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Article: Scoring systems of quantitative bone scanning in prostate cancer: historical overview, current status and future perspectives.

Zafeirakis, Athanasios

2014 Volume 17, Issue 2, Page(s) 136–144

Abstract: Whole-body bone scintigraphy using technetium-99m-methylene-diphosphonate ((99m)Tc-MDP) is the most widely used radionuclide imaging modality applied in patients with prostate cancer. With this technique, the choice of methods to estimate the extend of ... ...

Abstract	Whole-body bone scintigraphy using technetium-99m-methylene-diphosphonate ((99m)Tc-MDP) is the most widely used radionuclide imaging modality applied in patients with prostate cancer. With this technique, the choice of methods to estimate the extend of the metastatic disease on the skeletal system includes various different approaches, classified in two main categories: First, the quantitative measurements of tracer uptake, defined either as the percentage of the injected dose of tracer, or as the more complicated plasma clearance techniques and second, the various semi-quantitative scoring systems of the bone scan images. These scoring systems can be based either on visual counting of bone lesions, or on the estimation of a numerical index that expresses the fractional involvement of each bone by tumour, called "Bone Scan Index" (BSI); the latter can be produced either visually (manually) or by the more sophisticated techniques of fully- or semi-automated (computerized) forms. In this review, a brief chronological overview of the aforementioned methods is presented, along with the main advantages, drawbacks and the prognostic implications of each method. There remains, however, the challenge of defining, developing and validating the optimal measurement methodology in order these scoring systems to obtain a wider clinical use.
MeSH term(s)	Bone Neoplasms/diagnostic imaging ; Bone Neoplasms/secondary ; Bone and Bones/diagnostic imaging ; Humans ; Male ; Prognosis ; Prostatic Neoplasms/diagnostic imaging ; Prostatic Neoplasms/pathology ; Radionuclide Imaging/methods
Language	English
Publishing date	2014-05
Publishing country	Greece
Document type	Journal Article ; Review
ZDB-ID	2186026-9
ISSN	1790-5427 ; 1108-1430
ISSN	1790-5427 ; 1108-1430
DOI	10.1967/s002449910134
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Article ; Online: The increased angiogenic capacity and decreased inflammatory response when a mesh is used in combination with an omental flap. A prospective experimental study.

Karmiris, N I / Albanis, Z / Zafeirakis, A / Vezakis, A / Konstadoulakis, M / Fragulidis, G P

Journal of plastic, reconstructive & aesthetic surgery : JPRAS

2023 Volume 86, Page(s) 261–268

Abstract: Background: The use of a surgical mesh for abdominal wall reconstruction is well established and has been used for long with minor complications, whereas the omental flap has been used for decades in reconstructive surgery.: Aim: To demonstrate the ... ...

Abstract	Background: The use of a surgical mesh for abdominal wall reconstruction is well established and has been used for long with minor complications, whereas the omental flap has been used for decades in reconstructive surgery. Aim: To demonstrate the increased angiogenic capacity and the reduced inflammatory markers of a synthetic mesh when used in combination with an omental flap. Furthermore, we compare two independent meshes when used alone or in combination with the omental flap. Materials and methods: Twenty-eight rats were included in the study. To determine the effect of using an omental flap under two different meshes, the animals were separated into four groups, i.e., group A (flap + mesh 1), group B (flap + mesh 1 + silicone), group C (flap + mesh 2), and group D (flap + mesh 2 + silicone). A silicone sheet was placed as a barrier between the mesh and the flap. All groups were sacrificed 8 weeks post-operatively. Results: The use of a silicone sheet barrier between any of the two synthetic meshes and the omental flap in an abdominal wall defect is accompanied by a markedly reduced angiogenesis in terms of a cluster of differentiation (CD)-34 (p < 0.001) and factor VIII (p = 0.0012) and by increased inflammatory response CD-68 (p = 0.0024) and visual scoring (p < 0.001). Conclusions: Τhe increased angiogenic capacity and the reduced inflammatory markers of a synthetic surgical mesh when used in combination with an omental flap make it a useful option in the reconstruction of an abdominal wall defect on a large or contaminated wound.
MeSH term(s)	Rats ; Animals ; Surgical Mesh ; Prospective Studies ; Surgical Flaps/surgery ; Abdominoplasty ; Silicones ; Abdominal Wall/surgery
Chemical Substances	Silicones
Language	English
Publishing date	2023-09-14
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2217750-4
ISSN	1878-0539 ; 1748-6815 ; 0007-1226
ISSN (online)	1878-0539
ISSN	1748-6815 ; 0007-1226
DOI	10.1016/j.bjps.2023.09.034
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Article ; Online: Collagenous and non-collagenous biochemical markers of bone metastases from prostate cancer.

