Nano-tracers for sentinel lymph node detection: current trends in technique and application.

Sentinel lymph node (SLN) detection and biopsy is a critical staging component for several cancers. Apart from established methods using dyes or radiolabeled colloids, newer techniques are emerging, like near-infrared fluorescent compounds, targeted molecular radiopharmaceuticals and magnetic nano-tracers. In the overview section of this review, we categorize SLN detection tracers based on their principle of use.

Re-N-DEDC Lipiodol for Treatment of Hepatocellular Carcinoma (HCC)-A Clinical and Prospective Study to Assess In-Vivo Distribution in Patients and Clinical Feasibility of Therapy.

 The incidence of inoperable hepatocellular carcinoma (HCC) with/without malignant portal vein thrombosis (PVT) is increasing in India for the last decade; thus, Bhabha Atomic Research Centre (BARC), Mumbai, India, developed diethydithiocarbamate (DEDC), a new transarterial radionuclide therapy (TART) agent. Re-N-DEDC lipiodol is an emerging radiotherapeutic agent for inoperable HCC treatment due to its simple and onsite labeling procedure, cost-effectiveness, and least radiation-induced side effects. This study aimed to evaluate in-vivo biodistribution and clinical feasibility of Re-N-DEDC lipiodol TART in HCC and optimization of labeling procedure to assess post-labeling stability and radiochemical yield of labeled lipiodol with Re-N-DEDC complex.

The impact of pain on function after spinal cord injury.

Aim: Pain is a common complication of spinal cord injuries (SCI). Our objective was to quantify those who had pain on discharge from rehabilitation, and the level of interference it had on their functionality.

Method: This study used data collected prospectively from 2018 to 2019 via the New Zealand Spinal Cord Injury Registry (NZSCIR).

Preparation of radiolabeled erlotinib analogues and analysis of the effect of linkers.

Erlotinib is a first generation epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) which was granted Food and Drug administration (FDA) approval for treatment of patients with locally advanced or metastatic NSCLC. The present study aimed at development of radiolabeled erlotinib variants as tyrosine kinase inhibitors. Three DOTA-erlotinib conjugates were prepared for radiolabeling with Lu.

A case of double positive myeloproliferative neoplasm: A diagnostic and therapeutic challenge.

Chronic Myeloid Leukemia, BCR-ABL1 positive (CML) is distinct from other myeloproliferative neoplasms (MPNs) as it is positive for the Philadelphia chromosome (Ph) with presence of BCR-ABL1 translocation that makes it responsive to targeted therapy with tyrosine kinase inhibitors (TKI). Distinctly there is another group of Ph-negative myeloproliferative neoplasms as polycythemia vera (PV), primary myelofibrosis (PMF), essential thrombocythemia (ET) and others that harbor an activating mutation in the Janus Kinase 2 gene (JAK2), i.e.

Preparation of Rhenium-188-Lipiodol Using Freeze-Dried Kits for Transarterial Radioembolization: An Overview and Experience in a Hospital Radiopharmacy.

Rhenium-188(Re)-lipiodol is a clinically effective, economically viable radiopharmaceutical for Selective Internal Radiation Therapy of liver cancer. Present study evaluates the performance of three freeze-dried kits with respect to the radiochemistry, quality control, and overall "ease of preparation" aspects in a hospital radiopharmacy. Freeze-dried kits of acetylated 4-hexadecyl-4,7-diaza-1,10-decanedithiol (AHDD), super six sulfur (SSS), and diethyl dithiocarbamate (DEDC), obtained commercially or received as gift, were used for the preparation of Re-lipiodol using freshly eluted Re-sodium perrhenate from commercial Tungsten-188/Re generator following recommended procedures.

Clinical Management of Liver Cancer in India and Other Developing Nations: A Focus on Radiation Based Strategies.

Hepatocellular carcinoma (HCC) is a global killer with preponderance in Asian and African countries. It poses a challenge for successful management in less affluent or developing nations like India, with large populations and limited infrastructures. This review aims to assess the available options and future directions for management of HCC applicable to such countries.

