneys were classified as normal (77), hypotonic unobstructed (143) obstructed (65) and equivocal. (38). IAEA software was applied to each study. Parameters analyzed were: NORA at 20 minute (NORA ) and on the 20

post-micturition acquisition (NORA ), OE at 20 minute (OE ), and 20 minutes after PM 20

furosemide (OE ).F+20

Results for normal kidneys (mean±SD) were: NORA : 0.62±0.12, OE : 89±2%, OE : 20 20 F+20

95±2%, NORA : 0.07±0.002. Results for hypotonic unobstructed kidneys: OE : 92±1%; PM F+20

NORA : 0.08±0.02. Results for obstructed kidneys: OE : 79±8%; NORA : 0.22±0.10. PM F+20 PM

Difference between obstruction/dilatation was significant (p<0.001). Linear regression analysis between OE and NORA was significant (r = -0.975; p<0.001). Among 38 kidneys 20 20

with equivocal findings according to standard parameters, calculation of OE revealed 28 F+20

kidneys to be non- obstructed. In one kidney obstructive pattern was converted into non-obstructive according to NORA value. In remaining 9 kidneys both parameters were in PM

obstructive range.Conclusion: Results for OE , OE , NORA and NORA calculated by the use of IAEA 20 F+20 20 PM

software showed excellent agreement with previously reported values. High correspondence between OE and NORA gives the opportunity of replacing OE with NORA, when algorithm for OE could not be applied. OE and NORA contribute to clarify F+20 PM

equivocal findings of diuresis renography.

DIAGNOSTIC PERFORMANCE OF IAEA SOFTWARE PACKAGE FOR ANALYSIS OF RENAL DYNAMIC SCINTIGRAPHY: RESULTS FOR PARAMETERS OF TC-MAG-3 RENOGRAM IN HEALTHY INDIVIDUALS

1 2 1 3Beatovic Slobodanka , Jankovic Milica , Sobic - Saranovic Dragana , Blagic Miroslava , 1 1Jaksic Emilija , Artiko Vera

1University of Belgrade Faculty of Medicine, Center for Nuclear Medicine, Clinical Center of Serbia, Belgrade, Serbia2University of Belgrade Faculty of Electrical Engineering, Belgrade, Serbia3Center for Nuclear Medicine, Clinical Center of Serbia, Belgrade, Serbia

In nuclear medicine departments in developing countries the programs for analysis of kidney studies don't provide accurate quantitative analysis of kidney excretion. A decade

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ago the development of comprehensive software was initiated by IAEA, but the work hasn't been completed and only the draft version of software was available.Purpose of this study were: to implement IAEA software into analysis of Tc-99m MAG 3

dynamic scintigraphy, to validate results of renogram parameters against their reference values, and to compare different renogram indices in order to assess whether clinical information provided by all of them is identical.Patients and Methods: Study population consisted of 50 healthy subjects who were

99mevaluated by Tc MAG scintigraphy for kidney donation. IAEA software was applied and 3

the parameters analyzed were: time to maximum activity (T ), time to half maximum (T ), max 1/2

normalized residual activity (NORA), output efficiency (OE), residual activity (RA), elimination index (EI), whole kidney mean transit time (MTT), mean parenchymal transit time (MPTT) and relative kidney function (RF). Correspondence between OE, NORA, RA and EI was evaluated by Pearson correlation coefficient and linear regression analysis.Results for normal kidneys were: T : 3.4 ± 0.7 min; T : 6.1 ± 1.5 min; NORA: 0.34 ± 0.09; max 1/2

OE: 93 ± 2.2%; RA: 26 ± 6.2%; EI: 2.2 ± 0.4; MTT: 2.2 ± 0.4 min and MPTT: 1.7 ± 0.4 min. Relative function for the left and right kidney was 52% and 48% ± 2.4%, respectively. The excellent agreement was observed between the obtained values of renogram parameters and their reference values in the literature Significant linear correlation between parameters of kidney excretion was obtained. The highest correlation was observed between NORA and OE (r = -0.936, p< 0.01).Conclusion: IAEA software gives reliable numerical indices of kidney excretion. The values for normal kidneys were almost identical with previously reported reference values for MAG parameters. NORA highly corresponds with OE and could replace the former 3

parameter in the evaluation of kidney drainage. The results should be an incentive for IAEA to continue its work on completion of software in order to standardize technique of dynamic renal scintigraphy.

INTER-RATER AGREEMENT IN THE ASSESSMENT OF RENAL LONG AXIS ANGLE WITH TC-99M DIMERCAPTOSUCCINIC ACID SCAN IN CHILDREN

Likartsis Christodoulos, Alevroudis Emmanouil, Meristoudis Georgios, Tachtatzi Nikoleta, Zaromytidou Evangelia, Sakagiannis Georgios, Petrou Ioannis, Oikonomou Zoi, Kakatsiou Despoina, Psarouli Efthymia, Notopoulos Athanasios

Nuclear Medicine Department of Hippokration GH, Thessaloniki, Greece

Purpose To investigate agreement and reliability among nuclear medicine physicians when estimating renal long axis angle (renal angle) with Tc-99m DMSA (dimercaptosuccinic acid) scan in children.Method - Material In this retrospective study 265 children (139 males, 126 females) who had undergone DMSA scan in a two-year period at the Nuclear Medicine Department of Hippokration General Hospital were included. Among them 17 were neonates and 98 infants; Mean and median age for the remaining children was 6,2 and 4,5 years respectively. All scans where renal long axis could not be clearly defined, such as those of patients with deformities of the vertebral column, severely compromised renal function or history of surgery on the urinary tract were excluded. Three hundreds and eighteen kidney units were totally included. Renal angle was determined as the angle between the longitudinal body axis of the patient and the renal long axis and was drawn and measured by two nuclear medicine physicians, both blinded to each other.Results Calculation of Cohen's weighted kappa coefficient showed very good (weighted K = 0.839, 95% CI 79-88%, se 0.025) and good (weighted K = 0.759, 95% CI 69-83%, se 0.034) inter-rater reliability for the left and the right kidney renal angle respectively. Strength of agreement between two physicians for all measurements was very good (weighted K = 0.814, 95% CI 78-85%, se 0.02).Conclusion The reliability among nuclear medicine physicians who estimated renal angle of 318 kidney units on DMSA scan was very good. Therefore renal angle and renal axis may be used to provide useful indirect information in children with renal anatomic abnormalities.

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EVALUATION OF THE LEFT RENAL VEIN VARIATIONS IN PET/CT IMAGES: PRELIMINARY RESULTS

1 2 2Ayaz Sevin , Ayaz Umit Yaşar , DOĞen Mehmet Ercument1Mersin State Hospital Department of Nuclear Medicine2Mersin Women's and Children's Hospital Department of Radiology

Purpose: Detection of the left renal vein (LRV) variations before retroperitoneal surgery is important to avoid potential serious complications. It is also necessary to differentiate these variations from other retroperitoneal pathologies such as lymphadenopathy. In this prospective study, we aimed to identify retroaortic left renal vein (RLRV) and circumaortic left renal vein (CLRV) by using positron emission tomography/computed tomography (PET/CT) images, to obtain their percentages and to evaluate the effect of gender on their frequencies.Method-Material: Between August 2014 and October 2015, PET/CT images of 225 consecutive patients who underwent PET/CT for oncological imaging, were prospectively

18evaluated and three of them were excluded. Both plain CT images and radiolabeled [ F]-2-fluoro-2-deoxy-D-glucose (FDG) PET/CT images were used to detect RLRV and CLRV. The percentages and the numbers of total LRV variations, RLRV and CLRV were obtained. Fisher's exact test was used to determine the relation between the LRV variations and gender.Results: Regarding the whole study group (n=222), the percentages and the numbers of total LRV variations, RLRV and CLRV were 5.85% (n=13), 2.70% (n=6) and 3.15% (n=7), respectively. In male population (n=116) , the percentages and the numbers of total LRV variations, RLRV, and CLRV were 6.03% (n=7), 2.58% (n=3) and 3.45% (n=4), respectively. In female population (n=106), the percentages and the numbers of total LRV variations, RLRV, and CLRV were 5.66% (n=6), 2.83% (n=3) and 2.83% (n=3), respectively. The percentages of LRV variations (RLRV and CLRV) were found to be independent of gender (P = 1.000).Conclusion: PET/CT is a useful imaging modality in detecting RLRV and CLRV.

A NEW 99MTC-QUINAZOLINE COMPLEX FOR IMAGING OF EGFR

Triantis Charalampos, Shegani Antonio, Kiritsis Christos, Pelecanou Maria, Pirmettis Ioannis, Papadopoulos Minas

INRASTES, "Demokritos", Athens, Greece and FREDERICK UNIVERSITY, Nicosia, Cyprus

Introduction: Quinazoline derivatives inhibit tyrosine kinase of the EGFR and are used as 99manticancer agents. They have been labeled with Tc as SPECT radioligands for tumor

99m 99mimaging. In this study, the new complex Tc fac-[ Tc(quin)(qisc)(CO) ] carrying N-(4-((3-3

bromophenyl)amino)quinazoline-6-yl)-7-isocyanoheptanamide (qisc) as and quin is the bidentate ligand quinaldic acid has been synthesized and evaluated.

99m 99mMethods: fac-[ Tc(quin)(qisc)(CO) ], 1/ . To 500 i L of fac-[ Tc(quin)(H O)(CO) ], a 3 2 3-3methanolic solution of qisc (500 i L, 2·10 M) was added. The vial was sealed, flushed

with N and the mixture was left at room temperature for 30 min to give 1/ . RP-HPLC: t = 2 R

26.8 min, yield > 97%).Biodistribution studies: HPLC purified 1/ (1–2 i Ci in 0.1 ml ethanol/saline 1:9) was injected through the tail vein in three groups of 9 Swiss Albino male mice (26 ± 3 g). The animals were sacrificed by cardiectomy under slight ether anesthesia at predetermined time.Results: The monodentate ligand was synthesized in order to bear the isocyanate group for the coordination with the metal and the (3-bromophenyl)aminoquinazoline moiety

99mwhich has the affinity to the EGF receptor. fac-[Re/ Tc(quin)(qisc)(CO) ] complexes 1-1/ 3

can be obtained in good yield in a two-step procedure by first coordinating the bidentate ligand (quinaldic acid) followed by the monodentate ligand. The Tc-99m complex, 1/ ,

owhich formed quantitatively, is stable at 37 C in the presence of excess of histidine or cysteine for at least 6 hours. Biodistribution studies in mice of 1/ showed fast blood (2.09

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± 0.64 % D/organ at 30 min p.i.) and soft tissue clearance (< 1.0 % D/organ), while elimination via the hepatobiliary system was observed.

Conclusions: Complex 1/ is stable (yield > 97%) and merits further evaluation as a SPECT radioagent for tumor imaging. Preliminary results show that the radiolabelled derivative is promising for the imaging of EGFR.Acknowledgement: Charalampos Triantis would like to thank the State Scholarships Foundation (IKY) in Greece for the financial support during his postgraduate studies in the framework of "IKY fellowships Excellence for postgraduate studies in Greece - Siemens program"

DATSCAN SPECT IMAGING IN DIFFERENTIAL DIAGNOSIS OF PARKINSONISM1 2 2 2 2Brajkovic Leposava , Kostic Vladimir , Svetel Marina , Stefanova Elka , Petrovic Igor , Sobic -

1Saranovic Dragana1Center for Nuclear medicine2Clinic for Neurology

Brain SPECT with DaTSCAN (specific marker of dopamine transporter (DAT) on presynaptic nerve terminals) is objective neuroimaging method for assessment of nigrostriatal dopaminergic system integrity and degeneration.Objective: To evaluate usefulness of DaTSCAN-SPECT in differential diagnosis of Parkinsonism in clinical practice.Materials and methods: We performed SPECT-DaTSCAN in 261 patients (152 males, 109 females) age 21-84 with clinically unclear parkinsonism. Study was performed 3-5 hours after

123intravenous injection 125-185MBq I-ioflupane-FP-CIT (DaTSCAN, Amersham, GE Healthcare) . Image acquisition was carried out with a Medisso Nuclear Spirit, double-headed gamma camera (128 projections, matrix 128x128, pixel size 3, 84mm, 40 seconds per projection). Images were reconstructed using Filtered back projection method, with Butterworth filter (cut off 0.5, order 7) and attenuation correction (Chang method, factor 0, 12).The images were evaluated by visual and semiquantitative (ROI) analyses: the ratio of specific-striate to non specific-occipital binding was calculated.Results: In 116 patients SPECT have shown decreased uptake of DaTSCAN in striatum, especially in putamen, and confirmed PD diagnosis (27 with young onset PD, 19 in early stage of disease). 37 patients with Parkinsonian syndromes(PS): 13 with autonomic dysfunction and suspected multiple system atrophy (MSA), 10 with progressive supranuclear palsy (PSP), 12 with Dementia Lewy body(DLB) and 2 with suspected corticobasal degeneration (CBD) have reduction of

123accumulation I-ioflupane in striatum. Twenty patients with Dystonia (D) and 54 patients with atypical statoposturokinetical tremor and uncertain diagnosis - PS or Essential tremor (ET) have normal DaTSCAN, and confirmed diagnosis D and ET. Tthirteen patients with suspected drug induced parkinsonism (DIP), 12 with vascular parkinsonism (VP) and 4 with psychogenic parkinsonism (PP) have normal DaTSCAN. Five patients with Alzheimer disease (AD) have normal DaTSCAN.Conclusion: DaTSCAN is a useful diagnostic procedure for detecting nigrostriatal degeneration and differentiating neurodegenerative disease (PD, MSA, PSP, DLB, CBD) from other conditions such as ET, DIP, VP, PP, D and AD.

HOW FDG-PET HELPED US AFTER 100+ EPILEPSY OPERATIONS?1 2 2 1 1Brajkovic Leposava , Sokic Dragoslav , Vojvodic Nikola , Jesic Ana , Sobic - Saranovic Dragana , 3 1Bascarevic Vladimir , Artiko Vera

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1Center for Nuclear medicine, Serbia2Clinic for Neurology, Serbia3Clinic for neurosurgery, Serbia

Positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) is a standard used in noninvasive stage of presurgical evaluation of patients with focal pharmacoresistant epilepsy. Epileptogenic focus visualizes as hypometabolic zone interictally and as hypermetabolic zone ictally.Objective: Evaluation of FDG-PET imaging in the presurgical lateralization and localization of epileptogenic fociPatients and methods: FDG-PET scan was performed for 214 patients (ages 5-65) with refractory epilepsy. The findings were visually analyzed and compared with epileptogenic zones detected with video-EEG monitoring and the results of magnetic resonance (MR).Results: The epileptogenic focus manifested as hypometabolic zone-interictal PET in 189 patients. In 7 patients, ictal PET has shown epileptogenic focus as a hypermetabolic zone. FDG-PET detected epileptogenic focus in 91,5% of patients. PET was positive and consistent with the MR findings in all patients with a lesion discovered with MR. The size of hypometabolic zone suggested the successfulness of the outcome of the epilepsy surgery (less hypometabolic area - better prognosis). In patients with suspected bilateral hippocampal sclerosis on MR or discordant video-EEG and MR findings, PET helped in lateralization of foci. In some epilepsy patients with normal MR initially, PET findings (hypometabolic zone) pointed to a possible localization of focus. Detailed analysis of MR findings and additional MR sequences and coregistration of MR and PET findings confirmed localization of epileptogenic foci and according to that, patients were successfully operated. PET findings in neocortical temporal lobe epilepsy contributed to the decision of extensiveness of surgery-lesiectomy if there was maintained metabolism in mesiotemporal structure.Conclusion: FDG-PET may help in lateralization and localization of epileptogenic foci, especially in patients with normal-nonlesional MR or discordant MR and video-EEG findings. Size of hypometabolic zones can help in the decision of the extensiveness of the surgery resection.

THE CLINICAL IMPACT OF RCBF-SPECT STUDY IN MILD COGNITIVE IMPAIRMENT

1 1 2 1Moralidis Efstratios , Doumas Argyrios , Ioannidis Panagiotis , Gerasimou Georgios , 2 1 2 1Maiovis Pantelis , Gotzamani - Psarrakou Anna , Karakostas Dimitrios , Spyroglou Foteini ,

1 1Liaros Georgios , Vasilliadis Apostolos1Lab of Nuclear Medicine22nd Neurological Clinic, AHEPA University Hospital, Thessaloniki, Greece

The clinical impact of rCBF-SPECT study in mild cognitive impairment.G. Gerasimou1, Maiovis P2, Ioannidis P2, Moralidis E1, Doumas A1, Liaros G1,Vasilliadis A1, Spyroglou F1, Karakostas D2, Gotzamani-Psarrakou1. 1 Lab of Nuclear Medicine, 2 2nd Neurological Clinic, AHEPA University Hospital, Thessaloniki, Greece.Mild cognitive impairment (MCI) is considered as a status of memory disturbances in individuals not fulfilling the criteria of diagnosis of Alzheimer's disease (AD), but which are of high risk in developing the complete syndrome. SPECT study with lipophilic compound exametazime labeled with Tc-99m (Tc-99m-HMPAO), is a functional diagnostic approach, which is helpful in the evaluation of patients with MCI. We aimed to study the impact of

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cerebral blood flow study (rCBF) in the final diagnosis of patients with MCI.A total of 25 patients, with a mean age of 67+6.9 years, developing memory disturbances, are enrolled in the study. All patients underwent a complete clinical examination, including MMSE, biochemical evaluation plus CT or MRI imaging. Study with Tc-99m-HMPAO was performed at a two-headed GE a -camera, after iv injection of 740MBq of the radiopharmaceutical. The data of all patients were evaluated visually and after semi-quantitative processing.Three of the patients were considered as normal. Twenty-two patients revealed bilateral temporal hypoperfusion at the medial temporal cortex, plus hypoperfusion at the lateral temporal cortex being obvious in 15. Abnormalities at the level of parietal cortex were seen in 12 patients, posterior parietal in 15, posterior cingulated gyrus in 5, frontal cortex in 5, anterior cingulated gyrus in 2 and reduced perfusion was mentioned at the level of striatum. A follow-up in the three normal individuals revealed temporal hypoperfusion in one of them.Patients with temporal and parietal pathology were considered as AD. Combination of frontal and temporal pathology was considered as frontal dementia. In patients with frontal hypoperfusion, final diagnosis was changed to AD in 3. The patient presenting pathology at the level of the striatum, had an abrupt deterioration of his status and was considered as cortico-basal-degeneration, confirmed with a D2 receptors IBZM study. The matching between final diagnosis and evaluation of SPECT study was as high as 80%. SPECT study, was a trigger for initiating treatment in 10/22 and change of treatment in 2 patients.We can conclude that rCBF study in patients with MCI can be the trigger for the primary evaluation and maybe personalized treatment to them.

ATTENUATION CORRECTION IN BRAIN DATSCAN (I-123 IOFLUPANE ) SPECT STUDIES. IS THERE ANY NEED FOR LOW DOSE CT BASED ATTENUATION CORRECTION METHOD?

1 1 1 2Pipikos Theodoros , Vlachou Fani , Nikaki Alexandra , Dalianis Konstantinos , Papoutsani 1 1 1Despoina , Tsiakas Evagelos , Papoutsis Vasileios

1Nuclear Medicine department, Hygeia SA, Athens, Greece2Medical Physics department, Hygeia SA, Athens, Greece

Aim: DaTSCAN SPECT diagnosis is primarily based on visual assessment and semi quantitative methods are of complementary role. Loss of counts due to attenuation because of deep location of the striatum in the brain, makes attenuation correction methods useful in imaging processing and diagnosis. Modern SPECT/CT imaging systems offer the possibility of low dose CT attenuation correction. In this study we compare the results of low dose CT attenuation correction to the images obtained with Chang algorithm.Materials and Methods: We evaluated side by side the attenuation corrected (Chang and low dose CT based) DaTSCAN- SPECT images and the uncorrected images of 49 patients. Imaging was performed with a Philips BrightviewXCT a -camera. Best 2 slices were fused (slice thickness 4,6mm) and the produced image was evaluated visually and semi quantitative. Interpretation was blinded between the different sets of images. Specific uptake ratios (SUR) were calculated. Visual results were graded into 5 levels: 0-normal; 1-asymmetrical reduceduptake inthe putamen in one hemisphere; 2-reduced putamen uptake bilateral; 3- no uptake in both putamen and reduced in one caudate; 4-bilateral very reduced uptake in both striatum. Results: Corrected images had greater SUR compared to uncorrected images. Chang method showed greater SUR increase compared to CTAC method. Difference was 18,1 and 17,4 % for left and right striatum respectively, 17,7 and 17,2% for the left and right caudate and 19 and 19,1% for the left and right putamen. Visual interpretation was identical for the two methods, downstaging 14/49 patients compared to the uncorrected images. Image quality was of superior quality compared to uncorrected images for both methods.

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Conclusion: Chang attenuation method was as effective for diagnosis as low dose CT based attenuation correction method, providing images of equal quality. Our results indicate that low dose Ct attenuation correction method, with its increased radiological burden for the patients, does not contribute more to the diagnosis.

OVERVIEW OF RADIOPHARMACIST'S EDUCATION IN BALKAN COUNTRIES: IS IT INDIVIDUAL STRUGGLE OR WELL-DEFINED SYLLABUS?

1 2StankoviC Aljoša , RajkovaCa Zvezdana1Radiopharmacy2Nuclear Medicine

Purpose: Eventhough radiopharmacy practice is in expansion curriculum for education of radiopharmacists is still different and not well-defined among countries. In some countries radiopharmacy is not even recognized from the ministries of health as a pharmaceutical specialization. The aim of this work was to explore current situation of radiopharmaceutical practice in Balkan countries and compare it with the rest of Europe in order to see are there any improvements in solving similar problems.Method – Material: The questionnaire which contains 10 questions was sent to National delegates in European Association of Nuclear Medicine and National delegates in Radiopharmacy community from Balkan countries. The questions asked about number of nuclear medicine facilities, number of radiopharmacists, organization of radiopharmaceutical education in their country and also their vision in which direction it should be develop in the future.Results: Seven from eleven countries respond on the questionnaire and it was shown there are 406 nuclear medicine departments, 10 cyclotron facilities and 6 radiopharmaceutical companies. Furthermore, in these facilities 27 radiopharmacists and 29 radiochemists are employed which leads to the result of one radiopharmacist/radiochemist in every fifteen facility. In two countries there are organized radiopharmaceutical syllabus through pharmaceutical specialization recognized by the government. In other countries education is organized through master and PhD studies (one) or european postgraduate courses that are not recognized by governmental institutions. Conclusion: The number of nuclear medicine facilities in Balkan is very representative, but the number of radiopharmacists is not on the same level. In comparison with other part of Europe education of radiopharmaceutical staff in most of the Balkan countries is in its infancy. Cause for this is lack of syllabus for radiopharmacists defined by national authorities and disapproval of radiopharmacy as pharmaceutical specialization. There should be more initiative from national regulatory bodies in organization of postgraduate courses on state and regional level, in order to have harmonized curriculum which will be verified in front of governmental institutions. Following that, nuclear medicine centers which will expand their capacities in SPECT and PET field, in future could have more benefit from this specialization in the pharmaceutical point of view

A SYSTEMATIC REVIEW ON THE INFORMATION SEEKING BEHAVIOUR OF NUCLEAR PHYSICIANS: THE ROLE OF ONLINE INFORMATION LITERACY

1 2 3 4Persakis Evangelos , Kostagiolas Petros , Datseris Ioannis , Niakas Dimitrios

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1Department of Nuclear Medicine - PET/CT, Evaggelismos General Hospital, Athens, Greece & Department of Archives, Library Science and Museology, Faculty of Information Sciences and Informatics, Ionian University, Corfu, Greece 2Department of Archives, Library Science and Museology, Faculty of Information Sciences and Informatics, Ionian University, Corfu, Greece3Department of Nuclear Medicine – PET/CT, Evaggelismos General Hospital, Athens, Greece4School of Social Science, Hellenic Open University, Patras, Greece

Purpose: Studying the information seeking behaviour and preferences of nuclear physicians is rather important for their daily operations. This work aims in identifying the information needs, the information resources employed and the obstacles physicians encounter when seeking medical information. Based on the above we discuss the essential role doctors' online literacy skills have in everyday practices as well as in medical knowledge updating. Method - Material: The authors systematically reviewed the relevant literature on the information seeking behaviour of nuclear physicians. A PubMed and SCOPUS literature search for original articles published until the end of 2015 was carried out. Twenty five articles met the predefined inclusion criteria and included in the analysis.Results: The most important information needs of nuclear physicians are related to clinical decisions such as diagnosis, disease management and treatment (in 16 of the 25 articles), while physicians sought information in research and educational issues (14/25 articles). Internet and other online resources such as scientific databases and search engines were the most important information resources (17/25 articles), whilst a smaller proportion of doctors reported a preference for hospital and personal libraries (10/25 articles), printed such as textbooks (18/25 articles), and human information resources such as colleagues (15/25 articles). Moreover, the major obstacles encountered by physicians were credibility of information (3/25 articles), time constraints (7/25 articles), cost (3/25 articles) and lack of information seeking skills (7/25 articles). The importance of developing programs for enhancing nuclear physicians' online information literacy skills is evident.Conclusion: Internet and other digital information tools could provide valuable additional input into physicians' routines and clinical practices. For this a new set of online literacy skills is required by nuclear physicians.

