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3rd International Congress of Nuclear Medicine & 15th Iranian Annual<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti University of Medical Sciences 19-21 May 2011


3rd International Congress of Nuclear Medicine & 15th Iranian Annual<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti University of Medical Sciences 19-21 May 2011


3rd International Congress of Nuclear Medicine & 15th Iranian Annual<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti University of Medical Sciences 19-21 May 2011<br />

3rd International Congress of<br />

Nuclear Medicine<br />

&<br />

15th Iranian Annual Meeting of<br />

Nuclear Medicine<br />

Shahid Beheshti University of Medical<br />

Sciences<br />

19-21 May<br />

2011


3rd International Congress of Nuclear Medicine & 15th Iranian Annual<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti University of Medical Sciences 19-21 May 2011


3rd International Congress of Nuclear Medicine & 15th Iranian Annual<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti University of Medical Sciences 19-21 May 2011<br />

Content<br />

Congress Overview and Executive Secretary’s Message....7<br />

Welcome Message of Congress President........................9<br />

Welcome Message of President of Iranian Society of<br />

Nuclear Medicine........................................................10<br />

Message of Scientific Secretary....................................11<br />

Welcome Message of Scientific Secretary of Seminar of<br />

Nuclear Medicine Technology.......................................13<br />

Outline Scientific Program...........................................14<br />

Committees..............................................................17<br />

Awards.....................................................................20<br />

Continuing Medical Education, panels & Workshops........21<br />

CME Lectures............................................................34<br />

Oral Presentations.....................................................48<br />

Poster Presentations.................................................119<br />

Index.....................................................................193


3rd International Congress of Nuclear Medicine & 15th Iranian Annual<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti University of Medical Sciences 19-21 May 2011


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Congress Overview and Executive Secretary’s<br />

Message<br />

It is of a great honor that only after 6 months since the<br />

last congress of nuclear medicine which was held in<br />

Mashhad, we are to be host of the 3rd International<br />

Congress of Nuclear Medicine and the 15th Iranian<br />

Annual Meeting of Nuclear Medicine in Shahid Beheshti<br />

University of Medical Sciences. The scientific committee<br />

has organized the most worthy and useful plans for this<br />

event, which includes the major of the main and<br />

practical topics of this field. It is hoped that it become<br />

satisfactory and pleasant for you, dearest participants.<br />

In the 3rd International Congress of Nuclear Medicine<br />

and the 15th Iranian Annual Meeting of Nuclear<br />

Medicine some efforts has been done to put the<br />

practical subjects in the form of general CMEs and<br />

<strong>Panel</strong>s with the participation of local and foreign<br />

prominent professors and researchers with different<br />

expertise, that can be included to the conference to<br />

foster scientific richness and to consolidate the<br />

scientific communication of the various medical<br />

specialty groups. Also in the scientific plan of the<br />

congress several workshops will be run.<br />

In the other hand, to be more familiar with the<br />

application of related Basic Sciences,<br />

radiopharmaceutical meeting among all the other<br />

meetings such as imaging equipments and radiation<br />

protection and radiobiology while separated, will take<br />

place at the same time.<br />

Also independent retraining courses for the experts and<br />

employed technicians in nuclear medicine centers as “<br />

two-day seminar of nuclear medicine technology” is<br />

provided at the same time of the congress.<br />

It is to say that all the programs and plans of this<br />

congress were confirmed by EANM (European<br />

Association of Nuclear Medicine) and this Forum has<br />

even dedicated its logo to the secretariat.<br />

7


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Congress Iranian Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University of University Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Due to this important fact that the success of each<br />

congress depends on its articles and research<br />

achievements ,all dear colleagues including members of<br />

the board ,researchers, experts , assistants and<br />

students are invited to provide their valuable articles to<br />

this congress and make this an effective step in<br />

flourishing the medical knowledge and promoting the<br />

health of our beloved homeland. Your active presence<br />

and participation will be our pride and joy.<br />

We welcome you in the 15 th Congress of Nuclear<br />

Medicine to be held in Shahid Beheshti University of<br />

Medical Sciences.<br />

Mojtaba Ansari, M.D.<br />

Executive Secretary<br />

8


3rd International Congress of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid University Beheshti University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Welcome Message of Congress President<br />

Nuclear Medicine Department of Shahid Beheshti<br />

University of Medical Sciences is honored to host the<br />

"3 rd International Nuclear Medicine Congress<br />

accompanied with 15 th Annual Meeting of Iranian<br />

Society of Nuclear Meeting" on 19 th -21 st may 2011.<br />

I give my best praise to all nuclear physicians,<br />

physicists, radiopharmacists, technologists and other<br />

scientist colleagues in this international meeting.<br />

This meeting is under cooperation AEOI, Tehran<br />

municipality, NMRC, AOFNMB, EANM and Shahid<br />

Beheshti University of Medical Sciences.<br />

In this congress we will be informed and will discuss<br />

about any new development in all fields of nuclear<br />

medicine and technology.<br />

We are honored to provide a friendly scientific<br />

environment for sharing the research findings and<br />

nuclear medicine progressions with others.<br />

I attract you for your scientific contribution and<br />

abstracts in this international meeting.<br />

Isa Neshandar Asli, M.D.<br />

Congress President<br />

9


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Welcome Message of President of Iranian Society<br />

of Nuclear Medicine<br />

In God we Trust<br />

Endless praise and thanks to God for providing us the<br />

success of holding the 15 th annual conference of<br />

nuclear medicine .Fortunately ,after three decades of<br />

revolution , despite the problems and many ups and<br />

downs , nuclear medicine in the country has enjoyed<br />

significant growth. The result is one hundred people<br />

trained professionals and established the same number<br />

of nuclear medicine centers and teaching hundreds of<br />

students in grade Associate, Bachelor, Master and PhD<br />

degrees and other medical assistance, a parallel service<br />

to millions of our compatriots and outstanding research<br />

work that has been symbolized in the Iranian Journal of<br />

nuclear medicine which quarterly is published in<br />

English.<br />

From other successes ranked first in the 10 th World<br />

Congress of Nuclear Medicine in the Year 2010 in the<br />

number of articles and being selected as the Host of the<br />

10 th Asia Oceania Congress of Nuclear Medicine and<br />

Biology in 2012. The arrangements of holding such<br />

congress have been provided and we expect that our<br />

venerable colleagues cooperate and assist us in this<br />

event.<br />

At the end I wanted to thank Dr. Amouei the scientific<br />

secretary and Dr. Mojtaba Ansari the executive<br />

secretary for their unsparing efforts in holding this<br />

conference magnificently.<br />

Mohsen Saghari, M.D.<br />

President of Iranian Society of Nuclear Medicine<br />

10


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Message of Scientific Secretary<br />

In the name of GOD<br />

It is my great pleasure and honor to inform that the 3 rd<br />

International congress of nuclear medicine and 15th<br />

Annual meeting of nuclear meeting will be held under<br />

auspices of EANM and AOFNM in 29-31 th of Ordibehesht<br />

1390 (19-21 th of May 2011) in Shahid Beheshti<br />

University of Medical Sciences.<br />

In addition to multiple CMEs and research articles, 8<br />

panel discussions, 8 workshops and one seminar are<br />

proposed for ICNM program in assistance with 10<br />

invited lecturers and local experts. It would be<br />

appreciated Dr. Zakavi and his colleagues in Mashad<br />

Nuclear Medicine Research Center for great efforts in<br />

programming and executing the congress.<br />

Basic science section will be held accompanied with<br />

clinical nuclear medicine section as a new policy in<br />

assistance with Drs. Shahhossani, Dr. Jalilian, Dr.<br />

Monfared, Dr. Ay, and Dr. Tabaei and experts in<br />

radiopharmacy, instrumentation/software and radiation<br />

protection/radiobiology.<br />

Two-day precongress course of PET/CT is conducted in<br />

25-26 th Ordibehesht (15-16 th of May) by Dr. Bijan<br />

(USA) in executive support of Dr. Baharfar, Dr.<br />

Pirayesh and Dr. Shafiei. It includes cross-sectional CT<br />

and clinical applications of PET/CT.<br />

Two-day seminar of nuclear medicine technology will be<br />

held under auspices of ICNM for radiation workers in<br />

nuclear medicine departments. I thank Dr. Amiri as<br />

scientific secretary and Dr. Raziei as executive<br />

secretary of the seminar.<br />

You will find some interesting and helpful information<br />

about nuclear medicine in Iran in the Congress<br />

newspaper, published for the first time by help of my<br />

young colleagues in support of Mrs. Rezaian.<br />

11


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

We are waiting for effective presence of our colleagues<br />

to update knowledge, share invaluable experiences and<br />

improve our speciality.<br />

Mahasti Amoui, M.D.<br />

Scientific Secretary<br />

12


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Welcome Message of Scientific Secretary of<br />

“Seminar of Nuclear Medicine Technology”<br />

Nuclear Medicine has developed and progressed very<br />

rapidly in recent years. Higher sensitivity for detecting<br />

normal as well as pathologic tissues, quantitative<br />

analysis of diagnostic data and lower doses of ionizing<br />

radiation has made it as one of the most important<br />

imaging modalities in the medicine. Improvement of<br />

image quality, fast imaging techniques and early<br />

detection of diseases are unique criteria of nuclear<br />

imaging. The higher the technology, the more need to<br />

update the knowledge and skills. Fortunately, nuclear<br />

medicine technology has established as an academic<br />

course in some universities in Iran in recent years.<br />

Providing a two days seminar for nuclear medicine<br />

technology parallel with international congress of<br />

nuclear medicine is an excellent opportunity to<br />

promotion of knowledge and practice of nuclear<br />

medicine technologist. I hope our technologist<br />

colleagues find the seminar helpful and fruitful.<br />

M. Amiri, M.D.<br />

Seminar Scientific Secretary<br />

13


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Iranian Medicine Annual & 15th Congress Iranian Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid University Beheshti of University Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Thursday, May 19, 2011<br />

Outline Scientific Program<br />

Hall SA’DI Hall 4 Hall 1<br />

8:00<br />

Opening Ceremony<br />

9:00<br />

10:00<br />

CME 1<br />

Molecular Imaging & Nuclear Oncology<br />

break<br />

11:00<br />

<strong>Panel</strong> 1<br />

Management of Breast<br />

Cancer<br />

12:00<br />

CME 2<br />

Sentinel Lymph Node<br />

Biopsy<br />

CME 4<br />

Radiopharmacy<br />

Development 1<br />

13:00<br />

14:00 Oral<br />

Presentation<br />

Molecular Imaging &<br />

Nuclear Oncology<br />

15:00<br />

16:00<br />

17:00<br />

CME 3<br />

Nuclear Genitourinary<br />

<strong>Panel</strong> 2<br />

Hydronephrosis<br />

Pray & Lunch<br />

CME 5<br />

Instrumentation &<br />

Imaging 1<br />

Oral<br />

Presentation<br />

Workshop 1<br />

SNLB in Breast Cancer<br />

Seminar<br />

Clinical applications of<br />

PET in today oncologic<br />

practice<br />

CME 6<br />

Radiation Protection &<br />

Radiobiology 1<br />

Workshop 2<br />

Quantitative Renal<br />

Scan<br />

14


3rd International Congress of of Nuclear Medicine & 15th & 15th Iranian Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences 19-21 May 2011<br />

Friday, May 20, 2011<br />

Outline Scientific Program<br />

Hall SA’DI Hall 4 Hall 1 Hall 5<br />

8:00<br />

9:00<br />

10:00<br />

CME 7<br />

Nuclear<br />

Endocrinology<br />

<strong>Panel</strong> 3<br />

Management of<br />

DTC<br />

CME 9<br />

Instrumentation &<br />

Imaging 2<br />

Oral<br />

Presentation<br />

break<br />

Opening<br />

Ceremony<br />

Lectures<br />

11:00 Oral<br />

Presentation<br />

Nuclear<br />

Endocrinology<br />

12:00<br />

CME 8<br />

Nuclear Cardiology<br />

13:00<br />

CME 10<br />

Radiation<br />

Protection &<br />

Radiobiology 2<br />

Oral<br />

Presentation<br />

Lunch & Pray<br />

Workshop4<br />

Bone<br />

Densitometry<br />

Workshop5<br />

QC of Gamma<br />

Camera<br />

14:00<br />

15:00<br />

<strong>Panel</strong> 4<br />

Radiation Protection in Nuclear Medicine<br />

16:00<br />

CME 8<br />

Nuclear Cardiology<br />

<strong>Panel</strong> 5<br />

Coronary Artery<br />

Disease<br />

Oral<br />

Presentation<br />

CME 11<br />

Radiopharmacy<br />

Development 2<br />

Lectures<br />

17:00 Oral<br />

Presentation<br />

Nuclear Cardiology<br />

Oral<br />

Presentation<br />

Workshop3<br />

Gated SPECT<br />

15


3rd International Congress 3rd International of Nuclear Congress Medicine of & Nuclear 15th Iranian Medicine Annual & 15th Congress Iranian Annual of<br />

Nuclear Congress Medicineof Nuclear Medicine<br />

Shahid Beheshti Shahid University Beheshti of Medical University Sciences of Medical 19-21 May Sciences 2011 19-21 May 2011<br />

Saturday, May 21, 2011<br />

Outline Scientific Program<br />

Hall SA’DI Hall 4 Hall 1 Hall 5<br />

8:00<br />

9:00<br />

10:00<br />

Nuclear<br />

Medicine in<br />

Practice<br />

Forensic & Ethics<br />

CME 12<br />

Nuclear Neurology<br />

<strong>Panel</strong> 7<br />

Radiation Protection<br />

CME 13<br />

Disimetry & Radiation<br />

Protection<br />

Oral<br />

Presentation<br />

break<br />

Workshop7<br />

QC of<br />

Raiopharmaceuticals<br />

Lectures<br />

11:00<br />

12:00<br />

CME 12<br />

Nuclear Neurology<br />

<strong>Panel</strong> 6<br />

Nuclear Neurology<br />

<strong>Panel</strong> 8<br />

Radiopharmacy in<br />

Iran<br />

CME 14<br />

Radiopharmaceuticals<br />

& Radioprotection<br />

Lectures<br />

Workshop8<br />

Dosimeters /<br />

Decontamination<br />

13:00<br />

Lunch & Pray<br />

14:00<br />

15:00<br />

16:00<br />

Oral<br />

Presentation<br />

Nuclear Neurology<br />

Oral<br />

Presentation<br />

Miscellaneous<br />

CME 15<br />

Physics/Cyclotron<br />

Oral<br />

Presentation<br />

Workshop6<br />

Brain Scan<br />

Interpretation<br />

Lectures<br />

17:00<br />

Awards & Ending Ceremony<br />

16


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Committees<br />

Planning Committee<br />

I. Neshandar (President)<br />

M. Amiri<br />

M. Amoui<br />

M. Ansari<br />

M.R. Ay<br />

A.R. Jalilian<br />

Gh. Razi’ei<br />

A. Shabestani Monfared<br />

S. Shah’hosseini<br />

R. Zakavi<br />

Executive Committee<br />

Chair:<br />

M. Ansari<br />

Members:<br />

M. Akbari<br />

M. Amoui<br />

A. Ansari<br />

N. Baharfar<br />

M.B. Ghalibaf<br />

A. Hooman<br />

M. S. Malekzadeh<br />

E. Pirayesh<br />

Gh. Razi’ei<br />

S. Shah’hoseini<br />

B. Shaf’iei<br />

F. Tabe’ie<br />

A.R. Zakani<br />

M. Bagherzadeh<br />

S. Sedaghat<br />

Executive Managers<br />

N. Baharfar<br />

E. Pirayesh<br />

17


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Scientific Committee<br />

Chair:<br />

M. Amoui<br />

Members:<br />

F. Abbasi<br />

K. Abbasi<br />

A.H. Abedi’yekta<br />

M. Agha’miri<br />

M.E. Akbari<br />

Sh. Akhlaghpoor<br />

F. Akhzari<br />

A. Alavi<br />

M. Alavi<br />

M. Amiri<br />

A. Amirpoor<br />

M. Ansari<br />

A. Arjmand Shabestari<br />

K. Aryana<br />

M. Assadi<br />

M.R. Ay<br />

P. Azadeh<br />

H. Azarnik<br />

F. Azizi<br />

M.H. Baba’ee<br />

G. Bakhshanehpour<br />

M. Beheshti<br />

D. Beyki<br />

B. Bijan<br />

E. Bombardieri<br />

V.R. Dabbagh Kakhki<br />

Sh. Dabiri<br />

S. Dadparvar<br />

Y. Davari<br />

B. Davarpanah<br />

S. Derakhshan<br />

M. Eftekhari<br />

M. Erfani<br />

D. Fahimi<br />

J. Farahati<br />

B. Fallahi<br />

A. Fard<br />

M. Farsad<br />

H. Firrozabadi<br />

F. Fotouhi<br />

M. Ghannadi Maragheh<br />

H. Ghadiri<br />

Ch. Giannopoulou<br />

R. Hashemi<br />

S. Hekmat<br />

A. Hooman<br />

S.J Hosseini<br />

R. Hosseini<br />

J. Hosseinimehr<br />

H. Jadvar<br />

M. Jalili<br />

A.R. Jalilian<br />

H.R. Javadi<br />

M.R. Kardan<br />

D. Kamal’hedayat<br />

M. Khosh’niyat<br />

H. Khosravi<br />

V. Langesteger<br />

M. Lesan’pezeshki<br />

B. Mahmoodian<br />

H. Malek<br />

H. Mandegar<br />

B. Mansouri<br />

H.R. Mirza’ee<br />

K.P. Mishra<br />

M.M. Modarresi<br />

M. Momen’nejhad<br />

A. Moosavizadeh<br />

18


3rd International Congress of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid University Beheshti University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

M. Movahed<br />

H. Mozdarani<br />

M. Mozzafar<br />

R. Najafi<br />

A.R. Nasrollahi<br />

I. Neshandar Asli<br />

M. Noroozian<br />

M.A. Oghabian<br />

H.R. Pouraliakbar<br />

A. Rahmim<br />

H. Rajabi<br />

A. Rakhsha<br />

B. Rashidi<br />

M. Raygani<br />

M.R. Razzaghi<br />

S. Saber<br />

R. Sadeghi<br />

M. Safavi<br />

M. Saghari<br />

N. Salehi<br />

Sh. Samangou’ee<br />

F. Sami’ee<br />

H.R. San’ti<br />

F. Sarvghadi<br />

F. Sedaghat<br />

Sh. Seifollahi<br />

Gh.A. Shabani<br />

A. Monfared<br />

B. Shafi’ei<br />

S. Shah’hosseini<br />

N. Simforoosh<br />

B. Singh<br />

K. Soltani<br />

P.S. Soni<br />

H. Tabataba’ee<br />

F. Tabe’ie<br />

M. Taghavi<br />

A. Takavar<br />

A. Vakili<br />

N. Yaghoobi<br />

S.R. Zakavi<br />

Technologist Programme Committee<br />

Chair:<br />

M. Amiri<br />

Members:<br />

M.R. Ay<br />

V.R. Dabbagh<br />

S. Derakhshan<br />

H. Ghadiri<br />

A.R. Gholami<br />

M. Jalili<br />

A.R. Jalilian<br />

M. Khorrami<br />

H. Khosravi<br />

M. Momen’nejhad<br />

H. Mozdarani<br />

R. Sadeghi<br />

A. Monfared<br />

B. Shafi’ei<br />

F. Tabe’ie<br />

R. Zakavi<br />

19


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Awards<br />

As in the past years, Dr. Shahram Dabiri is offering<br />

awards to authors of good quality abstracts accepted<br />

for presentation at the congress. The purpose of these<br />

awards is to encourage nuclear medicine investigators<br />

and to highlight scientific excellence.<br />

Six selected papers submitted to the congress are<br />

bestowed with valuable prize money:<br />

<br />

<br />

<br />

<br />

<br />

<br />

Best Presented Paper by Young Resercher<br />

Best Clinical Nuclear Medicine Paper<br />

Best Scientific Paper in Radiation Protection and<br />

Radiobiology<br />

Best Scientific paper in Instrumentation and<br />

Software<br />

Best Scientific paper in Radiopharmacy<br />

Best Presented Poster<br />

In addition, 3 invaluable prizes will be awarded to the<br />

best accepted papers in Seminar of Nuclear<br />

Medicine Technology by the seminar scientific<br />

secretary to promote the exchange and expansion of<br />

knowledge among technicians who have demonstrated<br />

an interest and involvement in research experience in<br />

nuclear medicine and related fields.<br />

20


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Continuing Medical Education, <strong>Panel</strong>s &<br />

Workshops<br />

Continuing medical education sessions as well as<br />

multiple panels and workshops will span all 3 days of<br />

the Congress of Nuclear Medicine and dive attention on<br />

the newest practical developments. In order to provide<br />

the CME program with a thematic focus and clinical<br />

input while maintaining a board spectrum of education,<br />

there will be multiple categorized CME sessions in<br />

Diagnostic, Therapy, Radiopharmacy Development,<br />

Physics, Instrumentation, and Radiation Protection<br />

topics.<br />

CME 1: Molecular Imaging & Nuclear Oncology<br />

The Achievement and Future of Molecular<br />

Iimaging in Oncology, E. Bombardieri (Italy)<br />

Era of Hybrid Imaging, B. Bijan (USA)<br />

Quantitative PET Imaging, A. Rahmim (USA)<br />

Non-FDG PET Tracers, M. Farsad (Italy)<br />

Thursday, May 19, 2011, 9:00-10:30, Hall Sa’di & 4<br />

CME 2: Sentinel Lymph Node Biopsy<br />

Accuracy of SLNB in Breast Cancer after<br />

Incisional Biopsy, R. Sadeghi (Iran)<br />

SLNB in Cervical Cancer, E. Bombardieri<br />

(Italy)<br />

Review of SLNB in Prostate Cancer, R. Sadeghi<br />

(Iran)<br />

Thursday, May 19, 2011, 12:00-13:00, Hall Sa’di<br />

21


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

CME 3: Genitiurinary<br />

Renal Transplant Rejection, A. Nasrollahi<br />

(Iran)<br />

Renal Transplant Rejection and Nuclear<br />

Medicine, M. Movahed (Iran)<br />

Diagnosis & Management of UTI,<br />

N. Rahimzadeh (Iran)<br />

Patterns of Infection in Renal Scan,<br />

S. Hekmat (Iran)<br />

Thursday, May 19, 2011, 15:00-16:15, Hall Sa’di<br />

CME 4: Radiopharmacy Development 1<br />

Development of Non FDG PET Tracers in Iran,<br />

A.R. Jalilian (Iran)<br />

Production Problems Concerning Anti-CD20<br />

Radiopharmaceuticals, M.H. Babaei (Iran)<br />

Cancer Therapy by Alpha-emitters Labeled<br />

Peptides, F. Johari Daha (Iran)<br />

Radiopharmaceuticals for Bone Pain Palliation,<br />

D. Beiki (Iran)<br />

Peptide Based Radiopharmaceuticals for<br />

Diagnosis & Therapy, M. Erfani (Iran)<br />

Thursday, May 19, 2011, 11:00-13:00, Hall 4<br />

CME 5: Instrumentation & Imaging 1<br />

Recent Advances and Technological<br />

Innovations in Nuclear Medicine<br />

Instrumentations, P.S. Soni (India)<br />

State of the Art Image Reconstruction<br />

Algorithms in Emission Computed<br />

Tomography, A. Rahmim (USA)<br />

Preclinical Imaging & Imaging Technologies,<br />

M.R. Ay (Iran)<br />

Thursday, May 19, 2011, 14:00-15:30, Hall 4<br />

22


3rd International Congress of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid University Beheshti University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

CME 6: Radiation Protection & Radiobiology 1<br />

Approach to Protection Against Low Doses of<br />

Ionizing Radiation, K.P. Mishra (India)<br />

New Concepts in Radiation Biolog,<br />

H. Mozdarani (Iran)<br />

Low Dose Medical Exposure and Its Health<br />

Impacts, B. Singh (India)<br />

Thursday, May 19, 2011, 16:15-18:00, Hall 4<br />

CME 7: Endocrinology<br />

Neuroendocine Tumors, M. Malekzadeh (Iran)<br />

SPECT & PET in Neuroendocine Tumors,<br />

M. Farsad (Italy)<br />

Radionuclide Therapy in Neuroendocine<br />

Tumors, E. Bombardieri (Italy)<br />

Updates in Follow-up of Differentiated Thyroid<br />

Carcinoma, M. Eftekhari (Iran)<br />

Friday, May 20, 2011, 8:00-9:30, Hall Sa’di<br />

CME 8: Cardiology<br />

Where We Need to Study Viability,<br />

N. Salehi (Iran)<br />

Myocardial Viability and Case Selection for<br />

CABG, K. Abbasi (Iran)<br />

Nuclear Medicine in Myocardial Viability<br />

Assessment, Ch. Giannopoulou (Greece)<br />

Quantitative Myocardial Perfusion Scan &<br />

Prognosis of CAD, R. Zakavi (Iran)<br />

Friday, May 20, 2011, 12:00-13:00 & 15:30-16:00,<br />

Hall Sa’di<br />

23


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

CME 9: Instrumentation & Imaging 2<br />

PET/CT Instrumentation and QC,<br />

P.S. Soni (India)<br />

Direct 4D Parametric Imaging in PET,<br />

A. Rahmim (USA)<br />

Role of Physicist in NM/PET Departments,<br />

P.S. Soni (India) / A. Rahmim (USA)<br />

Friday, May 20, 2011, 8:00-9:40, Hall 4<br />

CME 10: Radiation Protection & Radiobiology 2<br />

Radio-Iodine Therapy (Discharge Criteria),<br />

F. Tabe’ie (Iran)<br />

Personnel Dosimetry in Nuclear Medicine,<br />

H. Moosavi (Iran)<br />

Radiophobia, Is Radiation All Bad?,<br />

A. Shabestani Monfared (Iran)<br />

Friday, May 20, 2011, 11:00-12:30, Hall 4<br />

CME 11: Radiopharmacy Development 2<br />

Is cyclotron produced 99m Tc a realistic<br />

alternative during 99 Mo shortage?<br />

D. Beiki (Iran)<br />

Radiopharmaceuticals for Synovectomy,<br />

A.R. Jalilian (Iran)<br />

Non Peptide Radiopharmaceuticals for Tumor<br />

Imaging, M.H. Babaei (Iran)<br />

Friday, May 20, 2011, 16:00-17:00, Hall 4<br />

24


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

CME 12: Neurology<br />

Dopamine Terminal Function in Central<br />

Movement Disorder, F. Sedaghat (Greece)<br />

Clinical Aspects of MCI & Dementia,<br />

M. Nouroozian (Iran)<br />

Applications of Emmision Tomography in<br />

Dementia, F. Sedaghat (Greece)<br />

Saturday, May 21, 2011, 10:00-10:30 &<br />

11:00-12:00, Hall Sa’di<br />

CME 13: Disimetry & Radiation Protection<br />

Dose Estimation and RP in Multi-modality<br />

Imaging, F. Bouzarjomehri (Iran)<br />

Internal Dosimetry, H. Rajabi (Iran)<br />

Radiation Protection in Special Cases,<br />

R. Mahdavi (Iran)<br />

Saturday, May 21, 2011, 9:00-10:00, Hall 4<br />

CME 14: Radiopharmaceuticals & Radioprotection<br />

Radiopharmaceuticals for Infection Diagnosis<br />

in Iran, M. Erfani (Iran)<br />

The Importance of Natural Products as<br />

Radioprotective Agents in Nuclear Medicine, J.<br />

Hosseinimehr (Iran)<br />

Saturday, May 21, 2011, 11:30-12:10, Hall 4<br />

CME 15: Physics/Cyclotron<br />

Medical Cyclotron: Physics & Instrumentation,<br />

M.R. Ay (Iran)<br />

Operational Aspects of Medical Cyclotron<br />

Facility, P.S. Soni (India)<br />

Saturday, May 21, 2011, 14:00-15:00, Hall 4<br />

25


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

<strong>Panel</strong> 1: Management of Breast cancer<br />

Thursday, May 19, 2011, 11:00-12:00, Hall Sa’di<br />

Moderator: R. Sadeghi (Iran)<br />

Members: E. Bombardieri<br />

M. Akbari<br />

F. Samiee<br />

F. Elahi<br />

A. Jangjoo<br />

B. Bijan<br />

M. Amoui<br />

Educational objectives:<br />

Interactive presentations of breast cancer patients<br />

referred to Nuclear Medicine Department for various<br />

reasons. The objectives of the panel are:<br />

To provide an overview of sentinel node biopsy<br />

applications in breast cancer patients with<br />

especial focus on the controversial issues in this<br />

regard.<br />

To provide an overview of radiotherapy and<br />

chemotherapy in breast cancer patients with<br />

special attention to nuclear physician<br />

involvement.<br />

To provide an overview of staging , follow-up<br />

and metastatic work-up in breast cancer patients<br />

To provide an overview of PET/CT applications in<br />

breast cancer patients.<br />

Summary:<br />

In this interactive panel, various aspects of<br />

conventional nuclear medicine applications in breast<br />

cancer patients are reviewed including bone<br />

scintigraphy, sentinel node biopsy, PET/CT, etc.<br />

Several controversial issues in sentinel node biopsy<br />

as well as radiotherapy and chemotherapy will be<br />

discussed.<br />

Key words: Breast cancer, Bone scintigraphy,<br />

Lymphoscintigraphy, Sentinel lymph node biopsy,<br />

PET/CT<br />

26


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

<strong>Panel</strong> 2: Hydronephrosis<br />

Thursday, May 19, 2011, 16:15-17:00, Hall Sa’di<br />

Moderator: S. Hekmat (Iran)<br />

Members: M. Bagheri<br />

R. Hosseini<br />

R. Maghsoodi<br />

H. Salimi<br />

B. Shafiei<br />

Educational objectives:<br />

General review on the neonatal hydronephrosis<br />

and medical management<br />

Adult hydronephrosis<br />

Surgical approach to neonatal hydronephrosis<br />

Radiologic imaging<br />

Indications and diagnostic value of nuclear<br />

medicine in hydronephrosis<br />

Summary:<br />

Hydronephrosis is a relatively common finding in<br />

the evaluation of patients, including those with<br />

symptoms related to the urinary tract, as an<br />

incidental finding during imaging of the abdomen<br />

and also in the routine prenatal sonographic studies<br />

Diagnosis of the underlying causes, medical<br />

treatment, defining the time and plan of surgical<br />

interventions, particularly during the neonatal<br />

period are considered vital issues.<br />

This session is directed toward a general review of<br />

the subject and the most recent diagnostic and<br />

therapeutic guidelines with more emphasis on the<br />

nuclear medicine values and beneficial findings.<br />

27


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

<strong>Panel</strong> 3: Management of Differentiated Thyroid<br />

carcinoma<br />

Friday, May 20, 2011, 9:30-10:30, Hall Sa’di<br />

Moderator: A. Fard (Iran)<br />

Members: A. Hedayati<br />

E. Bombardieri<br />

M. Farsad<br />

M.R. Mohajeri<br />

F. Sarvghadi<br />

M. Alavi<br />

B. Shafi’ei<br />

Educational objectives:<br />

Preoperative evaluation of DTC<br />

Surgical approaches and second surgery in DTC<br />

Management of hypocalcemia in DTC<br />

Value of Thyroglobulin in follow-up of DTC<br />

Value of exogenous TSH in follow-up of DTC<br />

<strong>Panel</strong> 4: Radiation Protection in Nuclear Medicine:<br />

Personnel Exposure, Medical Exposure,<br />

Low Dose Radiation<br />

Friday, May 20, 2011, 14:00-15:30, Hall Sa’di, 4 & 5<br />

Moderator: R. Zakavi (Iran)<br />

Members: M. Momen’nejhad<br />

A. Monfared<br />

K.P. Mishra<br />

M. Kardan<br />

H. Mozdarani<br />

A. Arjmand Shabestari<br />

Educational objectives:<br />

Radiation to patients from CT scan in<br />

multimodality imaging to patients<br />

Radiation to patients from nuclear medicine<br />

procedures and comparison with other risks<br />

Radiation to staff in nuclear medicine procedures<br />

Recommendations and ways to protect staff<br />

Low dose radiation; hazards vs benefits<br />

28


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

<strong>Panel</strong> 5: Coronary Artery Disease<br />

Friday, May 20, 2011, 16:00-17:00, Hall Sa’di<br />

Moderator: H. Malek (Iran)<br />

Members: Ch. Giannopoulou<br />

V.R. Dabbagh<br />

H.R. San’ati<br />

H.R. Pouraliakbar<br />

A. Arjmand Shabestari<br />

Educational objectives:<br />

Provide a brief review on the approach to a<br />

patient with chest pain.<br />

Provide an overview on the assessment of CAD,<br />

using radionuclide myocardial perfusion imaging,<br />

Coronary CT angiography and conventional<br />

angiography.<br />

Provide and overview on the risk assessment of<br />

hard cardiac events, using different diagnostic<br />

modalities.<br />

Provide and overview on the therapeutic<br />

strategies on the basis of the imaging techniques.<br />

Summery:<br />

This continuing education session is directed toward<br />

physicians, trainees and technologist interested in<br />

the practice of nuclear cardiology. It will cover<br />

state-of-the art protocols and technology of SPECT,<br />

Coronary CT Angiography, cardiac MR and<br />

conventional angiography in patients with ischemic<br />

heart disease (IHD). By providing an overview on<br />

relevant practical aspects of the different imaging<br />

modalities, this session will provide the audience<br />

the basis for approaching to patients with IHD and<br />

the application of different imaging modalities.<br />

Key Words: Myocardial Perfusion Imaging, SPECT,<br />

Coronary CT Angiography, Ischemic Heart Disease<br />

29


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

<strong>Panel</strong> 6: Minimal Cognetive Impairment &<br />

Alzheimer Disease<br />

Saturday, May 21, 2011, 12:00-13:00, Hall Sa’di<br />

Moderator: Sh. Seifollahi (Iran)<br />

Members: M. Nouroozian<br />

A. Shoja’ee<br />

M. Arbabi<br />

F. Sedaghat<br />

G. Bakhshandehpour<br />

Educational objectives:<br />

Definition of MCI & dementia<br />

Diagnostic problems in MCI & dementia<br />

Psychiatric aspects of MCI & dementia<br />

Management & outcomes of MCI & dementia<br />

Role of structural imaging in diagnosis &<br />

management of dementias<br />

Role of neuronuclear imaging in diagnosis &<br />

management of MCI & dementia<br />

Quantitative aspect of neuronuclear imaging<br />

Summery:<br />

Minimal cognitive impairment (MCI) is a precursor<br />

of dementia proposed to proceed to Alzheimer's<br />

disease (AD) and its progression could be controlled<br />

by drugs producing in advanced promising<br />

researches. This panel discussion is held to<br />

overview different aspects of MCI from standpoint<br />

of neurologists, psychiatrists, radiologists,<br />

neurosurgeons & nuclear physicians for better<br />

diagnosis & management of MCI & dementia and<br />

impression of novel software to quantify regional<br />

cerebral blood flow & metabolism.<br />

30


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

<strong>Panel</strong> 7: Structure, Policies & Prospective of<br />

Radiation Protection<br />

Saturday, May 21, 2011, 8:00-9:00, Hall 4<br />

Moderator: A. Shabestani Monfared (Iran)<br />

Members: H. Khosravi<br />

B. Singh<br />

K.P. Mishra<br />

M. Momen’nejhad<br />

Educational objectives:<br />

A closer and feasible look to radiation protection<br />

guidelines in nuclear medicine in Iran<br />

Protection or over protection against ionizing<br />

radiation in nuclear medicine<br />

The radiation protection guidelines on the basis of<br />

other radiobiological models<br />

<strong>Panel</strong> 8: Radiopharmacy in Iran<br />

Saturday, May 21, 2011, 11:00-11:30, Hall 4<br />

Moderator: A.R. Jalilian<br />

Members: R. Najafi<br />

S. Shah’hosseini<br />

D. Beiki<br />

M.H. Babaie<br />

J. Hoseinimehr<br />

Educational objectives:<br />

PhD of radiopharmacy in Iran<br />

Current status of radiopharmaceuticals in Iran<br />

(production and quality control)<br />

Clinical studies of new radiopharmaceuticals<br />

New added radiopharmceuticals to the list of<br />

Ministry of health and Iranian Pharmacopeia<br />

The current status of research in radiopharmcy<br />

Role of Radiopharmacist as a member of Nuclear<br />

Medicine Department<br />

Summary<br />

This session will highlight and give an update of<br />

radiopharmacy in Iran, that have attracted lots of<br />

attention in recent years and have large potential<br />

31


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

for further development of new<br />

radiopharmaceuticals. It will cover a review of<br />

current status of radiopharmaceuticals in Iran as<br />

well as insights into the clinical studies of new<br />

radiopharmaceuticals. It will also discuss the<br />

limitations and problems with production and<br />

research in the field of radiopharmacy in Iran.<br />

Workshop 1: Sentinel Lymph Node Biopsy in<br />

Breast Cancer<br />

Speaker: R. Sadeghi (Iran)<br />

Thursday, May 19, 2011, 14:00-15:00, Hall 1<br />

Workshop 2: Quantitative Renal Scan<br />

Speakers: H. Rajabi (Iran) / B. Shafi’ei<br />

(Iran)<br />

Thursday, May 19, 2011, 17:00-18:00, Hall 1<br />

Workshop 3: Gated SPECT<br />

Speaker: V.R. Dabbagh (Iran)<br />

Friday, May 20, 2011, 17:00-18:00, Hall 1<br />

Workshop 4: Bone Densitometry<br />

Speakers: H. Ghadiri / S. Derakhshan<br />

(Iran)<br />

Friday, May 20, 2011, 1100-1200, Hall 5<br />

32


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Workshop 5: QC of γ Camera<br />

Speakers: M.R. Ay / F. Tabe’ie (Iran)<br />

Friday, May 20, 2011, 12:30-13:00, Hall 5<br />

Workshop 6: Interpretation of Brain Perfusion<br />

Scan<br />

Speaker: F. Sedaghat (Greece)<br />

Saturday, May 21, 2011, 15:15-16:30, Hall 1<br />

Workshop 7: QC of Raiopharmaceuticals<br />

Speakers: A.R. Jalilian (Iran)<br />

Saturday, May 21, 2011, 8:30-9:00, Hall 5<br />

Workshop 8: Dosimeters & Decontamination<br />

Speakers: H. Khosravi (Iran) &<br />

A. Monfared (Iran)<br />

Saturday, May 21, 2011, 12:00-13:00, Hall 5<br />

33


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

CME Lectures<br />

34


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

NON-FDG PET TRACERS IN ONCOLOGY<br />

Mohsen Farsad (Italy)<br />

Nuclear Medicine Department, PET Unit, Policlinico S. Orsola-Malpighi, Bologna<br />

Educational Objectives:<br />

To delineate the appropriate clinical indications<br />

To help the imaging specialists to interpret correctly the images,<br />

avoiding pitfalls<br />

To get an insight on current status and future perspectives of NON<br />

FDG PET tracers<br />

Summery:<br />

[(18)F]-fluoro-2-deoxy-D-glucose (FDG) is the most frequently used<br />

radiopharmaceutical for clinical positron emission tomography (PET).<br />

However, FDG cannot be used for all cancer types, either because the<br />

abnormal tissue does not concentrate it, or because the tissues under<br />

investigation demonstrate high physiological glucose uptake.<br />

Consequently, alternative PET tracers have been produced and<br />

introduced into clinical practice. The most important NON FDG<br />

compounds in routine practice are 11 C-choline and 18 F-choline, mainly<br />

for the evaluation of prostate cancer; 11 C-methionine and 18 F-FET for<br />

brain tumours;<br />

18 F-DOPA and<br />

68 Ga-DOTA-PEPTIDES for<br />

neuroendocrine tumours. The lecture will highlight the major clinical<br />

applications of the above mentioned PET tracers in Oncology.<br />

Key Words: 11 C-choline; 18 F-choline; 18 F-DOPA; 11 C-methionine;<br />

18 F-FET; 68 Ga-DOTA-NOC; 68 Ga-DOTA-TOC; PET-CT Imaging<br />

35


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Diagnostic value of nuclear medicine in urinary trace infection<br />

Sepideh Hekmat (Iran)<br />

Hasheminejad Hospital<br />

Urinary tract infection (UTI) is a general term for a group of<br />

conditions in which bacteria grow in the urinary tract. It could be<br />

symptomatic or asymptomatic and is classified as acute<br />

pyelonephritis (that is renal parenchymal involvement and its main<br />

symptom is fever) and acute cystitis. It is of major importance to<br />

differentiate these two conditions in order to define the treatment<br />

schedule and plan for long trm follow up of the patients. We will<br />

shortly review the diagnostic value of the imaging procedures and the<br />

best recommended protocols pertinent to this issue.<br />

Keywords: UTI, DMSA renal scan, SPECT, planar<br />

Production Problems Concerning Anti-CD20<br />

Radiopharmaceuticals<br />

Mohammadhossein Babaei (Iran)<br />

PadtanGostar Co., Zarandieh<br />

Cancer treatment using radioimmunotherapy has been focus of much<br />

research in the last two decades. In radioimmunotherapy, a<br />

radioisotope is coupled to a monoclonal antibody to form a tumorspecific<br />

target agent. Radioimmunotherapy (RIT) is new therapy for<br />

the treatment of B-Cell non-Hodgkin’s lymphoma (NHL). Iodine-131,<br />

Yetterium-90 and Lutetium-177 are frequently used nuclides in<br />

clinical RIT, but their usefulness had been limited by several<br />

problems in their production.<br />

There are many methods that could have been used to label the<br />

radionuclide to the monoclonal antibody. However, in antibody<br />

labeling the aim is to produce a stable complex in an easy, fast and<br />

inexpensive procedure while preserving the immunoreactivity of the<br />

antibody. It has been investigated many conditions such as pH,<br />

temperature, antibody/chelator ratio and labeling time to optimize<br />

the method.<br />

In this lecture, the labeling efficiency, immunoreactivity, in vitro and<br />

in vivo stability of the produced complexes were considered.<br />

36


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Development of Non-FDG PET tracers in Iran<br />

