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Climbing the steps of the evidence-based medicine pyramid: highlights from Annals of Nuclear Medicine 2019

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Abstract

We aimed to provide an overview on research path in nuclear medicine climbing the steps of the Evidence-Based Medicine (EBM) pyramid using review of 14 subjectively selected papers out of 111 published in the Annals of Nuclear Medicine during January–December 2019. Following the structure of the EBM hierarchy, we chose at least one study for each step of the pyramid from the basis (pre-clinical research, expert opinion, case report and case series), to the middle (case-control and cohort studies, randomised controlled trials), towards the top (meta-analyses and systematic reviews). Additionally, we collected information on the promoter of each included study: investigator-initiated trials (IITs) vs industry-sponsored trials (ISTs). We found that pre-clinical studies are primarily focused on the development of novel molecular targets in cancer, with promising results. At the same time, clinical investigations deal with cardiological, neurological, infectious and oncological applications using both SPECT and PET modalities. Additionally, radionuclide therapy gained interest and is experiencing comprehensive clinical implementation. Our overview confirms the current central role of IITs as compared with ISTs. Challenges and future directions in Nuclear Medicine research are discussed.

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References

  1. Carrió I. New section in EJNMMI and Annals of Nuclear Medicine. Eur J Nucl Med Mol Imaging 2016.

  2. Farolfi A, Ghedini P, Fanti S. Highlights from 2017: impactful topics published in the Annals of Nuclear Medicine. Eur J Nucl Med Mol Imaging. Springer Berlin Heidelberg. 2019;46:217–23.

    Article  Google Scholar 

  3. Jadvar H. Highlights of articles published in annals of nuclear medicine 2016. Eur J Nucl Med Mol Imaging. Springer Berlin Heidelberg; 2017;44:1928–33.

  4. Inubushi M, Tatsumi M, Yamamoto Y, Kato K, Tsujikawa T, Nishii R. European research trends in nuclear medicine. Ann Nucl Med. Springer Japan. 2018;32:579–82.

    Article  Google Scholar 

  5. Inubushi M, Kaneta T, Ishimori T, Imabayashi E, Okizaki A, Oku N. Topics of nuclear medicine research in Europe. Ann Nucl Med. Springer Japan. 2017;31:571–4.

    Article  Google Scholar 

  6. Sollini M, Bandera F, Kirienko M. Quantitative imaging biomarkers in nuclear medicine: from SUV to image mining studies. Highlights from Annals of Nuclear Medicine 2018. Eur J Nucl Med Mol Imaging 2019.

  7. Wakasugi S, Fischman AJ, Babich JW, Aretz HT, Callahan RJ, Nakaki M, et al. Metaiodobenzylguanidine: evaluation of its potential as a tracer for monitoring doxorubicin cardiomyopathy. J Nucl Med. 1993;34:1283–6.

    CAS  PubMed  Google Scholar 

  8. Inubushi M, Shidahara M, Takahashi Y, Ogawa M, Kiyono Y. From the respective expert viewpoints of the ANM specialty editors. Ann Nucl Med. Springer Singapore. 2019;33:877–80.

    Article  CAS  Google Scholar 

  9. Thoma A, Eaves FF. A brief history of evidence-based medicine (EBM) and the contributions of Dr David Sackett. Aesthetic Surg J. 2015;35:NP261–3.

    Article  Google Scholar 

  10. Sharma R, Aboagye E. Development of radiotracers for oncology - the interface with pharmacology. Br J Pharmacol. 2011;163:1565–85.

    Article  CAS  Google Scholar 

  11. Süt N. Study designs in medicine. Balkan Med J 2014.

  12. Brighton B, Bhandari M, Tornetta P, Felson DT. Hierarchy of evidence: from case reports to randomized controlled trials. Clin Orthop Relat Res. 2003.

  13. Röhrig B, Prel J-B du, Wachtlin D, Blettner M. Types of study in medical research. Dtsch Aerzteblatt Online. 2009.

  14. Manchikanti L, Datta S, Smith HS, Hirsch JA. Evidence-based medicine, systematic reviews, and guidelines in interventional pain management: part 6. Systematic reviews and meta-analyses of observational studies. Pain Physician. 2009.

