Saeed Farzanefar

Tehran University of Medical Sciences | TUMS · Department of Nuclear Medicine (Valiasr)

Inflammation comprises a heterogeneous category of disease with multiple clinical conditions and basically includes infection, acute inflammation, and chronic inflammation. One of the concerns for clinicians is the differentiation between tumor tissue and an inflammation site which significantly influences the treatment decisions. Recent progresses...

Immunotherapy has emerged as a very considerable and potent therapeutic method in which immune inhibitors have gained a lot of attention in the curative field of various cancers. Under certain circumstances, when radiotherapy is accompanied by immunotherapy, the efficacy of the therapeutic procedure increases. Irradiated tumor cells follow a pathwa...

Segmentation of organs and lesions could be employed for the express purpose of dosimetry in nuclear medicine, assisted image interpretations, and mass image processing studies. Deep leaning created liver and liver lesion segmentation on clinical 3D MRI data has not been fully addressed in previous experiments. To this end, the required data were c...

Purpose Radiomics analysis of oncologic positron emission tomography (PET) images is an area of significant activity and potential. The reproducibility of radiomics features is an important consideration for routine clinical use. This preliminary study investigates the robustness of radiomics features in PSMA-PET images across penalized-likelihood...

Purpose The role of fibroblast activation protein inhibitor (FAPI) PET CT scan is not well documented in papillary thyroid cancer (PTC) patients. Patients with radioiodine refractory PTC and high thyroglobulin levels need PET/CT scan which is generally done by 18F FDG. In the current study, the diagnostic performance of 68Ga FAPI and FDG PET/CT sca...

Copper radioisotopes including copper-60/61/62, and -64 exhibit a wide range of decay characteristics, making them appropriate choices for diagnostic/therapeutic (theranostic) applications in nuclear medicine. One notable feature of copper is the feasible coordination chemistry, which makes radiolabeling of a wide range of chemical structures inclu...

Purpose: The main goal of this study was to determine the optimal collimator in the absence of medium energy collimators along with the impact of Attenuation Correction (AC) and different iterative reconstruction protocols on the quantitative evaluation of Gallium-67 (67Ga) SPECT/CT imaging. Materials and Methods: A GE Discovery 670 dual-head SPECT...

Background The Q.Clear algorithm is a fully convergent iterative image reconstruction technique. We hypothesize that different PET/CT scanners with distinct crystal properties will require different optimal settings for the Q.Clear algorithm. Many studies have investigated the improvement of the Q.Clear reconstruction algorithm on PET/CT scanner wi...

Background This study was aimed to optimize the fluorodeoxyglucose (FDG)-administered dose and scan time based on patient specifications using a highly sensitive five-ring bismuth germanium oxide (BGO)-based positron emission tomography/computed tomography (PET/CT) scanner (Discovery IQ). Methods We retrospectively analyzed 101 whole-body 18F-FDG P...

In this study, we aimed to examine the effect of varying β-values in the block sequential regularized expectation maximization (BSREM) algorithm under differing lesion sizes to determine an optimal penalty factor for clinical application. The National Electrical Manufacturers Association phantom and 15 prostate cancer patients were injected with 68...

Breast cancer is still one of the substantial malignancies with high mortalities which early and accurate diagnosis is very decisive in providing long survival. Nuclear medicine lately introduced a novel way for evaluation of breast cancer in early and advanced stages. This method is based on sentinel lymph node scintigraphy which is more preferabl...

Background: The surgery for a breast imaging-reporting and data system (BIRADS) IV lesions needs imaging or pathology supporting data. The roll of breast scintigraphy for this purpose is unclear. Materials and Methods: In a prospective design, 16 patients with 25 BIRADS IV lesions who were scheduled for surgery were included. Before the surgery, b...

