RESUMEN
BACKGROUND: Through its use of ionising radiation, the field of nuclear medicine forms a unique and significant part of medical diagnostics and patient treatment. Objectives. To assess the operational potential of nuclear medicine in Poland based on existing database/literature sources together with conducting a survey on the relevant healthcare facilities available, staffing, expertise and performance. MATERIAL AND METHODS: To gather all available literature data on the medical use of ionising radiation in Poland several data bases were used, since currently, there are no single statistical data base devoted to this issue. Data on radiation hygiene were thus collected from the Statistical Bulletin of the Ministry of Health, Annual reports from the National Atomic Energy Agency and Central Statistics Office. Additionally, national and provincial reports were used, as well as those received from the European Society of Nuclear Medicine. RESULTS: At present, the Public Healthcare system in Poland has 55 nuclear medicine departmental facilities operating and 8 that are private/non-public. These are staffed by 252 doctors, of whom 151 are qualified as nuclear medicine specialists; constituting one specialist per 300,000 inhabitants. In addition, 170 highly qualified staff (biologists, chemists, physicists, electronics engineers and IT specialists) provide indispensable scientific/operational support and are vital for the development of nuclear medicine departments. They are mainly responsible for ensuring that all equipment functions effectively and for developing new diagnostic techniques, together with new radiopharmaceuticals. Furthermore, there are approximately 500 other staff at intermediate-level also involved in nuclear medicine departments, such as technicians, nurses and support workers. The survey demonstrated an average of 22 persons employed per nuclear medicine department. For all institutions, it is estimated that there are 127 gamma cameras, 10 PET/CT scanners and 16 hybrid SPECT/CT systems operating. In 2000, approximately 117,435 diagnostic procedures were performed, compared to 156,214 in 2008 and with the current number of around 170,000; up to 38% were simple thyroid scintigraphies, 25% were bone scans, 11% heart scintigraphies and 10% kidney scans. CONCLUSIONS: The number of diagnostic radioisotopic procedures in Poland are strongly expected to increase by 300% during the next 5-6 years. To meet this rise, additional equipment will thus be necessary, which includes having an extra 100 SPECT/CT gamma cameras.
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Medicina Nuclear/estadística & datos numéricos , Medicina Nuclear/tendencias , Medicina Nuclear/instrumentación , PoloniaRESUMEN
BACKGROUND: Multidrug chemotherapy increases the efficacy of the treatment, but at the same time rises its cardiotoxicity. The majority of cardiac complications are caused by anthracyclines.Radiation therapy may intensify cardiotoxicity. The aim of this study was to determine early changes of cardiac function using radionuclide ventriculography in patients with breast cancer and to compare the toxicity of AC and AT chemotherapy programs. MATERIAL AND METHODS: The study included 71 patients with breast cancer between the ages of 38 and 71 years. All patients after surgery were qualified for chemotherapy, and for 37 (52%) of them subsequent irradiation treatment was planned.Patients received chemotherapy according to the scheme: AC- 47 patients (66%) and AT - 24 patients (34%). Patients were irradiated using a photon beam (4 to 6 MeV) and an electron beam (6-15 MeV). In all patients, before and six months after the treatment, radionuclide ventriculography was performed. RESULTS: In all 71 patients a reductions in left ventricular ejection fraction (EF) and in peak filling rate (PFR) as well as an increase in the end-systolic and end-diastolic volumes (ESvol,EDvol) were observed. AC chemotherapy, where cumulative anthracycline dose was higher, significantly decreased left ventricular ejection fraction and PFR and increased ESvol. AfterAT chemotherapy the EF reduction proved to be smaller. Radiotherapy did not significantly lower the value of EF as compared to the group of patients who underwent chemotherapy. CONCLUSIONS: Radionuclide ventriculography is a useful method of evaluating the cardiotoxicity of the treatment. Early indicators of myocardial damage are EF, PFR, ESvol and EDvol.AC chemotherapy, where the average cumulative dose of anthracyclines was higher, caused more cardiotoxic effects than AT chemotherapy.Applying additional radiotherapy did not significantly increase the cardiotoxicity of the treatment.
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Antineoplásicos/efectos adversos , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/terapia , Quimioradioterapia/efectos adversos , Corazón/diagnóstico por imagen , Adulto , Anciano , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/fisiopatología , Corazón/efectos de los fármacos , Corazón/fisiología , Corazón/efectos de la radiación , Hemodinámica/efectos de los fármacos , Hemodinámica/efectos de la radiación , Humanos , Persona de Mediana Edad , Ventriculografía con Radionúclidos , Factores de TiempoRESUMEN
BACKGROUND: Positron emission tomography (PET) combined with computer tomography (CT) using (68)Ga-DOTATATE is a promising method for the evaluation of patients with recognised or suspected neuroendocrine tumours (NET). The aim of this study was to assess the diagnostic value of (68)Ga-DOTATATE PET/CT in the visualisation of the expression of somatostatin receptors (SSTR) and identification of new lesions. MATERIAL AND METHODS: Between December 2009 and January 2011 ninety-seven patients with confirmed (88 cases) or suspected (9 cases) NET underwent (68)Ga DOTATATE PET/CT. The primary, confirmed or suspected, NET localizations were: GEP tumours--71 patients; medullary thyroid carcinoma--4 patients; cancer of an unknown primary--14 patients; and NET in other localisations--8 patients. PET/CT acquisitions were performed using standard techniques, 45 to 60 minutes after the intravenous injection of 111-185 MBq (68)Ga-DOTATATE. RESULTS: (68)Ga-DOTATATE PET/CT detected the presence of lesions demonstrating the somatostatin receptor affinity in 50 of the 97 patients (51.5%) and was negative in 47 patients (48.5%). Among 14 patients with metastatic unknown primary cancer, in 5 patients (45.5%) the primary tumour site was identified, and in 4 patients with medullary thyroid cancer distant metastases with SSTR expression were localized in only one patient. CONCLUSIONS: Our findings confirm the diagnostic role of (68)Ga-DOTATATE PET/CT as an accurate method of identifying primary tumours and distant metastases. It provides information on tumour cell receptors status, which has a significant bearing on planning target radionuclide therapy. Overall, (68)Ga-DOTATATE PET/CT can be used in staging, re-staging, and in regular follow up of oncology patients.