FEASIBILITY OF DEDICATED MOUSE IMAGING USING “a -EYE”, A NEW, LOW COST BENCHTOP SCINTIGRAPHIC CAMERA

1 1 2Georgiou Maria , Papadimitroulas Panagiotis , Fysikopoulos Eleftherios , Mikropoulos 2 2Konstantinos , Loudos George

1Bioemission Technology Solutions, Athens, Greece2Technological Educational Institute of Athens, Athens, Greece

Introduction Several dedicated imaging systems are commerically available for preclinical research, but their purchase and maintenance costs make them non affordable for the majority of most small and medium groups. Taking into account the average end user needs, we present “a -eye”, a dedicated a -camera suitable for in-vivo scintigraphic

2molecular imaging in mice, with 5x10cm field of view for whole-body mouse imaging.Methods The “a -eye” is based on two Position Sensitive Photomultiplier Tubes, coupled to a CsINa pixelated scintillator. The low energy collimator is made of lead with parallel hexagonal holes. The external dimensions of the entire system, including all required electronics, are 450mm x 300mm x 150mm. All studies can be stored as raw data and in a DICOM format and are handled through a Database Manager. The software supports a real-time viewer mode with selectable time frame as well as a post processing mode, where various tools are adapted.Results The spatial resolution of the system was measured 2mm @0mm and 3.2mm @20mm. The energy resolution for the 140keV energy is 26% and the maximum recorded

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sensitivity of the system is 200cps/MBq. The ability of the system for quantification was 99massessed using a phantom of 4 tubes filled with Tc solution and activities of 442, 235, 170

and 55,3 uCi. Our results demonstrate that accurate quantitative information was obtained even for 10 sec scans, which proves that the system can be used for fast dynamic stydies in small animals. The system was tested using a mouse injected with 100ul (~550uCi) 99mTc-labelled TechneScan™ HDP (bones). Images were obtained at 3h p.i, and at 27h p.i. Clear visualization of mouse bones verifies the high resolution of the system. In addition, a mouse injected with 100ul (~140uCi) 99mTc-DMSA (kidneys) was imaged at 1h p.i., 3h p.i., 5h p.i., 6h p.i. and 24h p.i. respectively.Conclusions A new low cost system, suitable for scintigraphic mouse imaging has been developed and has been evaluated both using phantoms and small animals. Its dimensions and cost make it a unique solution for groups activated in the field of small animal nuclear imaging.

PERFORFORMANCE EVLUATION OF A HYBRID PRECLINICAL PET/SPECT/X-RAY PROTOTYPE

1 2 3 3Rouchota Maria Tina , Georgiou Maria , Fragogeorgi Eirini , Fysikopoylos Eleftherios , 3 2 1Mikropoulos Konstantinos , Papadimitroulas Panagiotis , Kagadis George , Loudos

3Georgios1University of Patras, Rion, Patras, Greece2Bioemission Technology Solutions, Athens, Greece3Technological Educational Institute of Athens, Athens, Greece

In this work we present the design and development of a prototype SPECT/PET/CT system, suitable for whole body small animal imaging, which is unique not only in national but also in regional level. The system has been fully designed and constructed by our team. The integrated SPECT/PET/CT system has three components and is mounted on a rotating gantry, which is designed specifically for such applications and is computer controlled.The SPECT component is based on 2x H8500 Position Sensitive Photomultiplier Tubes (PSPMTs), a CsI(Na) pixelated scintillator with 1.5mm x 1.5mm x 5mm pixels and a general purpose hexagonal collimator. The data acquisition system (DAQ) consists of a FPGA (Xilinx SP605) for triggering and digital processing of the pulses acquired using free running ADCs (40MHz). The system has been evaluated with phantoms and small animals and has a 2mm spatial resolution, while it can provide fast images for dynamic mice studies.The PET components are based on similar PSPMTs coupled to BGO pixelated scintillators with 2mm x 2mm x 5mm pixel size. The DAQ consists of a bigger FPGA (Spartan 6 LX150T) and the sampling rate of the ADCs is 65MHz. An 20nsec and 350-700keV windows were selected as a good compromise between sensitivity and noise. The spatial resolution has been found equal to 2.5mm spatial resolution, while further optimization is possible by using proper reconstruction algorithms and corrections.The X-Ray is a high speed, low noise and high sensitivity flat panel detector, model C10900-40 from Hamamatsu. It is based on the CMOS technology and it is suitable for real-time static and CT imaging with high dynamic range due to its switchable pixel gain. The X-ray tube, SourceBlock™ by Source-Ray, Inc integrates an Xray tube and a high voltage generator into one physical package. The SB-80-500 model has a 33 micron minimal focal spot, a variable voltage 35-80kVp and 20 to 500uA current. The system is currently been mounted on the gantry and then will be evaluated using phantoms and finally small mice.The presented system provides unique infrastructure to support preclinical research on national and regional level.

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DOSIMETRIC EVALUATION TO MEDICAL WORKERS OPERATING IN A PET/CT DEPARTMENT AFTER THE USE OF DYNAMIC TECHNIQUES

1 1 2 2Dalianis Konstantinos , Kollias George , Efthimiadou Roxani , Prassopoulos Vasileios1Medical Physics Department, Hygeia Hospital, Greece2PET/CT Department, Hygeia Hospital, Greece

Aim: Due to the high-energy tracers emitting 511 KeV used in PET/CT departments and considering the risks associated to ionizing radiation that have been derived from previous studies, special attention is needed when dealing with radiation protection aspects in a PET/CT modality . New radiopharmaceuticals such us [18F]-fluorothymidine and 18F fluoromethylcholine are used, new imaging dynamic techniques are performed new measurements concerning the doses to staff are needed. Aim of this study was to measure the effective wholebody dose of the personnel in comparison with measurements that have been made in the past.Method: The estimation of equivalent dose from external dosimetry for all members of the staff was monitored with the use of TLDs badges and electronic dosimeters. In our department 18F-FDG, 18F-FCT, 18F-FCH is available in multi dose vials.Results: We compared the first six months of 2014 a period in which no FLT or FCH procedures were performed, with the second semester in which 36 FLT and 26 FCH examinations were performed. The average number of FDG patients was the same for every day. The measurements for the nurses show increased wholebody dose of about 7-12% and that is due to the longer time spent near the patient. Concerning the technologist doses, an increase of about 15-21% was measured because they are near to patient at the time of the injection.Conclusions: From our results we can observe that although there is an increase of the doses for technologists and nurses the numbers are significantly lower than the recommended annual dose limit by Euratrom 97/43.

FIRST STEPS TOWARDS THE STANDARDIZATION OF MULTI-CENTRE PET/CT SCANNING PARAMETERS ON A NATIONAL LEVEL: POTENTIAL FOR A PILOT STUDY IN GREECE

1 2 3 4Theodorakis Lampros , Loudos Georgios , Prassopoulos Vasilios , Kappas Constantinos , 4 1Tsougos Ioannis , Georgoulias Panagiotis

1Department of Nuclear Medicine, Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece2Department of Biomedical Engineering, Technological Educational institute of Athens, Egaleo, Athens, Greece3PET/CT Department, Hygeia Hospital, Marousi, Athens, Greece4Medical Physics Department, Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece

Purpose: Multi-centre PET/CT examinations are suffering from high level of variability especially related to the quantitative results. Often, the same patients are scanned in different institutions with scanners employing different technologies, protocol scanning parameters, reconstruction methods and even post processing workflows. It is the intention of this communication to investigate the first steps that should be undertaken towards a potential pilot study for the standardization of multi-centre trials among the PET/CT institutions in Greece.

2Method – Material: Noise Equivalent Count Rate (NECR=T /(T+Sc+kR), T:trues, Sc:scatter and R:randoms count rate, k=1 for a noiseless randoms correction) is an ideal candidate to act as a surrogate for count rate and image quality variation calculation between the scanners. GATE, an open source software based on the GEANT4 toolkit is used for simulations of nuclear medicine modalities and thus it can be used to achieve the needed flexibility of simulations versus experimental results. Previously validated simulation models of installed scanners in Greece can be used to perform a first level approach towards the analysis of the different counting responses. For this first level approach a phantom of uniform positron emitting activity can be utilized for NECR calculations.

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Results: The first step towards count rate standardization is NECRx values calculation for the different vendor technologies. Detector geometry, coincidence window, energy and temporal resolution and dead time are inputs to the simulation models. NECRx ratios are then used for count rate normalization.Conclusion: Count rate standardization is the first reasonable step towards a more holistic approach in multi-centre PET/CT studies in Greece. NECRx is an ideal surrogate for count rate normalization as a first step of the standardization. Image quality is then the next future step, but then reconstruction parameters should also be taken into account. Such a pilot could ultimately proven beneficial improving patient care for these patients scanned with different scanners in the country.

ESTIMATION OF COLLECTIVE EFFECTIVE DOSE TO THE POPULATION FROM NUCLEAR MEDICINE PROCEDURES

Vogiatzi Stavroula, Liossis Alexandros, Lamprinakou Martha, Hourdakis Constantinos


Introduction Greek Atomic Energy Commission (EEAE) conducted a national survey in order to estimate the annual collective effective dose received from nuclear medicine (NM) diagnostic procedures. It is the most recent survey in this area (2014 survey), performed under the EEAE PRISMA project, funded by the KRIPIS national program and co-funded by the European Regional Development Fund (National Strategic Reference Framework, 2007- 2013).Method Annual frequencies of diagnostic NM procedures and relevant radiopharmaceutical administered activities were collected via specifically formatted questionnaires by the NM departments operating nationwide. The average effective dose per NM procedure (mSv) was estimated by using the ICRP conversion factors and the calculated average administered activities (AAAs) (MBq). Based on the relevant data and the 2011 population census of the Hellenic Statistical Authority, the collective effective dose (personSv) and the annual per caput dose (mSv) were assessed. Furthermore, the respective standard uncertainties were estimated.Results The annual frequency of diagnostic NM procedures is 20 procedures/1,000 population. The national “Top 5 NM procedures”, i.e. the ones that mainly contribute to the annual collective effective dose received from NM, has slightly changed, compared to the 2009 survey. The annual per caput dose was estimated to 0.11 mSv ± 0.03 mSv (k=1). The AAAs do not seem significantly changed during the last decade.Conclusions The collective effective dose and the annual per caput dose from NM procedures have decreased in the last 5 years. Nevertheless, they appear higher than the recently assessed values in Europe. The AAAs are in good agreement with the European ones, apart from the renal, lung and thyroid (0% uptake) scans. The observed frequency decrease in Tl-201 myocardium scan, as a result of appropriate actions implemented at national level, in cooperation with national professional bodies and other authorities, highlights the added value of national surveys, for the optimization of patient medical exposure and for strengthening radiation safety culture in health care.

ESTIMATION OF THE COLLECTIVE EFFECTIVE DOSE TO THE GREEK POPULATION FROM MEDICAL EXPOSURES

Nikolaou Magda, Vogiatzi Stavroula, Kalathaki Maria, Simantirakis Georgios, Koukorava Christina, Economides Sotirios, Hourdakis Konstantinos, Kamenopoulou Vassiliki


Introduction Medical exposures contribute the largest to the population man-made radiation exposure, mainly due to the high frequency of diagnostic examinations and the patient doses involved. Greek Atomic Energy Commission (EEAE) estimates the annual collective effective dose and per caput dose to the Greek population from x-ray and nuclear medicine procedures. This work was performed in the framework of 'PRISMA'

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project within GSRT's KRIPIS action, funded by Greece and the European Regional Development Fund of the EU under the O.P. Competitiveness and Entrepreneurship, NSRF 2007-2013.Method The estimation of the annual collective effective dose, S, (person-Sv) and per caput dose, E , (mSv/caput) requires information on the frequency (i.e. annual number) and per-caput

the mean patient effective dose, E , (mSv) for each type of diagnostic and interventional pat

procedures. The frequency was assessed by a nationwide survey that has been conducted in all radiology and nuclear medicine departments. The E was evaluated from dose pat

measurements performed by EEAE and by using appropriate software or ICRP published conversion factors.Results In 2014, approximately 6.7 million diagnostic and interventional procedures were performed in Greece. Plain radiography constituted of about 60% of all procedures. The estimated frequency, i.e. number of procedures per 1,000 citizens was: 447 for plain radiographies, 135 for computed tomography scans, 7 for interventional procedures, 2 for fluoroscopic procedures and 20 for nuclear medicine procedures. The annual collective effective dose was estimated to 19776 person-Sv. The annual effective dose per caput was estimated to 1.7 mSv from diagnostic radiology and 0.1 mSv from nuclear medicine procedures.Conclusions CT scans contributed 80% of the collective dose from all diagnostic procedures. The frequency and the mean effective dose of plain radiography and mammography were similar or lower compared to relevant data from European countries, while the mean effective dose of CT scans was higher than that of the European average.

RESIDUAL ACTIVITIES OF COMMONLY USED 99MTC-LABELLED RADIOPHARMACEUTICALS.

Stavrou Petros, Papachristou M., Persakis E, Kouvelis K., Datseris E.

Evaggelismos General Hospital, Department of Nuclear Medicine & PET/CT, Athens, Greece

Purpose: In this study we present a series of common 99mTc-labelled radiopharmaceuticals administrations performed in a busy Nuclear Medicine department within a 1-year timeframe in routine practice. The main objective is to identify the true activity administered to the patient and whether that is in compliance with the EANM Guidelines, where applicable, and/or with the department's protocols. As a secondary objective we aimed to assess whether the volume of the injected dose correlates to the percentage of residual activity measured post-injection for each studied radiotracer.Materials and Methods: A number of commonly used 99mTc-labelled radiopharmaceuticals including 99mTc-Pertechnetate, MDP, HMDP, DPD, DMSA, MAG-3, Sestamibi, Tetrofosmin and Tektrotyd were assessed. All data were collected prospectively within a one-year period under routine medical practice and included a) injected activity, b) residual activity, c) percentage of residual activity (residual activity/injected activity*100), d) effective activity (injected activity minus the residual activity), e) injected volume, f) time of injection, g) type of procedure.Results: In the 1837 collected measurements the average percentage of residual activity was 13% (95% CI 12.75%-13.39%). Mean effective activities were within the recommended range by the EANM guidelines, where applicable, or did not exceed the recommended doses from the department's protocols. In cases where actual injected activity was lower than the minimum suggested by the department's protocols, the imaging quality was not compromised. There was a negative correlation between percentage of residual activity and administered volume for 99mTc-Pertechnetate, Teceos, Bonescan, HDP, DMSA, Renocis, Nephromag and Tektrotyd (Spearman's r coefficient ranging from -0.311 to -0.561). Cardiologic radiotracers presented no such correlation.Conclusion: It should be possible to reduce the level of administered activity for the diagnostic examinations, but with consideration over the residual activity, especially for radiopharmaceuticals with a high mean residual activity (mainly Tetrofosmin and Sestamibi).

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THE DIAGNOSTIC BENEFITS OF QUANTIFICATION APLYED IN DYNAMIC PARATHYROID SCINTIGRAPHY

Koljevic Ana

Institute of Oncology and Radiology of Serbia

Purpose: Aiming to improve results in parathyroid scintigraphy we developed new methods for scan data processing and statistic analysis of the time activity curves (TAC).Method: 78 patients, age 58(19-80) years, with hyperparathyroidism (PHPT) and ultrasound report of concomitant thyroid disease, underwent preoperative, dual- tracer: 99m Tc-pertecnetat and 99mTc-MIBI, double- phase scintigraphy (EANM guidelines 2009). Specially designed software, we developed, examined ROI time/activity changes in matrix with optional sizes and automatic preprocessing (linear fitted TAC logarithm, ensamble coupling) plus segmentation, based on semi automatic TACs clustering of pixels, as well as fractal analysis for TACs. We correlated our findings with PTH levels, histology results and conventional scintigraphic findings: subtraction and visual interpretation of planar images in oblique sections (according to ultrasound localization) and delayed scans (one hour interval).Results: Following histopathology parathyroid A.: autonomy 53/78pts: solitary- 44pts, hyperplasia: 8pts and one carcinoma; median lesion volume 796 mm³. B: thyroid – benign nodule only 25/78(32%)pts; malignancy: 15/78(19%)pts; C.: concomitant PHPT and thyroid nodular disease occurred in 36/53pts, among them 8pts had thyroid malignancies. Parathormone (PTH) was median 125,2 pg/ml (range 70- 658pg/ml). Scintigraphy findings (subtraction, oblique planar scans and delayed phase) in 63 lesion (in 53 pts) had 10 FN (mostly in hypeplasia PTA), and PPV was 81%; sensitivity 96%, specificity 76%. Using specially designed software, thyroid TACs represented exponentially declining curves but parathyroid lesions had typical uptake pattern in the form of late phase peak, independent to PTA volume and/or PTH levels. The ratio of PTA-to-normal thyroid uptake at peak maximum was 1.35(±0.21). Parameters of optimal PHPT curve enabled visual interpretation. Fractal theory was helpful in matrix 5x5 designing classifier dimension 1.1-1.3 for automatic procedure. A new processing method had PPV 97%, sensitivity 98%, and specificity 96%. The thyroid gland washout was up to 28% in normal, adenoma or thyroid carcinoma tissue and their slope analysis of TACs had equivocal negative slope: -0.04.Conclusion: New quantification method and dedicated software facilitated the recognition of small parathyroid lesions in the presence of concomitant thyroid nodular disease, overcoming diagnostic problem present in conventional as well as SPECT/CT and PET/CT imaging.

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PosterPresentations

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LEFT VENTRICULAR QUANTITATIVE PARAMETERS OBTAINED USING GATED MYOCARDIAL PERFUSION SPECT: COMPARISON OF THREE SOFTWARE PACKAGES.

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1 2 2 2Alexiou Sotiria , Georgoulias Panagiotis , Valotassiou Varvara , Tsougos Ioannis , Psimadas 2 3 4 4Dimitrios , Lakiotis Velissarios , Xanthopoulou Ioanna , Alexopoulos Dimitrios ,

3 3Apostolopoulos Dimitrios , Vassilakos Pavlos

Purpose Gated myocardial perfusion SPECT studies can evaluate the perfusion, function and several quantitative parameters of the left ventricle; ejection fraction (EF), end diastolic volume (EDV), end systolic volume (ESV). The aim of our study, was to measure and compare the aforementioned variables using three commercially available, processing programs; Emory Cardiac Toolbox (ECTb), Myovation and Quantitative Gated SPECT (QGS).

Method-material The study group consisted of 211 men and 89 women with mean age 62.8 years (SD=10.9 years), referred for myocardial perfusion scintigraphy for the evaluation of known or suspected coronary artery disease. 63 (21.1%) had previous myocardial infraction and 86 (28.7) coronary intervention. Patients with nonischemic cardiomyopathies, atrial fibrillation or other severe arrhythmias and those with qualitatively insufficient images were excluded. All participants underwent one-day

99mstress/rest Tc -Tetrofosmin myocardial gated SPECT (8 frames/cardiac cycle) protocol. Scintigrams were processed for the estimation of LVEF, EDV and ESV using three different software packages ECTb, Myovation and QGS on a central Xeleris 3workstation. The concordance of the three methods was evaluated with the computation of intraclass correlation coefficients (ICC) for random effects models.

Results An excellent concordance was found between the three software packages to ICCs values both for stress and rest variables. ICCs were all above 0.89 and ranged from 0.89 to 0.99 (p<0.001). Mean comparison between the three algorithms showed lower values (p<0.05) for Myovation calculations in comparison with ECToolbox and QGS measurements, for both stress and rest results. Correlation analysis concerning stress ESV, stress EDV, stress EF, rest ESV, rest EDV and rest EF indicated that the results from the three software were highly and positively correlated (p<0.001) with all coefficients being above 0.80.

Conclusion Our data indicated a good correlation between the three software programs, in the evaluation of LVEF, EDV, ESV. However, pair comparisons revealed differences in the mean values acquired by each method separately. To conclude, the utilization of the same processing method should be preferred to enhance the reproducibility of the studies.

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COMPARISON OF EARLY AND STANDARD POST-STRESS „GATED“ SPECT MIBI PROTOCOL IN PATIENTS WITH INTERMEDIATE DUKE TREADMILL SCORE

1 2 3 2Bojic Ljiljana , Sobic - Saranovic Dragana , Petrasinovic Zorica , Artiko Vera , Obradovic 2Vladimir

1Department of Nuclear medicine, Podgorica, Clinical Centre of Montenegro2Center of Nuclear medicine, Belgrade, Clinical Centre of Serbia3Clinic for Cardiology, Belgrade, Clinical Center of Serbia

Purpose: To compare perfusion and functional parameters between early post-stress „gated“ SPECT MIBI protocol (ES) and standard, delay „gated“ SPECT MIBI protocol (SS); to determine a potential advantages of ES against SS protocol for detection of transitory ischemic dysfunction of left ventricle (LV) in the group of patients with intermediate Duke Treadmill Score and normal to mild impaired LV function. Also, we have evaluated ES diagnostic value against coronary angiography (CA) as a gold standard for detection of significant coronary artery stenosis.

Methods: The sample included 63 patients with normal or mild impaired LV function and intermediate Duke Treadmill Score. They underwent a 2-day stress-rest „gated” SPECT






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MIBI with the post-stress data acquired at 15 minutes (ES) and 60 minutes (SS) after i.v. 99minjection of 740 MBq of Tc-MIBI. CA was done in all patients within 1 month after nuclear

medicine examination.