Zafeirakis, A

Hippokratia

2010 Volume 14, Issue 3, Page(s) 164–169

Abstract: The importance of the bone microenvironment to the pathophysiology and morbidity associated with prostate cancer bone metastasis is becoming increasingly apparent. Significant alterations take place in the microenvironment of bone, which disturb the ... ...

Abstract	The importance of the bone microenvironment to the pathophysiology and morbidity associated with prostate cancer bone metastasis is becoming increasingly apparent. Significant alterations take place in the microenvironment of bone, which disturb the normal coupling that exists between bone resorption and bone formation. Consequently, a better understanding of the mechanisms that interact at the molecular level will definitely result in more effective therapy for patients with this devastating complication of prostatic carcinoma. This review will discuss the diagnostic and predictive implications of various collagenous and non-collagenous bone markers, along with the novel markers of osteoclastogenesis and other matrix enzymes such as metalloproteinases and growth factors responsible for the complex biochemical mechanisms that upregulate bone resorption/formation during the development of metastasis. Further prospective studies are needed to determine whether any of these markers measured longitudinally in prostate cancer patients without bone scan evidence of skeletal disease will ultimately predict those patients who will develop bone metastases from their malignancy. Nonetheless, from the clinical point of view it is important to know that these novel markers carry the potential to provide meaningful information for daily practice by using upper normal reference values as cut-offs for identifying patients with an increased risk of developing progressive bone disease or skeletal related events.
Language	English
Publishing date	2010-10-26
Publishing country	Greece
Document type	Journal Article
ZDB-ID	2491943-3
ISSN	1790-8019 ; 1108-4189
ISSN (online)	1790-8019
ISSN	1108-4189
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Article: Can response to palliative treatment with radiopharmaceuticals be further enhanced?

Zafeirakis, Athanasios

Hellenic journal of nuclear medicine

2009 Volume 12, Issue 2, Page(s) 151–157

Abstract: Bone-seeking radiopharmaceuticals (RF) are an effective systemic pain-palliative treatment schedule in patients with disseminated bone disease. This treatment relies on selective uptake and prolonged retention of RF at sites of increased osteoblastic ... ...

Abstract	Bone-seeking radiopharmaceuticals (RF) are an effective systemic pain-palliative treatment schedule in patients with disseminated bone disease. This treatment relies on selective uptake and prolonged retention of RF at sites of increased osteoblastic activity, while the potential toxicity of systemic administration is reduced by relatively selective tumour targeting. The main theoretic advantage of bone-targeted radionuclide treatment is that radiation can be delivered selectively to subclinical tumours and to metastases that are too small to be imaged and treated by surgical excision or local external beam radiotherapy. The distribution of radiation dose throughout a tumour is heterogeneous, whilst the rate of response depends upon the pre-treatment condition of the patient and other factors. To enhance the effect of treatment with RF on cancer cells, the following strategies have been investigated: Individualisation of the administered dose, higher-doses, earlier or repeated radionuclide treatment, the use of new RF, and the use of a mixture of different RF. Furthermore, external beam radiotherapy, biphosphonates or chemotherapeutic agents have been combined with RF and have scored significantly better treatment results referring to pain relief, bone disease progression, etc, without important side effects. The role of bone seeking RF can be extended beyond bone pain palliation, to a synergistic anti-tumour effect.
MeSH term(s)	Humans ; Neoplasms/complications ; Neoplasms/therapy ; Pain/etiology ; Pain/prevention & control ; Palliative Care/methods ; Radiopharmaceuticals/therapeutic use ; Radiotherapy, Adjuvant/methods
Chemical Substances	Radiopharmaceuticals
Language	English
Publishing date	2009-05
Publishing country	Greece
Document type	Journal Article ; Review
ZDB-ID	2186026-9
ISSN	1790-5427 ; 1108-1430
ISSN	1790-5427 ; 1108-1430
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Article: Athens Eye Hospital Ocular Oncology multidisciplinary team providing combined treatments for patients with choroidal melanoma: 3 years results.