Background Rhabdomyosarcoma (RMS) is a malignant soft tissue tumor that accounts for approximately one-half of soft tissue sarcomas in childhood age groups. Metastatic RMS is a rare condition that occurs in less than 25% of patients at diagnosis and can have variable clinical presentations.Case presentationHere we report a 17-year-old boy with hist...

Objectives: This study aimed to evaluate the therapeutic outcomes of 177Lutetium (177Lu)-PSMA-617 in metastatic castrate-resistant prostate cancer (mCRPC) patients, based on post-treatment imaging findings. Methods: All post-therapeutic scans were collected retrospectively from patients treated with 100-200 mCi 177Lu-PSMA-617 from March 2018 to...

Objectives: The prevalence of coronary artery disease (CAD) is high in patients with epilepsy using antiepileptic drugs (AED). Epilepsy, AED, or the type and duration of AED use , may contribute to higher CAD risk.In this study, myocardial perfusion imaging (MPI) was compared between patients using carbamazepine and valproate. Method: Out of 73...

Purpose we aimed to investigate the effect of various β-value in BSREM algorithm under different lesion sizes, in order to determine an optimal penalty factor for clinical use. Methods The NEMA IQ phantom and 15 patients with prostate cancer were injected with 68Ga-PSMA and scanned by GE Discovery IQ PET/CT scanner. Images were reconstructed using...

Presentation No: EP-440 in the annual EANM'22

Simple Summary One of the most incredible advances in nuclear medicine is early detection of neuroendocrine tumors, which leads to appropriate and expedient treatment pathways. Advances made with somatostatin analogue derivatives radiolabeled with Gallium-68 clarified the paths of diagnosis and treatment properly. Despite the significant improvemen...

Purpose This work was set out to investigate the feasibility of dose reduction in SPECT myocardial perfusion imaging (MPI) without sacrificing diagnostic accuracy. A deep learning approach was proposed to synthesize full-dose images from the corresponding low-dose images at different dose reduction levels in the projection space. Methods Clinical...

Simple Summary In this literature review, we will provide a short overview of the role of nuclear medicine in the diagnosis of obstetric and gynecological cancers. Abstract Nuclear medicine is defined as the diagnosis and the treatment of disease using radiolabeled compounds known as radiopharmaceuticals. Single-photon emission computed tomography...

Abstract There is no biodistribution or imaging data on 99mtechnetium (Tc)-hexamethyl propylamine oxime (HMPAO)-labeled platelets in the literature. The current study aimed to present updated information about the clinical procedures for preparation and use of labeled platelets. Following two-step centrifugation at 1500 and 2500 rpm, the platelets...

A 41-year-old female with retractable epigastric pain due to an invasive neuroendocrine tumor of the pancreas was treated with blockage and radiofrequency ablation of the celiac and splanchnic plexuses. Then, the patient developed back pain, and a bone scan revealed abnormal uptake in the lower thoracic vertebrae despite a normal CT scan. The findi...

An 81-year-old woman with symptoms of upper Gastrointestinal (GI) obstruction but with no supporting evidence for obstruction in previous endoscopies was studied with a solid-liquid gastric emptying scintigraphic examination. There was evidence of accumulation of the tracer in a part of the stomach in the thorax before filling the stomach. The para...

Radiometal-based theranostics or theragnostics, first used in the early 2000s, is the combined application of diagnostic and therapeutic agents that target the same molecule, and represents a considerable advancement in nuclear medicine. One of the promising fields related to theranostics is radioligand therapy. For instance, the concepts of target...

Thyroid remnant after thyroidectomy is a major predictor for future recurrence of thyroid cancers; for which assessment, the accuracy of imaging is not optimal. To evaluate the value of the technetium uptake in the neck compared with neck ultrasonography, this application is used to predict future recurrence of differentiated thyroid cancer (DTC)....

The implication of 'theranostic' refers to targeting an identical receptor for diagnostic and therapeutic purposes, by the same radioligand, simultaneously or separately. In regard to extensive efforts, many considerable theranostic tracers have been developed in recent years. Emerging evidence strongly demonstrates the tendency of nuclear medicine...