Combination radionuclide therapy: A new paradigm.

Targeted molecular radionuclide therapy (MRT) has shown its potential for the treatment of cancers of multiple origins. A combination therapy strategy employing two or more distinct therapeutic approaches in cancer management is aimed at circumventing tumor resistance by simultaneously targeting compensatory signaling pathways or bypassing survival selection mutations acquired in response to individual monotherapies. Combination radionuclide therapy (CRT) is a newer application of the concept, utilizing a combination of radiolabeled molecular targeting agents with chemotherapy and beam radiation therapy for enhanced therapeutic index.

Analyzing Medical Guideline Dissemination Behaviors Using Culturally Infused Agent Based Modeling Framework.

Clinical practice guidelines are a critical medium for the standardization of practices within the overall medical community. However, several studies have shown that, in general, there is a significant delay in the adoption of recommendations in such guidelines. Surveys have identified multiple barriers, including clinical inertia, organizational culture/incentives, access to information and peer influence on guideline dissemination and adoption.

Architectured Therapeutic and Diagnostic Nanoplatforms for Combating SARS-CoV-2: Role of Inorganic, Organic, and Radioactive Materials.

Although extensive research is being done to combat SARS-CoV-2, we are yet far away from a robust conclusion or strategy. With an increased amount of vaccine research, nanotechnology has found its way into vaccine technology. Researchers have explored the use of various nanostructures for delivering the vaccines for enhanced efficacy.

Multifunctional Core-Shell Glyconanoparticles for Galectin-3-Targeted, Trigger-Responsive Combination Chemotherapy.

Galectin-3 (gal-3) plays a crucial role in various cellular events associated to tumor metastasis and progression. In this direction, gal-3 binding core-shell glyconanoparticles based on citrus pectin (CP) have been designed for targeted, trigger-responsive combination drug delivery. Depolymerization via periodate oxidation in heterogeneous medium yielded low-molecular weight dialdehyde oligomers (CPDA) of CP with a gal-3 binding property ( = 160.

Synthesis and Preliminary Biological Evaluation of Lu-Labeled Polyhydroxamic Acid Microparticles Toward Therapy of Hepatocellular Carcinoma.

Transarterial radioembolization (TARE) represents an effective targeted therapeutic option for hepatocellular carcinoma (HCC), a cancer with high mortality and poor prognosis. The aim of this study was the preparation and preliminary biological evaluation of Lu-labeled polyhydroxamic acid (PHA) microparticles toward possible use in the therapy of HCC. PHA microparticles were synthesized starting from polyacrylamide.

Association of Clinical, Imaging, and Thrombus Characteristics With Recanalization of Visible Intracranial Occlusion in Patients With Acute Ischemic Stroke.

Importance: Recanalization of intracranial thrombus is associated with improved clinical outcome in patients with acute ischemic stroke. The association of intravenous alteplase treatment and thrombus characteristics with recanalization over time is important for stroke triage and future trial design.

Objective: To examine recanalization over time across a range of intracranial thrombus occlusion sites and clinical and imaging characteristics in patients with ischemic stroke treated with intravenous alteplase or not treated with alteplase.

Preparation and preliminary in vivo evaluation of Ho-labeled microspheres for possible use in radioembolic therapy of liver cancer.

Hepatocellular carcinoma (HCC) or liver cancer is an increasingly prevalent and highly morbid disease with critical significance in the Asian and African subcontinents. Among the various therapies currently used in the clinic to combat the global menace of HCC, radioembolization with suitable therapeutic isotopes is an effective targeted approach. In the Indian context, the significant cost and logistical disadvantage of imported radioembolic formulations for HCC therapy make it essential to develop more feasible indigenous alternatives-using locally available radioisotopes and microspheric carriers-that can serve the nuclear medicine community.

Radiosynthesis and evaluation of a Tc-folic acid radiotracer prepared using [TcN(PNP)] metal fragment.