A.R. Jalilian (Iran)<br />

Radiopharmaceutical Research & Development Laboratory (RRDL), Nuclear<br />

Science and Technology Research Institute (NSTRI)<br />

Apart from FDG, which is the most widely used tracer in PET nuclear<br />

medicine, research has been continued for the creation and<br />

introduction of other PET radioisotopes and radiopharmaceuticals<br />

around the world as well as in our country. The development of first<br />

Iranian 68 Ge/ 68 Ga prototype generator, with great performance of 5-<br />

10 mCi per milking is a breakthrough in the development of<br />

radiopharmaceuticals in the country at NSTRI, which a progressive<br />

expanding program is underway for high scale production for<br />

upcoming country’s need.<br />

Production and preclinical studies of<br />

64 Cu-ATSM has also been<br />

recently performed at NSTRI and is ready for clinical studies in<br />

National Radiopharmaceutical Project having interesting<br />

PET/therapeutic properties yielding few hundred-millicurie amounts.<br />

Also great efforts are now being performed on the development of<br />

other molecular imaging probes such as 64 Cu-monoclonal antibodies<br />

and pepties such as trastuzumab, cetuximab and octreotide. In other<br />

research works 61 Cu, 89 Zr, 66 Ga and 82m Rb production have been<br />

performed while feasibility studies for high performance 62 Zn/ 62 Cu<br />

generator is finalized in collaboration with IAEA a CRP work on the<br />

production of 18 F-FLT, 18 F-FAZA and 18 F-Flumazenil is in process.<br />

37


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

APPROACHES FOR DEVELOPING RADIOPROTECTORS AGAINST<br />

LOW DOSE IRRADIATION<br />

K.P. Mishra (India)<br />

Nehru Gram Bharati University, George Town, Allahabad 211 002 INDIA &<br />

Ex Radiation Biology and Health Sciences Division, Bhabha Atomic Research<br />

Center, Mumbai<br />

Adverse effects of ionizing radiation became known soon after the<br />

discoveries of X ray and radioactivity at the end of 20 th century. With<br />

the increasing advances in radiation technology, growing concerns<br />

were expressed for likely exposure of humans to radiation with<br />

possible harmful effects. Radiation exposures could arise from<br />

planned, unplanned and natural environmental sources. The planned<br />

sources include diagnostic, therapeutic and industrial sources<br />

whereas unplanned exposures comprise of strategic explosions,<br />

reactor accidents, fall outs, dirty bombs and terrorist attacks. It is<br />

fairly well understood that ionizing radiations affect vital biological<br />

molecules through direct action or through indirect deposition of<br />

energy in abundant water generating reactive oxygen species (ROS).<br />

These ROS, in turn, react with critical biomolecules, namely, lipid,<br />

DNA and proteins leading to deleterious oxidative damage. To protect<br />

living organisms against high and low doses of radiation exposure it<br />

requires developing strategies depending upon the nature of radiation<br />

and severity of exposure. Over the years, a large chain of chemically<br />

synthesized compounds, vitamins, amino acids, nucleic acid<br />

derivatives were investigated for their radioprotective potential but<br />

these results were found not translatable into practical applications<br />

either due to poor efficacy or unacceptable associated toxicity. The<br />

available radioprotectors are either inefficient or unsafe for<br />

applications to humans. The effective radioprotector should be nontoxic,<br />

stable, prolonged activity, low cost and easy availability.<br />

Interestingly, past years have witnessed extensive screening of<br />

various plants for their radioprotective properties. Considering<br />

toxicity as the major constraint for the use of synthetic compounds,<br />

numerous plants have been screened for radioprotective efficacy<br />

against the deleterious effects of ionizing radiation. Herbal<br />

compounds rich in antioxidants may be a potential radioprotector.<br />

Compounds with efficient abilities to neutralize ROS produced by<br />

radiation may form potentially useful radioprotectors for practical<br />

applications. Also, compounds or formulations that can stimulate<br />

immunological responses may be another approach to develop<br />

effective radioprotection. This talk will present a highlight of<br />

developing new approaches for developing radioprotectors against<br />

radiation exposures especially low doses of radiation exposures.<br />

38


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Radiopharmaceuticals for bone pain palliation therapy<br />

Davood Beiki (Iran)<br />

Research Institute for Nuclear Medicine, Tehran University of Medical Sciences<br />

The incidence of cancer in the United States is over a million new<br />

cases a year (excluding cancers of the skin), of which over 100,000,<br />

perhaps up to 150,000 patients a year, develop bone metastases.<br />

The frequently occurring tumors that spread to the bone are prostate,<br />

breast, and lung cancer. The prevalence of pain in all patients with<br />

metastatic bone cancer has been estimated at 60% to 90%. Besides<br />

analgesics, treatment options include external beam radiotherapy,<br />

bisphosphonates, chemotherapy, surgery and bone seeking<br />

radiopharmaceuticals. Particle-emitting bone-seeking<br />

radiopharmaceuticals have attracted the attention of the nuclear<br />

medicine community over the last three decades for the treatment of<br />

the pain of osteoblastic metastases. For the eight<br />

radiopharmaceuticals including<br />

188 Re(Sn)HEDP, 153 Sm-EDTMP, 90 Y-<br />

citrate, 186 Re(Sn)HEDP, 117m Sn-DTPA, 32 P-phosphate, 89 Sr-chloride<br />

and 85 Sr-chloride, there are published data on clinical trials in<br />

humans. Of these eight, only phosphorus-32 (P-32) as sodium<br />

phosphate, Sm-153 lexidronam (EDTMP), and Sr-89 chloride are<br />

commercially available in the United States, although rhenium-186<br />

(Re-186) etidronate (HEDP) is widely employed in Europe. This talk<br />

will discuss the role of bone seeking radiopharmaceuticals in pain<br />

control of these painful osseous metastases.<br />

39


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Peptides based radiopharmaceuticals for Tumor Diagnosis and<br />

Therapy<br />

Mostafa Erfani (Iran)<br />

Nuclear Science Research School, Nuclear Science & Technology Research<br />

Institute (NSTRI), Atomic Energy Organization of Iran<br />

The specific binding of peptides to their receptors can be used to<br />

meet the key requirement in tumor targeting. Because of their small<br />

size, peptides exhibit faster blood clearance and higher target-tobackground<br />

ratios compared to macromolecular compounds.<br />

Although the use of an 111 In peptide was first explored for the use in<br />

nuclear medicine in 1981, it was not until a decade later that a 123 I<br />

labelled peptide was injected to tumor bearing animals. To date,<br />

radiolabelled receptor-binding peptides have emerged as a new class<br />

of radiopharmaceuticals. There is a tremendous amount of peptides<br />

that are potential candidates for being used as tumor imaging<br />

radiopharmaceuticals. For example octereotide, bombesin, gastrins,<br />

angiotansin, RGD, substance p, NPY are examples that are currently<br />

being tested, and many more have been suggested.<br />

There are several prerequisites for peptides used for scintigraphy or<br />

even radio-therapy. First of all, the corresponding receptors have to<br />

be expressed on the target in suitable amounts, over expression is<br />

desirable. There is no sense in developing a radioligand for a clinically<br />

important disease if the receptor is not concentrated in the target<br />

tissue in such an amount that an external image can be obtained.<br />

Natural peptide ligands exhibit high affinity to the receptor, usually in<br />

the nano molar range. It is crucial that the radiolabeled analog<br />

retains its high affinity. Because of the small size of peptides, the<br />

attachment of a bulky chelator and a radionuclide has a significant<br />

contribution the overall molecular weight, which may lead to<br />

conformational changes in the binding sequence. Thus, the<br />

attachment of the radiolabel should be made far from the receptor<br />

binding sequence, or a spacer should be introduced. Specificity is also<br />

a prerequisite. Whereas the natural ligand usually binds with similar<br />

affinities to receptor subtypes, chemically modified synthetic<br />

analogues often display pronounced subtype selectivity for only one<br />

or few receptor subtypes. Thus, receptor subtype expression on the<br />

targeted tumor tissue has to be considered. Receptor-agonists are<br />

preferred, since they usually exhibit receptor-mediated<br />

internalization. This results in accumulation of the radioligand in the<br />

target, providing an increased signal for scintigraphy. For therapeutic<br />

applications, internalization is an absolute precondition, as the<br />

cytotoxic moiety has to reach its target within the cell. A further<br />

prerequisite for radiopeptides is that the complexing of the chelatorpeptide<br />

with the radiometal is achieved in high yields. Last, but not<br />

least, a main concern of radiolabelled peptides is their stability under<br />

physiological conditions, i.e. peptide fragmentation by peptidases and<br />

the stability of the radiometal-chelator complex.<br />

40


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Myocardial viability<br />

Role of myocardial viability in patient management<br />

N. Salehi (Iran)<br />

The role of Nuclear Medicine imaging in Myocardial Viability<br />

assessment<br />

Ch. Giannopoulou (Greece)<br />

Educational Objectives:<br />

Provide an overview on the proposed pathophysiological<br />

mechanisms underlying stunned and hibernating myocardium, such<br />

as adoptive downregulation and structural alterations, in patients<br />

with ischemic left ventricular dysfunction.<br />

Provide an update on the use of radionuclide methods, both SPECT<br />

and PET, in the assessment of the presence and extent of<br />

hibernating myocardium, as well as on their prognostic and<br />

diagnostic value.<br />

Adopt knowledge on PET imaging principles, radiotracers’<br />

mechanisms of uptake and imaging protocols in myocardial PET<br />

(perfusion/metabolism) and SPECT viability studies.<br />

Compare radionuclide techniques to other viability imaging<br />

modalities.<br />

Provide a brief overview of recent clinical trials on the utility of<br />

myocardial viability assessment in patient revascularization<br />

selection.<br />

Summary:<br />

This continuing education session is directed toward physicians,<br />

trainees and technologists interested in the practice of nuclear<br />

cardiology. It will cover the topic of cardiac radionuclide imaging<br />

techniques and their applications in ischaemic left ventricular<br />

dysfunction and especially in assessing myocardial viability. Evidence<br />

for the role of these techniques will be summarized with particular<br />

reference to current guidelines. Knowledge on PET technology and<br />

acquisition protocols, as well as the importance of these imaging<br />

techniques in the clinical decision-making process and their present<br />

limitations will be discussed. An overview of the combination of<br />

various tests, to make it possible to establish correlations between<br />

coronary anatomy and functional imaging, further improving the noninvasive<br />

assessment of patients with ischaemic heart failure will be<br />

presented.<br />

Key Words: Cardiac PET, SPECT, metabolism, myocardial perfusion,<br />

viability, hibernation, stunning, FDG<br />

41


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Is cyclotron-produced Tc-99m a realistic alternative during<br />

Mo-99 shortage?<br />

Davood Beiki (Iran)<br />

Research Institute for Nuclear Medicine, Tehran University of Medical Sciences<br />

The radioisotope Technetium-99m ( 99m Tc) is the most commonly<br />

used radionuclide in nuclear medicine imaging and accounts for<br />

around 80% of all such imaging procedures<br />

being performed. In 2009 it is estimated that globally a total of<br />

almost 40 million procedures per year were performed in nuclear<br />

medicine and this equates to around 120,000 patient injections using<br />

99m Tc each day. The short supply in radiopharmaceuticals during the<br />

past three years is mainly caused by technical problems in research<br />

reactors producing medical radioisotopes on an industrial scale. On<br />

the other hand, the cyclotron technologies for manufacturing<br />

Molybdenum-99 or Technetium-99m have been described several<br />

times in the literature and a complete report on the topic was<br />

generated as early as 1999. Most of these publications extensively<br />

describe the technical feasibility of this approach at small scale, but<br />

never addressed the technical and economical impact associated with<br />

the scaling up. These issues including impurity profile control,<br />

regulatory constraints, pharmaceutical aspect, logistics and<br />

customers interest will be described here. Briefly, the conclusion<br />

leads that the cyclotron generated 99m Tc is not an economically viable<br />

alternative to the well-established 99 Mo/ 99m Tc generator. Even from a<br />

technical point of view the development of a cyclotron for large scale<br />

production of 99m Tc will be difficult to concretize. Therefore, despite<br />

its huge initial investment, the best option from an economical point<br />

of view will definitely remain the reactor route. Also, the decision to<br />

set up an alternative method will be based not just on the technology<br />

or capacity criteria but on a full economic and comprehensive<br />

business evaluation.<br />

42


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Radiopharmaceuticals for Synovectomy<br />

A.R Jalilian (Iran)<br />

Radiopharmaceutical Research and Development Lab (RRDL), Nuclear Science<br />

and Technology Research Institute (NSTRI)<br />

As the aging of the human population around the world, the need for<br />

the management of elderly-diseases such as rheumatoid arthritis and<br />

other joint problems has emerged. Also a majority of diseases can<br />

cause arthropathy leading to the pain, inflammation and also<br />

immobility of the patients such as spondylarthropathy, Lyme disease,<br />

Behcet´s disease, persistent synovial effusion, haemophilic arthritis,<br />

calcium pyrophosphate dihydrate (CPPD) arthritis, pigmented<br />

villonodular synovitis (PVNS), persistent effusion after joint<br />

prosthesis, undifferentiated arthritis, etc. among the most used<br />

radiopharmaceuticals used according to EANM protocols, three agents<br />

are of the great importance including,<br />

90 Y silicate/citrate,<br />

186 Re<br />

sulphide and 169 Er citrate.<br />

90 Y emits a beta particle with maximum energy 2.27 MeV with mean<br />

energy 0.935 MeV and average soft tissue range 3.6 mm and<br />

physical half life of 2.7 days suitable for the knee joint (5 – 6 mCi per<br />

joint).<br />

On the other hand, 186 Re emits a beta particle with maximum energy<br />

1.07 MeV, mean energy 0.349 MeV, average soft-tissue range 1.1<br />

mm and a 9% abundant gamma emission with a photopeak of 0.137<br />

MeV The physical half life is 3.7 days suitable for hip, shoulder,<br />

elbow, wrist, ankle and subtalar joints.<br />

Finally 169 Er emits a beta particle with maximum energy 0.34 MeV,<br />

mean energy 0.099 MeV and average soft tissue range 0.3 mm. and<br />

physical half life of 9.4 days used for metacarpophalangeal,<br />

metatarsophalangeal and digital interphalangeal joints.<br />

The production, quality control and clinical trials for above mentioned<br />

agents are in process by NSTRI and Iranian medical societies<br />

according to National Radiopharmaceutical Production Project started<br />

in Jan. 2010.<br />

43


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Cancer therapy with alpha-emitters labeled peptides<br />

Fariba Johari Daha (Iran)<br />

School of Nuclear Science, Nuclear Science and Technology Research Institute<br />

(NSTRI)<br />

Alpha particles are of considerable interest for radioimmunotherapy<br />

applications. Due to their short range in tissue(a few cell diameters),<br />

and high linear- energy- transfer (LET),they are specially suited for<br />

targeting micrometastases and single tumor cells such as leukemia<br />

and other blood-borne diseases. Actively targeted α-particles offer<br />

specific tumor cell killing action with less collateral damage to<br />

surrounding normal tissues than β-emitters. During the last decade,<br />

radiolabeled peptides that bind to different receptors on the tumors<br />

have been investigated as potential therapeutic agents both in the<br />

preclinical and clinical settings. Advantages of radiolabeled peptides<br />

over antibodies include relatively straightforward chemical synthesis,<br />

versatility, easier radiolabeling, rapid clearance from the circulation,<br />

faster penetration and more uniform distribution into tissues, and less<br />

immunogenicity. Rapid internalization of the radiolabeled peptides<br />

with equally rapid re-expression of the cell surface target is a highly<br />

desirable property that enhances the total delivery of these<br />

radionuclides into malignant sites. 211 At(t 1/2 =7.2 h), 212 Bi(t 1/2 =60.6<br />

h), 213 Bi(t 1/2 =45.6 h), 233 Ra(t 1/2 =11d) are potential radionuclides for<br />

these applications. Peptides, such as octreotide, α-melanocytestimulating<br />

hormone analogues, arginine-glycine-aspartic acidcontaining<br />

peptides, bombesin derivatives, and others may all be<br />

feasible for use with α-emitters. The on-going preclinical work has<br />

primarily concentrated on octreotide and octreotate analogues<br />

labeled with Bismuth-213 and Astatine-211.<br />

44


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Imaging of Dopamine-Terminal Function in Central Movement<br />

Disorders Using Emission Tomography<br />

F. Sedaghat (Greece)<br />

Aristotle University of Thessaloniki, Thessaloniki<br />

Educational Objectives:<br />

The importance of dopamine transporters and receptors imaging<br />

using SPECT in early differential diagnosis of parkinsonism,<br />

Its potential as a screening tool for subjects at risk of developing<br />

PD,<br />

Issues around the assessment of disease progression,<br />

The importance of semiquantitative analysis of the images.<br />

Summery:<br />

Patients suffering from central movement disorders share the<br />

common clinical symptom of parkinsonism. Differentiating between<br />

these pathologies and essential tremor (ET) is a difficult and<br />

important task as they demand different therapeutic strategies and<br />

have different prognoses. Studies suggest that almost one third of<br />

patients are incorrectly diagnosed with PD by primary care physicians<br />

initially. Even among movement disorder specialists, the rate of<br />

misdiagnosis of PD is reported to be 10% to 12%. The development<br />

of PET and SPECT imaging in movement disorders has been<br />

accelerated by the early descriptions of the loss of dopamine neurons<br />

of substantia nigra. The application of emission tomography using<br />

dopamine-transporters and receptors radiopharmaceuticals in<br />

investigation of movement disorders will be discussed.<br />

Keywords: SPECT, DaT Scan, Parkinsonism, IBZM, Parkinson,<br />

Dopamine receptors, Presynaptic dopamine transporters<br />

45


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

The Application of Emission Tomography in Dementia<br />

F. Sedaghat (Greece)<br />

Aristotle University of Thessaloniki, Thessaloniki<br />

Educational Objectives:<br />

The value of PET and SPECT in differential diagnosis of dementias,<br />

Their potential role as screening tools for cases with Mild Cognitive<br />

impairment and thus early diagnosis of Alzheimer’s disease,<br />

Monitoring of disease progression and therapy.<br />

Summery:<br />

Alzheimer’s disease (AD) is a progressive impairment of intellect,<br />

memory and personality with enormous impact on health care<br />

provision. Single photon emission computed tomography (SPECT)<br />

and positron emission tomography (ΡΕΤ) are imaging modalities<br />

which help the clinician to investigate the functional and<br />

neurochemical changes of the brain, in patients with dementia and in<br />

those at risk οf subsequent cognitive decline. AD with several<br />

pathophysiological characteristic features (amyloid plaques,<br />

neurofibrillary tangles, several neurotransmitter deficits) is a common<br />

cause of dementia in elderly. AD is characterized by biIateral<br />

posterior temporoparietal hypoperfusion on SPECΤ and<br />

hypometabolism on ΡΕΤ which may precede the onset of dementia,<br />

as similar perfusion changes can be demonstrated in prodromal stage<br />

of AD and in those who carry susceptibility genes.<br />

Multi-infarct dementia is associated with multiple asymmetric<br />

perfusion deficits. Fronto-temporaI dementia is characterized by both<br />

hypometabolism and hypoperfusion in fronto-temporal regions. In<br />

dementia with Lewy bodies temporoparietal and occipital perfusion<br />

deficits are seen together with a reduction in the striatal presynaptic<br />

dopamine transporter which can be visualized in 123 I-FP-CIT (DaT<br />

Scan).<br />

Several studies of therapy response in AD with cholinergic drugs,<br />

using specific ligands, have found changes in regional blood flow and<br />

nicotinic and muscarinic receptor function in the patients who<br />

respond to therapy.<br />

PET ligands are developed for demonstration of amyloid plaques.<br />

Emission tomography, with highly specific new ligands will have more<br />

increasing application in both, dementia research and patient<br />

management in the future.<br />

Disease-modifying therapies would be most important to initiate<br />

during the earliest phases of the disease, making it especially<br />

important to have an early clinical diagnosis of AD, when treatment<br />

could potentially delay the degenerative process at a time when<br />

damage to brain tissue is minimal.<br />

Key words: Dementia, Alzheimer’s disease, SPECT, PET, MCI,<br />

Amyloid Plaque imaging, Lewy Body, DaT scan, Frontotemporal<br />

dementia, Vascular dementia.<br />

46


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Radiopharmaceuticals for infection diagnosis in Iran<br />

Mostafa Erfani (Iran)<br />

Nuclear Science Research School, Nuclear Science & Technology Research<br />

Institute (NSTRI), Atomic Energy Organization of Iran<br />

Infectious diseases remain a major health problem and cause of<br />

death worldwide, particularly in developing countries. Nuclear<br />

medicine imaging, because of its sensitivity, offers an attractive<br />

option for diagnosis of focal. This needs a reliable<br />

radiopharmaceutical that can selectively concentrate in sites of<br />

infection. Radiopharmaceuticals for imaging infection have generally<br />

been divided into two types ‘specific’ and ‘non-specific’. The<br />

distinction between them relates to the mechanism of their action.<br />

‘Non-specific’ agents work solely by their ability to localize at the site<br />

of inflammation that is often accompanied with infection. ‘Specific’<br />

agents, while also exhibiting some degree of non-specific localization<br />

show an additional interaction with either the host immune system or<br />

the agent causing the inflammation that increases the efficiency of<br />

delivery. Both ‘specific’ and ‘non-specific’ radiopharmaceuticals may,<br />

depending on the nature of the condition under study is equally<br />

effective. For example, a ‘non-specific’ agent, 111In-hIgG has shown<br />

high accuracy in diagnosis of number of infections by localizing in<br />

associated inflammations. However, in some cases, particularly with<br />

regard to identifying the cause of an inflammation, a ‘specific’ product<br />

may be more appropriate.<br />

The most well established ‘specific’ agent that is still regarded as the<br />

‘gold-standard’ for infection imaging is 111In labelled WBCs. In view<br />

of the cost, limited availability, and not so favorable nuclear<br />

properties for imaging of 111In, techniques for 99mTc labelling of<br />

WBCs have also been developed and used. However, both these<br />

products have a number of drawbacks, in particular: the need for<br />

labelling individual patient’s blood sample and reinjection; need for<br />

well-trained staff and suitable facilities; the risk of infection and<br />

cross-contamination; and the considerable cost of the materials<br />

required for cell labelling. Because of these, WBC labelling procedure<br />

has not become so extensively used commensurate with its potential<br />

and considerable efforts have gone towards developing convenient<br />

replacements. They include 99mTc labelled anti neutrophil antibodies,<br />

chemotactic peptides, and platelet factor. However, these<br />

radiopharmaceuticals retain many disadvantages related to either<br />

their cost and availability or their performance. To achieve a more<br />

desirable 99mTc radiopharmaceutical for infection imaging, one<br />

displaying a faster blood clearance, less non- target uptake and<br />

better concentration in infection sites, it will be necessary to exploit<br />

alternate biochemical pathways. Some of these pathways like binding<br />

of antimicrobial peptides for example ubiquicidine, have been<br />

recently explored with promising results.<br />

47


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Oral Presentations<br />

48


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Comparison of pediatric thyroid cancer with adult thyroid<br />

cancer in a single thyroid cancer clinic<br />

Seyed Rasoul Zakavi 1 , Zohre Mousavi 2 , Vahidreza Dabbagh Kakhki 1 ,<br />

Ramin Sadeghi 1<br />

1 Mash’had University of Medical Science, Nuclear Medicine Research Center<br />

2 Mash’had University of Medical Science, Endocrinology and metabolism<br />

research Center<br />

Aim: To find differences in general characteristics of thyroid cancer in<br />

pediatric patients compared to adults.<br />

Methods and patients: All thyroid cancer files in the main thyroid<br />

cancer clinic in Khorasan were reviewed retrospectively. Different<br />

variables were compared between pediatric (age of ≤16 years at the<br />

time of diagnosis) and adult patients.<br />

Results: 785 patients with thyroid cancer referred for thyroid cancer<br />

clinic from 1995-2009. Thirty patients (20 female, 10 male) had<br />

age≤16 years old at the time of diagnosis with mean age of 13.08<br />

years. At the same period, 755 adult patients with mean age of<br />

42.5±15.7 years also recorded in the center. The sex ratio was not<br />

statistically significant comparing pediatric group with adult patients<br />

(p=0.2). 3% of adults and 0% of pediatric group had family history<br />

of thyroid cancer in first relatives (p=0.6) while 9.5% versus 5.9%<br />

had family history of other cancers respectively (P=0.5). Distant<br />

metastasis was the first presentation in 13.6% of pediatric and 9.4%<br />

of adult patients (P=0.6). No pediatric patient and 6.1% of adults had<br />

previous history of radiotherapy to head and neck region as a<br />

predisposing factor (P=0.2). Papillary carcinoma was seen in 93.3%<br />

of pediatric patients and 88.6% of adult patients (P=0.004).<br />

Extrathyroid invasion was seen in 39.3% of adult and 35.7% of<br />

pediatric group (P=0.8). Multifocal cancer was seen in 60.7% of<br />

pediatric group and 39% of adult patients (P=0.02) Distant<br />

metastasis was noted in 20% of pediatric and 8.9% of adult patients.<br />

T staging analysis showed that T1 was less prevalent and T4 was<br />

more prevalent in pediatric patients compared to adults(P=0.04). N<br />

staging analysis showed that 88.6% of pediatric and 52.7% of adults<br />

patients had N1(P=0.009).The mean number of involved lymph<br />

nodes was 6.06±3.8 in pediatrics and 3.52±3.4 in adults(0.005).<br />

There was no significant difference between adults and pediatrics in<br />

tumor size either in preoperative sonography or in pathology, mean<br />

first Tg level and mean first anti-Tg levels(P>0.2).<br />

Conclusion: 3.8% of all thyroid cancer patients in our center<br />

was


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Keywords: Thyroid Cancer, Pediatrics<br />

50


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

The role of 99mTc-EDDA/HYNIC-TATE(Octreotate) in the<br />

evaluation of solitary pulmonary nodule (SPN)<br />

Kamran Aryana<br />

Mashhad University of Medical Sciences<br />

Introduction: Solitary pulmonary nodule (SPN) radiologically<br />

defined as a single lesion that is less than 3cm in diameter, surround<br />

by lung parenchyma and not associated with adenopathy or<br />

atelectasis. Those SPNs that do not meet specific benign criteria are<br />

considered indeterminate and need to further evaluation. Tc99m-<br />

Octreotate is a somatostatin analogue that binds with high affinity to<br />

somatostatin receptors.<br />

Objective: Initial experience to assess the usefulness of 99mTc-<br />

Octreotate in the differential diagnosis of incidentally discovered SPN<br />

and to determinate the cut off value that would discriminate between<br />

benign and malignant nodules.<br />

Methods: 15 pulmonary nodules, with sized 1.2-3cm, were<br />

evaluated in 14 patients (8 male and 6 female) aged 22-70yrs (mean<br />

47 yrs). An activity of 740MBq of the Tc99m-Octreotate was injected<br />

intravenously in each patient. Imaging was started 2 h post injection,<br />

a static image (500 counts) and a SPECT acquisition was obtained<br />

from the chest.<br />

Results: The SPECT was true positive in 7/8 malignant SPNs.<br />

Negative scintigraphic results were found in 4 Pt’s with benign SPN.<br />

Two Pt’s with positive scan have infectious process (false positive).<br />

Definitive diagnosis was obtained in all of patients by<br />

histopathologiocal result or clinical and CT follow up.<br />

Conclusion: Our study demonstrated that Tc99m-Octreotate is a<br />

sensitive imaging modality with significant specificity and negative<br />

predictive value when compared with CT. We recommend this scan<br />

for the evaluation of SPNs, especially when PET is not available<br />

before biopsy.<br />

Keywords: Octreotate, Solitaire pulmonary nodule<br />

51


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Accuracy of sentinel lymph node biopsy for axillary staging of<br />

breast cancer patients undergone prior surgical biopsy: metaanalysis<br />

of the literature.<br />

Ramin Sadeghi 1 , Hassan Gholami 2 , Hadi Javan 3 , Azar Fani Pakdel 4 ,<br />

Mehdi Asadi 5<br />

1 Mash’had University of Medical Science, Nuclear Medicine Research Center<br />

2 Mash’had University of Medical Science, Evidence Based Medicine Committee<br />

3 Mashhad University of Medical Sciences<br />

4 Mash’had University of Medical Science, Cancer Research Center<br />

5 Mash’had University of Medical Science, Surgical Oncology Research Center<br />

Introduction: Sentinel lymph node biopsy is the standard method of<br />

axillary staging in early stage breast cancer patients. An important<br />

issue is the eligibility of patients undergone prior surgical biopsy of<br />

the primary breast lesion. In this meta-analysis we comprehensively<br />

searched the literature regarding this issue and summarized the<br />

results accordingly.<br />

Materials and methods: We systematically searched Medline,<br />

SCOPUS, and Google Scholar for studies with head to head<br />

comparison of sentinel lymph node biopsy method in patients with<br />

and without prior surgical biopsy. No language or date restriction was<br />

imposed. Studies with enough information to calculate detection rate<br />

as well as false negative rate for both groups were included. For<br />

pooling of the results random effects model was used (Der-Simonian<br />

and Laird method). Q statistics and I2 index were used for<br />

heterogeneity evaluation.<br />

Results: 68 studies for detection rate and 16 for false negative rate<br />

were located with the required information. Pooled detection rates for<br />

patients with and without history of prior surgical biopsy were<br />

91.33% [89.1-93%] and 92.7% [90.9-94.1%] respectively. OR of<br />

unsuccessful mapping was 1.14 [0.955-1.362] and risk difference<br />

was 0.00018 [-0.00844-0.00881] (Q value=104.730 p=0.001 and<br />

I2=38.89). Pooled false negative rates for patients with and without<br />

history of prior surgical biopsy were 13% [9.6%-17.4%] and 10%<br />

[7.6%-12.8%] respectively. OR of getting false negative results was<br />

1.418 [1.107-1.816] and risk difference was 2.2% [0.1%-4.3%] (Q<br />

value=14.12 p=0.516 and I2=0).<br />

Conclusion: Successful sentinel node mapping is not decreased by<br />

prior surgical biopsy of the primary breast lesion. However, the false<br />

negative rate in this group of patients is slightly higher compared to<br />

those without previous biopsy. Despite this fact, the difference is low<br />

(2.2%) and is not clinically relevant. In our opinion prior biopsy of<br />

the primary breast lesions should not be considered as a contraindication<br />

for sentinel lymph node biopsy procedure.<br />

Keywords: Sentinel breast cancer, meta-analysis, core-needlebiopsy,<br />

excisional-biopsy<br />

52


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Sentinel node mapping in the prostate cancer: systematic<br />

review and meta-analysis of the literature<br />

Ramin Sadeghi 1 , Hassan Gholami 2 , Kamyar Tavakkoli Tabasi 3 , Asieh<br />

Sadat Fattahi Masoom 4<br />

1 Mash’had University of Medical Science, Nuclear Medicine Research Center<br />

2 Mash’had University of Medical Science, Education Management<br />

3 Mash’had University of Medical Science, Urology Department<br />

4 Mash’had University of Medical Science, General Surgery Department<br />

Aim: Sentinel node (SN) biopsy is becoming a standard procedure in<br />

the management of several malignancies. Several groups have<br />

evaluated the feasibility and value of this procedure in prostate<br />

cancer patients. In the current meta-analysis, we comprehensively<br />

and quantitatively summarized the results of these studies.<br />

Methods: Several databases including Medline, SCOPUS, Google<br />

Scholar, Ovid, Springer, and Science direct were systematically<br />

searched for the relevant studies regarding SL biopsy in the prostate<br />

cancer (prostate AND sentinel as search keywords). The outcomes of<br />

interest were sensitivity and detection rate of the procedure.<br />

Results: For detection rate and sensitivity 21 and 16 studies met the<br />

criteria of inclusion respectively. Pooled detection rate was 93.8%<br />

(95% CI 89-96.6%). Cochrane Q value was 216.077 (I2 = 89.81%<br />

and p < 0.001). Pooled sensitivity was 94% (95% CI 91-96%).<br />

Cochrane Q value was 14.12 (I2 = 0.0 and p = 0.516).<br />

Conclusion: SL biopsy can prevent unnecessary pelvic lymph node<br />

dissection in prostate cancer patients. This procedure is feasible with<br />

low false negative rate and high detection rate.<br />

Keywords: Prostate-cancer, sentinel, systematic-review, metaanalysis<br />

53


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

99mTc-MIBI INFUSION VERSUS NITROGLYCERIN 99mTc-MIBI<br />

ON DETECTION OF MYOCARDIAL VIABILITY<br />

Shahram Dabiri Oskoei 1 , Babak Mahmoudian 2<br />

1 Tabriz University of Medical Science, Department of Nuclear Medicine<br />

2 Tabriz Gamma Scan Nuclear Medicine Center<br />

Objectives: Several studies have suggested that, rest 99mTc-MIBI<br />

underestimates the extent of viable myocardium. This study aimed to<br />

test whether 99mTc-MIBI infusion could increment the capacity of<br />

99mTc-MIBI to detect myocardial viability and to compare it with<br />

sublingual administration of nitroglycerine (TNG) before 99mTc-MIBI<br />

injection in the same sample.<br />

Method: Twenty patients (14 men, 6 women, mean age 51.5 ± 9.5<br />

years) with previous myocardial infarction (mean evolution 6.5 ± 4<br />

months) were submitted to myocardial perfusion scan with 99mTc-<br />

MIBI gated SPECT for evaluation of myocardial viability. Rest<br />

imaging, TNG 99mTc-MIBI scan and infusion of 99mTc-MIBI during<br />

30 minutes were performed in all patients. Acquisition was started 60<br />

minutes after starting of radiotracer infusion or injection. The uptake<br />

more than 50% of maximum activity on each segment of bull’s eye<br />

images was considered as viable tissue. Increased uptake more than<br />

5% in comparison to rest study was considered significant.<br />

Results: A total of 660 myocardial segments were analyzed, of which<br />

112(17%) showed viability on rest images. Viable tissue was<br />

observed in 135 segments (20.4%) on rest TNG99mTc-MIBI scan<br />

with significant increased uptake in 16 (2.4%) other segments. After<br />

99mTc-MIBI infusion, viability was seen on 132 segments (20%) and<br />

significant increased uptake in 18 (2.7%) other segments. All above<br />

mentioned segments were hypokinetic.<br />

Conclusion: Resting 99mTc-MIBI infusion imaging, with improved<br />

tracer delivery, may overcome some of the inadequacies of standard<br />

stress/rest 99mTc-MIBI imaging for assessing myocardial viability.<br />

The implication of this observation is that resting 99mTc-MIBI<br />

infusion scintigraphy can provide useful information when evaluating<br />

patients for the presence of hibernating myocardium. A prospective<br />

comparison of resting 99mTc-MIBI infusion scintigraphy with other<br />

noninvasive techniques which are used to identify viable myocardium<br />

may thus be warranted.<br />

Keywords: Myocardium, Perfusion, SPECT, MIBI, Infusion, Viability<br />

54


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Gated myocardial perfusion SPECT: patient position effect<br />

Vahid Reza Dabbagh Kakhki<br />

Mash’had University of Medical Science, Nuclear Medicine Research Center<br />

Objectives: Gated myocardial perfusion SPECT has traditionally been<br />

performed with the patient in the supine position. Prone position<br />

imaging is used to rule out of diaphragmatic attenuation. The main of<br />

this study was evaluation of patient position effect on left ventricular<br />

end-diastolic & end-systolic volumes (EDV & ESV) as well as left<br />

ventricular ejection fraction (LVEF) acquired on gated myocardial<br />

perfusion SPECT.<br />

Methods: Sixty patients (40 males and 20 females) with mean age:<br />

52.1±8.8 were studied. All patients underwent rest gated Tc99m-<br />

MIBI myocardial perfusion SPECT on both prone and supine positions.<br />

Gated images were analyzed by QGS software and EDV, ESV and<br />

LVEF were calculated for both supine and prone images.<br />

Results: EDV, ESV and stoke volume (SV) were significantly lower in<br />

prone positions, while no significant difference was noticed in LVEF<br />

between prone and supine positions. Heart rate (HR) was significantly<br />

lower on supine position as compared to the prone position (67.30 ±<br />

9.54 vs. 71.87 ± 9.56; P


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

The association of Rate-Pressure Product (RPP) and<br />

myocardial perfusion imaging (MPI) findings; a preliminary<br />

study<br />

Majid Assadi 1 , Hamid Javadi 2 , Mohammad Reza Pourbehi 1 , Maryam<br />

Rayzan 1 , Mehdi Mogharrabi 3<br />

1 The Persian Gulf Nuclear Medicine Research Center<br />

2 Golestan Research Center of Gastroenterology and Hepatology (GRCGH)<br />

3 Golestan University of Medical Science, Department of Nuclear Medicine<br />

Introduction: The product of heart rate and systolic blood pressure,<br />

termed as Rate-Pressure Product (RPP), is a very reliable indicator of<br />

myocardial oxygen demand and is widely used clinically .The study<br />

was aimed to evaluate the association of RPP results with scan<br />

findings which is scare in the literature.<br />

Materials and methods: In total from 1250 patients who suspected<br />

to coronary artery disease (CAD) underwent gated SPECT imaging<br />

with dipyridamole , exercise and dobutamine stress, 497 cases with<br />

satisfied inclusion and exclusion criteria were included in this study.<br />

The difference between the RPP max and the basal RPP is known as<br />

the RPP reserve. The semi-quantitave analysis of MPI using gated<br />

software, as well as the demographic, risk factors of CAD and pretest<br />

likelihood of CAD using nomogram were also obtained.<br />

Results: In total, 497 cases including 426 patients with dipyridamole<br />

stress, 59 with exercise stress and 12 with dobutamine stress<br />

underwent myocardial perfusion imaging. In patients undertaking<br />

dipyridamole , there was a significant difference between HR at rest<br />

and at maximum; between systolic BP in rest and maximum ;<br />

between diastolic BP and between EF at rest and maximum. There<br />

was a significant correlation between sum stress score(SSS) and<br />

reserved RPP (r= -0.12, p value =0.00) which in dipyridamole<br />

patients was r=-0.18, p value=0.00). In addition, there was a<br />

significant association between reserved RPP and risk of CAD (p<br />

value=0.00). In the patients with dipyridamole stress , the EF change<br />

(odds ratio =0.92; 95% CI: 0.86-0.98; p = 0.01), reserve RPP (odds<br />

ratio =1.00; 95% CI: 1.00-1.00; p = 0.04), risk of CAD (odds ratio<br />

=5.80; 95% CI: 3.21-10.50; p = 0.00) and age (odds ratio =0.94;<br />

95% CI: 0.89-0.98; p = 0.01) were associated significantly with MPI<br />

results by using multiple logistic regressions. Multivariate linear<br />

analyses adjusting for main clinical risk factors revealed that age,<br />

SSS, risk of CAD, and sex were the independent determinants for<br />

prediction of reserve RPP across different models in the patients.<br />

Conclusion: The study demonstrated that RPP might become an<br />

appropriate indicator for optimal analysis of the dipyridamole stress<br />

MPI and it can help to nuclear medicine physicians for a favorable<br />

interpretation.<br />

Keywords: RPP, MPI, CAD<br />

56


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Silent myocardial ischemia in diabetic patients: screening,<br />

diagnosis and early anti-ischemic pharmacotherapy<br />

Mehrshad Abbasi 1 , Alireza Emami Ardakani 1 , Alireza Esteghamati 2 ,<br />

Babak Falahi 1 , Mohamad Eftekhari 1<br />

1 Tehran University of Medical Science, Department of Nuclear Medicine<br />

2 Tehran University of Medical Science, Endocrine and Metabolism Research<br />

Center<br />

Diabetes is considered as myocardial infarction (MI) equivalent for<br />

the risk of subsequent MI and cardiac mortality; shouldn't diabetic<br />

patients undergo the workup of post-MI subjects? The cardiovascular<br />

mortality rate and complications are similar between diabetic subjects<br />

with asymptomatic and symptomatic ischemia underscoring the value<br />

of screening programs. The current recommendations suggest an<br />

individualized approach to the diagnosis and therapy for silent<br />

myocardial ischemia in diabetic subjects, based on patient’s specific<br />

characteristics. The objective of this review is to evaluate the<br />

evidence based data pertaining to the benefits and limitations of<br />

screening, diagnosis and treatment of asymptomatic ischemia in<br />

diabetic subjects. The feasibility of discrimination between the high<br />

and low risk populations employing traditional and new risk factors,<br />

the role of exercise tolerance test and additional myocardial imaging<br />

or echocardiography, as well as alternative options including calcium<br />

score determination, and finally the decision to initiate early<br />

pharmacotherapy are discussed.<br />

Keywords: sillent ischemia, diabetes mellites, MPI<br />

57


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Different aspects of gated myocardial perfusion SPECT<br />

Vahid Reza Dabbagh Kakhki<br />

Nuclear Medicine Research Center, Mashhad University of Medical Sciences<br />

Myocardial single-photon emission computed tomography (SPECT)<br />

has been utilized as an important tool for optimal decision making in<br />

cardiology. Gated SPECT allows evaluation of myocardial perfusion<br />

imaging with subsequent analysis of regional wall motion and<br />

calculation of global & regional myocardial function. This integrated<br />

approach with simultaneous evaluation of myocardial perfusion and<br />

function, is clinically useful for the diagnosis, prognosis and follow-up<br />

of coronary artery disease. Available software algorithms for<br />

computation of left ventricular functional indices are: Quantitative<br />

Gated SPET (QGS, Cedars-Sinai Medical Center, Los Angeles,<br />

California, USA), Emory Cardiac Toolbox (ECTb, Emory University,<br />

Atlanta, Georgia, USA), 4D-MSPET (University of Michigan, Medical<br />

Center), layer of maximum counts (LMC), MultiDim (Sopha, Medical<br />

Vision International, Buc, France) and left ventricular global<br />

thickening fraction (LVGTF). Previous studies have compared these<br />

methods against cardiac magnetic resonance imaging (cMRI),<br />

echocardiography , gated blood pool SPET, contrast ventriculography<br />

,and simulated images. Each of the above methods has its own<br />

advantages and drawbacks in estimating the left ventricular volumes<br />

(LVV) and left ventricular ejection fraction (LVEF) . It has also been<br />

reported that the calculated LVEF and LVV can be affected by<br />

different patient populations, imaging protocols, use of different<br />

isotopes, time to imaging after stress, differences in the image<br />

matrix, zoom, prereconstruction filtering, heart size, extent and<br />

severity of perfusion defects, etc.<br />

Keywords: Gated myocardial perfusion SPECT<br />

58


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

The effect of Methimazole on Thyroid gland uptake of<br />

technetium in hyperthyroid patients<br />

Farshid Gheisari, Alireza Mehdizadeh, Mehrosadat Alavi<br />

Shiraz University of Medical Science, Nuclear Medicine Department<br />

Abstract: The aim of this study was to investigate the effect of<br />

Methimazole on Technetium-99mreabsorbing by thyroid gland, it may<br />

be possible to perform thyroid scan when the patients are on<br />

Methimazole, this can be time saving and decrease the adverse effect<br />

of discontinuing Methimazole.<br />

Patients and methods: Among all the patients with<br />

hyperthyroidism who referred to Nuclear medicine department of<br />

Shiraz University of Medical Sciences, 50 Patients were randomly<br />

selected, we asked the patients who were on Methimazole, to<br />

discontinue the usage of all other drugs and keep exact thyroid diet<br />

for one week, after that thyroid scan was performed again. Revealed<br />

data was analyzed under supervision of statistical specialist with<br />

descriptive method on SPSS.<br />

Results: 34 patients were male (86%) and other were female. Mean<br />

age of the patients was 53.5 years (39-75). Although the region of<br />

interest (ROI)of thyroid was increase4d in the patients who used<br />

Methimazole before scan 398.72(SD:191.73)than the patients who<br />

discontinued Methimazole one week before scan 380.15(SD:112.49),<br />

but the difference wasn’t statistically significant . The ROI of<br />

peripheral tissue of the thyroid was decreased in the patients who<br />

used Methimazole before scan 26.44(SD:5.57), but the difference<br />

wasn’t statistically significant .<br />

Discussion: we demonstrated that Methimazole pretreatment<br />

doesn’t interfere with either the efficacy of ROI and reabsorbing of<br />

Technetium-99m in thyroid gland and peripheral tissues. A possible<br />

limitation of this study is the number of patients in the sample. In<br />

conclusion, it may be possible to perform thyroid scan when the<br />

patients are on the Methimazole, this can be time saving and<br />

decrease the adverse effect of discontinuing Methimazole.<br />

Keywords: Methimazole , Technetium -99m, Hyperthyroidism<br />

59


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Nasolacrimal Duct Obstruction as a Complication of Iodine-<br />

