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        Peptide Receptor Radionuclide Therapy and the Treatment of Gastroentero-pancreatic Neuroendocrine Tumors: Current Findings and Future Perspectives

        Hirmas, Nader,Jadaan, Raya,Al-Ibraheem, Akram 대한핵의학회 2018 핵의학 분자영상 Vol.52 No.3

        Purpose and Methods Patients with inoperable and metastasized neuroendocrine tumors (NETs), particularly those with grades 1 and 2, usually receive treatment with somatostatin analogues (SSAs). Peptide receptor radionuclide therapy (PRRT) has gained momentum over the past two decades in patients who progress on SSAs. 177Lu-DOTATATE is currently the most widely used radiopeptide for PRRT. We reviewed the recent evidence on PRRT and the treatment of gastroentero-pancreatic neuroendocrine tumors (GEP-NETs). Results $^{177}Lu$-DOTATATE can be used as neoadjuvant treatment in patients with inoperable GEP-NETs, who might be candidate for surgery after treatment and as adjuvant therapy after surgical intervention. Combination treatments of PRRT with chemotherapy or targeted agents as well as combinations of radionuclides in patients with NETs have been explored over the last few years. The majority of patients with NETs experience partial response or have disease stabilization, a small percentage has complete response, while some 30% of patients, however, will have disease progression. The safety and efficacy of retreatment with extra cycles of PRRT as salvage therapy have been evaluated in small retrospective series. Conclusion Overall, there is evidence that disease control and quality of life improve significantly after 117Lu PRRT therapy. Clinical trials on this therapy are scarce, and there is a need for further studies to establish proper management guidelines.

      • SCOPUSKCI등재

        C-Sphere Strength-Size Scaling in a Bearing-Grade Silicon Nitride

        Wereszczak, Andrew A.,Kirkland, Timothy P.,Jadaan, Osama M.,Strong, Kevin T.,Champoux, Gregory J. The Korean Ceramic Society 2008 한국세라믹학회지 Vol.45 No.9

        A "C-sphere" specimen geometry was used to determine the failure strength distributions of a commercially-available bearing-grade silicon nitride ($Si_3N_4$) with ball diameters of 12.7 and 25.4 mm. Strengths for both diameters were determined using the combination of failure load, C-sphere geometry, and finite element analysis and fitted using two-parameter Weibull distributions. Effective areas of both diameters were estimated as a function of Weibull modulus and used to explore whether the strength distributions predictably scaled between each size. They did not. That statistical observation suggested that the same flaw type did not limit the strength of both ball diameters indicating a lack of material homogeneity between the two sizes. Optical fractography confirmed that. It showed there were two distinct strength-limiting flaw types common to both ball diameters, that one flaw type was always associated with lower strength specimens, and that a significantly higher fraction of the 25.4-mm-diameter C-sphere specimens failed from it. Predictable strength-size-scaling would therefore not result as a consequence of this because these flaw types were not homogenously distributed and sampled in both C-sphere geometries.

      • KCI등재

        C-Sphere Strength-Size Scaling in a Bearing-Grade Silicon Nitride

        Andrew A. Wereszczak,Timothy P. Kirkland,Osama M. Jadaan,Kevin T. Strong,Gregory J. Champoux 한국세라믹학회 2008 한국세라믹학회지 Vol.45 No.9

        A “C-sphere” specimen geometry was used to determine the failure strength distributions of a commercially-available bearinggrade silicon nitride (Si3N4) with ball diameters of 12.7 and 25.4 mm. Strengths for both diameters were determined using the combination of failure load, C-sphere geometry, and finite element analysis and fitted using two-parameter Weibull distributions. Effective areas of both diameters were estimated as a function of Weibull modulus and used to explore whether the strength distributions predictably scaled between each size. They did not. That statistical observation suggested that the same flaw type did not limit the strength of both ball diameters indicating a lack of material homogeneity between the two sizes. Optical fractography confirmed that. It showed there were two distinct strength-limiting flaw types common to both ball diameters, that one flaw type was always associated with lower strength specimens, and that a significantly higher fraction of the 25.4-mm-diameter Csphere specimens failed from it. Predictable strength-size-scaling would therefore not result as a consequence of this because these flaw types were not homogenously distributed and sampled in both C-sphere geometries. A “C-sphere” specimen geometry was used to determine the failure strength distributions of a commercially-available bearinggrade silicon nitride (Si3N4) with ball diameters of 12.7 and 25.4 mm. Strengths for both diameters were determined using the combination of failure load, C-sphere geometry, and finite element analysis and fitted using two-parameter Weibull distributions. Effective areas of both diameters were estimated as a function of Weibull modulus and used to explore whether the strength distributions predictably scaled between each size. They did not. That statistical observation suggested that the same flaw type did not limit the strength of both ball diameters indicating a lack of material homogeneity between the two sizes. Optical fractography confirmed that. It showed there were two distinct strength-limiting flaw types common to both ball diameters, that one flaw type was always associated with lower strength specimens, and that a significantly higher fraction of the 25.4-mm-diameter Csphere specimens failed from it. Predictable strength-size-scaling would therefore not result as a consequence of this because these flaw types were not homogenously distributed and sampled in both C-sphere geometries.

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