Folate receptors (FR) are over-expressed on a wide variety of tumor cells and are a potential molecular target for radiolabeled folates. In this respect, several SPECT and PET based radiofolates have been evaluated in the past albeit with their high renal uptake posing limitation towards their clinical use. To overcome this, a new Tc labeled folic acid was synthesized via the use of [TcN(PNP)] metal fragment, where the presence of the latter pharmacophore redirects in vivo clearance via the hepatobiliary pathway.

Development of Semiautomated Module for Preparation of I Labeled Lipiodol for Liver Cancer Therapy.

Intra-arterial injection of I Lipiodol is an effective treatment option for primary hepatocellular carcinoma as it delivers high radiation dose to liver tumor tissue with minimal accumulation in adjacent normal tissue. The present article demonstrates design, fabrication, and utilization of a semiautomated radiosynthesis module for preparation of I labeled Lipiodol. The radiolabeling method was standardized for preparation of patient dose of I labeled Lipiodol radiochemical yield (RCY); radiochemical purity (RCP) and pharmaceutical purity of the product were determined using optimized procedures.

Preliminary evaluation of the potential of 99mTc carbonyl-DTPA-Rituximab as a tracer for sentinel lymph node detection.

Preliminary work with (99m)Tc carbonyl-DTPA-Rituximab was attempted to test its feasibility as a sentinel lymph node (SLN) tracer for patients with breast cancer. (99m)Tc labeling of DTPA-Rituximab conjugate was carried out via (99m)Tc carbonyl synthon which exhibited >95% radiochemical purity and good in vitro stability. In vitro studies of (99m)Tc carbonyl-DTPA-Rituximab in normal and malignant B cells showed higher binding in malignant cells.

An indigenous single-vial kit formulation of human serum albumin nanocolloid for use in sentinel lymph node detection.

Objective: In-situ sentinel lymph node (SLN) detection is an important component in staging cancers of various origins. At present, technetium-99m (Tc)-labeled nanoparticle formulations like sulfur colloid and human serum albumin (HSA) nanocolloid are used in the clinic as SLN tracers. In India, HSA nanocolloid cold kits have so far been imported.

A study on nitroimidazole-99mTc(CO)3 complexes as hypoxia marker: some observations towards possible improvement in in vivo efficacy.

Introduction: Hypoxia plays a negative role in the clinical management of cancer. Detection of hypoxic status of a cancer is important for selecting patients for hypoxia directed therapy. Though [(18)F]fluoromisonidazole ([(18)F]FMISO), a PET radiopharmaceutical, is presently being used in the clinic for the detection of hypoxia, considering the logistical advantages of (99m)Tc and wider availability of SPECT scanners, a radiopharmaceutical based on this isotope may find wider applicability.

Modification of PLGA nanoparticles for improved properties as a 99mTc-labeled agent in sentinel lymph node detection.

We have earlier reported on the possible application of poly [lactide (co-glycolide)] (PLGA) nanoparticles of suitable size to serve as a (99m)Tc-labeled diagnostic tracer in sentinel lymph node detection (SLND). Additional efforts have now been made to improve both the radiolabeling yield and the biological efficacy by modifying the PLGA particles. Two approaches were taken, one based on in situ loading of mebrofenin inside PLGA nanoparticles and the second one based on functionalization of existing terminal carboxylic acid groups on the nanoparticle surface with p-aminobenzyl diethylenetriamine pentaacetic acid (p-NH2-Bz-DTPA) for enhanced availability of functional groups suitable for (99m)Tc complexation.

Studies toward the biological efficacy of (99m)Tc-labeled dextran-cysteine-mannose ([(99m)Tc(CO)(3)]DCM20) for sentinel lymph node detection.

Abstract The aim of this work was to determine the potential of (99m)Tc carbonyl-labeled dextran-cysteine-mannose (DCM20) as a mannose receptor targeting agent for sentinel lymph node (SLN) detection using biological in vitro and in vivo assays. (99m)Tc labeling of the previously reported DCM20 ligand was carried out via the [(99m)Tc(H(2)O)(3)(CO)(3)](+) synthon. High-performance liquid chromatography (HPLC) showed >99% radiolabeling yield using 50 μg of the ligand.