ORCID Profile
0000-0001-9718-5598
Current Organisation
Royal Brisbane and Women's Hospital
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Publisher: Springer Science and Business Media LLC
Date: 13-08-2022
Publisher: Springer Science and Business Media LLC
Date: 27-09-2017
DOI: 10.1007/S00259-016-3527-X
Abstract: Bulky disease is an adverse prognostic factor for We reviewed patients (pts) with at least one lesion of a transaxial diameter >4 cm who completed 1-2 cycles of Twenty-six pts (17 men aged 27-74 years) received a median cumulative activity of 6.5 GBq PRCRT with
Publisher: Wiley
Date: 10-2021
DOI: 10.1111/IMJ.15141
Abstract: Because management is very different, it is important to differentiate between small focal insulinomas and diffuse pancreatic dysplasia (nesidioblastosis) in patients with confirmed endogenous hyperinsulinaemic hypoglycaemia (EHH). Most insulinomas highly express glucagon‐like peptide‐1 receptors enabling positron emission tomography–computed tomography imaging with its radiolabelled analogue 68 Ga‐DOTA‐Exendin‐4 (Exendin). To determine: (i) the utility of Exendin in EHH patients in a clinical setting and (ii) whether the degree of Exendin uptake differentiates non‐insulinoma pancreatogenous hypoglycaemia syndrome (NIPHS) from post‐gastric bypass hypoglycaemia (PGBH). This retrospective study reviewed the clinical, biochemistry and prior imaging findings in confirmed EHH patients referred for Exendin. Accuracy of Exendin was based on surgical findings and treatment outcomes. Finally, average Exendin uptake (SUVmax) of five PGBH studies was compared with the SUVmax of a key NIPHS case report. Twenty of 25 consecutive patients had confirmed EHH. Exendin located insulinomas in eight of nine patients enabling successful surgical excision with rapid and durable cure. Exendin correctly identified diffuse nesidioblastosis in two of three cases requiring partial pancreatectomy for hypoglycaemia control. All three relapsed within 1.7 years with one needing completion pancreatectomy. Establishing the cause in the remainder relied on other investigations, clinical correlation and response to empirical treatment. Finally, Exendin SUVmax could not distinguish between NIPHS and PGBH. In EHH patients, Exendin accurately identifies the site of insulinoma and thereby differentiates it from nesidioblastosis but negative findings should not be ignored. Exendin is unlikely to differentiate between normal pancreatic uptake, NIPHS and PGBH.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2018
Publisher: Springer Science and Business Media LLC
Date: 08-02-2019
Publisher: Mary Ann Liebert Inc
Date: 11-2019
Publisher: Elsevier BV
Date: 06-2022
DOI: 10.1016/J.UROLONC.2022.03.007
Abstract: Venous tumor thrombus (TT) occurs as part of the natural history of renal cell carcinoma (RCC) local progression in a small minority of cases. MRI is currently the most accurate imaging modality for determining TT extent. PSMA PET/CT may improve RCC staging and IVC TT characterization. The objective of this study was to investigate the role of PSMA PET/CT in defining superior extent of TT in RCC and TT IVC tributary vessel spread, with comparative accuracy vs. MRI, to assess suitability for resection and inform preoperative surgical planning. Patients who underwent PSMA PET/CT for assessment of renal malignancy with TT from 2015 to 2020 at 3 tertiary hospitals in Brisbane, Australia, were retrospectively identified. TT extent was classified using Mayo Clinic levels and compared according to imaging modality. Fourteen patients were included, all of which were clear cell RCC. Ten patients also underwent MRI, 6 of which were concordant in extent according to MRI and PSMA PET. Discordant extent occurred in 4 patients, of which 2 patients had non-PSMA avid thrombus (Mayo level 0 and level 3 on MRI). Further discordance was seen in a patient with adrenal vein and lumbar vein TT only seen on MRI and PSMA PET/CT, respectively. Finally, discordant extent was seen in another patient with Mayo level 4 TT without lumbar vein involvement on MRI vs. level 3 on PSMA PET/CT with lumbar vein involvement. PSMA PET/CT can provide additional information about TT extent in RCC which may not be seen on MRI. Additional information from PSMA PET/CT in this setting may assist surgical planning, in addition to detection of metastatic disease.