131 Therapy in Patients with Thyroid Cancer<br />

Armaghan Fard-Esfahani, Saeed Farzanefar, Babak Fallahi, Davood<br />

Beiki, Mohammad Eftekhari, Mohsen Saghari, Alireza Emami<br />

Ardekani, Mina Majdi<br />

Tehran University of Medical Sciences<br />

Aim: 131I has been widely used in treatment of differentiated thyroid<br />

carcinoma for almost 70 years. During this period many<br />

complications such as sialadenitis and lacrimal gland dysfunction<br />

have been established. This study argues a new complication<br />

asymptomatic or asymptomatic nasolacrimal duct obstruction.<br />

Materials and Methods: 81 patients (162 eyes) treated with more<br />

than 100 mCi 131I were categorized in 4 groups based on received<br />

cumulative dose and were evaluated in a historical cohort study. In<br />

addition 17 (34 eyes) age and sex matched persons were selected as<br />

control group. Using dacroscintigraphy, patients and control group<br />

were evaluated for partial or complete nasolacrimal duct obstruction.<br />

The data on different groups of patients were compared with the data<br />

of control group. Fishers exact and Mann-Whitney U tests were<br />

applied for analyses of categorical and numeric variables,<br />

respectively. The analyses were considered significant with p


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Evaluation of the therapeutic efficacy of treatment with<br />

olanzapine on regional cerebral blood flow measured by<br />

SPECT in patients with schizophrenia; correlating with the<br />

response to treatment<br />

Babak Fallahi 1 , Davood Beiki 1 , Seyed Mohammad Assadi 2 , Homayoun<br />

Amini 2 , Armaghan Fard-Esfahani 1 , Mohammad Eftekhari 1 , Mohsen<br />

Saghari 1 , Farzaneh Pooyafard 2<br />

1 Research Institute for Nuclear Medicine<br />

2 Psychiatry and Psychology Research Center<br />

Background: Some studies investigated the relations between<br />

regional cerebral blood flow (rCBF), psychopathology, positive and<br />

negative symptoms of schizophrenia. Dopamine D2 blocking typical<br />

antipsychotic drugs, such as haloperidol, are known to change the<br />

cerebral perfusion patterns of schizophrenic patients. The aim of this<br />

study was to evaluate the rCBF of the schizophrenic patients treated<br />

with atypical antipsychotic, Olanzapine, in a within-subject design.<br />

Methods: Twenty-one patients with schizophrenia participated in the<br />

study. Each subject was scanned and assessed according to PANSS<br />

and CGI in a medication-free state and after 4 weeks of 15 mg/day<br />

fixed dose Olanzapine treatment. Also a group of 12 cases without<br />

any history of neurological or psychological disorder was enrolled as a<br />

control group for comparing of the SPECT data. The changes in<br />

pattern of regional perfusion were evaluated between control and<br />

patient subjects and also in the patients group before and after<br />

treatment. The correlation between clinical improvement and rCBF<br />

changes after treatment was also analyzed.<br />

Results: In different patients, hyperperfusion (mainly in the inferior<br />

prefrontal and temporal regions) as well as hypoperfused patterns<br />

(mainly in the cerebellar, parietal and dorsolateral prefrontal regions)<br />

were found. Most of the positive symptoms were correlated with<br />

hyperperfusion in frontal and temporal regions and several negative<br />

symptoms were correlated with hypoperfusion in these areas. A<br />

correlation was found between some symptom improvement and<br />

rCBF changes after treatment with Olanzapine. The magnitude of<br />

increased rCBF before treatment may be considered as a predictor of<br />

clinical improvement in positive symptoms after treatment. However<br />

such a result was not met for negative and psychopathological<br />

symptoms.<br />

Conclusion: Hyperperfusion in the frontal and temporal regions is<br />

mostly correlated with the magnitude of positive symptoms before<br />

treatment and also with the degree of improvement in such<br />

symptoms after Olanzapine treatment. SPECT data may be valuable<br />

to predict the patients response to treatment with Olanzapine.<br />

Keywords: Olanzapine, SPECT Brain Perfusion, Schizophrenia<br />

61


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

A novel scintigraphic agent, 99mTc-UBI 29-41, to detect<br />

osteomyelitis<br />

Majid Assadi 1 , Katayoun Vahdat 2 , Iraj Nabipour 3 , Mohammad Reza<br />

Sehhat 1 , Fahimeh Hadavand 2 , Hamid Javadi 4 , Alireza Tavakoli 5 ,<br />

Jamshid Saberifard 1 , Mohammad Reza Kalantarhormozi 3<br />

1 The Persian Gulf Nuclear Medicine Research Center<br />

2 Department of Infectious Diseases<br />

3 Department of Endocrine and Metabolic Diseases<br />

4 Golestan Research Center of Gastroenterology and Hepatology (GRCGH)<br />

5 Department of Orthopedic Surgery<br />

Objective: The discrimination of bacterial infections from sterile<br />

inflammatory processes is of great importance in the management of<br />

inflammation. Currently available techniques cannot decisively<br />

address this issue. In this respect, antimicrobial peptide 99m Tcubiquicidin<br />

(UBI) 29-41 scans have been showing interesting results.<br />

The aim of this study was to determine 99m Tc-UBI scan accuracy in<br />

the detection of osteomyelitis and to compare it with 99m Tc-MDP<br />

scan and magnetic resonance imaging (MRI).<br />

Methods: Twenty patients (mean age=48.90 years) with suspected<br />

osteomyelitis were included in this study. After evaluation of each<br />

patient through history taking, physical examination, appropriate<br />

laboratory tests, and other processes including bone probing, wound<br />

culture, and plain film radiography (PFR), MRIs, 99m Tc-UBI scans,<br />

and 99m Tc-MDP scans were performed. For quantitative analysis,<br />

the mean count of abnormal to normal region (A/N) was calculated<br />

for images acquired at 15, 30, 45, 60, 120, and 240 min to obtain<br />

the most favorable time for imaging. The final diagnosis of<br />

osteomyelitis was made clinically, laboratorically, and<br />

radiographically.<br />

Results: In total, osteomyelitis was detected in the 99m Tc-UBI<br />

scans of 17 patients indicating 100% accuracy, compared with an<br />

accuracy of 90% for osteomyelitis detected in 3-phase bone scans.<br />

The maximum mean A/N was observed at 15 min after intravenous<br />

injection [median 1.91, interquartile range (1.54-2.94)]. MRI was<br />

performed in 12 cases only, with 75% accuracy. In addition, the A/N<br />

ratios for the 99m Tc-UBI scans were not significantly different<br />

between patients with or without Staphylococcus aureus growth on<br />

wound cultures.<br />

Conclusions: For fast imaging with high accuracy, 99mTc-UBI 29-41<br />

is a suitable choice for the detection of osteomyelitis.<br />

Keywords: Osteomyelitis; UBI scan; MRI<br />

62


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

THE EFFECT OF BARIUM SULFATE IN REDUCTION OF SUB<br />

DIAPHRAGMATIC ACTIVITY IN MYOCARDIAL PERFUSION<br />

IMAGING<br />

Alireza Mehdizadeh, Farshid Gheisari, Mehrosadat Alavi<br />

Shiraz University of Medical Sciences, Nuclear Medicine Department<br />

Background: The aim of this study was to investigate the effect of<br />

barium sulfate in reduction of sub-diaphragmatic activity in<br />

technetium 99m sestamibi myocardial perfusion scan.<br />

Methods: This study included 15 patients (6 male, 9 female)<br />

randomly selected from whom referred for 2 days rest-stress Tc-99m<br />

myocardial perfusion scan. All patients underwent stress phase of<br />

scan , after stress phase a planar static scan(for 5 min) from<br />

abdominal area of patients obtained, after that all patients were<br />

given 80 gr of barium sulfate , solved in 200 cc water , with 100 cc<br />

room temperature water and second planar static scan(for 5 min)<br />

obtained from them. The effect of barium sulfate on sub cardiac<br />

activity was evaluated both visually and quantitatively. After<br />

obtaining two planar static images, an area of about 1404 pixels<br />

(mean 1404.06 pixels) in left upper quadrant of abdomen, adjacent<br />

to inferior wall of heart in gastric area was selected in both images in<br />

same area of selection.<br />

Results: There was a significant reduction in the sub cardiac count<br />

per pixel in barium group compared to control group (p value <<br />

0.001).<br />

Conclusion: The findings indicate that filling of the stomach with<br />

barium sulfate, as a low price, safe and worldwide available oral<br />

contrast, resulted in an improvement in the image quality by<br />

decreasing the adjacent gut activity.<br />

Keywords: Myocardial perfusion, Barium sulfate, Sub-diaphragmatic<br />

63


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

TREATMENT OF DIFFERENTIATED THYROID CARCINOMA,<br />

CONTROVERSIES AND CHALLENGES<br />

M. Eftekhri 1 , S. Farzanefar 2 , B. Fallahi 1 , A. Fard Esfahani 1 , D. Beiki 1 , J.<br />

Esmaili 2 , A. Emami Ardekani 1 , S. Izadyar 2 M. Saghari 1<br />

1 Research Institute for Nuclear Medicine, Tehran University Of Medical Sciences<br />

2 Vali Asr Hospital, Tehran University Of Medical Sciences<br />

Thyroid cancer is a common endocrine malignancy. Despite long term<br />

experience concerning diagnosis and treatment of differentiated<br />

thyroid carcinoma especially more than 70 years experience with I-<br />

131 therapy, still controversies exist regarding appropriate diagnosis,<br />

treatment methods and follow up. Growing advances in technology<br />

including molecular imaging and introduction of new methods for<br />

tumor detection and dosimetry help the caring physicians for optimal<br />

individualized therapy. Type of surgical approach, staging methods,<br />

benefits of I-131 ablation depending on tumor size, ablation dosage,<br />

optimal method for replacement therapy and follow up by serological<br />

and/or different imaging modalities still remain controversial. Other<br />

issues such as low ablative dose of I-131, follow up according to<br />

thyroglobulin level, and radioiodine whole body scan, long term side<br />

effects and possibility of second malignancies need well controlled<br />

studies and clarification. In this presentation these issues and our<br />

own experience at research institute for nuclear medicine Tehran<br />

University of Medical Sciences specially concerns regarding response<br />

versus adverse effects of I-131 are discussed.<br />

Keywords: DTC, Treatment, Radoiodine, Thyroglobulin<br />

64


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Radionuclide Cisternography In Diagnosis & Management of<br />

NPH<br />

Shahram Seifollahi Asl<br />

Arad Hospital<br />

Cerebrospinal fluid (CSF) flow & dynamic study using radionuclide<br />

cisternography has been used from 1964 to diagnosis a site of CSF<br />

leak to determine shunt patency & to diagnosis & management of<br />

communicating hydrocephalus & particularly normal pressure<br />

hydrocephalus (NPH). For the evaluation of the latter, CT & MRI<br />

primarily image anatomy & not CSF dynamic, although special<br />

sequences in MRI & gated MRI are being evaluated in assessing CSF<br />

flow. In current nuclear medicine practice, radionuclide<br />

cisternography is complementary to CT/MRI & can still play an<br />

important role because of the unique physiologic information it<br />

provides.<br />

This lecture will focus on normal physiologic finding of radionuclide<br />

cisternography & different patterns in some types of hydrocephalus<br />

particularly NPH & explain its role in diagnosis & management of the<br />

latter as a possible treatable type of dementia.<br />

65


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Normal Pressure Hydrocephalus and Dementia<br />

A. Shoja’ee<br />

NPH is a state of chronic hydrocephalus in which the CSF pressure is<br />

in physiologic range, but a slight pressure gradient persists between<br />

the ventricles and the brain. There is ventriculomegaly without a rise<br />

in intracranial pressure (ICT) as a result of insidious obstruction of<br />

the CSF circulation due to subarchnoid block. The NPH syndrome has<br />

continued to present many questions with regard to the most reliable<br />

diagnostic and prognostic factors. In addition the high rate of<br />

complications associated with shunting makes treatment highly<br />

controversial.<br />

In these topics the considered etiologic suggestions, the<br />

pathophysiologics points, the differential diagnosis, the new steps of<br />

clinical investigations, and method of managements are discussed.<br />

66


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

The role of nuclear medicine in the diagnosis of infected joint<br />

prostheses<br />

K. Aryana<br />

Nuclear Medicine Department, Mashhad University of Medical Sciences<br />

Some complications of joint replacement surgery are easily<br />

diagnosed; however, differentiating infection from aseptic loosening<br />

is difficult because these entities are remarkably similar at clinical<br />

and histopathologic examination. Clinical signs and symptoms,<br />

laboratory tests, radiography, and joint aspiration are insensitive,<br />

nonspecic, or both. Cross-sectional imaging modalities are<br />

hampered by artifacts produced by the prosthetic devices<br />

themselves. Radionuclide imaging is not affected by the presence of<br />

metallic hardware and is therefore useful for evaluating the painful<br />

prosthesis. Bone scintigraphy is useful as a screening test, despite an<br />

accuracy of only 50%–70%, because normal results essentially<br />

exclude a prosthetic complication. The addition of gallium-67, a<br />

nonspecic inammation-imaging agent, improves the accuracy of<br />

bone scintigraphy to 70%– 80%. The accuracy of combined<br />

leukocyte-marrow imaging, 90%, is the highest among available<br />

radionuclide studies. Its success is due to the fact that leukocyte<br />

imaging is most sensitive for detection of neutrophil-mediated<br />

inammation . The success of leukocyte-marrow imaging is tempered<br />

by the limitations of in vitro labeling. In vivo labeling has been<br />

investigated, and a murine monoclonal antigranulocyte antibody<br />

appears promising. Ubiquicidin (UBI) 29–41 is a small synthetic<br />

antimicrobial cationic peptide that binds preferentially to the anionic<br />

present on microbial cell membrane at the site of infection is highly<br />

sensitive and specific for differentiating of infected prosthesis from<br />

loosening. Tc99m-ciprofloxacin (Infecton) has recently been<br />

established as a new radiopharmaceutical for infection imaging.<br />

Infecton has a sensitivity of 85%, specificity of 92%, and accuracy of<br />

88% in detecting orthopaedic infections compared with 78%, 100%,<br />

and 90% respectively for combined bone and gallium imaging. Some<br />

investigations have focused on uorodeoxyglucose imaging. Although<br />

this method is sensitive, specicity is a concern<br />

67


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Imaging Informatics & Nuclear Medicine<br />

Mansoor Fatehi<br />

Iranian Society of Radiology<br />

In a trend toward film-less medical practice, digital management of<br />

nuclear medicine images is becoming a major concern while there are<br />

few exceptional characteristics for handling nuclear medicine images<br />

compared to radiological ones. Specially after availability of PET/CT<br />

with its inherent data-overload, PACS is becoming part of any nuclear<br />

medicine department. Multiplanar and 3D reformatted images are<br />

frequently used in the practice of nuclear medicine. Image fusion is<br />

also a main area of research in nuclear medicine which relies on<br />

digital format of the images. Recently computer-aided diagnosis has<br />

become available in nuclear medicine as well. Electronic reporting<br />

options including structured reporting and voice recognition are other<br />

important areas of concern in imaging informatics for nuclear<br />

medicine<br />

departments.<br />

The purpose of this presentation is to introduce potential applications<br />

of imaging informatics in the practice of nuclear medicine and<br />

emphasize on specific differences between digital management of<br />

nuclear medicne images compared to radiological information.<br />

68


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Evidence Based Decision Making for Musculoskeletal Imaging:<br />

The Role of Scintigraphy<br />

Mansoor Fatehi<br />

Iranian Society of Radiology<br />

Currently, the most comprehensive resource for evidence-based<br />

imaging which means making the best decisions relying on sound<br />

research findings, are Appropriateness Criteria of American College of<br />

Radiology. Above 180 clinical conditions are defined where all<br />

potential imaging options are scored according to the literature by<br />

committees consisting of well-known experts of imaging and<br />

clinicians in that specific field. The scores are given from 1 to 9 where<br />

1 stands for always inappropriate and 9 stands for always appropriate<br />

imaging in each specific clinical condition.<br />

The purpose of this presentation is to overview selection criteria for<br />

imaging of musculoskeletal clinical conditions including scintigraphic<br />

studies. In this presentation we will explore where scintigraphic<br />

studies stand among other imaging options and the audience will be<br />

aware of the most appropriate imaging in each clinical condition if it<br />

is not a scintigraphic exam.<br />

69


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Update of V/Q Scan in Diagnosis of Pulmonary<br />

Thromboembolism<br />

Elahe Pirayesh<br />

Shahid Beheshti University of Medical Science, Shohada e Tajrish Hospital,<br />

Nuclear Medicine Department<br />

Perfusion-ventilation (V/Q) scintigraphy was introduced in 1964 and<br />

for several decades it was the only widely available method in<br />

imaging patients with suspected PE. The development of helical CT in<br />

the early 1990s provides a new means of imaging. Advanced<br />

technology of multidetector CT angiography (MDCTA) improved the<br />

ability of CT to depict small and subsegmental emboli. In view of<br />

increasing competition of CTA with V/Q scan, modernization of the<br />

conventional V/Q lung scan seems essential. V/Q SPECT as a mature<br />

technique has been shown to be obviously superior to planar V/Q in<br />

diagnosis of PTE. It is also associated a lower number of inconclusive<br />

reports; without limitations of CTA, including high radiation dose,<br />

pregnancy, renal failure and contrast allergy. Comparing MDCTA and<br />

V/Q scan also show equal sensitivity, specificity and accuracy of two<br />

techniques. So, many authors believe the enormous increase in the<br />

number of MDCTA must be reversed; not only because of<br />

unacceptably high radiation exposure, but also because of erroneous<br />

belief that it is a superior diagnostic tool as compared with V/Q<br />

SPECT imaging.<br />

SPECT/CT combines the high sensitivity of SPECT with the high<br />

specificity of CTPA and improves the diagnostic accuracy. SPECT/CT<br />

image fusion may be useful in cases of inconclusive CTPA imaging.<br />

Probabilistic interpretation of V/Q SPECT is also should be replaced by<br />

a holistic interpretation strategy on the basis of all relevant<br />

information about the patient.<br />

Keyword: perfusion ventilation scan, PTE, SPECT<br />

70


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Preliminary Imaging Studies of [61Cu] diacetyl-bis (N4-<br />

methylthiosemicarbazone)<br />

Amir Reza Jalilian, Hasan Yousefnia, Mohsen Kamali-dehghan,<br />

Sedigheh Moradkhani, Fatemeh Bolourinovin, Kamaleddin Shafaii,<br />

Gholamreza Aslani<br />

Nuclear science and technology research institute<br />

[61Cu] diacetyl-bis (N4-methylthiosemicarbazone) ([61Cu] ATSM) is<br />

a well-established hypoxia imaging tracer with simple production and<br />

significant specificity. In this work the accumulation of the tracer is<br />

studied in wild-type, necrotic and hypoxic fibrosarcoma tumors.<br />

[61Cu]ATSM was prepared using ATSM ligand and [61Cu]CuOAc<br />

followed by i.v. administration and imaging studies in wild-type rats<br />

and hypoxic fibrosarcoma-bearing mice.[61Cu]ATSM with high<br />

radiochemical purity (>99%, HPLC, RTLC) was injected to wild-type<br />

rats as well as hypoxic and necrotic fibrosarcoma-bearing mice<br />

followed by imaging up to 3 hours.[61Cu]ATSM was mainly<br />

accumulated in liver, as well as kidney and bladder and less but still<br />

significant in brain of wild-type rats. A significant and hypoxia-specific<br />

tumor/non tumor ratio in hypoxic models was observed by coincidence<br />

imaging 2 h post injection, while in necrotic and 12-week<br />

tumor-induced mice very slight tumor uptakes were detected.<br />

[61Cu]ATSM is a positron emission tomography (PET) radiotracer for<br />

selective tumor hypoxia imaging from necrotic and proliferative<br />

tumors.<br />

Keywords: [61Cu] ATSM, Hypoxia, Co-incidence imaging,<br />

Fibrosarcoma<br />

71


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Synthesis and Quality Control of 186Re-Sulphur Colloids as a<br />

Radiation Synovectomy Agent and its Biodistribution Studies<br />

in Rats<br />

M.R. Davarpanah, B.A. Kalantari, R. Nickzad, M. Ghannadi Maragheh,<br />

M. Erfani (Gandomkar), M. Mazidi, H. Mirfallah<br />

Nuclear Science and Technology Research Institute<br />

Introduction: One therapeutic approach to rheumatoid arthritis<br />

besides surgical removal is radiation synovectomy using betaemitting<br />

radionuclide to destroy the inflamed synovial tissue.<br />

Recently, rhenium radioisotopes have been paid attention more.<br />

186Re sulfur colloid is used for ablation of small and medium<br />

inflamed joints.<br />

Purpose: Our goal is 186Re sulfur colloid synthesis, fulfilling<br />

qualification control tests and biodistribution studies of this colloid.<br />

Methods: After 186Re sulfur colloid synthesis using acidic reduction<br />

of sodium thiosulfate in presence of perrhenate, below qualification<br />

control testes were implemented: a) Radiochemical purity: this factor<br />

was calculated with TLC (solvent: acetone) and measuring one third<br />

TLC paper activity (RF=1/3). b) Particle size: using optical<br />

microscope equipped with Motic Images plus 2.0 software we<br />

obtained a good estimation of particle size range. c) Toxicity studies:<br />

with inoculating synthesized sample in microorganism growth<br />

medium and successive studies this study was performed. d) In vitro<br />

stability: up to 5 days radiochemical purity and particle size were<br />

measured. In addition, animal studies were implemented with<br />

measuring activity of organs of rats been knees injected and killed<br />

within 4 days.<br />

Results: Qualification control tests showed a) radiochemical purity<br />

more than 99%, b) more than 95% colloids particles lied in the range<br />

of 1-5ï m, c) no toxicity and d) colloid was stable to 5 days out of<br />

living tissue. In addition, more than 90% of colloid activity was<br />

adsorbed in knee joints to four days.<br />

Conclusion: Because of a) gamma rays emitting, b) suitable half-life<br />

and beta energy and c) preventing leakage to other organs by<br />

particle size controlling 186Re sulfur colloid is a good alternative as a<br />

radiosynovectomy agent for small and medium joints.<br />

Keywords: 186Re-Sulfur Colloids, Radiation Synovectomy<br />

72


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Production and biodistribution studies of 64Cu-DOTAtrastuzumab<br />

as a diagnostic positron emitter<br />

radioimmunoconjugate for oncology molecular imaging<br />

Behrooz Alirezapour 1 , Amir Reza Jalilian 2 , Mohammad Javad Rasaee 1 ,<br />

Saeed Rajabifar 2 , Kamal Yavari 2 , Mohsen Kamalidehghan 2 , Fatemeh<br />

Bolourinovin 2 , Sedighe Moradkhani 2 , Hamid Zolata 2<br />

1 Tarbiat Modares University(TMU)<br />

2 Nuclear Science and Technology Research Institute (NSTRI)<br />

Introduction: Radiolabeled monoclonal antibodies have shown great<br />

promise for cancer diagnosis and therapy. Trastuzumab (trade name;<br />

Herceptin) is a humanized IgG1 monoclonal antibody directed against<br />

the extracellular domain of the Human Epidermal Growth Factor<br />

Receptor 2(HER2). HER 2 receptor is over expressed in 20-30% of<br />

the early-stage breast cancers and these patients may be candidates<br />

for Herceptin treatment. 64Cu (β= 17%, -β = 39%, EC = 43%) is an<br />

important emerging biomedical radionuclide that is suitable for<br />

labeling a wide range of radiopharmaceuticals for PET imaging. Its<br />

intermediate half-life (12.7 h) permits PET evaluation of slow<br />

biochemical pathways, such as protein and peptide interactions with<br />

cellular targets, and distribution to satellite imaging and therapy<br />

centers. In the present study, copper-64 labeled trastuzumab was<br />

prepared followed by the biodistribution studies in normal mice.<br />

Methods: Herceptin was conjugated with DOTA-NHS-ester<br />

(Macrocyclics), purified by molecular filtration, the average number of<br />

DOTA conjugated per mAb was calculated and total concentration<br />

was determined by spectrophotometrically. DOTA-Trastuzumab was<br />

labeled with 64Cu then Radiochemical purity, integrity of protein after<br />

radiolabeling and stability of 64Cu-DOTA-Trastuzumab were<br />

determined. The biodistribution study was performed in normal mice<br />

(64Cu-DOTA-Trastuzumab i.v., 30 ± 5.5 µCi, 2h, 6h, 12h,18h).<br />

Result: The radioimmunoconjugate was prepared with a<br />

radiochemical purity of 84% (RTLC). The average chelate to antibody<br />

ratio (c/a) for the conjugate used in this study was 5.8:1. The final<br />

compound was stable in presence of PBS at 37ºC and room<br />

temperature. The sample were showed to have similar patterns of<br />

migration in the gel electrophoresis.The accumulation of the<br />

radiolabeled antibody in lungs, liver, spleen and other tissues<br />

demonstrates a similar pattern to the other radiolabeled anti-HER2<br />

immunoconjugates.<br />

Conclusion: 64Cu-DOTA-Trastuzumab is a potential compound for<br />

molecular imaging of PET for diagnosis and treatment studies and<br />

follows up of HER2 expression in oncology.<br />

Keywords: 64Cu DOTA Trastuzumab, Radioimmunoconjugate<br />

Imaging<br />

73


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Production, quality control and biological evaluation of 177Lu-<br />

TTHMP as a possible bone palliation agent<br />

Hassan Yousefnia, Amir Reza Jalilian, Samaneh Zolghadri, Zohreh<br />

Naseri, Ali Bahrami-Samani, Mohammad Ghannadi Maragheh<br />

Nuclear Science and Technology Research Institute<br />

In this study, production, quality control and biodistribution studies of<br />

a newly developed therapeutic compound have been presented<br />

followed by imaging studies in wild-type rodents. In this study,<br />

177Lu-TTHMP complex was prepared successfully using synthesized<br />

TTHMP ligand and 177LuCl3. Lu-177 chloride was obtained by<br />

thermal neutron irradiation (4 x 1013 n.cm-2s-1) of natural Lu2O3<br />

samples. Radiochemical purity of 177Lu-TTHMP was checked by ITLC<br />

(>99%). Stability studies of the complex in the final preparation and<br />

in the presence of human serum were performed up to 72h. The<br />

biodistribution of 177Lu-TTHMP and 177LuCl3 in wild-type rats was<br />

checked in animal tissues up to 7 days. The produced 177Lu-TTHMP<br />

properties suggest a possible new bone palliative therapeutic to<br />

overcome the metastatic bone pains.<br />

Keywords: Lu-177, TTHMP, Radiopharmaceutical, Therapy,<br />

Biodistribution<br />

74


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Synthesis and evaluation of 99mTc-carbonyl phenyl piperazin<br />

dithiocarbamate as a 5-HT receptor imaging<br />

Mostafa Erfani(Gandomkar) 1 , Leila Hassanzadeh 2 , Seyed Esmaeil<br />

Sadat Ebrahimi 2 , Reza Najafi 1<br />

1 Nuclear Science Research School<br />

2 Department of Medicinal Chemistry<br />

Introduction: serotonin receptors are associated with a variety of<br />

neuropsychiatric disorder such as anxiety, depression, schizophrenia,<br />

and Alzheimer disease. There is a considerable interest in developing<br />

new 99mTc radiopharmaceuticals for imaging central neural system<br />

receptors by using single photon emission computer tomography. The<br />

goal of this study was to develop a novel 5-HT receptor imaging<br />

agent.<br />

Method: Phenyl piperazin dithiocarbamate was synthesized in the<br />

presence of potassium hydroxide. The desired structure was<br />

confirmed by IR and NMR analysis. 99mTc tricarbonyl precursor was<br />

prepared and the labeling conditions were optimized in the aspect of<br />

pH, reaction temperature, reaction time and the amount of ligand.<br />

The final complex was obtained with high yield following the optimal<br />

labeling procedure. The radiochemical purity of intermediate and final<br />

complex were evaluated by ITLC and HPLC methods. Stability in<br />

human serum, octanol/water partition coefficient and in vivo<br />

biodistribution study of labeled compound in rat were carried out.<br />

Results: Synthesized compound was labeled with 99mTc-tricarbonyl<br />

core in high yield (>%90 by HPLC). The labeled compound was a<br />

lipophilic complex, which was confirmed by octanol/water partition<br />

coefficient (P = 2.50). In vivo biodistribution indicated that this<br />

complex had moderate brain uptake (0.47 %ID/g at 5 min and 0.42<br />

%ID/g at 30 min). The labeled compound was stable up to 6h in<br />

saline.<br />

Conclusion: This result indicates that labeled complex has brain<br />

uptake and also has binding to receptor. Improvement of this<br />

compound needs further ligand modification to obtain an ideal brain<br />

receptor imaging agent.<br />

Keywords: carbonyl, 5-HT, imaging agent<br />

75


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Production and Labeling of Holmium-166 via DOTMP: A<br />

Promising Agent for Bone Marrow Ablation in Multiple<br />

Myeloma<br />

Reza Bagheri 1 , Ali Bahrami-Samani 2 , Mohammad Mazidi 2 , Amir Reza<br />

Jalilian 2 , Mohammad Ghannadi-Maragheh 2<br />

1 Faculty of Nuclear Engineering and Physics<br />

2 Radiopharmaceutical Research and Development Lab (RRDL)<br />

Introduction: Therapeutic radiopharmaceuticals are radiolabeled<br />

molecules to deliver sufficient doses of ionizing radiation to specific<br />

disease sites such as bone metastases, brain and liver tumors and<br />

bone marrows in multiple myeloma. Among some therapeutic<br />

radiopharmaceuticals, 166Ho - 1,4,7,10 tetraazacyclo dodecane<br />

1,4,7,10 tetraethylene phosphonic acid (166Ho-DOTMP) is used for<br />

delivering high doses to bone marrow.<br />

Methods: In this research production, quality control,<br />

pharmacokinetics and biodistribution studies of 166Ho-DOTMP with<br />

respect to its radiochemical and in-vivo biological characteristics have<br />

been presented. Holmium-166 was produced by irradiation of<br />

Holmium oxide (Ho2O3, purity > 99.8%) at a thermal neutron flux.<br />

This radionuclide was labeled at room temperature and<br />

Radiochemical purity of 166Ho-DOTMP was checked by ITLC.<br />

Results: 166Ho produced by irradiation of Holmium-165 oxide<br />

demonstrated high radionuclide purity. 166Ho-DOTMP complex was<br />

obtained in very high yields (radiochemical purity > 99%) under the<br />

reaction conditions employed. This complex exhibited excellent invitro<br />

stability at pH~7 when stored at room temperature and human<br />

serum.<br />

Conclusion: Wild tape rats were used for biodistribution and imaging<br />

studies of this agent. Biodistribution studies in rats showed favorable<br />

selective skeletal uptake with rapid clearance from blood along with<br />

insignificant accumulation of activity in any non-target organ or<br />

tissues. This warrants the detailed evaluation of the agent for bone<br />

marrow ablation in multiple myeloma by injection of high activity of<br />

radiopharmaceutical per kg of patient body.<br />

Keywords: 166Ho-DOTMP, Biodistribution, radiopharmaceutical,<br />

pharmacokinetics<br />

76


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

In vivo tracking of 111In-Oxine Labeled Mesenchymal Stem<br />

Cells Following Infusion in Patients with Advanced Cirrhosis<br />

Sahar Mirpour 1 , Ali Gholamrezanezhad 1 , Mohammad Bagheri 2 , Mehdi<br />

Mohamadnejad 2 , Kamran Alimoghadam 3 , Reza Malekzadeh 2 , Mohsen<br />

Saghari 1 , Nader Ahmadin 1 , Maryam Bashtar 3<br />

1 Tehran University of Medical Science, Research Institute for Nuclear Medicine<br />

2 Tehran University of Medical Science, Digestive Diseases Research Center<br />

3 Tehran University of Medical Science, Department of Hematology<br />

Background: So far progress from the use of both in-vitro and invivo<br />

regenerative medicine models already offers hope for the use of<br />

stem-cells as powerful new therapeutic option for different human<br />

diseases. We initiated a pilot study on human to evaluate stem-cell<br />

bio-distribution after peripheral infusion of mesenchymal stem-cells<br />

(MSCs) in patients with cirrhosis.<br />

Methods: After three passages of MSCs, the first patient (F,62y/o)<br />

received a total of 270x106cells and the second one(M,17y/o) was<br />

infused with 290x106cells. In both patients only 50% of cells were<br />

labeled with 111In-Oxine.A specific activity of 0.67MBq/106 cells and<br />

0.71MBq/106 cells were maintained for the injected labeled cells of<br />

the first and second patients, respectively. The labeling-efficiency<br />

was 36.2% for the cells injected to the first patient and 38.8% for the<br />

second patient. Planar whole body acquisitions(anterior/posterior<br />

projections)were acquired immediately following infusion as well as at<br />

2h,4h,6h,24h,48h, 7th and 10th days after stem-cell infusion. The<br />

SPECT images were obtained at 24th hour post-infusion.<br />

Results: Immediately after I.V. infusion, the radioactivity (labeled-<br />

MSCs) was first observed to accumulate in the lungs, and gradually<br />

shifted to the liver and spleen during the following hours to days. On<br />

SPECT images of the 24th hour, the activity distribution was rather<br />

homogenous throughout the livers and enlarged spleens. Region of<br />

Interest(ROI)analysis in the first patient showed that the percentage<br />

of the homing of the cells into the liver (following decay and<br />

background correction and geometric mean calculation) to be 2.8%,<br />

4.1%,4.1%,4.3%,4.7%,12% and13.5% at 2h,4h,6h,24h,48h,7th and<br />

10th days. The respective values for the second patient were 0%,<br />

3.6%, 3.6%, 3.9%, 4%, 11% and 13%. The residual<br />

activities(labeled MSCs) in the spleen of first patient were<br />

2%,3%,3%,4%,5%,21% and 30% in the previously-mentioned time<br />

points and were 2.5%, 4%, 5%, 7%, 9%, 14% and 42%, for the<br />

second one, respectively.<br />

Conclusion: The infusion of stem cell throughout a peripheral vein is<br />

a safe and feasible alternative route of administration for possible<br />

regenerative treatment of patients with cirrhosis. Also, cell labeling<br />

with 111In-Oxine is a suitable method for following-up of cell<br />

distribution after infusion. Regarding the previous studies in noncirrhotic<br />

patients, the bio-distribution of MSCs in patients with liver<br />

cirrhosis is altered significantly (with decreased hepatic and almost<br />

77


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

increased splenic homing) and hence, these alterations should be<br />

considered in predicting the therapeutic efficacy of stem cell infusion,<br />

when intravenous (systemic) route of administration is employed.<br />

Keywords: 111In-Oxine, Mesenchymal Stem Cell, Cirrhosis<br />

78


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Freeze-Dried cold Kit for Preparation of 99mTc-Ciprofloxacin<br />

as an Infection Imaging Agent<br />

Seyedeh Fatemeh Mirshojaei, Mostafa Erfani (Gandomkar), Mostafa<br />

Goudarzi<br />

Atomic Energy Organization of Iran<br />

Introduction: Radiolabeled antibiotics are being used for the specific<br />

diagnosis of infection by exploiting their specific binding properties to<br />

the bacterial components, thereby making it possible to differentiate<br />

infection from sterile lesions.99mTc-ciprofloxacin is the most widely<br />

used infection imaging agent. The aim of this work was to prepare a<br />

kit of 99mTc-ciprofloxacin with stability and biological activity<br />

preserved, able to identify a septic focous (E-coli) in the experimental<br />

infection model in mice.<br />

Methods: In this paper, different factors were investigated to make<br />

the ciprofloxacin kit. Kits were stored at the temperature of 4ºC<br />

under vacuum and evaluated for stability by estimating the<br />

radiochemical purity using instant thin layer chromatography (ITLC)<br />

following reconstitution with pertechnetate (99mTc) at regular<br />

intervals of time up to 75 days after their production date. The kit<br />

was reconstituted with 99mTc at room temperature and incubation<br />

time of 15 min. The kit stability and affinity to human serum was<br />

challenged for 24 hours and its in vitro binding to bacteria was<br />

assessed. Biodistribution and accumulation of labeled compound in<br />

staphylococcus aureus infected mice were studied using Scintigraphic<br />

methods and ex vivo counting. About 75% of the activity binds to the<br />

plasma proteins and the ratio of infected muscle to non-infected<br />

muscle is 3.2 and 1.8, 1h and 4 hours post injection.<br />

Results: Radiolabeling was performed in an easy way, and<br />

radiochemical purity was >90±4 %. The stability of radiolabeled<br />

antibiotic in human serum was 84.2% 1 h post incubation with<br />

human serum. In-vitro studies showed 75 % of radioactivity was<br />

bound to bacteria. After injection into mice with a bacterial infection,<br />

removing from the circulation occurred mainly by biliary-renal<br />

clearance and site of infection was rapidly detected within 30 min.<br />

Target to non-target muscle ratio was 3.23 ± 0.05 % at 30 min post<br />

injection.<br />

Conclusion: 99mTc-ciprofloxacin showed favorable radiochemical<br />

and biological characteristics which permitted detection of the<br />

infection with optimal visualization.<br />

Keywords: 99mTc-ciprofloxacin, infection imaging, kit preparation<br />

79


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Radiolabeled Affibody molecules as novel class of tumor<br />

targeted peptides for imaging and therapy<br />

Seyed Jalal Hosseinimehr 1 , Anna Orlova 2 , Vladimir Tolmachev 2 ,<br />

1 Department of Radiopharmacy<br />

2 Division of Biomedical Radiation Sciences, Uppsala, Sweden<br />

Affibody molecules are small, very stable, 58-amino acid residue<br />

proteins derived from one of the IgG-binding domains of<br />

staphylococcal protein A with the three-helix bundle structure.<br />

Affibody molecules with small size (7 kDa) have rapid tumor<br />

localization with fast clearance from nonspecific tissues. Affibody<br />

molecules can bind to HER2, IGF-1R and EGFR with high affinity. With<br />

these advantages, Affibody molecules are interesting as tumor<br />

targeted peptide for nuclear medicine. Another advantage of Affibody<br />

molecules is that they can be labeled with different radionuclides<br />

such as gamma- and beta- emitters for imaging and therapy.<br />

Recently, our research team prepared radiolabeled Affibody molecule<br />

for tumor imaging with 99mTc and 111In. These radiolabeled<br />

peptides showed excellent specific binding in vitro. Tumor bearing<br />

mice imaging showed a high contrast imaging with tumor localization.<br />

Affibody molecules can be labeled with beta emitters, such as 177Lu<br />

or 186Re, and used a therapeutic agents. Recently, we have evaluate<br />

a series of peptide-based chelators for 99mTc (and potentially for<br />

186/188 Re), which can be incorporated a C-orN-terminus of Affibody<br />

molecules. We have shown that modification of amino acids in such<br />

chelators enables modification of biodistribution of Affibody<br />

molecules.<br />

Keywords: Affibody, molecules imaging, 99mTc<br />

80


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Synthesis and labeling of a new bombesin analogue with 67Ga<br />

for imaging of BBN receptors<br />

Seyed Pezhman Shirmardi, Mostafa Erfani (Gandomkar), Mohammad<br />

Ghannadi Maragheh<br />

Nuclear Science & Technology Research Institute (NSTRI), Atomic Energy<br />

Organization of Iran<br />

Introduction: Bombesin (BBN) is a peptide showing high affinity for<br />

the gastrin releasing peptide receptor (GRPr). Tumors such as<br />

prostate, small cell lung cancer, breast, gastric and colon cancer are<br />

known to over express receptors to bombesin (BBN) and gastrin<br />

releasing peptide (GRP).<br />

Methods: The goal of this study was to evaluate a new 67Ga<br />

radiolabeled BBN analogue based upon the bifunctional chelating<br />

ligand DOTA which could be used as a tool for diagnosis of GRP<br />

receptor-positive tumors. DOTA-GABA-Bombesin (7-14) NH2 was<br />

synthesized using a standard Fmoc strategy. Labeling with 67Ga was<br />

performed at 95°C for 30 min in ammonium acetate buffer (pH =<br />

4.8). The stability of radiopeptide was examined in the presence of<br />

human serum at 37 °C up to 24 h. The receptor bound internalization<br />

and externalization rates were studied in GRP receptor expressing<br />

PC-3 cells. Biodistribution of radiopeptide was studied in mice.<br />

Results: labeling yield of >90% was obtained corresponding to a<br />

specific activity of 2.6 MBq/nmol. The radioligand showed a good and<br />

specific internalization into PC-3 cells (16.13 ± 0.71% at 4 h). After 4<br />

h a considerable amount of activity (52.42 ± 1.86%) was<br />

externalized. In animal biodistribution studies, a receptor-specific<br />

uptake of radioactivity was observed in GRP-receptor-positive organs.<br />

After 4 h, the uptake in mouse tumor and pancreas was 1.30 ±<br />

0.18% ID/g and 1.21 ± 0.13% ID/g respectively.<br />

Conclusion: These data show that [67Ga]-DOTA-GABA-Bombesin<br />

(7-14) NH2 is a specific radioligand for gastrin-releasing peptide<br />

receptor positive tumors and is a suitable candidate for clinical<br />

studies.<br />

Keywords: 67Ga Bombesin, synthesis, labeling<br />

81


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Production, Quality Control and Biological Evaluation of<br />

153Sm-TTHMP as a Possible Bone Palliation Agent<br />

Zohre Naseri 1 , Amir Reza Jalilian 2 , Ali Nemati Kharat 1<br />

1 University of Tehran, School of Chemistry<br />

2 Radiopharmaceutical Research and Development Lab (RRDL)<br />

Radionuclides have been used to treat skeletal diseases for decades.<br />

At present an array of radionuclides have been proposed for treating<br />

bone pain due to cancer. The most promising among these<br />

radionuclides is 153Sm. This radionuclide has favourable radition<br />

characteristics t1/2= 1.93d, βmax= 0.81 Mev(20%), 0.71 Mev<br />

(49%), 0.64 Mev (30%) and γ=103 Kev (30%) emission which is<br />

suitable for imaging purposes during therapy. Various bone palliative<br />

therapeutic agents have been developed for bone metastasis such as<br />

153Sm-EDTMP, widely used in the world. (EDTMP) has been proved<br />

to be a good therapeutic agent for the treatment of pain due to<br />

skeletal metastases and is now commercialized. In this study,<br />

production, quality control and biodistribution studies of a newly<br />

developed therapeutic compound have been presented followed by<br />

imaging studies in wild-type rodents. 153Sm-TTHMP was prepared<br />

starting 153Sm-SmCl3, prepared by neutron activation of an enriched<br />

152Sm sample (purity >98%), and in-house synthesized TTHMP in<br />

1h at 25ºC followed by stability tests, partition coefficient<br />

determination and biodistribution studies of in wild-type rodents<br />

using scarification. The radiolabeled Sm complex was prepared in<br />

high radiochemical purity (>99%, ITLC) and specific activity of 278<br />

GBq/mmol and demonstrated significant stability at 4, 25 and 37ºC<br />

(in presence of human serum). Initial biodistribution data showed<br />

significant bone accumulation of the tracer in 48h. The produced<br />

153Sm-TTHMP properties suggest an efficiently new bone palliative<br />

therapeutic agent in the country in order to overcome the metastatic<br />

bone pains.<br />

Keywords: Sm-153, TTHMP, Radiopharmaceutical, Therapy,<br />

Biodistribution, Imaging<br />

82


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Preparation and bio distribution of 99m Technetium-annexin V<br />

for in vivo detection of apoptosis<br />

Saeed Rajabifar, Hamidreza Zolata, Fateme Bolourinovin, Fariba<br />

Sadadi, Amir Reza Jalilian<br />

Nuclear Medicine group, Agricultural,Medicl and Industrial Research School,<br />

