Publications by authors named "Ian Kirkwood"

Background And Objective: There is uncertainty regarding the clinical significance of Ga-PSMA-11 positron emission tomography (PET) computed tomography (CT) findings in men with prostate cancer. In this prespecified objective of the proPSMA study, we report the prognostic value of PET-defined nodal involvement.

Methods: Men with intermediate- to high-risk prostate cancer (grade group 3-5, prostate-specific antigen [PSA] ≥20 ng/ml, or clinical stage ≥T3) underwent Ga-PSMA-11 PET-CT or CT and bone scanning as first- or second-line imaging.

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Article Synopsis
  • Lutetium-177 [Lu]Lu-PSMA-617 is being studied for its effectiveness in improving survival and quality of life for patients with metastatic castration-resistant prostate cancer, but its benefits for hormone-sensitive prostate cancer are still unclear.
  • The UpFrontPSMA trial involved patients with high-volume metastatic hormone-sensitive prostate cancer, who were randomly assigned to receive either [Lu]Lu-PSMA-617 followed by docetaxel or docetaxel alone as standard care.
  • The primary goal of the trial was to determine if patients treated with [Lu]Lu-PSMA-617 could achieve undetectable levels of prostate-specific antigen (PSA) after 48 weeks.
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Background: Enzalutamide and lutetium-177 [Lu]Lu-prostate-specific membrane antigen (PSMA)-617 both improve overall survival in patients with metastatic castration-resistant prostate cancer. Androgen and PSMA receptors have a close intracellular relationship, with data suggesting complementary benefit if targeted concurrently. In this study, we assessed the activity and safety of enzalutamide plus adaptive-dosed [Lu]Lu-PSMA-617 versus enzalutamide alone as first-line treatment for metastatic castration-resistant prostate cancer.

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Background: The TheraP study reported improved prostate-specific antigen responses with lutetium-177 [Lu]Lu-PSMA-617 versus cabazitaxel in men with metastatic castration-resistant prostate cancer progressing after docetaxel. In this Article, we report the secondary outcome of overall survival with mature follow-up, and an updated imaging biomarker analysis. We also report the outcomes of participants excluded due to ineligibility on gallium-68 [Ga]Ga-PSMA-11 and 2-[F]fluoro-2-deoxy-D-glucose (2-[F]FDG) PET-CT.

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Purpose: The O-(2-[F]-fluoroethyl)-L-tyrosine (FET) PET in Glioblastoma (FIG) trial is an Australian prospective, multi-centre study evaluating FET PET for glioblastoma patient management. FET PET imaging timepoints are pre-chemoradiotherapy (FET1), 1-month post-chemoradiotherapy (FET2), and at suspected progression (FET3). Before participant recruitment, site nuclear medicine physicians (NMPs) underwent credentialing of FET PET delineation and image interpretation.

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Background: Lutetium-177 [Lu]Lu-PSMA-617 is a radiolabelled small molecule that delivers β radiation to cells expressing prostate-specific membrane antigen (PSMA), with activity and safety in patients with metastatic castration-resistant prostate cancer. We aimed to compare [Lu]Lu-PSMA-617 with cabazitaxel in patients with metastatic castration-resistant prostate cancer.

Methods: We did this multicentre, unblinded, randomised phase 2 trial at 11 centres in Australia.

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Background: Conventional imaging using CT and bone scan has insufficient sensitivity when staging men with high-risk localised prostate cancer. We aimed to investigate whether novel imaging using prostate-specific membrane antigen (PSMA) PET-CT might improve accuracy and affect management.

Methods: In this multicentre, two-arm, randomised study, we recruited men with biopsy-proven prostate cancer and high-risk features at ten hospitals in Australia.

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Objective: Several different methods for measuring glomerular filtration rates (GFRs) have been developed in search of a more accurate and simplified technique. Currently, the main methods used are the slope-intercept and distribution volume techniques. In this work, 2922 GFR studies have been retrospectively reanalysed as two- and single-blood sample methods and compared with the three-blood sample data.