Publisher: Elsevier BV
Date: 02-2022
DOI: 10.1016/J.UROLONC.2021.11.006
Abstract: The objective of this study was to perform an intra-in idual dual tracer comparison of Fluorodeoxyglucose (FDG) and Prostate Specific Membrane Antigen (PSMA) computed tomography (CT)/Positron Emission Tomography (PET) against standard of care (SOC) imaging for the characterisation, staging and restaging of renal cell carcinoma (RCC). A multicentre retrospective cohort study was performed at 3 major tertiary referral institutions in Brisbane, Australia between 2015 and 2020. All patients who underwent both PSMA and FDG PET/CT following SOC imaging for investigation of RCC were identified. Clinical details, imaging characteristics and histopathology were collected prior to univariate statistical analysis. Eleven patients who underwent dual tracer PET/CT were included. Mean age was 65.5 years (SD 8.8). Most patients were male (64%) with clear cell morphology (91%). The indication for dual tracer PET was staging (36%) and restaging after radical artial nephrectomy (64%). Primary tumour assessment showed mixed avidity patterns (concordant 40%, discordant favouring PSMA 20%, and FDG 40%). Metastatic disease assessment showed concordant avidity in 6 patients (55%), concordant negative in 3 (27%), and discordant uptake favouring PSMA. PET outperformed SOC imaging for assessment of metastatic disease in 5 patients (45%) and equivalent for the remainder. A change in management was noted in three cases (27%). Dual tracer FDG and PSMA PET/CT for assessment of primary and metastatic RCC were mostly concordant. PET imaging outperformed conventional imaging and led to a change in management for 1 in 4 patients. Further studies with larger s les sizes are required to validate these findings and identify characteristics to guide patient selection for selective or dual tracer use.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 15-07-2022
Publisher: Society of Nuclear Medicine
Date: 07-04-2022
DOI: 10.2967/JNUMED.122.263996
Abstract: Theranostics is a burgeoning development in nuclear medicine which is being rapidly implemented worldwide. There is an increasing need to provide a multidisciplinary framework to the practice of theranostics, to ensure that patients receive this treatment in a safe manner and are provided with security in the knowledge that the health practitioners providing the service are adequately trained. Nuclear medicine experts in Australia have taken the initiative to produce a set of Theranostic guidelines relevant to Australian medical practice. These guidelines encompass specialist qualifications, patient care, radiopharmaceutical production, radiation safety and dosimetry. We propose these guidelines could be adapted for other countries, and promote standards of practice leading to optimal clinical outcomes for patients receiving theranostic treatments.
