Prostate-specific membrane antigen (PSMA) is a transmembrane protein that is highly expressed on the surface of prostate cancer (PC) cells, making it an excellent radiotracer for both therapeutic and diagnostic purposes. In this prospective study, we investigated the efficacy and toxicity of 177 Lutetium (Lu)-PSMA in metastatic castration-resistant PC (mCRPC) patients for the establishment and approval of this therapy in Iran. Fourteen mCRPC patients (mean age 70.57 ± 7.3 years) were treated with a single dose of 177 Lu-PSMA. Complete blood count, liver function tests (aspartate aminotransferase and alanine aminotransferase), alkaline phosphatase levels, renal function tests (urea and creatinine), and prostate-specific antigen (PSA) levels were obtained for the patients at baseline and every 2 weeks. A majority of the patients (11 patients, 64.2%) experienced a decline in their PSA levels; in 5 (45.4%) of these patients, the PSA levels declined > 50%.The severity of pain decreased in 8 (57.1%) patients, and performance status was improved in 5 (45.4%) patients. The treatment was well tolerated, and no severe hematological or nonhematological side effects were observed. Our findings show that 177 Lu-PSMA had a high efficacy and a low toxicity in an Iranian population and is a promising treatment option for PC patients.

Introduction; the aim of this study was to employ phase analysis to diagnose left ventricular mechanical dyssynchrony (LVMD)in asymptomatic patients with diabetes mellitus type 2 and normal perfusion study to prevent diabetic cardiomyopathy.Methods & materials; Ninety-three consecutive patients with known type 2 diabetes and 81 age-and gender-matched patients without diabetes who were candidates for SPECT-MPI were considered as the control group. The presence of LVMD as an indicator of cardiomyopathy-was determined using phase analysis for each scan with quantitative gated SPECT (QGS) and corridor4DM (4DM) software. All outcomes such as phase bandwidth (PBW) and phase standard deviation (PSD) were compared between the two groups.Results; A total of 174 patients were included in the study. There were no statistically signi cant difference regarding demographic factors between the two groups (P>0.05). PBW showed statistically signi cant differences (increased in diabetics) between the control and diabetic patients (P < 0.05).Kruskal Wallis analysis revealed that as the duration of diabetes is prolonged, especially more than 15 years, the probability of LVMD is increased as well (p=0.021).Discussion; Fraction of asymptomatic diabetic patients with normal ejection fraction and gated SPECT MPI-especially those with prolonged diabetes-might have some degrees of LVMD. Phase analysis can detect this which in turn would prevent progress into heart failure.

IntroductionConsidering the signi cant prevalence of silent myocardial ischemia and its related morbidity and mortality in asymptomatic type two diabetic patients, it is not well known whether early screening with MPI is cost-effective. However, predicting factors are not elucidated. Materials and MethodsThis was a cross-sectional study including 63 asymptomatic patients with type 2 diabetes mellitus (T2DM), with normal ECG and ejection fraction. Patients with any history of documented valvular, congestive or ischemic heart disease, renal or hepatic failure were excluded. At rst all patients were interviewed and checked for risk factors and then patients underwent a two-day rest/stress 99mTc-MIBI gated MPI SPECT. Data was assessed by QPS/QGS and 4DM software and evaluated by a nuclear medicine specialist with summed stress score (SSS) of more than 4 de ned as CAD. ResultsThere were 42 females (67%) and 21 males (33%), with a mean age of 61.33 ± 6.98 years and 7.97 ± 4.86 years history of T2DM. CAD was detected in 26 (41.3%) patients and was signi cantly associated with male gender, smoking, requiring insulin therapy and EF (P-value = 0.019, 0.046, 0.05, 0.033, respectively).A signi cant association was found between the duration of diabetes, especially when >15y, and the probability of having CAD.. Multivariable logistic regression revealed that smoking; male gender and diabetes duration were the strongest independent predictors of abnormal MPI results. ConclusionWe found a high (46%) prevalence of abnormal stress MPI SPECT in patients with type 2 diabetes mellitus, despite being asymptomatic. Asymptomatic patients with a history of smoking, long duration of diabetes, being under insulin treatment and male gender might bene t from MPI for early detection of silent ischemia.

Introduction ; An increase in the average volume of platelets has been associated with poor outcomes in patients with acute coronary syndrome. The aim of this study was to assess the use of myocardial perfusion scans to study the association between MPV and myocardial perfusion abnormalities in patients with and without diabetes mellitus (DM). diabetic and non-diabetic patients. Materials and Methods ; This was a cross-sectional study. Forty-nine patients with known type 2 diabetes DM and without obvious cardiovascular symptoms and 49 healthy individuals were included. A myocardial perfusion scan was performed in rest and stress with dipyridamole/dobutamine/exercise testing. Data entered SPSS software and analyzed. A p value below 0.05 was considered as statistically significant. Results; In total, 98 participants including 49 patients with DM and 49 healthy individuals were included. Laboratory variables as well as cardiac scan items including Summed Stress Score (SSS), Summed Rest Score (SRS), Summed Difference Score (SDS), Ejection Fraction (EF) and End Systolic Volume (ESV) were not statistically different in the two groups. Only the average platelet count was higher in controls than diabetics. In regression analysis, by one-unit increase in MPV, the SRS increased by an average of 0.46 (CI; 0.08–0.83 β: 0.46), only in healthy controls. Discussion and Conclusion ; MPV is a predictor of myocardial perfusion defects, which could be measured easily for patients in different clinical scenarios as a herald for coronary artery disease, especially in healthy individuals.