  15. Guyatt G, Rennie D, Meade MO, Cook DJ, editors. Evidence-based medicine and the theory of knowledge. 3rd ed. Users’ Guid. to Med. Lit. A Man. Evidence-Based Clin. Pract. McGraw-Hill Education, United States of America; 2015.

  16. Aoki M, Odani A, Ogawa K. Development of radiolabeled bis(zinc(II)-dipicolylamine) complexes for cell death imaging. Ann Nucl Med. Springer Singapore. 2019;33:317–25.

    Article  CAS  Google Scholar 

  17. Shimizu Y, Motomura A, Takakura H, Tamaki N, Kuge Y, Ogawa M. Accumulation of hypoxia imaging probe “ 18 F-FMISO” in macrophages depends on macrophage polarization in addition to hypoxic state. Ann Nucl Med. Springer Japan. 2019;33:362–7.

    Article  Google Scholar 

  18. Palangka CRAP, Hanaoka H, Yamaguchi A, Murakami T, Tsushima Y. Al18F-labeled alpha-melanocyte-stimulating hormone (α-MSH) peptide derivative for the early detection of melanoma. Ann Nucl Med. Springer Singapore. 2019;33:733–9.

    Article  CAS  Google Scholar 

  19. Aoki M, Watabe T, Nagamori S, Naka S, Ikeda H, Kongpracha P, et al. Distribution of LAT1-targeting PET tracer was independent of the tumor blood flow in rat xenograft models of C6 glioma and MIA PaCa-2. Ann Nucl Med. Springer Singapore. 2019;33:394–403.

    Article  CAS  Google Scholar 

  20. Hosono M, Ikebuchi H, Nakamura Y, Yanagida S, Kinuya S. Introduction of the targeted alpha therapy (with Radium-223) into clinical practice in Japan: learnings and implementation. Ann Nucl Med. Springer Japan. 2019;33:211–21.

    Article  Google Scholar 

  21. Imperiale A, Averous G, Helali M, Taieb D, Pessaux P, Goichot B, et al. Limited role of carbidopa-assisted 18F-FDOPA PET/CT in patients with sporadic non-functional gastroduodenal neuroendocrine neoplasms. Ann Nucl Med. Springer Singapore. 2019;33:697–707.

    Article  CAS  Google Scholar 

  22. Khawar A, Eppard E, Roesch F, Ahmadzadehfar H, Kürpig S, Meisenheimer M, et al. Preliminary results of biodistribution and dosimetric analysis of [ 68 Ga]Ga-DOTA ZOL : a new zoledronate-based bisphosphonate for PET/CT diagnosis of bone diseases. Ann Nucl Med. Springer Singapore. 2019;33:404–13.

    Article  CAS  Google Scholar 

  23. Alvandi M, Shaghaghi Z, Aryafar V, Fariba F, Sanaei Z. The evaluation of left ventricular dyssynchrony in hypertensive patients with a preserved systolic function undergoing gated SPECT myocardial perfusion imaging. Ann Nucl Med. Springer Singapore. 2019;33:899–906.

    Article  CAS  Google Scholar 

  24. Vitor T, Kozasa EH, Bressan RA, Lacerda SS, Campos Neto GC, Batista IR, et al. Impaired brain dopamine transporter in chemobrain patients submitted to brain SPECT imaging using the technetium-99m labeled tracer TRODAT-1. Ann Nucl Med. Springer Japan. 2019;33:269–79.

    Article  CAS  Google Scholar 

  25. Joraku A, Hatano K, Kawai K, Kandori S, Kojima T, Fukumitsu N, et al. Phase I/IIa PET imaging study with 89 zirconium labeled anti-PSMA minibody for urological malignancies. Ann Nucl Med. Springer Japan. 2019;33:119–27.

    Article  CAS  Google Scholar 

  26. Okuyama C, Nakajima K, Nakamura S, Nishimura T. The difference of risk factors predicting cardiac events in patients with chronic kidney disease between with and without diabetes. Ann Nucl Med Springer Singapore. 2019;33:532–40.

    Article  Google Scholar 

  27. Zogala D, Rucka D, Ptacnik V, Cerny V, Trnka J, Varejka P, et al. How to recognize stent graft infection after endovascular aortic repair: the utility of 18F-FDG PET/CT in an infrequent but serious clinical setting. Ann Nucl Med. Springer Singapore. 2019;33:594–605.

