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90 Y-microsphere selective internal radiation therapy (SIRT) is a valuable treatment in unresectable hepatocellular carcinoma (HCC). Partition-model predictive dosimetry relies on differential tumor-to-nontumor perfusion evaluated on pretreatment 99m Tcmacroaggregated albumin (MAA) SPECT/CT. The aim of this study was to evaluate agreement between the predictive dosimetry of in tumor volumes (TVs) and nontumor volumes (NTVs) for glass and resin spheres. The Lin concordance (r c ) was used to measure accuracy (C b ) and precision (r). Results: Administered activity ranged from 0.8 to 1.9 GBq for glass spheres and from 0.6 to 3.4 GBq for resin spheres, and the respective TVs ranged from 2 to 125 mL and from 6 to 1,828 mL. The mean dose D In selective internal radiation therapy (SIRT), 90 Y-microsphere radioembolization is a valuable therapeutic option in patients presenting with unresectable hepatocellular carcinoma (HCC) not eligible for other therapeutic options (1-3).SIRT with 90 Y-charged microspheres relies on differential vascularization between tumor and nontumor liver parenchyma, resulting in favorable, potentially tumoricidal, deposition of microsphere activity in tumors while minimizing absorbed dose to the functional parenchyma, thus preventing toxicity. Two microsphere types are clinically available: resin spheres (SIR spheres; SirTex Medical Ltd.) and glass spheres (TheraSphere; Nordion Inc.). Despite being of similar size (;30 mm), these two types of sphere differ in specific activity, density (ffi 4 · 10 5 glass spheres/GBq; ffi 2 · 10 7 resin spheres/GBq), and injection solution (NaCl for glass spheres; water for resin spheres), leading to potential differences in embolic effect and local variations in the radiation dose deposited in tissues.Predictive dosimetry has included hepatic CT angiography for catheter positioning and partition modeling based on 99m Tcmacroaggregate albumin (MAA) SPECT/CT acquisition (4,5).The manufacturer-recommended activity for resin spheres is based on a semiempiric formula including body surface area (6,7) and tumor burden. This approach can be refined using a 3-compartment partition model (4) including the lungs, liver TVs, and liver NTVs derived from a pretreatment 99m Tc-MAA SPECT/CT scan. The prescribed glass sphere activity is based on a 2-compartment model (lungs and targeted liver regions) aiming to deliver a dose of 80-150 Gy to the targeted liver volume.90 Y time-of-flight (TOF) PET/CT dosimetry (8) provides a valuable tool to verify 99m Tc-MAA SPECT/CT-based predictive dosimetry.

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Four consecutive annual surveys of 1200 women each were conducted in Lebanon in connection with the National Breast Cancer Awareness campaigns (2002-05) to measure the prevalence of mammography utilization and the impact of these campaigns, and to highlight regional and demographic differences. The utilization of mammography in the previous 12 months was low and increased only slightly over 4 years (from 11% to 18%). In the 2005 campaign, it was twice as high (25%) in greater Beirut than in mostly rural areas, and among women aged 40-59 years (about 21%) compared with younger (12%) or older (11%) women. In each wave, repeat mammograms were less common than first time screening.

Objective To assess the acceptability and effectiveness of two educational initiatives on patterns of antidepressant medication use in depressed Kuwaiti patients. Setting Patients were interviewed on three occasions at the Psychological Medicine Hospital, Kuwait. Method Two‐hundred and seventy‐eight patients attending a hospital outpatient clinic in Kuwait and receiving a single antidepressant for mild or moderate depression were randomised into a control and two treatment groups. Medication was dispensed from the pharmacy as normal. However, members of the treatment groups additionally received a patient information leaflet (PIL) written in Arabic with or without counselling from a clinical pharmacist. Medication adherence was monitored 2 months and 5 months later by self‐report and tablet counting. Patient knowledge of medication and the acceptability of the educational interventions were assessed after 2 months using questionnaires. Key findings Patients in each of the treatment groups had an improved knowledge of the rationale behind their therapy. Clinic attendance was more likely when patients had received a PIL (odds ratio (OR) 2.1, 95% confidence interval (CI) 1.3‐3.2) or a PIL plus counselling (OR 3.2, CI 2.1–4.9). Good medication adherence at 2 and 5 months was more common in patients who were given a PIL (OR 3.0, CI 1.7‐5.3) or a PIL plus counselling (OR 5.5, CI 3.2–9.6). Certain pre‐existing patient attitudes to therapy and the occurrence of side‐effects were not determinants of adherence. Conclusions Patient responses to each of these educational interventions were very positive. After 5 months, patients receiving a PIL were more likely to be adhering to their medication regimen, particularly when they had also received counselling from a clinical pharmacist.

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