Nuclear Science and Technology Research Institute (NSTRI), Tehran, Iran.<br />

Introduction: Annexin V a human protein belongs to a class of Ca 2+<br />

-dependent binding proteins and has a high affinity for<br />

phosphotydilserine and can be used in determination of apoptosis in<br />

cells. Annexin V and its conjugates may be used to detect apoptotic<br />

cells significantly earlier than DNA- based assays. Labeled Annexin V<br />

using 99m Technetium may be useful in detection of apoptosis in vivo<br />

as well as effects of the drugs used for the therapy.<br />

Methods and material: For radiolabeling of Annexin V with<br />

99m technetium succinic dihydrazide, propylene diamine tetra acetic<br />

acid, tricine, nicotinic acid and stannous chloride at their best<br />

concentrations in 0.1 M hydro chloric acid were added to phosphate<br />

buffer at PH=8.5 and then 110 MBq 99m technetium eluted by normal<br />

saline and Annexin V were added to this mixture and heated at 90 oc<br />

for 10 minutes using stirrer at 1400 rpm. The radiochemical purity of<br />

99m technetium was determined by ascending Instant Thin Layer<br />

Chromatography (ITLC) with silica gel fiber glass sheet. Two solvents<br />

such as physiologic saline and acidified 85% ethanol were used and<br />

compared. The radiopharmaceutical prepared was administered<br />

through tail vein to experimental animals (n=5) and under anesthesia<br />

sacrificed for bio distribution studies at 1 and 3 hrs. Liver, kidney,<br />

heart, muscle, spleen, stomach, and intestine.<br />

Results: The radio chemical purity was found to be not less than<br />

90% and the ethanol solvent showed better results as compare to the<br />

normal saline. The serum stability studies showed the product is<br />

stable at least up to 1 hr. The highest percentage of injected dose<br />

per gram of organ (%ID/g) with the mean value were observed in<br />

liver 2.56, kidney 1.36, heart 0.53, stomach 0.39, spleen 0.37 and<br />

muscle 0.12 . Appreciable radio activity could be detected in the liver<br />

and kidneys until 3 hrs post injection of 99m technetium- Annexin V<br />

indicating radiopharmaceutical primarily excretion by hepatic and<br />

renal pathway. Stomach uptake is commonly assumed as a control of<br />

99m technetium labeled compounds stability in vivo assays, this tissue<br />

actively uptakes free 99m technetium which is a good indicator of<br />

radiochemical purity.<br />

Conclusion: 99m technetium-Annexin V is successfully labeled and the<br />

highest uptake was observed in liver and kidney. Stomach uptake of<br />

99mTc labeled Annexin was negligible ,confirming no contamination<br />

of free 99m technetium in the preparation.<br />

Keywords:AnnexinV,Apoptosis, 99m technetium-AnnexinV, Labeling<br />

83


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Estimation of Fan Beam Parameters by Parallel Beam<br />

Collimator in Wire Mesh Design<br />

Abdollah Khorshidi 1 , Mansour Ashoor 2<br />

1 Department of Physics<br />

2 Nuclear Science & Technology Research Institute<br />

Introduction: Collimation of the low energy photons, allowing<br />

detection of only those photons propagating in the appropriate<br />

direction, plays a key role to obtain a suitable map in the Single<br />

Photon Emission Computed Tomography (SPECT) imaging.<br />

Methods: In this study, for assessment of Fan Beam (FB) and<br />

Parallel Beam (PB) collimators responses various parameters have<br />

been compared based on the Geometric Efficiency (G), Geometric<br />

Resolution (Rc), Full Width at Half Maximum (FWHM) and Scatter and<br />

Penetration (S+P) components. Monte Carlo (MC) simulations were<br />

used for estimate the response of cubic hole collimators.<br />

Results: Calculations demonstrated FB Geometry efficiency was<br />

raised when angle of slant hole increased. In FB collimator, while<br />

distance between point source and collimator surface (z) became<br />

larger for a special angle, the Rc increased. But when hole angles<br />

were enlarged for a special distance, the Rc reduced. Simulations in<br />

wire mesh design indicated FB had the better resolution rather than<br />

PB with cubic holes. Simulated point source responses are relatively<br />

close to ADAC Company data. Moreover, whereas z increased the<br />

S+P amounts decreased for both collimators.<br />

Conclusion: The FB had the highest S+P and PB specified the lowest<br />

amount with 1.04 ratio in air at 10 cm distance. The closeness of the<br />

FB collimator responses demonstrated the cubic holes approximation<br />

is applicable to the MC modeling of converging collimators.<br />

Keywords: Fan Beam, Cube, FWHM, Penetration, Phantom<br />

84


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Paired organ internal dosimetry; should be treated jointly or<br />

separately?<br />

Ali Asghar Parach, Hossein Rajabi, Mohammad Ali Askari<br />

Tarbiat Modares University<br />

Purpose: The size, shape and the position of paired organs are<br />

different in abdomen. However, the counterpart organs are<br />

conventionally treated together for calculation of the SAF and S-<br />

values in radiation protection purposes. This study was performed to<br />

quantify the difference in treating paired organs separately or jointly<br />

together.<br />

Methods: Zubal phantom and GATE Monte Carlo package was used<br />

to calculate the SAF and S-value for the self-absorption and crossirradiation<br />

of the liverlung, kidney, adrenal glands (as paired organs)<br />

and liver, spleen stomach and pancreas (single organs). The activity<br />

was assumed uniformly distributed in the organs and simulation was<br />

performed for photons of 10-1000 keV and mono-energetic electrons<br />

of 350, 500, 690, 935, 1200 keV.<br />

Results: The results demonstrated that self-absorption of left and<br />

right organ is inversely dependent upon the mass of the organs.<br />

However, the cross-irradiations of counterpart organs are almost<br />

equal irrespective of the differences in the mass of the organs. The<br />

cross-irradiation from the left and right counterpart organs to other<br />

organs are different (4-24 times in Zubal phantom) depending on the<br />

photon energy and organs. The cross-irradiation from the single to<br />

paired organs is always different irrespective of activity<br />

concentration.<br />

Conclusion: The counterpart organs always receive different dose<br />

from single organs. Therefore, for protection and treatment planning<br />

purposes, these organs should be treated separately just like two<br />

separate organs.<br />

Keywords: Paired-Organ, Specific-Absorbed-Fraction, S-value,<br />

Zubal-phantom, GATE Monte-Carlo<br />

85


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Assessment of Radioactive Waste per Patient in a Nuclear<br />

Medicine Center<br />

Ali Jomehzadeh 1 , Mohammad Bagher Tavakoli 2 , Zahra Jomehzadeh 3<br />

1 Rafsanjan University of Medical Sciences<br />

2 Isfahan University of Medical Sciences<br />

3 Kerman University of Medical Sciences<br />

Introduction: During the last decades, radio-emitter materials have<br />

been rapidly used in nuclear medicine. Undoubtedly, several<br />

problems have been caused due to the application of unsealed radioemitter<br />

materials in nuclear medicine centers. Since, contamination<br />

to radio-drug in nuclear medicine centers causes health problems,<br />

and also, because of workers and patient's exposure reduction in<br />

nuclear medicine centers, informing of internal and external sources<br />

seems to be necessary. Therefore, in this study level of radioactive<br />

waste and radiation contamination per patient with respect to the<br />

contamination radiation sources in Isfahan Dey nuclear medicine<br />

center in Azar 1389 were measured.<br />

Materials & Methods: In this study, after initial studies of imaging<br />

devices, type and level of radio-drug and number of patients per day<br />

in Isfahan Dey nuclear medicine center, radiation contamination with<br />

respect to contamination sources has been investigated. To this end,<br />

all of radiation contamination sources (waste) including, injection<br />

siring, disposable glove, alcoholic cotton and vial have been<br />

determined and level of radiation contamination of each waste per<br />

patient, immediately after injection, has been measured using<br />

gamma counter (Dose Calibrator).<br />

Results: In this study, 38 and 15 patients have been checked up for<br />

heart and bone scans, respectively. Average radiation contamination<br />

of injection siring, alcoholic cotton, disposable glove and vial per<br />

patient were respectively 0.90±0.39, 0.02±0.03, 0.00 and 0.32±0.11<br />

millecurie for heart scan. Also, average radiation contamination of<br />

injection siring, alcoholic cotton, disposable glove and vial per patient<br />

were respectively 1.24±0.17, 0.03±0.05, 0.00 and 0.17±0.03<br />

millecurie for bone scan.<br />

Conclusion: According to the results, the average level of<br />

radioactive waste per patient for heart and bone scan was in the<br />

range of acceptable limitation and there are no necessary additional<br />

radiation protection criteria for wasting the radioactive wastes.<br />

Keywords: radioactive waste, nuclear medicine, heart scan, bone<br />

scan<br />

86


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Direct Additional Acceleration of Relativistic Electron and<br />

Generation of Electron irradiation by intense Short Laser Pulse<br />

Ammar Alani<br />

Islamic Azad University, Gilane gharb Branch, Gilane gharb, IRAN<br />

Electron irradiation uses electrons accelerated in a velocity close to<br />

the speed of light to destroy microorganisms, bacteria, viruses, or<br />

insects that might be present in the food (Cold pasteurization),<br />

sprout inhibition, delay of ripening, and increase of juice yield. Also<br />

used on non-food items, such as Sterilization of medical hardware,<br />

shrink-foils for food packaging, etc. Electron irradiation does not<br />

become radioactive, but in some cases there may be subtle chemical<br />

changes. In this paper investigate increase energy of relativistic<br />

electrons in intraction, by femtosecond laser pulse. for this purpose<br />

an intense short laser pulse with intensity I0=4.19E+020 w/cm2<br />

,wavelength λ=0.8µm, laser spot size W0=100µm, laser pulse time<br />

duration tp=100fs in the doughnut mode TEM*(0,1) for Capture and<br />

Acceleration Scenario(CAS) in vacuum and initial electron velocity<br />

0.7c has been employed. In order to we investigate the intensity<br />

electromagnetic field of femtosecond laser pulse using threedimensional<br />

test particle simulation and numerical analysis via Fourth<br />

order runge kutta formula and utilize Ponderomotive potential<br />

model(PPM) as the theoretical model for description elestron<br />

acceleration .then we scrutinize transverse and longitudinal<br />

ponderomotive force, electrons trajectory, history of the electrons<br />

energy, scattering angles and other variety of graphs. we abserve<br />

that ponderomotive force traps the electrons near the central axis of<br />

laser pulse and increase time intraction and energy exchange<br />

between pulse and elctrons as access electron energy from 0.58Mev<br />

to 2.35Gev in Optimal status then scattered. Finally, the acceleration<br />

problem for a bunch of electrons with 500,000 electrons was<br />

investigated. In our simulation results electrons confined and<br />

accelerated by using the TEM*(0,1) mode laser . The transvers<br />

ponderomotive scattering of the electrons is suppressed by the<br />

potential well of the high mode laser .<br />

Keywords: Electron irradiation, intense Short Laser Pulse<br />

87


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Is parentage error of bone Density determined by DEXA<br />

technique influenced by density?<br />

Azadeh Emami 1 , Hossein Ghadiri 1 , Mohammad Reza Ay 1 , Shahram<br />

Akhlaghpour 2 , Pardis Ghafarian 1 , Sima Taghizadeh 1<br />

1 Research Center for Science and Technology in Medicine<br />

2 Departments of Interventional Radiology<br />

Introduction: accurate performance assessment of bone mineral<br />

densitometry is crucial due to the fact a high level of exact estimation<br />

of bone situation is needed for correct diagnosis of patient with bone<br />

disease. Variation of parameters like percentage error which highly<br />

affect the densitometry results may induce some level of uncertainty<br />

in diagnosis procedure. So, determination of this variation and<br />

designing an algorithm for correction is necessary to assure<br />

examiners about measurement results.<br />

Method: In this study several phantoms consisting of soft tissueand<br />

bone-equivalent material was devised to accurately test bone<br />

densitometry systems. A Plexiglas cylindrical phantom was designed<br />

and constructed as a spine phantom to assess different bone<br />

densities. This phantom consists of two male-female separated parts<br />

which each part consists of two cylindrical shape vertebras .Four<br />

inserts in spine phantom with precisely wide range of K2HPO4<br />

simulate trabecular bone, and provide the basis for the accurately<br />

check of bone densitometry systems. Torso phantom is made up of<br />

polyethylene and designed in such a way that imitates the torso<br />

contour of human body and a hole in the low-middle part of it for<br />

inserting the spine phantom in.<br />

Results: The designed phantoms were used for performance<br />

assessment of Bone Mineral Measurement DEXA Technique. Data<br />

represents percentage error variation in DEXA in different densities.<br />

It is clear that there is a declining trend of percentage error in<br />

measured density versus true density values in DEXA technique.<br />

There is a linear regression equation plot between measured density<br />

and percentage error. The correlation coefficient and slope resulting<br />

from the regression analysis of the measured density versus<br />

percentage error by DEXA is calculated (slope:-0.32, intercept: 0.44).<br />

Conclusion: As it is shown, sensitivity varies by mineral density of<br />

spine results in an uncertainty in measurement procedure. The need<br />

for standardization and evaluation in bone mineral measurements has<br />

been recognized. A spine phantom was designed and produced to<br />

evaluate the percentage error variation in bone densitometry<br />

measurements. These assessments cover wide range of mineral<br />

density that simulated to cover different stages of bone situation. In<br />

this research it is demonstrated that the percentage error can be<br />

affected by spine density that may cause uncertain results.<br />

Keywords: DEXA, BMD, Phantom, Percentage error<br />

88


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Development of<br />

radioimmunotherapy<br />

153 Sm-DOTA-cetuximab for<br />

Kamal Yavari ٭‎1‎ , Mohammad Ghannadi Maragheh 1 , Reza Solhifam<br />

1 Radiobiomedical Laboratory (RBML), Nuclear Science and Technology Research<br />

Institute (NSTRI),<br />

2 Azad University, Chemistry department, Tabriz, Iran<br />

The monoclonal antibody cetuximab binds to EGFR and thus provides<br />

an opportunity to create both imaging and therapies that target this<br />

receptor. The potential of cetuximab as a radioimmunoconjugate was<br />

investigated and in vitro and in vivo quality control tests were<br />

performed as a first step in the production of a new<br />

radiopharmaceutical. Cetuximab solution first was dialyzed and<br />

concentrated by centrifugation using an Amicon Ultra-15 filter<br />

(Millipore, MWCO 30,000). Purified antibody was labeled with 153 Sm<br />

using the DOTA-NHS and radioimmunoconjugates were purified by<br />

using PD10 columns. Radiochemical purity and stability in buffer and<br />

human blood serum were determined using thin layer<br />

chromatography. Integrity of the radiolabeled complex was checked<br />

by SDS-PAGE. Preliminary biodistribution studies in normal mice<br />

model performed to determine radioimmunoconjugates distribution<br />

up to 72h. The radiochemical purity of the complex was 96±1.4%.<br />

The stabilities in phosphate buffer and in human blood serum at 96 h<br />

postpreparation were 94±2 % and 75±1%, respectively. All of the<br />

samples, controls and radiolabeled antibodies, showed a similar<br />

pattern of migration in the gel electrophoresis. Biodistribution of<br />

Lu 177 -cetuximab was evaluated in normal mice and the highest %ID/<br />

g was observed in the blood (15.2±1.3 at 24 hr) and the liver<br />

12.1±2.8 at 24 hr). Cetuximab is readily modified with the<br />

bifunctional acyclic chelate, DOTA-NHS. When labeled with 153 Sm its<br />

immunoreactivity is retained. The studies detailed above demonstrate<br />

the flexibility of cetuximab as a potentially useful<br />

radioimmunoconjugate for both imaging and therapeutic applications<br />

for the treatment and management of a spectrum of cancers.<br />

Key Words: Cetuximab, radiopharmaceuticals, 153 Sm, DOTA<br />

89


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Calculation of absorbed dose in human body produced by PET<br />

machine using MCNP code<br />

Masood Abdolahzade 1 , Atiyeh Moshayedi 2 , Hasan Yousefnia 3 , Yaser<br />

Kasesaz 3 , Davood Ghasemabadi 1 , Mohsen Shayeste 1<br />

1 Imam Hossein University<br />

2 Tehran Center Azad University<br />

3 Atomic Energy Organization of Iran<br />

In This paper the gamma absorbed dose in a simulated phantom of<br />

adult human body is calculated. The 0.5 MeV gamma rays are<br />

produced in positron annihilation process in PET device. A certain<br />

amount of F-FDG18 drag is injected in human body to positron<br />

emission by F-18 isotope and gamma production in organs ob body.<br />

The MCNP code is used for phantom and radiation simulation. The<br />

good results are obtained and compared with other works.<br />

Keywords: PET<br />

90


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Evaluation of single dose 99m Tc-MIBI as a myocardial imaging<br />

agent in clinical test<br />

G.A. Shabani, H.R. Khosrounejad, M. Farahani, F. Hajhasan Abbasi,<br />

M. Goudarzi, M.H. Talebi, M. Mazidi<br />

Radioisotope research group, NSTRI, Atomic Energy org. of Iran<br />

Introduction: 99m Tc-sestamibi (MIBI) is widely used in evaluation of<br />

myocardial perfusion abnormalities. The radiopharmaceutical 99m Tc-<br />

MIBI is a monovalent cation in which 99mTc is surround by six<br />

isonitril ligands. 99m Tc-sestamibi is prepared from a kit and required<br />

boiling to effect labeling. 99m Tc-MIBI diffuses passively out of the blood<br />

and apparently localizes in mitochondria on the basis of their<br />

negative electrical potentials.<br />

Materials and methods: in new formulation of 99m Tc-MIBI as a<br />

single dose, for one patient, we changed the formulation and reduced<br />

the amount of MIBI. Finally, the kit lyophilized and checked QC,<br />

biodistribution in mice, shelf life, sterility and pyrogeuicity test. For<br />

checking in clinical test, we sent to some nuclear medicine centers.<br />

Results: Radiolabelling was performed by ITLC chromatography and<br />

it was more than 95 percent up to 30 mCi of 99m Tc.<br />

Conclusion: this study demonstrated that the new formulation of<br />

99m Tc-MIBI as a single dose is a useful method for myocardial imaging<br />

of one patient in nuclear medicine centers.<br />

Keywords: MIBI, myocardial, radiopharmaceutical, 99m Tc<br />

91


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Assessment of the impact of applying attenuation correction<br />

on the accuracy activity recovery in Tc99m-ECD brain SPECT<br />

of healthy subject using Statistical Parametric Mapping<br />

Faeze Vedaei, Mohammadreza Ay 1 , Alireza Kamali Asl, Faraz Kalantari<br />

1 Department of Medical Physics and Biomedical Engineering<br />

Photon attenuation correction in tissues is the primary physical<br />

degrading factor limiting both visual qualitative interpretation and<br />

quantitative analysis capabilities of reconstructed Single Photon<br />

Emission Computed Tomography (SPECT) images. The aim of this<br />

present study was to investigate the effect of attenuation correction<br />

(AC) on the detection of activation area following statistical analysis<br />

with SPM. The study population consisted of 19 normal subjects (11<br />

male, 8 female, and age 30-40 years). SPECT images were<br />

reconstructed using filter back projection and attenuation correction<br />

was done by the Chang method. The SPECT imaging was obtained 20<br />

min after intravenous injecting of 740-1110 MBq (20-30 mCi) of<br />

Tc99m-ECD and were acquired on 128*128 matrices with a 20%<br />

symmetric window at 140 keV.This data is related to the Society of<br />

Nuclear Medicine of Toronto Hospital and is available on<br />

http://brainscans.indd.org.The data was standardized with respect to<br />

the Montreal Neurological Institute (MNI) atlas with a 12 parameter<br />

affine transformations. Images were then smoothed by a Gaussian<br />

filter of 10 mm FWHM. Significance differences between SPECT<br />

images were estimated at every voxel using t-statistics and is<br />

detected by using a voxel threshold at 6.45.P-value of 0.05 was used<br />

to significant criteria. The contrast comparing NAC to AC images<br />

suggest that regional brain perfusion activity increase in the<br />

cerebrum, parietal lobe, inferior parietal lobule(T score=12.88) and<br />

frontal lobe (T score=10.84), superior frontal gyrus(T score=8.56)<br />

and temporal lobe, superior temporal gyrus(T score=8.68) and<br />

decrease in the cerebrum, frontal lobe, sub-gyral(T score=16.18),<br />

frontal gyrus(T score=16.18), precentral gyrus(T score=7.69),<br />

parietal lobe, precuneus(T score=7.81), inferior parietal lobule(T<br />

score=7.81), angular gyrus(T score=9.82) and posterior lobe,<br />

declive, pyramis, uvula(T score=12.06) and occipital lobe,lingual<br />

gyrus, sub-gyal(T score=8.05) and limbic lobe, anterior cingulated(T<br />

score=9.72) and posterior cingulated (T score=7.91),<br />

parahippocampal gyrus(T score=7.91) before attenuation correction<br />

compare with attenuation correction. I have been concluded that<br />

applying attenuation correction in brain SPECT can effectively<br />

improve the accuracy of the detection of activation area.<br />

Keywords: SPM SPECT, attenuation correction, activation area<br />

92


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

The effect of 3D resolution recovery in myocardial perfusion<br />

SPECT<br />

Faraz Kalantari 1 , Hossein Rajabi 1 , Mohsen Saghari 2 , Alireza Emami<br />

Ardakani 2<br />

1 Tarbiat Modares University, Department of Medical Physics<br />

3 Tehran University of Medical Science, Research Institute for Nuclear Medicine<br />

Introduction: Distance-dependent collimator-detector response<br />

(CDR) is one of the most important degrading factors in myocardial<br />

SPECT images. CDR is the main cause of resolution loss and partial<br />

volume effect in final reconstructed images. The primary assumption<br />

of conventional reconstruction algorithms is that projections are<br />

Radon transform of the object; however this model doesn’t consider<br />

the effect of non-ideal collimation. To correct for the effect of CDR<br />

accurately, CDR was modeled in iterative OSEM algorithm.<br />

Methods: Both simulated and real projections were used in this<br />

study. In simulation step, a point source of Tc-99m is modeled and<br />

placed in different distances from the face of collimator. SIMIND<br />

Monte Carlo simulator was used to create projections from this<br />

activity source. After finding suitable models, a digital torso phantom<br />

(NCAT) with a typical Tc99m-MIBI distribution and two small defects<br />

was used to validate the ability of the algorithm. In clinical step a<br />

point source of activity was prepared and used to find distance<br />

dependent CDRs. Projections of 10 patients (5 men and 5 women)<br />

who underwent myocardial SPECT were used to evaluate algorithm.<br />

Gaussian functions as function of distance were used to model CDR.<br />

The 3D collimator blurring was implemented into the forward and<br />

backprojection of OSEM (4 iterations, 8 subsets) to correct for its<br />

degrading effect. The FBP and iterative OSEM without compensation<br />

were also used in image reconstruction to compare our results with<br />

conventional methods.<br />

Results: Drastic improvements in both simulated and clinical image<br />

quality were found using the 3D OSEM and CDR model. In contrast to<br />

conventional OSEM, this algorithm is much more robust against noise<br />

when the number of iteration rises up.<br />

Conclusion: By using more suitable models for image formation it is<br />

possible to reconstruct images with much higher quantitative and<br />

qualitative accuracy which is essential in both diagnostic and image<br />

guided therapy procedures.<br />

Keywords: OSEM Resolution-recovery SPECT Modeling<br />

93


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Weighting Coefficient Studies for Compton Scattering Effect<br />

Compensation in SPECT Imaging Using Monte-Carlo<br />

Simulation<br />

Firouz Payervand, Mansour Ashoor, Ali Ramezani Moghaddam<br />

Nuclear Science & Technology Research Institute<br />

The aim of single photon emission computed tomography is to<br />

provide accurate images of the radionuclide distribution after<br />

injecting and to provide metabolic and physiologic functional data of<br />

some internal organs of the object being scanned. The inclusion of<br />

scatter radiation in the projections is one of the main sources of error<br />

in SPECT imaging.Tthe detection of scattered events affects the<br />

contrast, the signal to noise ratio and the resolution of the images. At<br />

the photon energies of interest in SPECT imaging, Compton scattering<br />

is the dominant mode of interaction. During Compton scattering, the<br />

photon is reduced in energy as well as deflected from its original<br />

path. Thus one can use energy loss and energy windowing to reduce<br />

the amount of scattered photons imaged. Several methods for the<br />

effects of scattered events have been proposed. The difference<br />

between methods is the way of estimating the scatter contribution.<br />

To modeling imaging systems or developing algorithms or evaluating<br />

and improving those methods, one can use Monte-Carlo simulation<br />

code. In this paper to evaluating and improving Energy Window<br />

Subtraction (EWS), MCNP code has been used and then scatter<br />

phenomena has been studied and the best weighting coefficient and<br />

the appropriate position and width of each energy window has been<br />

determined and quantitative parameters of image have been studied.<br />

Generally, with using the result of this paper and the mathematical<br />

modeling, one can eliminates scattering effects. Simulation results<br />

showed that by operating weighting coefficients we can improve<br />

quantitative parameters of image and provide suitable images with<br />

anatomical and physiological data of internal organs.<br />

Keywords: Compton scattering, Photo eak, SPECT, MCNP Code<br />

94


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Validation of Gate Monte Carlo simulation for bremsstrahlung<br />

planar imaging and assessment the energy window<br />

Hadi Ahangari 1 , Hosein Rajabi 1 , Saeed Farzanefar 2 , Mohammad<br />

Eftekhari 3<br />

1 Tarbiat Modares University<br />

2 Vali Asr Hospital<br />

3 Tehran University of Medical Science, Research Institute for Nuclear Medicine<br />

Introduction: Treatment in nuclear medicine base on beta emitter<br />

radioisotopes. Therapeutic radionuclides energy is outside the range<br />

of gamma camera imaging system sensitivity. Beta emitters interact<br />

with tissue and make bremsstrahlung ray that could contaminate the<br />

primary photon and hence could increase quantitative problem. In<br />

absence of gamma ray emission, bremsstrahlung ray could be used<br />

for imaging. GATE based on Geant4 is a general and very strong<br />

simulator. This simulator was used for nuclear medicine simulations.<br />

This package was already validated for several nuclear medicine<br />

studies. However, P-32 planar imaging has not validated with GATE<br />

yet.<br />

Materials & Methods: Imaging was performed with ADAC scanner<br />

equipped with VXGP collimators. A cylindrical shape bottle with 5 cm<br />

diameter and 20 cm height was filled with water (solution with 0.1<br />

mCi of phosphorus 32) as phantom at the center of the scanner. All<br />

the events were recorded. Also, this experiment simulated with GATE<br />

and given energy spectrum was validated. The simulation was<br />

repeated for this experiment without collimator.<br />

Results & Discussion: The simulation energy spectrums have a<br />

significant correlation with experiment energy spectrum. Detected<br />

counts in the image resultant of phantom and collimator<br />

bremsstrahlung ray. Thus, in the energy window, the spectrum of<br />

collimator bremsstrahlung should be considered. Collimator<br />

bremsstrahlung energy spectrum in the window below 100 keV is<br />

negligible.<br />

Keywords: GATE, Bremsstrahlung, Spectrum<br />

95


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Design and fabrication of imaging detector for medical<br />

application<br />

Hossein Zamani Zeinali 1 , Maryam Nazari 2 , Anita Alipoor 1<br />

1 Dosimetry and Radiation Monitoring Research Group. Agricultural, Medical and<br />

Industrial Research School, Nuclear Science and Technology Research Institute,<br />

AEOI, Karaj, Iran.<br />

2 Islamic Azad University of Tehran<br />

Introduction: An Imaging detector system, based on scintillation<br />

detectors, is designed. Fabricated and optimized for diagnostic<br />

radiology, industrial radiography, nuclear medicine and research<br />

application.<br />

Materials and methods: X radiation beam from a Siemens<br />

Stabilipan Orthovoltage unit, after passing through an object, which<br />

may be living sample or electronic device, produce a planar<br />

distribution of visible light on a GOS(Gd2O2S:Tb3+), that is the<br />

image of the object under examination. The image is displaced on a<br />

Cathode Ray Tube (CRT) by a Charged Coupled Camera (CCD)<br />

camera and is recorded digital by a video capture device. The image<br />

quality parameters, including contrast and resolution were<br />

determined by Inpatient Quality Indicator (IQI) tests. Imaging<br />

practices were carried out for different X ray tube voltages (kV) and<br />

Focal-spot Surface Distances (FSD). The data corresponding imaging<br />

quality parameters were then analyzed and plotted by MATLAB and<br />

Origin software.<br />

Results and discussion: The results for image quality parameters<br />

(contrast and resolution) for different x-ray tube voltages are fairly<br />

close to each other. Thus the imaging system has the capability to be<br />

used for different x-ray energies and radionuclide with relatively<br />

desired results. The study is considered to be an initiative for<br />

fabricating industrial fluoroscopy and radiation surveillance system in<br />

the country.<br />

Keywords: QC, Dose calibrators, Nuclear Medicine<br />

96


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

An investigation of Iran's profile Nuclear Medicine centers in<br />

terms of Dose calibrator system<br />

Hossein Zamani Zeinali, Mostafa Ghafori, Anita Alipoor<br />

Dosimetry and Radiation Monitoring Research Group. Agricultural, Medical and<br />

Industrial Research School, Nuclear Science and Technology Research Institute,<br />

AEOI, Karaj, Iran<br />

Introduction: To investigate the status of the Nuclear Medicine<br />

centers in Iran for the performance of the dose calibrators, 100 out of<br />

130 centers providing nuclear medicine services in Iran were selected<br />

and inspected during 2008-2010.<br />

Materials and Methods: The QC test were performed using<br />

standardized radionuclides of Cs-137 and Ba-133 and calibrated dose<br />

calibrators type PTW curimentor 2 in which the nuclear medicine dose<br />

calibrators were calibrated against it. Besides the Cs-137 and Ba-133<br />

standard sources the nuclear medicine dose calibrators were<br />

calibrated for most commonly used radionuclides i.e. Tc-99m, I-131,<br />

Ga-67 and Tl-201 in the form of vials.<br />

Results: According to the obtained results in the study, 10 centers<br />

were found to be in unacceptable situation. Following this study, all<br />

the concerned nuclear medicine centers were informed about the<br />

results, and at the same time the replacement of some of the dose<br />

calibrator were requested.<br />

Keywords: QC, Dose calibrator, Iran.<br />

97


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Bone material decomposition by energy resolved CT:<br />

application in CT-based attenuation correction of PET data<br />

Hossien Ghadiri 1 , Mohammad Bagher Shiran 1 , Mohammad Reza Ay 1 ,<br />

Habib Zaidi 2 , Hamid Soltanian-Zadeh 3<br />

1 Department of Medical Physics and Biomedical Engineering<br />

2 Geneva Neuroscience Center<br />

3 CIPCE<br />

Introduction: Energy resolved CT (ERCT) could gain considerable<br />

improvements in its application, more likely in dual modality imaging<br />

systems like PET/CT, especially in terms of CT-based attenuation<br />

correction (AC). Utilizing ERCT would effectively improve<br />

determination of tissue types and consequently more accurate AC of<br />

PET data. The aim of this study was to develop a new approach in<br />

tissue determination by ERCT, especially bones, to improve PET<br />

image quality.<br />

Methods: The study was performed by using XCAT CT projector for<br />

simulation and patient images acquired from GE 64 slices scanner. X-<br />

ray spectrum divided to 5 bins: 20-40, 40-60, 60-80, 80-100, 100-<br />

120 KeV and for each bin an image was reconstructed. A matrix of<br />

data included a vector of LAC values was made which its elements<br />

related to corresponding pixels of all images. For each vector, using<br />

cubic spline algorithm, a curve was fitted and by tri-diagonal matrix<br />

algorithm the values of polynomials coefficients (PC) were extracted.<br />

Using a simple thresholding in map of PCs, 3 types of bones (i.e. rib<br />

cortical, spine cortical and trabeculars) were segmented and by<br />

utilizing appropriate scaling factor for each bone type, energy<br />

mapping was performed.<br />

Results: Conversion curve of current PET/CT systems suggest a<br />

0.40±0.1 factor to scale bone which leads to (9.0±3.0)% and<br />

(7.0±3.3)% relative error for cortical rib and trabeculars respectively.<br />

In contrast, utilizing bone segmentation method which is proposed in<br />

this study, gains errors of (2.1±0.3)%, (2.8±0.7)% and (2.3±0.9)%<br />

for cortical rib, cortical spine and trabeculars respectively. The linear<br />

correlation between PCs and amount of high atomic number materials<br />

in hydroxyapatite solutions concentration has a slope of 0.09 and 1.0<br />

intercept.<br />

Conclusion: This study suggested that an accurate segmentation of<br />

bones utilizing an ERCT could decrease the CT-based AC error and<br />

improve the image quality of PET systems.<br />

Keywords: Energy Resolved CT, PET Attenuation Correction<br />

98


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

On The Protection Standards of Shielded Waste Containers in<br />

Five Nuclear Medicine Departments in Tehran<br />

Marzieh Goudarzi 1 , Shadi Davari 2<br />

1 Babol University of Medical Science<br />

2 Nuclear Medicine Department<br />

Since the shielded waste containers are a must for any facility that<br />

generates radioactive waste, all nuclear medicine departments need<br />

standard shielded waste containers to hold radioactive waste safely<br />

until disposal and to reduce radiation dose by appropriate designs to<br />

shield the personnel from the contents of the containers -even when<br />

their lids are open.<br />

Goal: We are attempting to discover whether the protection<br />

standards of shielded waste containers used in nuclear medicine<br />

departments of Tehran are within standard limits or not.<br />

Methods: Here, we present the quality assessment of shielded waste<br />

containers used in five nuclear medicine departments located in<br />

Tehran to evaluate the rate of protection standards applied for the<br />

mentioned containers by a Gayger Muller dose calibrator.<br />

Results: The study shows that shielded waste containers used in the<br />

5 mentioned departments are almost within standard limits but there<br />

can absolutely be some more ways to improve radiation protection<br />

procedures through developing shielded waste containers.<br />

Keywords: Shielded Waste Containers, Dose Calibrator, Radiation<br />

Protection<br />

99


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Semi-automated kidney region of interest selection method<br />

using the threshold technique in renography images<br />

Marzieh Rahmatpour 1 , Hosein Rajabi 2 , Farshid Babapour 1<br />

1 Islamic azad university, science and research branch<br />

2 Tarbiat modares university<br />

Introduction: In study of performance of kidneys in diagnosing<br />

kidney disorders, using renography images of nuclear medicine is<br />

among the most common methods. Dynamic imaging is made in two<br />

stages of perfusion and function. The function images are provided to<br />

study the function of kidneys such as refining and evacuation. By<br />

collecting the initial ROI frames, the kidneys are determined by<br />

operator and by coping it on the other frames, the renogram curve is<br />

drawn separately for the right and left kidneys. The renogram curve<br />

indicates changes of the kidney counting in each frame based on the<br />

time.<br />

Goal: Drawing the favorite region around the kidneys is manual<br />

which may reduce reliability in accuracy of the curve of kidneys<br />

activity. This error is due to unevenness of the medium defined by<br />

operator in different times and or due to selecting several operators.<br />

Through semi-automatic methods we can minimize the dependence<br />

of drawing error of the kidneys favorite environment to the operators.<br />

Numerous studies in this regard have been performed by threshold<br />

method which the notified results based on the maximum of kidneys<br />

count. Despite noise of nuclear medicine images, our method could<br />

decrease error.<br />

Methods: To automize selection of ROI in this research, thresholding<br />

method was used. Study on the real images including 19 dynamic<br />

images of different patients. The clinical images were categorized in<br />

two groups of images with different imaging protocols. Studies on<br />

two separate and simultaneous groups after normalizing was made<br />

and the appropriate threshold relations were gained by counting<br />

average.<br />

Results: In the thresholding method, the most suitable mood of<br />

studying thresholding after applying coefficient is normalizing the<br />

images. The correlation coefficient of threshold relation with average<br />

count is 0.95. With relation 1.03xmean count for the right and we<br />

gained 1.08xmean count for the left kidneys.<br />

Conclusion: The relationship between thresholds with counting<br />

average reduces the counting of noise error and by automatizing<br />

selection of ROI, in addition to reducing the error related to operator<br />

we can use this method for other renography images in variable<br />

maximum count.<br />

Keywords: Renography, Region of interest, Thresholding<br />

100


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Assessment two motion detection methods for patient<br />

motions in simulated and clinical renal dynamic imaging<br />

Mohamad Ali Tajik Mansoury 1 , Hossein Rajabi 1 , Ali Reza Emami<br />

Ardekani 3 , Saleh Salehi Zahabi 1<br />

1 Department of Medical Physics, Tarbiat Modares University<br />

2 Department of Nuclear Medicine, Tehran University of Medical Science<br />

Introduction: Considering the importance of renography in<br />

evaluating kidney function especially in children and hydronephrosis<br />

disease, motion is one of the limiting factors in this diagnostic<br />

method, however this motion may be not identified visually in image<br />

but will affected in quantitative assessment of renographic data and<br />

can lead to errors in clinical interpretation of results. The aim of this<br />

paper is assessment of two methods, the center of gravity and crosscorrelation,<br />

for motion detection in variety kind of predictable patient<br />

motion in renal dynamic imaging.<br />

Methods: In this study 4D NCAT phantom was used to generate a<br />

typical human torso and the SimSET Monte Carlo nuclear medicine<br />

(NM) simulator was used to generate phantoms images. Dynamic<br />

images were adjusted to construct 180 phantoms that each<br />

representing a 10 second duration. Here, kidneys in two sizes and<br />

two levels of kidney-to-background counts ratio and 32 types of<br />

predictable motion in different directions were simulated. Motion<br />

detection algorithms, center of gravity and cross-correlation, (were<br />

implemented in Matlab 7.1 environment) were used for motion<br />

determination in renal imaging data. and finally algorithms used for<br />

motion detection in 30 clinical images.<br />

Results: Data obtained from motion detection algorithms shows that<br />

the precision of motion detection in rotational motions was<br />

significantly (p-value < 0.03) better than cross-correlation method.<br />

Dissociation: Results show that two methods of center of gravity<br />

and cross-correlation were suitable for motion detection and<br />

correction in simulated and clinical renographic images and center of<br />

gravity algorithm have more precision than cross correlation method.<br />

Keywords: Renal-Dynamic-Imaging, Motion-Detection, Center Of<br />

Gravity, Cross-Correlation<br />

101


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Applying interpolated projections in cardiac SPECT and its<br />

effect on lesion detectability using Hotelling Trace<br />

Mohammad Ali Askari 1 , Hossein Rajabi 1 , Armaghan Fard Esfahani 2<br />

1 Department of Medical Physics, Tarbiat Modares University<br />

2 Tehran University of Medical Science, Research Institute for Nuclear Medicine<br />

Introduction: Myocardial SPECT imaging is usually performed<br />

acquiring 32 views in 180 degree with equal steps of 5.625 degrees.<br />

Mathematically, increasing the number of projections can increase<br />

the image quality and decrease reconstruction artifacts. But acquiring<br />

more projections requires spending more time or injection of more<br />

activity to the patients. An idea to improve the quality of the<br />

reconstructed images without acquiring extra projections is applying<br />

interpolated data between adjacent projections. The aim of present<br />

study was using Hotelling Trace method to investigate the lesion<br />

detectability in reconstructed images with interpolated projections.<br />

Methods: Such investigation cannot be performed on real patient's<br />

data. Therefore, data were simulated using NCAT digital phantom and<br />

SimSET Monte Carlo code. The imaging was performed as usual,<br />

acquiring 32 views from right anterior oblique to left posterior<br />

oblique. The data were interpolated to construct 5 images between<br />

adjacent projections convert it into 187 projections. The simulation<br />

was performed again acquiring 187 images as the reference. The<br />

conventional, interpolated and reference data set were reconstructed<br />

and compared for improvement and degradation in quality of final<br />

images. Four methods of interpolation used, linear, cosine, cubic and<br />

hermit. The above procedure was repeated for phantoms<br />

representing different types of heart disease, different cardiac size<br />

and different count densities. Then short-axis cuts were used for<br />

Hotelling Trace analysis. Comparing Hotelling J-number would show<br />

the best method for interpolation.<br />

Results: The results showed that linear interpolation technique<br />

produces better lesion detectability comparing to other interpolation<br />

methods tested. Results also confirmed that streak artifacts<br />

decreases, signal to noise ratio and contrast increased due to<br />

increasing the number of samples.<br />

Conclusion: These results indicate that lesion detectability and the<br />

physical properties of reconstructed images improve significantly<br />

using interpolation.<br />

Keywords: Myocardial SPECT, Reconstruction, Interpolation, Image<br />

Hotelling<br />

102


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Quantification of bremsstrahlung images with respect to postradioembolization<br />

liver dosimetry<br />

Mohammad Reza Teimoori Sichani 1 , Shahram Akhalghpoor 2 ,<br />

Mohammad Reza Ay 3 , Faraz Kalantari 3 , Mahasti Amoui 4<br />

1 Islamic Azad University<br />

2 Novin radiation medicine institute<br />

3 Medical Physics department<br />

4 Department of Nuclear Medicine, Shahid Beheshti University of Medical<br />

University<br />

Introduction: Evaluation of quantitative bremsstrahlung SPECT and<br />

planar images was done using phantom and patient study to calculate<br />

liver and tumor dose post radioembolization with colloidal<br />

Phosphorus-32.<br />

Material and methods: Bremsstrahlung SPECT and planar images<br />

from Jaszczak phantom and 10 patients under specific condition<br />

(MEGP collimator, Energy peak: 100keV±20%) were obtained. Due to<br />

low quality of bremsstrahlung images a method which used<br />

backscatter photons from external 99mTc sources was applied to<br />

determine body contour in SPECT images. Two small 99mTc sources<br />

on patient body were also used as landmarks. A computer program<br />

was written to calculate liver and tumor dose from raw SPECT data<br />

and CT images of patients. SPECT images were reconstructed using<br />

MLEM method. Registration of SPECT and CT images was done on a<br />

point-to-point basis using body contour and landmarks. Uniform and<br />

non-uniform attenuation maps were made from CT images. Then<br />

attenuation correction (AC) for SPECT images was done using 2<br />

different methods, conventional Chang’s method and during an<br />

iterative reconstruction method using expectation maximization (EM)<br />

algorithm. Evaluation of both AC methods was done using SIMIND<br />

MC simulation code. VOIs for each patient were defined by user and<br />

system calibration factor is calculated using a syringe containing<br />

known activity of 32P dissolved in water. Volume and activity within<br />

each VOI are calculated using attenuation corrected images and<br />

system calibration factor. Absorbed dose within each VOI is estimated<br />

using MIRD method. Also activity and dose within liver area were<br />

calculated from planar images using Conjugate View Method (CVM).<br />

Validation of suggested methods for bremsstrahlung planar and<br />

SPECT quantification was done by phantom study and delivered dose<br />

to tumor and liver of 10 patients were estimated.<br />

Results: Phantom study reveals the most accurate method for image<br />

quantification is using attenuation corrected SPECT images using EM<br />

method and according to patient study delivered dose to livers of<br />

80% of patients is below liver’s tolerance dose (40 Gy) while tumors<br />

receive great amount of dose.<br />

Conclusions: The study shows bremsstrahlung SPECT quantification<br />

is possible even without corrections for scatter and collimatordetector<br />

response and cumulated activity in each organ can be<br />

103


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

calculated with the precision of ±4% while activity determination<br />

from planar images can be done with higher degree of uncertainty.<br />

Keywords: Bremsstrahlung Imaging, SPECT quantitation,<br />

Radioembolization<br />

104


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Dual isotope cardiac imaging using Tl-Tc cross-contamination<br />

correction by subtraction method<br />

Mohsen Kohanpour 1 , Hossein Rajabi 2 , Mohsen Beheshti 3 , Faraz<br />

Kalantari 2 , Majid Pouladian 1<br />

1 Islamic Azad University<br />

2 Department of Medical Physics, Tarbiat Modares University<br />

3 Paracelsus Medical University<br />

Introduction: Separate dual isotope, rest 201Tl-stress 99mTc, is a<br />

common protocol for heart imaging. Theoretically, this imaging<br />

protocol can perform simultaneously by defining different energy<br />

windows for each radionuclide. However, a potential limitation of<br />

simultaneous dual isotope SPECT imaging is contribution of scattered<br />

photons from technetium-99m and lead X-rays produced in the<br />

collimator into the thallium-201 energy window, referred to here as<br />

cross-contamination. The aim of this study is introducing a modified<br />

middle energy window method to compensate for this crosscontamination.<br />

Material and Methods: This investigation was performed in clinical<br />

study, that 30 men is gone for cardiac study. In simulation step, the<br />

most suitable functions by their ability to modeling crosscontamination<br />

were determined. To achieve this goal, Root Mean<br />

Square errors between our estimated and real cross-contamination<br />

for each view were used. SPECT images of patients who had<br />

angiographic data were acquired in different energy windows. In each<br />

step of this study, in addition to 201Tl and 99mTc windows centered<br />

at 77 keV and 140 keV respectively; a third window centered at 100<br />

keV is established. at each projection angle, the contaminant image<br />

to be subtracted from the image in the 201Tl window was estimated<br />

as a linear combination of a scatter-window (90-110 keV) image,<br />

convolved by a 2D modified exponential function, and the 99mTc<br />

photopeak image, convolved by a different Gaussian function. All of<br />

these images were compared by determining defect or left ventricle<br />

cavity to myocardium contrast.<br />

Results: Significant improvements in contrasts of simultaneous dual<br />

201Tl images were found in each step . Better results in comparison<br />

with other similar methods also were acquired by our suggested<br />

functions.<br />

Discussion and Conclusion: Our results showed contrast<br />

improvement, however many other parameters should be evaluated<br />

for clinical approaches. Simultaneous dual-isotope201Tl/99mTc<br />

myocardial imaging is seems feasible with 99mTc crosscontamination<br />

correction specific. There are many advantages by<br />

simultaneous dual isotope imaging. It halves imaging time and<br />

doubles patient throughput, improves scheduling flexibility, and<br />

reduces patient waiting time and discomfort. Identical rest/stress<br />

registration of images also makes motion or attenuation correction<br />

easy by physicist and image interpretation by physicians.<br />

105


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Keywords: dual-isotope, cardiac SPECT, cross-contamination,<br />

