Society Communications The 8th International Congress of the Croatian Society of Nuclear Medicine: highlights from Šibenik, 9–12 May 2014 A. T. Golubić & D. Huić
Introduction The 8th International Congress of the Croatian Society of Nuclear Medicine (CSNM) was held in Šibenik, from 9 to 12 May 2014, under the chairmanship of Professor Dražen Huić and the auspices of the Croatian Ministry of Health and the European Association of Nuclear Medicine (EANM). It was again recognised as the largest nuclear medicine meeting in the region, with more than 200 participants. This was a very special occasion as the CSNM was celebrating the 20th anniversary of the first congress, held in Zagreb in 1994. Having organised several successful congresses in Opatija, the Organising Committee decided on a new venue in the historical town of Šibenik, a beautiful and picturesque Adriatic city situated on the coastline of Dalmatia. This international event was a perfect opportunity to meet world experts in nuclear medicine, examine their work, discuss the status of nuclear medicine in the region and worldwide, and present and explore novel nuclear medicine achievements (Fig. 1).
Original scientific work submitted included 85 papers, with presenters from 14 European countries (Austria, Croatia, Italy, Slovenia, Hungary, Bosnia and Herzegovina, Germany, Serbia, Montenegro, Bulgaria, the UK, Russia, the Netherlands and France) as well as from the USA and India. The programme consisted of 22 invited lectures, 32 oral presentations and 31 poster presentations (Fig. 2). The President of CSNM, Professor Dražen Huić, opened the congress by welcoming the participants and showing a retrospective summary of previous congresses. Over the last 20 years, locations, venues and faces have changed, but the goals of scientific progress, knowledge exchange, and regional interaction and collaboration have always remained the priority. Times past were remembered with fondness. EANM President, Professor Fred Verzijlbergen, was a special guest at the opening ceremony (Fig. 1). He greeted the attendees and briefly discussed the status of nuclear medicine, accomplishments in the field and future improvements.
A. T. Golubić : D. Huić (*) Department of Nuclear Medicine and Radiation Protection, University Hospital Centre Zagreb, Zagreb, Croatia e-mail: [email protected]
Continuing medical education programme An important part of the congress agenda was the introductory lectures that were delivered as part of the continuing medical education (CME) programme by invited, highly respected experts in nuclear medicine. F. Verzijlbergen (Rotterdam) gave a broad and novel overview of biomedical imaging and therapy in metastatic prostate cancer, with emphasis on recent developments in the field as well as on current and future radiotracers. L. Kostakoglu (New York) then gave a sweeping lecture describing the role of positron emission tomography (PET)/ CT imaging in various stages of lymphoma and introducing the newest studies and recommendations for imaging of
"Society communications" are items of general interest for the nuclear medicine community: • Reports on meetings • National society news • Courses, fellowships • Other items of interest Announcements of meetings or industry advertisements cannot be published in this section. Mail your text to [email protected] [email protected]
Eur J Nucl Med Mol Imaging DOI 10.1007/s00259-014-2846-z EANM 2014
Eur J Nucl Med Mol Imaging (2014) 41:–
Fig. 1 EANM President Professor Fred Verzijlbergen giving his lecture on the present and future of prostate cancer imaging (photo by Ž. Jurašinović)
2001
all its possibilities, as presented by C. Decristoforo from Innsbruck. With an increasing incidence of cancer worldwide, it was highly interesting to hear new developments in radiotherapy. R.V. Parameswaran from Bangalore, India, intrigued the audience by reporting the impact of 90Y-microspheres in primary and metastatic liver tumours, concluding that this method is a powerful tool for achieving regional tumour response and disease control in hepatic malignancies. He was followed by the long-term Dean of the European School of Nuclear Medicine, C.A. Hoefnagel (Amsterdam), who gave an innovative and appealing historical review of MIBG therapy in patients with neuroendocrine tumours. The current status and future prospects of radionuclide therapy of bone metastases were discussed by V. Ivančević from Celle.
