Alan C Perkins

University of Nottingham | Notts · Radiological Sciences

Transarterial chemoembolization (TACE) and transarterial radioembolization (TARE) are promising treatments for unresectable liver tumours. Some recent studies suggested that combining TACE and TARE in one treatment course might improve treatment efficacy through synergistic cytotoxicity effects. Nonetheless, current formulations do not facilitate a...

Personalised cancer treatment is of growing importance and can be achieved via targeted radionuclide therapy. Radionuclides with theranostic properties are proving to be clinically effective and are widely used because diagnostic imaging and therapy can be accomplished using a single formulation that avoids additional procedures and unnecessary rad...

Background Scintigraphy is used for overall assessment of gastric emptying. Adherence to an international consensus protocol is recommended to ensure quality; however, this has not been widely adopted because preparation of the “egg‐beater” meal is inconvenient in clinical practice. In this report, we audit the tolerability and the results of gastr...

Drug absorption following oral administration is determined by complex and dynamic interactions between gastrointestinal (GI) physiology, the drug, and its formulation. Since many of these interactions are not fully understood, the COST action on “Understanding Gastrointestinal Absorption-related Processes (UNGAP)” was initiated in 2017, with the a...

Purpose: Hepatic radioembolization is an effective minimally invasive treatment for primary and metastatic liver cancers. Yttrium-90 [90Y]-labelled resin or glass beads are typically used as the radioembolic agent for this treatment; however, these are not readily available in many countries. In this study, novel samarium-153 oxide-loaded polystyr...

This unique book provides an accessible introduction to both the scientific background and the key people involved in the discovery and use of radiation and radioactivity. It begins by providing a short history of radiation exposures and radiation poisoning; from the early inappropriate use of X-rays and radium cures through the misadventures of th...

Theranostics in nuclear medicine refers to personalized patient management that involves targeted therapy and diagnostic imaging using a single or combination of radionuclide (s). The radionuclides emit both alpha (α) or beta (β⁻) particles and gamma (γ) rays which possess therapeutic and diagnostic capabilities, respectively. However, the producti...

Objective: In England, 27,500 children are referred annually to hospital with constipation. An objective measure of whole gut transit time (WGTT) could aid management. The current standard WGTT assessment, the x-ray radiopaque marker (ROM) test, gives poor definition of colonic anatomy and the radiation dose required is undesirable in children. Ou...

Recording gamma images using a hand held small field of view (SFOV) hybrid gamma camera requires a few minutes to complete an acquisition. Operator motion during image acquisition may deteriorate image quality and hence affect diagnostic accuracy. The purpose of this study was to assess the magnitude of movement caused by the operator when holding...

Measurement of gastric emptying is of clinical value for a range of conditions. Gamma scintigraphy (GS) has an established role, but the use of magnetic resonance imaging (MRI) has recently increased. Previous comparison studies between MRI and GS showed good correlation, but were performed on separate study days. In this study, the modalities were...

Objective: Fibroblast growth factor 21 (FGF21) has been shown to rapidly lower body weight in the Siberian hamster, a preclinical model of adiposity. This induced negative energy balance mediated by FGF21 is associated with both lowered caloric intake and increased energy expenditure. Previous research demonstrated that adipose tissue (AT) is one...

A novel hand-held hybrid optical-gamma camera (HGC) has previously been described that is capable of displaying co-aligned images from both modalities in a single imaging system. Here, a dedicated NIR imaging system for NIR fluorescence surgical guidance has been developed for combination with the HGC . This work has evaluated the performance of tw...

Intensity Modulated Radiation Therapy (IMRT) is a complex form of radiation delivery for the treatment of malignant tumours and other diseases. In IMRT treatment planning, quantitative assessment is crucial to measure and improve the plan quality and treatment delivery. The search for simple and universal quantitative metrics to assess IMRT treatme...

This study aimed to evaluate the absorbed doses received by the organs at risk (OARs) following prostate treatment with permanent Iodine-125 (125 I) brachytherapy seeds. In order to simulate an enlarged abnormal prostate due to malignancy, the MIRD5 adult male anthropomorphic phantom (readily available in the Geant4 Monte Carlo package) was modifie...

This study aimed to evaluate the absorbed doses received by the organs at risk (OARs) following Iridium-192 (192 Ir) high dose rate (HDR) brachytherapy of the left breast. The MIRD5 adult female anthropomorphic phantom, readily available in the Geant4 Monte Carlo package was used. However, the left breast was modified from 195 to 145 cm 3 , to repr...

