Person: Fahey, Frederic
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Fahey
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Frederic
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Fahey, Frederic
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Publication Pharmacokinetic modeling of [18F]fluorodeoxyglucose (FDG) for premature infants, and newborns through 5-year-olds(Springer Berlin Heidelberg, 2016) Khamwan, Kitiwat; Plyku, Donika; O’Reilly, Shannon E.; Goodkind, Alison; Cao, Xinhua; Fahey, Frederic; Treves, S.; Bolch, Wesley E.; Sgouros, GeorgeBackground: Absorbed dose estimates for pediatric patients require pharmacokinetics that are, to the extent possible, age-specific. Such age-specific pharmacokinetic data are lacking for many of the diagnostic agents typically used in pediatric imaging. We have developed a pharmacokinetic model of [18F]fluorodeoxyglucose (FDG) applicable to premature infants and to 0- (newborns) to 5-year-old patients, which may be used to generate model-derived time-integrated activity coefficients and absorbed dose calculations for these patients. Methods: The FDG compartmental model developed by Hays and Segall for adults was fitted to published data from infants and also to a retrospective data set collected at the Boston Children’s Hospital (BCH). The BCH data set was also used to examine the relationship between uptake of FDG in different organs and patient weight or age. Results: Substantial changes in the structure of the FDG model were required to fit the pediatric data. Fitted rate constants and fractional blood volumes were reduced relative to the adult values. Conclusions: The pharmacokinetic models developed differ substantially from adult pharmacokinetic (PK) models which can have considerable impact on the dosimetric models for pediatric patients. This approach may be used as a model for estimating dosimetry in children from other radiopharmaceuticals. Electronic supplementary material The online version of this article (doi:10.1186/s13550-016-0179-6) contains supplementary material, which is available to authorized users.Publication Targeted Radionuclide Therapy: Practical Applications and Future Prospects(Libertas Academica, 2016) Zukotynski, Katherine; Jadvar, Hossein; Capala, Jacek; Fahey, FredericIn recent years, there has been a proliferation in the development of targeted radionuclide cancer therapy. It is now possible to use baseline clinical and imaging assessments to determine the most effective therapy and to tailor this therapy during the course of treatment based on radiation dosimetry and tumor response. Although this personalized approach to medicine has the advantage of maximizing therapeutic effect while limiting toxicity, it can be challenging to implement and expensive. Further, in order to use targeted radionuclide therapy effectively, there is a need for multidisciplinary awareness, education, and collaboration across the scientific, industrial, and medical communities. Even more important, there is a growing understanding that combining radiopharmaceuticals with conventional treatment such as chemotherapy and external beam radiotherapy may limit patient morbidity while improving survival. Developments in radiopharmaceuticals as biomarkers capable of predicting therapeutic response and targeting disease are playing a central role in medical research. Adoption of a practical approach to manufacturing and delivering radiopharmaceuticals, assessing patient eligibility, optimizing post-therapy follow-up, and addressing reimbursement issues will be essential for their success.Publication Saul Hertz, MD, and the birth of radionuclide therapy(Springer International Publishing, 2017) Fahey, Frederic; Grant, Frederick; Thrall, JamesThe year, 2016, marked the 75th anniversary of Dr. Saul Hertz first using radioiodine to treat a patient with thyroid disease. In November of 1936, a luncheon was held of the faculty of Harvard Medical School where Karl Compton, PhD, president of the Massachusetts Institute of Technology was invited to give a presentation entitled “What Physics Can Do for Biology and Medicine.” Saul Hertz who attended the luncheon spontaneously asked the very pertinent question that perhaps changed the course of treatment of thyroid disease, “Could iodine be made radioactive artificially?” We review the events leading up to the asking of this question, the preclinical investigations by Dr. Hertz and his colleague Arthur Roberts prior to the treatment of the first patient and what occurred in the years following this landmark event. This commentary seeks to set the record straight to the sequence of events leading to the first radioiodine therapy, so that those involved can be recognized with due credit.Publication How we read pediatric PET/CT: indications and strategies for image acquisition, interpretation and reporting(BioMed Central, 2017) Colleran, Gabrielle C.; Kwatra, Neha; Oberg, Leah; Grant, Frederick; Drubach, Laura; Callahan, Michael; MacDougall, Robert D.; Fahey, Frederic; Voss, StephanPET/CT plays an important role in the diagnosis, staging and management of many pediatric malignancies. The techniques for performing PET/CT examinations in children have evolved, with increasing attention focused on reducing patient exposure to ionizing radiation dose whenever possible and minimizing scan duration and sedation times, with a goal toward optimizing the overall patient experience. This review outlines our approach to performing PET/CT, including a discussion of the indications for a PET/CT exam, approaches for optimizing the exam protocol, and a review of different approaches for acquiring the CT portion of the PET/CT exam. Strategies for PACS integration, image display, interpretation and reporting are also provided. Most practices will develop a strategy for performing PET/CT that best meets their respective needs. The purpose of this article is to provide a comprehensive overview for radiologists who are new to pediatric PET/CT, and also to provide experienced PET/CT practitioners with an update on state-of-the art CT techniques that we have incorporated into our protocols and that have enabled us to make considerable improvements to our PET/CT practice.