Thallium, Technetium<br />

106


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Synthesis and evaluation of [99mTc-HYNIC]-BOC-ATE as a<br />

new somatostatin analogue for receptor scintigraphy<br />

Mostafa Erfani(Gandomkar), Reza Najafi<br />

Nuclear Science Research School<br />

Introduction: Radiolabeled somatostatin analogues have been<br />

successfully used for targeted radiotherapy and imaging of<br />

somatostatin receptor (sstr) positive tumours. In an effort to make<br />

available radiolabeled analogues with a broader spectrum and able to<br />

target other sstr in addition to sstr2, [DOTA0, 1-Nal3]-octreotate has<br />

been recently developed. In this study the preclinical evaluation of<br />

Boc-Octreotate labeled with 99mTc using HYNIC chelator and<br />

ethylenediamine-N,N'-diacetic acid (EDDA) as a coligands is<br />

described.<br />

Methods: Peptide was synthesized on a solid phase following typical<br />

Fmoc/Boc protection strategies. Labeling with 99mTc was performed<br />

at 100 °C for 10 min using SnCl2 as reducing agent. Radiochemical<br />

analysis involved ITLC and HPLC methods. The internalization rate<br />

was studied in sstr2 expressing AR4-2J. Biodistribution was studied in<br />

rats.<br />

Results: [99mTc-EDDA-HYNIC]-Boc-ATE was prepared in high<br />

radiochemical yield and purity (>95%). The radiopeptide showed a<br />

fast and specific internalization into AR4-2J cells (15.17% ± 0.81% at<br />

4 h). In animal biodistribution studies a receptor-specific uptake of<br />

radioactivity was observed in sstr-positive organs like pancrase (1.83<br />

± 0.33 %ID/g).<br />

Conclusions: These data show that radioligand have a potential to<br />

target tumours with sstr2 and sstr3 expression, either alone or<br />

concomitantly with other subtypes. [99mTc-EDDA-HYNIC]-Boc-ATE<br />

might prove to be useful in the diagnostic imaging of tumours<br />

expressing sstr2 or additional receptor subtypes.<br />

Keywords: Somatostatin, 99mTc, Tumour<br />

107


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Assessment of the influence of crystal material and size on the<br />

performance of dual head small animal PET scanners<br />

Nafise Ghazanfari 1 , Mohammad Reza Ay 1 , Saeed Sarkar 1 , George<br />

Loudos 2<br />

1 Department of Medical Physics and Biomedical Engineering<br />

2 Department of Medical Instrument Technology<br />

Introduction: Small animal imaging is a significant tool at the<br />

disposition of biological researchers to use in non-invasive study of<br />

preclinical animal models. In the last two decades, commercialization<br />

of these technologies has significantly increased due to the<br />

specifications and ability of them. However, several groups try to<br />

develop high-resolution and high-sensitivity dual head systems,<br />

which are cost benefits and can satisfy requirement of basic PET<br />

studies. It is well known system performance significantly depend on<br />

different crystal factors such as material, size, thickness.<br />

Methods: In this study pixilated dual head animal PET scanner using<br />

GATE MC package was modeled. In order to assess the influence of<br />

crystal dimension on system performance numerous pixel size,<br />

ranging between 0.5—0.5 to 3.0—3.0 mm by increment of 0.5 mm<br />

and crystal materials BGO, LSO, and GSO was considered. For all<br />

measurements a point source with the activity 1 MBq was placed at<br />

the center of FOV.<br />

Results: According to the achieved result, by increasing pixel size<br />

sensitivity will be increased from %1 to %7 and percentage of mispositioned<br />

events will be decreased between the range %76 to % 45<br />

and spatial resolution in different designs will be lost from 0.6 to 2.6<br />

mm. But by increment of crystal length from 10 mm to 15 mm,<br />

sensitivity enhance from %2 to %6, percentage of mis-positioned<br />

events increased from % 89 to % 59 and also spatial resolution<br />

changed from 0.6 to 3.5 mm.<br />

Conclusion: The simulation illustrated that BGO based scanners<br />

have higher sensitivity than equivalent size of LSO and GSO and also<br />

less registration of mis-position events. The results of the evaluation<br />

demonstrate to achieve proper dimension of crystal size, can be said,<br />

considering pixel size 2 mm, crystal thickness 10 mm could provide<br />

the best situation to get better system performance.<br />

Keywords: small animal PET, DHC, GATE<br />

108


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

STUDY ON NEW NON-RADIOACTIVE FDG-like MAGNETIC<br />

NANOMATERIALS FOR DIAGNOSIS, MARKING AND<br />

TREATMENT OF MALIGNANT TUMORS<br />

Nicolae Verga 1 , Jenica Neamtu 2 , Dariush Sardari 3<br />

1 Carol Davila Univ- Romania<br />

2 ICPE-CA - Romania<br />

3 Islamic Azad University<br />

Introduction: PET-CT imaging is a valuable method to detect<br />

malignant neoplasia of either primary or metastatic types. There are<br />

always the technical possibilities of implementing PET-CT but no MRI<br />

and CT scanners, which is why we have invented a nanogranular<br />

magnetic compound on whose surface was fixed 2-deoxy-D-glucose.<br />

After the diagnosis of malignancy it is necessary for tumor marking to<br />

track its evolution under treatment. There are currently implanted<br />

invasive fiduciary markers. Hyperthermia therapy is another method<br />

that increases efficiency in radiotherapy and chemotherapy. Our<br />

compound nanogranular meets all these three qualities.<br />

Scope and aims: In this paper are presented some results regarding<br />

the effect of a colloidal solution of magnetite-saccharide nanosystem<br />

on both normal and tumor cells. For this purpose we chose a cell<br />

culture with high sensitivity to glucose. The cells have been grown in<br />

order to obtain two cell cultures with different response to the<br />

dynamics of glucose metabolism. We supposed that the tumor cells<br />

alike will absorb significant amount of magneto-saccharidic<br />

nanocomposite.<br />

Methods: Both cultures were exposed to the same colloidal solution<br />

of a magnetite-saccharide nanosystem. Sample of colloidal solution of<br />

magneto-saccharidic nanocomposite is ferromagnetic at room<br />

temperature behavior: saturation magnetization of 20 emu / g, the<br />

saturation magnetic field (SA) of 3500 Oe, coercivity (HC) of 100 Oe.<br />

We will also present the specific experimental device for modeling the<br />

arterial system and target tissue. Findings Results are analyzed<br />

before and after exposure to the solution of composite regarding the<br />

number of cells (toxicity), the ferromagnetic behavior culture medium<br />

of the two cell types, and magnetic resonance imaging diagnostic in<br />

T1 and T2 of both two cell culture.<br />

Results: Small quantity of magnetite-saccharide nanosystem has<br />

been produce and examined. Due to small amount of material, the<br />

results are not conclusive enough. We consider it necessary to<br />

produce a larger amount of magneto-saccharide nanocomposite.<br />

Complementary experiments are to carried out both to bi-cellular<br />

model and experimental animal with cancer.<br />

Keywords: Malignancy, Nanomgnetism, PET/CT Diagnostic<br />

109


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Correction of contrast agent induced artifacts in CT-based<br />

attenuation correction of cardiac PET data using a semiautomated<br />

segmentation algorithm<br />

Pardis Ghafarian 1 , Mohammad Reza Ay 2 , Javad Hassani Bidgholi 2<br />

1 NRITLD<br />

2 Research Center for Science and Technology in Medicine<br />

Introduction: With the advent of 64-slice CT subsystems combined<br />

with PET scanners, full clinical cardiac protocols are possible including<br />

CTA and calcium score imaging as an adjunct to myocardial viability<br />

and perfusion examination. The propagation of CT artifacts into PET<br />

images due to CT image contaminated with high density intravenous<br />

contrast agent during CTA is one of the main reasons that force the<br />

physicians to take two different CT for the purpose of CTA and CTAC.<br />

In this study, we developed a semi-automated algorithm for<br />

segmentation and classification of regions containing contrast<br />

medium to correct for artifacts in CTAC using the segmented contrast<br />

correction (SCC) algorithm in order to reduce patient dose during full<br />

cardiac assessment.<br />

Methods: The study was performed using 12 patients including CTA<br />

and perfusion/viability examinations acquired on the Biograph TP 64<br />

PET/CT scanners. After segmentation of contrast agent in myocardial<br />

wall and chamber the values replaced with correct value based on<br />

SCC algorithm and then the µ-map generated using both CTA and the<br />

CT images acquired for the purpose of CTAC.<br />

Results: After correction of CTA for all patients and generation of<br />

their µ-map based on CTAC method for both corrected CTA and<br />

ACCT it was showed that the percentage absolute relative difference<br />

between the generated µ-map from ACCT and CTA before and after<br />

correction was 8.8±3.9 and 1.3±1.2 for myocardium wall and<br />

15.5±4.7 and 0.3±0.2 for left ventricle chamber, respectively.<br />

However the percentage absolute relative differences between the CT<br />

numbers of the same regions were 340.7±193.8, 21.4±18.6,<br />

599.7±215.6 and 10.7±11.3, respectively. The preliminary results of<br />

this study showed that corrected CTA can be used for CTAC of cardiac<br />

PET data.<br />

Conclusion: This feasibility study suggested the potential to<br />

eliminate the ACCT scan that normally used for attenuation<br />

correction, thus allowing reduction of patient dose during full cardiac<br />

assessment.<br />

Keywords: CTAC, PET, Contrast Agent, CTA<br />

110


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Estimation of Human Effective Absorbed Dose of 67Ga-DTPA-<br />

Gonadorelin Based On Biodistribution Rat Data<br />

Saeed Shanehsazzadeh, Afsaneh Lahooti<br />

Department of Biomedical Physics and Engineering<br />

Background: In this investigation, we estimated the effective<br />

absorbed dose to human organs, following i.v. administration of<br />

67Ga-labeled gonadorelin -one of the gonadotropin releasing<br />

hormone (GnRH) agonists- using biodistribution data from injected<br />

normal rats.<br />

Methods: Four rats were sacrificed at exact time intervals (0.25, 0.5,<br />

1, 2, 4, 24 and 48 hour post injections) and the percentage of<br />

injected dose per gram of each organ was measured by direct<br />

counting from rat data. The Medical Internal Radiation Dose (MIRD)<br />

formulation was applied to extrapolate from rat to human and to<br />

project the absorbed radiation dose for various organs in the human.<br />

Results: From rat data we estimate that a 185-MBq injection of<br />

67Ga-cDTPA-GnRH into the human might resulted in an estimated<br />

absorbed dose of 5.26 mGy to the whole body and the highest<br />

effective absorbed dose was in lung with 2.73 mSv and the organs<br />

received the next highest doses were the bladder wall 1.59 mSv, liver<br />

0.80 mSv and Bone marrow 0.52 mSv.<br />

Conclusion: The biodistribution of 67Ga-cDTPA-GnRH in rats showed<br />

high breast uptake and low muscle and blood uptake. These results<br />

suggest that it should be possible to perform early imaging of the<br />

breast anomalies and GnRH receptors indicating potential malignant<br />

lesions.<br />

Keywords: Absorbed dose, GnRH, Biodistribution<br />

111


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Patient and Staff Dose Optimization in Nuclear Medicine<br />

Diagnosis Methods<br />

Sajad Abedi<br />

The implementation of the Basic Safety Standards (BSS) Directive<br />

96/29 on the protection of workers and general population against<br />

the danger arising from ionizing radiation [1] and the Directive 97/43<br />

on health protection of individuals against dangers of ionizing<br />

radiation in relation to medical exposure, known as the Medical<br />

Exposure Directive (MED) [2], they started in Poland some years ago<br />

with the Polish Atomic Law [3] and executive orders published by the<br />

Polish Government and Polish Health Minister [4]. Poland’s<br />

Government has applied for several years transitory period to<br />

complete implementation of the Directive 97/43/EURATOM because<br />

of the technical, organizing and economical problems related with this<br />

procedure. The most important task has arisen to prepare procedures<br />

according with the current state of knowledge in the area of Quality<br />

Assurance (QA) and Quality Control (QC) of medical equipment using<br />

ionizing radiation in diagnosis. QA and QC in X-ray diagnosis<br />

equipment started to be introduced since several years ago and<br />

nowadays they are put in common practice in almost every X-ray<br />

laboratory in Poland. As result, the nuclear medicine departments<br />

must follow the new legislation which has imposed also obligatory<br />

necessity of regular Quality Assurance and Quality Control of<br />

equipment and procedures for preparing and using<br />

radiopharmaceuticals. In this paper the QA and QC procedure<br />

elaborated for the nuclear medicine department has been presented.<br />

Keywords: 97/43/EURATOM, Staff Dose Optimization, Diagnosis<br />

Methods<br />

112


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Therapeutic applications and dosimetry of<br />

radiopharmaceuticals with the help of compartmental analysis<br />

Sajad Abedi<br />

The successful application of radiopharmaceuticals requires a patientspecific<br />

optimization of the activity to be administered, in order to<br />

deliver the desired therapeutic dose to the target organ while saving<br />

the healthy tissues. For a therapy specifically tailored on the<br />

characteristics of the patient, the correct knowledge of the<br />

morphology of the regions of interest, of the fractional uptake and of<br />

the related kinetics is necessary. Compartmental analysis is a<br />

modeling tool used to describe a system as a series of units<br />

(compartments), where the quantities of interests (variables of state,<br />

Qi) can be considered to behave in a uniform and homogeneous<br />

way.The examples presented have shown that compartmental<br />

models, although still excessively demanding for being used in the<br />

daily routine in nuclear medicine departments, can be a valuable tool<br />

in preliminary studies to provide better, individualized dosimeter for<br />

the patient, to improve and optimize the time schedule for data<br />

measurements, to improve and optimize the modality of drug<br />

administration and to improve the understanding of the underlying<br />

pharmacokinetics and pharmacodynamics.<br />

Keywords: Compartmental analysis, Therapeutic compartments<br />

D120<br />

113


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Development of Ho-166 chitosan for radiosynovectomy<br />

Samaneh Zolghadri, Amir Reza Jalilian, Hasan Yousefnia, Ali Bahrami-<br />

Samani, Simindokht Shirvani-Arani, Mohammad Ghannadi-Maragheh<br />

Nuclear Science and Technology Research Institute<br />

Chitosan (CHITO), a natural and biodegradable polysaccharide with<br />

wide range applications in bio-pharmaceutics, agriculture and water<br />

treatment purposes, is an excellent molecule for intra-cavital therapy.<br />

In this research, 166Ho-CHITO complex production is described in<br />

details, followed by determination of complex radiochemical purity,<br />

stability and biodistribution (after intra-articular injection) in wildtype<br />

male rats. Finally a Ho-166 based chitosan kit for ultimate<br />

radiosynovectomy applications in the country was developed.<br />

Production of 166Ho was performed at the Tehran Research Reactor<br />

(TRR) using natHo (n, gamma)166Ho nuclear reaction. 166Ho-<br />

Holmium chitosan complex was prepared and Radiochemical purity<br />

was determined using ITLC. The stability of prepared 166Ho-holmium<br />

chitosan complex was checked up to 48 hours after preparation. The<br />

distribution of injected dose in rat organs up to 144 h after intraarticular<br />

injection of 166Ho-holmium chitosan complex (60 µCi/100ul)<br />

solution was determined for control studies. labeling yield increased<br />

with increasing chitosan concentration and reached above 98% when<br />

the concentration reached 35 mg/3 ml. The highest labeling yield was<br />

achieved at pH=2.8-3.2 while decreased beyond this range. The<br />

labeling yield of 99% was achieved after 30 minutes. The effect of<br />

absence and presence of ascorbic acid (at various concentrations) as<br />

a complex stabilizer were also studied. A kit formulation was<br />

developed for the in-situ preparation of the radiopharmaceutical in<br />

remote clinical centers.<br />

Keywords: chitosan, holmium, biodistribution, labeling<br />

114


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Evaluation of hand dose and internal dose of workers in<br />

selected nuclear medicine centers of Iran<br />

Seyed Mehdi Hosseini Pooya 1 , Tahereh Orouji 2 , Jila Karimi Diba 3 ,<br />

Mansour Jafarizadeh 3<br />

1 National Radiation Protection Department<br />

2 Radiation Application Research school, Nuclear Science & Technology Research<br />

Institute (NSTRI)<br />

3 Agriculture, Medicine and Industry Research school, Nuclear Science &<br />

Technology Research Institute (NSTRI)<br />

Abstract: The Annual hand dose of nuclear medicine personnel who<br />

directly deal with the injection of radionuclides to the patients have<br />

been measured using TLD finger dosimeters and statistically<br />

evaluated. This task related monitoring has been carried out in 8<br />

diagnostic nuclear medicine centers during the years 2006 to 2010 in<br />

Iran. The results show that the maximum equivalent hand dose is<br />

about 270 mSv and showing a decreasing trend by a factor of around<br />

5 to about 55 mSv value during 2006 to 2010. As well in spite of<br />

increased number of workers during 2006 to 2010, the average hand<br />

dose has been decreased from 17 mSv in 2006 to 8.46mSv in 2010.<br />

Also the internal dose due to the inhalation of 131I have been<br />

measured for workers in two volunteer therapeutic nuclear medicine<br />

centers (with high load of patients) and the results did not show any<br />

significant internal contamination for the majority of them. The<br />

maximum contamination has been measured to be 70 kBq which can<br />

make a maximum committed effective dose of 0.764 mSv. It can be<br />

concluded that by observing the radiation protection principles and<br />

using appropriate radiation protection equipments, the hand<br />

equivalent dose and committed effective dose extremities could be<br />

kept less than the annual limits of 500 mSv and 20 mSv respectively.<br />

Keywords: nuclear medicine, committed dose, internal<br />

contamination, finger dosimetry<br />

115


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Radiolabeling of Cefepime and its evaluation as an infection<br />

imaging agent<br />

Seyedeh Fatemeh Mirshojaei, Mostafa Erfani (Gandomkar),<br />

Mohammad Hossein Talebi, Seyed Mohammad Mazidi<br />

AEOI<br />

Introduction: Contrary to conventional imaging techniques like CT<br />

and MRI, scintigraphic imaging is based on physiological and<br />

biochemical alterations resulting from inflammatory and infectious<br />

processes. A new proposal is based on the use of radiolabeled<br />

antibiotics. They are used as specific infection imaging because of<br />

their affinity to bind with bacteria. Antibiotics localize in the infectious<br />

focus, where they are frequently taken up and metabolized by<br />

microorganisms. The majority of the various antibiotics studied so far<br />

are those of the quinolones group. Recently, a new<br />

radiopharmaceutical, 99mTc-ciprofloxacin (Infecton), has been<br />

developed. Cefepime a third-generation cephalosporin antibiotic used<br />

to treat bacterial infections was investigated to label with 99mTc.<br />

Methods: labeling of Ceftazidime with 99mTc was performed by<br />

using sodium dithionite as reducing agent. Labeling was performed at<br />

100 ºC for 10 min and radiochemical analysis involved ITLC and HPLC<br />

methods. The stability of labeled antibiotic was checked in the<br />

presence of human serum at 37ºC up to 24 h.<br />

Results: This study aimed to investigate the labeling condition of<br />

cefepime, a third generation cephalosporin. The radiolabeling yield as<br />

measured by chromatographic method was 86.7±2%. The labeling<br />

of 99mTc-cefotaxime was optimal in the following reaction mixture:<br />

Cefepime (2.5 mg in 200 µl distilled water), 7.25 mg of Na2S2O4 in<br />

200 µl NaHCO3 0.5%, pH: 8.5-9, reaction time: 10 min and reaction<br />

temperature: 100ºC. 86.7±2%. Bacterial binding assay was<br />

performed with S. aureus and the in vivo distribution was studied in<br />

mice. Images showed minimal accumulation in non-target tissues,<br />

with an average target/non-target ratio of 1.88±0.28.<br />

Conclusion: Reaction was easygoing within a very short time which<br />

makes it a good radiopharmaceutical for clinical usage in nuclear<br />

medicine laboratories. The radiotracer demonstrated excellent<br />

radiochemical stability even up to 24 h post labeling. This antibiotic<br />

showed an improvement in excretion pathway from liver to kidney<br />

followed by an accumulation of radioactivity in infected areas.<br />

Keywords: Cefepime, Radiolabeling, Infection detection,<br />

Biodistribution<br />

116


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Attenuation Correction in SPECT, using Inverse Monte Carlo<br />

Methodduring Image reconstruction, A Simulation Study<br />

Shahla Ahmadi 1 , Hossein Rajabi 2 , Farshid babapour 1 , Faraz Kalantari 2<br />

1 Department of Medical Radiation Engineering<br />

2 Department of Medical Physics, Tarbiat Modares University<br />

Material and Methods: List mode output of SIMIND Monte Carlo<br />

simulator was used to find the relation between activity distribution<br />

and pixel values in projections. MLEM iterative reconstruction method<br />

then was used to reconstruct activity distribution from projections.<br />

Attenuation free projections were also simulates. Reconstructed<br />

images from these projections were used as our reference image. Our<br />

suggested attenuation correction method was evaluated using three<br />

different phantom configurations: uniform activity and uniform<br />

attenuation phantom, non-uniform activity and non-uniform<br />

attenuation phantom and NCAT torso phantom. The mean pixel<br />

values and fit between profiles were used as quantitative parameters.<br />

Results: Images free from the attenuation related artifact were<br />

reconstructed by our suggested method. A significant increase in<br />

pixel values was found after attenuation correction. Better fit<br />

between profiles of our corrected images and our reference images<br />

were also found for all phantom configurations.<br />

Conclusion: Using Monte Carlo it is possible to find the most precise<br />

relation between activity distribution and its projections. Therefore it<br />

is possible to create mathematical projections with the effect of<br />

attenuation. This helps to have more realistic comparison between<br />

mathematical and real projections that is necessary step for image<br />

reconstruction using MLEM. This results in images with much better<br />

quantitative accuracy, at the cost of computation time and memory.<br />

Keywords: MLEM, Reconstruction, Attenuation correction,<br />

117


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Production of colloidal radiopharmaceutical 90Y<br />

Hydroxyapatite for radiosynovectomy uses<br />

Sima Attar Nosrati, Mohamad Reza Davarpanah, Hoseinali<br />

Khoshhosn, Mohsen Harati<br />

NSTRI<br />

Introduction: Radiosynovectomy is a well-accepted therapeutic<br />

procedure in inflammatory joint diseases. There are several<br />

radionuclides available for this treatment, However, Yttrium-90 (90Y)<br />

is often believed to be among the most useful of the radionuclides<br />

that have been considered for therapeutic applications in large joints.<br />

90Y has a half-life of 64.1 h and emits beta rays of high energy<br />

(Eβmax=2.3 MeV), with no accompanying gamma-rays.<br />

Hydroxyapatite (HA) [Ca10(PO4)6(OH)2] is the natural mineral<br />

constituent of bone matrix and can be synthesized in the desired<br />

particle size range. HA particles get converted to Ca2+ and PO43-<br />

ions by natural metabolic process and eliminated over a period of 6<br />

weeks.<br />

Purpose: The present study describes the production of 90Y-HA<br />

colloidal radiopharmaceutical and its characterization including the<br />

size distribution profile of the particles, radiochemical purity,<br />

radionuclidic purity, stability and biodistribution studies.<br />

Method: For the preparation of 90Y labeled HA particles, 40 mg of<br />

HA particles added to a 2ml conical vial, 0.8 ml of saline solution, the<br />

suspension was stirred for 5 minutes at room temperature. 100 μL of<br />

90YCl3 solution (~370 MBq of 90Y) was added and the mixture was<br />

shaken for 1 h at room temperature and the radiolabeled particles<br />

were then separated from free 90Y activity by centrifugation. The<br />

radiolabeled particles were resuspended in 2 ml saline, shaken for<br />

few minutes and centrifuged to determine the labeling efficiency.<br />

Results: The radiolabelling yield was 98% and the radiochemical<br />

purity of the labelled product was 97%. Particle size distribution of<br />

the product was 2-10 μm. Stability studies in vitro showed that 90Y-<br />

HA particles were stable in saline as well as at least 3 days).<br />

Biodistribution experiments in rats showed good localization of the<br />

particles in the synovium of the knee joint.<br />

Conclusion: HA particles labeled with 90Y can be prepared with high<br />

labeling efficiency for radiosynovectomy applications. The 90Y-HA<br />

particles prepared are stable and the method is convenient for<br />

routine production of this radiopharmaceutical.<br />

Keywords: Colloide, Radiopharmaceutical, Radiosynovectomy, 90Y-<br />

HA, Hydroxyapatite<br />

118


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Poster Presentations<br />

119


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Effect of Restricted Sea foods on 99m Technetium Thyroid<br />

Scintigraphy: A Neglectful Issue in Routine Practice<br />

Hamid Javadi 1 , Mehdi Mogharrabi 2 , Isa Neshandar Asli 3 , Sara<br />

Jalallat 1 , Iraj Nabipour 4 , Majid Assadi 5<br />

1 Golestan Research Center of Gastroenterology and Hepatology (GRCGH)<br />

2 Golestan University of Medical Science, Department of Nuclear Medicine<br />

3 Shahid Beheshti University of Medical Science, Department of Nuclear Medicine<br />

4 The Persian Gulf Marine-Medicine Biotechnology Research Center<br />

5 The Persian Gulf Nuclear Medicine Research center<br />

Introduction: Although patients are recommended to avoid sea food<br />

and iodine-containing medications prior to I-131 scanning, the<br />

efficacy of this approach for Tc 99m-pertechnetate thyroid<br />

scintigraphy is not well addressed in the literature. We evaluated a<br />

self-managed, outpatient, restricted iodine diet (RID) designed to<br />

reduce total body iodine (TBI) in preparation for such scan.<br />

Methods: Thirty-nine subjects (30 females and 9 males; age: 14-54<br />

years) with poor visualization of thyroid gland on Tc99mpertechnetate<br />

thyroid scintigraphy were called to carry out the<br />

repeated scan after going on a RID for at least two weeks prior to the<br />

second scintigraphy. The semiquantitative analysis in 8 regions of<br />

interest (ROIs) was accomplished using Wilcoxon signed rank test.<br />

Results: Thirty-six subjects had better quality scintigraphy images in<br />

post RID thyroid scan, assessed by two nuclear medicine physicians<br />

with full agreement. There was a statistically significant difference in<br />

two regions of right and left thyroid lobes (ROI 5, 6) with increased<br />

count rates in the post RID projections (p


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Statistical Evaluation of Pulmonary Embolism with Lung<br />

Ventilation-Perfusion Scan<br />

Esmael Gharepapagh¹, Arman Salarifar 2<br />

1 Tabriz University of Medical Sciences, Department of Nuclear Medicine<br />

2 Tabriz University of Medical Sciences<br />

Background: Pulmonary embolism (PE) is a common fatal disease,<br />

therefore, the accurate and prompt diagnosis is very important. The<br />

aim of this study is evaluation of lung perfusion-ventilation scan with<br />

relative radiodrugs including 99mTc-MAA and radioaerosols as a noninvasive<br />

and readily available methods with acceptable sensitivity and<br />

specificity in the diagnosis of PE.<br />

Materials and Methods: In this study 149 patients with respiratory<br />

problems, who had referred to the nuclear medicine department of<br />

Tabriz Imam Hospital, from October 2005 to November 2006, were<br />

studied. The perfusion scans performed after iv. injection of 99mTc-<br />

MAA,and the ventilation scans performed after inhalation of 99mTc-<br />

DTPA aerosol on the routine views of lungs. The resulting images<br />

were evaluated by nuclear medicine specilalist regarding the<br />

probabilities of PE. The relationship of sex, age, clinical presentations,<br />

risk factors, previous cardio-pulmonary disorders and chest X-Rays of<br />

the patients, with high and low probability of PE were also evaluated.<br />

This study’s subjects were consisting of 78 men and 71 women who<br />

were examined based on taking their medical history, studying their<br />

medical files and evaluating their related documents.<br />

Results: In the present study, it was discovered that the number of<br />

involved men with PE was higher than women (P < 0.005), as the<br />

patients get older, the incidence of PE becomes higher (P = 0.005),<br />

there was a direct connection between the probability of PE and<br />

having clinical presentations of their illness(P = 0.005).It was also<br />

apparent that the existence of cardio-pulmonary disorders, having an<br />

abnormal CXR and the lack of a risk factor, were all accompanied<br />

with low probability of PE, but the presence or absence of risk factors<br />

showed no meaningful difference for the high probability of PE (P =<br />

0.232).<br />

Conclusion: The lung perfusion-ventilation scan is recommended as<br />

an acceptable method in the early diagnosis of PE and also evaluation<br />

of prevalence and affecting factors of disease.<br />

Key words: Lung perfusion-ventilation scan, pulmonary embolism<br />

121


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Brain SPECT in patients with history of unsuccessful suicide<br />

Fariba Saddadi, Reza Shokouhizadeh<br />

AIM: Brain scintigraphy is a helpful method to evaluate psychiatric<br />

patients and the aim of this study to assess depressive patients who<br />

attempted suicide to find any significant changes in their cerebral<br />

flow.<br />

Material and Methods: 14 patients who attempted unsuccessful<br />

suicide were enrolled and underwent brain SPECT study. The mean<br />

time of scan from suicide was 6 months. SPECT imaging was<br />

performed as standard protocol using Philips ADAC with LEAP<br />

collimator to find rCBF changes.<br />

Results: There is almost reduced rCBF in frontal cortex in all 14<br />

patients. Which 10/14 shows perfusion deficits in left frontal lobe and<br />

4/14 with sever depression show bilateral deficits throughout the<br />

frontal lobes, fronto-parietal and temporo-parietal cortex as well.<br />

Conclusions: We found that brain scintigraphy can helpful in<br />

management of depressive patients and via close monitoring of<br />

cerebral flow with doing periodically scans it can also help in<br />

prevention of suicide.<br />

Keywords: Brain SPECT, Suicide<br />

122


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Hybride Imaging in Thyroid Cancer<br />

Mehrossadat Alavi, Farshid Gheisari<br />

Shiraz University of Medical Sciences<br />

Whole-body scintigraphy (WBS) performed after radioiodine ablation<br />

or therapy has the ability to detect new or additional metastases in<br />

10-25% of cases, alter staging in 10%, and affect further<br />

management in 9-15% of patients. Radioiodine-avid metastases can<br />

be small and may occur in regions with distorted anatomy after<br />

surgery. SPECT/CT will improve the ability for their correct<br />

localization. On post-therapeutic WBS, the high activity contained in<br />

residual thyroid tissue often hampers cervical N-staging, a limitation<br />

that is overcome with SPECT/CT. SPECT/CT is expected to improve<br />

the diagnostic accuracy of WBS and therefore to have a significant<br />

effect on patient management. The majority of radioiodine-avid foci<br />

were correctly classified as benign or malignant by hybrid imaging.<br />

SPECT/CT was found to change the therapeutic procedure in 25% of<br />

patients. In There is currently no well-established role for 18Ffluorodeoxyglucose<br />

(FDG) PET/CT for routine diagnosis and follow-up<br />

of patients with differentiated thyroid carcinoma. 18F-FDG PET/CT is<br />

currently recommended for patients with differentiated thyroid cancer<br />

who have elevated thyroglobulin levels and negative radioiodine WBS<br />

post-therapy.<br />

Keywords: Hybrid imaging, Thyroid cancer, SPECT-CT<br />

123


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Radiolabeling of ceftriaxone with 99mTc for detecting site of<br />

infection in mouse model<br />

Akram Fazli, Gholamreza Ahmadi, Mojtaba Salouti, Shahrzad<br />

Mirshojaei<br />

Introduction: Although our understanding of microorganisms has<br />

advanced significantly and antimicrobial therapy has become<br />

increasingly available, infection remains a major cause of patient<br />

morbidity and mortality. The use of radiopharmaceuticals for<br />

diagnosis of infection is increasing due to their ability to distinguish<br />

between septic and aseptic inflammation.<br />

Aims: The aim of this work was, labeling of ceftriaxone (a<br />

cephalosporin antibiotic) with 99mTc for Staphylococcus aureus<br />

infection diagnosis in nuclear medicine.<br />

Methods: Radiolabeling of ceftriaxone was carried out by adding<br />

99mTc to ceftriaxone (1.5 µCi to 1 mg) in the presence of<br />

SnCl2.2H2O at PH 5.5. The radiolabeling yield and radiochemical<br />

purity of product was evaluated with ITLC. The mice were induced<br />

infection intramusculary with Staphylococcus aureus and strile<br />

inflammations with turpentine oil. The biodistribiotion and<br />

scintigraphy imaging were performed at 1, 4 and 16h post injection.<br />

Results: Radiochemical yield of product was 94±5% with a good<br />

stability in room temperature and human serum. The biodistribution<br />

and scintigraphic imaging studies showed the specific localization of<br />

99mTc-ceftriaxone at the site of infection in relation to inflamated leg<br />

and other organs with high sensivity.<br />

Conclutions: One may consider 99mTc-ceftriaxone as a promissing<br />

candidate for Staphylococcus aureus infection diagnosis in nuclear<br />

medicine.<br />

Keywords: Radiolabeling, Infection, Biodistribution, Scintigraphy<br />

124


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Correlation of circulating omentin-1 with bone mineral density<br />

in multiple sclerosis: the crosstalk between bone and adipose<br />

tissue<br />

Majid Assadi 1 , Hooman Salimipour 2 , Samad Akbarzadeh 3 , Zahra<br />

Samani 1 , Reza Nemati 2 , Seyed Mojtaba Jafari 4 , Mohammad<br />

Seyedabadi 1 , Iraj Nabipour 4<br />

1 The Persian Gulf Nuclear Medicine Research Center<br />

2 Department of Neurology<br />

3 Department of Biochemistry<br />

4 Department of Endocrine and Metabolic Diseases<br />

Introduction: Adipose tissue-derived adipokines play important<br />

roles in inflammatory and autoimmunediseases. Although the<br />

relationship of adipokines with chondrocyte function and the skeleton<br />

have been investigated, the role of novel adipokines (e.g., omentin-1<br />

and vaspin) in osteoimmunology remains to be elucidated. Patients<br />

with multiple sclerosis (MS) are at increased risk of osteoporosis and<br />

fractures.<br />

Methods: In order to investigate circulating levels of these novel<br />

adipokines in relation to bone health in MS, 35 ambulatory MS<br />

patients with elapsingremitting courses were compared with 38<br />

healthy age- and sex-matched healthy controls. Bone mineral density<br />

(BMD) was determined for the lumbar spine (L2-L4) and the proximal<br />

femur using dual-energy x-ray absorptiometry. Circulating omentin-<br />

1, vaspin, osteocalcin, osteopontin, osteoprotegerin, the receptor<br />

activator of nuclear factor-ĸB ligand, matrix metalloproteinase 9, and<br />

C-reactive protein were evaluated by highly specific enzyme-linked<br />

immunosorbent assay methods.<br />

Results: There was no significant difference between the two groups<br />

regarding bone-related cytokines, adipocytokines, and the BMD<br />

measurements of patients with MS and the healthy controls.<br />

However, age- and body mass index- adjusted circulating omentin-1<br />

levels were positively correlated with BMD at the femoral neck (r=<br />

0.44, p=0.017), total hip (r=0.41, p=0.027), osteopontin (r=0.44,<br />

p=0.031) and osteocalcin (r=0.47, p=0.012) in MS patients. No<br />

correlations were found between vaspin, biochemical, and BMD<br />

measures in both groups.<br />

Conclusion: Elevated omentin-1 serum levels are correlated with<br />

BMD at the femoral neck and the serum levels of osteocalcin and<br />

osteopontin in MS patients. Therefore, there is crosstalk between<br />

adipose tissue and bone in MS as an autoimmune disorder.<br />

Keywords: Multiple sclerosis, Bone mineral density, Omentin-1<br />

125


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Functional anatomical cardiac imaging: PET/CT molecular<br />

imaging<br />

Mehrshad Abbasi 1 , Alireza Emami 1 , Salam Heydarinejad 2 , Babak<br />

Falahi 1 , Mohammad Eftekhari 1<br />

1 Tehran University of Medical Sciences, Department of Nuclear Medicine<br />

3 Endocrine and Metabolism Research Center<br />

Comparable with the pure anatomical findings of the CT, the<br />

functional PET/CT imaging provides two additional advantages over<br />

the SPECT technique: attenuation correction and corresponding<br />

feasibility of absolute measurements. In cardiology, the absolute<br />

measures of myocardial blood flow and the myocardial flow reserve<br />

joint with the metabolic imaging can be used for noninvasive<br />

evaluation of sub-clinical as well as more advanced clinical<br />

abnormalities in the coronary function, tissue viability of the<br />

myocardium, left ventricular dysfunction and the response to<br />

therapy. The co-registration of PET/CT biological and morphological<br />

data with the higher accuracy for detection of trivial or balanced<br />

perfusion abnormalities and better assessment of the extent and<br />

severity of pathology would probably limit the number of superfluous<br />

invasive procedures in future. In this review the diversity of the usual<br />

tracers as well as endothelial and metabolic molecular markers<br />

(targeting apoptosis, inflammation, remodeling, and above all,<br />

reporter genes) with their current and possible forthcoming clinical<br />

applications are discussed.<br />

Keywords: PET, Molecular imaging, CAD<br />

126


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Overview of the lymph edema caused by radiation<br />

Mohamadreza Chahkandi 1 , Sanaz Amirian 2 , Amene Yalodbardan 3<br />

1 Mash’had University of Medical Sciences<br />

2 Islamic Azad University-Young Research Club-Mashhad Brunch<br />

3 Emdad Hospital-Mashhad University of Medical Sciences<br />

Radiotherapy in the treatment of many diseases such as cancers is<br />

used. In the meantime problems such as arm swelling caused by<br />

swelling of lymph organs, which may in some cases after<br />

radiotherapy, especially radiotherapy due to breast cancer that is<br />

done is very common. In this review article The causes and<br />

treatment of this complication will.<br />

Intoduction & Conclusion: high-energy X-rays in breast cancer are<br />

used to destroy cancer cells. Side effects that may result from<br />

damage to tissues near the tumor, but usually they can be controlled.<br />

In external radiation, radiation to the tumor carefully shining and<br />

shining from the surrounding healthy tissue, can be avoided. In<br />

internal radiation therapy or brakyatrapy, radioactive material<br />

directly into the breast is placed. After a lumpectomy, breast<br />

irradiation under fully placed. After mastectomy, the chest may also<br />

be irradiated. In some cases, the lymph nodes that area are probably<br />

irradiated. Lymphedema or swelling of lymph hands and arms, and<br />

one of the most common complications of breast cancer is about 30<br />

percent of patients with this condition involves. This condition for<br />

protein-rich fluid in the subcutaneous tissue comes into existence.<br />

Patients following mastectomy, radiotherapy and axillary lymph<br />

glands discharge after surgery due to impaired lymphatic drain upper<br />

extremity on the affected side of 10 to 49 percent in the risk of<br />

lymphedema are. Effective methods for controlling edema lymph to<br />

mobilize fluid accumulated as a first step in treatment and to mobilize<br />

fluid lymph tissue, subcutaneous methods such as using Stynhay<br />

genocidal _ exercise because the exercise by moving fluid nodes of<br />

total it being a place prevents and reduces edema and improve organ<br />

function is affected Vlavh this exercise heart rate and blood flow can<br />

increase lymphatic flow Dhddr result is also higher. hack such a fluid<br />

pump using maneuvers performed by hand or pump pressure can<br />

also be useful.<br />

Keywords: Lymphedema, radioactive material, breast cancer,<br />

Radiotherapy<br />

127


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Radiosynovectomy: A noble treatment for joint diseases<br />

Mohammad Qodsi Rad, Nasim Norouzbeigi<br />

Mashhad University of Medical Science, Imam Reza Hospital<br />

Introduction: Joint disorders are relatively common in any society<br />

and radiosynovectomy is an reliable and effective treatment for joints<br />

diseases like rheumatoid arthritis and hemophilic artheropathy.<br />

Aims: This study aims to review latest achievements in the field of<br />

radiosynovectomy.<br />

Methods: Two important data base PUBMED and SCOPUS as well as<br />

the Cochrane library was searched for latest articles about<br />

radiosynovectomy.<br />

Results: Three radionuclides are in current use: 90Y-silicate/citrate,<br />

186Re-sulfide, and 169Ercitrate. 90Y emits a beta particle with a<br />

maximum energy of 2.27 MeV, a mean energy of 0.935 MeV and an<br />

average soft tissue range of 3.6 mm. The physical half-life is 2.7<br />

days. 186Re emits a beta particle with a maximum energy of 1.07<br />

MeV, a mean energy of 0.349 MeV, an average soft tissue range of<br />

1.1 mm and the physical half-life is 3.7 days. 169Er emits a beta<br />

particle with a maximum energy of 0.34 MeV, a mean energy of<br />

0.099 MeV and an average soft tissue range of 0.3 mm. The physical<br />

half-life is 9.4 days. It is generally accepted that Y90 is an ideal<br />

radioisotope agent for treating knees. For medium sized joints as<br />

elbows, ankles or shoulders. Because of rational level of local energy<br />

capacity and limited tissue penetration, Re186 seems to be as an<br />

ideal isotope for medium-sized joints. 169Er citrate colloid is suitable<br />

for metacarpophalangeal, metatarsophalangeal and digital<br />

interphalangeal joints. The subjectively estimated success rates for<br />

the small, medium-sized, and large joints were 89% (215/242), 86%<br />

(112/130), and 79% (41/52), and for RA and OA 89% (280/313) and<br />

79% (88/111). The scintigraphically determined response rates for<br />

small and medium-sized joints were 81% (86/106) and 69% (35/51).<br />

Conclusion: Regarding cost and effectiveness it is highly<br />

recommended to use radiosynovectomy specially in hemophilic<br />

arthropathy (level 1b of recommendation) and hemophilic<br />

artheropathy (level 2a of recommendation).<br />

Keywords: radiosynovectomy, rheumatoid arthritis, hemophilic<br />

artheropathy<br />

128


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Rate Dependent Left Bundle Branch Block: The Pattern of<br />