Clinical SPECT-MPI images of 345 patients acquired from a dedicated cardiac SPECT in list-mode format were retrospectively employed to predict normal-dose images from low-dose data at the half, quarter, and one-eighth-dose levels. A generative adversarial network was implemented to predict non-gated normal-dose images in the projection space at the...

Objectives: In patients with papillary thyroid cancer (PTC), sentinel lymph node (SLN) radio-guided biopsy is not routinely used for detection of involved neck lymph nodes (NLN); 99mTc- antimony sulfide colloid (99mTc- ASC) has been used for this purpose. In this study, besides 99mTc-ASC another radiotracer, 99mTc-phytate (99mTc-P) with different...

Objective(s): Prostate-specific membrane antigen (PSMA) ligand positron emission tomography/computed tomography (PET/CT) is an emerging modality to detect metastatic disease in patients with prostate cancer (PCa). This prospective study aimed to evaluate the role of [ 68 Ga]-PSMA PET/CT in the initial workup of intermediate and high-risk PCa. Metho...

Background: Tc-prostate-specific membrane antigen (PSMA) SPECT/CT is less expensive and readily available modality compared with Ga-PSMA PET/CT for imaging prostate cancer (PC). The aim of this study is to compare the value of these 2 modalities in patients confirmed or suspicious to have metastatic prostate cancer. Patients and methods: Twenty-...

This review paper aimed to examine radiation safety issues related to relatives as well as caregivers of patients with thyroid diseases treated with radioiodine (I-131). During I-131 therapy for thyroid disorders such as hyperthyroidism, patients receiving I-131 doses (200-800 MBq) emit radioactive radiations which pose a prospective risk to other...

99mTc-HMPAO labeled platelet (LP) imaging may integrate thrombosis imaging into routine clinical procedures. In the current study, we assessed the feasibility of the use of 99mTc-HMPAO LP for imaging of small clots in an animal model. Thrombosis was induced by application of FeCl3 solution in the distal part of the inferior vena cava (IVC) of a 610...

Objective For preoperative radionuclide myocardial perfusion imaging, metabolic equivalent is one of the key factors to evaluate the appropriateness. Duke Activity Status Index is a practical method to calculate metabolic equivalents. We intended to validate Duke Activity Status Index in our population for the assessment of preoperative myocardial...

This study aimed to determine the effective doses of caregivers taking care of non-cancerous patients treated with iodine-131 (I-131). Patients (administered 185-1110 MBq of I-131) were given specific radiation safety instructions (RSI). Afterwards, caregivers were provided with thermoluminescent (TLD) dosimeter badges to be worn for 12-28 days whe...

Background: The application of FDG PET/CT scan for assessment of patients with breast cancer is increasing. The cost effectiveness of the application could be different in a developing country with limited PET scanners and treatment priorities Methods: Open discussions of the PET reviewers from 2 out of 4 PET centers of Tehran, the capital city of...

The extent of radiation exposure in emergency settings is not well documented; here, the corresponding effective dose (ED) is provided. In 500 patients admitted in row to the emergency department, ED was compared in patients according to complaints and their visiting physicians. Out of all, 220 patients aged 43.5 ± 22.2 years (admission: 2.0 ± 1.6...

The practical diagnostic performance of Prospective Investigative Study of Acute Pulmonary Embolism Diagnosis (PISAPED) criteria for the detection of acute pulmonary thromboembolism (APTE) in hospitalized patients is not yet well determined. This is the report of the initial results of our recently implemented protocol to employ PISAPED. One hundre...

Objectives: 68Ga-DOTATATE positron emission tomography (PET)/computed tomography (CT) has shown promising results in imaging of neural crest tumors (NCT). Herein, we compared the performance of 68Ga-DOTATATE PET/CT and 131I-MIBG single photon emission computed tomography (SPECT)/CT in the initial diagnosis, staging and follow-up of patients with N...