Scientific programme lymphoma patients. In another engaging lecture, S. Dizarević from Brighton presented the exciting role of a novel alphaemitting 223Ra-chloride treatment in patients with prostatic cancer. Most importantly, she shed new light on the possibilities of prostate cancer treatment and gave new hope for the future. New developments in the sentinel lymph node (SLN) biopsy procedure in breast cancer were presented by F. Giammarile from Lyon, who was followed by P. Jager from Zwolle. The possibilities of 1-day single photon emission computed tomography (SPECT), calcium scoring and coronary CT in patients with cardiac diseases were presented, and in a time of patient-tailored medicine, this type of combined procedure seems alluring. S. Mirzaei from Vienna underlined the role of myocardial metaiodobenzylguanidine (MIBG) scan in the estimation of cardiac innervation. New prospects in molecular imaging of early Alzheimer’s disease were discussed in a wideranging lecture by P. Bartenstein from Munich. K. Knešaurek from New York presented an engaging lecture on the current status of PET/MRI, elaborating diverse pro and contra arguments. In the setting of the 99mTc shortage, it was intriguing to hear more on the role of 68Ga imaging and
Fig. 2 Well-attended poster session (photo by Ž. Jurašinović)
The oral presentations started with the oncology session, the first presentations being devoted to the role of 18F-choline imaging in patients with prostate cancer. Several papers discussed 18F-choline PET/CT, reviewing its advantages and challenges. It is decidedly a superior diagnostic method for imaging prostate cancer and is especially appropriate for restaging the disease. Unspecific uptake of 18F-choline in lymph nodes is found in about half of the imaged patients and careful appraisal is advised when reporting PET/CT scans. Standard bone scanning is still found to be a reliable and widely available method for the follow-up of prostate cancer patients. The role of SPECT/CT in SLN mapping of melanoma is well recognised as it improves accuracy and facilitates surgical detection of SLNs, especially in patients with head and neck melanomas. Prior to SLN biopsy, ultrasound examination combined with fine-needle aspiration biopsy might be considered, as it reduces the number of SLNs, improves the course and decreases the cost of treatment. Reports were presented on the benefits of SLN biopsy in the management of breast cancer, which are particularly evident when using a 2-day imaging protocol and administering larger particles, allowing for better visualisation of SLNs. Thyroid cancer was extensively discussed, with several substantial longterm follow-up studies concluding that the histological type of tumour is a significant predictor of survival. In terms of thyroid cancer therapy, ethanol injection in lymph node metastases has proved useful when surgery is not possible. Size reduction of involved lymph nodes has also been found to be considerable when applying neoadjuvant chemotherapy. A lively discussion followed on comparison of the costs and benefits of recombinant thyroid-stimulating hormone (TSH) stimulation versus thyroid hormone withdrawal prior to radioiodine ablation. Thyroid function was explored in diverse clinical circumstances, with interesting outcomes. A minor proportion of
2002
tested pregnant women were found to have subclinical thyroid disorder, but considering the impact of maternal thyroid function on pregnancy outcome, routine screening should be considered. Iodine intake in schoolchildren was assessed in a UNICEF-supported study using thyroglobulin as a biomarker, which concluded that iodine sufficiency exists in the Zagreb region. An increase in mandatory salt iodisation resulted in a higher incidence of euthyroid Hashimoto’s thyroiditis in Slovenia. A neurology session followed in the diverse congress programme. Early recognition of depression and optimal treatment may improve quality of life, as shown in a study presenting the role of PET in patients with refractory temporal lobe epilepsy. Perfusion brain SPECT was reported to be a useful method for differential diagnosis of various dementia types, leading to implementation of preventive strategies and optimal treatment for the individual patient. An intriguing study was presented on regional cerebral blood flow asymmetry and hypoperfusion of different cortical regions detected using perfusion SPECT, representing a continuation of the effort to understand the pathophysiology and psychopathology of the brain in eating disorders. The session on physics/chemistry discussed the novel, fully automated preparation of radiolabelled peptides in a self-shielded radiosynthesis box, which has several important advantages, such as small size and low weight, and is suitable for PET and β-radioisotopes. A method of labelling haematopoietic progenitor cells with 99m Tchexamethylpropyleneamine oxime (HMPAO) was presented, with reports of high cell viability, unchanged proliferative ability and high labelling stability, enabling SPECT imaging and cell movement monitoring. Another study reported the possibility of imaging 133Ba sources in a water phantom for simulation of 131I quantitative imaging in therapy, with SPECT/CT imaging for accurate dosimetry. Ventilation/perfusion (V/P) SPECT has been found to have a role in the detection of cardiopulmonary diseases beyond pulmonary embolism, such as chronic obstructive pulmonary disease, left heart failure and tumours. Finally, a study has shown that 99mTc-methoxyisobutylisonitrile (MIBI) parathyroid scintigraphy combined with neck ultrasound examination is essential in areas with a high prevalence of thyroid diseases.