Publisher: Society of Nuclear Medicine
Date: 31-03-2016
Publisher: Springer Science and Business Media LLC
Date: 22-07-2021
Publisher: Springer Science and Business Media LLC
Date: 12-2021
DOI: 10.1186/S13550-021-00869-5
Abstract: Accurate prostate cancer imaging is critical for patient management. Multiple studies have demonstrated superior diagnostic accuracy of [ 68 Ga]-PSMA-11 PET/CT over conventional imaging for disease detection, with validated clinical and biochemical predictors of disease detection. More recently [ 18 F]PSMA-1007 offers theoretical imaging advantages, but there is limited evidence of clinical and biochemical predictors of scan findings in the staging population. This study investigates the association of clinical variables with imaging characteristics among patients who underwent [ 18 F]PSMA-1007 PET/CT for primary staging of men with histopathologically confirmed prostate carcinoma. A retrospective review of 194 consecutive patients imaged between May 2019 to May 2020 was performed. Association between imaging variables (presence and distribution of metastatic disease, primary tumour SUVmax) and clinical variables (EAU risk criteria) were assessed using descriptive statistics, logistic regression model and ROC analysis. The median age, PSA level and ISUP grade were 70 years, 10 ng/mL and ISUP grade 3, respectively. There were 36.6% of patients with intermediate-risk and 60.8% of patients with high-risk disease. ISUP grade was associated with the presence of metastasis overall ( p = 0.008) as well as regional nodal ( p = 0.003), non-regional nodal ( p = 0.041) and bone ( p = 0.006) metastases. PSA level was associated with metastatic disease overall ( p = 0.001), regional ( p = 0.001) and non-regional nodal metastases ( p = 0.004), but not with bone metastases ( p = 0.087). There were too few visceral metastases for meaningful analysis. SUVmax of the primary prostatic tumour was associated with ISUP grade ( p = 0.004), PSA level ( p 0.001) and AJCC stage ( p = 0.034). PSA 20 ng/mL and ISUP grade 3 had a specificity of 85% (95% CI 78–91%) and 60% (95% CI 50–68%) and a sensitivity of 36% (95% CI 25–49%) and 62% (95% CI 49–74%), respectively, for detection of metastatic disease. Metastatic disease according to [ 18 F]PSMA-1007 PET/CT was associated with ISUP grade and PSA level. This is the largest study using [ 18 F]PSMA-1007 PET/CT to confirm a positive correlation of PSA level, ISUP grade and stage with primary prostate tumour SUVmax.
Publisher: Springer Science and Business Media LLC
Date: 17-08-2016
Publisher: Elsevier BV
Date: 12-2020
Publisher: Society of Nuclear Medicine
Date: 15-11-2020
Publisher: Bioscientifica
Date: 2012
DOI: 10.1159/000345528
Publisher: Hindawi Limited
Date: 18-08-2021
DOI: 10.1155/2021/1544208
Abstract: PSMA PET is more accurate than conventional imaging (CT/bone scan) for staging of intermediate- or high-risk prostate cancer (PCa), but 5–10% of primary tumours have low PSMA ligand uptake. FDG PET has been used to further define disease extent in end-stage castrate-resistant PCa and may be beneficial earlier in the disease course for more accurate staging. The objective of this study was to review the available evidence for patients undergoing both FDG and PSMA PET for PCa staging at initial diagnosis and in recurrent disease. A systematic literature review was performed for studies with direct, intrain idual comparison of PSMA and FDG PET for staging of PCa. Assessment for radioligand therapy eligibility was not considered. Risk of bias was assessed. 543 citations were screened and assessed. 13 case reports, three retrospective studies, and one prospective study were included. FDG after PSMA PET improved the detection of metastases from 65% to 73% in high-risk early castration-resistant PCa with negative conventional imaging (M0). Positive FDG PET was found in 17% of men with negative PSMA PET for postprostatectomy biochemical recurrence. Gleason score ≥8 and higher PSA levels predicted FDG-avid metastases in BCR and primary staging. Variant histology (ductal and neuroendocrine) was common in case reports, resulting in PSMA-negative FDG-positive imaging for 3 patients. Dual-tracer PET for PCa may assist in characterising high-risk disease during primary staging and restaging. Further studies are required to determine the additive benefit of FDG PET and if the FDG-positive phenotype may indicate a poorer prognosis.
