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Medical imaging phantoms are considered critical in mimicking the properties of human tissue for calibration, training, surgical planning, and simulation purposes. Hence, the stability and accuracy of the imaging phantom play a significant role in diagnostic imaging. This study aimed to evaluate the influence of hydrogen silicone (HS) and water (H2O) on the compression strength, radiation attenuation properties, and computed tomography (CT) number of the blended Polydimethylsiloxane (PDMS) samples, and to verify the best material to simulate kidney tissue. Four samples with different compositions were studied, including samples S1, S2, S3, and S4, which consisted of PDMS 100%, HS/PDMS 20:80, H2O/PDMS 20:80, and HS/H2O/PDMS 20:40:40, respectively. The stability of the samples was assessed using compression testing, and the attenuation properties of sample S2 were evaluated. The effective atomic number of S2 showed a similar pattern to the human kidney tissue at 1.50 × 10−1 to 1 MeV. With the use of a 120 kVp X-ray beam, the CT number quantified for S2, as well measured 40 HU, and had the highest contrast-to-noise ratio (CNR) value. Therefore, the S2 sample formulation exhibited the potential to mimic the human kidney, as it has a similar dynamic and is higher in terms of stability as a medical phantom.

18F-fluorination using aluminum-fluoride ([18F]AlF) chelate technique has been reported to give a low-to-moderate radiochemical yield, between 5 and 20%. Therefore, the work described here outlines the optimum 18F-fluorination condition for the formation of [18F]AlF2+ and [18F]AlF-NOTA-NHS complex with the radiochemical yield (RCY) and purity (RCP) of more than 90% as a prerequisite step before proceeding with the radiopharmaceutical preparation using the [18F]AlF-bifunctional chelator technique. As well as being simple, the suggested method is practical and relevant for beginners interested in 18F-fluorination with [18F]AlF-chelate complex technique or also for a researcher who aims to proceed on an extensive scale.

Introduction: Exponential research and development of nanotechnology has lead to its implementation in medical line such as radiographic imaging. In current practice, iodine is clinically used as a contrast media in radiographic analyses. However, contraindication of iodine to kidney in clinical practice warrants for a better contrast enhancer with lower toxicity. Gold nanoparticles (GNPs) and Iron Oxide nanoparticles (IONPs) have been proposed as potential iodine’s substitute due to their novel biocompatibility. Methods: In accordance with technology-driven toxicity impact, an animal modeling study has been conducted to assess the nephrotoxicopathology of GNPs and IONPs with Perchloric Acid and SiPEG by biochemical study, in-depth tissue examination by histopathology, apoptosis, and ultrastructural observation, and molecular analysis by Comet Assay. Results: Renal function test (RFT) revealed significant alteration in iodine group compared to nanoparticles and negative control group (p<0.05). Reactive oxygen species (ROS) generation and lipid peroxidation (MDA) levels demonstrated significant reduction in both nanoparticles’ groups compared to iodine (p<0.05), suggesting for lower oxidative stress induction. Morphological aberration demonstrated by histology and ultrastructural evaluation (TEM) showed a distortion in kidney tissues and nucleus’ structure of iodine-administered group as compared to control and nanoparticles’ group. Apoptosis detection by TUNEL assay for GNPs and IONPs group also revealed a significant reduction in apoptotic cells compared to iodine group. Comet assay revealed significant reduction in DNA damaging effect of GNPs and IONPs group compared to iodine group. Conclusion: The present study may postulate that GNPs and IONPs show better contrast enhancer properties with lesser toxic properties than iodine.

Introduction: In Peptide Receptor Radionuclide Therapy (PRRT), the administration of radionuclide such as Lu-177 label with a pharmaceutical agent useful to destroy the lesion. The amount of Lu-177 radioactivity administered to the patients is still not standardize and generally not more than 7.4 GBq per session due to the patient’s safety issues. The first cycle of Lu-177 is an excellent technique to estimate radionuclide uptake for organs at risk. This study aims to simplify five SPECT-CT scanning points into less scanning points to estimate absorbed dose to the organ at risk. Methods: Ten patients who have neuroendocrine tumors enrolled in 177Lu-Dotatate therapy dosimetry. The serial SPECT-CT done after 2, 4, 24, 48 and 72 hours to acquired time disintegration for organ at risk. Partik’s categorical grading criteria is relevantly used in this study to convert the numeric value of Lin’s concordance coefficient into an ordinal scale. Results: Our current result demonstrated an excellent agreement between three and five scanning with LSA exponential fit method. These excellent results presented for kidney, liver and spleen. However, the bladder shows poor results due to the urinary system. Conclusion: Three data point of SPECT-CT images is the best option to estimate absorbed dose to the lesion and organ at risk for 177Lu-Dotatate dosimetry technique.