Results: Perfusion parameters did not significantly differ between ES and SS (p>0.05). Ejection fraction was significantly lower on ES than SS (p<0.05) and regional wall motion abnormalities were significantly higher on ES than SS (p<0.001). The corresponding perfusion and functional parameters were strongly related (linear regression slope

2 0.65–1.00, intercept -0.36–8.5, R 0.98–0.75). ES parameters show high sensitivity (96%) and specificity (83%) for detecting >70% stenosis, compared with CA. Also, the correlation between two methods was very strong, with the unweighteid coefficient of agreement (e) =0.793; (95% IP: 0.60 – 0.99, p<0.001).

Conclusion: ES yields comparable perfusion and functional parameters as SS protocol. The advantage of ES against SS protocol is better detection of transitory post-stress regional wall motion abnormalities of LV. ES is very powerful diagnostic tool for detection of ischemic heart disease compared with CA, and it is definitely recommended for improving patient compliance and efficiency of nuclear cardiology services.

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NON–INVASIVE EVALUATION OF THREE CORONARY HEART DISEASE WITH ECG-GATED SPECT - A CASE REPORT

1 2 2Chiriac Iulia Andreea , Mititelu Raluca Mihaela , Lepu? Mihaela Georgiana , Niculescu 2 2Olga , Mazilu Victor CĂtĂlin Victor CĂtĂlin

1Department of Nuclear Medicine, Central Universitary Emergency Military Hospital “Dr Carol Davila”, Bucharest and Department of Nuclear Medicine and Radioiodotherapy, National Institute of Endocrinology “C. I. Parhon”, Bucharest, Romania2Department of Nuclear Medicine, Central Universitary Emergency Military Hospital “Dr Carol Davila”, Bucharest, Romania

Background And Patient Findings Myocardial perfusion scintigraphy is a widely used investigation for the detection of reversible ischemia or non-reversible ischemic segments of the heart. Important information concerning the myocardial function is obtained when the ECG gating is used concomitantly with the SPECT (single-photon emission computed tomography) acquisition and moreover the misinterpreting of artifactual defects are avoided. We report a case of a 63-year-old-female with many cardiac comorbidities, cervical discopathy and chronic autoimmune thyroiditis with partial thyroidectomy who recently had an acute coronary episode without an electrocardiography (ECG) elevation of the ST segment. The current blood tests and biological markers were in normal range. A myocardial perfusion scintigraphy was recommended for the assessment of the coronary artery disease extension.

Method And Results We performed a one-day stress-rest ECG-gated SPECT myocardial scintigraphy. The technique requires minimum patient preparation and we choose 99mTc-MIBI as a radiopharmaceutical. We used a large field gamma camera (Dual-head AXIS, PHILIPS Picker / Marconi, USA) with a low-energy, general-purpose parallel-hole collimator. The 99mTc-MIBI SPECT ECG-gated myocardial perfusion stress-rest studies showed left ventricular dilation with reversible perfusion defects in the inferior-septal wall, apex, median-anterior and distal septal walls; partially reversible defects were detected in the anterior wall. On the ECG-gated processed studies, we noticed marked global hypokinesia/ akinesia, more obvious in the apical, anterior, septal and inferior regions of the left ventricle, associated with and intense reduction of the regional ejection fractions and impaired systolic wall thickening on both studies.

Conclusion Ischemic coronary heart disease is one of the leading causes of death in the world. Nuclear cardiology studies play a significant role in the noninvasive diagnosis of coronary artery disease, the assessment of the pumping function of the heart and in the prediction of outcomes in patients with heart disease. In this case the myocardial perfusion scintigraphy was useful for the regional assessment of the patient heart

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disease, the study results showed hypoperfused vascular territories of three-vessel coronary artery disease, more extensive in the left anterior and right coronary arteries. The patient was referred to the interventional cardiology department for the therapeutic management.

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BRAIN SPECT IN EVALUATION OF THE RENAL ARTERY SYMPATHETIC DENERVATION EFFECT ON THE CEREBRAL BLOOD FLOW LEVEL: CORRELATION WITH COGNITIVE FUNCTION IN PATIENTS WITH ARTERIAL HYPERTENSION RESISTANT

1 2 3 3 3 3Efimova Nataliya , Chernov V , Efimova I , Krivonogov N , Saushkin V , Lichikaki V , 1 4Lishmanov Yu , Ryzhkova D

1Federal State Budgetary Scientific Institution «Research Institute for Сardiology», Tomsk, Russia, National Research Tomsk Polytechnic University, Tomsk, Russia2National Research Tomsk Polytechnic University, Tomsk, Russia3Federal State Budgetary Scientific Institution «Research Institute for Сardiology», Tomsk, Russia4Federal State Budgetary Institution «V. A. Almazov Federal North-West Medical Research Centre» of the Ministry of Health of the Russian Federation, St. Petersburg, Russia

Purpose: To study the effect of radiofrequency ablation of renal arteries on regional cerebral blood flow (rCBF) and cognitive function in patients with arterial hypertension (AH) resistantMaterial and methods: The study involved 17 patients (pts) with AH resistant investigated

99mby SPECT with Tc- HMPAO, 24-hours blood pressure monitoring and comprehensive neuropsychological testing before and after transcatheter renal denervation. Brain SPECT slices were divided into 14 symmetrical (right and left) regions of interest per patients: inferior and superior frontal lobes, temporal, anterior and posterior parietal, occipital lobes and cerebellar hemispheres Regional cerebral blood flow (ml/100g/min) in these regions was calculated. Fifteen pts without angiographic signs of carotid atherosclerosis, coronary artery disease and AH, neurological and psychiatric disorders were investigated as control group.

Results: It was revealed decrease in rCBF in AH pts in right and left inferior frontal lobe on 13,5% (p=0.00002) and 15,5% (p=0.0006), correspondingly; in right temporal brain region on 11,5% (p=0.008) ; in right and left occipital cortex on 8,2% (p=0.04), in comparison with control group. The results of neuropsychological testing showed 12,8% decrease in mentation (p=0.0003), 42,3% long-term verbal memory (p=0.0004), 20,5% long-term visual memory (p=0.02), 19% learning (p=0,0008), as well as 26,4% decrease in attention (p=0.001) in pts with AH as compared with control group. Improvement of rCBF, 24-hours blood pressure monitoring parameters and cognitive functions after 6 months of transcatheter renal denervation in patients with AH was noted. Relationship between changes rCBF, indices of 24-hours blood pressure monitoring and dynamics of cognitive function was found. Improvement of long-term verbal memory correlated well with increase in rCBF in left superior frontal region and right occipital region. Significant correlation was shown between dynamics of mentation and attention and changes of rCBF in right posterior parietal region.Conclusion: Our results suggest, that transcatheter renal denervation leads to beneficial effect on levels of 24-hour mean BP, as well as indices of load pressure, increases in cerebral blood flow and improves of cognitive function in patients with resistant hypertension. The study was supported by a grant from the Russian Science Foundation ? 15-15-10016

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PMYOCARDIAL VIABILITY- THE VALUE OF TC-99M MIBI SPECT DURING NITRATE ADMINISTRATION IN ASSESSMENT OF VIABLE MYOCARDIUM IN PATIENTS WITH DILATED CARDIOMYOPATHY

1Izic BelkisaUniversity Clinical Centre Tuzla, Radiology and Nuclear Medicine clinic, Bosnia and Herzegovina

Background: Tc-99m MIBI myocardial SPECT has shown promise for evaluation of coronary artery disease, but its role in predicting myocardial viability is still under investigation. The aim of the study was to determine clinical use and efficacy of the 99mTcMIBI with nitrate (ISDN) administration for detection of viable myocardium in patients with dilated cardiomyopathy.

Methods: Thirty-seven patients (27 male and 10 female) with dilated cardioyopathy were studied. All patients were examined under baseline study at rest and after administration ISND. The data were reconstructed in transaxial slices and then reoriented into short, vertical long and horizontal long axis slices. The images were divided into seven different segments for qualitative analysis. The images were interpretated by two independent observers.

Results: The results showed that out of 68 segments with hypoperfusion at resting SPECT, 29 segments (42,67%) had an increase in Tc-99m MIBI uptake during administration ISDN. The degree of improvement in perfusion was related to the age of patients.

Conclusion: The data suggest that use of Tc-99m MIBI SPECT in patients with dilated cardiomyopathy during administration ISDN may be a useful for assessing myocardial viability becouse ISDN augmented 99mTcMIBI protocol in Cardiac SPECT imaging resulting in improved detection of viable but hypoperfused segments.

MYOCARDIAL STATUS IN FEMALE PATIENTS WITH NON-SPECIFIC CARDIAC COMPLAINTS EVALUATED WITH 99MTECHNETIUM-TETROFOSMIN MYOCARDIAL PERFUSION IMAGING

1 1 1Sioka Chrissa , Tsiouris Spyridon , Papadopoulos Athanasios , Kotrotsios Tzimis - 1 1 1 1Dimitrios , Nikos Vasileios , Papadimitropoulos Konstantinos , Sakellariou Konstantinos ,

1 1 1 1Exarhopoulos Thomas , Spiliotopoulou Maria , Xourgia Xanthi , Al - Boucharali Jihad , 2 2 1Lakkas Lampros , Pappas Konstantinos , Fotopoulos Andreas

1Department of Nuclear Medicine, University Hospital of Ioannina, University of Ioannina School of Medicine, Ioannina, Greece2Department of Cardiology, University Hospital of Ioannina, University of Ioannina School of Medicine, Ioannina, Greece

Purpose: To assess the myocardial status in female patients with non-specific cardiac 99m 99mcomplaints evaluated with Technetium-tetrofosmin ( Tc-TF)-single photon emission

computer tomography (SPECT) myocardial perfusion imaging (MPI).

Method-material: Forty female patients [main age 58.4 years old (41 to 76 years)], were 99msubjected to Tc-TF-SPECT MPI for evaluation of non-specific cardiac complaints of

various type, such as chest wall pains, palpitations or shortness of breath and negative clinical cardiology examination and normal ECG. MPI was evaluated visually using polar map of 17 segments. Myocardial ischemia (MIS) was defined as mild when the summed stress score (SSS) was 4-8, and moderate or severe when SSS was ≥9. According to MPI results, the role of factors such as obesity, diabetes mellitus, hypertension, dyslipidemia and cardiac heredity was assessed. Results: Abnormal MPI was found in 14/40 (35%) patients [56.4 years old (42 to 70 years)], all defined as mild MIS. Among them, 8/14 (57%) were obese patient, 4/14 (29%) patients had diabetes mellitus, 7/14 (50%) patients had dyslipidemia, 12/14 (86%) patients had hypertension, 7/14 (50%) patients had medical history of cardiac heredity. Furthermore, 11/14 (79%) patients had at least two and 7/14 (50%) at least three risk factors. None of the patients were smokers.






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Conclusions: The study suggested that adult females with non-specific cardiac complaints are at risk for MIS, especially if they have a history of hypertension or at least two cardiac risk factors.

RELATIONSHIP OF MYOCARDIAL PERFUSION SCINTIGRAPHY SUMMED STRESS SCORE AND CORONARY ARTERY STENOSIS

1 1 2 1 1 1Stevic Milos , Vlajkovic Marina , Koracevic Goran , Rajic Milena , Kojic Marko , Misic Ivana , 1Ilic Slobodan

1Center of nuclear medicine, Clinical Center Nis, Serbia2Clinic for cardiovascular disease, Clinical center Nis, Serbia

Summed stress score (SSS) is one of semiquantitative parameters for assessing the extent and severity of myocardial perfusion defect of the left heart ventricle obtained on myocardial perfusion scintigraphy (MPI).Purpose: We try to correlate values of SSS on MPI with the degree of coronary artery stenosis (CAS) obtained on coronary angiography (CAG) in patients with angina pectoris (AP).Methodology: We have examined 135 patients with AP, of which 99 men and 36 women, mean age 59.0 ± 10.1 years. All patients underwent two-day MPI protocol with the use of exercise testing. SSS was estimated with quantification software 4DMSPECT, INVI, LLC, the University of Michigan, USA. The values of SSS are categorized into three categories: normal findings (SSS 0-4), moderate (SSS 5-9) and severe (SSS> 9). Coronary angiography was performed according to standard femoral Seldinger approach, where the stenosis is less than 70% was considered anatomically insignificant, while stenosis higher than 70% were considered as anatomically significant. We performed a descriptive statistical analysis, with the cross-tabulations of the results.Results: Normal SSS was obtained in 17.8%, moderate in 19.2% and severe in 60% of patients. Significant CAS was found in 79.3% of patients and in 20.7% it was insignificant. In the group with normal SSS, 95.8% of patients had insignificant CAS, while 4.2% had significant stenosis. In the group with moderate SSS, 11.5% of patients had insignificant, while 88.5% had significant CAS. In the group with severe SSS, insignificant stenosis was found in 2.4% while 97,6% of patients had significant stenosis.Conclusion: The values of the MPI SSS that fall into the severe category (SSS> 9) can indicate the existence of anatomically or hemodynamically significant coronary artery stenosis in patients with AP. Keywords: Perfusion myocardial scintigraphy, Summed stress score, Coronary angiography

IS THERE A ROLE OF SERUM 25 HYDROXY-VITAMIN- D LEVELS IN PATIENTS WITH CORONARY ARTERY DISEASE. CORRELATION WITH SPECT MYOCARDIAL SCINTIGRAPHY

1 2 3 4Baloka Lukia , Karathanos Evangelos , Pavlidis Pavlos , Thomaidou - Ntanasel Antina , 2 3 2Zissimopoulou Orestia , Karakasi Valeria – Maria , Tsartsarakis Antonios , Sotiropoulou

5 2 1 5 2Rodoula , Tsaltabasidou Maria , Galiotou Maria , Barmpouti Vasiliki , Tzelepi Maria , 2Zissimopoulos Athanassios

1Molecular Biology and Genetics School, Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.2Nuclear Medicine Dept., Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.3Laboratory of Forensic Sciences, Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.4Cardiology Clinic, Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.5Medical School Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.

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Introduction: Recent studies have reported that low serum vitamin D levels are associated with a variety of diseases, including cardiovascular disease and in particular ischemic heart disease (IHD). Possible mechanisms underlying this association include increased inflammation, renin-angiotensin system upregulation, insulin resistance, altered lipid metabolism, and altered vascular smooth muscle growth and function that lead to hypertension, diabetes, dyslipidemia and atherosclerosis.Aim: The aim of this study is to evaluate the serum levels of 25 hydroxy- vitamin D [25(OH) D] in patients with Coronary Artery Disease (CAD), as a prognostic factor of the severity of the disease, in correlation with SPECT myocardial scintigraphy.Patients and method: We study 78 patients (48 male and 30 female) aged between 37 and 73 years old (median age of 58±9 years) who suffer from Coronary Artery Disease (CAD). The most of them (61) were patients of the University Cardiology Clinic of the University Hospital of Evros and the rest were patients of other cardiologists. In all patient's blood samples were taken for (25-OH-D) determination and after this in everyone SPECT

99mmyocardial scintigraphy with Tc-MIBI and tomographic ã-camera was performed. After centrifugation the serum was collected and kept refrigerated at -70 ° C. The vitamin D

125status was measured by radioimmunoassay (RIA) method with I [25(OH)D] kits Diasorin at in- vitro laboratory of Nuclear Medicine Dept. University Hospital of Evros, Democritus University of Thrace.Statistical analysis: Statistical analysis was performed by the Pearson correlation test and statistical significance was considered to be p <0.005.Results: 37 patients with myocardial infarction had low values of vitamin D,[( ≤ 0-20 ng/mL ( 0-50 nmol/L)], (p <0.005). In this group there is statistical significance in the relationship between very low values of vitamin D and patients with extensive myocardial infarction. (p <0.005). Therefore the very low prices associated with the severity of disease and the impending death of patients. These patients might need more intensive monitoring.32 patients with reversible myocardial ischemia had low values of vitamin D 20-40 ng/mL (50-100 nmol/L). (p <0.005). Therefore the very low levels associated with the progression of the disease.9 patients who had normal myocardial scintigraphy had values of vitamin D to normal levels > 40 ng/mL (>100 nmol/L). (p <0.005).Conclusions: In conclusion low vitamin (25-OH-D) levels may underlie established cardiovascular risk factors. The very low levels associated with the severity of (CAD) disease and the impending death of patients. The determination of vitamin D levels in patients with coronary artery disease is essential to monitor patients in the treatment and outcome of disease.

25 HYDROXY-VITAMIN- D LEVELS AS PROGNOSTIC FACTOR IN PATIENTS WITH DIABETES MELLITUS AND MYOCARDIUM ISCHEMIA. CORRELATION WITH SPECT MYOCARDIAL SCINTIGRAPHY

1 2 3 4Baloka Lukia , Papanas Nicolaos , Karathanos Evangelos , Pavlidis Pavlos , Thomaidou - 5 3 3 3Ntanasel Antina , Zissimopoulou Orestia , Tsartsarakis Antonios , Srataki Aphrodity ,

3 1 6 6 3Tsaltabasidou Maria , Darousi Smaro , Sotiropoulou Rodoula , Resta Ioanna , Arapi Maria , 3 7 3 3Pistola Anastasia , Lambropoulou Maria , Tzelepi Maria , Zissimopoulos Athanassios

1Molecular Biology and Genetics School, Democritus University of Thrace, Medical School, University Hospital of Alexandroupolis Dragana, Greece.2Diabetes Center- Second Department of InternalMedicine, Democritus University of Thrace, Medical School, University Hospital of Alexandroupolis Dragana, Greece.3Nuclear Medicine Dept., Democritus University of Thrace, Medical School, University Hospital of Alexandroupolis Dragana, Greece.4Laboratory of Forensic Sciences, Democritus University of Thrace, Medical School, University Hospital of Alexandroupolis Dragana, Greece.5Cardiology Clinic, Democritus University of Thrace, Medical School, University Hospital of Alexandroupolis Dragana, Greece.6Medical School, Democritus University of Thrace, Medical School, University Hospital of Alexandroupolis Dragana, Greece.7Lab Histology-Embryology, Democritus University of Thrace, Medical School, University Hospital of Alexandroupolis Dragana, Greece.

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Introduction: The presence of hypovitamin D increases the risk of fractures, low vitamin D levels are also associated with hypertension, cancer, diabetes mellitus and cardiovascular disease.Aim: The aim of this study is to evaluate the serum levels of 25 hydroxy- vitamin D [25(OH) D] in patients with ischemic heart disease (IHD), as a prognostic factor of the severity of the disease, in correlation with SPECT myocardial scintigraphy.Patients and method: We study 48 patients (32 male and 16 female) aged between 39 and 65 years old (median age of 53±9 years) who suffer from diabetes mellitus and ischemic heart disease (IHD). All the patients were from the Cardiology Clinic of the University Hospital of Alexandroupolis. In all patient's blood samples were taken for (25-OH-D)

99mdetermination and after this in everyone SPECT myocardial scintigraphy with Tc-MIBI and tomographic ã-camera was performed. After centrifugation the serum was collected and kept refrigerated at -70 ° C. The vitamin D status was measured by radioimmunoassay

125(RIA) method with I [25(OH)D] kits Diasorin at in- vitro laboratory of Nuclear Medicine Dept. University Hospital of Alexandroupolis, Democritus University of Thrace.Statistical analysis: Statistical analysis was performed by the Pearson correlation test and statistical significance was considered to be p <0.005.Results: 41 patients with reversible myocardial ischemia had low values of vitamin D 20-40 ng/mL (50-100 nmol/L). (p <0.005). Therefore the very low prices associated with the progression of the disease. 7 patients who had normal myocardial scintigraphy had values of vitamin D to normal levels > 40 ng/mL.Conclusions: In conclusion low vitamin (25-OH-D) levels may underlie established cardiovascular risk factors. The very low levels associated with the severity of ischemic heart disease. The determination of vitamin D levels in patients with (IHD), is essential to monitor patients in the treatment and outcome of disease.

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CONTRIBUTION OF WHOLE BODY SPECT/CT POST I131-THERAPY IMAGING TO THE DIAGNOSIS. WHAT HAS THE METHOD TO OFFER?

1 2 1 1Pipikos Theodoros , Koutsikos Ioannis , Vlachou Fani , Nikaki Alexandra , Dalianis 3 1 1 1Konstantinos , Papoutsis Vasileios , Tsiakas Evagelos , Papoutsani Despoina

1Nuclear Medicine department, Hygeia SA, Athens, Greece2Nuclear Medicine department, NIMITS Hospital, Athens, Greece3Medical Physics department, Hygeia SA, Athens, Greece

Aim: Modern Hybrid SPECT/ low doseCT Imaging devices offer the acquisition of functional and anatomical images at the same time, providing more diagnostic information. The purpose of our study is to evaluate the possible contribution of SPECT/low dose CT acquisition to the diagnosis, compared to planar whole body imaging in the restaging of patients with differentiated thyroid carcinoma (DTC) after total thyroidectomy and ablative radioiodine therapy.Methods: Twenty-six patients with DTC and total thyroidectomy were studied after

131administration of 2775- 3700 MBq of I for thyroid remnants radioablation. A week after 131radioiodine administration a planar I whole-body scintigraphy (WBS) was performed,

131followed by a I SPECT/ low dose CT imaging the day after. Planar and SPECT/CT data were compared and correlated with ultrasound imaging (U/S), which was considered as gold standard for evaluation of thyroid or thyroglossal cyst remnants, or for pathological lymph nodes. The patients were under clinical surveillance in the next 18 months.Results: Planar imaging is sufficient to determine the residual thyroid remnants (3,84% false negative). WBS did not reveal thyroglossal duct cyst in 2 of 26 patients (7,69% false negative). The most important diagnostic information provided from the SPECT/CT imaging, was about neck lymph node involvement, since WBS was false positive in 7 from 26 (26,92%) and false negative in 1 patient. False positive neck lymph node represented either thyroglossal duct cyst(1/7) or residual thyroid gland (5/7) or normal bio distribution(esophagus) (1/7). Metastasis in mediastinum and mediastinal lymph nodes infiltrations were better visualized with SPECT/CT while WBS was false positive in 1

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patient (radioactive contamination) and false negative in 5 from 26 patients (19,23%). In 1 patient SPECT/CT revealed pelvic lymph node metastasis, a lesion that in WBS was

131evaluated as extraction of the radiopharmaceutical. Over all I SPECT/CT in our study altered nodal stage from N1 to N0 in 7 from 26 patients. Furthermore SPECT/CT was useful in cases of intense colon radiopharmaceutical tracer accumulation in abdomen and pelvis with uncertain WBS findings.

131Conclusion: I SPECT/CT improved diagnostic performance, revealing more lesions and leading to reduction of false positive findings. Over all SPECT/low dose CT imaging had a serious impact in diagnosis.

THE DIAGNOSTIC SEQUELAE OF THE INCIDENTAL FINDING OF FOCAL ACTIVITY IN THE PROSTATE ON 18F-FDG PET/CT SCAN

1 1 1 1Paschali Anna , Ahmed Haseeb , Szyszko Teresa , Cook Gary1PET Imaging Centre (Kings College London), St Thomas' Hospital, London, UK

Aim: To determine the incidence and sequelae of incidental hypermetabolic foci in the prostate in patients who have undergone 18F-FDG PET/CT for non-prostate malignancies.Materials and Methods We retrospectively reviewed the reports of 2130 18F-FDG PET/CT studies performed in men for non-prostate malignancies and no previous history of prostate cancer, from January 2014 to December 2014. In those patients with incidental prostate uptake, the electronic patient record (EPR) was searched for chemical pathology results, further imaging and histopathology.Results Incidental prostate uptake was noted in 60 patients (3%). 12/60 (20%) with a history of TURP had central activity interpreted as being due to urinary activity in the TURP defect. In the remaining 48/60 cases (80%) there were either solitary or multiple peripheral foci of uptake reported. In 28/48 (58%) no further evaluation was found on EPR. In 20/48 cases (42%) PSA measurement, MRI or U/S of the prostate and biopsy was undertaken. Finally in 4/48 (8%) cases the imaging was indicative of malignancy and biopsies were confirmatory.Conclusion: The incidence of malignancy in those with peripheral prostatic uptake is at least 8% and hence this should be included in the PET/CT report and further evaluation advised.