Anastasakis, Anastasios / Zafeirakis, Panagiotis / Livir-Rallatos, Charalampos / Livir-Rallatos, Gerasimos

Journal of B.U.ON. : official journal of the Balkan Union of Oncology

2017 Volume 22, Issue 3, Page(s) 801–802

MeSH term(s)	Brachytherapy ; Choroid Neoplasms/therapy ; Combined Modality Therapy ; Eye Enucleation ; Humans ; Melanoma/therapy ; Patient Care Team
Language	English
Publishing date	2017-07-20
Publishing country	Greece
Document type	Journal Article
ZDB-ID	2040386-0
ISSN	2241-6293 ; 1107-0625
ISSN (online)	2241-6293
ISSN	1107-0625
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Article ; Online: An Ultra-Rapid Biosensory Point-of-Care (POC) Assay for Prostate-Specific Antigen (PSA) Detection in Human Serum.

Mavrikou, Sophie / Moschopoulou, Georgia / Zafeirakis, Athanasios / Kalogeropoulou, Konstantina / Giannakos, Georgios / Skevis, Athanasios / Kintzios, Spyridon

Sensors (Basel, Switzerland)

2018 Volume 18, Issue 11

Abstract: Prostate-specific antigen (PSA) is the established routine screening tool for the detection of early-stage prostate cancer. Given the laboratory-centric nature of the process, the development of a portable, ultra rapid high-throughput system for PSA ... ...

Abstract	Prostate-specific antigen (PSA) is the established routine screening tool for the detection of early-stage prostate cancer. Given the laboratory-centric nature of the process, the development of a portable, ultra rapid high-throughput system for PSA screening is highly desirable. In this study, an advancedpoint-of-care system for PSA detection in human serum was developed based on a cellular biosensor where the cell membrane was modified by electroinserting a specific antibody against PSA. Thirty nine human serum samples were used for validation of this biosensory system for PSA detection. Samples were analyzed in parallel with a standard immunoradiometric assay (IRMA) and an established electrochemical immunoassay was used for comparison purposes. They were classified in three different PSA concentration ranges (0, <4 and ≥4 ng/mL). Cells membrane-engineered with 0.25 μg/mL anti-PSA antibody demonstrated a statistically lower response against the upper (≥4 ng/mL) PSA concentration range. In addition, the cell-based biosensor performed better than the immunosensor in terms of sensitivity and resolution against positive samples containing <4 ng/mL PSA. In spite of its preliminary, proof-of-concept stage of development, the cell-based biosensor could be used as aninitiative for the development of a fast, low-cost, and high-throughput POC screening system for PSA.
MeSH term(s)	Biosensing Techniques/methods ; Electrochemical Techniques ; Gold/chemistry ; Humans ; Immunoassay/methods ; Male ; Metal Nanoparticles/chemistry ; Point-of-Care Systems ; Prostate-Specific Antigen/blood ; Prostatic Neoplasms/blood
Chemical Substances	Gold (7440-57-5) ; Prostate-Specific Antigen (EC 3.4.21.77)
Language	English
Publishing date	2018-11-08
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2052857-7
ISSN	1424-8220 ; 1424-8220
ISSN (online)	1424-8220
ISSN	1424-8220
DOI	10.3390/s18113834
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Article ; Online: Predictive value of the clinically and scintigraphically important bone lesions in hormone-refractory prostate cancer (HRPC).

Zafeirakis, Athanasios / Limouris, Georgios S

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico

2009 Volume 11, Issue 11, Page(s) 773–774

MeSH term(s)	Antineoplastic Agents, Hormonal/therapeutic use ; Bone Neoplasms/secondary ; Bone Neoplasms/therapy ; Drug Resistance, Neoplasm ; Hormones/metabolism ; Humans ; Kinetics ; Male ; Medical Oncology/methods ; Predictive Value of Tests ; Prognosis ; Prostatic Neoplasms/diagnosis ; Prostatic Neoplasms/drug therapy ; Treatment Outcome
Chemical Substances	Antineoplastic Agents, Hormonal ; Hormones
Language	English
Publishing date	2009-11-04
Publishing country	Italy
Document type	Comment ; Letter
ZDB-ID	2397359-6
ISSN	1699-3055 ; 1699-048X
ISSN (online)	1699-3055
ISSN	1699-048X
DOI	10.1007/s12094-009-0443-6
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Article ; Online: Clinical and imaging correlations of bone turnover markers in prostate cancer patients with bone only metastases.

Zafeirakis, Athanasios G / Papatheodorou, Georgios A / Limouris, Georgios S

Nuclear medicine communications

2010 Volume 31, Issue 3, Page(s) 249–253

Abstract: Objectives: To correlate serum levels of bone markers with pain levels and extent of skeletal disease (EOD), in patients suffering from prostate cancer with bone only metastases.: Methods: Thirty-six males with hormone-refractory prostate carcinoma, ... ...