This study aimed to evaluate the learning styles among healthcare students and to study the relationship with their academic achievement. This cross-sectional study was conducted among 137 healthcare students from six different courses. Data was collected using a self-administered questionnaire and developed based on the original visual, aural/auditory, read/write, and kinesthetic (VARK) assessment. The questionnaire was divided into two sections: the demographic status and the learning style perspective. A total of 119 respondents (86.8%) has chosen unimodal as their learning styles, while the rest of the 18 respondents (13.2%) choose multimodal as their preferred learning method. Among the unimodal learning styles, visual (32%) and reading (26%) were most preferred among respondents. The auditory and kinesthetic methods of learning were less and accounted for 10% to 20%. Notably, in multimodal learning styles preferences, 4% of students prefer a combination learning style of visual and kinesthetic methods. There was no significant relationship between learning styles and academic achievement using Pearson’s Chi-square test (p>0.05). Hence, both were independent of one another. Hence, some of the dominant learning styles needed to be considered based on their future profession.

Introduction: This preliminary study aimed to non-invasively evaluate choline (CHO), creatine (Cr) and intramyocellular lipid (IMCL) metabolites in skeletal muscles at pre- and post-functional electrical stimulation (FES) exercise among incomplete spinal cord injury (SCI) of American Spinal Injury Association Impairment Scale (ASIA-AIS) D patients using proton magnetic resonance spectroscopy or 1 H-MRS. Methods: These metabolites were measured from the vastus lateralis and semitendinosus muscles of three incomplete SCI ASIA-AIS D patients who completed the FES exercise and later underwent 3 Tesla (T) MRI (repetition time/echo time; TR/TE of 3500ms/100ms, field-ofview; FOV of 20cm, slice thickness of 6mm) and 1 H-MRS (TR/TE of 2000ms/31ms, voxel size of 20mm x 20mm x 35mm). Results: Out of those selected metabolites, only CHO value of vastus lateralis showed a statistically significant difference between pre- and post FES exercise 1 H-MRS scanning (p = 0.01). Conclusion: Therefore, this preliminary finding has postulated that the quantification of muscle metabolites using 1 H-MRS imaging could be used as a potential indicator in evaluating the muscle strength for incomplete SCI ASIA-AIS D patients after the completion of FES cycling exercise.

Background: Organic solvents play an indispensable role in most of the radiopharmaceutical production stages. It is almost impossible to remove them entirely in the final formulation of the product. Objective: In this presented work, an analytical method by gas chromatography coupled with flame ionization detection (GC-FID) has been developed to determine organic solvents in radiopharmaceutical samples. The effect of injection holding time, temperature variation in the injection port, and the column temperature on the analysis time and resolution (R ≥ 1.5) of ethanol and acetonitrile was studied extensively. Methods: The experimental conditions were optimized with the aid of further statistical analysis; thence, the proposed method was validated following the International Council for Harmonisation (ICH) Q2 (R1) guideline. Results: The proposed analytical method surpassed the acceptance criteria including the linearity > 0.990 (correlation coefficient of R2), precision < 2%, LOD, and LOQ, accuracy > 90% for all solvents. The separation between ethanol and acetonitrile was acceptable with a resolution R > 1.5. Further statistical analysis of Oneway ANOVA revealed that the increment in injection holding time and variation of temperature at the injection port did not significantly affect the analysis time. Nevertheless, the variation in injection port temperature substantially influenced the resolution of ethanol and acetonitrile peaks (p < 0.05). Conclusion: The proposed analytical method has been successfully implemented to determine the organic solvent in the [18F]fluoro-ethyl-tyrosine ([18F]FET), [18F]fluoromisonidazole ([18F]FMISO), and [18F]fluorothymidine ([18F]FLT).