10th Alpe-Adria Symposium This 10th Anniversary Alpe-Adria Symposium, organised jointly by the Austrian, Croatian, Italian and Slovenian societies of nuclear medicine, was a particularly joyous occasion. This year, the two main topics for discussion were hypothyroidism and imaging of infection/inflammation.
Eur J Nucl Med Mol Imaging (2014) 41:–
Fig. 3 Enthusiastic participants leaving the farewell party on a pirate ship (photo by C.A. Hoefnagel)
A comprehensive review of diagnosis and treatment of subclinical hypothyroidism was followed by a presentation on the impact of hypothyroidism on pregnancy. Hashimoto’s thyroiditis associated with thyroid nodules was discussed and connections between hypothyroidism and the less often seen ophthalmopathy were ascertained. A string of lectures on the imaging of infection/inflammation followed, beginning with a thorough and comprehensive review of imaging modalities and, more specifically, a detailed report on imaging of patients with suspected infection associated with an orthopaedic prosthesis. Assessment of the impact of antibiotic therapy in spondylodiscitis was described, followed by the best and most effective ways of using nuclear medicine methods in fever of unknown origin and arteritis imaging. All lectures were well attended and followed by lively discussion.
Last word The Organising Committee of the 8th International Congress of the CSNM ensured that participants enjoyed not only the diverse and interesting scientific programme, but also experienced a pleasurable social life. Coffee and lunch breaks were hot spots of communication, dialogue, reacquainting with colleagues and networking. The congress dinner was held at a historical replica of a Dalmatian village, with traditional delicacies and live music, and was unanimously declared a success. After the intense schedule, diverse topics and abundance of information, participants were rewarded by an exciting and delightful boat excursion on a traditional pirate ship that took the multitude of interested nuclear medicine physicians, chemists and physicists on a round trip on the captivating blue sea of Šibenik archipelago, passing the
Eur J Nucl Med Mol Imaging (2014) 41:–
unique island of Krapanj, the lowest and smallest inhabited island in the Adriatic Sea, and the mysterious and forested island of Zlarin, dark green with pine and cypress trees, and finally revealing the beautiful sight of Šibenik’s panorama (Fig. 3).
2003
The participants and the Organising Committee agreed that they will all have fond memories of the 8th International Congress of the CSNM and are already looking forward to the next congress in 3 years’ time, the dates and venue for which will be available soon.
Introduction The 8th International Congress of the Croatian Society of Nuclear Medicine (CSNM) was held in Šibenik, from 9 to 12 May 2014, under the chairmanship of Professor Dražen Huić and the auspices of the Croatian Ministry of Health and the European Association of Nuclear Medicine (EANM). It was again recognised as the largest nuclear medicine meeting in the region, with more than 200 participants. This was a very special occasion as the CSNM was celebrating the 20th anniversary of the first congress, held in Zagreb in 1994. Having organised several successful congresses in Opatija, the Organising Committee decided on a new venue in the historical town of Šibenik, a beautiful and picturesque Adriatic city situated on the coastline of Dalmatia. This international event was a perfect opportunity to meet world experts in nuclear medicine, examine their work, discuss the status of nuclear medicine in the region and worldwide, and present and explore novel nuclear medicine achievements (Fig. 1).
Original scientific work submitted included 85 papers, with presenters from 14 European countries (Austria, Croatia, Italy, Slovenia, Hungary, Bosnia and Herzegovina, Germany, Serbia, Montenegro, Bulgaria, the UK, Russia, the Netherlands and France) as well as from the USA and India. The programme consisted of 22 invited lectures, 32 oral presentations and 31 poster presentations (Fig. 2). The President of CSNM, Professor Dražen Huić, opened the congress by welcoming the participants and showing a retrospective summary of previous congresses. Over the last 20 years, locations, venues and faces have changed, but the goals of scientific progress, knowledge exchange, and regional interaction and collaboration have always remained the priority. Times past were remembered with fondness. EANM President, Professor Fred Verzijlbergen, was a special guest at the opening ceremony (Fig. 1). He greeted the attendees and briefly discussed the status of nuclear medicine, accomplishments in the field and future improvements.