Publisher: Society of Nuclear Medicine
Date: 18-08-2017
Publisher: Wiley
Date: 09-12-2021
DOI: 10.1111/CEN.14375
Abstract: Phaeochromocytomas and paragangliomas (PPGLs) are rare tumours that arise from the adrenal medulla or extra‐adrenal sympathetic or parasympathetic paraganglia. Recent advances in genetics have greatly enhanced understanding of the pathogenesis and molecular physiology of PPGL. Concomitantly, advances in molecular imaging mean four techniques are now available for use in PPGLs: [ 123 I]‐MIBG coupled with SPECT/CT [ 18 F]‐ FDG, [ 68 Ga]‐DOTATATE and [ 18 F]‐FDOPA coupled with PET/CT. Each modality relies on unique cellular uptake mechanisms that are contingent upon the tumour's molecular behaviour—which, in turn, is determined by the tumour's genetic profile. This genotype‐phenotype correlation means the appropriate choice of radiotracer may depend on the known (or suspected) underlying genetic mutation, in addition to the clinical indication for the scan—whether confirming diagnosis, staging disease, surveillance or determining eligibility for radionuclide therapy. Given these rapid recent changes in genetic understanding and molecular imaging options, many clinicians find it challenging to choose the most appropriate scan for an in idual with PPGL. To this end, recent guidelines published by the European Association of Nuclear Medicine and the Society of Nuclear Medicine and Molecular Imaging (EANM/SNMMI) have detailed the preferred radiotracer choices for in iduals with PPGL based on their genotype and/or clinical presentation, providing timely clarity in this rapidly moving field. The current review summarizes the implications of the genotype‐phenotype relationship of PPGL, specifically relating this to the performance of molecular imaging modalities, to inform and enable practising endocrinologists to provide tailored, personalized care for in iduals with PPGL.
Publisher: S. Karger AG
Date: 09-2022
DOI: 10.1159/000526848
Abstract: Hormonal crises are a rare but increasingly recognized phenomenon following peptide receptor radionuclide therapy (PRRT) in patients with neuroendocrine neoplasms (NENs). Due to the paucity of published studies, approaches to the identification, prevention, and management of risk factors are inconsistent between different institutions. This consensus statement aimed to provide guidance for NEN patients undergoing PRRT. Our statement has been created on the basis of clinical demand and concerns regarding the precipitation of hormonal crises. A formal literature review was conducted to identify available studies. A total of 19 Australian and New Zealand experts in the fields of medical oncology, nuclear medicine, anaesthetics, and endocrinology collaborated on this consensus statement. The main focus is on carcinoid crises. Other hormonal crises seen in patients with functional pancreatic NENs are addressed briefly. These recommendations are relevant to PRRT centres internationally and should be tailored to local experience and available resources.
Publisher: Wiley
Date: 03-2018
DOI: 10.1002/CCR3.1448
Publisher: AMPCo
Date: 08-2008
DOI: 10.5694/J.1326-5377.2008.TB01982.X
Abstract: To investigate the first reported cases of strongyloidiasis in the Solomon Islands, and to establish whether this disease poses a risk to personnel of the Regional Assistance Mission to Solomon Islands (RAMSI). Retrospective review of the pathology database of the RAMSI Medical Facility in Honiara, Solomon Islands, for the period 1 July 2006-30 September 2007. Number and clinical features of confirmed cases of Strongyloides stercoralis infestation, as diagnosed by serological tests or faecal microscopy. Fourteen confirmed cases of strongyloidiasis in previously healthy RAMSI participants were identified. Of 13 patients with notes available, symptoms documented at presentation included epigastric pain (10 patients), diarrhoea (7) and urticaria (4). Clinical disease in all patients responded to oral antihelminthic therapy (albendazole or ivermectin). Strongyloidiasis is endemic in the Solomon Islands and a risk for RAMSI personnel. Australian medical professionals should be aware of this potentially fatal and lifelong infestation, particularly the importance of an occupation history, appropriate diagnostic tests, effective treatment and adequate follow-up to document cure. We recommend implementation of a postdeployment screening program for strongyloidiasis.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 25-01-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 30-03-2021
