The Impact of Somatostatin Receptor-Directed PET/CT on the Management of Patients with Neuroendocrine Tumor: A Systematic Review and Meta-Analysis
Somatostatin receptor (SSTR) imaging is widely used for guiding the management of neuroendocrine tumor (NET) patients. Ga-DOTATATE approval by the U.S. Food and Drug Administration has triggered widespread clinical interest in SSTR PET/CT throughout the United States. Here, we performed a systematic...
Gespeichert in:
| Veröffentlicht in: | Journal of Nuclear Medicine 2017-05, Vol.58 (5), p.756-761 |
|---|---|
| Hauptverfasser: | , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 761 |
|---|---|
| container_issue | 5 |
| container_start_page | 756 |
| container_title | Journal of Nuclear Medicine |
| container_volume | 58 |
| creator | Barrio, Martin Czernin, Johannes Fanti, Stefano Ambrosini, Valentina Binse, Ina Du, Lin Eiber, Matthias Herrmann, Ken Fendler, Wolfgang P |
| description | Somatostatin receptor (SSTR) imaging is widely used for guiding the management of neuroendocrine tumor (NET) patients.
Ga-DOTATATE approval by the U.S. Food and Drug Administration has triggered widespread clinical interest in SSTR PET/CT throughout the United States. Here, we performed a systematic review and meta-analysis to evaluate the impact of SSTR PET/CT on the management of patients with NETs.
A comprehensive literature search was performed using The National Center for Biotechnology Information PubMed online database, applying the following key words: "management" AND "PET" AND "neuroendocrine". Fourteen of 190 studies were deemed suitable based on the following inclusion criteria: original research, cohort study, number of patients 10 or more, and reported change in management after SSTR PET/CT. Change in management across studies was determined by a random-effects model.
A total of 1,561 patients were included. Overall, change in management occurred in 44% (range, 16%-71%) of NET patients after SSTR PET/CT. In 4 of 14 studies, SSTR PET/CT was performed after an
In-Octreotide scan. In this subgroup, additional information by SSTR PET/CT led to a change in management in 39% (range, 16%-71%) of patients. Seven of 14 studies differentiated between inter- and intramodality changes, with most changes being intermodality (77%; intramodality, 23%).
The management was changed in more than one third of patients undergoing SSTR PET/CT even when performed after an
In-Octreotide scan. Intermodality changes were 3 times more likely than intramodality changes, underlining the clinical impact of SSTR PET/CT. |
| doi_str_mv | 10.2967/jnumed.116.185587 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_osti_</sourceid><recordid>TN_cdi_osti_scitechconnect_1537152</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1964526419</sourcerecordid><originalsourceid>FETCH-LOGICAL-c399t-8cb4a710909c01bb0c0fcd0b732249e045f34ffbbea2f4c8a568d3d2f99cca6c3</originalsourceid><addsrcrecordid>eNpdkcFuEzEURS0EoqHwAWyQBRs2k9oztsdmF4UClVqoaFhbHs8b4ihjB9tDld_gi3GYdsPKT_K59-m-i9BrSpa1Eu3Fzk8j9EtKxZJKzmX7BC0ob3jFhWifogWhglacE36GXqS0I4QIKeVzdFZLImvWyAX6s9kCvhoPxmYcBnwXRpNDyiY7j7-DhUMOsfroItgMPb693FysNzh4nIvsxnjzE0bw_6S3RVPGhO9d3uKvMMUAvg82Og94M40hfsArfHdMGcoOZ4v9bwf32Pge30A21cqb_TG59BI9G8w-wauH9xz9-HS5WX-prr99vlqvrivbKJUraTtmWkoUUZbQriOWDLYnXdvUNVNAGB8aNgxdB6YemJWGC9k3fT0oZa0RtjlHb2ffktfpZF0Gu7XB-5JVlzO2lNcFej9Dhxh-TZCyHl2ysN8bD2FKmkpBGWetUgV99x-6C1MsoQqlBOO1YPRE0ZmyMaQUYdCH6EYTj5oSfWpVz63q0qqeWy2aNw_OU3f6elQ81tj8BbINn-8</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1964526419</pqid></control><display><type>article</type><title>The Impact of Somatostatin Receptor-Directed PET/CT on the Management of Patients with Neuroendocrine Tumor: A Systematic Review and Meta-Analysis</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Barrio, Martin ; Czernin, Johannes ; Fanti, Stefano ; Ambrosini, Valentina ; Binse, Ina ; Du, Lin ; Eiber, Matthias ; Herrmann, Ken ; Fendler, Wolfgang P</creator><creatorcontrib>Barrio, Martin ; Czernin, Johannes ; Fanti, Stefano ; Ambrosini, Valentina ; Binse, Ina ; Du, Lin ; Eiber, Matthias ; Herrmann, Ken ; Fendler, Wolfgang P ; Univ. of California, Los Angeles, CA (United States)</creatorcontrib><description>Somatostatin receptor (SSTR) imaging is widely used for guiding the management of neuroendocrine tumor (NET) patients.