Nasal delivery of large peptides such as parathyroid 1-34 (PTH 1-34) can benefit from a permeation enhancer to promote absorption across the nasal mucosa into the bloodstream. Previously, we have published an encouraging bioavailability (78%), relative to subcutaneous injection in a small animal preclinical model, for a liquid nasal spray formulati...

Objective: To examine the imaging capability of a novel small field of view hybrid gamma camera (HGC) using 125I seeds prior to surgical use. Methods: The imaging performance of the camera system was assessed quantitatively and qualitatively at different source depths, source to collimator distances (SCD), activity levels, acquisition times and...

Background: Radical chemoradiotherapy is the primary treatment for head and neck cancers in many hospitals. Tumour hypoxia causes radiotherapy resistance and is an indicator of poor prognosis for patients. Identifying hypoxia to select patients for intensified or hypoxia-modified treatment regimens is therefore of high clinical importance. Patien...

Introduction: Parkinson's disease (PD) is the most common movement disorder in the elderly and is characterised clinically by bradykinesia, tremor and rigidity. Diagnosing Parkinson's can be difficult especially in the early stages. High-resolution nigrosome MRI offers promising diagnostic accuracy of patients with established clinical symptoms; h...

Osteoporosis treatment with PTH 1-34 injections significantly reduces the incidence of bone fracture. Potential further reductions in fracture rate should be observed through nasal spray delivery to address the poor compliance associated with patient dislike of repeated PTH 1-34 subcutaneous injections. In vitro human osteoblast-like Saos-2 cell in...

We aimed to investigate the validity of the partition model (PM) in estimating the absorbed doses to liver tumour (DT), normal liver tissue (DNL) and lungs (DL), when cross-fire irradiations between these compartments are being considered. MIRD-5 phantom incorporated with various treatment parameters, i.e. tumour involvement (TI), tumour-to-normal...

The increased prevalence of obesity and its cardiometabolic implications demonstrates the imperative to identify novel therapeutic targets able to effect meaningful metabolic changes in this population. Antibody-mediated targeting of fibroblast growth factor receptor 1c isoform (FGFR1c) has been shown to ameliorate hyperglycaemia and protect from d...

Background A prototype anthropomorphic head and neck phantom has been designed to simulate the adult head and neck anatomy including some internal organs and tissues of interest, such as thyroid gland and sentinel lymph nodes (SLNs). The design of the head and neck phantom includes an inner jig holding the simulated SLNs and thyroid gland. The thyr...

Introduction: Hybrid imaging has proven to be a major innovation in nuclear medicine, allowing the fusion of functional information with anatomical detail. In the past, the use of hybrid imaging such as PET-CT, PET-MRI and SPECT-CT has been of great clinical benefit; however, these scanners are relatively large and bulky. We have developed and inv...

Purpose This review aims to summarise the hybrid modality radioguidance techniques currently in clinical use and development, and to discuss possible future avenues of research. Due to the novelty of these approaches, evidence of their clinical relevance does not yet exist. The purpose of this review is to inform nuclear medicine practitioners of c...

FGF21 exerts profound metabolic effects in Siberian hamsters exposed to long day (LD) photoperiods that increase appetite and adiposity, however these effects are attenuated in short day (SD) animals that display hypophagia and reduced adiposity. The aim of this study was to investigate whether the beneficial effects of a novel mimetic of FGF21 in...

An oral presentation was presented at SNMMI17 meeting under New system session. The abstract was published online at Journal of Nuclear Medicine http://jnm.snmjournals.org/content/58/supplement_1/220.abstract?sid=5dae89d9-b7d5-47cb-b095-0dd9473be29b

An oral presentation was presented at SNMMI17 meeting under Emerging technologies session. The abstract was published online at Journal of Nuclear Medicine http://jnm.snmjournals.org/content/58/supplement_1/157.abstract?sid=013cd0d6-8298-465d-a1a8-f53b6d89d3e1

Background: Current investigations of stomach function are based on small test meals that do not reliably induce symptoms and analysis techniques that rarely detect clinically relevant dysfunction. This study presents the reference intervals of the modular "Nottingham test meal" (NTM) for assessment of gastric function by gamma scintigraphy (GSc)...

The development of low profile gamma-ray detectors has encouraged the production of small field of view (SFOV) hand-held imaging devices for use at the patient bedside and in operating theatres. Early development of these SFOV cameras was focussed on a single modality—gamma ray imaging. Recently, a hybrid system—gamma plus optical imaging—has been...