Myocardial Perfusion SPECT<br />

Sahar Mirpour, Ali Gholamrezanezhad<br />

Tehran University of Medical Science, Research Institute for Nuclear Medicine<br />

Introduction: We report myocardial perfusion SPECT pattern in four<br />

subsequent patients with rate dependent left bundle branch block<br />

(LBBB).<br />

Methods: All patients were tested for baseline and serial heart rate,<br />

blood pressure, and electrocardiogram recordings. The exercise<br />

treadmill tests (ETT) tests were carried out under the strict<br />

supervision of a cardiologist, a nuclear medicine physician and close<br />

availability of an expert cardio-pulmonary resuscitation team and<br />

cardiac care unit within just few seconds. Maximal stress test (at<br />

least 85% of calculated heart rate, even following development of<br />

LBBB) was achieved in all three patients according to standard Bruce<br />

protocol. No adverse cardiac events were noted and all ETT stress<br />

protocols terminated completely and safely.<br />

Results: Three females and one male (aged 48, 63 and 67 years)<br />

were studied. None of the patients had history of typical chest pain<br />

and all were suffered from atypical chest pain or dyspnea on<br />

exertion. Myocardial perfusion SPECT imaging showed no evidence of<br />

reversible perfusion defects. The only patient with past history of<br />

exercise induced LBBB showed nonreversible perfusion defects in the<br />

septal and anteroseptal regions and mild LV cavity dilatation.<br />

Conclusion: The limited number of patients enrolled in our study<br />

does not allow us to draw a definite conclusion. Despite the presence<br />

of false positive defects in myocardial perfusion SPECT in patients<br />

with sustained LBBB, it seems that rate dependent or exercisedinduced<br />

LBBB has not shown such a pattern, unlike we expect. Maybe<br />

it can be possible to continue ETT as the stress protocol for those<br />

patients undergoing myocardial perfusion scintigraphy and<br />

developing rate dependent LBBB.<br />

Keywords: Rate Dependent LBBB<br />

129


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

How Ictal Brain Perfusion SPECT-CT help for determining<br />

treatment plan of patient?<br />

Seyed Mahdi Modarresi 1 , Kazem Shiroodi 2<br />

1 Baqiyatallah Medical Sciences University<br />

2 Khatam-al-Anbia Hospital<br />

Introduction: It is well known that ictal brain perfusion SPECT can<br />

determine the seizure onset zone with high accuracy especially in<br />

temporal lobe. Unfortunately performing ictal SPECT needs a<br />

complicated logistics and few nuclear medicine departments have<br />

access to such facilities.<br />

Objects: For the first time in Iran we performed both interictal and<br />

ictal SPECT-CT in several patients at Khatam-al-Anbia hospital<br />

nuclear medicine department that is equipped with SPECT-CT (GE-<br />

Infinia- Hawkeye4). Our object was setting up this procedure and<br />

training the personnel and technicians of both nuclear medicine and<br />

epilepsy departments.<br />

Findings: In the following section we present two cases that ictal<br />

SPECT-CT can be helpful to determine treatment plan. In a male 22<br />

years old patient that had history of brain surgery for<br />

hypocampectomy without improving seizure attacks the brain<br />

perfusion study shows another onset zone at contralateral side. In<br />

another female 33 year old patient the study showed a definite<br />

seizure onset zone in left temporal lobe.<br />

Conclusion: Because ictal brain perfusion SPECT-CT can help for<br />

determining treatment plan of patient it should not be ignored and<br />

setting up this procedure is easy and practical.<br />

Keywords: Ictal, Interictal, SPECT-CT, ECD Radioisotope<br />

130


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

DETECTION OF PITUITARY ADENOMA BY 68Ga-DOTATATE<br />

PET/CT<br />

Sudabeh Sobhani, Ozlem Nuriye Kucuk, Elgin Ozkan, Erkan Ibis<br />

Ankara University, Turkey<br />

PURPOSE: 68Ga-Peptide PET/CT is a sensitive and specific imaging<br />

in diagnose of neuroendocrine tumors . In this case we performed<br />

68Ga-DOTATATE PET/CT scan for detecting pituitary adenoma.<br />

METHOD: In a 66 year-old man referred to the hospital for routine<br />

medical assessment, was detected increased T3,T4 and TSH levels.<br />

The sella MRI showed an 5x3mm adenoma in the left half of<br />

hypophyseal fossa. This patient was referred to nuclear medicine<br />

department for 68Ga-DOTATATE PET/CT imaging and the scan<br />

detected focal 68Ga-DOTATATE uptake in the pituitary gland location.<br />

RESULTS AND CONCLUSION: Pituitary adenomas are suspected if<br />

there are hyperthyroidism and/or galactorrhea symptoms and it’s<br />

usually used MRI for detection of this adenoma. According to<br />

guidelines, 68Ga-Peptide PET/CT can be helpful in the detection of<br />

pituitary adenomas, but there is no literature or case report about<br />

using this imaging to find the pituitary adenomas. In this case we<br />

reported intense 68Ga-DOTATATE uptake in the location of adenoma.<br />

According to this case we can use 68Ga-Peptide PET/CT to detect<br />

pituitary adenomas, also taking whole body scan beside the scan of<br />

interest region.<br />

Keywords: Pituitary adenoma, PET/CT, Sella MRI<br />

131


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Evaluation of different pattern bone metastasis from breast,<br />

lung, prostate and gastrointestinal cancers in whole body<br />

bone scans<br />

Vahid Reza Dabbagh Kakhki, Kazem Anvari, Ramin Sadeghi,<br />

Anooshesadat Mahmoudian<br />

Mashhad University of Medical Science, Nuclear Medicine Research Center<br />

Introduction: Bone metastasis is one of the important and disabling<br />

side effects of cancers, so immediate diagnosis can improve the<br />

quantity and quality of patient's life and prevent from disabling<br />

factors. Metastatic patterns of different cancers may be helpful for<br />

physicians to follow up the existence of bone metastasis. These kinds<br />

of researches were done in different countries and races, therefore,<br />

we decided to evaluate bone metastasis of variable cancers in<br />

Nuclear Medical Center of Imam Reza hospital in Mashhad.<br />

Materials & Methods: In this descriptive cross sectional study we<br />

assessed bone metastasis in lung. GI, prostate and breast cancers<br />

among patients referred to Imam Reza hospital to do bone scan.<br />

Bone scan procedure includes three steps: 1- Injection of 2mc TC99-<br />

MDP 2- Whole body bone scan (Ant and post view) 3- According to<br />

check list watch includes location, number intensity, bone metastasis<br />

is reported in both genders with different ages.<br />

Results: 160 patients were studied (113 male and 47 female) with a<br />

mean age of 55.66±14.08 years. The prevalence of breast, prostate,<br />

GI and lung cancers among these patients were 107, 32, 13 and 8,<br />

respectively. Metastasis was found in 58 patients.<br />

Conclusion: The most prevalent locations of metastasis are: ribs,<br />

lumbar vertebrae, thoracic vertebrae, sternum and pelvis,<br />

respectively. High frequency of bone metastatic lesions is seen in ribs<br />

and lumbar vertebrae.<br />

Keywords: Bone Scan, Bone metastasis<br />

132


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Recent developments in RPC Technology for PET Detector<br />

Akbar Anvari, Doman Arefan, Alireza Kamali-asl<br />

Department of Radiation Medicine<br />

Introduction: In this study, small animal positron emission<br />

tomography system based on the resistive plate chamber technology<br />

is briefly reviewed. RPC invented in 1980, experimental and<br />

theoretical studies of it are still under development. RPCs are<br />

gaseous parallel plate detectors with good spatial and time resolution<br />

and high efficiency. They operating at atmospheric pressure with<br />

non-flammable gases and they made with glass and metal electrodes<br />

that separated by precision spacers.<br />

Methods: The system is composed of two counting heads, able to<br />

measure the photon interaction point in two dimensions, the<br />

transaxial dimension and the Depth of Interaction. Each head<br />

composed of 16 single-gap RPC detectors capable of detecting the<br />

photon interaction point in the transaxial plane.<br />

Results: The yields of prototype RPC-PET reconstructed 22Na pointsource<br />

reported, spatial resolution of 0:6 mm FWHM without parallax<br />

error and time resolution below 50 ps σ with efficiencies 99% for<br />

minimum ionizing particles.<br />

Conclusions: RPC technology to be very appropriate for used in<br />

small animal PET systems, providing a very high spatial resolution<br />

and efficiency with accurate TOF at a low cost.<br />

Keywords: RPC, PET, TOF<br />

133


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Biological studies of samarium-153 bleomycin complex in<br />

human breast cancer murine xenografts for therapeutic<br />

applications<br />

Ali Bahrami-Samani, Amir Reza Jalilian, Mohammad Mazidi,<br />

Mohammad Ghannadi-Maragheh<br />

Radiopharmaceutical Research and Development Lab (RRDL)<br />

Introduction: Bleomycins are tumor seeking antibiotics that are<br />

widely used in cancer chemotherapy produced by the bacterium<br />

Streptomyces verticullus. Bleomycin as well as other compounds such<br />

as doxorubicin, methotrextate, dactinomycin, cisplatin is an<br />

important chemotherapeutic agent while possesses no bone marrow<br />

depression. It is believed that bleomycin antibiotics interfere with<br />

DNA as false nucleotides, assuming the dithiazole moiety acts like a<br />

purine base.<br />

Methods: In this work, a potential therapeutic DNA targeting agent,<br />

153Sm-bleomycin complex (153Sm-BLM), was developed and the<br />

tumor accumulation studies were performed using single photon<br />

emission computed tomography (SPECT) and scarification studies.<br />

153Sm-BLM was prepared at optimized conditions (room<br />

temperature, 4-8 h, 0.1 mg bleomycin for 740-3700 MBq 153SmCl3,<br />

radiochemical purity over 98%, HPLC, specific activity = 55<br />

TBq/mmol).<br />

Results: 153Sm-BLM was administered into human breast cancer<br />

murine xenografts and the biodistribution and imaging studies were<br />

performed up to 48h. 153Sm-BLM demonstrated superior tumor<br />

accumulation properties in contrast with the other radiolabeled<br />

bleomycins with tumor:blood ratios of 41, 72 and 182 at 4, 24 and<br />

48 h respectively and tumor:muscle ratios of 23, 33 and >1490 at 4,<br />

24 and 48 h respectively while administered intravenously. The<br />

SPECT images also demonstrated the obvious tumor uptake at the<br />

chest region of the breast-tumor bearing mice.<br />

Conclusion: These initial experiments demonstrate significant<br />

accumulation of 153Sm-BLM in tumor tissues. 153Sm-BLM is a<br />

potential therapeutic compound and our experiments on this<br />

compound have shown satisfactory quality, and stability suitable for<br />

future therapeutic studies.<br />

Keywords: Bleomycin, Sm-153, breast cancer-xenograft,<br />

Biodistribution, SPECT<br />

134


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Development of radiogallium ethylenecysteamine cysteine<br />

complex as a possible renal imaging agent<br />

Amir Reza Jalilian, Hassan Yousefnia, Samaneh Zolghadri,<br />

Mohammad Khoshdel, Fatemeh Bolourinovin, Ali Rahiminejad<br />

Nuclear Science and Technology Research Institute<br />

The interesting physical properties and availability of gallium-67<br />

make it an interesting nuclide for radiopharmaceutical research. The<br />

mono-carboxylic derivative of EC, i.e., ECC has only been reported as<br />

99mTc complex [12] use in renal imaging. Since there was no report<br />

of any radiogallium radiolabeled ethylenecysteamine cysteine (ECC)<br />

in the literature, in this study we developed a new radiogallium-ECC<br />

complex demonstrating significant urinary excretion like that of the<br />

homolog Tc-99m compound (99mTc-ECC) for future 68Ga-homolog<br />

development.[67Ga]-ethylenecysteamine cysteine ([67Ga]ECC)was<br />

prepared using freshly prepared [67Ga]GaCl3 and<br />

ethylenecysteamine cysteine (ECC) for 30 min at 90C (radiochemical<br />

purity &97 ± 0.88% ITLC, specific activity: 210 ± 5 GBq/mM).<br />

Stability of the complex was checked in human serum for 24 h at 37<br />

C. Partition coefficient of the tracer in octanol:saline mixture was<br />

determined (log P; 0.8). The biodistribution of the radiolabeled<br />

compound in vital organs of wild-type rats were compared with that<br />

of free Ga3? cation up to 48 h. Initial biodistribution results showed<br />

significant kidney excretion of the tracer comparable to that of<br />

homologous 99mTc compound.<br />

Keywords: 7Ga-complexation, Ethylenecysteamine cysteine,<br />

Biodistribution, Renal agent<br />

135


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Preparation, quality control and biodistribution studies of<br />

[61Cu]-oxinate for PET tumor imaging<br />

Amir Reza Jalilian 1 , Samaneh Zolghadri 1 , Reza Faghihi 2 , Hassan<br />

Yousefnia 1 , Javad Garousi 1 , Kamaledin Shafaii 1<br />

1 Nuclear Science and Technology Research Institute<br />

2 Shiraz University<br />

Targeting apoptosis is an interesting issue in molecular imaging and<br />

various modalities have been presented. However recent experiences<br />

in nuclear pharmacy demonstrated the application of small tracer<br />

molecules is more desired. This work was conducted for production of<br />

a radiolabeled copper complex, i.e. 61Cu-oxinate as a potential PET<br />

tracer for apoptosis imaging in oncology. Cu-61 was prepared from<br />

natural zinc target irradiation by 22 MeV protons (150 uA) via nuclear<br />

reaction with a yield of 3.33 mCi/µAh. In order to obtain the best<br />

labeling method optimization reactions were performed for pH,<br />

temperature and concentration followed by solid phase extraction.<br />

Biodistribution of the tracer was studied in wild-type and<br />

fibrosarcoma bearing mice. At the optimized conditions, radio-thinlayer<br />

chromatography (RTLC) and HPLC showed radiochemical<br />

purities of 99.99% and 97% respectively (with a minimum specific<br />

activity of 16 Ci/mM). Biodistribution of the tracer in fibrosarcoma<br />

bearing mice demonstrated significant tumor uptake after 3h.<br />

Tumor:blood and tumor:muscle ratios were 2.0 and 6.0 respectively<br />

at 3 h.<br />

Keywords: Cu-61, oxine, PET, Fibrosarcoma<br />

136


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Evaluation of difference between pure positron emitter and<br />

non-pure positron emitter in three gamma PET imaging<br />

Amir Hakimi, Dariush Sardari<br />

Department of Nuclear Engineering<br />

Introduction and Purpose: PET is a technique for measuring the<br />

concentrations of positron-emitting radioisotopes within the body by<br />

registering the emitted annihilation radiation. At present, the basic<br />

process employed in PET is the annihilation of the emitted positron an<br />

electron that results in two almost co-linear gamma-photons<br />

travelling in opposite directions, each with 511 keV energy. Recently<br />

it has been shown, that extra information could also be obtained in<br />

PET by registering the annihilations into three photons. In spite of the<br />

relative rareness of positron annihilation into three photons, it may<br />

still be exploited to develop a new imaging modality. Although the<br />

rate of 3gamma decays is small, the positioning information<br />

conveyed by a single event is much larger than in the case of two<br />

gamma, so the total information gained from three gamma may be<br />

significant.<br />

Material and Methods: Three high resolution detectors arranged in<br />

a plane forming angels of about 120° with respect to each other to<br />

form a primitive 3-gamma scanner. Each detector generates pulse,<br />

which passes to a time pick-off units. Using non-pure positron emitter<br />

such as 22Na, cause increasing the probability of random coincidence<br />

while the level of background would be much lower for a pure<br />

positron emitter, e.g., 18F.<br />

Results: Three gamma imaging would provide information not only<br />

about the local concentration of radionuclide, but also, by virtue of<br />

chemical interactions of Positronium, the local chemical environment<br />

in tissue. Using pure positron emitter according to energy and time<br />

window will drop up the proportion of true 3gamma-counts. Random<br />

triple coincidences can also arise due to a single 2gamma-annihilation<br />

when one of the 5ll keV photons is Compton scattered from one<br />

detector into one of two others, the third one begin hit by the nuclear<br />

photon of non-pure positron emitter, partially detected.<br />

Keywords: Three gamma, PET, Random coincidence<br />

137


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Preparation, quality control and biodistribution studies of<br />

[61Cu]-doxorubicin for PET tumor imaging<br />

Amir Reza Jalilian 1 , Hassan Yousefnia 1 , Reza Faghihi 2 , Mehdi<br />

Akhlaghi 1 , Hassan Zandi 1<br />

1 Nuclear Science and Technology Research Institute<br />

2 Shiraz University<br />

This work was conducted for radiolabeling of an anticancer antibiotic,<br />

i.e. doxorubicin with Cu-61 for production of possible tracer used in<br />

PET oncology. Cu-61 was prepared from natural zinc target<br />

irradiation by 22 MeV protons (150 A) via nuclear reaction with a<br />

yield of 3.33 mCi/µAh. In order to obtain the best labeling method<br />

optimization reactions were performed for pH, temperature and<br />

concentration. Biodistribution of the tracer was studied in normal and<br />

fibrosarcoma bearing mice. At the optimized conditions, ITLC showed<br />

radiochemical purity more than 97% with a specific activity of 0.06<br />

Ci/mM. This was kept unchanged even with presence of human<br />

serum as well as room temperature for 5h. Biodistribution of the<br />

tracer in fibrosarcoma bearing mice demonstrated significant tumor<br />

uptake after 2h. This tracer can be used in the detection of various<br />

tumors responding to doxorubicin chemotherapy using PET scan<br />

and/or determination of tumor therapy response to doxorubicin<br />

chemotherapy.<br />

Keywords: Copper-61, Doxorubicin, Radiolabeling, Biodistribution<br />

138


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Development of 153Sm-[Tris (1,10 Phenanthroline) Samarium<br />

(III)]trithiocyanate complex as a therapeutic agent<br />

Amir Reza Jalilian 1 , Amir Hakimi 2 , Simindokht Shirvani-Arani 1 ,<br />

Mohammad Ghannadi-Maragheh 1<br />

1 Radiopharmaceutical Research and Development Lab (RRDL)<br />

2 Department of Nuclear Engineering<br />

In this work, 153Sm-[Tris(1,10-phenanthroline) Samarium(III)]<br />

trithiocyanate (153Sm-TPTTC) was developed for possible therapeutic<br />

properties. The cold compound, i.e. natSm-TPTTC was prepared and<br />

characterized by IR, UV and 1H NMR spectroscopy. 153Sm-TPTTC<br />

was prepared starting 153Sm-SmCl3, prepared by neutron activation<br />

of an enriched 152Sm sample (purity >98%), in 1h at 25ï‚°C.<br />

Stability tests, partition coefficient determination and biodistribution<br />

studies of the complex in wild-type rats were also determined. The<br />

radiolabeled complex was prepared in high radiochemical purity<br />

(>99% precipitation method) and specific activity of 278 GBq/mmol<br />

and demonstrated significant stability at 4, 25 and 37ï‚°C (in<br />

presence of human serum). Hepatotoxicity of the cold compound was<br />

also checked by serum enzyme measurements after rat<br />

administration. Initial biodistribution data showed significant bone<br />

accumulation of the tracer in 48h. The produced 153Sm- TPTTC<br />

properties suggest an efficiently new liver accumulating therapeutic<br />

agent in order to overcome possible liver malignancies with the<br />

lowest toxicity.<br />

Keywords: Therapy Biodistribution Phenanthroline Sm-153<br />

139


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

The development of radiogallium-acetylacetonate bis<br />

(thiosemicarbazone) complex for tumour imaging<br />

Amirreza jalilian, Hassan yousefnia, Javad Garousi, Aytak Novinrouz,<br />

Amir Rajamand, Kamaledin Shafaii<br />

Nuclear Science and Technology Research Institute<br />

Various radiometal complexes have been developed for tumor<br />

imaging, especially Ga-68 tracer. In this work, the development of a<br />

radiogallium bis (thiosemicarbazone) complex has been<br />

reported.[67Ga] acetylacetonate bis (thio-semicarbazone)complex<br />

([67Ga]AATS) was prepared starting with [67Ga]Gallium acetate and<br />

freshly prepared acetylacetonate bis (thiosemicarbazone) (AATS) for<br />

30 min at 90∞C. The partition co-efficient and stability of the tracer<br />

was determined in final solution (25C) and the presence of human<br />

serum (37C) for up to 24 hours. The biodistribution of the labeled<br />

compound in wild-type and fibrosarcoma-bearing rodents were<br />

determined for up to 72 hours. The radiolabelled Ga complex was<br />

prepared to a high radiochemical purity (> 97%, HPLC) followed by<br />

initial biodistribution data with the significant tumour accumulation of<br />

the tracer at two hours, which is far higher than free Ga-67 cation,<br />

while the compound wash-out is significantly faster. The abovementioned<br />

pharmacokinetic properties suggest an interesting<br />

radiogallium complex prepared by the PET Ga radioisotope, 68Ga, in<br />

accordance with the physical half life, for use in fibrosarcoma<br />

tumours and possibly in other malignancies.<br />

Keywords: Gallium-67, acetyl acetone bis (thiosemicarbazonate),<br />

biodistribution, fibrosarcoma<br />

140


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Preparation, Quality control studies of [90Y]-DOTA-Cetuximab<br />

for radioimmunotherapy<br />

Ariandokht Vakili 1 , Simindokht Shirvani-Arani 2 , Dariush Sardari 1 , Ali<br />

Bahrami-Samani 2 , Mohamad Ghanadi-Maragheh 2<br />

1 Islamic Azad university<br />

2 Radiopharmaceutical Research and Development Lab (RRDL)<br />

Introduction: Yttrium-90 is a useful radionuclide for<br />

radioimmunotherapy (RIT), due to its energetic beta emissions<br />

(Emax=2.3 MeV), ready availability at moderate cost and absence of<br />

γ emissions, allowing outpatient RIT. Its half-life of 64 hr is<br />

comparable to the uptake and residence time of many antibodies on<br />

the tumor. The anti-epidermal growth factor receptor (anti-EGFR)<br />

antibody Cetuximab is clinically approved for the treatment of EGFRexpressing<br />

metastatic colorectal cancer and advanced head and neck<br />

cancer. The overall goal of this study was to develop the<br />

radioimmunoconjugation of monoclonal anti-EGFR with 90Y as a<br />

potential tracer for radioimmunotherapy(RIT).<br />

Methods: Cetuximab was successively labeled with [90Y] chloride<br />

(185MBq) 5mCi after conjugation with macrocyclic bifunctional<br />

chelating agent , 1,4,7,10-tetraazacyclododecane-N,N,N,N-tetraacetic<br />

acid mono-(N-hydroxysuccinimidyl) ester (DOTA-NHS). Conjugated<br />

Cetuximab was obtained by the addition of 1ml of Cetuximab<br />

pharmaceutical solution (2mg/1ml , in phosphate buffer pH=8) to a<br />

glass tube pre-coated with DOTA-NHS at 25°C with continuous mild<br />

stirring for 15h. Y-90 chloride was obtained by thermal neutron flux<br />

(4 — 1013 n.cm-2.s-1) of a natural Y2O3 sample, dissolved in acidic<br />

media. Radiolabeling was completed in 24 hours by the addition of<br />

DOTA-NHS-Cetuximab conjugate at 37°C. The stability of<br />

radiolabeled was studied in human serum. For biological evaluation<br />

we carried out the cell binding assay.<br />

Results: Radiochemical purity of 92% (using ITLC) was obtained for<br />

final radioimmunoconjugate (Specific activity = 440-480 MBq/mg).<br />

The final isotonic 90Y-Cetuximab complex was checked by gel<br />

electrophoresis for protein integrity retention. Stability of radiolabeled<br />

protein in presence of human serum was tested at 37°C for up to<br />

24h. A high binding affinity was determind for the<br />

radioimmunoconjugate (90Y-DOTA-NHS-Cetuximab) in comparison to<br />

radiolabeled bifunctional chelating agent(90Y-DOTA).<br />

Conclusion: This study demonstrated that 90Y-DOTA-NHS-<br />

Cetuximab is a potential compound for the treatment of EGFRexpressing<br />

cancers. The experiments on animal models should be<br />

performed for this radioimmunoconjugate before human use.<br />

Keywords: Radiopharmaceutical, Yttrium-90, Cetuximab,Targetted<br />

Therapy<br />

141


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Synthesis and biodistribution studies of 67Ga-DOTAtrastuzumab<br />

as a diagnostic radioimmunoconjugate for<br />

oncology imaging by SPECT<br />

Behrooz Alirezapour 1 , Amir Reza Jalilian 1 , Mohammad javad Rasaee 2 ,<br />

Saeed Rajabifar 1 , Kamal Yavari 1 , Javad Mohammadnejad 1 ,<br />

Mohammad Reza Aboudzadeh 1 , Fatemeh Bolourinovin 1 , Sedigheh<br />

Moradkhani 1 , Mojtaba Fathi 2<br />

1 Nuclear Science and Technology Research Institute (NSTRI)<br />

2 Tarbiat Modares University(TMU)<br />

Introduction: Radiolabeled monoclonal antibodies have shown great<br />

promise for cancer diagnosis and therapy. Trastuzumab (trade name;<br />

Herceptin) is a humanized IgG1 monoclonal antibody directed against<br />

the extracellular domain of the Human Epidermal Growth Factor<br />

Receptor 2(HER2). HER 2 receptor is over expressed in 20-30% of<br />

the early-stage breast cancers and these patients may be candidates<br />

for Herceptin treatment. we attempted to label trastuzumab with<br />

radioactive gallium(67Ga) 67Ga is cyclotron produced, decays by<br />

electron capture (EC) with t1/2 = 77.9h accompanied with γ-rays,<br />

mainly 93, 184 and 296 keV, and is suitable for SPECT imaging. In<br />

the present study, 67Ga labeled trastuzumab was prepared followed<br />

by the biodistribution studies in normal mice.<br />

Methods: Herceptin was conjugated with DOTA-NHS-ester<br />

(Macrocyclics), purified by molecular filtration, the average number of<br />

DOTA conjugated per mAb was calculated and total concentration<br />

was determined by spectrophotometrically. DOTA-Trastuzumab was<br />

labeled with 67Ga then Radiochemical purity, integrity of protein after<br />

radiolabeling and stability of 67Ga -DOTA-Trastuzumab were<br />

determined. The biodistribution studies was performed in normal rats<br />

(67Ga -DOTA-Trastuzumab i.v., 75 ± 5.5 µCi, 30min, 2h, 4h, 24h,<br />

48h, 72h).<br />

Result: The radioimmunoconjugate was prepared with a<br />

radiochemical purity of 88% (RTLC). The average chelate to antibody<br />

ratio(c/a) for the conjugate used in this study was 5.8:1. The final<br />

compound was stable in presence of PBS at 37ºC and room<br />

temperature.The sample were showed to have similar patterns of<br />

migration in the gel electrophoresis.The accumulation of the<br />

radiolabeled antibody in lungs, liver, spleen and other tissues<br />

demonstrates a similar pattern to the other radiolabeled anti-HER2<br />

immunoconjugates.<br />

Conclusion: 67Ga-DOTA-Trastuzumab is potentially good probe for<br />

diagnosis and treatment studies of HER2 expression in oncology by<br />

SPECT.<br />

Keywords: 67Ga DOTA, Radioimmunoconjugate, Trastuzumab,<br />

HER2<br />

142


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Calculation of relative dose of human body produced by fusion<br />

neutrons using MCNP code<br />

Masoode Abdolahzade 1 , Masome Nonbede 2 , Yaser kasesaz 3 , Amir<br />

Moslehi 3 , Davoode Gasemabadi 1 , Mohsen Shayeste 1<br />

1 Imam Hossein University<br />

2 Tehran Center Azad University<br />

3 Atomic Energy Organization of Tehran<br />

In this paper a simulated phantom of adult human body using Monte<br />

Carlo method and MCNP code, is used for the neutron effective dose<br />

equivalent calculation. The plasma focus device emits neutrons with<br />

2.45 MeV energy in D-D fusion reactions. Effective dose equivalent is<br />

calculated in four geometry, AP, PA, LLAT, RLAT, for some organs by<br />

the weight coefficients of radiation and the tissue weight factor<br />

reported by ICRP. The results are compared by the occupational<br />

exposures effective dose equivalent recommended by ICRP.<br />

Keywords: Neutron emission, Dosimetery, Phantom, CodeMCNP<br />

Simulation<br />

143


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Biological and Dosimetry Studies of Three Radiolabeled of<br />

Rituximab for Human Based on Distribution Data in Rats<br />

Edalat Radfar 1 , Amir Reza Jalilian 1 , Ariandokht Vakili 2 , Ali Bahrami-<br />

Samani 1 , Hassan Yousefnia 1 , Simindokht Shirvani-Arani 1 , Mohammad<br />

Ghannadi-Maragheh 1<br />

1 Radiopharmaceutical Research & Development Laboratory (RRDL)<br />

2 Islamic Azad University<br />

Introduction: Rituximab binds with human B-lymphocate-restricted<br />

differentiation antigen: CD20. Many beta emitters such as I-131, Y-<br />

90, Sm-153 and Lu-177 were widely used in antibody labeling for<br />

radioimmunotherapy (RIT).<br />

Purpose: In the present article, preparation and biodistribution of<br />

177Lu, 153Sm and 90Y labeled rituximabs have been studied and<br />

followed by calculation of preliminary dosimetry for human based on<br />

distribution data in rats by acceptable approximations.<br />

Method: Radiolabeled compound was prepared according to the<br />

methods previously given in the literature and their QCs and stability<br />

testing was run completely. 177Lu-DOTA-rituximab, 90Y-DOTArituximab<br />

and 153Sm-DOTA-rituximab were administered to normal<br />

rats separately (10-15 rats). The animals were killed at the exact<br />

time and the specific activities of different organs were measured by<br />

using an HPGe detector (for 177Lu and 153Sm) and a beta scintillator<br />

detector (for 90Y). The following equation was used to extrapolate<br />

biodistribution data of radiolabeled from rats to humans: %ID/g<br />

human organ = %ID/g animal organ * k k= Body mass animal/ Body<br />

mass human Absorbed dose rate of each organ was calculated in<br />

determined time by MIRD method with linear approximation in<br />

measurement of activities.<br />

Result: Absorption and biodistribution of radiolabeled in organs of<br />

rats were determined by measuring %ID/g at different times. The<br />

uptakes were observed in limited organs such as liver, spleen and<br />

lungs and less in kidneys, bone and blood.<br />

Discussion: Dose rate estimate was calculated for 1.5 times more<br />

than effective half-life of each radiolabeled. The results showed that<br />

the high absorbed dose is in liver, lungs and spleen; and absorbed<br />

dose of other organs is low as acceptable level values.<br />

Keywords: Lu-177 Radiolabeled Rituximab, Biodistribution,<br />

Dosimetry, MIRD<br />

144


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Comparative Assessment of Different Energy Mapping<br />

Methods in CT-Based Attenuation Correction in PET/CT<br />

Systems Using Whole Body XCAT Phantom<br />

Elham Soleimani, Mohammad Reza Ay, Majid Pouladian<br />

Introduction: This paper presents the result of assessing different<br />

attenuation correction methods for PET data according to CT data<br />

(CTAC). These methods are intended for use with a combined PET/CT<br />

scanner. We discuss five possible methods of energy mapping from<br />

the CT energies to the required 511keV. CT images are obtained<br />

using a computerized whole body phantom, 4DXCAT, which is<br />

simulation of physically and anatomically of human body.<br />

Materials and methods: The aim of this study is to compare<br />

different energy-mapping techniques: scaling, segmentation, hybrid,<br />

bilinear calibration curve and dual energy approach through<br />

attenuation map generated from CT data through XCAT phantom.<br />

The CT images acquired from XCAT phantom are applied to generate<br />

µ-maps in 511keV. Then these generated µ-maps are compared to<br />

the image acquired from XCAT phantom in 511keV as the gold<br />

standard image. For comparing methods we use three ways:<br />

Assessing different ROIs, correlation coefficients and difference<br />

images for comparing pixel by pixel.<br />

Results and Discussion: Nearly all energy-mapping methods shown<br />

similar results in soft tissues. A noticeable relative difference is seen<br />

in lung tissues in Segmentation method which refers to the variability<br />

in densities. Also a bias in bone in the same method, which is due to<br />

the extended borders of the segments. In Scaling results for different<br />

tissues are acceptable beside bone as it has a high photoelectric<br />

ratio. Hybrid and Bilinear are somehow good. Dual Energy reports the<br />

best results.<br />

Keywords: attenuation correction, PET/CT, XCAT Phantom<br />

145


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Evaluation of<br />

153 Sm-EDTMP as a therapeutic<br />

radiopharmaceutical for bone pain palliation in clinical test<br />

G.A. Shabani, H.R. Khosrounejad, F. Hajhasan Abbasi, M. Farahani,<br />

M. Goudarzi, Y.H. Tavakoli, M.H. Talebi<br />

Radioisotope research group, NSTRI, Atomic Energy org. of Iran,<br />

Introduction: Owing to its favorable decay characteristic of<br />

153 Sm[t 12 =46.27h, Eβ (max) =810 KeV and Eγ=103KeV] and EDTMP<br />

(Ethylene diamine tetra methylene phosphonate as a ligands, is one<br />

of the most widely used as therapeutic radiopharmaceutical for bone<br />

pain palliation. Also it was approved by FDA in 1997.<br />

Methods: Enriched 152 Sm target was irradiated by thermal neutron<br />

flux in Tehran research reactor then dissolved in acidic media; EDTMP<br />

was dissolved in DDW. After labelling, the QC and RCP were done by<br />

ITLC chromatography.<br />

Results: Radiochemical purity of 153 Sm-EDTMP was more than 98<br />

percent at RT. Biodistribution in rat was the same the other<br />

references.<br />

Conclusion: More than 20 patients received our produced 153 Sm-<br />

EDTMP as a bone pain palliation.<br />

Keywords: 153 Sm, Bone Pain palliation, EDTMP<br />

146


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Photon scatter and penetration in parallel hole collimator in<br />

preclinical Gamma Camera: A Monte Carlo study<br />

Farzaneh Adibpour 1 , Mohammad Reza Ay 1 , Saeed Sarkar 1 , George<br />

Loudos 2<br />

1 Department of Medical Physics and Biomedical Engineering<br />

2 Department of Medical Instrument Technology<br />

Introduction: Parallel hole SPECT is rapidly obtaining popularity for<br />

preclinical imaging using gamma-emitting molecules. Scatter and<br />

septal penetration degrade contrast and quantitative accuracy in<br />

SPECT. The magnitude of penetrated and scattered photons depends<br />

on the photon’s energy, object under study and collimator design<br />

parameters. The main goal of this study is to quantify the effects of<br />

penetration and scatter as function of collimator thickness and septa<br />

with parallel hole collimator (made of lead).<br />

Methods: In this study, GATE was applied for accurate modeling of<br />

collimator. In order to separate the contribution of scatter and<br />

penetration components, we simulated Tc-99m and I-131 point<br />

sources in air,5cm away from the detector surface. To evaluate<br />

penetration and scatter in collimator, three different classes are<br />

considered in order to classify the registered events. In first category<br />

there are photons which were registered within the crystal under<br />

which the source has been located. This group is called true photons.<br />

In the second group, penetration occurs when the photon without any<br />

interaction with collimator, are detected in another crystal. Third<br />

category belongs to photons incident which experience one or more<br />

scatter interaction in collimator and finally were registered in another<br />

crystal.<br />

Result: Simulation results demonstrated that in case of Tc-99m point<br />

source with collimator thickness of 10mm only approximately 18% of<br />

the photons detected resulted from both penetration and scatter<br />

while this ratio will increase to 85% for I-131.By increasing collimator<br />

thickness fraction of photons undergo penetration and scattering<br />

decrease particularly for collimator thickness above 25mm(for<br />

140keV photons).The results also indicate, increasing collimator septa<br />

from 0.1 to 0.4 leads to 8% decrease in penetration and scatter in<br />

our desired energy window.<br />

Conclusion: The current assessment of septal penetration and septal<br />

scatter in parallel hole collimator not only provides a deeper<br />

understanding of their respective contributions but is also aimed to<br />

be utilized for optimization of collimator design in high resolution<br />

preclinical imaging.<br />

Keywords: septal penetration, septal scatter, parallel hole collimator<br />

147


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Formulation and quality control of<br />

diagnostic of MCT and tumor agent<br />

99m Tc-DMSA(V) as a<br />

G.A. Shabani, H.R. Khosrounejad, M. Farahani, F. Hajhasan Abbasi,<br />

M. Goudarzi, M.H. Talebi, M.H. Mir Falah<br />

Radioisotope research group, NSTRI, Atomic Energy org. of Iran<br />

Introduction: 99m Tc-DMS(V) is a tumor seeking agent that is known<br />

for its ability to detect medullary Thyroid carcinoma (MTC), soft<br />

tissue tumors, lung cancer, metastatic disease and brain tumors.<br />

Medullary thyroid carcinoma (MTC) is a rare thyroid cancer secreting<br />

calcitonin which is the most sensitive and specific marker for MTC.<br />

This type of thyroid cancer is able to metastasize to different body<br />

areas including regional lymph nodes, lung, liver and bone.<br />

Materials and methods: in this study and new formulation for<br />

preparation of 99m Tc-DMS(V) complex, we changed the formulation in<br />

two steps.<br />

Results: radiochemical purity of<br />

99m Tc-DMS(V) complex was<br />

performed by ITLC chromatography at various amount of<br />

Pertechnetate up to 100 mCi and it was more than 95 percent.<br />

Conclusion: Our study showed that the new kit formulation was<br />

stable at Ref up to one year.<br />

Keywords: MTC, DMS(V), 99m Tc<br />

148


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Preparation and quality control of lutetium-177 bleomycin as<br />

a possible therapeutic agent<br />

Hassan Yousefnia, Amir Reza Jalilian, Samaneh Zolghadri, Ali<br />

Bahrami-Samani, Simindokht Shirvani-Arani, Mohammad Ghannadi-<br />

Maragheh<br />

Nuclear Science and Technology Research Institute<br />

Bleomycins are tumor seeking antibiotics that are widely used in<br />

cancer chemotherapy .It is believed that bleomycin antibiotics<br />

interfere with DNA as false nucleotides, assuming the dithiazole<br />

moiety acts like a purine base .It has been shown that labeling of<br />

bleomycin with bi/trivalent radioisotopes can produce<br />

pharmacologically active compounds carrying a diagnostic and/or<br />

therapeutic radioisotope depending on the decay type.Due to<br />

interesting therapeutic properties of 177Lu and antineoblastic<br />

antibiotic, bleomycin (BLM), 177Lu-bleomycin (177Lu-BLM) was<br />

developed as a possible therapeutic compound. Lu-177 of 2.6-3<br />

GBq/mg specific activity was obtained by irradiation of a natural<br />

Lu2O3 sample with a thermal neutron flux of 4x1013 n.cm-2.s-1. The<br />

product was converted into chloride form which was further used for<br />

labeling of BLM. In optimized conditions a radiochemical purity of<br />

98% was obtained for 177Lu-BLM shown by instant thin-layer<br />

chromatography (ITLC) (specific activity, 740 GBq/mmole).<br />

Biodistribution studies of Lu-177 chloride and 177Lu-BLM were<br />

performed in wild-type rats. The accumulation of the radiolabeled<br />

compound in lungs, liver and spleen demonstrates a pattern similar<br />

to the other radiolabeled bleomycins. Lu-BLM is a possible<br />

therapeutic agent in human malignancies and the efficacy of the<br />

compound should be tested in various tumor-bearing models.<br />

Keywords: bleomycin, Lu-177, biodistribution, radiolabeling<br />

149


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Preparation and quality control of 177Lu-[tris(1,10-<br />

phenanthroline) lutetium(III)] complex for therapy<br />

Hassan Yousefnia, Amir Reza Jalilian, Samaneh Zolghadri, Ali<br />

Bahrami-Samani, Mohammad Ghannadi-Maragheh<br />

Nuclear Science and Technology Research Institute<br />

The 177Lu-[tris(1,10-phenanthroline)lutetium(III)]complex (177Lu-<br />

PQ3) was prepared successfully with high radiochemical purity<br />

(>99%). Lu-177 chloride was obtained by thermal neutron flux (4<br />

× 1013 n.cm-2.s-1) of natural Lu2(NO3)3 sample, dissolved in<br />

acidic media. The radiochemical yield was checked by measuring of<br />

radiochemical purity of 177Lu-PQ complex by ITLC ( 10mM DTPA,<br />

pH.5, as mobile phase). The final complex solution was injected<br />

intravenously to wild-type male rats and biodistribution of the<br />

complex was checked up to 48 h. the dose limiting organs were<br />

shown to be reticuluendothelial system. The bidsitribution of the<br />

labeled compounds in tumor-bearing animals is under investigation.<br />

Keywords: Lutetium-177, 1,10-Phenanthroquinone, Biodistribution<br />

150


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Development of 177Lu-phytate complex for radiosynovectomy<br />

Hassan Yousefnia, Amir Reza Jalilian, Samaneh Zolghadri, Ali<br />

Bahrami-Samani, Mohammad Mazidi, Mohammad Ghannadi<br />

Maragheh<br />

Nuclear Science and Technology Research Institute<br />

Lu-177 of 2.6-3 GBq/mg specific activity was obtained by irradiation<br />

of natural Lu2O3 sample with thermal neutron flux of 4—1013 n.cm-<br />

2.s-1. The product was converted into chloride form which was<br />

further used for labeling of 177Lu-phytate complex successfully with<br />

high radiochemical purity (>99.9 %, ITLC, MeOH: H2O: acetic acid,<br />

4: 4: 2, as mobile phase). The complex stability and viscosity were<br />

checked in the final solution up to 7 days. The prepared complex<br />

solution (100 µCi/100 µl) was injected intra-articularly to male rat<br />

knee joint. Leakage of radioactivity from injection site and its<br />

distribution in organs were investigated up to 7 days. Approximately,<br />

all injected dose has remained in injection site 7 days after injection.<br />

The complex was proved to be a feasible agent for cavital<br />

radiotherapy in oncology and rheumatology.<br />

Keywords: phytate, radiosynovectomy, lutetium-177, biodistribution<br />

151


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Development of [177Lu]-Tetra phenyl porphyrin complexes as<br />

possible imaging agents<br />

Hassan Yousefnia 1 , Amir Reza Jalilian 1 , Samaneh Zolghadri 1 , Yousef<br />

Fazaeli 2 , Ali Bahrami Samani 1 , Mohammad Ghannadi-Maragheh 1<br />

1 Nuclear Science and Technology Research Institute<br />

2 Agriculture, Medicine and Industry Research School<br />

Due to interesting therapeutic properties of 177Lu and tumor avidity<br />

of tetraphenyl porphyrins (TPPs), 177Lu-tetraphenyl porphyrin<br />

(177Lu-TPP) was developed as a possible therapeutic compound. Lu-<br />

177 of 2.6-3 GBq/mg specific activity was obtained by irradiation of<br />

natural Lu2O3 sample with thermal neutron flux of 4—1013 n.cm-<br />

2.s-1. [17Lu]labeled tetraphenyl porphyrin ([177Lu]-TPP) was<br />

prepared using freshly prepared [177Lu]-LuCl3 and tetraphenyl<br />

porphyrin (TPPH2) for 30-60 min at 25°C (radiochemical purity:<br />

>97±1% ITLC, >98±0.5 % HPLC, specific activity: 13-14<br />

GBq/mmol). Stability of the complex was checked in final formulation<br />

and human serum for 24 h. The partition coefficient was calculated<br />

for the compound (log P. 1.89). The biodistribution of the labeled<br />

compound in vital organs of wild-type rats was studied using<br />

scarification studies and SPECT imaging up to 24 h. A detailed<br />

comparative pharmacokinetic study performed for 177Lu cation and<br />

[177Lu]-TPP. The complex is mostly washed out from the circulation<br />

through kidneys and can be an interesting tumor imaging/targeting<br />

agent due to low liver uptake and rapid excretion through the urinary<br />

tract.<br />

Keywords: 177Lu, tetra phenyl prophyrin, biodistribution<br />

152


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Production, quality control and biological evaluation of 177Lu-<br />