Abstract	Objectives: To correlate serum levels of bone markers with pain levels and extent of skeletal disease (EOD), in patients suffering from prostate cancer with bone only metastases. Methods: Thirty-six males with hormone-refractory prostate carcinoma, bone only metastases and no history of therapies, drugs, or diseases that affect bone metabolism were studied. Karnofsky performance status, pain scoring, EOD, osteocalcin (OC), prostate-specific antigen, bone alkaline phosphatase amino-terminal and carboxy-terminal propeptides and telopeptides of type I collagen were analysed. Twenty-four healthy controls of the same age were also established. Results: With only the exception of OC, bone marker values of patients were significantly increased compared with the upper reference limits (P<0.0001 for bone alkaline phosphatase and amino-terminal telopeptide of type I collagen, 0.012 for amino-terminal propeptide of type I collagen, 0.0023 for carboxy-terminal propeptide of type I collagen, and 0.04 for carboxy-terminal telopeptide of type I collagen). All bone markers and prostate-specific antigen also showed significant paired correlations (P < or = 0.019) and linear increases with advancing EOD (P < or = 0.032). Finally, none of the measured markers correlated significantly with pain levels. Conclusion: Bone markers are remarkably elevated in the serum of prostate cancer patients with metastatic bone disease and correlate with EOD. Paired correlations also suggest an accelerated but proportional (coupled) bone metabolism.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Alkaline Phosphatase/biosynthesis ; Biomarkers, Tumor/metabolism ; Bone Neoplasms/diagnosis ; Bone Neoplasms/secondary ; Bone and Bones/pathology ; Case-Control Studies ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Osteocalcin/biosynthesis ; Prostate-Specific Antigen/biosynthesis ; Prostatic Neoplasms/diagnosis ; Prostatic Neoplasms/pathology
Chemical Substances	Biomarkers, Tumor ; Osteocalcin (104982-03-8) ; Alkaline Phosphatase (EC 3.1.3.1) ; Prostate-Specific Antigen (EC 3.4.21.77)
Language	English
Publishing date	2010-03
Publishing country	England
Document type	Journal Article
ZDB-ID	758141-5
ISSN	1473-5628 ; 0143-3636
ISSN (online)	1473-5628
ISSN	0143-3636
DOI	10.1097/MNM.0b013e328335a5ed
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Article: Performance and safety profile of regadenoson myocardial perfusion imaging: first experience in Greece.

Koutsikos, John / Angelidis, George / Zafeirakis, Athanasios / Mamarelis, Ioannis / Vogiatzis, Merkourios / Ilia, Eliverta / Lazaridis, Kyriakos / Demakopoulos, Nikolaos

Hellenic journal of nuclear medicine

2017 Volume 20, Issue 3, Page(s) 232–236

Abstract: Objective: MPI can provide valuable information in the investigation of patients with known or suspected coronary artery disease. The stress component of the studies can be conducted with regadenoson, which was approved for clinical use in Greece in ... ...

Abstract	Objective: MPI can provide valuable information in the investigation of patients with known or suspected coronary artery disease. The stress component of the studies can be conducted with regadenoson, which was approved for clinical use in Greece in 2016. We investigated the performance and safety profile of regadenoson MPI based on our 7 months institutional experience. Patients and methods: We studied 96 consecutive patients (59 males, 37 females, mean age 70.35y.o, range: 46-87y.o.) referred to our department for a clinically indicated MPI study with pharmacological stress. Eleven patients suffered from chronic obstructive pulmonary disease. Patients underwent regadenoson stress test, combined with both stress and rest imaging. Data on the symptoms and electrocardiographic changes due to regadenoson administration were recorded. Symptoms were graded as 1-mild: a symptom that did not distress the patient, 2-moderate: a symptom that distressed the patient but it was self-limiting, or 3-severe: a symptom that distressed the patient requiring medical intervention. Results: Regadenoson-related symptoms were reported in 56 patients and were: dyspnea, discomfort, dizziness, chest pain, epigastric pain, neck pain, headache, flushing, nausea, heartburn, weakness, and upper limbs numbness. The severity of symptoms was recorded as grade 1 in 30 patients, grade 2 in 25 patients, and grade 3 in 1 patient. Two or more different symptoms were reported in 28 patients. Ischemic electrocardiographic changes and arrhythmias were observed in 8 patients. Conclusion: Our findings support previously published data indicating the optimal safety profile of regadenoson MPI, even in the group of patients suffering from chronic obstructive pulmonary disease.
MeSH term(s)	Aged ; Aged, 80 and over ; Causality ; Comorbidity ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/epidemiology ; Drug-Related Side Effects and Adverse Reactions/diagnosis ; Drug-Related Side Effects and Adverse Reactions/epidemiology ; Exercise Test/statistics & numerical data ; Female ; Greece/epidemiology ; Humans ; Male ; Middle Aged ; Myocardial Perfusion Imaging/methods ; Myocardial Perfusion Imaging/statistics & numerical data ; Pilot Projects ; Positron-Emission Tomography/methods ; Positron-Emission Tomography/statistics & numerical data ; Prevalence ; Purines ; Pyrazoles ; Reproducibility of Results ; Risk Factors ; Sensitivity and Specificity ; Treatment Outcome ; Vasodilator Agents
Chemical Substances	Purines ; Pyrazoles ; Vasodilator Agents ; regadenoson (2XLN4Y044H)
Language	English
Publishing date	2017-09
Publishing country	Greece
Document type	Clinical Trial ; Journal Article
ZDB-ID	2186026-9
ISSN	1790-5427 ; 1108-1430
ISSN	1790-5427 ; 1108-1430
DOI	10.1967/s002449910607
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Article: Introduction of a new semi-quantitative index with predictive implications in patients with painful osseous metastases after (186)Re-HEDP therapy.