Gamma cameras are traditionally large devices that are situated in nuclear medicine departments, but recent advances in detector design have enabled the production of compact gamma cameras that allow nuclear imaging at the patient bedside and in the operating theatre. Gamma Cameras for Interventional and Intraoperative Imaging is the first book to...

In intraoperative medical imaging, the development of small field of view (SFOV) hybrid gamma cameras is an expanding research field. Combining both gamma and optical imaging in a co-aligned configuration is a new innovation that could provide high spatial resolution scintigraphic imaging and enhance the physical localisation of radiopharmaceutical...

For intraoperative medical imaging, the development of small field of view (SFOV) hybrid gamma cameras is an expanding area of research. The performance characteristics of a new innovation combining both gamma and optical imaging in a co-aligned configuration, the Hybrid Gamma Camera (HGC) have been evaluated and compared. In this study the HGC was...

There is currently no ideal radiotracer for imaging protein synthesis rate (PSR) by positron emission tomography (PET). Existing fluorine-18 labelled amino acid-based radiotracers predominantly visualize amino acid transporter processes, and in many cases they are not incorporated into nascent proteins at all. Others are radiolabelled with the shor...

There is currently no ideal radiotracer for imaging protein synthesis rate (PSR) by positron emission tomography (PET). Existing fluorine-18 labelled amino acid-based radiotracers predominantly visualize amino acid transporter processes, and in many cases they are not incorporated into nascent proteins at all. Others are radiolabelled with the shor...

Introduction The Hybrid Gamma Camera (HGC) is being developed to enhance the localisation of radiopharmaceutical uptake in targeted tissues during surgical procedures such as sentinel lymph node (SLN) biopsy. Purpose To assess the capability of the HGC, a lymph-node-contrast (LNC) phantom was constructed for an evaluative study simulating medical...

Objective: The hybrid gamma camera (HGC) has been developed to enhance the localization of radiopharmaceutical uptake in targeted tissues during surgical procedures such as sentinel lymph node (SLN) biopsy. To assess the capability of the HGC, a lymph node contrast (LNC) phantom was constructed to simulate medical scenarios of varying radioactivit...

18F-FDG PET/CT plays a crucial role in the diagnosis and management of patients with head and neck squamous cell cancer (HNSCC). The major clinical applications of this method include diagnosing an unknown primary tumour, identifying regional lymph node involvement and distant metastases, and providing prognostic information. 18F-FDG PET/CT is also...

90Y-radioembolization is a palliative treatment for liver cancer. 90Y decays via beta emission, making imaging difficult due to absence of gamma radiation. Since post-procedure imaging is crucial, several theranostic radionuclides have been explored as alternatives. However, exposures to gamma radiation throughout the treatment caused concern for t...

The Cancer Research Laboratories at Nottingham University were a collection of old single story huts on the university site now occupied by the Biomedical Sciences Building, on the opposite side of the ring road to the Medical School. In the early 1980’s Professor Robert Baldwin lead a team of 50 scientists who were developing the then new monoclon...

Background: Current investigations of stomach function are based on small test meals that do not reliably induce symptoms and analysis techniques that rarely detect clinically relevant dysfunction. This study introduces the large 'Nottingham Test Meal' (NTM) for assessment of gastric motor and sensory function by non-invasive imaging. Methods: N...

The Hybrid Compact Gamma Camera (HCGC) is a small field of view (SFOV) portable hybrid gamma-optical camera intended for small organ imaging at the patient bedside. In this study, a thyroid phantom was used to determine the suitability of the HCGC for clinical thyroid imaging through comparison with large field of view (LFOV) system performance.A d...

Background: Management of infection is a major clinical problem. Staphylococcus aureus is a Gram-positive bacterium which colonises approximately one third of the adult human population. Staphylococcal infections can be life-threatening and are frequently complicated by multi-antibiotic resistant strains including methicillin-resistant S. aureus (...

Hypothalamic tanycytes are considered to function as sensors of peripheral metabolism [1]. To facilitate this role, they express a wide range of receptors, including fibroblast growth factor receptor 1 (FGFR1). Using a monoclonal antibody (IMC-H7) that selectively antagonizes the FGFR1c isoform [2], we investigated possible actions of FGFR1c in a n...

Introduction: Samarium-153 (153Sm) styrene divinylbenzene microparticles were developed as a surrogate for Yttrium-90 (90Y) microspheres in liver radioembolization therapy. Unlike the pure beta emitter 90Y, 153Sm possess both therapeutic beta and diagnostic gamma radiations, making it possible for post-procedure imaging following therapy. Methods...