Publisher: Wiley
Date: 20-05-2013
DOI: 10.1111/J.2047-2927.2013.00093.X
Abstract: Our objective was to evaluate the effectiveness of implementing standardized guidelines to mitigate metabolic and bone side effects of androgen deprivation therapy (ADT) in men with non-metastatic prostate cancer. We conducted a 2-year prospective cohort study at a tertiary referral teaching hospital. Overall, 236 men (mean age 69.8 ± 7.1) commencing ADT for non-metastatic prostate cancer attended a baseline clinic visit between 2007 and 2011, and 153 men were eligible for follow-up after 2 years of continuous ADT. Of these, 113 men had data available for analysis at 2 years. At baseline, 87% of the men were overweight or obese, 61% had hypertension, 56% had hypercholesterolaemia, 27% prior cardiovascular disease, 11% osteoporosis and 40% osteopaenia. After 2 years of ADT, there was an increase in waist circumference (+2.8 ± 6.3 cm, p = 0.002), and, in men without diabetes, in HbA1c (+0.13 ± 0.34%, p = 0.019). Despite this, due to treatment, there were significant reductions in total cholesterol (-0.35 ± 1.00 mmol/L, p < 0.001), and blood pressure (systolic -7.6 ± 19.3 mmHg diastolic -4.7 ± 11.6 mmHg, p < 0.001). After 2 years, men not receiving anti-resorptive therapy experienced a significant decline in lumbar spine (-0.042 ± 0.134 g/cm(2) , p = 0.012) and total hip bone mineral density (BMD) (-0.026 ± 0.036 g/cm(2) , p < 0.001), whereas bisphosphonate treatment maintained stable BMD. Prevalence of anaemia increased from 13.8 to 32.5%. Older age independently predicted a greater drop in haemoglobin (p = 0.005). We conclude that a structured approach to assess and treat men undergoing ADT effectively improves cardiovascular risk factors and prevents bone decay. Larger studies are needed to determine effects on cardiovascular outcomes, fracture prevention and survival.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 30-07-2013
Publisher: The Endocrine Society
Date: 09-06-2017
Abstract: Treatment options for unresectable paraganglioma (PGL) heochromocytoma (PCC), especially with uncontrolled secondary hypertension (HTN), are limited. Preliminary studies with peptide receptor radionuclide therapy (PRRT) suggest efficacy, but data on HTN control and survival are lacking. We assessed PRRT outcomes in such patients from two referral centers. Twenty consecutive patients (13 men age range, 21 to 77 years) with high somatostatin receptor (SSTR) expression treated with 177Lu-DOTA-octreotate, nine with radiosensitizing chemotherapy, were retrospectively reviewed. Median cumulative activity was 22 GBq (median 4 cycles). Fourteen patients were treated for uncontrolled HTN and six for progressive or symptomatic metastatic disease or local recurrence. Three months after PRRT, 8 of 14 patients treated for HTN required reduced medication doses, 5 had no change in anti-HTN doses, and 1 was lost to follow-up. Eighty-six percent had serum chromogranin-A reduction. Of the entire cohort, 36% had disease regression (29% partial and 7% minor response) on computed tomography, with stable findings in 50%. Three other patients had bony disease evaluable only on SSTR imaging (2 partial response and 1 stable). Median progression-free survival was 39 months median overall survival was not reached (5 deaths median follow-up, 28 months). Four patients had grade 3 lymphopenia 2 had grade 3 thrombocytopenia. Renal impairment in 2 patients was attributed to underlying disease processes. PRRT achieves worthwhile clinical and biochemical responses with low toxicity and encouraging survival in PGL/PCC. Because PRRT has logistic and radiation-safety advantages compared to 131I-MIBG therapy, further prospective evaluation is warranted.