    Article  CAS  Google Scholar 

  28. Tadesse GF, Geramifar P, Tegaw EM, Ay MR. Techniques for generating attenuation map using cardiac SPECT emission data only: a systematic review. Ann Nucl Med Springer Japan. 2019;33:1–13.

    Article  Google Scholar 

  29. Sheikhbahaei S, Jones KM, Werner RA, Salas-Fragomeni RA, Marcus CV, Higuchi T, et al. 18 F-NaF-PET/CT for the detection of bone metastasis in prostate cancer: a meta-analysis of diagnostic accuracy studies. Ann Nucl Med. Springer Singapore. 2019;33:351–61.

    Article  CAS  Google Scholar 

  30. Masaki Y, Shimizu Y, Yoshioka T, Nishijima Kichi, Zhao S, Higashino K, et al. FMISO accumulation in tumor is dependent on glutathione conjugation capacity in addition to hypoxic state. Ann Nucl Med. 2017

  31. Whiting P, Rutjes A, Westwood M, Mallett S, Deeks J, Reitsma J, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 2011

  32. Negrouk A, Lacombe D, Cardoso F, Morin F, Carrasco E, Maurel J, et al. Safeguarding the future of independent, academic clinical cancer research in Europe for the benefit of patients. ESMO Open 2017

  33. Konwar M, Bose D, Gogtay NJ, Thatte UM. Investigator-initiated studies: challenges and solutions. Perspect Clin Res 2018

  34. European Parliament and Council of the European Union. Regulation (EU) No 536/2014. Off J Eur Union. 2014

  35. Siepe B, Hoilund-Carlsen PF, Gerke O, Weber WA, Motschall E, Vach W. The move from accuracy studies to randomized trials in pet: current status and future directions. J Nucl Med. 2014;55:1228–34.

    Article  Google Scholar 

  36. Concato J, Shah N, Horwitz RI. Randomized, controlled trials, observational studies, and the hierarchy of research designs. N Engl J Med 2000

  37. Abadi E, Segars WP, Tsui BMW, Kinahan PE, Bottenus N, Frangi AF, et al. Virtual clinical trials in medical imaging: a review. J Med Imaging 2020

  38. Kimberlin CL, Winterstein AG. Validity and reliability of measurement instruments used in research. Am. J. Heal. Pharm. 2008

  39. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al., editors. Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Handb. Syst. Rev. Interv. Wiley; 2019.

  40. Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, Moher D TP, Welch V, Kristjansson E H DA. AMSTAR 2: a critical appraisal tool for systematic reviews. BMJ. 2017

  41. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008

  42. Moher D, Liberati A, Tetzlaff J, Altman DG, Altman D, Antes G, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009.

  43. Wilkinson MD, Dumontier M, Aalbersberg IJ, Appleton G, Axton M, Baak A, et al. The FAIR guiding principles for scientific data management and stewardship. Sci Data Nat Publ Group. 2016;3:160018.

    Article  Google Scholar 

  44. Corrado EM. The importance of open access, open source, and open standards for libraries. Issues Sci Technol Librariansh 2005;1–7.

  45. Falagas ME. Peer review in open access scientific journals. Open Med 2007;

  46. Minssen T, Rajam N, Bogers M. Clinical trial data transparency and GDPR compliance: implications for data sharing and open innovation. Sci Public Policy 2020

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Authors and Affiliations

  1. Humanitas University, Pieve Emanuele, Milan, Italy

    Fabrizia Gelardi & Martina Sollini

  2. Humanitas Clinical and Research Center – IRCCS, Rozzano, Milan, Italy

    Fabrizia Gelardi & Martina Sollini

  3. Nuclear Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy

    Margarita Kirienko

Authors
  1. Fabrizia Gelardi
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  2. Margarita Kirienko
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  3. Martina Sollini
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Contributions

MS and MK conceptualised the paper. MS, MK and FG performed data selection and drafted the paper. FG provided the figures. All the authors approved the manuscript.

Corresponding author

Correspondence to Margarita Kirienko.

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The authors declare that they have no conflict of interest.

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Gelardi, F., Kirienko, M. & Sollini, M. Climbing the steps of the evidence-based medicine pyramid: highlights from Annals of Nuclear Medicine 2019. Eur J Nucl Med Mol Imaging 48, 1293–1301 (2021). https://doi.org/10.1007/s00259-020-05073-6

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