A. T. Golubić : D. Huić (*) Department of Nuclear Medicine and Radiation Protection, University Hospital Centre Zagreb, Zagreb, Croatia e-mail: [email protected]
Continuing medical education programme An important part of the congress agenda was the introductory lectures that were delivered as part of the continuing medical education (CME) programme by invited, highly respected experts in nuclear medicine. F. Verzijlbergen (Rotterdam) gave a broad and novel overview of biomedical imaging and therapy in metastatic prostate cancer, with emphasis on recent developments in the field as well as on current and future radiotracers. L. Kostakoglu (New York) then gave a sweeping lecture describing the role of positron emission tomography (PET)/ CT imaging in various stages of lymphoma and introducing the newest studies and recommendations for imaging of
"Society communications" are items of general interest for the nuclear medicine community: • Reports on meetings • National society news • Courses, fellowships • Other items of interest Announcements of meetings or industry advertisements cannot be published in this section. Mail your text to [email protected] [email protected]
Eur J Nucl Med Mol Imaging DOI 10.1007/s00259-014-2846-z EANM 2014
Eur J Nucl Med Mol Imaging (2014) 41:–
Fig. 1 EANM President Professor Fred Verzijlbergen giving his lecture on the present and future of prostate cancer imaging (photo by Ž. Jurašinović)
2001
all its possibilities, as presented by C. Decristoforo from Innsbruck. With an increasing incidence of cancer worldwide, it was highly interesting to hear new developments in radiotherapy. R.V. Parameswaran from Bangalore, India, intrigued the audience by reporting the impact of 90Y-microspheres in primary and metastatic liver tumours, concluding that this method is a powerful tool for achieving regional tumour response and disease control in hepatic malignancies. He was followed by the long-term Dean of the European School of Nuclear Medicine, C.A. Hoefnagel (Amsterdam), who gave an innovative and appealing historical review of MIBG therapy in patients with neuroendocrine tumours. The current status and future prospects of radionuclide therapy of bone metastases were discussed by V. Ivančević from Celle.
Scientific programme lymphoma patients. In another engaging lecture, S. Dizarević from Brighton presented the exciting role of a novel alphaemitting 223Ra-chloride treatment in patients with prostatic cancer. Most importantly, she shed new light on the possibilities of prostate cancer treatment and gave new hope for the future. New developments in the sentinel lymph node (SLN) biopsy procedure in breast cancer were presented by F. Giammarile from Lyon, who was followed by P. Jager from Zwolle. The possibilities of 1-day single photon emission computed tomography (SPECT), calcium scoring and coronary CT in patients with cardiac diseases were presented, and in a time of patient-tailored medicine, this type of combined procedure seems alluring. S. Mirzaei from Vienna underlined the role of myocardial metaiodobenzylguanidine (MIBG) scan in the estimation of cardiac innervation. New prospects in molecular imaging of early Alzheimer’s disease were discussed in a wideranging lecture by P. Bartenstein from Munich. K. Knešaurek from New York presented an engaging lecture on the current status of PET/MRI, elaborating diverse pro and contra arguments. In the setting of the 99mTc shortage, it was intriguing to hear more on the role of 68Ga imaging and
Fig. 2 Well-attended poster session (photo by Ž. Jurašinović)
The oral presentations started with the oncology session, the first presentations being devoted to the role of 18F-choline imaging in patients with prostate cancer. Several papers discussed 18F-choline PET/CT, reviewing its advantages and challenges. It is decidedly a superior diagnostic method for imaging prostate cancer and is especially appropriate for restaging the disease. Unspecific uptake of 18F-choline in lymph nodes is found in about half of the imaged patients and careful appraisal is advised when reporting PET/CT scans. Standard bone scanning is still found to be a reliable and widely available method for the follow-up of prostate cancer patients. The role of SPECT/CT in SLN mapping of melanoma is well recognised as it improves accuracy and facilitates surgical detection of SLNs, especially in patients with head and neck melanomas. Prior to SLN biopsy, ultrasound examination combined with fine-needle aspiration biopsy might be considered, as it reduces the number of SLNs, improves the course and decreases the cost of treatment. Reports were presented on the benefits of SLN biopsy in the management of breast cancer, which are particularly evident when using a 2-day imaging protocol and administering larger particles, allowing for better visualisation of SLNs. Thyroid cancer was extensively discussed, with several substantial longterm follow-up studies concluding that the histological type of tumour is a significant predictor of survival. In terms of thyroid cancer therapy, ethanol injection in lymph node metastases has proved useful when surgery is not possible. Size reduction of involved lymph nodes has also been found to be considerable when applying neoadjuvant chemotherapy. A lively discussion followed on comparison of the costs and benefits of recombinant thyroid-stimulating hormone (TSH) stimulation versus thyroid hormone withdrawal prior to radioiodine ablation. Thyroid function was explored in diverse clinical circumstances, with interesting outcomes. A minor proportion of
