P-492 A novel method for assessing inflammation and treatment effects in recurrent pregnancy loss and early pregnancy using ultra-low dose total body PET/CT
Notice bibliographique
Résumé
Abstract Study question Can ultra-low dose total body (ULD TB) 2-18F-FDG PET/CT detect systemic and local inflammation in patients with unexplained recurrent pregnancy loss (RPL)? Summary answer ULD TB 2-18F-FDG PET/CT demonstrated feasibility in evaluating inflammation in unexplained RPL with minimal radiation exposure. What is known already Recurrent pregnancy loss (RPL) is the spontaneous loss of two or more pregnancies before 24 weeks, affecting 1-3% of women. Approximately 50-70% of cases remain unexplained. Immune dysfunction and inflammation have been associated with unexplained RPL. However, when treated with immunomodulatory drugs, monitoring the local and systemic inflammatory changes can be challenging - especially during pregnancy. Total body PET/CT systems allow for reduced radiotracer activity while maintaining image quality, enabling studies of early pathology in non-malignant diseases such as RPL with minimal radiation exposure. Study design, size, duration Patients with unexplained RPL and four or more consecutive pregnancy losses undergoing experimental treatment with hydroxychloroquin in a placebo-controlled randomized clinical trial were prospectively included. Patients underwent three ULD TB 2-18F-FDG PET/CT on a Siemens Biograph Vision Quadra PET/CT: before initiation of treatment, after 2 months treatment and after obtaining pregnancy (gestation week 6-8). Participants/materials, setting, methods Patients received 0.3 MBq/kg of 2-18F-FDG, followed by a 30-min PET/CT scan 60 min post-injection. ULD CT was performed for attenuation correction. Inflammation in reproductive organs was assessed by 2-18F-FDG uptake categorization and SUVmean in the uterus, spleen, and bone marrow. A volume of interest (VOI) was drawn in the uterus. Statistical analyses included Friedman’s test, GAMM for SUV changes, and a Cumulative Link Mixed Model for uptake characterization. Main results and the role of chance Fifteen patients were included in the study. Eight patients had completed all three scans and were used in this analysis. Six patients had completed their pregnancy, one had another pregnancy loss, and one had an ongoing pregnancy at the time of the analysis. Mean injected activity was approximately 23 MBq, corresponding to a total effective dose of 1mSv for each PET/CT scan. SUVmean of the liver were within normal range in all scans (1.3-3.0), however a significant difference was observed across the scans with a decreasing tendency (p = 0.031). The GAMM analysis showed a significant non-linear change in SUVmean of the uterus over time (p = 0.023) with a clear increase in median value between 1st and 3rd scan. No significant difference in SUVmean of the spleen or the bone marrow were observed. Significant differences in uptake categories were observed in the uterus, but the CLMM model showed no significant difference over time. Nevertheless, patients with a viable pregnancy had moderate to intense uptake in the uterus and a visible corpus luteum on the third scan, whereas the patient who had a pregnancy loss had light uptake in the uterus and no certain corpus luteum. Limitations, reasons for caution The study had a small sample size, and findings should be interpreted with caution. Additional studies are needed to confirm results. Wider implications of the findings ULD TB 2-18F-FDG PET/CT could be a valuable tool for assessing inflammation in unexplained RPL with minimal radiation exposure. Its application in early pregnancy could provide new insights into implantation processes and maternal immune adaptations, potentially informing future clinical management and treatment strategies for pregnancy complications. Trial registration number Yes
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».