Simple Summary [68Ga]Ga-DOTA-SSTR PET imaging has recently been introduced in the management of patients with brain tumors, mostly meningiomas and pituitary adenomas or carcinomas. The current literature demonstrated the superior diagnostic accuracy of this imaging modality, especially for lesions difficult to be detected or characterized on conventional imaging protocols, such as skull base or transosseous meningiomas. [68Ga]Ga-DOTA-SSTR PET tracers also seem to provide superior volume contouring for radiotherapy planning and may also be used to evaluate the tumor’s overexpression of somatostatin receptors for devising patient-tailored peptide receptor radionuclide therapy. In this review, we comprehensively analyzed the current literature discussing the implementation of [68Ga]Ga-DOTA-SSTR PET imaging in brain tumors, further presenting ongoing clinical trials and suggesting potential future applications. Abstract Background: The development of [68Ga]Ga-DOTA-SSTR PET tracers has garnered interest in neuro-oncology, to increase accuracy in diagnostic, radiation planning, and neurotheranostics protocols. We systematically reviewed the literature on the current uses of [68Ga]Ga-DOTA-SSTR PET in brain tumors. Methods: PubMed, Scopus, Web of Science, and Cochrane were searched in accordance with the PRISMA guidelines to include published studies and ongoing trials utilizing [68Ga]Ga-DOTA-SSTR PET in patients with brain tumors. Results: We included 63 published studies comprising 1030 patients with 1277 lesions, and 4 ongoing trials. [68Ga]Ga-DOTA-SSTR PET was mostly used for diagnostic purposes (62.5%), followed by treatment planning (32.7%), and neurotheranostics (4.8%). Most lesions were meningiomas (93.6%), followed by pituitary adenomas (2.8%), and the DOTATOC tracer (53.2%) was used more frequently than DOTATATE (39.1%) and DOTANOC (5.7%), except for diagnostic purposes (DOTATATE 51.1%). [68Ga]Ga-DOTA-SSTR PET studies were mostly required to confirm the diagnosis of meningiomas (owing to their high SSTR2 expression and tracer uptake) or evaluate their extent of bone invasion, and improve volume contouring for better radiotherapy planning. Some studies reported the uncommon occurrence of SSTR2-positive brain pathology challenging the diagnostic accuracy of [68Ga]Ga-DOTA-SSTR PET for meningiomas. Pre-treatment assessment of tracer uptake rates has been used to confirm patient eligibility (high somatostatin receptor-2 expression) for peptide receptor radionuclide therapy (PRRT) (i.e., neurotheranostics) for recurrent meningiomas and pituitary carcinomas. Conclusion: [68Ga]Ga-DOTA-SSTR PET studies may revolutionize the routine neuro-oncology practice, especially in meningiomas, by improving diagnostic accuracy, delineation of radiotherapy targets, and patient eligibility for radionuclide therapies.

/pdf/the-role-of-68ga-ga-dota-sstr-pet-radiotracers-in-brain-30582s17.pdf

The Role of [68Ga]Ga-DOTA-SSTR PET Radiotracers in Brain Tumors: A Systematic Review of the Literature and Ongoing Clinical Trials

OBJECTIVE To assess the links between structural and household determinants of household water insecurity and test three water insecurity measures against self-reported diarrhoea, dengue fever and perceived stress in the middle-income and low-income urban areas of Torreon, Mexico. DESIGN Cross-sectional household survey conducted in two waves (rainy and dry seasons). PARTICIPANTS 500 households selected via multistage cluster sample in selected communities. Socioeconomic status determined the selection of participant neighbourhoods; five were identified in low socioeconomic status neighbourhoods and five in low-medium socioeconomic status neighbourhoods. We examine how the context of urban water provision is related to a new cross-culturally valid Household Water Insecurity Experiences (HWISE) Scale. PRIMARY OUTCOME MEASURES The HWISE Scale, self-reported diarrhoea, dengue fever and the Perceived Stress Scale. RESULTS Water system intermittency (adjusted OR (AOR) 3.96, 95% CI 2.40 to 6.54, p<0.001), unpredictability (AOR 2.24, 95% CI 1.34 to 3.74, p=0.002) and the dry season (AOR 3.47, 95% CI 2.18 to 5.52, p<0.001) were structural correlates of the HWISE Scale. This study also found that the HWISE Scale was associated with two health outcomes, self-reported diarrhoea (AOR 1.09, 95% CI 1.03 to 1.15, p=0.002) and perceived stress (β=0.28, SE=0.07, t=4.30, p<0.001), but not self-reported dengue fever (AOR 1.02, 95% CI 0.98 to 1.06). A 3-item hygiene subscore and a 3-item water worry subscore were also both positively associated with self-reported diarrhoea and perceived stress. CONCLUSION Short-form screeners of water insecurity may be useful for assessing certain health risks by lay survey workers in settings with limited healthcare resources, particularly in lieu of more expensive microbiological tests that require specialised training and facilities.

https://bmjopen.bmj.com/content/bmjopen/11/3/e040825.full.pdf

Cross-sectional study to measure household water insecurity and its health outcomes in urban Mexico.

