Humanitas University, Pieve Emanuele, Milan, Italy.
Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy.
Eur J Nucl Med Mol Imaging. 2021 May;48(5):1293-1301. doi: 10.1007/s00259-020-05073-6. Epub 2020 Nov 4.
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.
我们旨在提供核医学研究路径的概述，使用对 2019 年 1 月至 12 月期间发表在《核医学纪事》上的 111 篇论文中主观选择的 14 篇论文进行回顾，来攀登循证医学（EBM）金字塔的各个步骤。按照 EBM 层次结构的结构，我们从金字塔的基础（临床前研究、专家意见、病例报告和病例系列）到中间（病例对照和队列研究、随机对照试验），再到顶部（荟萃分析和系统评价），为每个步骤选择了至少一项研究。此外，我们还收集了每个纳入研究的发起人的信息：研究者发起的试验（IIT）与工业赞助的试验（IST）。我们发现，临床前研究主要集中在癌症新的分子靶点的开发上，结果很有前景。与此同时，临床研究使用 SPECT 和 PET 模式处理心脏病学、神经病学、传染病和肿瘤学的应用。此外，放射性核素治疗也引起了人们的兴趣，并正在全面临床实施。我们的综述证实了当前 IIT 与 IST 相比的核心作用。还讨论了核医学研究的挑战和未来方向。