COMPARISON OF 67GA-CITRATE AND 99MTC-HMPAO LEUKOCYTES IN TECHNICAL MATTERS (RADIOLABELING, QUALITY CONTROL, INJECTED DOSES, PATIENT RADIATION EXPOSURE AND IMAGING PROTOCOLS)

1 1 1 1Priftakis Dimitrios , Papachristou Maria , Xyrafi Eirini , Datseris Ioannis1Nuclear Medicine Department – PET/CT , GHA “Evaggelismos”, Athens, Greece

Purpose: 67Ga-citrate and 99mTc-HMPAO leukocytes are widely used conventional agents for radionuclide imaging of inflammation and infection. Their common clinical indications include osteomyelitis, prosthetic joint infection, diabetic foot, chronic infections and fever of unknown origin. The selection of the appropriate radiopharmaceutical should be guided by the clinical question based on the reported efficiency of each agent for each indication. Nevertheless, in everyday practice, various technical matters might also play a role in the selection between the two. The purpose of this study is to highlight how 67Ga-citrate and 99mTc-HMPAO leukocytes compare with regard to such technical matters.

Methods: 67Ga-citrate is a ready-to-use radioisotope so the quality control includes pH measurements, visual and radiometric controls. Leukocytes labeling procedure with 99mTc-HMPAO was carried out according to the protocol of the EANM and the European Pharmacopeia. After labeling, the quality control includes pH measurements, visual control and instant thin layer chromatography (TLC), in order for the product to be released. The dose of the 67Ga-citrate is 4 mCi and the dose of 99mTc-HMPAO leukocytes

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is 15 mCi per patient. Both dosages are in accordance with our Department protocols.

Results: Releasing 99mTc-HMPAO labeled leukocytes takes 2 hours, where 67Ga-citrate is ready for use. As far as the imaging protocols are concerned, the main disadvantages of gallium imaging are the interaction with recent contrast studies, the need to change to a medium energy collimator, and imaging both at 24 and 48 hours, which means multiple visits and double exam duration. The main advantages of 99mTc-HMPAO leukocytes include imaging 1-4 hours after the injection, superior resolution and higher count density, which provide better quality planar and SPECT images. Patients injected with 67Ga have higher radiation exposure than the patients injected with 99mTc.

Conclusion: Both procedures and radiopharmaceuticals are well standardized and known. Their costs are almost the same. 67Ga-citrate has a 2-day protocol, higher radiation exposure and short availability. 99mTc-HMPAO leukocytes have long radiolabeling procedure and quality control, lower radiation exposure, 1-day protocol and broad availability. Both radiopharmaceuticals have advantages and disadvantages. The choice depends on the Nuclear Medicine Department's resources, protocols and qualification standards.

RADIONUCLIDE TREATMENT IN PROSTATE CANCER: IS THERE ANY CORRELATION OF FAVORABLE OUTCOME WITH PSA LEVELS AND SPREAD OF BONE DISEASE?

1 2 2 2Karanikiotis C , Doumas A. , Papanastasiou E , Gerasimou Georgios , Gerasimou 2 2 2 2 2 2Georgios , Liaros G , Gkirgkoudis M , Vasileiadis A , Spyroglou F , Gotzamani - Psarrakou A

1424 Military Hospital2AHEPA Hospital-2nd Laboratory of Nuclear Medicine

Aim: Prostate cancer is an osteophilic neoplasm spreading to the bones, producing thus pain, discomfort and poor quality of life of patients. Treatment with radiopharmaceuticals emitting a radiation is an effective alternative treatment reducing pain scale and improving quality of life. The aim of this study is to clarify if pain relief is correlated with reduction of prostatic specific antigen (PSA) levels plus reduction of bone involvement evaluated by bone scan index (BSI).Patients and Methods: Twenty-one patients aged 59-81 years (73.7+6.4) with proven by biopsy prostate cancer and secondary bony involvement evaluated by bone scan with 99mTc-HDP, are enrolled in the study. All patients underwent radionuclide treatment with Samarium (153Sm-EDTMP-14 patients) or strontium-89 (89Sr-7 patients). Repetition of treatment was performed with a 1-2 months interval when receiving 153Sm-EDTMP or 3-4 months interval when receiving 89Sr, to all of them. Acceptable levels of erythrocytes, leukocytes and platelets and a good level of renal function were conditions for the application of treatment. PSA levels were measured pre- and post radionuclide treatment and a second bone scan was performed after the third application of treatment.Results: All patients had median or major recession of pain evaluated by daily diary of activities and drug intake. The non-parametric Wilcoxon Signed Ranks test was used for statistical analysis of the data. Baseline mean PSA levels (PSA1) were as high as 231.36ng/ml (minimum 9.00-maximum 1899.40), whilst mean post treatment levels (PSA2) were 212.78ng/ml (minimum 9.50-maximum 2149.50)-p=0.18, non significant. Negative ranks (PSA2PSA1) in 6 of patients. BSI score was reduced to only 2/21 patients.Conclusion: It seems that recession of pain and patients' activity after radionuclide treatment with 153Sm and 89Sr in cases of prostate cancer with bony involvement, is independent of PSA levels pre- and post treatment and extension of skeletal metastatic disease.

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SILENT MYOCARDIAL ISCHEMIA IMAGED WITH 99MTECHNETIUM-TETROFOSMIN MYOCARDIAL PERFUSION IMAGING IN PATIENTS WITH ISCHEMIC STROKE

1 1 1Sioka Chrissa , Fotopoulos Andreas , Spiliotopoulou Maria , Papadimitropoulos 1 1 1 1Konstantinos , Sakellariou Konstantinos , Kotrotsios Tzimis - Dimitrios , Nikos Vasileios ,

2 2 2 3 3Naka Katerina , Michalis Lampros , Behlioulis Aris , Markoula Sofia , Zouroudi Sofia , 3 3Kyritsis Athanasios , Giannopoulos Sotirios

1Department of Nuclear Medicine, University Hospital of Ioannina, University of Ioannina School of Medicine, Ioannina, Greece2Department of Cardiology, University Hospital of Ioannina, University of Ioannina School of Medicine, Ioannina, Greece3Department of Neurology, University Hospital of Ioannina, University of Ioannina School of Medicine, Ioannina, Greece

Aim: To assess the myocardial status in patients with stroke, employing myocardial 99m 99mperfusion imaging (MPI) with Technetium-tetrofosmin ( Tc-TF) -single photon emission

computer tomography (SPECT). Materials and methods: Fifty two patients with ischemic 99mstroke were subjected to Tc-TF-SPECT MPI within 1 month after stroke. None of the

patients had any history or symptoms of coronary artery (CAD) or other heart disease. MPI was evaluated visually using polar map of 17 segments. Myocardial ischemia (MIS) was defined as mild when the summed stress score SSS was 4-8, and moderate or severe when SSS was ≥9. These MPIs were compared to patients with SSS<4, which is considered as nonsignificant MIS. Parameters such as age, BMI, abdominal perimeter, alcohol consumption, smoking habits and medical history (diabetes mellitus, dyslipidemia, etc) were evaluating according to MPI results. Results: Abnormal MPI was found in 32/52 (61.53%) stroke patients ( p<0.05). Among them, 20/32 (62%) patients had mild

99mabnormalities and 12/32 (38%) moderate or severe. All Tc-TF-SPECT abnormalities were clinically silent. Statistical difference was found in stroke patients with abnormal MPI and abdominal perimeter, independent of the severity of MIS (p<0.05). Conclusion: The study suggested that more than half of stroke patients without history of cardiac disease have abnormalities in MPI. Although most of them have mild myocardial ischemia, we suggest a thorough cardiological evaluation in this group of patients, for prevention of future symptomatic cardiac disease.

EARLY DIAGNOSIS OF ALZHEIMER'S DISEASE USING BRAIN PERFUSION SPECT WITH BRODMANN AREAS MAPPING.

1 2 3 1Valotassiou Varvara , Papatriantafyllou John , Sifakis Nikolaos , Tzavara Chara , Alexiou 1 1 1 1 1Sotiria , Psimadas Dimitris , Ziaka Anastasia , Baniora Eleni , Tsougos Ioannis ,

1Georgoulias Panagiotis1Department of Nuclear Medicine, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece2Memory & Cognitive Disorders Clinic, Department of Neurology, “G. Gennimatas” Hospital, Athens, Greece3Department of Nuclear Medicine, “Alexandra” University Hospital, Athens, Greece

Purpose: Diagnosis of Alzheimer's disease (AD) in early stages using clinical criteria may be difficult. The aim of this study was the evaluation of brain perfusion in mild AD using single photon emission computed tomography (SPECT) and automated software (NeuroGamTM) for the semi-quantitative evaluation of perfusion in Brodmann areas (BAs) and the comparison with a database of normal subjects of the same age. Method-material: We studied 34 consecutive patients with mild AD, 9 men, 25 women, mean age 70.9±8.1 years. We used the DSM-IV and NINCDS-ADRDA criteria for the clinical diagnosis. All the patients underwent a neuropsychological evaluation with a battery of tests including the Mini-mental state examination (MMSE, mean 22.6±2.5) and a brain SPECT 20 min after the administration of 740MBq 99mTc-HMPAO.

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Results: The lower mean perfusion values were found in subgenual (BAs 25L, 25R), temporopolar (BAs 38L, 38R), entorhinal (BAs 28L, 28R) and ectorhinal (BAs 36L, 36R) cortices bilaterally, while dorsal posterior cingulated (BAs 31L, 31R) and occipital (BAs 19R, 18L, 18R, 17L, 17R) cortices had the higher mean values. Compared with normal database, the greatest deviations from the healthy subjects were found in subgenual, entorhinal and ectorhinal cortices bilaterally (BAs 25L, 25R, 28R, 28L, 36L, 36R), while the lowest deviations were found in bilateral dorsal anterior cingulated, left ventral anterior cingulated and occipital cortices (BAs 32L, 32R, 19R, 24L, 17L, 17R, 18L and 18R). Perfusion values more than -2SDs below the mean of healthy subjects were found in temporopolar, ectorhinal, entorhinal, subgenual and ventral posterior cingulated cortices bilaterally, as well as in left superior temporal gyrus and left inferior frontal gyrus (BAs 38R, 38L, 36L, 36R, 23L, 23R, 22L, 44L, 28L, 28R, 25L, 25R) in a percentage of ≥94% of patients. The corresponding proportion was less than 38% for left orbitofrontal, bilateral dorsal anterior cingulated, left ventral anterior cingulated and occipital cortices (BAs 11L, 32L, 32R, 19R, 18L, 18R, 24L and 17R).Conclusion: Brain perfusion SPECT with automated analysis could be a useful tool in daily practice for the early diagnosis of AD.

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THE FIRST EXPERIENCE OF USING A NEW RADIOPHARMACEUTICAL BASED ON THE 1-THIO-D-GLUCOSE LABELED WITH 99MTC FOR TUMOR IMAGING IN THE EXPERIMENT

1 2 1 2 1 2 1 2 2Zeltchan Roman , , Chernov Vladimir , , Medvedeva Anna , , Sinilkin Ivan , , Bragina Olga , 2 2 2 2 2Rogov Alexandr , Ilina Ekaterina , Stasyuk Elena , Skuridin Viktor , Efimova Natalya ,

2Dergilev Alexandr1Tomsk Cancer Research Institute, Tomsk, Russia2Tomsk Polytechnic University, Tomsk, Russia

Purpose: to study possibility of using 1-thio-D-glucose labeled with 99mTc for cancer imaging in the experiment.Materials and method: study was performed in cell culture of normal CHO (Chinese hamster ovary cells CHO) and malignant tissues MCF-7 (human breast adenocarcinoma MCF-7). In the tubes with the cells in an amount of 3 million was added 25MBq 1-thio-D-glucose labeled with 99mTc and incubated for 30 minutes at room temperature. Thereafter, a centrifugation of the tube with the cells the supernatant was removed. Then made a measurement of radioactivity in tubes with normal and tumor cells. In addition, the study included 10 mice of C57B1/6j lines with tumor lesion of the right femur. For neoplastic lesions model in mice was used carcinoma Lewis. Following anesthesia, mice were injected intravenously with the 25MBq 1-thio-D-glucose labeled with 99mTc. After 15 minutes planar scintigraphy was performed in a matrix of 512x512 pixels for 5 minutes.Results: in measuring the radioactivity of normal and malignant cells after incubation with the 1-thio-D-glucose labeled with 99mTc it was found that the radioactivity of malignant cells is higher. The mean values of radioactivity levels in normal cells were 0.3±0.15MBq. The mean values of the level of radioactivity in the malignant cells were 1.07±0.6MBq (p<0.05).All examined animals were revealed increased accumulation of the 1-thio-D-glucose labeled with 99mTc at the tumor site. The accumulation of the 1-thio-D-glucose labeled with 99mTc in the tumor was on average twice as high as compared to the symmetric region. The mean value the index tumor/background ratio was 2.15±0,35.Conclusion: The present study demonstrated that 1-thio-D-glucose labeled with 99mTc is a prospective radiopharmaceutical for the cancer visualization. In addition, high accumulation of the 1-thio-D-glucose labeled with 99mTc in the culture of cancer cells and in animals tumor tissue demonstrates tumor tropism of the radiopharmaceutical.

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99MTC-TETROFOSMIN UPTAKE CORRELATES WITH THE SENSITIVITY OF GLIOBLASTOMA CELL LINES TO TEMOZOLOMIDE

1 2 1 1Alexiou George , Xourgia Xanthi , Vartholomatos Evrysthenis , Gerogiannia Paraskevi , 3 2 1Kalef Ezra John , Fotopoulos Andreas , Kyritsis Athanasios

1Neurosurgical Institute, University of Ioannina, Ioannina, Greece2Department of Nuclear Medicine, University Hospital of Ioannina, Ioannina, Greece3Department of Medical Physics, University of Ioannina, Ioannina, Greece

99m 99m 99mPurpose: Tc-Tetrofosmin ( Tc-TF) is a myocardial perfusion imaging agent. Tc-TF has also been found useful for brain tumor imaging. The aim of the present study was to

99minvestigate if Tc-TF uptake by glioblastoma cell lines correlates with their response to temozolomide (TMZ), a chemotherapeutic agent currently used for glioblastoma treatment.

99mMethod-material: We investigated the correlation of TMZ anti-tumor effect with the Tc-TF uptake in two glioblastoma cell lines (U251MG and T98G). The U251MG cell line is sensitive to TMZ, whereas T98G is resistant. Viability and proliferation of the cells were examined with trypan blue exclusion assay and xCELLigence system. Cell cycle was analyzed with flow cytometry. The radioactivity in the cellular lysate was measured with a gamma scintillation counter.

Results: U251MG cells were sensitive to TMZ and the effect was most prominent at a concentration of 500 ìM. T98G cells were resistant even at a concentration of 500 ìM. After 72 hours of treatment with TMZ there was a significant decrease in the cell index of U251MG cells that were treated with 500 ìM of TMZ compared to control (p<0.001), whereas the difference was not significant for T98G cells (p=0.38). TMZ induced G /M cell 2

cycle arrest in U251MG cells, whereas there was no effect in the cell cycle of T98G cells. 99mLower Tc-TF uptake was observed in U251MG cells that were exposed to TMZ compared

99mto control (p=0.0159). No significant difference in respect to Tc-TF uptake was found in T98G cells when exposed to TMZ compared to control (p=0.8).

99mConclusion: Tc-TF uptake could provide clues for the differentiation between TMZ-99msensitive and resistant glioblastoma cells. Thus, Tc-TF may hold promise as a novel

agent for an early assessment of the response of glioblastoma to chemotherapy and deserves further investigation.

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ROLE OF POSITRON EMISSION TOMOGRAPHY (PET/CT) IN IDENTIFYING UNKNOWN PRIMARY IN PATIENTS WITH LUNG METASTASIS.

1 2 2Barai Sukanta , Prasanth Arun , Gambhir Sanjay1Sanjay Gandhi postgraduate Institute of Medical sciences, Lucknow,India2Department of Nuclear Medicine, SGPGIMS,Lucknow,India

Introduction: Positron emission tomography (PET/CT) is currently increasingly being used to identify an unknown primary (UP).The reported results range from 20 to 90%, hence it is

still unclear if PET/CT canbe used for initial evaluation of an unknown primary. Aim of the study was to determine if success in identifying the primary site varied according to the site

of metastasis at presentation.Material and Methods: Data of patients who presented with single site of metastasis and underwent the PET/ CT study for the detection of primary were retrospectively analyzed. A

total of 50 patients were studied and classified according to metastatic site peripheral lymph nodes (PLN) n=17, lung n=23, bone n=6, livern=2, peritoneum n=2). Detected lesion

in PET/CT was biopsied and the PET/ CT scan was consideredsuccessful in detecting the primary only if histopathology reports were concordant.

Results: We compared the proportion of positive PET scans according to metastatic site and found a wide variation. It ranged from 86.9% (20/23) for lung, 29.4% (5/17) for PLN

(cervical, axillary and inguinal), 67% (4/6) for bone and 50% (1/2) for liver. When comparing






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results in lung andbone metastasis to the others, the PET scan positive proportion was significantly greater for lung and bone compared to the rest (p<0.01).

Conclusions: The success rate for identification of unknown primary by PET/CT scan is influenced by the site of metastasis at presentation. When patients present with

metastasis to lung or skeleton the chances of successful localization of the primary tumor by PET/CT scan is very high.

Ρ

Aim: The purpose of this study is to explore the role of FLT in metastatic brain lesions.Methods-material: 20 FLT-PET examinations were performed in 14 patients for evaluation of metastatic brain lesions. All patients had received the appropriate treatment prior to FLT-PET/CT examination, according to their disease. In 7 cases the patients suffered from breast cancer, in 9 cases from lung cancer, 2 from thymoma, 2 from melanoma. PET/CT was performed 55±5min after the iv administration of 18F-FLT at a Siemens Biograph LSO PET/CT device. Qualitative- visual analysis, as well as semiquantitative analysis using SUVmax and tumor-to-background ratio (T/B: SUVmax of the tumor/ SUVmean of the background) was performed. P values >0.5 were categorized as statistically significant.Results: In 3 cases PET/CT was characterized negative and in 17 positive (19 lesions). Average SUVmax and T/B were 2.32±1.59 and 12.72±9.6 respectively. In 15 cases patients were referred for treatment after PET (14 with positive PET). In 2 positive PET cases the patients were referred for biopsy; both samples were negative. In 2 PET negative cases patients were put under surveillance, while in the other FLT-PET negative case, the patient was referred for chemotherapy, due to disease lesions other than brain. Using paired t-test statistically significant differences were recorded between SUVmax and T/B values for metastatic lesions (p <0.05).Conclusions: With respect to our inhomogeneous sample, our results point out that 18F-FLT-PET, with utilization of semiquantitative markers, may be a useful tool in investigation of metastatic tumor lesions, by offering additional functional information. Statistical significant difference was found between SUVmax and T/B values.

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DIFFERENT PATTERNS OF F18-FDG UPTAKE IN THE BOWEL IN PATIENTS UNDER ANTIDIABETIC METFORMINE MEDICATION

1 1 1 1 1Pipikos Theodoros , Eftymiadou Roxani , Vlachou Fani , Fillipi Vasiliki , Nikaki Alexandra , 1 2 1 1Kechagias Dimitrios , Dalianis Konstantinos , Merisoglou Sofia , Andreou Ioannis

1PET/CT department, Hygeia SA, Athens, Greece2Medical Physics department, Hygeia SA, Athens, Greece

Aim: One of the most common prescribed antidiabetic agents is metformin. A usual finding in diabetic patients under metformine is high intestinal radiopharmaceutical uptake, with variable distribution, sometimes causing diagnostic difficulties. In this study we describe the different patterns of intestinal FDG uptake in our diabetic population under metformine.Material-methods: We retrospectively reviewed the pattern of intestinal FDG uptake in 108 type 2 diabetic patients under metformine medication that underwent FDG PET/CT

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FLT-PET/CT IN METASTATIC BRAIN LESIONS1 1 2 1Nikaki Alexandra , Prassopoulos Vasileios , Tsougos Ioannis , Efthymiadou Roxani ,

1 1 3 4Vlachou Fani , Filippi Vasiliki , Nomikos Panagiotis , Kosmidis Paris , Dalianis 5 1 6Konstantinos , Merisoglou Sofia , Georgoulias Panagiotis

1PET/CT department, Hygeia SA, Athens, Greece22Medical Physics Department , University of Thessaly, Larissa,Greece3Neurosurgery Clinic Hygeia SA, Athens,Greece52nd Internal Medicine - Oncology Clinic Hygeia SA, Athens,Greece4Medical Physics department, Hygeia SA, Athens, Greece6Department of Nuclear Medicine, University of Thessaly, Larissa, Greece

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examination in the last three years in our institution. Exclusion criteria were colorectal carcinoma or other intestinal pathology, such as inflammatory bowel disease, recent infectious colitis, symptoms like abdominal pain, diarrhea etc. Activity was graded as grade1 if uptake was lower than hepatic activity, grade 2 when activity was similar to hepatic uptake and grade 3 when colon activity was clearly greater than the liver activity. Then we reviewed the distribution of increased activity, depending on its localization in the small intestine or colon, and if it involved diffusely the whole colon or a part of it.Results: All patients showed even mild increased F18FDG bowel uptake in the colon. 37/108 (35%) patient had high uptake in the small intense as well. Uptake in small intense was generally mild and more faint than colon in all cases. 27/108 patients showed uptake less than liver activity (grade 1), 40 had similar activity to the liver (grade 2) and 41 showed clearly more intense uptake than the liver (grade 3).Colonic involvement was diffuse in 71 patients. Nine (9) patients had increasedactivity in ascending colon only, 5 patients in transverse, descending and sigmoidcolon, 9 patients had uptake involving descending and sigmoid colon and finally in 5patients ascending, descending and sigmoid colon were involved. Nine (9) of thepatients with diffuse colonic uptake showed great tracer heterogeneity, with multiple sites of intense focally increased uptake through the large bowel and no abnormalities (i.e. diverticulums) discovered on CT images.Conclusion: Metformine increased intestinal F18-FDG uptake is noted mainly in the colon. Small bowel increased concentration is less frequent and less intense. Colonic activity is usually intense and homogenous. Although diffuse uptake is the most usual pattern, segmental uptake images can be seen.

