ACR–ABS–ACNM–ASTRO–SIR–SNMMI practice parameter for selective internal radiation therapy or radioembolization for treatment of liver malignancies

PurposeThe American College of Radiology (ACR), American Brachytherapy Society (ABS), American College of Nuclear Medicine (ACNM), American Society for Radiation Oncology (ASTRO), Society of Interventional Radiology (SIR), and Society of Nuclear Medicine and Molecular Imaging (SNMMI) have jointly developed a practice parameter on selective internal radiation therapy (SIRT) or radioembolization for treatment of liver malignancies. Radioembolization is the embolization of the hepatic arterial supply of hepatic primary tumors or metastases with a microsphere yttrium-90 brachytherapy device.Materials and MethodsThe ACR -ABS -ACNM -ASTRO -SIR -SNMMI practice parameter for SIRT or radioembolization for treatment of liver malignancies was revised in accordance with the process described on the ACR website (https://www.acr.org/ClinicalResources/Practice-Parameters-and-Technical-Standards) by the Committee on Practice Parameters—Interventional and Cardiovascular Radiology of the ACR Commission on Interventional and Cardiovascular, Committee on Practice Parameters and Technical Standards—Nuclear Medicine and Molecular Imaging of the ACR Commission on Nuclear Medicine and Molecular Imaging and the Committee on Practice Parameters—Radiation Oncology of the ACR Commission on Radiation Oncology in collaboration with ABS, ACNM, ASTRO, SIR, and SNMMI.ResultsThis practice parameter is developed to serve as a tool in the appropriate application of radioembolization in the care of patients with conditions where indicated. It addresses clinical implementation of radioembolization including personnel qualifications, quality assurance standards, indications, and suggested documentation.ConclusionsThis practice parameter is a tool to guide clinical use of radioembolization. It focuses on the best practices and principles to consider when using radioemboliozation effectively. The clinical benefit and medical necessity of the treatment should be tailored to each individual patient.     

Mass spectrometric differentiation of the isomers of mono-methoxyethylamphetamines and mono-methoxydimethylamphetamines by GC–EI–MS–MS

Mass spectrometric differentiation of the six isomers of mono-methoxyethylamphetamines (MeO-EAs) and mono-methoxydimethylamphetamines (MeO-DMAs) by gas chromatography–electron ionization–tandem mass spectrometry (GC–EI–MS–MS) was investigated. Based on their EI-mass spectra, the fragment ions at m/z 121 and 72 were selected as precursor ions for their regioisomeric and structurally isomeric differentiation, respectively. Collision-induced dissociation provides intensity differences in product ions among the isomers, enabling mass spectrometric differentiation of the isomers. Furthermore, high reproducibility of the product ion spectra at the optimized collision energy was confirmed, demonstrating the reliability of the method. To our knowledge, this is the first report on mass spectrometric differentiation of the six isomers of MeO-EAs and MeO-DMAs by GC–EI–MS–MS. Isomeric differentiation by GC–EI–MS–MS has a high potential to discriminate isomers of newly encountered designer drugs, making GC–MS–MS a powerful tool in the forensic toxicology field.     

Simple and rapid analysis of amatoxins using UPLC–MS–MS

Amatoxins, such as α-amanitin and β-amanitin, are highly toxic bicyclic octapeptides present in Amanita mushrooms. We present a simple and rapid sensitive determination of α-amanitin, β-amanitin, and phalloidin in body fluids (serum, plasma, and urine) using an ultraperformance liquid chromatography (UPLC)–tandem mass spectrometry (MS–MS) system. After extraction from serum, plasma, and urine samples by an Oasis HLB column, the three compounds were subjected to an UPLC–MS–MS system with an electrospray ionization interface. All three compounds were completely separated within 4.5 min. The calibration curves for serum, plasma, and urine samples showed good linearities in the range of 2–420 ng/ml, using virginiamycin B as internal standard. Their detection limits were as low as 0.5–1.5 ng/ml. The present method was validated; the coefficients of variation (CV) were: intraday for serum, plasma, and urine samples, less than 9.9, 13.2, and 11.5 %, respectively; interday for serum, plasma, and urine samples, less than 15.0, 10.4, and 15.3 %, respectively. The influence of matrix effects, especially in urine, was observed in human and rat samples; however, the difference in matrix effects between individuals were low. Therefore, each calibration curve was prepared for each biological specimen type. Furthermore, we succeeded in determining the compounds in rat urine samples, obtained 6 or 24 h after intraperitoneal administration. The present method is applicable in forensic and clinical toxicology because of its simplicity and rapidness with high sensitivity.     

Bilateral retinal detachment in a patient with Vogt–Koyanagi–Harada syndrome

We present a 38-year-old woman with bilateral serous retinal detachments and bilateral panuveitis on fundoscopic exam. CT of the orbits and MRI scans revealed bilateral ocular choroidal thickening and bilateral retinal detachments; however, no other CNS or meningeal lesion was detected. This patient met the clinical criteria for Vogt–Koyanagi–Harada (VKH) Syndrome. Review of VKH syndrome as well as the radiographic findings will be discussed.     

Joseph Dettling 1890–1959

Ohne Zusammenfassung

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Joseph Dettling 1890–1959

     

Heinrich Zangger 1874–1957

Ohne Zusammenfassung     

Hermann Merkel 7.6.1873–27.5.1957

Ohne Zusammenfassung     

ACR–ABS–ASTRO practice parameter for the performance of radionuclide-based high-dose-rate brachytherapy

purposeThis practice parameter aims to detail the processes, qualifications of personnel, patient selection, equipment, patient and personnel safety, documentation, and quality control and improvement necessary for an HDR brachytherapy program.Methods and MaterialsThis practice parameter was revised collaboratively by the American College of Radiology (ACR), the American Brachytherapy Society (ABS), and the American Society for Radiation Oncology (ASTRO).ResultsBrachytherapy is a radiotherapeutic modality in which radionuclide or electronic sources are used to deliver a radiation dose at a distance of up to a few centimeters by surface, intracavitary, intraluminal, or interstitial application. Brachytherapy alone or combined with external beam radiotherapy plays an important role in the management and treatment of patients with cancer. High-dose-rate (HDR) brachytherapy uses radionuclides, such as iridium-192, at dose rates of ≥12 Gy/hr to a designated target point or volume, and it is an important treatment for a variety of malignant and benign conditions. Its use allows for application of high doses of radiation to defined target volumes with relative sparing of adjacent critical structures.ConclusionsHDR brachytherapy requires detailed attention to personnel, equipment, patient and personnel safety, and continuing staff education. Coordination between the radiation oncologist and treatment planning staff and effective quality assurance procedures are important components of successful HDR brachytherapy programs.