This study aimed to establish the local diagnostic reference levels (LDRLs) of computed tomography pulmonary angiography (CTPA) examinations based on body size with regard to noise magnitude as a quality indicator. The records of 127 patients (55 males and 72 females) who had undergone CTPAs using a 128-slice CT scanner were retrieved. The dose information, scanning acquisition parameters, and patient demographics were recorded in standardized forms. The body size of patients was categorized into three groups based on their anteroposterior body length: P1 (14–19 cm), P2 (19–24 cm), and P3 (24–31 cm), and the radiation dose exposure was statistically compared. The image noise was determined quantitatively by measuring the standard deviation of the region of interest (ROI) at five different arteries—the ascending and descending aorta, pulmonary trunk, and the left and right main pulmonary arteries. We observed that the LDRL values were significantly different between body sizes (p < 0.05), and the median values of the CT dose index volume (CTDIvol) for P1, P2, and P3 were 6.13, 8.3, and 21.40 mGy, respectively. It was noted that the noise reference values were 23.78, 24.26, and 23.97 HU for P1, P2, and P3, respectively, which were not significantly different from each other (p > 0.05). The CTDIvol of 9 mGy and dose length product (DLP) of 329 mGy∙cm in this study were lower than those reported by other studies conducted elsewhere. This study successfully established the LDRLs of a local healthcare institution with the inclusion of the noise magnitude, which is comparable with other established references.

The present investigation dealt with the assessment of clinicians perceived views on the impact of PET-CT in esophageal cancer management from practicality, clinical efficacy and cost –effectiveness point of views. Reviews on publication and retrospective data to develop and carry out a decision-making model-based economic evaluation to investigate the relative cost-effectiveness of PET/CT in esophageal cancer management staging compared with conventional pathway. Clinicians identified from patient medical records were included in the survey. Retrospective analysis of patient data from 2001-2008 was taken from esophageal cancer patient medical records and North West Cancer Intelligence Services (NWCIS) database. A decision tree was developed using TREEAGE software. The results of the cost-effectiveness analysis were presented in terms of the incremental cost-effectiveness ratios (I-CERs). PET compared with conventional work-up results for ICER for the strategy estimated at £28,460 per QALY; PET/CT compared with PET for ICER was £ 32,590 per QALY; and the ICER for PET/CT combined with conventional work-up versus PET/CT was £ 44,118. The package became more expensive with each additional diagnostic test added to PET and more effective in terms of QALYs gained. The conventional work-up was the preferred options as probabilistic sensitivity analysis showed at a willingness-to-pay threshold of £ 20,000 per QALY. Result of the current analysis suggested that the use of PET/CT in the diagnosis of esophageal cancer was unlikely to be cost-effective given the current willingness-to-pay thresholds that were accepted in the United Kingdom by decision-making bodies such as the National Institute for Health and Clinical Excellence.

This research study aimed to evaluate metabolites in human skeletal muscles pre- and post-exercise non-invasively via proton magnetic resonance spectroscopy (¹H-MRS). The upper legs of 6 lightly active male subjects underwent imaging pre- and post-exercise via 1.5 T MRI (TR/TE = 3500ms/100ms, FOV = 20cm, slice thickness = 6mm) and ¹H-MRS (TR/TE = 2000ms/31ms, VOI = 20mm x 20mm x 35mm). The researchers measured the pre- and post-exercise metabolic readings (NAA, CHO, and Cr metabolites) for the vastus lateralis and semitendinosus muscles. A paired t-test was performed. In the vastus lateralis muscle, NAA, CHO, and Cr metabolites values decreased with no significant difference after the exercise. Similarly, in the semitendinosus muscle, NAA, CHO, and Cr metabolites values were also decreased with CHO (p<0.02) and Cr (p<0.01) showed the significant difference after the exercise. Evaluating human skeletal muscles via ¹H-MRS at 1.5 T is feasible.