2002
tested pregnant women were found to have subclinical thyroid disorder, but considering the impact of maternal thyroid function on pregnancy outcome, routine screening should be considered. Iodine intake in schoolchildren was assessed in a UNICEF-supported study using thyroglobulin as a biomarker, which concluded that iodine sufficiency exists in the Zagreb region. An increase in mandatory salt iodisation resulted in a higher incidence of euthyroid Hashimoto’s thyroiditis in Slovenia. A neurology session followed in the diverse congress programme. Early recognition of depression and optimal treatment may improve quality of life, as shown in a study presenting the role of PET in patients with refractory temporal lobe epilepsy. Perfusion brain SPECT was reported to be a useful method for differential diagnosis of various dementia types, leading to implementation of preventive strategies and optimal treatment for the individual patient. An intriguing study was presented on regional cerebral blood flow asymmetry and hypoperfusion of different cortical regions detected using perfusion SPECT, representing a continuation of the effort to understand the pathophysiology and psychopathology of the brain in eating disorders. The session on physics/chemistry discussed the novel, fully automated preparation of radiolabelled peptides in a self-shielded radiosynthesis box, which has several important advantages, such as small size and low weight, and is suitable for PET and β-radioisotopes. A method of labelling haematopoietic progenitor cells with 99m Tchexamethylpropyleneamine oxime (HMPAO) was presented, with reports of high cell viability, unchanged proliferative ability and high labelling stability, enabling SPECT imaging and cell movement monitoring. Another study reported the possibility of imaging 133Ba sources in a water phantom for simulation of 131I quantitative imaging in therapy, with SPECT/CT imaging for accurate dosimetry. Ventilation/perfusion (V/P) SPECT has been found to have a role in the detection of cardiopulmonary diseases beyond pulmonary embolism, such as chronic obstructive pulmonary disease, left heart failure and tumours. Finally, a study has shown that 99mTc-methoxyisobutylisonitrile (MIBI) parathyroid scintigraphy combined with neck ultrasound examination is essential in areas with a high prevalence of thyroid diseases.
10th Alpe-Adria Symposium This 10th Anniversary Alpe-Adria Symposium, organised jointly by the Austrian, Croatian, Italian and Slovenian societies of nuclear medicine, was a particularly joyous occasion. This year, the two main topics for discussion were hypothyroidism and imaging of infection/inflammation.
Eur J Nucl Med Mol Imaging (2014) 41:–
Fig. 3 Enthusiastic participants leaving the farewell party on a pirate ship (photo by C.A. Hoefnagel)
A comprehensive review of diagnosis and treatment of subclinical hypothyroidism was followed by a presentation on the impact of hypothyroidism on pregnancy. Hashimoto’s thyroiditis associated with thyroid nodules was discussed and connections between hypothyroidism and the less often seen ophthalmopathy were ascertained. A string of lectures on the imaging of infection/inflammation followed, beginning with a thorough and comprehensive review of imaging modalities and, more specifically, a detailed report on imaging of patients with suspected infection associated with an orthopaedic prosthesis. Assessment of the impact of antibiotic therapy in spondylodiscitis was described, followed by the best and most effective ways of using nuclear medicine methods in fever of unknown origin and arteritis imaging. All lectures were well attended and followed by lively discussion.
Last word The Organising Committee of the 8th International Congress of the CSNM ensured that participants enjoyed not only the diverse and interesting scientific programme, but also experienced a pleasurable social life. Coffee and lunch breaks were hot spots of communication, dialogue, reacquainting with colleagues and networking. The congress dinner was held at a historical replica of a Dalmatian village, with traditional delicacies and live music, and was unanimously declared a success. After the intense schedule, diverse topics and abundance of information, participants were rewarded by an exciting and delightful boat excursion on a traditional pirate ship that took the multitude of interested nuclear medicine physicians, chemists and physicists on a round trip on the captivating blue sea of Šibenik archipelago, passing the
Eur J Nucl Med Mol Imaging (2014) 41:–
unique island of Krapanj, the lowest and smallest inhabited island in the Adriatic Sea, and the mysterious and forested island of Zlarin, dark green with pine and cypress trees, and finally revealing the beautiful sight of Šibenik’s panorama (Fig. 3).
2003
The participants and the Organising Committee agreed that they will all have fond memories of the 8th International Congress of the CSNM and are already looking forward to the next congress in 3 years’ time, the dates and venue for which will be available soon.