Aim: The purpose of this study was to investigate the usefulness of FLT-PET/CT in assessing recurrence of primary brain tumors.Methods-material: 12 patients with primary brain tumor were referred to our PET/CT department for evaluation of possible recurrence: 3 patients for grade II tumors, 3 for grade III, 6 for grade IV. All patients had undergone surgical excision of primary tumor, while 10/12 had received additional radiotherapy. 18F-FLT was administered intravenously to the patients and 12min PET/CT acquisition was performed 55±5min later at a Siemens Biograph LSO PET/CT device. Findings were evaluated visually as well as semiquantitatively using SUVmax and tumor-to-background ratio (T/B: SUVmax of the tumor/ SUVmean of the background). P values >0.5 were categorized as statistically significant.Results: FLT-PET/CT was positive in all cases (total number of lesions: 13). Average SUVmax was 1.9±0.93 and average T/B was 10.47±4.81. Using unpaired t-test no statistical significant difference was observed in semiquantitative calculations (including both SUVmax and T/B) among the different grades of primary tumors (p>0.5). Using paired t-test statistically significant differences were recorded between SUVmax and T/B values.Conclusions: With respect to our small sample and the referral bias, our results indicate that 18F-FLT- PET, may be used as an additional tool in investigation of recurrence of primary brain tumors. Average SUVmax among different grades of primary tumors did not substantially differ, although this could -at least partially- attributed to the fact that primary brain tumors usually recur to lower differential status (higher grade). T/B values were higher than SUVmax values, possibly due to relatively low background activity.

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FLT-PET/CT IN INVESTIGATION OF RECURRENCE IN PRIMARY BRAIN TUMORS1 1 2 1Nikaki Alexandra , Eftymiadou Roxani , Tsougos Ioannis , Pipikos Theodoros , Filippi

1 3 4 1 1Vasiliki , Razi Evagelia , Dalianis Konstantinos , Papoutsis Vasileios , Andreou Ioannis , 1 5Prassopoulos Vasileios , Georgoulias Panagiotis

1PET/CT department, Hygeia SA, Athens, Greece2Medical Physics Department , University of Thessaly, Larissa,Greece3Pathology Oncology Clinic, Hygeia SA, Athens, Greece4Medical Physics Department, Hygeia SA, Athens, Greece5Department of Nuclear Medicine, University of Thessaly, Larissa, Greece






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18F-FDG-PET/CT IN RESTAGING TESTICULAR CANCER PATIENTS1 1 1 1Prassopoulos Vasileios , Andreou Ioannis , Papoutsis Vasileios , Nikaki Alexandra ,

1 1 1 1Efthymiadou Roxani , Fani Vlachou , Despina Savvidou , Pipikos Theodoros , Kechagias 1 1Dimitrios , Dalianis Konstantinos

1PET/CT Department, HYGEIA Hospital, Athens, Greece

Purpose: CT is the imaging method of choice for staging and restaging testicular cancer patients. However, CT suffers from the limitation of size criterion when evaluating residual enlarged lymph nodes. The aim of this study is to investigate the value of PET/CT in assessment of treatment response in testicular cancer patients.Method-Material: 83 testicular cancer patients 17- 56 y.o (86 PET/CT examinations) were included in the study. All patients had previously been restaged by conventional imaging (CT). Comparison between PET/CT and CT was performed. Patients were followed up for 1year.Results: PET/CT was considered positive in 27/86 cases and negative in 57/86. Both PET and CT were positive in 23/27 cases, with PET showing more metastatic lymph node lesions in 4 cases. Discrepancy was observed in 4/27 cases with CT being negative while PET was positive (1 bone and 3 lymph node metastasis). In 27/57 cases PET and CT were negative. In 30 cases CT was either positive or equivocal showing slightly enlarged lymph nodes and/or small pulmonary nodules, while PET showed no evidence of hypermetabolism in the according lesions. Both PET and CT were equivocal in 2/86 cases.Conclusion: For restaging testicular cancer patients, PET/CT, as whole body imaging modality, may be hepful, especially when evaluating borderline lymph nodes, since functional alterations precede the anatomical ones. Attention should be paid at small non- hypermetabolic pulmonary nodules.

LONG TERM, SINGLE CENTER, FOLLOW-UP OF WELL DIFFERENTIATED THYROID CARCINOMA

1 1 1PopoviĆ Marina , TasiĆ Slobodan , KoljeviĆ MarkoviĆ Ana1Department of nuclear medicine, Institute of oncology and radiology of Serbia, Belgrade, Serbia

Purpose: Differentiated thyroid cancer(DTC) is a common malignancy and is increasing in incidence. Although, patients with DTC have a good prognosis, recidive development can negatively affect disease outcome.Accordingly, the aim of this study was to gain more information about DTC and DTC recidive occurring.Methods: This was a retrospective study, performed using Surveillance Epidemiology among 255 patients, diagnosed with DTC, that undergo thyroid surgery, followed at the at the Institute of Oncology and Radiology of Serbia. Summary statistics were used to compare the demographic, clinical and pathological characteristics of selected patients.Results: A total of 255 patients (218 female and 37 male) were identified, 182 (71.37%) with papillare, 61 (23.92%) with follicular and 12 (4.71%) with mixed (papillary and follicular) form of thyroid carcinoma. Median follow up was 24 (range 10-52) years while mean follow up was 24.15 (SD=6.5; SEM= 0.41) years. At the moment of DTC diagnose, years of patients ranged from 5 to 70, mean and median age were similar and had a value of 39.53 and 39 years respectively (SD=11.10; SEM=0.7). Total thyroidectomy was performed in 200 patients, near total thyroidectomy in 25 patients and thyroid lobectomy in 30 patients (21

-right and 9 left).A 69 patients were treated with J 131 after surgery.Radio therapy received 23 patients of which 12 patients received therapy due to DTC and 11 patients received radiotherapy as a result of other existing cancers. Local spread developed 14 (5.5) patients, recidive occurred in 13 (5.1%) patients while distant metastasis appeared in 9 patients (3.5%). At the moment of recidive diagnose, years of patients ranged from 21 to 79. Mean age were 46 while median were 42 years (SD=18.74; SEM=1.17).Conclusion: Considering previously mentioned facts we can say that due to long-term risk






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of recurrence life-long and very sensitive follow-up of patients with well differentiated thyroid carcinoma must be performed thoroughly.Key words: Differentiated thyroid cancer,follow-up,recidive

TECHNETIUM-99M TETROFOSMIN SPECT FOR HEAD AND NECK TUMORS 1 1 1Sioka Chrissa , Exarchopoulos Thomas , Sakellariou Konstantinos , Papadimitropoulos

1 1 1 2Konstantinos , Nikos Vasileios , Kotrotsios Tzimis - Dimitrios , Ragos Vasileios , 3 3 3Asimakopoulos Asimakis , Asimakopoulos Dimitrios , Exarchakos Georgios , Fotopoulos

1Andreas1Department of Nuclear Medicine, University Hospital of Ioannina, University of Ioannina School of Medicine, Ioannina, Greece2Department of Maxillofacial Surgery, University Hospital of Ioannina, University of Ioannina School of Medicine, Ioannina, Greece3Department of Ear Nose and Throat, University Hospital of Ioannina, University of Ioannina School of Medicine, Ioannina, Greece

Purpose: To evaluate if 99mTechnetium-tetrofosmin (99mTc-TF) -single photon emission computer tomography (SPECT) is useful in patients with head and neck cancers. Method-material: 99mTc-TF-SPECT planar imaging of the neck was employed in twelve patients with probable head and neck malignancies. Patients with positive findings (tumor or lymph nodes) had tumor-to-background index (T/Bg) calculation. Results: There was increased tracer uptake in pathological sites (primary tumor or lymph node) in 9/12 patients (sensitivity of 75%). Primary tumor was visualised in 7 patients (sensitivity 58%) and infiltrated lymph nodes in 4/7 patients (sensitivity 57%). The mean values for T/Bg index were 5.44±1.28 for primary tumors and 4.25±1.67 for lymph nodes. In patients with in situ or grade I carcinoma the mean values for T/Bg index were 4.5±0.71 and for patients with grade II and III tumors 6.68±0.36 (p=0.034, Mann-Whitney U test). Conclusion: The present study suggested that the 99mTc-TF may represent a valuable radiotracer for head and neck cancer imaging, but further larger studies are needed to confirm our findings.

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THE ROLE OF 68GA-DOTATATE PET/CT IMAGING IN THE DECISION OF PEPTIDE RECEPTOR RADIONUCLIDE THERAPY (PRRT) ADMINISTRATION



Aim: Peptide receptor radionuclide therapy (PRRT) consists of the systemic administration of a synthetic peptide, labeled with a suitable a-emitting radionuclide, able to irradiate

90 177tumors and their metastases. PRRT, with either Y-octreotide or Lu-octreotate, has established to be an efficient and effective therapeutic modality that provides objective responses in neuroendocrine tumors (NET), and is well tolerated with moderate toxicity.

68This study was performed to reveal if Ga-DOTATATE PET/CT can influence the decision of .PRRT administration in NET patients

Methods: Data from patients with NET who received PRRT or were candidate for PRRT were analyzed.

68Results: Between 25/5/2005 and 19/8/2013, 1246 Ga-DOTATATE PET/CT scans were performed in patients with confirmed or suspected NET. In 13.4% of these cases (167

177cases, from 122 patients), radioisotope therapy, either as PRRT, (i.e. Lu-DOTATATE and 90 131 68Y-DOTATOC) or I-MIBG was received after Ga-DOTATATE PET/CT scans. Of these PRRT

68was decided as new treatment in 85 cases (6.8% of the total 1246 cases). In these Ga-

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DOTATATE PET/CT imaging showed extensive unresectable and/or metastasized disease 68 177with intense Ga-DOTATATE uptake. In detail, Lu-DOTATATE was administrated in 46

90cases, Y-DOTATOC in 25 cases, while in 14 cases the given radiopharmaceutical for PRRT 131is not known to us. In 4 cases I-MIBG was decided as new treatment, because the MIBG

123 68uptake in diagnostic I-MIBG scan, was more intense than the Ga-DOTATATE uptake in PET/CT scan.Conclusions: PRRT is an established treatment in patients with advanced and/or

68progressive. Ga-DOTATATE PET/CT imaging is necessary prior PRRT in order to target the somatostatin receptors. Our study reveals that PRRT could be decided as a new treatment

68in a significant percentage of NET patients, when Ga-DOTATATE PET/CT scan shows extensive unresectable and/or metastasized disease with intense uptake.

PP68GA-DOTATATE PET/CT VS PET/ MRI IN NEUROENDOCRINE TUMOURS: A COMPARATIVE STUDY

1 1 1 1Alshammari Alshaima , Skoura Evangelia , Michopoulou Sofia , Fraioli Francesco , Syed 1 1Rizwan , Bomanji Jamshed

1Nuclear medicine department, UCL hospital, London, UNITED KINGDOM

Purpose: Studies are emerging about the utilization of PET/magnetic resonance imaging (PET/MRI) in NETs. From the existing studies PET/MRI is believed, to have significant advantages in body areas where MRI is better over CT, including central nervous system, upper abdominal, urogenital system and head and neck imaging. The aim of this study is

68 68to compare Ga-DOTATATE PET/CT with Ga-DOTATATE PET/MRI imaging in patients with known neuroendocrine tumours, and assess the confidence in anatomic lesion detection and localization. Furthermore, the value of each sequence of MRI was evaluated separately.

68Method-Material: We retrospectively analysed the data of 38 NET patients. Both Ga-DOTATE PET/CT and PET/MRI scans were performed. MR sequences undertaken were T1and T2 weighted, HASTE MR, and diffusion-weighted imaging (DWI).Results: Interobserver reliability was equally very good in both modalities. All lesions considered as malignant in PET/CT were equally depicted in PET/MRI in most of the

68visualized areas. Significant inter observer correlation between Ga-PET/CT and PET/MRI 68SUV max values for both primary and liver lesions was also observed. However, Ga-

DOTATATE PET/MRI recognized more liver lesions in 3 patients. The contrast and DWI sequence of PET/MRI did not have a significant effect on final outcome, however in a selected number of cases these images confirmed and helped to further characterize and detect more lesions. There was no significant correlation between DWI mean values and SUV max for the same lesions.

68Conclusion: This study demonstrates the potential of Ga-DOTATATE PET/MRI in patients with NET, with special advantages in the characterization of liver lesions.

CORRELATION OF [18F]FDG UPTAKE WITH CLINICAL AND LABORATORY PARAMETERS IN PATIENTS WITH LUNG CANCER.

1 2 2 1Boudali Maria , Skoura Evangelia , Michopoulou Sofia , Datseris Ioannis E , Syrigos 3Konstantinos N

1Evangelismos General Hospital, Athens, GREECE2UCLH, London, UNITED KINGDOM3Oncology Unit GPP, University of Athens, School of Medicine, Athens, GREECE

18Purpose: This prospective study aimed to evaluate the correlation between [ F]FDG uptake in PET/CT imaging, measured by maximum standardized uptake value (SUVmax), with several tumor markers and histopathological results in patients with lung cancer

18Method-Material: Patient demographics data, indications for [ F]FDG PET/CT and the

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correlation of SUVmax values with histopathological data and with several tumor markers level- CEA, Ca 125, Ca19-9, Ca15-3, AFP, NSE- were assessed.Results: During two year time, a total of 189 patients with lung cancer were included in this prospective study. The group included 137 males and 52 females with a mean age of 63.9 years old. The majority of the patients' clinical indication was the initial staging. Regarding the correlation of SUVmax with laboratory and histopathological data, there was no significant difference for SUVmax values across the histological types identified (adenocarcinoma, squamous cell carcinoma and small cell lung carcinoma). By contrast, a significant difference in CEA values, between the three different histological types, was found, with the highest values identified in adenocarcinomas (p<0.05). Furthermore, no significant correlation was identified between the SUVmax value and the levels of six different tumor markers-CEA, Ca 125, Ca19-9, Ca15-3, AFP, and NSE.Conclusions: This prospective study showed no significant difference regarding the SUVmax values in different histologic subtypes of lung cancer or any correlation with the levels of several tumor markers examined for lung cancer. On the contrary, there was a significant difference in CEA values for the different histopathological categories identified, with the highest values in adenocarcinomas.

THE CONTRIBUTION OF BRAIN SPECT AND ADVANCED MAGNETIC RESONANCE IMAGING IN THE DIFFERENTIAL DIAGNOSIS OF CEREBRAL TUMORS.

1 2 3 4Tsitsia Vasiliki , Valotasiou Varvara , Fountas Konstantinos , Kapsalaki Eytychia , 4 2 1Fezoulidis Ioannis , Georgoulias Panagiotis , Tsougos Ioannis

1DEPARTMENT OF MEDICAL PHYSICS, UNIVERSITY OF THESSALY, Greece2NUCLEAR MEDICINE DEPARTMENT, UNIVERSITY OF THESSALY, Greece3NEUROSURGERY DEPARTMENT, UNIVERSITY OF THESSALY, Greece4RADIOLOGY DEPARTMENT, UNIVERSITY OF THESSALY, Greece

Purpose: Neuroimaging has evolved from a purely anatomy-based specialty to a multi-parameter discipline that incorporates morphologic abnormalities with hemodynamics and cellular metabolism. The exciting new advances in MRI and Nuclear Medicine and the growing demands in Neuro-oncology make the need for diagnostic information combination evident. A pre-surgical multi-parametric imaging protocol that incorporates information from Advanced MRI techniques and brain SPECT are applied in collaboration of the Medical Physics/Radiology/Neurosurgery departments of the University of Thessaly in order to optimize differential diagnosis of cerebral tumors.Materials-Methods: 22 patients (5 meningiomas, 9 high-grade gliomas, 3 metastases, 2 oligodendrogliomas, 1 neurocytoma, 1 lymphoma, 1 gliosarcoma) were included in the pre-surgical imaging protocol. Image fusion of the data derived from the advanced MRI techniques and brain SPECT was performed in Xeleris workstation (GE Healthcare). MRI techniques: The study was performed on a 3-Tesla MRI whole body scanner (GE, Healthcare, Signa® HDx) using a standard birdcage phased-array head coil and on a Functional Imaging Scanner (GE, Infinia II gamma-camera). The MRI protocol included a

1standardized series of brain sequences as well as HMRS, DWI, DTI and PWI. Brain SPECT: The Brain SPECT was obtained 20–30 min after iv injection of 925 MBq (25 mCi) tracer activity. The radiopharmaceutical was prepared using Myoview™, (GE Healthcare Ltd) that was reconstituted with technetium-99m pertechnetate (99mTcO4?) sterile solution in the Department of Nuclear Medicine.

99Results: Our preliminary results show positive correlation between Tc uptake and MR Spectroscopy and DSC MRI. Furthermore, brain SPECT gives additional diagnostic information and the combined multi-parametric data may help considerably in the differential diagnosis between metastases and gliomas as well as between atypical meningiomas and high-grade gliomas.Conclusion: The pre-surgical imaging protocol that combines the advanced MRI techniques and brain SPECT gives the opportunity of a more realistic approach and hence may optimize patient treatment.

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ROLE OF HYBRID NUCLEAR MEDICINE METHODS IN DETERMINING THERAPY APPROACH IN ONCOLOGICAL PATIENTS. CLINICAL CASES.

1 1 1Demirev A. , Hadzhiiska V , Garcheva Marina18Four patients were examined by hybrid nuclear medicine methods including F FDG

18 99mPET/CT, F-Choline PET/CT and -Tc tectrotyde SPECT/CT. Patient one (1) had hepatocellular carcinoma and surgical resection of recurrent primary carcinoma, as well

18 18as metastatic spread to the lungs. The combination of F FDG-PET/CT and F- Choline helped determine the nature of the residual and prolonged FDG activity in the location of the resected reccurence, which being choline negative, turned out to represent post-operative changes during VEGFR (sorafenib) therapy. The pulmonary lesions showed avid choline uptake interpreted as activity in differentiated hepatocellular carcinoma - so the therapy with sorafenib continued. Patient two had early recurrence of a lung tumor with (reassessed after surgical resection) histological diagnosis that showed rare benign inflammatory myofibroblastic tumor with a fast growth and high metabolic activity. The patient was treated with nonsteroid anti-inflammatory drugs (NSAIDs) and the complete response was verified by PET/CT. Patient 3 three had neuro endocrine tumor suspicious of dedifferantiation. Expression of somatostatin receptors was visualized in a few out of

18numerous lesions with F- FDG uptake, which determined the choice of the chemotherapy regimen. Patient four had lung transplantion with newly diagnosed lymphoma which occurred in the course of immunosuppressive therapy. He was successfully treated by customized chemotherapy for lymphoma which continued until reduction of the tumor mass and disappearance of any metabolic activity. Conclusion. Hybrid nuclear medicine methods have significant role in individualizing of oncological patients' management by characterizing tumor behaviour, therapy response, as well as differentiation between posttherapeutic changes and reccurence of the disease.

CHANGES IN THE MANAGEMENT OF SELECTED PATIENTS WITH SECONDARY PULMONARY LESIONS ACCORDING TO THE EARLY EFFECT OF CHEMOTHERAPY, EVALUATED BY 18F-FDG PET/CT.CLINICAL CASES.

1 1 1Garcheva Marina , Hadzhiyska V. , Minchev Zv. Sofia18Aim. -F-FDG PET/CT was performed in patients with solitary, or few pulmonary lesions

after three cycles of chemotherapy for the evaluation of the therapeutic effect and determining further management.Material and methods: The study group included patients with bladder, rectal and mamma carcinoma. The decision about further management differed according to the number, localization and metabolic response of the lesions.Results: Three patients with a solitary, or few metastases without metabolic response underwent excision. One patient with partial metabolic response of the smaller lesions and progression of the largest one was sent to radiotherapy. The follow-up for 6 months demonstrated stable disease in three out of the four patients, in one of them a progression was detected thereafter. Progressive disease was documented in the patient sent for radiotherapy. Our first impression is that patients with few (one or two metastases) have good prognosis after excision despite the lack of metabolic response to chemotherapy.

18Conclusion: The early evaluation of the chemotherapeutic effect by -F-FDG PET/CT can play a role in the decision about changes in the management of selected patients with solitary, or few pulmonary lesions.

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CLINICAL IMPORTANCE OF BONE MARROW 18F-FDG UPTAKE AFTER TREATMENT IN LYMPHOMA PATIENTS

1 1 1Garcheva Marina , Hadzhiiska V , Nikolova P.

Numerous examinations confirm the importance of 18F-FDG PET/CT for initial evaluation of bone marrow involvement in lymphoma. The aim of this study was to evaluate the clinical significance of the patterns of bone marrow uptake in regarding different periods after the end of the chemotherapy. Material and method: Sixty six patients, examined by the standard FDG PET/CT protocol were retrospectively evaluated: 36 with Hodgkin disease (HD), 17 with diffuse large B-cell lymphoma (DLBCL), 7- with follicular lymphoma (FL) and 6 - with other lymphoma types. We excluded patients with initially proved bone marrow involvement. Twenty patients (gr.1)

nd thwere examined in the course of one month, 26 (gr.2) – in the period 2 to the 6 month and 20 patients (gr.3) – in one year after chemotherapy. Results: In gr. 1 diffuse uptake was detected in 7 patients, 35%; negative bone marrow uptake in 65%. In gr. 2 diffuse uptake was found in 2 patients (7.6%) and focal uptake abnormalities were detected in 1 patient (3.8%). Twenty three, 88% of patients had negative bone marrow uptake. In gr. 3 four of the patients (20%) had diffuse uptake and other three (15%) had focal uptake abnormalities, 65% showed no uptake. Consequent biopsy proved in 2 out of 4 patients with diffuse uptake in the bones - bone marrow involvement. Conclusion: While the diffuse bone marrow uptake early after the end of the chemotherapy can be attributed to post therapeutic activation, one year after the end of the therapy it is highly suspicious for bone marrow involvement. We consider that these patients should be reevaluated by magnetic resonance imaging, or bone marrow biopsy.

THE EFFICACY OF SPECT WITH 199TL FOR BREAST, LARYNGEAL AND LARYNGOPHARYNGEAL CANCER DETECTION

1 2 1 2 1 2 1 2Medvedeva Anna , , Zelchan Roman , , Chernov Vladimir , , Sinilkin Ivan , , Slonimskaya 2 2 1 2 1 2Elena , Belevich Yuliya , Chijevskaya Svetlana , , Choynzonov Evgenii ,

1Tomsk Cancer Research Institute, Tomsk, Russia2Tomsk Polytechnic University, Tomsk, Russia

Purpose: was to assess the efficacy of SPECT with 199Tl for detection of primary breast cancer, laryngeal and laryngopharyngeal.Materials and Methods: 59 women with breast disease (thirty-nine patients with breast cancer and twenty patients with benign breast tumors) and 51 patients with laryngeal and laryngopharyngeal cancer and 10 patients with recurrent laryngeal cancer were included into the study. The E.CAM 180 (Siemens), double-head gamma-camera equipped with parallel high energy collimators was used to perform SPECT.Results: SPECT with 199Tl showed no pathological radiotracer uptake in all patients with benign breast tumors indicating 100% specificity of this diagnostic method. For breast cancer patients, increased radiotracer accumulation in the breast was visualized in 37 of 39 (94.8%) patients. For lesions less than 10 mm in size, pathological radiotracer accumulation in the breast was detected in 4 (66%) patients. Tumors more than 10 mm in size were visualized in 100% of cases. Pathological radiotracer uptake in axillary lymph nodes was detected in 15 of 25 (60%) patients with metastases in the axillar lymph nodes. Sensitivity, specificity and accuracy of SPECT with 199Tl in patients with laryngeal and laryngopharyngeal cancer were 95%, 100% and 96.7% respectively. The sensitivity of the method to identify the regional lymph nodes metastases was 75%, to identify the recurrent laryngeal cancer - 100%.Conclusion: the present study has shown that 199Tl SPECT can be one of the supplementing methods in detection of breast, laryngeal and laryngopharyngeal tumor.