Many efforts have been made to introduce an appropriate radiopharmaceutical as a theranostic agent for metastatic castration-resistant prostate cancer. Prostate-specific membrane antigen (PSMA) is expressed in most types of prostate cancer (PCa), with only 5–10% of primary PCa lesions being PSMA-negative. When radiolabeled, PSMA tracers show outsta...

tObjective: Diagnostic accuracy of myocardial perfusion imaging (MPI) is not optimal to predict the resultof angiography. The current study aimed at investigating the application of artificial neural network(ANN) to integrate the clinical data with the result and quantification of MPI.Methods: Out of 923 patients with MPI, 93 who underwent angiogra...

Objective Diagnostic accuracy of myocardial perfusion imaging (MPI) is not optimal to predict the result of angiography. The current study aimed at investigating the application of artificial neural network (ANN) to integrate the clinical data with the result and quantification of MPI. Methods Out of 923 patients with MPI, 93 who underwent angiogr...

Magnetic resonance imaging (MRI) and computed tomography (CT) are not always conclusive for the detection of cerebral venous sinus thrombosis (CVST). 99mTc-HMPAO-labeled platelets may be useful in cases with high clinical suspicion. Three patients with headaches with or without intraparenchymal hemorrhage that were highly suspected to have CVST, de...

Aim : Bull's eye pattern recognition with artificial neural networks (ANNs) has the potential to assist interpretation of myocardial perfusion images (MPIs). We aimed to develop a model for interpretation of MPI based on the clinical variables and imaging data. Materials and Methods : The study included 208 patients referred to the department of nu...

Background: The assessment of body composition during the course of treatment of hemodialysis patients is crucial for optimal treatment. We intended to assess the diagnostic performance of bioelectrical impedance analysis (BIA), which could be used at the bedside in dialysis wards, and compare it with the results of dual-energy X-ray absorptiometry...

A 17-year-old boy with hyperparathyroidism exhibited a large cyst in the left hemi-thorax on his chest X-ray. The cyst was identified as a hydatid cyst. He was referred for biphasic methoxy isobutyl isonitrile (MIBI) parathyroid scan. A discrete ectopic parathyroid was detected in the left upper mediastinum in addition to accumulation of the MIBI t...

Introduction: Cardiac contraction significantly degrades quality and quantitative accuracy of gated myocardial perfusion SPECT (MPS) images. In this study, we aimed to explore different techniques in motion-compensated temporal processing of MPS images and their impact on image quality and quantitative accuracy. Material and method: 50 patients...

Objective(s) Malignant melanoma is the most lethal type of skin cancers with unfavorable prognosis. Alpha-MSH peptide analogues have a high affinity for melanocortine-1 (MC1) receptors on melanocytes over expressing in malignant melanoma cells. Pre-clinical studies have shown promising results for radiolabeled MSH imaging in this malignancy. The pu...

Prostate-specific membrane antigen (PSMA) is a type II transmembrane protein, which is anchored in the cell membrane of prostate epithelial cells. It is highly expressed on prostate epithelial cells and strongly up-regulated in prostate cancer. Although, 177 Lu-PSMA has been recently introduced for radionuclide therapy of metastatic castration-resi...

A 45-year-old woman presented with a headache and visual complaints. Brain MRI revealed a large mass in the right occipital cortex. The tumor was surgically removed and pathological examination showed papillary carcinoma originating from thyroid gland. She had a history of thyroid surgery 27 years ago indicating papillary thyroid cancer with centra...

Objectives: Clinical difficulty to discriminate between the Alzheimer disease (AD) and dementia with Lewy bodies (DLB) has led researchers to focus on highly sensitive functional imaging modalities. The aim of the present study was to assess 131I-MIBG cardiac imaging to distinguish between AD and DLB. Patients and Methods: Seventeen patients who w...