Publisher: Elsevier BV
Date: 02-2021
Publisher: Wiley
Date: 2018
DOI: 10.1111/IMJ.13664
Publisher: Elsevier BV
Date: 10-2015
DOI: 10.1016/J.CPET.2015.05.005
Abstract: This review provides practical guidance for clinicians involved in the management of endocrine malignancies, including endocrinologists, medical oncologists, surgeons and nuclear medicine specialists regarding the indications and use of 2-fluoro-2-deoxy-d-glucose F-18 (FDG) PET/computed tomography (CT), particularly with respect to targeted radionuclide therapy. Key principles of FDG PET/CT for radionuclide therapy are explored in detail using gastroenteropancreatic neuroendocrine tumors as a prototype endocrine malignancy. The relevant literature is reviewed, and practical application in this new and emerging field is highlighted with the use of case ex les.
Publisher: Wiley
Date: 21-04-2021
DOI: 10.1111/BJU.15384
Abstract: To assess the activity and safety of sequential lutetium‐177 ( 177 Lu)‐PSMA‐617 and docetaxel vs docetaxel on a background of androgen deprivation therapy (ADT) in men with de novo metastatic hormone‐naïve prostate cancer (mHNPC). UpFrontPSMA (NCT04343885) is an open‐label, randomized, multicentre, phase 2 trial, recruiting 140 patients at 12 Australian centres. Key eligibility criteria include: prostate cancer with a histological diagnosis within 12 weeks of screening commencement prostate‐specific antigen (PSA) ng/mL at diagnosis ≤4 weeks on ADT evidence of metastatic disease on computed tomography (CT) and/or bone scan high‐volume prostate‐specific membrane antigen (PSMA)‐avid disease with a maximum standardized uptake value and absence of extensive discordant fluorodeoxyglcuose (FDG)‐positive, PSMA‐negative disease. 68 Ga‐PSMA‐11 and 18 F‐FDG positron‐emission tomography (PET)/CT undergo central review to determine eligibility. Patients are randomized 1:1 to experimental treatment, Arm A ( 177 Lu‐PSMA‐617 7.5GBq q6w × 2 cycles followed by docetaxel 75 mg/m 2 q3w × 6 cycles), or standard‐of‐care treatment, Arm B (docetaxel 75 mg/m 2 q3w × 6 cycles). All patients receive continuous ADT. Patients are stratified based on disease volume on conventional imaging and duration of ADT at time of registration. The primary endpoint is the proportion of patients with undetectable PSA (≤0.2 ng/L) at 12 months after study treatment commencement. Secondary endpoints include safety, time to castration resistance, overall survival, PSA and radiographic progression‐free survival, objective tumour response rate, early PSMA PET response, health‐related quality of life, and frequency and severity of adverse events. Enrolment commenced in April 2020. The results of this trial will generate data on the activity and safety of 177 Lu‐PSMA‐617 in men with de novo mHNPC in a randomized phase 2 design.
Publisher: Elsevier BV
Date: 11-2022
Publisher: SAGE Publications
Date: 09-2008
Abstract: A 20-year-old fit male soldier presented on two separate occasions 16 months apart with severe, symptomatic hyponatraemia and a clinical and biochemical picture consistent with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). In the intervening period, repeated plasma sodium values were in the reference range. Intensive investigation failed to reveal a cause for SIADH that was initially considered idiopathic. The description of a family comprising several adults with intermittent or water load induced-hyponatraemia associated with an activating mutation in the arginine vasopressin (AVP) receptor type 2 (AVPR2) raised the question of whether our patient could have a similar ‘nephrogenic syndrome of inappropriate antidiuresis’. Mutational screening of AVPR2 in our patient revealed a single missense mutation (R137C) in the second intracellular loop, which has been associated with constitutive activation of the AVPR2. In conclusion, adults with intermittent, severe hyponatraemia may have a constitutively activating mutation in the AVPR2 with resultant nephrogenic syndrome of inappropriate antidiuresis. Patients with idiopathic SIADH, particularly those with unmeasurable circulating AVP concentrations, should be considered for mutational screening of AVPR2.