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In January 2017, an 11.5-year-old male child with autism was referred for radioiodine (RAI) therapy post total thyroidectomy for papillary thyroid carcinoma. The treatment required swallowing a RAI capsule and remaining isolated (48-72 h).

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Radioiodine (I) therapies on younger children with thyroid cancer and neuroblastoma can be challenging as they are required to be isolated for a period of time due to radiation safety concerns. At our hospital these therapies are performed in a purpose-built child-friendly therapy room. Nursing staff are able to provide personal care during the isolation period with minimum radiation exposure.

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Objective: Attempts are underway to standardize paediatric administered activities, but equally important is knowing the actual activities administered to patients. In this work, paediatric administered activities are reviewed to determine compliance with the institution-prescribed guidelines.

Patients And Methods: Paediatric administered activities for common studies at our institution, August 2011 to January 2017, have been analysed to determine their deviations from the set guideline tolerance of 10% from prescribed activities.

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Introduction: Preparation for postoperative radioiodine ablation for differentiated thyroid carcinoma is performed by either thyroid hormone withdrawal or recombinant human thyroid-stimulating hormone (rhTSH) administration. There is little information on the impact of the method of preparation with respect to whole-body effective I-131 half-life and its potential clinical implications in the Australian setting.

Methods: A retrospective study was performed on patients admitted for adjuvant radioiodine ablation for non-metastatic differentiated thyroid carcinoma at the Royal Adelaide Hospital over a 4½-year period from 2009.

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Purpose: Positron emission tomography (PET) was evaluated in low-grade non-Hodgkin lymphoma (NHL) to determine its impact on staging and management and to compare PET and gallium scans.

Methods: PET resulted in management plan changes in 74 patients with untreated low-grade NHL stages I to III. Patient outcomes to 12 months were documented.

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The aim of this study was to evaluate the use of the [14C]-sodium bicarbonate/urea technique to measure the change in total energy expenditure after weight loss and a period of weight maintenance. Eleven healthy subjects (6 men and 5 women aged 50 +/- 3 yrs, BMI 34.1 +/-2.

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The aim of this study was to evaluate the utility of the [(14)C]-sodium bicarbonate/urea technique to detect physical activity-induced increases in total energy expenditure in free-living healthy men. Thirteen healthy males aged 34.1 +/- 11.

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Objectives: This study was designed to explore the relationships of early diabetic microangiopathy to alterations of cardiac sympathetic tone and myocardial blood flow (MBF) regulation in subjects with stable type 1 diabetes.

Background: In diabetes, augmented cardiac sympathetic tone and abnormal MBF regulation may predispose to myocardial injury and enhanced cardiac risk.

Methods: Subject groups comprised healthy controls (C) (n = 10), healthy diabetic subjects (DC) (n = 12), and diabetic subjects with very early diabetic microangiopathy (DMA+) (n = 16).

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Background: [(18)F]-fluorodeoxyglucose positron emission tomography (FDG-PET) is reported to change the management in 20-56% of patients with recurrent or metastatic colorectal cancer. It is not clear if FDG-PET has a role in all such patients or only a subgroup. The aim of the present study was to assess the influence of FDG-PET on the surgical management of patients with known or suspected colorectal liver metastases.

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A patient is described with non-Hodgkin lymphoma and erythematous skin nodules suspected to be erythema nodosum. The patient underwent serial fluorodeoxyglucose (FDG) positron emission tomography (PET), which demonstrated normalization of FDG uptake by the lymphoma after 2 cycles of chemotherapy, but there was new abnormal uptake involving the subcutaneous tissues of the lower extremities. A typical skin lesion was sampled and showed the appearance of erythema nodosum with no evidence of lymphoma.

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Unlabelled: An animal model of gastric emptying may have use in the study of gastric physiology and pharmacoscintigraphy. The pig has anatomy and physiology similar to that of humans. Our aim was to develop a model of gastric emptying in the pig.

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