1,2-propylene di-amino tetra(methy1enephosphonicAcid) as a<br />

possible bone palliation agent<br />

Hassan Yousefnia, Amir Reza Jalilian, Samaneh Zolghadri, Zohreh<br />

Naseri, Ali Bahrami-Samani, Mohammad Ghannadi Maragheh<br />

Nuclear Science and Technology Research Institute<br />

In this study, production, quality control and biodistribution studies of<br />

a newly developed therapeutic compound have been presented<br />

followed by imaging studies in wild-type rodents. In this study,<br />

177Lu-1,2-propylene di-amino tetra(methy1enephosphonicAcid)<br />

(PDTMP) complex was prepared successfully using synthesized<br />

PDTMP ligand and 177LuCl3. Lu-177 chloride was obtained by<br />

thermal neutron irradiation (4—1013 n.cm-2s-1) of natural Lu2O3<br />

samples. Radiochemical purity of 177Lu-PDTMP was checked by ITLC<br />

(>99%). Stability studies of the complex in the final preparation and<br />

in the presence of human serum were performed up to 72h. The<br />

biodistribution of 177Lu-PDTMP and 177LuCl3 in wild-type rats was<br />

checked in animal tissues up to 7 days. The produced 177Lu-PDTMP<br />

properties suggest a possible new bone palliative therapeutic to<br />

overcome the metastatic bone pains.<br />

Keywords: Lu-177, PDTMP, Radiopharmaceutical, Therapy,<br />

Biodistribution<br />

153


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Effect of usual lead apron in decreasing dose rate in nuclear<br />

medicine departments<br />

Hassan Gheshlaghi, Seid-mohammad Haeri, Karim Ghazikhanlou Sani<br />

Hamadan University of Medical Sciences<br />

Introduction: In a busy nuclear medicine department personnel<br />

exposure to radiation is inevitable during patient positioning and<br />

radiotracer preparation. There is controversy regarding usage of<br />

usual lead aprons with respect to penetrating gamma rays used in<br />

nuclear medicine departments as well as production of characteristic<br />

lead x-ray from aprons .This study tries to evaluate the effect of 0.5<br />

mm lead apron on dose reduction.<br />

Methods and materials: We used three point sources usual<br />

radioisotopes used in nuclear medicine departments (99mTc, 201Tl<br />

and 131I) and a single head LFOV gamma camera (SMV, DSX) was<br />

used for counting purposes. The count rate for each source was about<br />

20 Kcount/sec in air and in a brain water phantom. All point sources<br />

were placed at a distance of 3 meters, parallel to the center of the<br />

detector. The collimator was removed and imaging was performed for<br />

1 min with and without lead apron on the detector. Lead apron<br />

covered all field of view of the detector. Each imaging was repeated 3<br />

times and mean count was obtained for each radioisotope.<br />

Result: The measurement and comparison of count rates<br />

(count/min) for each source in different conditions (with and without<br />

apron source in air and in water phantom) showed that count rates<br />

were reduced in air about 77.3%, 84.2% and 40.8% for 99mTc,<br />

201Tl and 131I respectively. The reduction in count rates when<br />

sources placed in brain water phantom were 83.5%, 87% and 53.7%<br />

for the same isotope respectively. As the main source of radiation for<br />

personnel is from scattered photon and with respect to about 83% of<br />

count rate reduction using lead aprons for 99mTc, it is expected that<br />

wearing lead apron significantly decrease dose rate.<br />

Conclusion: Our study showed that lead aprons significantly<br />

decrease count rate and it is expected to reduce dose rate as well.<br />

We recommend wearing apron in NM departments especially at the<br />

time of injection and any times that need to be near the patient for<br />

long times.<br />

Keywords: Nuclear medicine, Dose, Radioisotope, Gamma camera<br />

154


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Development of 177Lu-DOTA-Trastuzumab for<br />

radioimmunotherapy<br />

Hassan Yousefnia, Amir Reza Jalilian, Samaneh Zolghadri, Ali<br />

Bahrami-Samani, Mohammad Ghannadi-Maragheh<br />

Nuclear Science and Technology Research Institute<br />

Trastuzumab was successively labeled with 177Lu-lutetium chloride.<br />

Lu-177 chloride was obtained by thermal neutron flux (4— 013 n.cm-<br />

2.s-1) of natural Lu2O3 sample with a specific activity of 2.6-3<br />

GBq/mg. The macrocyclic bifunctional chelating agent, N-<br />

succinimidyl-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic<br />

acid (DOTA-NHS) was prepared at 25°C using DOTA, N-hydroxy<br />

succinimide (NHS) in CH2Cl2. DOTA-Trastuzumab was obtained by<br />

the addition of 1 ml of a Trastuzumab pharmaceutical solution (5<br />

mg/ml, in phosphate buffer, pH=7.8) to a glass tube pre-coated with<br />

DOTA-NHS (0.01-0.1 mg) at 25°C with continuous mild stirring for 15<br />

h. Radiolabeling was performed at 37°C in 24h. Radio-thin layer<br />

chromatography showed an overall radiochemical purity of >98% at<br />

optimized conditions (specific activity=444 MBq/mg, labeling efficacy;<br />

82%). The final isotonic 177Lu-DOTA-Trastuzumab complex was<br />

checked by gel electrophoresis for structure integrity control. Radio-<br />

TLC was performed to ensure that only one species was present after<br />

filtration through a 0.22 µm filter. Preliminary biodistribution studies<br />

in normal rats were carried out to determine complex distribution of<br />

the radioimmunoconjugate up to 168h. The biodistribution data were<br />

in accordance with other antiCD20 radioimmunoconjugates already<br />

reported.<br />

Keywords: radioimmunotherapy, 177-Lu, trastuzumab<br />

155


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Design and fabrication of imaging detector for medical<br />

application<br />

Hossein Zamani Zeinali 1 , Maryam Nazari 2 , Anita Alipoor 1<br />

1 Agricultural, Medical and Industrial Research School, Nuclear Science and<br />

Technology Research Institute, AEOI, Karaj, Iran.<br />

2 Islamic Azad University of Tehran<br />

Introduction: An Imaging detector system, based on scintillation<br />

detectors, is designed. Fabricated and optimized for diagnostic<br />

radiology, industrial radiography, nuclear medicine and research<br />

application.<br />

Materials and methods: X radiation beam from a Siemens<br />

Stabilipan Orthovoltage unit, after passing through an object, which<br />

may be living sample or electronic device, produce a planar<br />

distribution of visible light on a GOS(Gd2O2S:Tb3+), that is the<br />

image of the object under examination. The image is displaced on a<br />

Cathode Ray Tube (CRT) by a Charged Coupled Camera (CCD)<br />

camera and is recorded digital by a video capture device. The image<br />

quality parameters, including contrast and resolution were<br />

determined by Inpatient Quality Indicator (IQI) tests. Imaging<br />

practices were carried out for different X ray tube voltages (kV) and<br />

Focal-spot Surface Distances (FSD). The data corresponding imaging<br />

quality parameters were then analyzed and plotted by MATLAB and<br />

Origin software.<br />

Results and discussion: The results for image quality parameters<br />

(contrast and resolution) for different X ray tube voltages are fairly<br />

close to each other. Thus the imaging system has the capability to be<br />

used for different X ray energies and radionuclide with relatively<br />

desired results. The study is considered to be an initiative for<br />

fabricating industrial fluoroscopy and radiation surveillance system in<br />

the country.<br />

Keywords: QC, Dose calibrators, Nuclear Medicine<br />

156


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Legal requirements in the operation of laboratory rays<br />

Jamal Salehizahaby<br />

lawyer<br />

Discussion: Performing any activity in connection with the<br />

construction, establishment, start-up, operation, knock-up and<br />

charging any unit in which the work is done with radiation, requires<br />

getting a profession license in the relevant unit and the employment<br />

license in the Atomic Energy Organization of Iran. All those persons in<br />

terms of their job duties are in connection with the radiation sources,<br />

should notify the Atomic Energy Organization of any event,<br />

disruption, defect or changes related to radiation sources, which<br />

increases the possibility of potential radiation hazards to people and<br />

also radiation accidents and human suspicious radiation; Designating<br />

the persons to work, which as a result of medical experiments<br />

verified by the "Organization", working with the radiation is harmful<br />

for their health, is prohibited in these labs; also by comply with all<br />

the regulations, standards, by-laws and radiation protection<br />

guidelines, those labs should forecast, supply and implement all<br />

necessary protective measures and equipment in accordance with<br />

related regulations; and should avoid in unnecessary radiation; in the<br />

area of their occupational activities, they should provide the facilities<br />

for the supervision and inspection of the "Organization" and put the<br />

required information and documents in its option. Before and after<br />

the recruitment and periodically during employment or in emergency<br />

circumstances, the laboratory employees should be checked up by<br />

medical required tests and specialized examinations. Conclusion:<br />

Scientifically, there is no doubt about the losses caused by the<br />

radiation of medical diagnostic laboratories on the human; because of<br />

the losses caused by radiation, in the legal perspective, the radiation<br />

using is prohibited principally; unless in a case which medical need so<br />

appropriate, and in such cases the physician should compare the<br />

losses resulting from the operation of the radiation to losses from the<br />

disease; in cases which the interests of radiation operation prevail, he<br />

can exploit; otherwise he would not be allowed to use; also when<br />

using the radiation is necessary, he will suffice as much as necessary<br />

and no more.<br />

Keywords: Laboratory, human, ray, loss, law.<br />

157


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Simulation of Msgc using two methods: Monte carlo and Finite<br />

difference method<br />

Kokab moosavi<br />

Nuclear Science and Technology Research Institute<br />

Micro Strip Gas Chambers (MSGCs) are suited for the application in<br />

modern experiments of high energy physics because of their good<br />

spatial resolution and their high rate capability. In this work msgc<br />

was simulated by using two methods: Monte Carlo and Finite<br />

Difference Method. The electric field variations versus different anode<br />

and cathode widths and cathode to anode distance studied and at<br />

least the number of particles entered on anode and the deposited<br />

energy in the region of electric field lines were calculated. This<br />

chamber could be useful in medical imaging systems because of<br />

excellent position resolution.<br />

Keywords: MSGC, simulation, electric field<br />

158


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Development of an in vivo radionuclide generator by labeling<br />

Bleomycin with 191Os<br />

Leila Moghaddam-Banaem 1 , Amir Reza Jalilian 1 , Mina Jamreh 2 ,<br />

Nafiseh Salek 2 , Mojtaba Shamsaee 2<br />

1 Radiopharmaceutical Research and Development Lab (RRDL)<br />

2 Faculty of Nuclear Engineering and Physics-AmirKabir Technical University<br />

Bleomycin (BLM) has been labeled with various radioisotopes and<br />

widely used in therapy and diagnosis. 191Osmium is a parent<br />

radionuclide with 15.4d half-life and decays by beta emission to<br />

191mIridium which is a radionuclide with 4.96s half-life. It decays by<br />

isometric transition to stable 191Ir, emitting a 129-keV gamma<br />

photon. In this study BLM was labeled with 191Os-hexachloro-osmate<br />

and its distribution and stability in mice was determined. The<br />

complex was obtained at the pH=2 in normal saline at 90°C in 60<br />

minutes. Radio-TLC showed an overall radiochemical yield of 95-97%<br />

(radiochemical purity >97%). The biodistribution studies for 191Os<br />

and 191Os -BLM were carried out in mice up to 15d. Liver and spleen<br />

uptake increased 24-48 hours after administration of 191Os-BLM.<br />

Lung uptake increased after 48 hours. Twenty four hours after<br />

administration, the radioactivity of the bladder and kidney increased<br />

and remained constant. This research introduces 191Os-BLM in<br />

therapeutic studies as an in-vivo generator for therapy because of<br />

beta emissions and also for localization and dosimetry study in<br />

relevant organs by gamma emission of the daughter radio-nuclide.<br />

Keywords: 191Osmium-Bleomycin, Labeling, Biodistribution<br />

159


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Production of Os191/Ir191m generator by Tehran Research<br />

Reactor<br />

Leila Moghaddam-Banaem 1 , Amir Reza Jalilian 1 , Nafiseh Salek 2 , Mina<br />

Jamreh 2 , Mojtaba Shamsaee 2<br />

1 Radiopharmaceutical Research and Development Lab (RRDL)<br />

2 Faculty of Nuclear Engineering and Physics-AmirKabir Technical University<br />

In this research production of 191Os/191mIr generator was<br />

investigated. 191Osmium is a parent radionuclide with 15.4d half-life<br />

and 191mIridium is daughter radionuclide with 4.96s half-life. It<br />

decays by isometric transition to stable 191Ir, emitting a 129-keV<br />

gamma photon. In addition, iridium x-rays at about 65 keV are<br />

emitted, as a result of internal conversion, from the 129-keV excited<br />

state. The half-life of 191Os (15.4 days) is sufficiently long to<br />

facilitate transportation, generator construction, quality control, and<br />

clinical use. 191mIr is recently has been used as an angiography<br />

radionuclide. One major use of this technique is in the evaluation of<br />

children with congenital heart disease. The information obtained with<br />

radio-angiography is of importance in the diagnosis and management<br />

of these patients and, at times, can take the place of a cardiac<br />

catheterization. In this work, 191Os-hexachloro-osmate was obtained<br />

by thermal neutron flux (4—1013 n.cm-2.s-1) of natural osmium<br />

oxide sample followed by fusion with KOH and KNO3 in acidic media.<br />

One of the important radionuclide impurities is 192Ir that produced<br />

with 191Os in reactor. Separation this impurity from 191Os is<br />

developed by a new performance in this research and the total<br />

recovery yield of 191Os is about %99 and the total time required for<br />

completion the procedure is about 2h. This method improved the<br />

yield and the time of performance in comparison with the published<br />

literatures. Then 191Os is loaded on an anion-exchange column and<br />

191mIr eluted with normal saline. Each elution is 1 ml of 0.9% saline<br />

at pH 1. The yield of generator was assessed for two weeks. 191mIr<br />

yield is 8 to 11% and 191Os breakthrough is 0.001 to 0.005%.<br />

Keywords: Radiopharmaceutical, Gnerator 191Os/191Ir<br />

160


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Preparation and evaluation of 166Ho-DTPA for medical<br />

applications<br />

H. Salehi, M. Gourani, H. Farahani, M. Zoghi, M. Mazidi, S. Shaybani<br />

Radioisotope research Group, Science & Technology Nuclear Center (NSTRI)<br />

Atomic Energy Organization of IRAN (AEOI)<br />

Introduction: Radiopharmaceuticals are now increasingly used for<br />

therapy of cancer, palliation of pain caused due to bone metastasis<br />

and for the treatment of rheumatoid arthritis. 166Ho, with its<br />

favorable radiation characteristics of t1/2 26.8 h and β 1.85 and 1.75<br />

MeV is decayed to stable daughter. It also emits an 80.5 Kev<br />

gamma-ray (6.2%) and thus is imaginable by conventional<br />

techniques.<br />

Purposes: Irradiating 165Ho(n,γ)166Ho 2- Labeling 166HoCl3-<br />

DTPA(diethylentriaminepentaacetic acid).<br />

Investigation Methods: Holmium oxide (Ho2O3, purity >99.9%, 1-<br />

3 mg target mass) was irradiated in a thermal neutron flux 5—1013<br />

n.cm-2.s-1 in the TRR reactor. Irradiated target is dissolved in 20%<br />

HCl, evaporated to dryness. 166Ho should be labeled by DTPA kit as<br />

a complex (DTPA: 166HoCl3) with a same molecular weight (1:1) and<br />

pH~ 7-8 at room temperature in 30 min.<br />

Results: The purity of radionuclide was checked by a multichannel<br />

analyzer coupled with HPGe detector and measured in curimeter dose<br />

calibrator. The radiochemical purity of the DTPA:166HoCl3 was<br />

determined by paper chromatography and 0.9% saline as solvent.<br />

Radiochemical purity of the DTPA:166HoCl3 was 99 %. Gamma<br />

spectrometry of the 166Ho didn't show gamma peaks for any other<br />

radionuclide other than 166Ho.<br />

CONCLUTION: Results of this investigation indicate that<br />

166HoCl3:DTPA kit proposed as a suitable choice for the<br />

endovascular radionuclide therapy (EVRT) technique of liquid filled,<br />

low pressure balloon angioplasty. In a study using mice >85% of the<br />

injected dose was cleared into the urine within 30 min post-injection,<br />

with insignificant retention in any major tissues. The studies show<br />

that the 166Ho-DTPA complex could be an alternative to the more<br />

expensive and difficult to access 188Re based products for EVRT, and<br />

provide adequate uniform radiation dose for the arterial vessel wall<br />

under treatment.<br />

Keywords: ho-166 DTPA Irradiation angioplasty<br />

161


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Radiolabeled annexin V imaging: a useful technique for<br />

determining apoptosis in multiple sclerosis<br />

Majid Assadi 1 , Reza Nemati 2 , Iraj Nabipour 1 , Hooman Salimipour 2 ,<br />

Abdullatif Amini 1<br />

1 The Persian Gulf Nuclear Medicine Research Center<br />

2 Department of Neurology<br />

Multiple sclerosis (MS) is an inflammatory disease of the central<br />

nervous system (CNS) that involves myelin, oligodendrocytes and<br />

axons and culminates in consecutive neuronal death and progressive<br />

neurologic disability. Based on magnetic resonance imaging (MRI),<br />

neuroaxonal loss in MS results in brain atrophy and has a strong<br />

correlation with neurological disability. The newer MR imaging tools<br />

seem to be sensitive biomarkers for measuring the pathogenetic<br />

processes associated with disease activity and progression. However,<br />

it has been difficult to predict the prognosis of MS patients<br />

undergoing an exacerbation from the cross-sectional area of the<br />

contrast-enhanced lesions seen on MRI (or with FLARE MRI). The<br />

edema assocaited with MS lesions creates confusion between changes<br />

in extracellular fluid space and damage to the neuronal elements.<br />

Annexin V has a high affinity for phosphatidylserine (PS) that<br />

presents on the outer surface of the plasma membrane early on<br />

during the onset of apoptosis. Radiolabeled annexin V imaging may<br />

reveal the initiation and degree of neuronal apoptosis. It is our<br />

expectation that annexin will pass through the blood-brain-barrier at<br />

the site of new lesions and localize at the site of stressed or damaged<br />

neurons. The extent of localization should be proportional to the<br />

extent of damage to the cellular elements of the brain. Thus, we<br />

expect a much better correlation of annexin imaging to prognosis.<br />

Based on this model, it might be good to image as soon as possible<br />

after clinical presentation of an exacerbation to determine the extent<br />

of neuronal involvement and then to do a follow up study about 14<br />

days post treatment to determine response to therapeutic<br />

intervention. Such studies should provide specific information on<br />

severity and prognosis of the and on individual response to<br />

treatment. We hypothesize that radiolabeled annexin V imaging is a<br />

useful modality in the determination of apoptosis in MS and can<br />

assess and monitor the effectiveness of neuroprotective and<br />

immunomodulatory therapies on the clinical course of MS. It would<br />

be productive to study MS patients with Tc-99m annexin V imaging.<br />

Unfortunately, this cold kit is unavailable for human use in the world.<br />

Keywords: Multiple sclerosis , phosphatidylserine<br />

162


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Comparison between Neutron Flux and Spectrum in North<br />

Beam Tubes of Tehran Research Reactor by MCNP4C Code for<br />

BNCT<br />

Majid Zamani, Hossein Khalafi, Yaser Kasesaz, Mohsen Shayesteh<br />

In order to investigate the possibility of using the T.R.R beam tubes<br />

in BNCT, it is necessary to select the best one from three north beam<br />

tubes. This beam tube should have more flux and better spectrum<br />

compare to others. So, after simulation of the last configuration of<br />

reactor’s core (NO.55) by MCNP4C code, the neutron flux and<br />

spectrum were calculated at the start, middle, and end of each three<br />

north beam tubes (B1, B2, B3). Because of the relation between<br />

these parameters and the state of core, this calculation has been<br />

done in three different situations of reactor’s core: BOC, MOC and<br />

EOC. The analyses of results showed that the neutron spectrum is<br />

almost the same in all of the beam tubes, but the neutron flux in<br />

northwest beam tube is better than the others .so, this beam tube is<br />

more proper to be used in BNCT.<br />

Keywords: BNCT, Reactor, MCNP4C, Tubeon Flux<br />

163


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Successful implementation of Electronic Medical Records in<br />

research settings: Diabetes and Cardiovascular Surgery<br />

Mohammad Kia<br />

All aspects of modern medical practice are greatly influenced by<br />

technology advancements. New advancements for handling of<br />

Medical Records failed to get popular and still handling of medical<br />

data uses inefficient traditional paper based approach. Employing of<br />

new diagnostic and therapeutic technologies culminates in dramatic<br />

rising in diversity, quantity and quality of medical data which can not<br />

be handled in an old style. Different demanding disciplines (such as:<br />

National and local health policies, prerequisites of Scientific Bodies,<br />

Insurances, Consumer expectations etc.) and new requirements (e.g.<br />

Research needs, early diagnostic and therapeutic intervention etc.)<br />

call for qualified information and worsens the shortages of paper<br />

based works. Presuming computers can solve the riddle but good<br />

planning and proper insight should be considered. Implementation of<br />

Electronic Medical Record (EMR) at various levels (National registries,<br />

Medical Research Centers and clinics) aligned with national and local<br />

health systems' objectives can play a significant role on quality and<br />

quantity of services and researches. Implementation of EMR in Iran in<br />

both private and governmental sectors is not prioritized due to some<br />

systemic flaws such as: Lack of strategic planning for producing and<br />

consuming of medical data. Considering EMR as cost and not as an<br />

investment. Decision makers suffer from lack of EMR insight.<br />

Investing on scientific show offs instead of infrastructures. Caring<br />

about quantitative indices of processes instead of qualitative ones,<br />

etc. Unsuccessful EMR implementation is common due to the same<br />

managerial and workflow mistakes and role of employing well known<br />

methodologies and best practices on successful EMR implementation<br />

is inevitable. In this article we are going to elaborate learned<br />

experiences of implementing of Hakim Diabetes EMR and Nuclear<br />

Medicine EMR in different clinical and research settings across the<br />

Country.<br />

Keywords: Electronic Medical Record<br />

164


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Dosimetry of a new 192Ir PDR brachytherapy source<br />

Mohammad Reza Javanshir 1 , Shahab Sheibani 1 , Behrooz Ghozati 2 ,<br />

Hosein Poorbeygi 1 , Farzam kabiri 2<br />

1 AEOI Nuclear Science and Technology Research Institute<br />

2 Shahid Beheshti University<br />

The PDR brachytherapy source, has got application in some cases of<br />

cancer treatment. According to the AAPM ,determining of the<br />

dosimetry parameters of a new source , should be done by a qualified<br />

group. In this research , we study the functions related to the<br />

dosimetry of Ir 192 brachytherapy source , which includes 3mm<br />

length and 140mci activity , using experiment measurements in<br />

water equivalent phantom. The value of dose were measured using<br />

TLD dosimeter (LiF-100) with putting in to holes which were<br />

embedded in a Plexiglas phantom .The result of anisotropy function,<br />

the radial dose function and the dose rate constant with less than 5%<br />

error indicate that the new Ir192 PDR source is applicable in<br />

radiotherapy.<br />

Keywords: Brachytherapy, PDR, anisotropy, radial dose<br />

165


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

A new bombesin kit labeled with 99mTc for breast cancer<br />

imaging<br />

Mostafa Erfani (Gandomkar), Seyed Pejman Shirmardi<br />

Nuclear Science Research School<br />

Introduction: Tumors such as prostate, small cell lung<br />

cancer,breast, gastric and colon cancer are known to over express<br />

receptors to bombesin (BBN). In this study, a new bombesin<br />

analogue was labeled with 99mTc via HYNIC and tricine/EDDA as<br />

coligands and investigated further.<br />

Methods: HYNIC-GABA-Bombesin (7-14) NH2 was synthesized using<br />

a standard Fmoc strategy. Labeling with 99mTc was performed at<br />

100 C for 10 min and radiochemical analysis involved ITLC and HPLC<br />

methods. The stability of radiopeptide was checked in the presence of<br />

humane serum at 37C up to 24 h. The receptor bound internalization<br />

and externalization rates were studied in GRP receptor expressing<br />

PC-3 cells. Biodistribution of radiopeptide was studied in mice.<br />

Results: Labeling yield of 98% was obtained corresponding to a<br />

specific activity of 2.6 MBq/nmol. Peptide conjugate showed good<br />

stability in the presence of human serum. The radioligand showed<br />

high and specific internalization into PC-3 cells (14.63±0.41% at 4<br />

h). In biodistribution studies, a receptor-specific uptake was observed<br />

in GRP-receptor-positive organs so that after 4 h the uptakes in<br />

mouse pancreas was 1.2±0.13% ID/g.<br />

Conclusion: The prepared conjugate showed high accumulation in<br />

pancreas as a positive GRP receptor targeted tissue followed by<br />

excretion via the kidney. These promising characteristics make our<br />

new designed labeled peptide conjugate as a very suitable candidate<br />

for diagnostic of malignant tumors.<br />

Keywords: Radiolabeling, Bombesin, 99mTc, Tumor<br />

166


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Preparation and labeling of a Bombesin analogueWith 99mTc<br />

for imaging of GRP receptors<br />

Mostafa Erfani(Gandomkar), Seyed Pezhman Shirmardi, Mohammad<br />

Ghannadi Maragheh<br />

Nuclear Science Research School, Nuclear Science & Technology Research<br />

Institute (NSTRI), Atomic Energy Organization of Iran<br />

Introduction: It has been shown that some primary human tumors<br />

and their metastases, including prostate and breast tumors, overexpress<br />

gastrin-releasing peptide (GRP) receptors. Bombesin is a<br />

neuropeptide with a high affinity for these GRP receptors. The<br />

purpose of this study was to prepare and evaluate the characteristics<br />

of a new Bombesin analogue, [6-hydrazinopyridine-3-carboxylic acid<br />

(HYNIC)]-GABA-Bombesin (7-14) NH2 designed for the labeling with<br />

99mTc using tricine and EDDA as coligand.<br />

Methods: Synthesis was performed on a solid phase using a<br />

standard Fmoc strategy and HYNIC precursor coupled at the N-<br />

terminus. Purified peptide conjugate was labeled with 99mTc at<br />

100°C for 10 min. Radiochemical analysis involved ITLC and highperformance<br />

liquid chromatography methods. Peptide conjugate<br />

stability and affinity to human serum was challenged for 24 hours.<br />

The internalization rate was studied in GRP receptor expressing PC-3<br />

cells. Biodistribution of radiopeptide was studied in rats.<br />

Results: Radiolabeling was performed at high specific activities, and<br />

radiochemical purity was >98%. The stability of radiolabeled peptide<br />

in human serum was excellent. In vitro studies showed >14% of<br />

activity was specific internalized into PC-3 cells up to 4 h. After<br />

injection into rat biodistribution data showed a rapid blood clearance,<br />

with renal excretion and specific binding towards GRP receptorpositive<br />

tissues such as pancreas (1.15±0.19% ID/g after 4 h).<br />

Conclusion: [99mTc-HYNIC]-GABA-Bombesin (7-14) NH2 showed<br />

favorable radiochemical and biological characteristics which make our<br />

new designed labeled peptide conjugate as a very suitable candidate<br />

for diagnostic of malignant tumors.<br />

Keywords: 99mTc Bombesin, Synthesis, Labeling<br />

167


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Isolation and labeling of a toxic fraction from Iranian<br />

Mesobuthus eupeus venom<br />

Mostafa Erfani(Gandomkar), Seyed Pezhman Shirmardi, Mohammad<br />

Ghannadi Maragheh<br />

Nuclear Science Research School, Nuclear Science & Technology Research<br />

Institute (NSTRI), Atomic Energy Organization of Iran<br />

Introduction: In this study, Preparation, purification and evaluation<br />

of biological distribution for venom of Iranian Mesobuthus eupeus<br />

labeled with 99mTc has been performed. Its venom has different<br />

toxin same the other scorpions which affect on ion channels.<br />

Material and Methods: For studying of these toxins, the venom was<br />

purified during 3 stages gel chromatography, anion resin and cation<br />

resin respectively. The fractions were identified with UV spectroscopy<br />

and collected with Fraction collector. The fractions were injected to 2<br />

normal mice and the toxic fraction with killing effect was selected for<br />

next stage. For toxic fraction labeling with 99mTc has been done and<br />

biological distribution was obtained in normal mice.<br />

Results: High labeling yield (97%) was achieved using stannous<br />

chloride (SnCl2) and sodium borohydride (NaBH4) as reducing<br />

agents. In biodistribution study, excretion via kidney and liver were<br />

distinguished as a major excretion pathway.<br />

Conclusion: In this study, we have shown an approach toward<br />

preparation and purification of a toxic fraction from venom of<br />

Mesobuthus eupeus. The radiolabeling of its toxic fractions with<br />

99mTc could help to investigate the biological effects.<br />

Keywords: Mesobuthus venom purification labeling<br />

168


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Preparation and evaluation of a neuropeptide Y analogue for<br />

diagnosis of breast tumors<br />

Mostafa Erfani(Gandomkar), Mohammad Mazidi, Mostafa Goudarzi,<br />

Nuclear Science Research School, Nuclear Science & Technology Research<br />

Institute (NSTRI), Atomic Energy Organization of Iran<br />

Introduction: Over expression of selected peptide receptors in<br />

human tumors has been shown to represent clinically relevant targets<br />

for cancer diagnosis and therapy. The aim of this work was to<br />

investigate Neuropeptide Y (NPY) as a new radiopharmaceutical for<br />

diagnosis of breast cancer.<br />

Methods: A neuropeptide Y analogues with Y1 receptor preference<br />

and agonistic properties was synthesized by solid phase method.<br />

After conjugation with HYNIC labeling with 99mTc was performed.<br />

For labeled peptide, yield of labeling, stability in human serum,<br />

receptor binding in cell surface with internalization in SK-N-MC cells,<br />

and biodistribution in normal rat were determined.<br />

Results: Peptide was synthesized and labeled with more than 95%<br />

purity. Radiolabeled peptide was stable in human serum and<br />

specifically binds and internalized in the cells with Y1 receptor (4h =<br />

22%). A rapid clearance from blood pool and urinary with<br />

hepatobiliary excretion were observed.<br />

Conclusion: Our results showed that this peptide can be considerate<br />

as a candidate for diagnosis of breast tumors.<br />

Keywords: Neuropeptide Y, HYNIC, 99mTc, Tumor<br />

169


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Preparation and evaluation of 99mTc-cefotaxime for infection<br />

imaging<br />

Mostafa Erfani (Gandomkar), Fatameh Mirshojaei<br />

Nuclear Science Research School, Nuclear Science & Technology Research<br />

Institute (NSTRI), Atomic Energy Organization of Iran<br />

Introduction: A wide range of radiopharmaceuticals have been<br />

proposed to visualize infection and inflammation scintigraphically.<br />

The use of radiolabeled antibiotics is fast emerging as a promising<br />

diagnostic test for the detection of infective lesions. Second and third<br />

generation cephalosporines, including cefuroxime and ceftizoxime<br />

have been labeled with 99mTc. In this study we describe the<br />

optimum condition for radiolabeling of cefotaxime with the most<br />

widely used imaging radionuclide, 99mTc.<br />

Method: The radiolabeling was performed by the sodium dithionite<br />

as the reducing agent. The labeling yield and radiochemical purity<br />

were determined by thin layer chromatography. The affinity of the<br />

labeled antibiotic to human serum proteins was examined by mixing<br />

1 mL of labeled cefotaxime with activity between 5 and 20 mCi to 1<br />

mL of human serum in a vial. Binding of 99mTc-cefotaxime to<br />

bacteria was assessed in S. aureus suspention. Animal biodistribution<br />

was evaluated in mice with infectious thigh muscle.<br />

Result: The maximum radiolabeling yield was 92±2% and was stable<br />

for up to 12 h. This antibiotic showed an improvement in excretion<br />

pathway from the liver to the kidney followed by an accumulation of<br />

radioactivity in infected areas. Images showed minimal accumulation<br />

in non-target tissues, with an average target/non-target ration of<br />

2.89±0.58%.<br />

Conclusion: The promising characteristics make our new radiotracer<br />

a very suitable candidate for diagnostic of infectious foci in nuclear<br />

medicine<br />

Keywords: 99mTc, Cefotaxime, Infection imaging<br />

170


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

B10 distribution in adult rat’s brain<br />

Nasrin Baghban Khojasteh, Ali Pazirandeh, Behnam Jameie<br />

Islamic Azad University<br />

Background: Boron Neutron Capture Therapy is a tumor specific<br />

modality to treat some hard to cure cancers such glioblastoma<br />

multiform and melanoma. It is based on the reaction of 10B atoms<br />

absorbed in the tumor and thermal neutrons. The exact mechanism,<br />

absorption rate and distribution of boron in different areas of brain<br />

are still unknown. In order to find the distribution of 10B in different<br />

regions of brain the present study was done.<br />

Material and Methods: Adult Wistar female rats were used; animals<br />

were divided into two groups including control and trial. Trial group<br />

received two single intraperitoneal shots of 1 ml of neutral boron<br />

compound. Three hours later, the animals were sacrificed and the<br />

brains were removed and three coronal sections of 20μm thickness of<br />

forebrain, midbrain and brainstem were prepared by using freezing<br />

microtome. The sections were sandwiched between two pieces of<br />

polycarbonates and irradiated with thermal neutrons and then<br />

etched. Alpha tracks were detected and studied by optical<br />

microscopy. The plots of 10B distribution in three regions of brain<br />

were obtained, compared and analyzed statistically.<br />

Results: We found significant differences in 10B distribution among<br />

forebrain, midbrain and brainstem with the highest concentration in<br />

the midbrain.<br />

Conclusion: Based on our findings the concentration of 10B in<br />

midbrain may help therapists use more effective treatment planning,<br />

including neutron flux level and irradiation time.<br />

Keywords: BNCT, Rat brain, Boron distribution<br />

171


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Research of exposure rate of urinary tract and gonads of<br />

nuclear medicine patients during kidney scan with Tc-99m-Ec<br />

with the use of TLD-100h and comparison with VMC method<br />

Navideh Aghaei Amirkhizi, Sepideh Hekmat, Elham Shahhoseini,<br />

Farhad Manouchehri, Mohaddeseh Naderi<br />

In kidney diseases that are reported widely in our country, in order to<br />

evaluation and diagnostic of physiological situation of kidney and<br />

bladder, nuclear medicine method is the first priority among other<br />

diagnostic methods. In this research, exposure rate of urinary tract<br />

and gonad of selected patients were measured in kidney scan with<br />

Tc-99m-Ec with the use of TLD-100h and skin surface doses were<br />

studied during imaging time. In general, skin surface doses were<br />

measured and the results were compared with Visual Mont<br />

Carlo(VMC) method. The final results show, skin and total dose have<br />

been lower than annual dose limits.<br />

Keywords: TLD, Urinary tract, VMC<br />

172


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

The calculation of absorbed dose due to 131I-Chlorotoxin in<br />

liver using monte carlo method<br />

Rohollah Adeli, Seyed Pezhman Shirmardi, Mostafa Erfani<br />

(Gandomkar), Mohammad Ghannadi-Maragheh<br />

Nuclear Science & Technology Research Institute (NSTRI), Atomic Energy<br />

Organization of Iran<br />

Introduction: Chlorotoxin is a peptide derived from the venom of<br />

the scorpion Leiurus Quinquestriatus. It can bind with mmp2<br />

receptors on glioma cells. In this research,we used Monte carlo<br />

method to calculate the absorbed dose in organ of interest.this<br />

method is a useful tool to transport of particles and absorbed dose<br />

calcululation.<br />

Methods: The peptide was synthesized by standard Fmoc solidphase<br />

synthesis on Rink amide MBHA resin with substitution of 0.69<br />

mmol/g. Labeling of product was performed by chloramine-T method.<br />

Peptide (40 µg) was dissolved in PBS buffer (50 µl, 0.25 M, pH=7.5)<br />

then was added to a solution of 200 µci Na131I (in 0.1 N NaOH),<br />

followed by 50 µl chloramine-T (4 mg/ml in PBS 0.05 M, pH=7.5).<br />

For ex vivo counting mice were sacrificed after 1, 4 and 24 h and<br />

various organs were dissected, weighed and counted for radioactivity.<br />

The obtained data from organs was used in Monte Carlo method<br />

(MCNP code) to calculate the tissues dose according to MIRD<br />

principles.<br />

Results: Our results suggest that, this labeled chlorotoxin derivative<br />

might be useful in determining tumor extent and also tumor therapy<br />

of gliomas or possibly other cancers. The overall radiolabeling<br />

efficiency was about 80% at a specific activity of 0.740 GBq/mol. The<br />

liver of mouse was assumed as target organ. The sum of gamma and<br />

beta particles dose emitted by 131I were used to calculate total<br />

absorbed dose to liver. The results show that the delivered dose to<br />

liver was very small and 98% of total dose is due to beta particles.<br />

Conclusion: In this study, we have shown a synthetic approach<br />

toward preparation of a chemically and metabolically stable<br />

chlorotoxin derivative. Iodine-131 radiolabeling of these novel<br />

conjugate was performed in order to assess the most optimum<br />

conditions for radiolabeling and potential usage in clinical<br />

applications. We calculated the absorbed dose in liver using Monte<br />

Carlo method (MCNP code). Liver as a target organ absorbed very<br />

small dose as mentioned above.<br />

Keywords: Chlorotoxin 131I, Monte Carlo, Dosimetry, MIRD<br />

173


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Production and quality control of 99mTechnetium-IgG-hynic<br />

for infection imaging in experimental rats<br />

Saeed Rajabifar, Amir Reza Jalilian, Mahdie Ghafori, Sedighe<br />

Moradkhani, Fariba Sadadi<br />

Introduction: Over the last decades several radiopharmaceuticals<br />

have been developed for the detection of infection and inflammation<br />

some have found their way into clinical practice and routinely used<br />

for evaluation of infectious and inflammatory diseases. Human<br />

gamma globulin can be labelled by direct or indirect method of<br />

radiotracer incorporated in protein molecule. In this indirect method<br />

hydrazino nicotinic acid or hynic is used which saves the structure<br />

and biological activity of the protein. Infection is induced by<br />

inoculation of S.aureus in one thigh and inflammation by turpentine<br />

in another.<br />

Methods and material: Immuno globulin is mixed with s-hynic and<br />

IgG-hynic is developed using slide- A lyzer and stored at -20 oC<br />

which can be used at least for six months and then sn-tricine kit is<br />

prepared which is used for 99mTc labelling. Efficiency of 99mTc-IgGhynic<br />

labelling at pH 6.4 was very much dependent on ligand (hynic)<br />

and coligand (tricine) presence in the reaction mixture. Wistar rats<br />

(n=5) were used for bio distribution as well as imaging studies.<br />

Result: Radiochemical purity was found to be more than 90% in the<br />

kits prepared. Serum stability study showed no decomposition of<br />

99mTechnetium from the complex. The bio distribution studies<br />

showed the highest percentage ID/organ in Blood, Liver and Kidney<br />

respectively and the imaging studies revealed the site of infection in<br />

the thigh as compared to the inflamed thigh using turpentine.<br />

Conclusion: A human gamma globulin was successfully labelled<br />

through hynic to 99mTechnetium by indirect method with high<br />

radiochemical purity and differentiation in infected and inflamed thigh<br />

by imaging studies which is a good imaging property.<br />

Keywords: IgG-Hyni, Infection, Inflammation, 99mTechnetium<br />

174


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Development of holmium-166 bleomycin as a possible<br />

therapeutic complex<br />

Samaneh Zolghadri, Amir Reza Jalilian, Hassan Yousefnia, Ali<br />

Bahrami-Samani, Simindokht Shirvani-Arani, Mohammad Ghannadi-<br />

Maragheh<br />

Nuclear Science and Technology Research Institute<br />

Due to interesting therapeutic properties of 166Ho and the<br />

antineoblastic antibiotic, bleomycin (BLM), 166Ho-bleomycin (166Ho-<br />

BLM) was developed as a possible therapeutic compound. Ho-166<br />

chloride was obtained by thermal neutron irradiation (1—1013 n.cm-<br />

2.s-1) of natural Ho2(NO3)3 samples (Specific activity = 3-5<br />

GBq/mg), dissolved in acidic media. At optimized conditions (room<br />

temperature, 12 h, 0.15-0.3 mg bleomycin for 74 MBq 166HoCl3) a<br />

radiochemical purity of 94-97% was obtained as shown by ITLC and<br />

HPLC (Specific activity, 700-740 GBq/mmol). Biodistribution studies<br />

of Ho-166 chloride and 166Ho-BLM were performed in wild-type rats.<br />

The accumulation of the radiolabeled compound in lungs, liver and<br />

spleen demonstrates a similar pattern to the other radiolabeled<br />

bleomycins.<br />

Keywords: Bleomycin, Ho-166, Biodistribution, Radiolabeling<br />

175


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Production, quality control and biological evaluation of 166Ho-<br />

PDTMP as a possible bone palliation agent<br />

Samaneh Zolghadri, Amir Reza Jalilian, Hassan Yousefnia, Zohreh<br />

Naseri, Ali Bahrami-Samani, Mohammad Ghannadi-Maragheh<br />

Nuclear Science and Technology Research Institute<br />

In this study, 166Ho-1,2-propylene di-amino tetra<br />

(methy1enephosphonic Acid) (166Ho-PDTMP) complex was prepared<br />

successfully using an in-house synthesized EDTMP ligand and<br />

166HoCl3. Ho-166 chloride was obtained by thermal neutron<br />

irradiation (1—1013 n.cm-2.s-1) of natural Ho(NO3)3 samples<br />

(Specific activity = 3-5 GBq/mg), dissolved in acidic media.<br />

Radiochemical purity of 166Ho-PDTMP was checked by ITLC (>99%).<br />

Stability studies of the complex in the final preparation and in the<br />

presence of human serum were performed up to 72h. The<br />

biodistribution of 166Ho-PDTMP and 166HoCl3 in wild-type rats was<br />

checked in animal tissues up to 48h. The produced 166Ho-PDTMP<br />

properties suggest a possible new bone palliative therapeutic to<br />

overcome the metastatic bone pains.<br />

Keywords: 166Ho, PDTMP, Radiopharmaceutical, Therapy,<br />

Biodistribution<br />

176


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Development of 166Ho-phytate complex for radiosynovectomy<br />