Publisher: Elsevier BV
Date: 06-2022
Publisher: Bioscientifica
Date: 06-2017
DOI: 10.1530/ERC-17-0005
Abstract: There has been recent progress in molecular imaging using a variety of cellular targets for the investigation of adult non-diabetic hypoglycaemic syndromes and its integration into patient management. These targets include peptide receptors (somatostatin receptors (SSTRs) and glucagon-like peptide-1 receptor (GLP-1R)) the amine precursor uptake and decarboxylation system utilising the diphydroxyphenylaline (DOPA) analogue 6-[ 18 F]- l -fluoro- l -3,4-dihydroxyphenylalanine ( 18 F-FDOPA), and glycolytic metabolism with 2-[ 18 F]fluoro-2-deoxy- d -glucose (FDG). Accurate preoperative localisation and staging is critical to enable directed surgical excision or enucleation with minimal morbidity and preservation of residual pancreatic function. Benign insulinoma has near ubiquitous dense GLP-1R expression enabling accurate localisation with radiolabelled-exendin-4 compounds (e.g. 68 Ga-NOTA-exendin-4 PET/CT), whilst the rarer and more difficult to manage metastatic insulinoma typically express SSTR and is preferably imaged with radiolabelled-SSTR analogues such as 68 Ga-DOTA-octreotate (DOTATATE) PET/CT for staging and assessment of suitability for peptide receptor radionuclide therapy (PRRT). Similar to other metastatic neuroendocrine tumours, FDG PET/CT is used in the setting of higher-grade metastatic insulinoma to provide important prognostic information that can guide treatment and determine suitability for PRRT. Interestingly, these three tracers appear to represent a spectrum of differentiation, which we conceptually describe as the ‘triple-flop’ phenomenon, with GLP-1R SSTR FDG in benign insulinoma and the opposite in higher-grade disease. This paper will review the clinical syndromes of adult hypoglycaemia (including a practical overview of the differential diagnoses to be considered), comparison of techniques for insulinoma localisation with emphasis on molecular imaging before discussing its implications for management of metastatic insulinoma.
Publisher: SAGE Publications
Date: 06-12-2012
Publisher: Society of Nuclear Medicine
Date: 12-10-2018
Publisher: Wiley
Date: 20-07-2016
DOI: 10.1002/AJH.24469
Publisher: Springer Science and Business Media LLC
Date: 19-03-2015
DOI: 10.1007/S00221-015-4249-1
Abstract: The brain needs information about the size of the body to control our interactions with the environment. No receptor signals this information directly the brain must determine body size from multiple sensory inputs and then store this information. This process is poorly understood, but somatosensory information is thought to play a role. In particular, anaesthetising a body part has been reported to make it feel bigger. Here, we report the first study to measure whether changes in body size following anaesthesia are uniform across dimensions (e.g. width and length). We blocked the digital nerves of ten human subjects with a clinical dose of local anaesthetic (1 % lignocaine) and again in separate sessions with a weaker dose (0.25 % lignocaine) and a saline control. Subjects reported the perceived size of their index finger by selecting templates from a set that varied in size and aspect ratio. We also measured changes in sensory signals that might contribute to the anaesthetic-induced changes using quantitative sensory testing. Subjects perceived their finger to be up to 32 % wider during anaesthesia when compared to during a saline control condition. However, changes in perceived length of the finger were much smaller (<5 %). Previous studies have shown a change in perceived body size with anaesthesia, but have assumed that the aspect ratio is preserved. Our data show that this is not the case. We suggest that nonuniform changes in perceived body size might be due to the brain increasing the body's perimeter to protect it from further injury.
