Although the patients studied are few and heterogeneous, our data show that (68)Ga-DOTA-NOC is accurate for the detection of gastro-entero-pancreatic and lung neuro-endocrine tumours in either the primary or metastatic site and that it offers several advantages over (18)F-DOPA.

The purpose of this study was to investigate the effect of total prostate-specific antigen (PSA) at the time of 11 C-choline PET/ CT (trigger PSA), PSA velocity (PSAvel), and PSA doubling time (PSAdt) on 11 C-choline PET/CT detection rate in patients treated with radical prostatectomy for prostate cancer, who showed biochemical failure during follow-up. Methods: A total of 190 patients treated with radical prostatectomy for prostate cancer who showed an increase in PSA (mean, 4.2; median, 2.1; range, 0.2-25.4 ng/mL) were retrospectively enrolled. All patients were studied with 11 C-choline PET/CT. Patients were grouped according to trigger PSA (PSA # 1 ng/mL, 1 , PSA # 2 ng/mL, 2 , PSA # 5 ng/mL, and PSA . 5 ng/mL). In 106 patients, data were available for calculation of PSAvel and PSAdt. Logistic regression analysis was used to determine whether there was a relationship between PSA levels and PSA kinetics and the rate of detection of relapse using PET. Results: 11 C-choline PET/CT detected disease relapse in 74 of 190 patients (38.9%). The detection rate of 11 C-choline PET/CT was 19%, 25%, 41%, and 67% in the 4 subgroups-PSA # 1 ng/mL (51 patients), 1 , PSA # 2 ng/mL (39 patients), 2 , PSA # 5 ng/mL (51 patients), and PSA . 5 ng/mL (49 patients)-respectively. Trigger PSA values were statistically different between PET-positive patients (median PSA, 4.0 ng/mL) and PET-negative patients (median PSA, 1.4 ng/mL) (P 5 0.0001). Receiver-operating-characteristic analysis showed an optimal cutoff point for trigger PSA of 2.43 ng/mL (area under the curve, 0.76). In 106 patients, PSAdt and PSAvel values were statistically different between patients with PET-positive and -negative scan findings (P 5 0.04 and P 5 0.03). The 11 C-choline PET/CT detection rate was 12%, 34%, 42%, and 70%, respectively, in patients with PSAvel , 1 ng/mL/y (33 patients), 1 , PSAvel # 2 ng/mL/y (26 patients), 2 , PSAvel # 5 ng/mL/y (19 patients), and PSAvel . 5 ng/mL/y (28 patients). The 11 C-choline PET/CT detection rate was 20%, 40%, 48%, and 60%, respectively, in patients with PSAdt . 6 mo (45 patients), 4 , PSAdt # 6 mo (20 patients), 2 , PSAdt # 4 mo (31 patients), and PSAdt # 2 mo (10 patients). There was no statistical difference between PET-positive and -negative scan detection rates according to the Gleason score, pT and N status, patient age, or duration between surgery and biochemical relapse. Trigger PSA and PSAvel were found to be independent predictive factors for a PET-positive result (P 5 0.002; P 5 0.04) and PSAdt was found to be an independent factor only in patients with trigger PSA less than 2 ng/mL (P 5 0.05) using multivariate analysis. Conclusion: The 11 C-choline PET/CT detection rate is influenced by trigger PSA, PSAdt, and PSAvel. This finding could be used to improve the selection of patients for scanning by reducing the number of false-negative scans and increasing the detection rate of disease in patients with early relapse and potentially curative disease.

The high radiochemical yield and purity showed that this method is a reliable tool for the production of 68Ga citrate to be used in the detection of inflammatory and infectious diseases using high resolution and qualitative PET.

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AIMTo analyse the risk factors and outcomes of delayed graft function (DGF) in patients receiving a steroid sparing protocol.METHODSFour hundred and twenty-seven recipients of deceased donor kidney transplants were studied of which 135 (31.6%) experienced DGF. All patients received monoclonal antibody induction with a tacrolimus based, steroid sparing immunosuppression protocol.RESULTSFive year patient survival was 87.2% and 94.9% in the DGF and primary graft function (PGF) group respectively, P = 0.047. Allograft survival was 77.9% and 90.2% in the DGF and PGF group respectively, P < 0.001. Overall rejection free survival was no different between the DGF and PGF groups with a 1 and 5 year rejection free survival in the DGF group of 77.7% and 67.8% compared with 81.3% and 75.3% in the PGF group, P = 0.19. Patients with DGF who received IL2 receptor antibody induction were at significantly higher risk of rejection in the early post-transplant period than the group with DGF who received alemtuzumab induction. On multivariate analysis, risk factors for DGF were male recipients, recipients of black ethnicity, circulatory death donation, preformed DSA, increasing cold ischaemic time, older donor age and dialysis vintage.CONCLUSIONAlemtuzumab induction may be of benefit in preventing early rejection episodes associated with DGF. Prospective trials are required to determine optimal immunotherapy protocols for patients at high risk of DGF.