Samaneh Zolghadri, Akbar Anvari, Amir Reza Jalilian, Hasan<br />

Yousefnia, Ali Bahrami-Samani, Mohammad Ghannadi-Maragheh<br />

Nuclear Science and Technology Research Institute<br />

66Ho-chloride was obtained by bombardment of natural Ho(NO3)3,<br />

dissolved in acidic media using thermal neutron flux (4-5 — 1013<br />

n.cm-2.s-1). 166Ho-holmium chloride (185 MBq) was used for<br />

preparation of 166Ho-phytate complex successfully with high<br />

radiochemical purity (>99.9 %, ITLC, MeOH: H2O: acetic acid, 4: 4:<br />

2, as mobile phase). The complex stability and viscosity were<br />

checked in the final solution up to 2 days. The prepared complex<br />

solution (60 µCi/100 µl) was injected intra-articularly to male rat<br />

knee joint. Leakage of radioactivity from injection site and its<br />

distribution in organs were investigated up to 2 days. Approximately,<br />

all injected dose has remained in injection site 2days after injection.<br />

The complex was proved to be a feasible agent for cavital<br />

radiotherapy in oncology and rheumatology.<br />

Keywords: phytate, radiosynovectomy, holmium-166,<br />

biodistribution, SPECT<br />

177


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Synthesis and quality control of magnetic nanoparticles<br />

labeled 177Lu as a radiopharmaceutical agent for targeted<br />

cancer therapy<br />

Samira Rasaneh 1 , Hossein Rajabi 2 , Fariba Johari Daha 1 , Shahab<br />

Sheybani 1<br />

1 Nuclear Science and Technology Research Institute<br />

2 Tarbiat Modares University<br />

Introduction: Magnetic nanoparticles are good candidates used for<br />

the targeted drug delivery. They can be concentrated on a desired<br />

region, reducing collateral effects and improving the efficiency of<br />

therapy. In this paper we synthesized iron oxide nanoparticles as<br />

magnetic nanoparticles and labeled with 177Lutetium to produce a<br />

new radiopharmaceutical agent for targeted cancer therapy.<br />

Material and methods: Lutetium-177 was produced by bombarding<br />

176Lu2O3 at a flux of 2.6—1014 n.Cm-2.S-1 for 10 days. Iron oxide<br />

nanoparticles were prepared using co-precipitation method. 177Luiron<br />

oxide nanoparticles was synthesized and all the quality control<br />

tests such as labeling yield, nanoparticle hydrodynamic and core size,<br />

stability up to 10 days, magnetization and cell toxicity was<br />

determined.<br />

Results: The good results of quality control tests indicated that<br />

177Lu-iron oxide nanoparticles could be used for further investigation<br />

as a radiopharmaceutical agent in mice bearing tumor. The mean<br />

hydrodynamic size of the nanoparticles was 170±30 nm and the<br />

average core size was 120±25 nm. The Labeling yield was calculated<br />

61±2%. On the average 86±5% of 177lu-iron oxide nanoparticles<br />

were stable in up to 10 days and no meaning changes were seen in<br />

nanoparticles size. This conjugation showed very good cytotoxcicity<br />

on cancer cells.<br />

Conclusion: We can conclude that 177Lu-iron oxide nanoparticles<br />

may be considered for further evaluation as a new<br />

radiopharmaceutical agent for targeted cancer therapy that needs<br />

more investigations.<br />

Keywords: magneticnanoparticles, 177Lutetium, drugdelivery,<br />

targetedcancertherapy<br />

178


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Biodistribution study of 177Lu- iron oxide nanoparticles in<br />

mice under an external magnetic field<br />

Samira Rasaneh 1 , Fariba Johari Daha 1 , Shahab Sheybani 1 , Shahram<br />

Akhlaghpoor 2<br />

1 Nuclear Science and Technology Research Institute<br />

2 Departments of Interventional Radiology<br />

Introduction: This study explored the possibility of utilizing iron<br />

oxide nanoparticles as a 177Lu delivery vehicle under an external<br />

magnetic field. In this study the biodistribution of 177Lu-iron oxide<br />

nanoparticles in mice with and without of an external magnetic field<br />

was considered.<br />

Material and methods: 177Lu-iron oxide nanoparticles were<br />

synthesized and all the quality control tests was performed. For the<br />

biodistribution study, female mice(n=24) were used. Before injection<br />

of 177Lu-iron oxide nanoparticles, an external magnetic field<br />

(magnetic flux density of 0.6 T) was positioned on the right feet of<br />

the mice, and it would persist in existence for 72 h. The mice were<br />

killed at 24, 48 and 72 h post-administration, tissues were removed<br />

and considered for 177Lu activities and iron concentration. This<br />

procedure was repeated without external magnetic field.<br />

Results: Comparison of the biodistribution results showed that<br />

177Lu-iron oxide nanoparticles accumulated in the right feet of the<br />

mice more than other organs under the external magnetic field. The<br />

results indicated that the distribution of 177Lu-iron oxide<br />

nanoparticles was different with and without using magnetic field.<br />

Conclusion: The good biodistribution results accented that 177Luiron<br />

oxide nanoparticles may be considered for further evaluation as<br />

a new radiopharmaceutical agent for targeted cancer therapy that<br />

needs more investigations.<br />

Keywords: ironoxidenanoparticles, 177Lutetium, biodistribution,<br />

drugdelivery, cancertargetedtherapy<br />

179


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Evaluation and quality control of Radiolabeled Streptokinase<br />

for dignostic purposes<br />

Sayyede Fateme Mirazizi, Amir Reza Jalilian, Hossein Sadeghpour<br />

Introduction: Cardiovascular diseases are major cause of morbidity<br />

and mortality in developing and developed countries. Rapid diagnosis<br />

of the thrombosis can be an essential step in management of the<br />

stroke people.<br />

Methods: Streptokinase was successively labeled with gallium<br />

chloride using cyclic DTPA-dianhydrid. In this work a recently<br />

developed radiolabeled streptokinase tracer was evaluated in an<br />

animal thrombotic model using SPECT imaging and biodictribution<br />

studies. Produced [67Ga]-Streptokinase was checked by RTLC, HPLC<br />

and SDS-PAGE experiments to check the tracer integrity/purity. The<br />

biodistribution studies were performed in femoral vein thrombotic<br />

rats (up to 12h) using tissue counting and preliminary SPECT studies<br />

respectively (up to 3 h- 48 h).<br />

Results: [67Ga]-Streptokinase prepared with suitable radiochemical<br />

purity (HPLC >95%, RTLC >99%) was administered to FeCl3 induced<br />

thrombotic rats and the percentage of injected dose per gram of<br />

tissue (ID/g%) and SPECT images demonstrated the specific binding<br />

of the tracer in thrombotic clots located in heart and aortic 2-3 hours<br />

post injection.<br />

Conclusion: [67Ga]-DTPA-SPK can be a suitable probe for imaging<br />

of thrombosis in cardiovascular diseases .Further studies use of Ga-<br />

68 labeled SPK can result in a superior labeled compound due to<br />

positron emission properties for PET studies as well as appropriate<br />

physical half live.<br />

Keywords: Streptokinase, Gallium-67, Thrombosis, SPECT,<br />

biodistribution<br />

180


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Radioprotective agents prevent genotoxicity induced by<br />

ionizing radiation in nuclear medicine practice<br />

Seyed Jalal Hosseinimehr<br />

Department of Radiopharmacy<br />

Ionizing radiation passing through living tissues induces damage,<br />

these damage are caused directly or indirectly with producing free<br />

radicals and toxic agents. Interaction of free radicals with critical<br />

macromolecules such as DNA is leading to genotoxicity and then<br />

mutation and carcinogenesis. In nuclear medicine practice, personnel<br />

and patients expose to ionizing radiation through radiopharmaceutical<br />

preparation and administration. Although, gamma irradiation<br />

produced by radiopharmaceuticals is not high level, it can induce<br />

genotoxicity. There are several compounds were evaluated for<br />

protection against genotoxicity induced by external or internal<br />

irradiation on culture human lymphocytes in our laboratory. These<br />

compounds are mainly natural origin products. Radioprotective<br />

effects of Hawthorn, Zataria extracts and hesperidin were<br />

investigated against genotoxicity induced by external gamma<br />

irradiation in vitro cultured human lymphocytes, they have good<br />

radioprotection. In other study, we showed that hesperidin protected<br />

significantly, DNA damage induced by gamma irradiation produced by<br />

99mT-MIBI in lymphocytes. These results showed that natural<br />

products could be candidate as radioprotective agents in internal and<br />

external genotoxicity induced by ionizing radiation.<br />

Keywords: Radioprotective, natural product, gamma iradiation,<br />

genotoxicity<br />

181


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Preparation and biodistribution study of a chlorotoxin<br />

derivative peptide labeled with 131-iodine for tumor therapy<br />

Seyed Pezhman Shirmardi, Mostafa Erfani (Gandomkar), Mohammad<br />

Ghannadi Maragheh<br />

Nuclear Sciences and Technology Research Institute, Tehran, Iran<br />

Introduction: Chlorotoxin is a 36-amino acid peptide found in the<br />

venom of the Leiurus quinquestriatus which blocks small-conductance<br />

chloride channels. Chlorotoxin binds preferentially to glioma cells that<br />

allow development of new methods for the treatment and diagnosis<br />

of several types of cancer. Due to this a chlorotoxin derivative was<br />

labeled with 131I and investigated further.<br />

Methods: A chlorotoxin derivative was synthesized on a solid phase<br />

using a standard Fmoc strategy. Labeling with iodine-131 was<br />

performed through chloramine-T method and radiochemical analysis<br />

involved sephadex G-25 and HPLC methods. The stability of<br />

radiopeptide was checked in the presence of PBS and human serum<br />

at 37°C up to 24 h. The biodistribution was studied in mice. Results:<br />

The chemical purity of synthesized peptide as assessed by analytical<br />

RP-HPLC was 95%. Labeling of peptide resulted in a radiochemical<br />

yield of 80% with radiochemical purity of > 95% with specific activity<br />

of 0.740 GBq/μmol. Results of In vitro studies demonstrated<br />

acceptable stability of compound in human serum and PBS solution.<br />

Biodistribution data showed moderate blood clearance, with<br />

concentration of radioactivity in the kidneys, liver, intestine and<br />

stomach.<br />

Keywords: cancer, peptide, 131I labeling, Chlorotoxin<br />

182


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Synthesis, Radiolabeling and Biological Evaluation of [67Ga]-<br />

5,10,15,20-tetrakis(pentafluorophenyl) porphyrin complex as<br />

an imaging agent<br />

Seyed Yousef Fazaeli 1 , Amir Reza Jalilian 1 , Mostafa M. Amini 2 , Abbas<br />

Majdabadi 1 , Ali Rahiminejad 1 , Fatemeh Bolourinovin 1 , Sedigheh<br />

Moradkhani 1<br />

1 Nuclear Science and Technology Research Institute (NSTRI)<br />

2 Department of Chemistry<br />

INTRODUCTION: Porphyrins appeal large attention because of their<br />

impersonation in the human body, ability to accumulate in many<br />

kinds of cancer cells, as well as magnetic and optical properties.<br />

Radiolabeled porphyrins have been developed for the therapeutic<br />

purposes such as, 109Pd-protoporphyrins , 109Pd-porphyrins [1],<br />

and 188Re-porphyrin [2]. In continuation of our previous work [3] ,<br />

we report, synthesis, radiolabeling, partition coefficient, quality<br />

control and biodistribution studies (using: SPECT and scarification) of<br />

67Ga-F20P in wild-type rats. METHODS [67Ga] labeled 5,10,15,20-<br />

tetrakis(pentafluorophenyl) porphyrin ([67Ga]-F20P) was prepared<br />

using freshly prepared [67Ga]GaCl3 and 5,10,15,20-tetrakis<br />

(pentafluorophenyl)porphyrin (F20PH2) for 50 min at 25°C<br />

(radiochemical purity: >97% ITLC, >98% HPLC, specific activity: 13-<br />

14 GBq/mmol). Stability of the complex was checked in final<br />

formulation and human serum for 24 h. The partition coefficient was<br />

calculated for the compound (log P=0.58). The biodistribution of the<br />

labeled compound in vital organs of wild-type and tumor bearing rats<br />

was studied using scarification studies and SPECT imaging up to 24 h.<br />

A detailed comparative pharmacokinetic study performed for 67Ga<br />

cation and [67Ga]-F20P. Results Total labeling and formulation of<br />

[67Ga]- F20P took about 30-60 min (RCP >97% ITLC, >98% HPLC,<br />

specific activity: 13-14 GBq/mmol). The complex was stable in final<br />

formulation and human serum at least for 24 h. At the pH.7, the logP<br />

was 0.58. The biodistribution of the labeled compound in vital organs<br />

of wild-type rats was studied using scarification studies and SPECT<br />

imaging up to 24 h. The complex is mostly washed out from the<br />

circulation through liver and kidneys and can be an interesting tumor<br />

imaging/targeting agent due to high tumor uptake and rapid<br />

excretion through the urinary tract. Conclusion It is suggested that<br />

67Ga-F20P could be a possible SPECT tracer, however considering<br />

the fast wash-out, the short half life gallium-68 can be a suitable<br />

candidate for tumor imaging applications and future 68Ga-PET<br />

studies and less imposed radiation doses to patients.<br />

References: 1. R.A. Fawwaz , F. Frye , W.D. Loughman, W.<br />

Hemphill, Survival of skin homografts in dogs injected with 109Pdprotoporphyrin.<br />

J Nucl Med 15 (1974) 997-1002. 2. H.D. Sarma, T.<br />

Das, S. Banerjee, M. Venkatesh, P.B. Vidyasagar, K.P. Mishra.<br />

Biologic evaluation of a novel 188Re-labeled porphyrin in mice tumor<br />

model. Cancer Biother Radiopharm 25 (2010) 47-54. 3.Yousef<br />

183


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Fazaeli, Amir. R. Jalilian, Mostafa .M. Amini, J. Radioanal. Nucl.<br />

Chem, 288 (2011) ,17-24<br />

Keywords: [67Ga]- 5,10,15,20-tetrakis(pentafluorophenyl)<br />

porphyrin , imaging agent<br />

184


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Production, quality control and imaging of 64Cu-ATSM in<br />

healthy rabbits for clinical applications<br />

Seyed Yousef Fazaeli, Amir Reza Jalilian, Mohsen Kamali-Dehghan,<br />

Fateme Bolourinovin, Sedigheh Moradkhani, Gholamreza Aslani, Ali<br />

Rahiminejad, Mohammad Ghannadi-Maragheh<br />

Nuclear Science and Technology Research Institute (NSTRI)<br />

INTRODUCTION: [64Cu]diacetyl-bis(N4-methylthiosemicarbazone)<br />

([64Cu]ATSM) is a well-established hypoxia imaging tracer with<br />

reproducible production and significant specifity. In this work the high<br />

yield production and quality control as well as imaging studies in<br />

healthy rabbits is reported.<br />

METHODS: Copper-64 produced via the 68Zn(p, n)64Cu nuclear<br />

reaction (30 MeV protons at 180 µA) was used for the preparation of<br />

[64Cu]diacetyl-bis(N4-methylthiosemicarbazone)([64Cu]ATSM).<br />

Followed by quality control and administration to healthy rats as well<br />

as healthy rabbits for biodistribution and imaging studies respectively<br />

Results 64Cu2+ (500 mCi, separation yield> 95%, radionuclide<br />

purity>96%) was used for [64Cu]ATSM production (radiochemical<br />

purity>99%, specific activity of 300 Ci/mmol) followed by<br />

administration to healthy rabbits and coincidence imaging<br />

demonstrating uptake in liver, kidney and bowel as shown by other<br />

reports in various rodents and human. Conclusion Copper-64 in the<br />

form of 64Cu2+ (500 mCi, separation yield> 95%, radionuclide<br />

purity>96%) was used for [64Cu]ATSM production (radiochemical<br />

purity>99%, specific activity of 300 Ci/mmol) in 10 min. No other<br />

labeled by-products were observed upon RTLC/HPLC analysis of the<br />

final preparations after solid phase extraction (SPE) purification. The<br />

radio-labeled complex was stable in aqueous solutions for at least 12<br />

hours and no significant amount of other radioactive species were<br />

detected by RTLC 12 hours after labeling. The biodistribution of the<br />

tracer in normal rats up to 210 min demonstrated similar<br />

biodistribution to the other reports for [64Cu]ATSM. Intravenous<br />

administration of the tracer to healthy rabbits and coincidence<br />

imaging demonstrated uptake in liver, kidney and bowel as shown by<br />

other reports in various rodents and human. [64Cu]ATSM, is PET<br />

radiotracer with a long half life, and the high yield, large scale<br />

production and stability of this radiopharmaceutical make it a<br />

accessible diagnostic agent for clinical trial initiation in the country.<br />

Keywords: [64Cu]ATSM, Rabbits, biodistribution, coincidence<br />

imaging<br />

185


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Synthesis, Radiolabeling and Biological Evaluation of [67Ga]-<br />

maltolate complex as an imaging agent<br />

Seyed Yousef Fazaeli 1 , Amir Reza Jalilian 1 , Mostafa M. Amini 2 , Abbas<br />

Majdabadi 1 , Ali Rahiminejad 1 , Fatemeh Bolourinovin 1 , Mehraban<br />

Pouladi 1<br />

1 Nuclear Science and Technology Research Institute (NSTRI)<br />

2 Department of Chemistry<br />

INTRODUCTION: The interesting physical properties and availability<br />

of gallium-67 make it an interesting nuclide for radiopharmaceutical<br />

research [1] recently. Studies of gallium maltolate as a potential<br />

treatment for liver cancer and gastrointestinal cancers has been done<br />

[2]. Gallium maltolate is stable in aqueous solutions between about<br />

pH 5 and 8, and it has significant solubility in both water and lipids.In<br />

this work we report, synthesis, radiolabeling, partition coefficient,<br />

quality control and biodistribution studies (using SPECT and<br />

scarification) of 67Ga-maltolate in Swiss mice.The time/activity<br />

diagrams for the labeled compound in vital organs have been plotted<br />

compared to gallium cation. METHODS [67Ga] labeled 3-hydroxy-2-<br />

methyl-4H-pyran-4-onate ([67Ga]- maltolate) was prepared using<br />

freshly prepared [67Ga]GaCl3 and 3-hydroxy-2-methyl-4H-pyran-4-<br />

onate in a sodium salt form for 25 min at 40°C (radiochemical purity:<br />

>96% ITLC, >98% HPLC, specific activity: 13-17 GBq/mmol).<br />

Stability of the complex was checked in final formulation and human<br />

serum for 24 h. The partition coefficient was calculated for the<br />

compound (log P=0.40). The biodistribution of the labeled compound<br />

in vital organs of Swiss mice studied using scarification studies and<br />

SPECT imaging up to 24 h. A detailed comparative pharmacokinetic<br />

study performed for 67Ga cation and [67Ga]-maltolate. Results Total<br />

labeling and formulation of [67Ga]-maltolate took about 30 min. The<br />

complex was stable in final formulation and human serum at least for<br />

24 h. At the pH.7, the logP was 0.4. The biodistribution of the labeled<br />

compound in vital organs of Swiss mice was studied using<br />

scarification studies and SPECT imaging up to 24 h. Conclusion It is<br />

suggested that [67Ga]-maltolate could be a possible SPECT tracer,<br />

however considering the fast wash-out and the short half life gallium-<br />

68, [67Ga]-maltolate can be a suitable candidate for tumor imaging<br />

applications and future 68Ga-PET studies and less use and therefore<br />

less imposed radiation doses to patients.<br />

References: 1. R.B. Firestone, In: Table of isotopes. 8th edition,<br />

John Wiley and Sons, p.1447, New York, (1996). 2. C.R. Chitambar,<br />

"Development of Gallium Compounds for Treatment of Lymphoma:<br />

Gallium Maltolate. J. Pharmacol. Exp. Ther. (2007) 322.<br />

Keywords: ([67Ga]- maltolate), imaging agents, biodistribution<br />

186


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Preparation and biological evaluation of radiogallium-labeled<br />

folate-embedded superparamagnetic nanoparticles in<br />

fibrosarcoma-bearing rat<br />

Seyydeh Leila Hosseini Salekdeh 1 , Amir Reza Jalilian 2 , Morteza<br />

Mahmoudi 3 , Hassan Yousefnia 2 , Majid Pouladian 1<br />

1 Nuclear Engineering Departmant<br />

2 Radiopharmaceutical Research and Development Lab (RRDL)<br />

3 Institute for Nanoscience and Nanotechnology<br />

The development of a large variety of colloidal dispersions of super<br />

paramagnetic iron oxide nanoparticles (SPION) has added a<br />

supplementary function to nanomaterials, their magnetic properties,<br />

which led to a range of new biological and biomedical (diagnostic and<br />

treatment) applications. The interesting biological activity of folic acid<br />

as well as amphiphilic properties of this important hematopoietic<br />

vitamin was considered to be a multi-purposes functional additive to<br />

SPION core. Superparamagnetic iron oxide nanoparticles (SPION)<br />

embedded by folic acid (SPION-folate) were prepared by a modified<br />

co-precipitation method. The structure, size, morphology, magnetic<br />

property and relaxivity of the SPION-folate were characterized<br />

systematically by means of XRD, VSM, HRSEM and TEM and the<br />

interaction between folate and iron oxide (Fe3O4) was characterized<br />

by FT-IR. The particle size was shown to be ≈ 5-10 nm. Stability of<br />

67Ga-SPION-folate in final preparation was determined by storing the<br />

final solution at 25C for 4 days and performing frequent ITLC<br />

analysis to determine radiochemical purity. Biocompatibility of the<br />

compound was investigated using an MTT assay followed by stability<br />

tests and tumor accumulation studies in fibrosarcoma-bearing mice<br />

after subcutaneous (s.c.) application. [67Ga]-SPION-folate<br />

(radiochemical purity> 96%, RTLC method) was evaluated in<br />

fibrosarcoma-bearing rat after subcutaneous injection. All values<br />

were expressed as mean ± standard deviation (mean ± SD) and the<br />

data were compared using student T test. Statistical significance was<br />

defined as P


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Development of 165Dy-chitosan for radio-synovectomy<br />

Simindokht Shirvani-Arani, Ali Bahrami-Samani, Amir Reza Jalilian,<br />

Mohammad Ghannadi-Maragheh<br />

Radiopharmaceutical Research and Development Laboratory (RRDL)<br />

Introduction: Radioactive chitosan complexes are new internal<br />

radiation therapeutic agents; they exist in solution state in acidic pH<br />

and in gel state in pH of the human body. Therefore they do not leak<br />

from the lesion. In addition radioactive chitosan complex is a natural<br />

biocompatible and biodegradable product which can be excreted after<br />

decay. In this research the 165Dy-chitosan complex (165Dy-Chit)<br />

was prepared successfully with high radiochemical purity (>99%) in<br />

diluted acetic acid solution.<br />

Methods: 165Dy was produced by thermal neutron bombardment on<br />

natural Dy (NO3)3 at the Tehran Research Reactor (TRR) for a period<br />

of 6 hours at a flux of 3-4—1013 neutrons/cm2.s. The preparation of<br />

165Dy-Chit was performed with regard to the optimized situation<br />

reported by shin et al in which complexation gradually increased with<br />

increase in ligand concentration and reached to almost 100% at a<br />

value of 35mg of chitosan in 4 ml acetic acid (pH. 3). Radiochemical<br />

purity was determined using ITLC.<br />

Results: The 165Dy-Chit complex was prepared with high<br />

radiochemical yield (>99 %) in the optimized condition; 35mg/3ml of<br />

chitosan concentration in diluted acetic acid solution (pH=3). The<br />

prepared complex was stable in the final solution at room<br />

temperature, 37ºC and presence of human serum, and can be used<br />

even 24 hours after preparation. The retention in the injected rabbit<br />

knee joint was observed after passing three half lives of radionuclide.<br />

Conclusion: The short half-life of 165Dy (2.3 h) suggests minimal<br />

exposure of non-target organs by reduction of leakage. Numerous<br />

reports have shown the efficacy and safety of 165Dy for the<br />

treatment of chronic synovitis. These studies indicate that 165Dy-Chit<br />

shows promising features and warrants further investigation for<br />

development as a cost-effective agent for radiosynovectomy. It is<br />

ready to be used for therapeutic applications in the country.<br />

Keywords: 165Dy Chitosan, radiosynovectomy<br />

188


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Study of radioprotection effects of some bis-<br />

Thiosemicarbazone compounds<br />

Zahra Mehdipour, Amir Reza Jalilian 1 , Alireza Shirazi<br />

1 Radiopharmaceutical Research and Development Laboratory (RRDL)<br />

ATSM, PTSM and GTS are bis- thiosemicarbazone ligands used in the<br />

preparation of copper radiopharmaceuticals. According to the<br />

theoretical studies, these ligands possess radical scavenging<br />

properties due to the presence of NH, SH functional groups, leading<br />

to radioprotection effects. In this work, radiaprotective effect of the<br />

compounds at various doses (20, 40 and 80 μg) and two time<br />

intervals injections prior to Co-60 gamma radiation (40 min, 7.5 Gy)<br />

have been studied compared to control experiments. The survival of<br />

the animals was recorded in one month post irradiation. At the next<br />

step, the hepatotoxicity of the effective compounds at the exact<br />

protective doses (ATSM, 80 μg and GTS, 20 μg) were checked by the<br />

determination of ALT and AST enzyme concentrations in the rat sera<br />

7 days after injection. ATSM at the effective radioprotection doses<br />

demonstrate no significant increase in SGPT and SGOT serum levels<br />

demonstrating no hepatotoxicity compared to the control, while a 30-<br />

40% of increase in enzymes was observed for GTS even 7 days postinjection.<br />

Due to the similar moles of injections in both cases, ATSM<br />

is definitely a better candidate for future radioprotection studies.<br />

Keywords: ATSM, PTSM, GTS, radioprotection, ALT, AST<br />

189


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

The influence of misalignment between PET and CT images on<br />

the accuracy of CT-based attenuation correction in thorax<br />

imaging: a simulation study<br />

Zahra Anvari 1 , Mohammad Reza Ay 1 , Babak Fallahi 2<br />

1 Department of Medical Physics and Biomedical Engineering<br />

2 Research Institute for Nuclear Medicine<br />

Purpose: The accuracy of activity recovery from PET images is<br />

affected by respiratory motion especially in lung imaging. Moreover,<br />

Misregistration between PET and CT images in PET/CT imaging<br />

significantly influences the quantification of PET images due to the<br />

CT-based attenuation correction process. The aim of this study was to<br />

evaluate the impact of misregistration between PET and CT images<br />

on the accuracy of CTAC.<br />

Methods: Using 4-dimensional extended Cardiac Torso (XCAT)<br />

phantom, 4 lesions with 10 mm diameter and specified activity were<br />

defined in different locations of lung. To investigate the impact of<br />

respiratory motion on CT-based attenuation correction of PET images,<br />

first static PET images were generated as reference. Then the<br />

average PET data was acquired in 10 phases of a respiratory cycle.<br />

Two CT image sets were generated. One, obtained at end expiration<br />

called EE-CT, and another was the average of one respiratory period<br />

called Ave-CT. As phantom images are ideal, first PET sinograms<br />

were attenuated with the corresponding CT images using STIR<br />

(Software for Tomographic Image Reconstruction) code. Attenuation<br />

correction of PET sinograms was performed with EE-CT and Ave-CT.<br />

After adding poisson noise to sinograms, PET images were<br />

reconstructed using OSEM algorithm with 4 subsets and 24<br />

subiterations followed by a 4 mm Gaussian filter. The attenuation<br />

corrected PET images were compared with the static images.<br />

Results: For upper lesions with 11mm diaphragm motion amplitude,<br />

Standardized Uptake Values (SUVmax) underestimation was not<br />

significantly different between Ave-CTAC and EE-CTAC. However, for<br />

middle and lower lesions with 16 mm motion, errors were 25 % and<br />

61% respectively for Ave-CTAC rather than 62% and 73% for EE-<br />

CTAC.<br />

Conclusion: Respiratory motion complicates lung tumor<br />

quantification. Using Ave-CT for attenuation correction can yield<br />

smaller mismatch errors than EE-CT. Our study suggests that<br />

mismatched attenuation correction can be partly compensated by<br />

using Ave-CT for attenuation correction.<br />

Keywords: PET/CT, attenuation correction, respiratory, STIR, XCAT<br />

190


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Determination of neutron flux of Esfahan ZPR in different level<br />

of energy by MCNP cod for investigate of BNCT<br />

Zahra Eslami 1 , Feridoun Payami 2 , Behzad Timuri 2<br />

1 Payamnoor university Tehran<br />

2 Nuclear science and technology research institute reactor and accelerator<br />

research and development school (Esfahan)<br />

Introduction: Relating to deaths caused by cancers, we have tried<br />

to investigate the type of the cancers, and common method used for<br />

their treatments. Then we have evaluated the advantage and<br />

disadvantage of different methods, in regarding with the type of<br />

cancers, aiming to proof, that BNCT (boron neutron capture therapy )<br />

method can be the most appropriate methods for treatment of cancer<br />

in comparison with the other methods available. Now of days,<br />

advanced method of BNCT use a thermal (E n < 0.5 eV), or<br />

epithermal (0.5 eV < E n < 10 keV), neutron beam in conjunction<br />

with tumor- targeting boron compound for irradiation of glioblastoma<br />

and metastatic melanomas.<br />

Methods: In conjunction with, a systematic Mont carlo N-particle<br />

(MCNP) investigation of the different level of energy for neutron in<br />

ZPR (Zero Power Reactor) has been performed.<br />

Results: We did calculated with MCNP code, on neutron flux in ZPR,<br />

for different level of energies, and to complete the work, we<br />

compared the results with neutron flux requirements in BNCT cancer<br />

treatments.<br />

Conclusion: we believe that in future, BNCT can pursue its way as<br />

one of the safest, and fastest method of brain cancers treatment, and<br />

We hope that in the near future, an appropriate (bed) will be<br />

established, for research and development of this methods in our<br />

country, so that this method can become vastly available to those<br />

patients, who are hopelessly seeking, a safer methods of brain cancer<br />

treatment.<br />

Keywords: BNCT, neutron flux, cancer therapy<br />

191


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

192


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Index<br />

A<br />

Abbasi K. 23<br />

Abbasi M. 57, 126<br />

Abdolahzade M. 90, 143<br />

Abedi S. 112, 113<br />

Aboudzadeh M.R. 142<br />

Adeli R. 173<br />

Adibpour F. 147<br />

Aghaei Amirkhizi N. 172<br />

Ahangari H. 95<br />

Ahmadi G.R. 124<br />

Ahmadi Sh. 117<br />

Ahmadin N. 77<br />

Akbari M. 26<br />

Akbarzadeh S. 125<br />

Akhlaghi M. 138<br />

Akhlaghpour Sh. 88, 103, 179<br />

Alani A. 87<br />

Alavi M. 28, 59, 63, 123<br />

Alipoor A. 96, 97, 156<br />

Alirezapour B. 73, 142<br />

Amini A. 162<br />

Amini H. 61<br />

Amini M.M. 183, 186<br />

Amirian S. 127<br />

Amoui M. 26, 103<br />

Anvari A. 133<br />

Anvari K. 132, 177<br />

Anvari Z. 190<br />

Arbabi M. 30<br />

Arefan D. 133<br />

Arjmand Shabestari A. 28, 29<br />

Aryana K. 51, 67<br />

Asadi M. 52<br />

Ashoor M. 84, 94<br />

Askari M.A. 85, 102<br />

Aslani G.R. 71, 185<br />

Assadi M. 56, 62, 120, 125, 162<br />

Assadi S.M. 61<br />

Attar Nosrati S. 118<br />

Ay M.R. 22, 25, 33, 88, 92, 98, 103, 108, 110,<br />

145, 147, 190<br />

B<br />

Babaei M.H. 22, 24, 31, 36<br />

Babapour F. 100, 117<br />

Baghban Khojasteh N. 171<br />

Bagheri M. 27<br />

Bagheri M. 77<br />

Bagheri R. 76<br />

Bahrami Samani A. 74, 76, 114, 134, 141, 144, 149, 150,<br />

151, 152, 153, 155, 175, 176, 177, 188<br />

Bakhshandepour G.R. 30<br />

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3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Bashtar M. 77<br />

Beheshti M. 105<br />

Beyki D. 22, 24, 31, 39, 42, 60, 61, 64,<br />

Bijan B. 21, 26<br />

Bolourinovin F. 71, 73, 83, 135, 142, 183, 185, 186<br />

Bombardieri E. 21, 23, 26, 28<br />

Bouzarjomehri F. 25<br />

C<br />

Chahkandi M.R. 127<br />

D<br />

Dabbagh Kakhki V.R. 29, 32, 49, 55, 58, 132<br />

Dabiri Oskoei Sh. 54<br />

Davari Sh. 99<br />

Davarpanah M.R. 72, 118<br />

Derakhshan S. 32<br />

E<br />

Eftekhari M. 23, 57, 60, 61, 64, 95, 126<br />

Elahi F. 26<br />

Emami A. 88<br />

Emami Ardakani A.R. 57, 60, 64, 93, 101, 126<br />

Erfani(Gandomkar) M. 22, 25, 40, 47, 72, 75, 79, 81, 107,<br />

116, 166, 167, 168, 169, 170, 173, 182<br />

Eslami Z. 191<br />

Esmaili J. 64<br />

Esteghamati A.R. 57<br />

F<br />

Faghihi R. 136, 138<br />

Fallahi B. 57, 60, 61, 64, 126, 190<br />

Fani Pakdel A. 52<br />

Farahani H. 161<br />

Farahani M. 91, 146, 148<br />

Fard Esfahani A. 28, 60, 61, 64, 102<br />

Farsad M. 21, 23, 28, 35<br />

Farzanefar S. 60, 64, 95<br />

Fatehi M. 68, 69<br />

Fathi M. 142<br />

Fattahi Masoom A.S. 53<br />

Fazaeli Y. 152, 183, 185, 186<br />

Fazli A. 124<br />

G<br />

Gannadi Maragheh M. 72, 74, 76, 81, 89, 114, 134, 139, 141,<br />

144, 149, 150, 151, 152, 153, 155,<br />

167, 168, 173, 175, 176, 177, 182,<br />

185, 188<br />

Garousi J. 136, 140<br />

Gasemabadi D. 143<br />

Ghadiri H. 32, 88, 98<br />

Ghadiri P. 88<br />

Ghafarian P. 110<br />

Ghafori M. 174<br />

Ghafori M. 97<br />

194


3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Gharepapagh E. 121<br />

Ghasemabadi D. 90<br />

Ghazanfari N. 108<br />

Ghazikhanlou Sani K. 154<br />

Gheisari F. 59, 63, 123<br />

Gheshlaghi H. 154<br />

Gholami H. 52, 53,<br />

Gholamrezanezhad A. 77, 129<br />

Ghozati B. 165<br />

Giannopoulou Ch. 23, 29, 41<br />

Goudarzi M. 99<br />

Goudarzi M. 79, 91, 146, 148, 169<br />

Gourani M. 161<br />

H<br />

Hadavand F. 62<br />

Haeri M. 154<br />

Hajhasan Abbasi F. 91, 146, 148<br />

Hakimi A. 137, 139<br />

Harati M. 118<br />

Hassani Bidgoli J. 110<br />

Hassanzadeh L. 75<br />

Hedayati A. 28<br />

Hekmat S. 22, 27, 36, 172<br />

Heydarinejad S. 126<br />

Hosseini R. 27<br />

Hosseini Pooya M. 115<br />

Hosseini Salekdeh L. 187<br />

Hosseinimehr J. 25, 31, 80, 181<br />

I<br />

Ibis E. 131<br />

Izadyar S. 64<br />

J<br />

Jafari M. 125<br />

Jafarizadeh M. 115<br />

Jalallat S. 120<br />

Jalilian A.R. 22, 24, 31, 33, 37, 43, 71, 73, 74, 76 ,<br />

82, 83, 114, 134, 135, 136, 138, 139,<br />

140, 142, 144, 149, 150, 151, 152,<br />

153, 155, 159, 160, 174, 175, 176,<br />

177, 180, 183, 185, 186, 187, 188, 189<br />

Jameie B. 171<br />

Jamreh M. 159, 160<br />

Jangjoo A. 26<br />

Javadi H. 56, 62, 120<br />

Javan H. 52<br />

Javanshir M.R. 165<br />

Johari Daha F. 22, 44, 178, 179<br />

Jomehzadeh A. 86<br />

Jomehzadeh Z. 86<br />

K<br />

Kabiri F. 165<br />

Kalantarhormozi M.R. 62<br />

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Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Kalantari B.A. 72<br />

Kalantari F. 92, 93, 103, 105, 117<br />

Kamali Asl A.R. 92, 133<br />

Kamali Dehghan M. 71, 73, 185<br />

Kardan M. 28<br />

Karimi Diba J. 115<br />

Kasesaz Y. 90, 143, 163<br />

Khalafi H. 163<br />

Khorshidi A. 84<br />

Khoshdel M. 135<br />

Khoshhosn H.A. 118<br />

Khosravi H. 31, 33<br />

Khosrounejad H.R. 91, 146, 148<br />

Kia M. 164<br />

Kohanpour M. 105<br />

Kucuk O.N. 131<br />

L<br />

Lahooti A. 111<br />

Loudos G. 108, 147<br />

M<br />

Mahdavi R. 25<br />

Mahmoudi M. 187<br />

Mahmoudian A. 132<br />

Mahmoudian B. 54<br />

Maghsoodi R. 27<br />

Majdabadi A.<br />

183, a86<br />

Majdi M. 60<br />

Malek H. 29<br />

Malekzadeh M. 23<br />

Malekzadeh R. 77<br />

Manouchehri F. 172<br />

Mazidi M. 72, 76, 91, 116, 134, 151, 161, 169<br />

Mehdipour Z. 189<br />

Mehdizadeh A.R. 59, 63<br />

Mifallah H. 72<br />

Mir Falah M.H. 148<br />

Mirazizi F. 180<br />

Mirpour S. 77, 129<br />

Mirshojaei F. 79, 116, 170<br />

Mirshojaei Sh. 124<br />

Mishra K.P. 23, 28, 31, 38<br />

Modarresi M. 130<br />

Moghaddam Banaem L. 159, 160<br />

Mogharrabi M. 56, 120<br />

Mohajeri M.R. 28<br />

Mohamadnejad J. 142<br />

Mohamadnejad M. 77<br />

Momen’nejhad M. 28, 31<br />

Moosavi H. 24<br />

Moosavi K. 158<br />

Moradkhani S. 71, 73, 142, 174, 183, 185<br />

Moshayedi A. 90<br />

Moslehi A. 143<br />

Mousavi Z. 49<br />

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3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Movahed M. 22<br />

Mozdarani H. 23, 28<br />

N<br />

Nabipour I. 62, 120, 125, 162<br />

Naderi M. 172<br />

Najafi R. 31, 75, 107<br />

Naseri Z. 74, 82, 153, 176<br />

Nasrollahi A. 22<br />

Nazari M. 96, 156<br />

Neamtu J. 109<br />

Nemati Kharat A. 82<br />

Nemati R. 125, 162<br />

Neshandar Asli I. 120<br />

Nikzad R. 72<br />

Nonbede M. 143<br />

Norouzbeigi N. 128<br />

Novinrouz A. 140<br />

Nouroozian M. 25, 30<br />

O<br />

Orlova A. 80<br />

Orouji T. 115<br />

Ozdan E. 131<br />

P<br />

Parach A.S. 85<br />

Payami F. 191<br />

Payervand F. 94<br />

Pazirandeh A. 171<br />

Pirayesh E. 70<br />

Poorbeygi H. 165<br />

Pooyafard F. 61<br />

Pouladi M. 186<br />

Pouladian M. 105, 145, 187<br />

Pouraliakbar H.R. 29<br />

Pourbehi M.R. 56<br />

Q<br />

Qodsi Rad M. 128<br />

R<br />

Radfar E. 144<br />

Rahiminejad A. 135, 183, 185, 186<br />

Rahimzadeh N. 22<br />

Rahmatpour M. 100<br />

Rahmim A. 21, 22, 24<br />

Rajabi H. 25, 32, 85, 93, 95, 100, 101, 102, 105,<br />

117, 178<br />

Rajabifar S. 73, 83, 142, 174<br />

Rajamand A. 140<br />

Ramezani Moghaddam A. 94<br />

Rasaee M.J. 73, 142<br />

Rasaneh S. 178, 179<br />

Rayzan M. 56<br />

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3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

S<br />

Saberifard J. 62<br />

Sadadi F. 83, 122, 174<br />

Sadat Ebrahimi E. 75<br />

Sadeghi R. 21, 26, 32, 49, 52, 53, 132<br />

Sadeghpour H. 180<br />

Saghari M. 60, 61, 64, 77, 93<br />

Salarifar A. 121<br />

Salehi H. 161<br />

Salehi N. 23, 41<br />

Salehi Zahabi S. 101<br />

Salehizahaby J. 157<br />

Salek N. 159, 160<br />

Salimi H. 27<br />

Salimipour H. 125, 162<br />

Salouti M. 124<br />

Samani Z. 125<br />

Samiee F. 26<br />

San’ati H.R. 29<br />

Sardari D. 109, 137, 141<br />

Sarkar S. 108, 147<br />

Sarvghadi F. 28<br />

Sedaghat F. 25, 30, 33, 45, 46<br />

Sehhat M.R. 62<br />

Seifollahi Asl Sh. 30, 65<br />

Seyedabadi M. 125<br />

Shabani G.A. 91, 146, 148<br />

Shabestani Monfared A. 24, 28, 31, 33<br />

Shafaii K. 71, 136, 140<br />

Shafiei B. 27, 28, 32<br />

Shahhoseini E. 172<br />

Shahhoseini S. 31<br />

Shamsaee M. 159, 160<br />

Shanehsazzadeh S. 111<br />

Shaybani S. 161<br />

Shayeste M. 90, 143, 163<br />

Sheibani Sh. 165<br />

Sheybani Sh. 178, 179<br />

Shirazi A.R. 189<br />

Shirin M.B. 98<br />

Shirmardi P. 81, 166, 167, 168, 173, 182<br />

Shiroodi K. 130<br />

Shirvani-Arani S. 114, 139, 141, 144, 149, 175, 188<br />

Shojaee A. 30, 66<br />

Shokouhizadeh R. 122<br />

Singh B. 23, 31<br />

Sobhani S. 131<br />

Soleimani E. 145<br />

Solhifam R. 89<br />

Soltani-Zadeh H. 98<br />

Soni P.S. 22, 24, 25<br />

T<br />

Tabeie F. 24, 33<br />

Taghizadeh S. 88<br />

Tajik Mansouri M.A. 101<br />

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3rd International Congress of of Nuclear Medicine & & 15th 15th Iranian Annual Annual Congress of<br />

Congress of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical of Medical Sciences Sciences 19-21 19-21 May May 2011<br />

Talebi M.H. 91, 116, 146, 148<br />

Tavakoli A.R. 62<br />

Tavakoli M.B. 86<br />

Tavakoli Tabasi K. 53<br />

Tavakoli Y.H. 146<br />

Teimoori Sichani M.R. 103<br />

Timuri B. 191<br />

Tolmachev V. 80<br />

V<br />

Vahdat K. 62<br />

Vakili A. 141, 144<br />

Vedaei F 92<br />

Verga N. 109<br />

Y<br />

Yalodbardan A. 127<br />

Yavari K. 73, 89, 142<br />

Yousefnia H. 71, 74, 90, 114, 135, 136, 138, 140,<br />

144, 149, 150, 151, 152, 153, 155,<br />

175, 176, 177, 187<br />

Z<br />

Zaidi H. 98<br />

Zakavi R. 23, 28, 49<br />

Zamani M. 163<br />

Zamani Zeinali H. 96, 97, 156<br />

Zandi H. 138<br />

Zoghi M. 161<br />

Zolata H. 73, 83<br />

Zolghadri S. 74, 114, 135, 136, 149, 150, 151, 152,<br />

153, 155, 175, 176, 177<br />

199


3rd International Congress 3rd International of Nuclear Congress Medicine of Nuclear & 15th Medicine Iranian Annual & 15th Iranian Congress Annual of<br />

Nuclear Congress Medicine of Nuclear Medicine<br />

Shahid Beheshti Shahid Beheshti University University of Medical Sciences of Medical 19-21 Sciences May 201119-21 May 2011<br />

Note<br />

200

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