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THE COMBINATION OF 123I-FP-CIT-SPECT-DATSCAN AND CARDIAC 123-I-MIBG SCAN IN DIAGNOSIS OF PARKINSONIAN SYNDROMES: SIX YEARS EXPERIENCE

1 1 2 1Papadaki Emmanouela , Stathaki Maria , Spanaki Kleanthi , Koukouraki Sophia , 1 1 1 1Bourogianni Olga , Galanopoulos Konstantinos , Alefantinou Marina , Tsaroucha Angeliki

1Nuclear Medicine Dept, Heraklion University Hospital, Crete, Greece2Department of Neurology, Heraklion University Hospital, Crete, Greece

Background and purpose: The differential diagnosis in neurodegenerative syndromes is established with clinical criteria, however in early stages this is very difficult. 123-I-FP-CIT-SPECT-DATSCAN is able to differentiate Parkinsonism from essential tremor (ET), but can't discriminate Parkinson's disease (PD) from atypical parkinsonian syndromes (multiple system atrophy-MSA, progressive supranuclear palsy-PSP, corticobasal degeneration-CBD, Lewy body dementia-LBD). In PD there is cardiac sympathetic denervation, so 123I-MIBG myocardial imaging can be helpful in the differential diagnosis of Parkinsonian syndromes. The purpose of our study is to investigate the clinical application of cardiac MIBG scintigraphy in the differentiation of PD from APS, in difficult clinical cases.Material-method: during the last 7 years 265 patients underwent 123I-FP-CIT-SPECT- DATSCAN for differential diagnosis between Parkinsonism and essential tremor (ET). 113 had pathologic Datscan, but for some (25) of them the differentiation of PD from Parkinson plus syndrome was impossible through clinical criteria. Therefore, myocardial MIBG scan was performed in pts with diagnostic dilemma. Anterior thorax planar images were acquired (for 5 min, matrix 128x128) at 10 min and 4 hours post iv injection of 4-6mCi 123I-MIBG. Heart to mediastinum (H/M) uptake ratio was calculated. Patients who either had medical conditions that confused the MIBG SPECT results or who took medications that interfere with MIBG accumulation were excluded from the study.Results:113/265 pts had positive Datscan and 88/113 were diagnosed with PD, while 25 pts underwent cardiac adrenergic innervations scintigraphy. Based on qualitative and quantitative analysis the myocardial MIBG studies characterized as positive or negative with H/M cut-off values H/M(10min)=1.48 and H/M(4h)=1.43 (calculated from controls).12/ 25 were positive with mean value H/M(10min)=1.18 and H/M(4h)=1.06. 13 studies were negative with mean value H/M(10min)=1.94 and H/M(4h)=1.82. The final clinical diagnosis for PD was in 9/12 pts with positive MIBG scan, while the rest 3 had LBD, entity which seems to be clinically similar to progressed PD with coexisting dementia (PDD). 13 pts with negative MIBG were considered as APS (5 PSP, 7 MSA and 1 CBD).Conclusion: The combination of Datscan and MIBG scintigraphy seems to be a simple, useful method in difficult clinical cases of differential diagnosis of PD vs APS.

FALSE POSITIVE RADIOIODINE UPTAKE IN WHOLE BODY SCINTIGRAPHY: PHYSIOLOGIC OR PATHOLOGIC UNEXPECTED FINDINGS.

1 1 1Papadaki Emmanouela , Bourogianni Olga , Galanopoulos Konstantinos , Alefantinou 1 1 1Marina , Stathaki Maria , Koukouraki Sophia

1Nuclear Medicine Department, Heraklion University Hospital, Crete, Greece

Background-purpose: Whole Body Scintigraphy (WBS) has been used in detection of differentiated thyroid cancer (DTC). Nevertheless, radioiodine uptake (RAIU) is not specific for thyroid tissue. In this study we summarize unusual findings in WBS due to physiologic variants, artifacts and non-physiologic iodine accumulation.Material-methods: 200 WBScans were evaluated retrospectively. Unexpected findings were observed in 42 studies: 26 diagnostic WBS (dxWBS) during follow up –all pts had TSH >30 ìIU/mL and serum Tg <0.5 ng/mL- and 16 WBS post radioiodine therapy/ablation (rxWBS). Planar (anterior-posterior) images of head, neck, thorax, abdomen and pelvis were

131acquired 48h after 5mCi I, or 1 week after iodine therapy, respectively.

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Results: Unusual uptake in head-neck was depicted in 17 of totally 42 false positive (FP) studies. There was RAIU in hair of 7 cases and in the bear of 2 men, probably due to sweating contamination. In a dxWBS we observed intensive uptake in parotid glands symmetrically, while in a rxWBS in one parotid, because of saliva retention. Furthermore, there was FP uptake in dental inflammation in 2 dxWBS, increased perfusion and vasodilation and in thyroglossal duct in 4dxWBS, due to functional NIS expression. Unexpected RAIU in thorax was found in 19 cases. Esophageal uptake was imaged in 7dxWBS because of saliva retention or swallowing, uptake in thymus in 9pts due to functional NIS expression and iodine concentration in Hassal's bodies, while RAIU in breast was observed in rxWBS of 3 women, perhaps due to functional NIS expression or breast cyst. FP RAIU in abdomen-pelvis was depicted in 6 pts. There was excessive stomach uptake in a dxWBS of a patient who proved to have helicobacter gastritis, 4 dxWBSs had focal uptake in right iliac fossa, due to retention of intestinal contents in terminal ilea, while unusual pelvic RAIU was reported in a young woman during dxWBS (menaustrial blood in uterus).Conclusion: Unexpected findings in WBS due to physiologic or pathologic RAIU are not rare. Therefore, one should be aware of them in order to accurately interpret radioiodine WBS results for the optimal management of patients with DTC.

SERUM CGRP UPREGULATION IN PATIENTS WITH MIXED IN SITU AND INVASIVE DUCTAL BREAST CARCINOMA (DCIS+IDC): CORRELATED WITH MAMMOGRAPHIC BREAST DENSITY AND CELL PROLIFERATION INDEX Ki67?



Aim: To investigate the divergence of serum calcitonin gene-related peptide (CGRP) values in patients with benign and malignant breast diseases. The possible association of this neuropeptide with mammographic breast density (BD%) and Ki67 is explored.Subjects and Methods: Forty eight women with histologically confirmed breast diseases were retrospectively studied: mild epithelial hyperplasia (MEH): n=12, florid epithelial hyperplasia (FEH): n=5, atypical hyperplasia (AH): n=4, DCIS: n=5, DCIS+IDC: n=9 and pure IDC: n=13. Radioimmunoasssay (RIA) was used in order to define serum CGRP concentrations and Mann-Whitney test was applied for serum CGRP comparison among the various patient groups. By computer-assisted methods the mammographic BD% was calculated and then correlated (linear regression analysis) with serum CGRP level. Furthermore, in a group of twenty three women with histologically verified breast cancer (DCIS: n=6, mixed DCIS+IDC: n=8 and pure IDC: n=9), serum CGRP levels were compared (t-test) among the three groups and correlated (linear regression analysis) with Ki67 expression, immunohistochemically estimated in the surgical specimens.Results: In DCIS+IDC lesions versus MEH, FEH, AH, DCIS, and IDC, serum CGRP levels were significantly higher (P<0.001, FEH p<0.001, AH P<0.001, DCIS P<0.001 and IDC P<0.001, respectively). Serum CGRP concentrations and BD% were significantly correlated (r=0.947, P<0.0001). Regarding the group of patients with Ki67 determination, subjects with mixed DCIS+IDC presented significantly higher values of serum CGRP and Ki67, as compared to pure IDC (P=0.003 and P=0.04, respectively). Linear regression analysis established a significant coefficient of correlation between Ki67 and CGRP (r=0.829, P<0.001).Conclusion: Women with DCIS+IDC lesions developed significantly higher serum CGRP levels. The statistically significant correlation between serum CGRP levels and BD% as well as Ki67, strengthens the promulgation of DCIS+IDC denoting a distinct pathological entity and conveys a latent hypoxia-induced mitogenic role of CGRP. Our study exhibits serum CGRP measurement as a novel, potentially useful, simple preoperative index

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concerning the nature or type of equivocal mammographic lesions, eventually implicating guidance of treatment decisions and adjunctive therapeutic administration of anti-CGRP peptides.

SERUM CGRP UPREGULATION IN PATIENTS WITH MIXED IN SITU AND INVASIVE DUCTAL BREAST CARCINOMA (DCIS+IDC): CORRELATED WITH MAMMOGRAPHIC BREAST DENSITY AND CELL PROLIFERATION INDEX Ki67?



Aim: To investigate the divergence of serum calcitonin gene-related peptide (CGRP) values in patients with benign and malignant breast diseases. The possible association of this neuropeptide with mammographic breast density (BD%) and Ki67 is explored.Subjects and Methods: Forty eight women with histologically confirmed breast diseases were retrospectively studied: mild epithelial hyperplasia (MEH): n=12, florid epithelial hyperplasia (FEH): n=5, atypical hyperplasia (AH): n=4, DCIS: n=5, DCIS+IDC: n=9 and pure IDC: n=13. Radioimmunoasssay (RIA) was used in order to define serum CGRP concentrations and Mann-Whitney test was applied for serum CGRP comparison among the various patient groups. By computer-assisted methods the mammographic BD% was calculated and then correlated (linear regression analysis) with serum CGRP level. Furthermore, in a group of twenty three women with histologically verified breast cancer (DCIS: n=6, mixed DCIS+IDC: n=8 and pure IDC: n=9), serum CGRP levels were compared (t-test) among the three groups and correlated (linear regression analysis) with Ki67 expression, immunohistochemically estimated in the surgical specimens.Results: In DCIS+IDC lesions versus MEH, FEH, AH, DCIS, and IDC, serum CGRP levels were significantly higher (P<0.001, FEH p<0.001, AH P<0.001, DCIS P<0.001 and IDC P<0.001, respectively). Serum CGRP concentrations and BD% were significantly correlated (r=0.947, P<0.0001). Regarding the group of patients with Ki67 determination, subjects with mixed DCIS+IDC presented significantly higher values of serum CGRP and Ki67, as compared to pure IDC (P=0.003 and P=0.04, respectively). Linear regression analysis established a significant coefficient of correlation between Ki67 and CGRP (r=0.829, P<0.001).Conclusion: Women with DCIS+IDC lesions developed significantly higher serum CGRP levels. The statistically significant correlation between serum CGRP levels and BD% as well as Ki67, strengthens the promulgation of DCIS+IDC denoting a distinct pathological entity and conveys a latent hypoxia-induced mitogenic role of CGRP. Our study exhibits serum CGRP measurement as a novel, potentially useful, simple preoperative index concerning the nature or type of equivocal mammographic lesions, eventually implicating guidance of treatment decisions and adjunctive therapeutic administration of anti-CGRP peptides.

99MTC-PYP MYOCARDIAL SCINTIGRAPHY: REPLACING ENDOMYOCARDIAL BIOPSY OR MASS SPECTROSCOPY IN PATIENTS WITH CARDIAC AMYLOIDOSIS OF UKNOWN ORIGIN?

1 2 3 1Valsamaki Pipitsa , Kastritis Eustathios , Tsiouris Spyridon , Skiadaresi Chaido , Delichas 1 1 1 1Zisis , Papantoniou Ioannis , Tsiouma Maria , Athanasoulis Theodoros , Fotopoulos

3 2 1Andreas , Dimopoulos Meletios Athanasios , Papantoniou Vassilios1Nuclear Medicine Department, University General Hospital Alexandra , Athens, Greece2Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece3Nuclear Medicine Department, University Hospital of Ioannina, Ioannina, Greece

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Aim: The purpose of this pilot study was to investigate the efficacy of technetium-99m 99mpyrophosphate ( Tc-PYP) in the diagnosis of transthyretin-related cardiac amyloidosis

(ATTR), which hitherto may only be verified by endomyocardial biopsy in conjunction with immunohistochemical parameters or ultimately mass spectroscopy. In ATTR, whether familial amyloid cardiomyopathy or senile systemic amyloidosis, misfolded monomers or dimers of the normally tetrameric protein of transthyretin are deposited in the myocardium resulting in cardiac amyloidosis (CA), a cause of cardiac insufficiency. In light-chain CA (immunoglobulin light-chain amyloidosis-AL) the deposited fibrils consist of light-chain immunoglobulins produced by a clonal plasma cell population in bone marrow. We aimed to discriminate scintigraphically ATTR from AL.Patients and Methods: Seventeen patients (10 males, aged [mean±SD] 71±13y; 7 females, aged 66±8y) patients with CA (8/17 with ATTR and 9 with AL) underwent myocardial

99mscintigraphy with Tc-PYP, i.e. planar and tomographic imaging at 1, 2 and/or 3h after iv administration of 555-925MBq of the tracer. Optical assessment of the myocardial tracer uptake and semiquantitative estimation provided the diagnosis. We drew two regions of interest (ROI) of standardized shape and size: one over the heart and another one over the contralateral hemithorax, to calculate the corresponding heart-to-contralateral (H/CL) count ratio. Based on current international literature, we applied a cut-off H/CL value of 1.5 to discriminate between the two conditions. Our results were compared with biopsy, combined with the clinical and laboratory investigation of the patients.

99mResults: In all patients with ATTR, Tc-PYP scintigraphy showed diffuse intense myocardial uptake upon visual assessment, also verified semiquantitatively. Four patients with AL presented faint or no myocardial tracer uptake. In the rest five AL patients, an optically borderline-positive scan was observed, but the H/CL ratio was estimated below the cut-off value of 1.5. Taking into account the semiquantitative evaluation both sensitivity

99mand specificity of Tc-PYP scintigraphy were 100% in distinguishing ATTR in this small patient population.

99mConclusion: Our findings suggest that Tc-PYP scintigraphy, being a simple, non-invasive and widely available method, may eventually replace biopsy/mass spectroscopy in differentiating ATTR from AL, two conditions with a completely different clinical course and treatment.

EVALUATION OF SERUM 25 HYDROXY-VITAMIN- D LEVELS IN PATIENTS WITH DIABETES MELLITUS

1 2 2 3Tsigalou Christina , Papazoglou Dimitrios , Papanas Nicolaos , Patsiamanidi Maria , 4 4 4 5Zissimopoulou Orestia , Pistola Anastasia , Tsartsarakis Antonios , Katsimbri Maria ,

6 7 4Lambropoulou Maria , Giorgos Vasilis , Zissimopoulos Athanassios

Biopathology Lab, Democritus University of Thrace, Medical School University Hospital of Alexandroupolis Dragana, Greece.Diabetes Center- Second Department of Internal Medicine, Democritus University of Thrace, Medical School University Hospital of Alexandroupolis Dragana, Greece.3Ophalmology Clinic, Democritus University of Thrace, Medical School University Hospital of Alexandroupolis Dragana, Greece.4Nuclear Medicine Dept., Democritus University of Thrace, Medical School University Hospital of Alexandroupolis Dragana, Greece.5Molecular Biology and Genetics School, Democritus University of Thrace, Medical School University Hospital of Alexandroupolis Dragana, Greece.6Lab Histology-Embryology, Democritus University of Thrace, Medical School University Hospital of Alexandroupolis Dragana, Greece.7Medical School, Democritus University of Thrace, Medical School University Hospital of

Alexandroupolis Dragana, Greece.Introduction: Vitamin D de?ciency is a condition of increasing prevalence worldwide. Diabetes mellitus (DM) is related to vitamin D levels. In recent studies there is association with vitamin D de?ciency and the risk of developing diabetes and diabetes complications.

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Aim: The aim of this study is to evaluate the serum levels of 25 hydroxy- vitamin D [25(OH) D] in patients with type 2 diabetes mellitus.Patients and method: We study 108 patients (66 male and 42 female) aged between 43 and 70 years old (median age of 58±12 years) with type 2 diabetes mellitus with or without diabetes complications. All were in follow up at the University Hospital of Evros. In all patient's blood samples were taken for (25-OH-D) determination. After centrifugation the serum was collected and kept refrigerated at -70 ° C. The vitamin D status was measured

125by radioimmunoassay (RIA) method with I [25(OH)D] kits Diasorin at in- vitro laboratory of Nuclear Medicine Dept. University Hospital of Evros, Democritus University of Thrace. Also we studied 40 healthy individuals (blood donors) as control group.Statistical analysis: Statistical analysis was performed by the x²- test (student test) and statistical significance was considered to be p <0.005.Results: Diabetes mellitus patients had lower levels of 25(OH)D than controls ( p <0.005).In 62 patients with severe complications of the disease, the levels of [25(OH)D] were significantly low 0-20 ng/mL ( p <0.005), in 28 patients with mild complications of the disease the levels were 20-40 ng/mL (hypovitaminosis) and the rest 18 with no complications, had levels of [25(OH)D] > 40 ng/mL( p <0.005).Conclusions: Diabetes mellitus patients had lower levels of 25(OH)-D than controls. Patients with severe complications of the disease had significantly low levels than the others. Vitamin D deficiency may be a risk factor for DM. Clinical trials with vitamin D supplementation are needed.

EVALUATION OF FOOD ALLERGY TESTING IN INFANTS AND CHILDREN BY DETECTION OF SERUM ALLERGENS USING RAST TEST

1 2 3 4Tsigalou Christina , Damianidou Sofia , Tsalkidis Angelos , Sotiropoulou Rodoula , 2 5 6 7Theocharis Gerasimos , Pistola Anastasia , Lambropoulou Maria , Christofis Christos ,

5Zissimopoulos Athanassios1Biopathology Lab., Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.2Molecular Biology and Genetics School, Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.3Pediatrics Clinic, Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.4Medical School, Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.5Nuclear Medicine Dept., Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.6Lab Histology-Embryology, Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.7Department of Anaesthesiology, Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.

Introduction: Food allergy is defined as an abnormal immune response to food. It is a complex situation affected by many different factors. A wide variety of food can cause allergy. The organism reactions to various food allergens are also diverse: respiratory, dermatological and gastrointestinal.The aim of this study is to evaluate the rate of food allergens factors in infants and children, so as, according to the results of the nutritional factor, to change and facilitate monitoring person by medical specialists.Patients and method: 143 infants and children (61 boys and 82 girls) was studied aged between 3 months and 13 years old. The most of them (112) were patients of the University Pediatrics Clinic of the University Hospital of Evros and the rest were patients of other pediatricians. All of the children had food allergy because of different reasoning. Special group were the infants (71), who had allergy to milk. In all children blood samples were taken and after centrifugation the serum was collected and kept refrigerated at -70 ° C until the measurment. The F group (food group) from the list of allergens were tested by Radioallergosorbent test (RAST test) and concerns the quantification of the IgE antibodies

125 to the specific allergen, with I allergen kits Bio-Line at in- vitro laboratory of Nuclear

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Medicine Dept. University Hospital of Evros, Democritus University of Thrace.Statistical analysis: Statistical analysis was performed by the x²- test (student test) and statistical significance was considered to be p <0.005.Results: 79 % of the infants had milk allergy especial to the factors F76 (Alpha lactalbumin), F78 (Casein) and F79 (Gluten). 80% of the children had allergy especial to the factors F2 (Cow milk), F74 (Egg whole) or F1 (Egg white). 10% of the children were negative.Conclusions: The identification of various types of allergens by RAST method is an accurate and sensitive test that helps in the diagnosis and proper treatment.

THE LEVELS OF SERUM 25 HYDROXY-VITAMIN- D IN PEDIATRIC PATIENTS WITH BRONCHIAL ASTHMA

1 2 2 3Maziotis Evangelos , Tsalkidis Angelos , Parashakis Emmanouel , Zissimopoulou Orestia , 1 3 4 1 5Benti Daphni , Pistola Anastasia , Christofis Christos , Bilali Anna , Maridaki Zinovia ,

3Zissimopoulos Athanassios1Molecular Biology and Genetics School, Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.2Pediatrics Clinic, Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.3Nuclear Medicine Dept., Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.4Department of Anaesthesiology, Democritus University of Thrace, Alexandroupolis, University Hospital of Alexandroupolis Dragana, Greece.5Medical School, Democritus University of Thrace, Alexandroupolis, University Hospital of

Alexandroupolis Dragana, Greece.

Introduction: Bronchial asthma is a serious childhood disease which can cause discomfort in young patients and may have severe effects in their later life. The control of the aggravating factors of bronchial asthma may lead to the discovery of better treatments that will relief the young patients.Aim: The aim of this study is to evaluate the serum levels of 25 hydroxy- vitamin D [25(OH)D] of children patients and to correlate them with the severity of the disease's symptoms, in order to modify the pharmaceutical treatment which will improve the patient's condition.Patients and method: 85 pediatric patients (44 boys and 41 girls) was studied aged between 3 and 13 years old (median age of 8±3 years old). The most of them (62) were patients of the University Pediatrics Clinic of the University Hospital of Evros and the rest were patients of other pediatricians. All of the children had bronchial asthma because of different reasoning (mostly due to allergic reasoning and other lung diseases).In all children blood samples were taken and after centrifugation the serum was collected and kept refrigerated at -70 ° C. The vitamin D status was measured by radioimmunoassay

125(RIA) method with I [25(OH)D] kits Diasorin at in- vitro laboratory of Nuclear Medicine Dept. University Hospital of Evros, Democritus University of Thrace.Statistical analysis: Statistical analysis was performed by the x²- test (student test) and statistical significance was considered to be p <0.005.Results: In 52 patients with severe symptoms of the disease, the levels of [25(OH)D] were significantly low 0-20 ng/mL ( 0-50 nmol/L), in 21 patients with mild symptoms of the disease the levels were 20-40 ng/mL (50-100 nmol/L) (hypovitaminosis) and the rest with no symptoms, had levels of [25(OH)D] > 40 ng/mL (>100 nmol/L)Conclusions: According to our results it is concluded that a statistically significant number of children who have vitamin D deficiency show severe symptoms of asthma(p <0.005). Pediatric patients with mild asthma have hypovitaminosis (p <0.005). While pediatric patients with adequate vitamin D levels had no symptoms. The levels of serum vitamin D is statistically significantly associated with the severity of the symptoms of asthma. It is possible to administer vitamin D supplements in pediatric patients with bronchial asthma

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in order to cause a reduction in the severity of disease symptoms. Clinical trials with vitamin D supplementation are needed.

TOWARDS OPTIMIZATION OF PROTECTION IN PET/CT IMAGING: ROLE OF TECHNOLOGY IN PATIENT DOSE MANAGEMENT

1 2 3Antic Vojislav , Ciraj - Bjelac Olivera , Haglund Joulie1Center for Nuclear Medicine, University Clinical Centre of Serbia, Belgrade, Serbia2Vinča Institute of Nuclear Sciences, University of Belgrade, Mike Petrovica Alasa 12-14, Belgrade, Serbia and School of Electrical Engineering, University of Belgrade, Bulevar kralja Aleksandra 73, Belgrade, Serbia3Medical physicist, Gothenburg, Sweden

Optimization of protection in nuclear medicine relays both on the selection of the radionuclide activity to be injected and on definition of the desired image quality that corresponds to the particular clinical question. This is by far more complex task than selection of the injected activity which basically relays on the definition of the appropriate imaging protocol in the context of the available resources and patient's individual characteristics. Thus, both operational and technological aspects influence the image quality and patent dose relationship. The objective of this work is to provide an overview of the PET-related and CT-related methods to optimize radiation dose in PET/CT imaging, with special emphasis on technology base methods.Time-of-flight (TOF) introduction in positron emission tomography (PET) improved the imaging technique by bringing a new information to the imaging process. Compared with non-TOF imaging, better time resolution reduces brings to the better signal-to-noise-ratio (SNR) and this the better image quality. The TOF concept has become more pronounced with the lutetium based scintillation detectors that combine high light output, short decay time and excellent timing resolution. Having in mid a need to balance the contradictory needs as time of the scanning process and magnitude of the patient dose, one of the possible options could be the use of TOF technology with achievable dose reduction of up to 30% without compromising image quality. On the other hand, it has been demonstrated that combined with the PSF information and current ordered-subset-maximum-likelihood (OSEM) algorithms, image quality for overweight patients could be significantly improved by applying TOF. This encourages further study towards use of body-mass-index (BMI) concept for patient dose optimization.Besides TOF, other PET-related methods as management of the injected radionuclide activity, hydration to increase the excretion, use 3D PET emission acquisition mode, increase duration of acquisition time per bed position were discussed. CT-related methods including minimization of z-axis coverage, appropriate selection of exposure parameters as tube voltage and tube current , use of automatic tube current modulation and selection of desired image quality index were also presented as a part of the optimization strategy in PET/CT.