Watermelon (Citrullus lanatus) is a nutritious fruit that has attracted scientific interest due to its phytonutrient content including carotenoids and amino acids. Watermelon juice is the richest known source of amino acids including L-arginine and L-citrulline. For a complete separation of amino acids in watermelon juices, a gradient mode of reverse phase high performance liquid chromatography (RP-HPLC) with UV detection was utilised owing to its supremacy over isocratic mode. This present study was aimed at achieving good separation of chromatography profiles and baseline between L-arginine and L-citrulline in red and yellow crimson watermelon juice extract. The edible parts of watermelons were juiced, stored at – 80 oC and freeze dried to obtain dried juice powder. Samples were analysed by gradient mode of RP-HPLC using 0.1% orthophosphoric acid in water (v/v) and acetonitrile as mobile phase A and B. The chromatograph separation was performed using Gemini C18 column at a flow rate of 1.0 mL/min, maintained temperature at 25 oC while detection was made at four different wavelengths; 195 nm, 200 nm, 207 nm and 210 nm with total analysis time of 35 min. Excellent chromatographic separation was achieved at conditions of gradient elution (0%B - 95%B, 0-18 minutes and 95%B, 18-23 minutes, 95%B-0%B, 23-25 minutes, 0%B, 25-35 minutes) with baseline between L-arginine and L-citrulline in both watermelon juice extracts. The gradient mode used in this RP-HPLC successfully achieved efficient separation of chromatographic profile for amino acids, L-arginine and L-citrulline in the red and yellow crimson watermelon juice extracts.

Watermelons (Citrullus lanatus) are known to have sufficient amino acid content. In this study, watermelons grown and consumed in Malaysia were investigated for their amino acid content, L-citrulline and L-arginine, by the isocratic RP-HPLC method. Flesh and rind watermelons were juiced, and freeze-dried samples were used for separation and quantification of L-citrulline and L-arginine. Three different mobile phases, 0.7% H3P04, 0.1% H3P04, and 0.7% H3P04 : ACN (90 : 10), were tested on two different columns using Zorbax Eclipse XDB-C18 and Gemini C18 with a flow rate of 0.5 mL/min and a detection wavelength at 195 nm. Efficient separation with reproducible resolution of L-citrulline and L-arginine was achieved using 0.1% H3P04 on the Gemini C18 column. The method was validated and good linearity of L-citrulline and L-arginine was obtained with = 0.9956, and , , respectively. L-citrulline content showed the highest concentration in red watermelon of flesh and rind juice extract (43.81 mg/g and 45.02 mg/g), whereas L-arginine concentration was lower than L-citrulline, ranging from 3.39 to 11.14 mg/g. The isocratic RP-HPLC method with 0.1% H3P04 on the Gemini C18 column proved to be efficient for separation and quantification of L-citrulline and L-arginine in watermelons.

The purpose of this article is to demonstrate the appearance of active TB lymphadenitis using multimodality imaging apparatus. Multi-modality diagnostic imaging tools, including chest radiograph, Ultrasound (US), Computed Tomographic Scan (CT), Magnetic Resonance Imaging (MRI), and integrated 18F-FDG Positron Emission Tomography/CT examination, were performed to demonstrate TB lymphadenitis in the neck and superior mediastinum of a 26 year old female patient. There was widening of superior mediastinum on chest radiograph. Meanwhile, the ultrasound carried out detected superficial cystic lesions in the cervical region. The MRI found multiple gadolinium enhanced cervical and mediastinal lymphadenophaties. Contrast enhanced CT found heterogeneous enhancing lymphadenopathies in the same anatomical region. FDG PET/CT demonstrated a high metabolic activity in all lesions, as demonstrated by conventional imaging modalities. Mycobacterium tuberculosis was isolated from 1ml aspirate using US guidance. Post-treatment FDG PET CT scan demonstrated a complete metabolic remission of active lesions FDG PET CT can be used to demonstrate metabolic activity of active TB lesions in addition to guide clinicians in treating TB lesions.

The aim of this report was to assess the changes in the 18F-fluorodeoxyglucose (18F-FDG) uptake of brown fats on integrated positron emission tomography/computed tomography (PET/ CT) imaging. The patient presented with an enlargement of the neck lymph nodes, and was suspicious for tuberculous lymphadenitis. A whole body PET/CT imaging was performed, followed by a delayed imaging of the neck and thoracic regions. A visually increased 18F-FDG uptake was taken as a positive finding. A semi-quantitative evaluation was performed using a maximum standardised uptake value (SUVmax) with a cut-off value above 2.5. There were a number of 18F-FDG avid activity areas seen at the supraclavicular, mediastinal, paravertebral and perirenal regions. These are in keeping with the physiological 18F-FDG uptake in brown fat. The differences in SUVmax between the two scans ranged from -20 percent to +20 percent. Based on our observation, dual time point imaging may not be a reliable method for assessing the 18F-FDG uptake of brown fat.