Zafeirakis, A / Zissimopoulos, A / Baziotis, N / Limouris, G S

The quarterly journal of nuclear medicine and molecular imaging : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of...

2011 Volume 55, Issue 1, Page(s) 91–102

Abstract: Aim: In this study, a new method has been used to predict pain response to (186)Re-HEDP therapy in patients suffering from painful osseous metastases, on the basis of a modified bone scan index and pre-therapy pain scoring.: Methods: Forty five ... ...

Abstract	Aim: In this study, a new method has been used to predict pain response to (186)Re-HEDP therapy in patients suffering from painful osseous metastases, on the basis of a modified bone scan index and pre-therapy pain scoring. Methods: Forty five patients received a total of 73 doses of (186)Re-HEDP during a period of pain relapse without extra-osseous disease progression. All patients were under stable regimen of zoledronic acid, far off other therapeutic manipulations. Imaging studies regarding a modified estimation of bone scan index, were applied; the value of the largest bony lesion (called mBSI), provided that it also corresponded to the most prominent site of osseous pain was taken into account, and a new semi-quantitative index called Double Product Value (DPV), equal to pre-therapy pain score times mBSI was entered in the result analyses, to investigate any possible correlations with response endpoints. Results: Favourable response occurred in 35/47 evaluated therapeutic doses of (186)Re-HEDP (74.5%; excellent response in 12 doses, 25.5%). Responders had significantly lower DPV (3.4 ± 2.3 vs. 10.2 ± 6.2, P=0.0029, for non-responders). Patients with pre-therapy DPV <or =4, had higher probability for considerably better (HR 2.29; P<0.0001) and excellent (HR 7.46; P=0.009) pain response versus those with DPV>4, and also a longer median period of pain relief (respective mean values 5.9 versus 2.1 months, HR 2.82; P=0.0001). Conclusion: DPV, as developed and implemented in this study proved a valuable and reproducible pre-therapy tool for assessing degree and duration of pain response after (186)Re-HEDP therapy.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Bone Neoplasms/physiopathology ; Bone Neoplasms/radiotherapy ; Bone Neoplasms/secondary ; Breast Neoplasms/physiopathology ; Breast Neoplasms/radiotherapy ; Etidronic Acid/therapeutic use ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Organometallic Compounds/therapeutic use ; Pain/physiopathology ; Pain/radiotherapy ; Pain Measurement ; Predictive Value of Tests ; Prostatic Neoplasms/physiopathology ; Prostatic Neoplasms/radiotherapy ; Radioisotopes/therapeutic use ; Radiopharmaceuticals/therapeutic use ; Rhenium/therapeutic use
Chemical Substances	Organometallic Compounds ; Radioisotopes ; Radiopharmaceuticals ; rhenium-186 HEDP (140709-07-5) ; Rhenium (7440-15-5) ; Etidronic Acid (M2F465ROXU)
Language	English
Publishing date	2011-02
Publishing country	Italy
Document type	Journal Article
ZDB-ID	1281687-5
ISSN	1827-1936 ; 1824-4785 ; 0392-0208 ; 1125-0135 ; 1824-4661
ISSN (online)	1827-1936
ISSN	1824-4785 ; 0392-0208 ; 1125-0135 ; 1824-4661
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