Publisher: Springer Science and Business Media LLC
Date: 22-01-2022
Publisher: Elsevier BV
Date: 09-2016
DOI: 10.1016/J.COGNITION.2016.05.006
Abstract: Psychological characterisation of sensory systems often focusses on minimal units of perception, such as thresholds, acuity, selectivity and precision. Research on how these units are aggregated to create integrated, synthetic experiences is rarer. We investigated mechanisms of somatosensory integration by asking volunteers to judge the total intensity of stimuli delivered to two fingers simultaneously. Across four experiments, covering physiological pathways for tactile, cold and warm stimuli, we found that judgements of total intensity were particularly poor when the two simultaneous stimuli had different intensities. Total intensity of discrepant stimuli was systematically overestimated. This bias was absent when the two stimulated digits were on different hands. Taken together, our results showed that the weaker stimulus of a discrepant pair was not extinguished, but contributed less to the perception of the total than the stronger stimulus. Thus, perception of somatosensory totals is biased towards the most salient element. 'Peak' biases in human judgements are well-known, particularly in affective experience. We show that a similar mechanism also influences sensory experience.
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.UROLOGY.2017.12.010
Abstract: Lymphangitic carcinomatosis refers to the rare process of diffuse malignant invasion of the pulmonary lymphatics. We describe the first reported case of lymphangitic carcinomatosis visualized with gallium-68 prostate-specific membrane antigen positron emission tomography and its clinical significance in a 53-year-old man with prostate carcinoma. This case highlights the ability of gallium-68 prostate-specific membrane antigen positron emission tomography for prostate carcinoma characterization and the importance of always considering atypical patterns of metastatic disease.
Publisher: Springer Science and Business Media LLC
Date: 12-09-2021
Publisher: Springer Science and Business Media LLC
Date: 22-09-2020
DOI: 10.1186/S40644-020-00344-9
Abstract: Positron Emission Tomography with Computed Tomography (PET/CT) is widely used in the assessment of many diseases, particularly including cancer. However, many factors can affect image quality and diagnostic performance of PET scans using FDG or other PET probes. The aim of this pictorial essay is to review PET/CT protocols that can be useful to overcome these confounding factors in routine clinical situations, with a particular focus on pharmacological interventions and problem-oriented CT acquisition protocols. Imaging protocols and representative cases will be discussed, in addition to potential contraindications and precautions to be taken.
Publisher: The Endocrine Society
Date: 09-2014
DOI: 10.1210/JC.2013-4090
Publisher: Springer Science and Business Media LLC
Date: 15-12-2022
DOI: 10.1186/S41824-022-00150-5
Abstract: The postulated benefits of the ketogenic diet in the management of multiple medical conditions have seen more patients who are in therapeutic ketosis attending 18 F-FDG PET scans. This study aimed to investigate the effect of ketosis on cerebral glucose metabolism in a clinical PET scanning environment using 18 F-FDG uptake as a surrogate marker. A retrospective audit was conducted of the brain 18 F-FDG uptake in 52 patients who underwent PET scans for possible cardiac sarcoidosis or suspected intracardiac infection, following a ketogenic diet and prolonged fasting. SUVbw for whole brain and separate brain regions was compared with serum glucose and serum ketone body (beta-hydroxybutyrate) levels. The expected negative association between serum glucose levels and whole brain 18 F-FDG uptake was confirmed. A reduction in SUVbw due to increasing serum ketones levels was also observed that was independent of and in addition to the effects of glucose. The magnitude of the reduction in SUVbw related to serum glucose level and serum ketone level was found to be greater in the precuneus than in the cerebellum or whole brain. In a real-world clinical PET setting, cerebral 18 F-FDG uptake appears to be affected by glycaemia and ketonaemia. This means when assessing the brain, both serum glucose and ketone levels need to be considered when SUVs are used to distinguish between pathologic and physiologic states. The magnitude of this effect appears to vary between different brain regions. This regional difference should be taken into consideration when selecting the appropriate brain region for SUV normalisation, particularly when undertaking database comparison in the assessment of dementia.
Publisher: Springer Science and Business Media LLC
Date: 16-06-2021
Publisher: Springer Science and Business Media LLC
Date: 24-06-2015
Publisher: Wiley
Date: 03-2011
Publisher: Society of Nuclear Medicine
Date: 15-11-2019
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2015
Location: Australia
No related grants have been discovered for David Pattison.