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MEDICAL WORKERS OPERATING IN NUCLEAR MEDICINE VS PET/CT: RADIATION EXPOSURE COMPARISON

1 1 2 2Dalianis Konstantinos , Kollias George , Pipikos Theodoros , Prassopoulos Vasileios , 2Efthimiadoy Roxani

1Medical Physics Department, Hygeia Hospital, Greece2PET/CT Department, Hygeia Hospital, Greece

Purpose: The aim of this study was to compare the gamma dose received by dedicated medical workers operating in the first PET/CT department in Greece and also by dedicated medical workers operating in conventional Nuclear Medicine procedures in the same center.Method: To estimate the effective dose from external exposure, all 9 members of the staff had TLD badges worn at the upper pocket of their overall and digital dosimeters worn at the side pocket. Nurses and Medical Physicists also had TLD rings.Results: In the period of January 2014 to December 2014 a total of 1006 PET/CT and 2311 conventional Nuclear Medicine procedures were performed. The collective effective and finger doses received by all 4 members of the PET/CT staff were the following: Nurse 1 received 2,94 mSv as a whole body dose and 6,84 mSv as a hand dose and Nurse 2 received 2,87 mSv whole body dose and 5,91 mSv hand dose respectively. Technologists 1 and 2 received 1,95 mSv and 1,56 mSv as the whole body dose respectively. Technologists 3,4 and 5 received 1,85 mSv, 1,76 mSv and 1,82 mSv as whole body doses respectivelyConclusion: The higher value of gamma dose for PET/CT workers by comparison with the staff operating conventional Nuclear Medicine procedures is attributable to the higher

18specific gamma constant of F, as well as the longer exposure time required for accurate positioning.

A HIGH SENSITIVITY GAMMA IMAGING PROBE FOR SENTINEL LYMPH NODE DETECTION

1 2 2 2Georgiou Maria , Fysikopoulos Eleftherios , Lamproy Efthimis , Loudos Georgios , 3Gewrgoulias Panagiotis

1Department of Nuclear medicine, Medicine School, University of Thessaly, Greece and Department of Biomedical Engineering, Technological Educational Institute of Athens, Greece2Department of Biomedical Engineering, Technological Educational Institute of Athens, Greece3Department of Nuclear medicine, Medicine School, University of Thessaly, Greece

Purpose: Sentinel lymph node (SLN) mapping is a technique for assessing whether early-stage invasive breast cancer has metastasized, thus determining prognosis and treatment options. SLN identification is achieved using the blue-dye and radioactive colloids techniques, which are sometimes combined with lymphoscintigraphy. Furthermore, intra-operative gamma acoustic probes, as well as gamma imaging probes are used during surgery. The purpose of this study is the construction of a gamma probe for sentinel lymph node imaging and its optimization in terms of sensitivity with respect to spatial resolution.

2Method – Material: The reference probe has small field of view (2.5 x 2.5 cm ) and is based on a position sensitive photomultiplier tube (PSPMT) coupled to individual CsI(Tl) scintillators. Based on simulation results using the GATE Monte Carlo toolkit (GATE v6.1), the optimal detector was found to be an integrated structure of a tungsten square collimator with individual CsI(Tl) scintillators inserted into its holes. The external

2 3dimensions of the collimator are 2.2 x 2.2 cm and each hole is 2 x 2 x 16 mm , with 0.2 3mm septa. Each scintillator is 1.9 x 1.9 x 5 mm and is wrapped with Teflon tape. Custom

analog circuits were designed for the amplification of the PSPMT anode signals. The data acquisition system (DAQ) is based on free running Analog-Digital Converters (ADCs) and the LX9 Microboard with the Spartan-6 Field Programmable Gate Array (FPGA) by Xilinx. A Wi-Fi adapter (CC3000-Pmod) is used for the data transmission to a standard laptop.

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Results: The gamma imaging probe was constructed having dimensions and weight acceptable for hand-held use during the surgery. The detector provides high performance with sensitivity close to 500 cps/MBq and ii) spatial resolution equal to 6mm at 2 cm source-to collimator distance and ~10mm at 5 cm. Following the experimental evaluation of the system, clinical trials will be scheduled.Conclusion: The prototype gamma imaging probe was constructed and experimentally evaluated using phantoms. Its high sensitivity, combined with good spatial resolution, can provide useful information during the surgery about remaining tissues with high radioactivity uptake.

QUANTITATIVE ASSESSMENT OF 32P COLLOID IN THE BRAIN CANCERS USING PLANAR IMAGES AND A NEW SKULL PHANTOM

1 2 2 3Poorbaygi Hosein , Babaee Maryam , Sardari Dariuosh , Shahzadi Sohrab , Amoui 3Mahasti

1Nuclear Science and Technology Research Institute, Tehran, Iran2Islamic Azad University, Science and Research branch, Tehran, Iran3Department of Nuclear medicine, Shohada-e-Tajrish center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Purpose: Internal irradiation using beta-emitting radionuclides for cystic 32craniopharyngioma is an expanding treatment modality. It has been treated with P (E = max

1.71 MeV, T = 14.3days) in form colloidal chromic phosphates by a stereotactic method in 1/2

neurosurgery departments. The objective of this study was to examine a skull phantom and planar bremsstrahlung imaging may to determine whether the present methods are

32suitable for quantitative assessment of P colloid in the brain lesion.Methods &Material: The sensitivity of gamma camera in the appropriated energy window and an effective attenuation coefficient for bremsstrahlung were measured using the skull phantom with cystic tumor and a gamma camera equipped Low energy collimator. A

99m 32standard Tc and P test source (with 4150 Bq activities) was used for determination of 32energy window. The Skull phantom and cystic part are filled with water and 15000 Bq P

colloid, respectively (Figure 1). The source consisted of a Plexiglas hollow sphere enclosing the P-32 colloid (with external radius of 2.5cm).Results: Table 1 shows the amounts of sensitivity for two attenuation materials, air and

32skull phantom. Bremsstrahlung P images in the planar study with LEHR collimator are shown in Figure 2.Conclusion: Bremsstrahlung images are useful to confirm localization and activity constitution in the neoplastic site to assess activity in the reservoir or extravasation into entraneoplastic sites.

Figure 1: Skull phantom consisted P-32 colloid

Table 1. Amounts of sensitivity for experimental studiesAttention materialAirSkull phantomMatrix128*128128*128Window (keV)50-15070-17050-15070-170Sensitivity ( (cps)/(kBq) )0.0130.0130.00510.0059

A VOXEL-BASED ANALYTICAL DOSE CALCULATION ALGORITHM1 1 1 1Spirou Spiridon V. , Kostou Theodora , Papadimitroulas Panagiotis , Loudos George

1Department of Biomedical Engineering, Technological Educational Institute of Athens, Greece

Purpose: To describe a dose calculation algorithm that calculates dose in each voxel, rather than in each organ, and which relies on individual radionuclide dose kernels.Methods: First, using ray-tracing techniques, the algorithm calculates the materials traversed from the source voxel to the target voxel, as well as the distance within each material. Then, using the dose kernels, the algorithm calculates the fractional energy absorbed within the first material and the fractional energy that enters the second material. The dose kernels, i.e. the dose as a function of distance, have been previously

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calculated for various radionuclides and homogeneous media using the GATE Monte Carlo toolkit. In the second material, the dose kernel curve is read beginning at the distance at which the fractional energy is the same as the one that is available after the first material. At the end of the second material, the fractional energy that enters the third material is calculated, and the process is repeated until the last material.Results: The algorithm has been applied to various geometric setups containing different materials, as well as the XCAT computational anthropomorphic model. In all cases, the

99mradionuclide was Tc and the dose distributions were also calculated using GATE for comparison. Figure 1 shows the dose as a function of distance for a spherically symmetric two-component setup, in which the inner material is water (r < 50 mm) and the outer material is bone. Figure 2 shows a horizontal profile in the XCAT model on a slice at the superior part of the chest.Conclusion: A voxel-based analytical dose calculation algorithm that relies on dose kernels has been developed. Discrepancies between the algorithm and Monte Carlo simulations can be attributed to the fact that the dose kernels have been calculated in homogeneous media and, therefore, do not sufficiently predict scatter dose between different materials.

MANAGEMENT OF IN VIVO RADIOISOTOPES AND RADIOPHARMACEUTICALS [IMPORT-USE-HANDLING-REJECTION] FROM A3 LABORATORY – HOSPITAL EXPERIENCE

1 1 1 1 1Datseris Ioannis , Moraitis Nikos , Ntonas Christos , Xirafi Eirini , Papachristou Maria1Radiopharmacy, Nuclear Medicine Department – PET/CT, GHA “Evaggelismos”

Introduction We report the general handling of in vivo radioisotopes and radiopharmaceuticals in our Radiopharmacy laboratory from their import in the lab until their rejection in order to:

a. manage the appropriate quantities of radioactivity for the patients referred to the Department,

b. assess the amount of radioactivity handled by the personnel in diagnostic and therapeutic procedures,

c. rationalize the expenses of the Department for the service of the referred patients.

Methods – Results We used the records kept in the Radiopharmacy laboratory. These are:

1.“ Daily Patient Programme – Examinations”

2.“Daily Production of Radiopharmaceuticals”

3.“Daily Quality Control of Released Radiopharmaceuticals”99m4.“Weekly worksheet of Tc – generator elutions”

5.“Daily rejection of radioactive materials”

6.“Registration of radioactive waste”1317.“Registration of I therapy: patients and doses”

All the above archives were combined and analysed within a “typical” working month (30 days). They were statistically processed to produce the conclusions.

99mConclusions We conclude that the activity of Tc – generator is covering the Department 67 111well during the daily routine and the “on call” time. The radioisotopes Ga, In for

131 201 131diagnosis and I for therapy are ordered in patient bases with small deviations. Tl and I for diagnostic needs (thyroid fixation, whole body scan) were found to be in excess. According to the measurements there should be a cutting down in ordering the above isotopes but the cooperating Clinics [Cardiology and Endocrinology] are not in position to predict their status. Having these under consideration the Department should have a leverage in isotopes to cover the resulting needs. We will continue these measurements as to be more sufficient and accurate in the near future, because of the economical situation and the essential need of the staff for radioprotection.

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FEATURES OF PRODUCTION OF HIGHLY ACTIVE GENERATORS OF TECHNETIUM-99м ON THE BASIS OF THE ENRICHED MOLYBDENUM-98.

1 1 1 1 1Ilina Ekaterina , Skuridin Victor , Stasyuk Elena , Nesterov Evgeniy , Rogov Aleksander , 1 1Sadkin Vladimir , Larionova Lyudmila

1National Research Tomsk Polytechnic University, Russia

Chromatography (sorption) technetium-99m generators in terms of production and use in nuclear medicine today occupy leading positions due to their compactness, ease of use

99mcombined with high stable yield of Tc at level 90%. As a rule, their charge is used highly active molybdenum-99 (200 Ci/g), isolated from the fission products of uranium-235. With this technology, a large amount of radioactive waste, processing of which leads to significant material costs and environmental issues.

99A real alternative to uranium technology is the production of Mo at research reactors for waste-free reaction of radiative capture (n,g) enriched molybdenum-98. The main drawback of the reaction (n,g) is a low specific activity of the resulting product: an less 10 Ci / g. The use of such low-level generator technology feedstock with a large amount of

98carrier in the form of stable isotope Mo nucleiа leads to the necessity of draw the column of the generator of large mass of molybdenum and application the column increased in size. For elution of technetium-99m from such columns requires the bigger volume of physical solution, which leads to a decrease in the volume activity of the drug. In this

99regard, the creation of powerful generators of on low-activity (n,g) Mo requires an integrated approach involving, on the one hand, the study of the possibility of increasing

99the specific activity of Mo at the expense of optimizing the conditions of irradiation of molybdenum target, and on the other - to optimize processing methods of preparation and production of sorbent generators that provide a maximum yield of technetium-99m.The mechanism of activation Al O oxides in their interactions with hydrochloric acid was 2 3

studied. The effect of acid treatment on sorption characteristics oxides. Found pattern 99mchanges output from Tc generator depending on the mass adsorbed molybdenum

oxide and the amount of absorbed acid. Elution profiles in generators with different adsorbed mass molybdenum was studied. The effect of the distribution of the

99mmolybdenum in the chromatographic column on the yield of Tc from the generator was studied. As a result of this work practical recommendations for the manufacture of generators based on (n,g) 99Mo with specified characteristics on general and volumetric

99mactivity eluted Tc. This work was performed financially supported by Government represented by the Ministry of Education and Science of the Russian Federation (RFMEFI57514X0034).

RECEIVING NEW RADIOPHARMACEUTICAL BASED ON FATTY ACID MARKED TECHNETIUM-99M

1 1 1 1 2Ilina Ekaterina , Scuridin Victor , Stasyuk Elena , Nesterov Evgeniy , Sazonova Svetlana , 1 1 1Sadkin Vladimir , Larionova Lyudmila , Rogov Aleksander

1National Research Tomsk Polytechnic University, Russia2National Research Tomsk Polytechnic University, Tomsk cancer research institute, Russia

Cardiovascular diseases remain the main reason of permanent disability and mortality in the Russian Federation. Now for inspection of cardiological patients use a big arsenal of beam methods of radiodiagnosis. Thus, methods of a nuclear medicine are used in practice of the Russian cardiology insufficiently actively. A distinctive feature of radionuclide techniques is their functionality and not invasiveness. Conceding to an x-ray and magnetic and resonant tomography in space permission, scintigram are reflective the physiological and pathophysiological changes happening in an organism. It is reached due to use of the radiopharmaceuticals (RP) capable to collect in certain morphological structures or to reflect dynamics of the physiological or biochemical processes proceeding in body.






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In recent years, the increasing popularity in stsintigrafichesky diagnosis of cardial pathology is gained by studying of a metabolism of a cardiac muscle by means of marked fatty acids. Potentially important advantage of use of a stsintigrafiya with fatty acids is that the method allows visualizing a direct condition of bioenergetics of a myocardium.

For development of a technique of branding the modified fatty acid - 15-(4 carboxymethyl (2 carboxymethyl (2 carboxymethyl (4-(14- carboxytetradecyl) phenylcarbamoylmethyl) aminoethyl) aminoethyl) was taken as a basis - aminomethylcarboxamidophenyl) - pentadecanoic acid (PDA-DTPA). The main premises to use of PDA-DTPA, as initial substance for receiving marked technetium-99 m of radiopharmaceutical (RP) is that the molecule of PDA-DTPA includes two main structural fragments providing successful functioning of new radiopharmaceutical. The first of them, a fragment of phenylpentadecanoic acid has to provide bioavailability of drug to a myocardium. The

99msecond key fragment is the substituted DTPA that serves for chelate binding Tc.

According to the developed strategy of synthesis at the first stage solubility of PDA-DTPA in the various solvents, providing possibility of intravenous administration of drug was investigated. As solvent 5% solution of hydrosodium carbonate since in other tested environments (0,9 % chloride sodium solution, 5% solution of sodium carbonate, muriatic environments) substance is difficult soluble was chosen and forms a colloid. At the

99mfollowing stage of researches recovery process studying was carried out Tc in the presence of different quantities of PDA-DTPA. For recovery of a pertechnetate different reducers were investigated: ions of Sn (II) tin, ascorbic acid in combination with Fe(II), borgidrid sodium, sodium thiosulphate, a hydrazine, sulphhydryl and aldehydic

99m 99mconnections. In a result in quality of reducing agent for transfer Tc (VII) in Tc (IV) was chosen by us SnCl ·2H O and its quantitative ratios are picked up.2 2

This work was performed financially supported by Government represented by the Ministry of Education and Science of the Russian Federation (RFMEFI60414X0071).

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SYNTHESIS AND CHARACTERIZATION OF NEW RE AND 99MTC “2+1” MIXED LIGAND COMPLEXES CARRYING 3-BROMOANILINOQUINAZOLINE AS PHARMACOPHORE

1 1 1 1Lazopoulos Aristotelis , Kiritsis Christos , Shegani Antonio , Papasavva Aphrodite , 2 2 1 1Panagiotopoulou Angeliki , Pelecanou Maria , Papadopoulos Minas , Pirmettis Ioannis

1INRASTES, NCSR “Demokritos”, Athens, Greece2IB-A, NCSR “Demokritos”, Athens, Greece

Purpose Over-expression of epidermal growth factor receptor (EGFR) has been associated with the initiation, progression and invasiveness of a great spectrum of human cancers. Lately, several EGFR inhibitors, mainly quinazoline derivatives, were labelled with fluorine-18, iodine-124, technetium-99m, and their potential either as PET or SPECT biomarkers was investigated. We report herein the synthesis, characterization and preliminary

99mbiological evaluation of a novel Tc-complex of the general formula fac-99m[ Tc(CO) (SS)(IsoQz)], where SS is the diethyldithiocarbamate and IsoQz is an isocyanide 3

derivative of 3-bromoanilinoquinazoline.Method–Material Synthesis of fac-[Re(CO) (SS)(IsoQz)]: To a solution of [NEt ] [ReBr (CO) ] 3 4 2 3 3

dissolved in methanol, SS and IsoQz ligands were added and the reaction mixture was refluxed. The residue was purified to afford the target complex.

99mSynthesis of fac-[ Tc(CO) (SS)(IsoQz)]: A methanolic solution of SS and IsoQz was 399m +incubated with fac-[ Tc(CO) (H O) ] , at room temperature.3 2 3

99mBiodistribution studies: A solution of fac-[ Tc(CO) (SS)(IsoQz)] was injected through the 3

tail vein in Swiss Albino mice. Animals were sacrificed and organs of interest were removed and counted in gamma counter.Results Reaction of the [Et N] [ReBr (CO) ] precursor with SS and IsoQz results in the 4 2 3 3

formation of complex fac-[Re(CO) (SS)(IsoQz)], where SS acts as a bidentate ligand and 31IsoQz acts as a monodentate ligand. IR showed the presence of Re(CO) core, while H-3






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99mNMR confirmed the coordination of both ligands in 1:1 ratio. The analogous complex Tc was synthesized in high yield and radiochemical purity. Its biodistribution studies in mice showed fast blood and soft tissue clearance, while elimination via the hepatobiliary system was observed.

99mConclusion Searching for useful Tc probes for early detection and staging of EGFR positive tumors, we have accomplished the synthesis and characterization of the MCp(CO) 3

99mcomplexes at the macroscopic scale (M = Re) and the radiotracer scale (M = Tc) carrying the tyrosine kinase inhibitor 6-amino-4-[(3-bromophenyl)amino]quinazoline and the SS

99mligand. The radiocomplex Tc is stable and merits further evaluation as a SPECT radioagent for tumor imaging.

ACUTE AND CHRONIC TOXICITY OF 199TL-DIETHYLDITHIOCARBAMATE1 1 1 1 2Maslov Leonid , Lishmanov Yury , Efimova Natalia , Naryzhnaya Natalia , Ryzhkova Dariya

1Research Institute of Cardiology, Tomsk, Russia2Northwestern Federal Medical Research Center, St. Petersburg, Russia

199 199It was studied the acute and chronic toxicity of Tl-diethyldithiocarbamate ( Tl-DDC) in mice, rats and rabbits. The compound was administered intravenously twice at a diagnostic dose (DD), which is 1.25 mg/kg. It was assessed the state of internal organs and the weight of the animals at 14 days after administration. The results showed no animal deaths, changes of internal organs, and weight of the animals at the administered used

199 199doses of Tl-DDC. In our study, due to the lack of animal deaths LD of Tl-DDC was 50

impossible to calculate. In such situations, according to A.N. Mironov's guidelines (2012) for taking LD dose of the drug contained in the maximum allowable volume for this route 50

199of administration. According to our experiments the maximum volume for Tl-DDC is: in the intravenous route of administration in mice (males and females) is 25 ml/kg, in rats

199(males and females) is 10 ml/kg. Considering that 1 ml of the solution contains 5 mg Tl-DDC its LD in mice was 125 mg/kg (intravenously), in rats LD was 50 mg/kg 50 50

199(intravenously). Since the diagnostic dose of Tl-DDC is 1.25 mg/kg in rats the ratio of LD 50199to Tl-DDC was 40. In mice, the LD /DD ratio was 100. Chronic toxicity at repeated 50

administration was examined on the general condition of the animals (rats and rabbits), the weight of the body, the cells of peripheral blood and bone marrow, the functional state of the liver, kidneys, heart, central nervous system and the histological picture of internal organs during morphological study. Administration of test substance for 7 days at dosages corresponding DD1, DD2 and DD10 did not affect the indicated parameters. Delayed study

199performing 30 days after discontinuation of Tl-DDC administration did not cause pathological changes in studied organs and systems. These data indicate the absence of

199acute and chronic toxicity in Tl-DDC when using the substance in the diagnostic dose.

68GA RADIOLABELING OF CHELATED AND CHELATOR-FREE MAGNETIC NANOPARTICLES; IN VITRO AND IN VIVO EVALUATION

1 2 2Papadopoulou Sofia , Tsoukalas Charalampos , Karageorgou Maria , Paravatou - Petsotas 2 3 4 5 5Maria , Gazouli Maria , Bakandritsos Aristides , Meristoudi Anastasia , Pispas Stergios ,

1 1 2Tsitsilonis Ourania , Stravopodis Dimitrios , Bouziotis Penelope1Faculty of Biology, National and Kapodistrian University of Athens, Athens, Greece2Institute of Nuclear and Radiological Sciences and Technology, Energy and Safety (INRaSTES), National Center for Scientific Research Demokritos, Aghia Paraskevi Athens, Greece3Department of Basic Medical Sciences, School of Medicine, University of Athens, Athens, Greece4Materials Science Department, University of Patras, Patra, Greece5Theoretical and Physical Chemistry Institute, National Hellenic Research Foundation, Athens, Greece.

Purpose Radiolabeled magnetic nanoparticles, as dual-modality imaging agents, can be used in a number of diagnostic applications, since they combine the advantages of both

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PET and MR Imaging. In this study, a class of magnetic nanoparticles (NPs), radiolabeled 68with the positron emitting radionuclide Ga (t =1,13 hours), is described. Herein we 1/2

present a comparative evaluation of the radiolabeled NPs, synthesized in the presence or absence of a chelating unit, using in vitro and in vivo methods.Materials and Methods Colloidal magnetic nanoparticles, were prepared through arrested precipitation of magnetite in presence of the coating polymer, poly(methacrylic acid)-graft-polyethyleneglycolmethacrylate (PMMA-g-PEGMA). The carboxylate groups of the polymer facilitated robust interactions with the surface of the iron oxides, while the PEG grafts offered exceptional colloidal stability. One group (chelated NPs) was functionalized with the NODA-GA-NHS chelator, while the other one (chelator-free NPs) remained without a chelating unit. The radiolabeling procedure was conducted by incubating a mixture

68 0 containing GaCl and NPs in Sodium Acetate Buffer (pH 4) at 70 C. Samples were taken 3

30, 60 and 120 minutes post labeling and analyzed for radioactivity incorporation by Thin 68Layer Chromatography (TLC). Stability studies of the Ga-NPs in human serum and fetal

bovine serum (FBS) were performed by incubating the radiolabeled NPs in serum (pH 7) at 0 37 C, for up to 120 minutes and analyzed with TLC.