Objective: To develop a method for the assessment of small field of view (SFOV) gamma cameras using a novel phantom designed to simulate the localization of sentinel nodes in the presence of a high-activity injection site. Materials and methods: The phantom consisted of a cube-shaped acrylic glass support frame. Sixteen acrylic glass plates and...

The Hybrid Compact Gamma Camera (HCGC) is a portable optical-gamma hybrid imager designed for intraoperative medical imaging, particularly for sentinel lymph node biopsy procedures. To investigate the capability of the HCGC in lymphatic system imaging, two lymphoscintigraphic phantoms have been designed and constructed. These phantoms allowed quant...

Objectives The Hybrid Compact Gamma Camera (HCGC) [1] is a handheld device designed to enhance radio-guided surgical procedures such as sentinel lymph node (SLN) biopsies. This study evaluates the performance of the HCGC for lymphoscintigraphic imaging utilising a bespoke melanoma lymph node phantom. Materials and Methods The melanoma lymph node ph...

Over the last two decades advances in semiconductor detector technology have reached the point where they are sufficiently sensitive to become an alternative to scintillators for high energy gamma ray detection for application in fields such as medical imaging. This paper assessed the Cadmium-Telluride (CdTe) XRI-UNO semiconductor detector produced...

Samarium-153 (153Sm) is widely used in radiation synovectomy and pain management of bone metastases. It emits 103 keV gamma radiation suitable for imaging, providing an alternative for therapy with pure beta emitter, especially liver radioembolization using Yttrium-90 (90Y). This study investigated153Sm theranostics (therapy plus diagnostic) proper...

A device (1) for use in imaging a subject using both light and gamma rays emanating from the subject, the device including: a first sensor means (2) responsive to light received thereby from the subject to generate first signals (6) for use in forming a first image (10) of the subject; a second sensor means (3) responsive to gamma rays received the...

MRI can assess multiple gastric functions without ionizing radiation. However, time consuming image acquisition and analysis of gastric volume data, plus confounding of gastric emptying measurements by gastric secretions mixed with the test meal have limited its use to research centres. This study presents an MRI acquisition protocol and analysis a...

The UK has no research nuclear reactors and relies on the importation of 99Mo and other medical radioisotopes (e.g. Iodine-131) from overseas (excluding PET radioisotopes). The UK is therefore vulnerable not only to global shortages, but to problems with shipping and importation of the products. In this context Professor Erika Denton UK national Cl...

[(18)F]HX4 is a 2-nitroimidazole based investigational radiotracer for imaging hypoxia. A two-step, one-pot synthetic procedure was developed on a GE Tracerlab MX-FDG with a disposable cassette. Nucleophilic substitution of a nosylate group with [(18)F]fluoride was followed by solvent evaporation and acidic removal of the acetyl protecting group. H...

The development of compact low profile gamma-ray detectors has allowed the production of small field of view, hand held imaging devices for use at the patient bedside and in operating theatres. The combination of an optical and a gamma camera, in a co-aligned configuration, offers high spatial resolution multi-modal imaging giving a superimposed sc...

Existing protocols for assessing the performance characteristics of large field-of-view (LFOV) gamma cameras can be inappropriate and require modification for use with small field-of-view (SFOV) gamma camera systems. This communication proposes a generic scheme suitable for evaluating the performance characteristics of SFOV gamma cameras, based on...

A lymphoscintigraphic phantom study using a novel hybrid optical-gamma camera M.S. Alqahtani, J.E. Lees, S.L. Bugby, B.S. Bhatia, L.K. Jambi, A.H. Ng and A.C. Perkins Objectives The Hybrid Compact Gamma Camera (HCGC) [1] has been developed to provide additional localisation information during procedures such as sentinel lymph node biopsies. These p...

The development of portable gamma cameras offers new applications for intraoperative imaging. Multi-modality systems have a long heritage in nuclear medicine. A multi-model gamma-optical system has been proposed as one possibility for improving surgical utility. The Hybrid Compact Gamma Camera (HCGC) is novel handheld small field of view (SFOV) com...

Primary degenerative dementia syndromes are an increasingly relevant problem worldwide because of the progressive aging of the population. Their diagnosis is often a challenge for clinicians and, even in the best cases, only a possible or probable diagnosis can be reached. Molecular neuroimaging techniques can be very useful in dementia patients, e...