Introduction: Chronic recurrent multifocal osteomyelitis (CRMO) is a rare migratory skeletal disorder with non-infectious inflammatory etiology which usually causes bone pain in children and adolescents. Intermittent periods of exacerbation and remission are usually noted during the course of the disease. It is a multifocal bone disease usually inv...

Objective: Technetium thyroid uptake (TTU) is not inhibited by antithyroid drugs (ATD) and reflects the degree of thyroid stimulation. We intended to predict the relapse rate from hyperthyroidism based on TTU measurement. Methods: Out of 44 initially enrolled subjects, 38 patients aged 41.6 ± 14.6 with Graves disease (duration: 84 ± 78 months) c...

We report a young male with an initial excisional biopsy report of melanoma of the lower back, referred to our hospital for complete excision and sentinel lymph node (SLN) biopsy. Four peritumoral intradermal Tc-99m phytate injection was performed and SLNs were detected in both axillary and right inguinal regions. On the biopsy only the right axill...

Background: The implications of cardiac risk stratification before orthotopic liver transplantation (OLT) are not well established. We studied the usefulness of myocardial perfusion imaging (MPI) in this scenario. Methods: MPI data of 24 patients (9 females), candidates of OLT, were collected. They underwent MPI as part of their preoperative risk a...

Background: Because of the increasing prevalence of both ischemic heart diseases and vitamin D deficiency and also due to recent evidences on association between these two phenomena, it is vital to clarify the association of ischemic heart disease with vitamin D deficiency and low bone mass. Objectives: The aim of the present study was to assess th...

Background: This study was designed to compare radioguided versus routine wire localization of non palpable nonmalignant breast lesions in terms of efficacy for complete excision, ease of use, time saving, and cosmetic outcome. Materials and methods: Patients with nonpalpable breast masses and nonmalignant core biopsy results who were candidates...

A discrete MIBI avid lung lesion was found in cinematic views of myocardial perfusion imaging (MPI) of a 59 year-old woman. Interestingly, the abnormal uptake in the lung was detectable only in the rest phase images and not in the images acquired in the stress phase. MPI was performed for pre-operation cardiac risk assessment before correction surg...

Patients with diabetes have higher stress-to-rest mean left ventricular volume (SRLVV) ratio in myocardial perfusion imaging (MPI) and hyperhomocysteinemia. We studied the effect of folate therapy on SRLVV ratio and plasma homocysteine levels in patients with diabetes. Forty patients were enrolled and thirty-two completed the study. The patients un...

Introduction: The gastrin releasing peptide (GRP) receptor is over expressed in a variety of common human tumors. Radiolabeled bombesin analogues have exhibited high binding affinity for these receptors. The aim of this study was to assess the value of a new 99mTc-bombesin analog in the differentiation of malignant from benign breast tumors. Method...

A 22-year-old woman presented with acute left-sided pleuritic chest pain and dyspnea 6 days after surgery for revision of the stenotic central aortopulmonary shunt. She had a history of tetralogy of Fallot (TOF), pulmonary valve stenosis, ventricular septal defect and major aortopulmonary collateral artery. Her Waterston shunt was placed when she w...

Introduction: We intended to assess the accuracy of re-expressed Modification of Diet for Renal Disease (MDRD) and Cockcroft-Gault (CG) equations to estimate glomerular filtration rate (GFR) in chronic kidney disease in two different etiologies of acute renal failure (ARF): acute tubular necrosis (ATN) and acute glomerulonephritis (AGN). Methods: P...

There are few studies evaluating the effect of radioioine therapy on the lacrimal drainage system. This study reports on symptomatic and asymptomatic nasolacrimal duct obstruction (NLDO) as complications of high-dose radioiodine therapy in these patients. Eighty-one cases were randomly selected from a population of radioiodine-treated differentiate...