Results Radiolabeling of the NPs was carried out in high radiochemical yields for both chelated and chelator-free NPs (>94%, 30 minutes post labeling) and the stability in human serum and FBS was demonstrated for all constructs (>85%).

68Conclusion Radiolabeling of both chelated and chelator-free nanoparticles with Ga, resulted in high radiolabeling efficiency and stable complexes in human serum and FBS. The results imply that the chelating unit is not required for radiochemical incorporation. Ongoing in vitro studies comprise cytotoxicity evaluation using MTT assay, conducted in

68normal and cancer cell lines. In vivo studies including biodistribution of the Ga labeled NPs in normal mice models and athymic mice models bearing a tumor xenograft, are also in progress.

SYNTHESIS AND BIODISTRIBUTION STUDIES OF 68GA LABELED FITC FLUOROPHORE MANNOSYLATED DEXTRAN FOR SENTINEL LYMPH NODE DETECTION

1 1 1 1Papasavva Aphroditi , Shegani Antonio , Kiritsis Christos , Kontogeorgaki Sofia , 1 1 1Karachaliou Chrysa - Euaggelia , Tsoukalas Charalampos , Bouziotis Pinelopi , Pelecanou

2 1 1 1Maria , Papadopoulos Minas , Pirmettis Ioannis , Papasavva Aphroditi1INRASTES, NCSR “Demokritos”, Athens, Greece2IB-A, NCSR “Demokritos”, Athens, Greece

99mPurpose Mannosylated dextrans labeled with Tc have been explored for sentinel lymph node detection (SLND). In addition to the presence of a radioactive element, the introduction of a fluorophore on the dextran may combine preoperative planning and intraoperative localization of deeply located SLNs with direct optical guidance in a single lymphatic tracer.Aiming at the development of multimodal mannosylated dextrans for SLND, we report herein the synthesis and biodistribution studies of a new mannosylated dextran carrying fluorescein isothiocyanate (FITC) and NODAGA chelator for labeling with Ga-68 for PET imaging.Method-Material The new derivative compound NODAGA-DCM20-FITC was synthesized by reacting of NODAGA NHS ester with DCM20, followed by addition of FITC. Labeling was

68achieved by addition of GaCl to NODAGA-DCM20-FITC solution and incubation at 40 °C 3

for 20 min. Biodistribution studies were performed in Swiss Albino mice. In brief, animals 68were injected with 20 ìL of Ga-NODAGA-DCM20-FITC in their footpad. At 15, 30 and 60

min p.i. animals were sacrificed, organs of interest were excised and measured.Results Based on NMR of spectroscopy NODAGA-DCM20-FITC, 2 NODAGA chelators, 7 mannoses and 6 FITC moieties have been added, while 20 S-derivatized cysteines remain free. The new mannosylated derivative NODAGA-DCM20-FITC was quantitatively labeled

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68with GaCl . HPLC analysis showed the formation of a single product (~99 %, t = 12.5 min). 3 R

Periodic HPLC analysis suggesting that the complex formed was stable for up to 3 hours. 68The biological evaluation of the Ga labeled mannosylated dextran showed high

accumulation in the popliteal lymph node and fast injection site clearance. These data are 68comparable with our previous data of Ga-NODAGA-DCM20, indicating that the

attachment of FITC fluorophore did not alter its biodistribution.Conclusion In this study, a new hybrid fluorescence and radioactive tracer for SLND in patients was synthesized. The new compound did reveal attractive biological features, leading to a novel imaging agent combining SLN radioimaging with direct optical guidance.

SYNTHESIS AND CHARACTERIZATION OF NEW RE AND TC TRICARBONYL DITHIOCARBAMATE COMPLEXES

1 1 1 1Papadopoulos Ioannis , Ischyropoulou Myrto , Shegani Antonio , Kiritsis Christos , 2 2 3 1Raptopoulou Catherine , Psycharis Vassilis , Pelecanou Maria , Pirmettis Ioannis ,

1Papadopoulos Minas1INRASTES, NCSR “Demokritos”, Athens, Greece2DMS, NCSR “Demokritos”, Athens, Greece3IB-A, NCSR “Demokritos”, Athens, Greece

Purpose The coordination chemistry of rhenium (Re) and technetium (Tc) has been studied extensively owing to their importance in radiopharmaceutical design, including state-of-

99mthe-art Tc-radiotracers for molecular imaging applications in nuclear medicine. In this work, we have studied the synthesis and characterization of three new “2+1” mixed-ligand

99m 1fac-[Re/ Tc(SS)L (CO) ] complexes, with Sodium diethyldithiocarbamate (SSNa) serving as 3

the bidentate SS ligand and Triphenylphosphine (PPh ), Cyclohexyl isocyanide (Cisc) or 4-31Aminopyridine (4AP) as the monodentate ligand, L .

1Method-Material In equimolar amounts, SSNa and the appropriate L ligand readily reacts with the [Et N] [ReBr (CO) ] precursor to afford fac-[Re(SS)(PPh )(CO) ], 1, fac-4 2 3 3 3 3

[Re(SS)(Cisc)(CO) ], 2, and fac-[Re(SS)(4AP)(CO) ], 3 complexes in high yields. A methanol 3 3-3 1 -3solution of SSNa (10 M) and the respective L ligand (10 M) was incubated with fac-

99m + 99m[ Tc(H O) (CO) ] (≈10 mCi) at 70 °C for 30 min. The complexes fac-[ Tc(SS)(PPh )(CO) ], 2 3 3 3 399m 99m1b, fac-[ Tc(SS)(Cisc)(CO) ], 2b, and fac-[ Tc(SS)(4AP)(CO) ], 3b, formed as single 3 3

radiochemical species in >95% yields.Results The Re complexes have been fully characterized in the solid and solution states by elemental analysis, IR and NMR spectroscopies. Their solid-state structure has been elucidated by X-ray crystallography. As expected, the rhenium center presents a distorted octahedral geometry. Results at the macroscopic Re-level were successfully translated at

99m 99m +the Tc-tracer level using the corresponding fac-[ Tc(H O) (CO) ] precursor. Reaction of 2 3 31equivalent amounts of SSNa and monodentate ligand L (PPh3, Cisc or 4AP) with fac-

99m +[ Tc(H O) (CO) ] in water-methanol system resulted in the quantitative formation of 2 3 399mcorresponded complexes. The Tc-complexes were characterized by comparative HPLC

analysis using the analogous authentic Re-samples and comparison of elution times. During histidine and cysteine challenge experiments all complexes remained stable.Conclusion In this work, a series of “2+1” mixed ligand tricarbonyl complexes of the

99m 1general formula fac-[Re/ Tc(SS)(L )(CO) ] were synthesized, characterized and evaluated 3

as potential radiopharmaceutical model compounds. The high affinity of diethyldithiocarbamate for the tricarbonyl core, the ease and high yield of preparation,

99malong with the stability of the forming Tc-chelates, advocates further exploration of the 99m 1fac-[Re/ Tc(SS)(L )(CO) ] system in biological models.3

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IMPACT OF 99MTC-LABELLING ON BINDING AND VIABILITY OF HUMAN ADIPOSE TISSUE-DERIVED CELLS IN VITRO AND ON THE CELL-TRACKING PROPERTIES USING SPECT IN VIVO

1 1 2 3Fragogeorgi Eirini , Efthimiadou Eleni , Rosenblat Gennady , Georgioy Maria , Daich 4 5 1 1 6Julian , Laurent Sophie , Bouziotis Penelope , Kordas George , Velez Marisela , Muller

5 2 1Robert , Meretzki Shai , Loudos George1National Center for Scientific Research – NCSR “DEMOKRITOS” 2BonusBioGroup Ltd.3BioEmission Technology Solutions4Bioimag Soluciones de Contraste, S.L.5University of Mons6Bioimag Soluciones de Contraste, S.L AND Catalysis and Oil-chemistry Institute (C.S.I.C.)

Purpose: Stem cells derived from different sources hold a great potential as novel therapeutic approach in several diseases. Adipose tissue contains a population of mesenchymal stem cells known as human adipose tissue-derived cells (HATDCs). HATDCs can be harvested readily, safely and are capable of differentiating into other mesenchymal tissue types, including adipocytes, chondrocytes, myocytes and osteoblasts.

99mThe increasing interest of 99m-technetium ( Tc)-labelled stem cells encouraged us to optimize and characterize the radioactive labelling of HATDCs with a range of techniques.Method – Material: HATDCs were isolated from adipose (fat) tissue. Cells are labelled with 99mTc by applying two radiolabeling techniques: i) the direct labelling method with reduced

99m 99mNa TcO and ii) with Tc-based radiopharmaceutical approved for bone imaging 499mmethylene diphosphonate ( Tc-MDP), as HATDCs are considered a very promising cell

source for the repair of skeletal defects. The optimal incubation period for reduced 99mtechnetium-99m and Tc-MDP cell uptake is investigated and tracers' radiotoxicity on

these cells is determined. Additionally, normal mice are injected with HATDCs pre-labelled with technetium tracers, and cell biodistribution is investigated using small-animal single-photon emission computed tomography (SPECT) imaging.Results: HATDCs' successful labelling, uptake kinetics and cell viability (affected by radiolabeling) studies are ongoing and open the possibility for non-invasive monitoring of therapeutic stem cells.Conclusion: A thorough examination of HATDCs in vitro and in vivo properties and function after labeling is presented. This preliminary work will contribute to a further assessment of bone healing while combined with other two required processes osteoinduction (by using signals and growth factors) and osteoconduction (through a matrix or scaffold). This research is carried out in terms of the H2020-MSC-RISE project VIVOIMAG (645757).

ATYPICAL SUBACUTE THYROIDITIS SCINTIGRAPHICALY PRESENTED AS TOXIC ADENOMA – CASE REPORT

1 2 3 1 1AleksiĆ Željka , AleksiĆ Aleksandar , RistoviĆ Nenad , MiliĆeviĆ Mirjana , JoliĆ Bojana , 2JoliĆ Aleksandar

1Health center Zajecar, Nuclear medicine department, Zajecar, Serbia 2Health center Zajecar, Internal medicine department, Zajecar, Serbia3Health center Zajecar Department for infectious disesases, Zajecar, Serbia

Subacute thyroiditis (SAT), also known as DeQuervain's or granulomatous thyroiditis is an inflammatory condition of the thyroid gland, which is usually fully affected. Severe pain and tenderness in the thyroid bed occur typically and are followed by weakness, fatigue, pain in muscles and joints, and light to moderate fever and symptoms of thyrotoxicosis - nervousness, sweating and rapid heartbeat and trembling. Temporary elevated serum

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thyroxine, suppressed TSH and elevated serum markers of inflammation in the acute phase are pathognomonic for the SAT, with diffusely absent binding of radioactive iodine or technetium-pertechnetate in the thyroid gland due to thyrocytes destruction. Rare cases of atypical SAT - painless or with minimal pain, SAT limited to one thyroid lobe or focal thyroiditis, are reported in literature.

A 72 year old female patient was hospitalized in the department of infectious diseases with fever of unknown origin and malaise lasting about a month back. Inflammatory markers, fibrinogen and CRP were positive, with elevated serum level of free thyroid hormones and suppressed serum TSH level. Thyroid echosonography revealed diffusely hypoechogenic thyroid with isoechoic nodule distally in the right lobe, with approximate diameter 15,8x12,5x15,8mm. Thyroid pertechnetate scan indicated the existence of a functional tissue in the lower half of the right lobe, with total suppression of the surrounding tissue. Thyroid scintigraphy with methoxy-isobutyl-isonitrile (MIBI) showed diffusely lower uptake, with slightly inhomogeneous distribution and areas of slightly increased uptake into the lower parts of both lobes. We started a glucocorticoid therapy with a gradual reduction in dose every five days, lasting about a month, with monitoring of thyroid status. Clinical and biochemical thyroid status was normalized around 6 weeks after the diagnosis. Control pertechnetate scan confirmed the existence of functional nodule in the distal part of right lobe along with the recovery of uptake in the surrounding tissue of the thyroid gland.

We reported a rare case of a minimally painful SAT associated with functional adenoma in the right lobe of the thyroid gland, which was, in thyrotoxic, acute phase, scintigraphicaly presented as toxic adenoma, in fact representing a functional adenoma tissue unaffected by destructive thyroiditis.

BAD CHOICES OR GOOD SURVIVAL - A CASE REPORT OF THYROID CARCINOMA1 1 1 1Chiriac Iulia Andreea , Purice Mariana , Voicu Gabriela , Goldstein Andrei Liviu

1Department of Nuclear Medicine and Radioiodotherapy, National Institute of Endocrinology “C. I. Parhon”, Bucharest, Romania

Thyroid cancers are rare neoplasms, representing less than 2% of all human cancers, and overall survival after surgery and radioiodine ablation therapy is 95% at 10 years. The subject of this presentation is a 65-year-old lady who was diagnosed with polynodular goiter at the age of 36 years, and at the age of 51 years with papillary thyroid carcinoma follicular variant (pT3 Nx ST3 G1 Rx) after total thyroidectomy at a private clinic.The patient showed a lack of interest in post-intervention follow-up and for 14 years didn't schedule an appointment with an endocrinologist. At the age of 59 years she is suspected of pulmonary carcinoma and at bronchial lavage thyroid adenocarcinoma cells are revealed. After other 4 years of no follow-up and a femoral fracture she undergoes a femoral biopsy which revealed metastatic follicular thyroid carcinoma.The patient presents in the Nuclear Medicine Department for radioiodine therapy and after three ablation sessions the bone, pulmonary metastatic and thyroid remains are still visible on the whole body acquisition.The particularity of this case is the natural evolution of a patient with differentiated thyroid cancer, who didn't receive any radioiodine ablation therapy for almost 15 years, knowing that this is a kind of cancer with a good outcome if treated accordingly at the time of diagnosis.

CORRELATION OF 99MTC-MIBI SCAN WITH HISTOPATHOLOGIC DIAGNOSIS IN PATIENTS WITH “COLD“ THYROID NODULES

1 1 1 1 1 1Kojić Marko , Vlajković Marina , Rajić Milena , Mišić Ivana , Stević Milos , Ilić Slobodan , Kojić 1 2Ljiljana , Karanikolić Aleksandar

1Department of Nuclear Medicine, Clinical Center Niš, Serbia2Surgical Clinic, Clinical Center Niš, Serbia

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99mPurpose: Technetium 99m-methoxyisobutylisonitrile ( Tc-MIBI) was found to be taken up by a variety of tumours, including thyroid cancer. The purpose of this study was to estimate

99mthe diagnostic value of Tc-MIBI scintigraphy in patients operated due to cold thyroid nodules by comparing it with histopathology finding.Material and Methods: A total of 70 consecutive patients operated due to presence of thyroid lesion which were found „cold“ on pertechnetate scan were included in the study. 99mTc-MIBI scintigraphy was performed two to four weeks following pertechnetate scan in all patients. Acquisition was performed collecting 10-minute images in anterior projection

99mof the patients neck, 20 (early scan) and 120-minute (late scan) following Tc-MIBI administration. Scans were reported as either negative or positive depending on the

99muptake of Tc-MIBI in thyroid nodules, compared with that in the normal surrounding thyroid tissue, and a score between 1 and 3 was assigned to each finding as follows: 1, absent or decreased uptake (negative); 2, equal (indeterminate); 3, higher or intense uptake (positive).Results: Histopathologic diagnosis revealed 42 patients (60%) with benign thyroid lesions and 28 (40%) with differentiated thyroid carcinomas (DTC). Four out of 28 patients with DTC had a negative MIBI scan with score 1 in 2 patients and score 2 in another. The sensitivity

99mof Tc-MIBI scan was 86% (for the score 3), and specificity was found to be 100%. 99mNegative predictive value of Tc-MIBI scan was 91% and positive predictive value was

100%.Conclusions: Absent or decreased MIBI uptake in thyroid nodule accurately excludes malignancy in thyroid nodule, while higher uptake strongly suggests the presence of a malignancy. In combination with pertechnetate scan, clinical and laboratory findings, 99mTc-MIBI scan could be helpful in preoperative assessment of thyroid nodules.

99mAfterwards, because of its availability, rather low cost, and easy visual interpretation, Tc-MIBI scan could take part in routine imaging of cold thyroid nodules.

TRACER UPTAKE UNRELATED TO THYROID CANCER ON RADIOIODINE WHOLE BODY SCAN

1 1 1 1Koutsikos Ioannis , Sarris Konstantinos , Papachristou Aristidis , Christodoulou Sotiris , 1Koutoulakos Antonis

1Biomedicine group

Purpose: Differentiated thyroid cancer (DTC) represents over 90% of thyroid malignant tumors. Effective DTC management includes radioiodine (RAI) administration either for diagnostic or therapeutic purposes. However, the ability of this procedure to detect local disease or distant metastases is compromised by the non-specific RAI localization in body sites other than thyroid tissue. The aim of this retrospective study was to define abnormal RAI uptake in non-thyroidal tumors and other pathologic tissues leading to false-positive results after performing whole body scan (WBS).Material and Method: A total of 229 WBS were retrospectively reviewed; 177 diagnostic WBS (DxWBS) and 52 post-treatment WBS (RxWBS). RAI uptake unrelated to local disease or distant metastasis was mentioned. Further exams (SPECT-CT, MRI, US, etc.) were performed to further define our findings.

Results: Abnormal RAI uptake in non-thyroidal tumors and other pathologic tissues was defined in 31/177 DxWBS and in 46/52 RxWBS. Thyroglossal duct cyst (TDC) was the most common finding in DxWBS (15/31); other findings were thymus (9/31), struma ovarii (2/31) and inflammation mainly in salivary glands (4/31) and esophagus (1/31). Diffuse hepatic uptake was seen in all 46 RxWBS. Other etiologies of Iodine uptake in RxWBS was TDC (12/46), thymus (4/46) and struma ovarii (1/46)

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Conclusion: The knowledge of benign diseases and benign or malignant non-thyroidal tumors accumulating RAI could greatly enhance the interpretation of our studies. Diffuse liver uptake was our most common finding in RxWBS (as an indicator of functioning thyroid remnant or metastasis). TDC can be frequently observed both in DxWBS and RxWBS; therefore, care should be taken not to confuse Iodine uptake by TDC with metastatic foci.

POSTPROCEDURALLY HYPOTHYROIDISM IN PATIENTS TREATED WITH RADIOIODINE FOR AUTOIMUNE HYPERTHYROIDISM

1 1 2Milicevic Mirjana , Aleksic Zeljka , Aleksic Aleksandar1Health Centre Zajecar, Department of Nuclear Medicine, Serbia2Health Centre Zajecar, Internal Medicine Department, Serbia

Introduction: Autoimmune hyperthyroidism, also known as Graves-Basedow (GB) disease, is tyrotoxical state due to excessive production of thyroid hormones, caused by pathologically stimulated thyroid by TSH receptor antibodies. Radioiodine therapy (RIT) is widely applied in a therapy with patients with GB disease who do not achieve remission during the tirosupressive drug therapy (MIT), or have frequent recurrences of disease. Post-procedural hypothyroidism (PPH) occurs as a long-term effect of RIT at treated patients.

Aim: Assessment the incidence of PPH in our GB patients treated with RIT.

Methods and material:

· Data taken from the patiens'charts from Registry book for endocrine disorder of the Department of Nuclear Medicine, Health Centre Zajecar, treated in the period 2002-2007 and followed until the end of 2012.

Data were processed with retrospective and 'life-table' analysis.

· During this period 91 patients were treated with radioiodine, 62 patients were treated with a single dose and their data were included in the analysis.

· Average age 55.3±11.71 (range 33-83).

· Total number of patients: 62; 8 men and 54 women,

· The medium Th dose 131 J was 6.6±1.7 mCi (range 4.5-15) – medium to moderate fixed dose.

Results Nearly half (47%) patents developed PPH, the largest number during the year one after receiving the therapeutical dose 131 J , 39%. By 'life-table' analysis method, and taken in account the number of 'lost-cases', we demonstrated the likelihood of PPH in the first post therapy year of 41%, and 7-9% new cases in the following years.Conclusion The data indicated the need for lifelong monitoring of the function of the thyroid status of patients treated with radioiodine for GB disease. Medium to moderate fixed doses give no higher incidence of post procedural hypothyroidism

SERUM CGRP: A NOVEL BIOMARKER AT THE ENDS OF A SPECTRUM POSTULATING THE INVERSE INCIDENCE OF ALZHEIMER'S DISEASE VERSUS MIXED DCIS+IDC?

1 1 2 1Papantoniou Vassilios , Valsamaki Pipitsa , Marinopoulos Spyridon , Skiadaresi Chaido , 1 1 1 3Delichas Zisis , Papantoniou Ioannis , Tsiouma Maria , Papadimitriou Alexandros ,

2 4Loutradis Dimitrios , Papageorgiou Sokratis1Nuclear Medicine Department, University General Hospital “Alexandra”, Athens, Greece2Obstetrics and Gynecology Department, University General Hospital “Alexandra”, Athens, Greece3Neurology Department, Henry Dunant Clinic, Athens, Greece4Neurology Department, University General Hospital “Attikon”, Athens, Greece

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Aim: This study aimed to assess the possible impact of serum calcitonin gene-related peptide (CGRP) fluctuation in identifying two diseases that appear implausible to occur concurrently: Alzheimer's disease (AD) and breast cancer (BC). The pathophysiological interlink of these disorders may correspond to the ends of a spectrum.Patients and methods: Radioimmunoassay (RIA) was applied for the determination of serum CGRP concentrations, which were afterwards compared (t-test) between patients with AD (n=17) and subjects with BC of different histological subtypes [invasive ductal carcinoma (IDC) n=7, mixed IDC+DC in situ (IDC+DCIS) n=5 and DCIS n=5)]. Serum CGRP levels of AD and BC patients were also compared to the corresponding values of a healthy control group (n=10).Results: Serum CGRP levels in AD, BC, and controls were determined (mean±SD: pg/mL): 179.7±50.4, 438.3±448.1, and 90.2±32.1, respectively. Patients with AD and healthy controls presented significantly lower CGRP levels as compared to BC (P=0.04 and P=0.09, respectively). Only in BC patients with mixed DCIS+IDC lesions a statistically significant difference was revealed compared to AD patients (P=0.00013). Patients with AD had significantly higher CGRP levels compared to the control group (P=0.001). Non-significant difference was established between AD vs IDC (P=0.16) and AD vs DCIS (P=0.8).Conclusion: Downregulation of CGRP expression appears to play a critical role in AD progression, whereas CGRP upregulation is clearly associated with mixed DCIS+IDC. CGRP multilevel activity spectrum may enlighten the underlying pathophysiological mechanisms, in terms of a-amyloid formation and deposition at lower levels in AD versus hypoxia-induced neoangiogenesis at high levels in BC. Our findings may eventually introduce a novel, simple diagnostic assay coupled with anti-CGRP-peptide treatment of both disorders.






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