This article compares urban and rural household water insecurity experiences during the last major drought period (2011–17) in the semi-arid interior region of Ceara, Brazil. Using data from a hous...

A comparative analysis of urban and rural household water insecurity experiences during the 2011–17 drought in Ceará, Brazil

Objective: Social and economic changes associated with new roads can bring about rapid nutritional transitions. To study this process, we: (1) describe trends in adult overweight and obesity (OW/OB) among rural Afro-Ecuadorians over time and across a gradient of community remoteness from the nearest commercial centre; (2) examine the relationship between male and female adult OW/OB and factors associated with market integration such as changing livelihoods and (3) examine the co-occurrence of adult OW/OB and under-five stunting and anaemia. Design:
 Adult anthropometry was collected through serial case–control studies repeated over a decade across twenty-eight communities. At the same time, anthropometry and Hb were measured for all children under 5 years of age in every community. Setting:
 Northern coastal Ecuador. Participants:
 Adults (n 1665) and children under 5 years of age (n 2618). Results:
 From 2003 and 2013, OW/OB increased from 25·1 % to 44·8 % among men and 59·9 % to 70·2 % among women. The inverse relationship between remoteness and OW/OB in men was attenuated when adjusting for urban employment, suggesting that livelihoods mediated the remoteness–OW/OB relationship. No such relationship was observed among women. Communities with a higher prevalence of male OW/OB also had a greater prevalence of stunting, but not anaemia, in children under 5 years of age. Conclusions:
 The association between male OW/OB and child stunting at the community level, but not the household level, suggests that changing food environments, rather than household- or individual-level factors, drove these trends. A closer examination of changing socio-economic structures and food environments in communities undergoing rapid development could help mitigate future public health burdens.

/pdf/multiple-burdens-of-malnutrition-and-relative-remoteness-in-3d15qilomp.pdf

Multiple burdens of malnutrition and relative remoteness in rural Ecuadorian communities.

The aim of this review was to rapidly synthesize the available evidence regarding the expected impacts of piped water chlorination, drainage, and sewerage on individuals living in lowand middleincome urban settings. A systematic search was conducted in bibliographic databases and library catalogs. Impact evaluations that included a comparator and one of the three interventions of interest, attempted to control for confounding and selection bias, and took place in urban settings in a lowor middle-income country were considered. Outcomes related to health, well-being, economic growth, and the bacterial content of water were considered. A total of 1,483 articles were identified, with 18 included after final screening. Most studies were case-control and took place in Brazil, the Pacific Islands, or south-western Asia. Fifteen studies considered sewerage, five considered chlorination, and two studies considered drainage with some studies considering multiple interventions. All primary outcomes were related to health. When implemented alone, the sewerage and chlorination interventions were largely successful. The evidence regarding the effects of chlorination, drainage, and sewerage interventions is limited and generally has a high risk of bias. When properly implemented, sewerage and chlorination are likely to have positive health impacts. However, when implemented poorly, all three interventions can have negative health impacts.

/pdf/rapid-evidence-assessment-of-the-impacts-of-sewerage-4wqzmhm9r6.pdf

Rapid evidence assessment of the impacts of sewerage, drainage, and piped water chlorination in urban settings of low- and middle-income countries

In addition to gastroenteropancreatic neuroendocrine neoplasms, a wide variety of tumors express somatostatin receptors. Somatostatin receptor imaging, heavily utilized in neuroendocrine oncology, may also have utility in the diagnosis of other neoplasms and raises the possibility of potential therapeutic options. We describe the case of a 60-year-old man who underwent 68Ga-DOTATATE PET/CT, demonstrating an avid invasive pituitary macroadenoma. This mass was persistent and refractory despite traditional treatment options. Because of the avidity, 177Lu-DOTATATE therapy was offered, although not ultimately performed, demonstrating a potential treatment for challenging cases utilizing the principles of theranostics.

68Ga-DOTATATE PET/CT Imaging of Refractory Pituitary Macroadenoma Invading the Orbit.

Household coping strategies associated with unreliable water supplies and diarrhea in Ecuador, an upper-middle-income country.

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68Ga-DOTATATE PET/CT Imaging of Refractory Pituitary Macroadenoma Invading the Orbit.

Household coping strategies associated with unreliable water supplies and diarrhea in Ecuador, an upper-middle-income country.