Tahani O. Alkahtani

Background/Objective: This cross-sectional study assessed the knowledge, attitudes, and practices (KAP) of radiology professionals in Saudi Arabia regarding environmental sustainability. Methods: An online survey with 298 participants revealed moderate knowledge and positive attitudes towards sustainability. Results: However, a significant gap between awareness and practice was observed. The most common sustainable practice was digital documentation (53.4%), while energy saving and water saving measures were rare, with more than half rarely or never practicing energy saving. The primary barrier to implementation was a lack of awareness and training (50%). The sustainability association was significantly higher among older, female, and hospital-based professionals. Conclusions: The findings underscore the urgent need for improved educational initiatives, strong institutional support, and clear policy frameworks to effectively integrate sustainable practices into radiology departments in Saudi Arabia.

Quantitative molecular imaging via single-photon emission computed tomography-derived standardised uptake value (SPECT/CT-SUV) is used to assess the response of metastatic castration-resistant prostate cancer (mCRPC) patients to targeted radionuclide therapy (TRT) with [177Lu]Lu-PSMA. This imaging technique determines the radiopharmaceutical distribution and internal dosimetry in patients who receive TRT. However, there is limited evidence regarding the role of image quantification in monitoring changes induced by [177Lu]Lu-PSMA. This systematic examines the role of quantitative SPECT/CT-SUV during [177Lu]Lu-PSMA TRT and assesses whether SUV changes correlate with quantitative imaging and biomarkers. A systematic review was conducted in accordance with the PRISMA guidelines. The MEDLINE/PubMed databases were searched from January 2016 to July 2024 to identify relevant articles. The inclusion criterion was the use of quantitative SPECT/CT-SUV during [177Lu]Lu-PSMA TRT for patients with mCRPC. The records were screened to determine their eligibility. The abstracts of 62 records were screened, and 28 were excluded because they were not relevant; the full texts of 34 original papers were retrieved and assessed for eligibility. A total of five studies were included in this systematic review (two prospective studies and three retrospective studies). The sample sizes of the studies ranged from 6 to 73 patients. The highest number of lesions analysed was 144. Three studies reported the SPECT/CT-SUV following cycle 1, and only one study reported the correlation with pretherapy PET/CT (r = 0.9, p = 0.005). SPECT/CT-SUV changes between the first two to three cycles were reported in one study. None of the studies reported the SPECT/CT-SUV for normal organs. One study reported correlations between SPECT/CT-derived SUV and PET/CT-derived SUV in target and nontarget tissues. Quantitative SPECT/CT-SUV can be used to predict responses to subsequent PSMA-TRT cycles. Disease burden and tumour heterogeneity are the leading causes of TRT individualisation.

Osteoporosis is a bone density associated disease that causes fading of the bone structure and function, which thereby makes the bone fragile. This fragile bone can be easily fractured as a result of mechanical forces, or events that would otherwise not cause a fracture if the bones were healthy. Most previous studies have been conducted on postmenopausal females. The few studies that have been conducted on a Saudi population have primarily focused on risk factors for osteoporosis in women > 60 years of age or who are postmenopausal. This study aimed to evaluate younger, premenopausal Saudi females, <59 years old to investigate the impact of body mass index (BMI) on bone mineral density (BMD) using a quantitative ultrasound (QUS) machine. Cross-sectional observational study of 100 Saudi women aged 19 to 58 years. Body mass index (BMI) was calculated from each participant's weight in kilograms divided by the square of her height in meters (kg/m 2). The DMS PEGASUS SMART Bone Densitometer, Mauguio, France, was used for portable quantitative ultrasound (QUS) with a Caucasian ethnicity setting and measurement of the right calcaneus bone. The mean age of the participants was 29.62 year (SD ± 10.25), range (19 to 58 years). A total of 5% exhibited evidence of osteoporosis and 64% had normal broadband ultrasound attenuation (BUA). The average BMI was 24.7268 kg/m² and average SOS was 1,390.28 m/s. Spearman's rho showed weak negative correlation between BMI and SOS (p = 0.001≤ 0.05 and r =-.331) and fairly positive correlation between BUA and SOS (p = .000 ≤ 0.05 and r = .463). Furthermore, none of the participants in the low and normal BMI category showed evidence of osteoporosis. A total of 6.9% of the participants in the overweight BMI category showed evidence of osteoporosis, and 17.6% of those in the obese BMI category had evidence of osteoporosis. In conclusion, low and high BMI were positively correlated with low BMD regardless of age. A BMD screening test using QUS should be considered as primary screening for BMD in pre-and postmenopausal females with low or high BMI, to prevent future development of osteoporosis. QUS should be used for primary screening because it is, portable, fast, efficient, user friendly, widely available and uses non-ionizing radiation.