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001-es BibID:	BIBFORM124078
035-os BibID:	(scopus)85203631691 (WoS)001312824900001
Első szerző:	Barna Sándor (kutató orvos)
Cím:	[131I]6β-Iodomethyl-19-norcholesterol SPECT/CT for the Lateralization of Mineralocorticoid Overproduction in Primary Aldosteronism / Barna Sandor, Sira Livia, Bhattoa Harjit Pal, Toth Laszlo, Czine Zsigmond, Szoboszlay Lilla, Nagy Edit B., Kepes Zita, Garai Ildiko, Bodor Miklos, Varga Jozsef, Nagy Endre V.
Dátum:	2024
ISSN:	2075-4418
Megjegyzések:	Primary: aldosteronism is a frequent cause of secondary hypertension. With access to specialized care, an increasing number of patients with aldosteronism are being identified. Primary aldoste-ronism is treatable by adrenal surgery if aldosterone excess originates from one of the two, and not from both, adrenals. Bilateral hyperplasia requires lifelong mineralocorticoid receptor antago-nist treatment. Up till now, adrenal venous sampling (AVS) has been widely used to distinguish between one-sided and two-sided aldosterone overproduction and patient selection for surgery. AVS is an invasive technique, and the unsuccessful sampling of the right adrenal vein during AVS often prevents side comparison, making the AVS procedure useless. Molecular imaging using [131I]6?-iodomethyl-19-norcholesterol with SPECT CT imaging (SPECT/CT) may be a potential al-ternative. Methods: In 42 consecutive patients with confirmed primary aldosteronism, molecular imaging has been performed. After dexamethasone suppression of the non-affected adrenal tis-sue, 37 MBq [131I]6?-iodomethyl-19-norcholesterol was injected i.v., and SPECT/CT images were taken 7 days later. Based on the visual evaluation of the images by two nuclear medicine special-ists, patients with one-sided tracer accumulation underwent adrenalectomy. To identify a SPECT/CT parameter that best characterizes the side difference, the maximum counts and the mean counts of spherical VOIs were analyzed. Results: Of the 42 patients, 24 had one-sided aldos-terone overproduction by SPECT/CT. After surgical removal of the involved adrenal, all 24 pa-tients with SPECT/CT-identified unilateral aldosteronism achieved biochemical cure, defined as a normalized potassium level combined with an aldosterone-to-renin ratio ? 30. To identify the best measurable parameter of SPECT/CT side difference, the mean counts and maximum counts of a series of spherical VOIs of different diameters were analyzed. The ratio of the mean counts of 3 cm spherical VOIs of the right and left adrenal regions (lateralization index) was the best discrimi-nator; a ratio of ?1.29 was characteristic of one-sided disease, without overlap between the one-sided and two-sided patient groups. Conclusions: [131I]6?-iodomethyl-19-norcholesterol SPECT/CT with a count-based image interpretation and side-ratio calculation may be an equipol-lent non-invasive substitute for adrenal venous sampling in the lateralization of mineralocorticoid overproduction. It reliably identifies unilateral disease and facilitates patients' selection for surgical intervention. If confirmed by others, this functional imaging may replace AVS when lateralization is required for management decisions in primary aldosteronism
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk hypertension primary aldosteronism [131I]6?-iodomethyl-19-norcholesterol SPECT/CT
Megjelenés:	Diagnostics. - 14 : 17 (2024), p. 1-10.-
További szerzők:	Sira Lívia (1973-) (endokrinológus) Bhattoa Harjit Pal (1973-) (laboratóriumi szakorvos) Tóth László (1971-) (patológus) Czine Zsigmond Szoboszlay Lilla Nagy Edit B. Képes Zita (1991-) (orvos) Garai Ildikó (1966-) (radiológus) Bodor Miklós (1969-) (belgyógyász, endokrinológus) Varga József (1955-) (fizikus) Nagy Endre V. (1957-) (belgyógyász, endokrinológus)
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001-es BibID:	BIBFORM029177
Első szerző:	Ujhelyi Bernadett (szemész)
Cím:	Retrobulbar 99mTc-diethylenetriamine-pentaacetic-acid uptake may predict the effectiveness of immunosuppressive therapy in Graves' ophthalmopathy / Bernadett Ujhelyi, Annamaria Erdei, Laszlo Galuska, Jozsef Varga, Lajos Szabados, Erzsebet Balazs, Miklos Bodor, Bela Cseke, Zsolt Karanyi, Andras Leovey, Emese Mezosi, Kenneth D. Burman, Andras Berta, Endre V. Nagy
Dátum:	2009
ISSN:	1050-7256
Megjegyzések:	Background: In Graves' ophthalmopathy (GO), only patients with immunologically active disease respond toimmunosuppressive therapy. Previous studies and theoretical considerations suggest that elevated orbital 99mTcdiethylenetriamine-pentaacetic-acid (DTPA) single photon emission computed tomography (SPECT) reflectsinflammatory disease activity. We studied whether corticosteroid treatment causes a substantial decrease inDTPA uptake in GO, a result consistent with successful immunosuppressive treatment of GO and referred to asa favorable treatment outcome.Methods: One hundred fourteen orbits in 57 patients with active GO (CAS?4) were entered into the study. Allpatients received corticosteroid treatment. Orbital DTPA uptakes were numerically quantified for the entire orbitas well as the anterior and posterior segments separately. DTPA SPECT was performed before, and 2 to 9months after the initiation of immunosuppressive treatment. The normal range for DTPA uptake was establishedin 34 orbits of 17 patients who were being worked up for Raynaud's phenomenon and had no thyroiddisease.Results: The mean DTPA uptake of the 114 orbits of GO patients was higher prior to corticosteroid therapy thanafter this treatment (11.03?4.26MBq/cm3 and 9.84?3.51MBq/cm3, respectively, p<0.001) but a substantialdecline in DTPA uptake was seen in only 39.5% of GO patients. The positive predictive value of an initialDTPA >12.28MBq/cm3 for a substantial decline in DTPA uptake (favorable treatment outcome) was 76%, whilea negative predictive value of a pretreatment DTPA?12.28MBq/cm3 was 78%.Conclusions: Corticosteriod treatment is associated with a decline in DTPA uptake in a fraction of GO patients.GO patients with a DTPA uptake above 12.28MBq/cm3 are more likely to have a favorable response to corticosteroidtherapy while patients with lower values are less likely to have this potentially favorable response.An elevated DTPA uptake may identify patients who are most likely to benefit from immunosuppressivetreatment.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban Graves' orbitopathy immunological activity DTPA SPECT egyetemen (Magyarországon) készült közlemény
Megjelenés:	Thyroid. - 19 : 4 (2009), p. 375-380. -
További szerzők:	Erdei Annamária (1976-) (belgyógyász) Galuska László (1946-) (belgyógyász, izotópdiagnoszta) Varga József (1955-) (fizikus) Szabados Lajos (1977-) (orvos) Balázs Erzsébet (1952-) (szemész) Bodor Miklós (1969-) (belgyógyász, endokrinológus) Cseke Béla (1974-) (belgyógyász, endokrinológus) Karányi Zsolt (1961-) (biostatisztikus, bioinformatikus) Leövey András (1926-2019) (belgyógyász) Mezősi Emese Burman, Kenneth D. Berta András (1955-) (szemész, gyermekszemész) Nagy Endre V. (1957-) (belgyógyász, endokrinológus)
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