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
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".