Ga-DOTATATE approval by the U.S. Food and Drug Administration has triggered widespread clinical interest in SSTR PET/CT throughout the United States. Here, we performed a systematic review and meta-analysis to evaluate the impact of SSTR PET/CT on the management of patients with NETs.
A comprehensive literature search was performed using The National Center for Biotechnology Information PubMed online database, applying the following key words: "management" AND "PET" AND "neuroendocrine". Fourteen of 190 studies were deemed suitable based on the following inclusion criteria: original research, cohort study, number of patients 10 or more, and reported change in management after SSTR PET/CT. Change in management across studies was determined by a random-effects model.
A total of 1,561 patients were included. Overall, change in management occurred in 44% (range, 16%-71%) of NET patients after SSTR PET/CT. In 4 of 14 studies, SSTR PET/CT was performed after an
In-Octreotide scan. In this subgroup, additional information by SSTR PET/CT led to a change in management in 39% (range, 16%-71%) of patients. Seven of 14 studies differentiated between inter- and intramodality changes, with most changes being intermodality (77%; intramodality, 23%).
The management was changed in more than one third of patients undergoing SSTR PET/CT even when performed after an
In-Octreotide scan. Intermodality changes were 3 times more likely than intramodality changes, underlining the clinical impact of SSTR PET/CT.</description><identifier>ISSN: 0161-5505</identifier><identifier>EISSN: 1535-5667</identifier><identifier>EISSN: 2159-662X</identifier><identifier>DOI: 10.2967/jnumed.116.185587</identifier><identifier>PMID: 28082438</identifier><language>eng</language><publisher>United States: Society of Nuclear Medicine</publisher><subject>Biotechnology ; Computed tomography ; Endocrine system ; Humans ; Management ; Medical imaging ; Meta-analysis ; Molecular Imaging - statistics & numerical data ; Neuroendocrine tumors ; Neuroendocrine Tumors - diagnostic imaging ; Neuroendocrine Tumors - metabolism ; Neuroendocrine Tumors - therapy ; Octreotide ; Organometallic Compounds - pharmacokinetics ; Patient Care Management - statistics & numerical data ; Patients ; Positron emission ; Positron emission tomography ; Positron Emission Tomography Computed Tomography - methods ; Positron Emission Tomography Computed Tomography - statistics & numerical data ; Prevalence ; Radiology, Nuclear Medicine & Medical Imaging ; Radiopharmaceuticals - pharmacokinetics ; Receptors, Somatostatin - metabolism ; Reproducibility of Results ; Risk Factors ; Sensitivity and Specificity ; Somatostatin ; Somatostatin receptors ; Systematic review ; Tomography ; Treatment Outcome ; Tumors</subject><ispartof>Journal of Nuclear Medicine, 2017-05, Vol.58 (5), p.756-761</ispartof><rights>2017 by the Society of Nuclear Medicine and Molecular Imaging.</rights><rights>Copyright Society of Nuclear Medicine May 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c399t-8cb4a710909c01bb0c0fcd0b732249e045f34ffbbea2f4c8a568d3d2f99cca6c3</citedby><cites>FETCH-LOGICAL-c399t-8cb4a710909c01bb0c0fcd0b732249e045f34ffbbea2f4c8a568d3d2f99cca6c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28082438$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/1537152$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Barrio, Martin</creatorcontrib><creatorcontrib>Czernin, Johannes</creatorcontrib><creatorcontrib>Fanti, Stefano</creatorcontrib><creatorcontrib>Ambrosini, Valentina</creatorcontrib><creatorcontrib>Binse, Ina</creatorcontrib><creatorcontrib>Du, Lin</creatorcontrib><creatorcontrib>Eiber, Matthias</creatorcontrib><creatorcontrib>Herrmann, Ken</creatorcontrib><creatorcontrib>Fendler, Wolfgang P</creatorcontrib><creatorcontrib>Univ. of California, Los Angeles, CA (United States)</creatorcontrib><title>The Impact of Somatostatin Receptor-Directed PET/CT on the Management of Patients with Neuroendocrine Tumor: A Systematic Review and Meta-Analysis</title><title>Journal of Nuclear Medicine</title><addtitle>J Nucl Med</addtitle><description>Somatostatin receptor (SSTR) imaging is widely used for guiding the management of neuroendocrine tumor (NET) patients.
Ga-DOTATATE approval by the U.S. Food and Drug Administration has triggered widespread clinical interest in SSTR PET/CT throughout the United States. Here, we performed a systematic review and meta-analysis to evaluate the impact of SSTR PET/CT on the management of patients with NETs.
A comprehensive literature search was performed using The National Center for Biotechnology Information PubMed online database, applying the following key words: "management" AND "PET" AND "neuroendocrine". Fourteen of 190 studies were deemed suitable based on the following inclusion criteria: original research, cohort study, number of patients 10 or more, and reported change in management after SSTR PET/CT. Change in management across studies was determined by a random-effects model.
A total of 1,561 patients were included. Overall, change in management occurred in 44% (range, 16%-71%) of NET patients after SSTR PET/CT. In 4 of 14 studies, SSTR PET/CT was performed after an
In-Octreotide scan. In this subgroup, additional information by SSTR PET/CT led to a change in management in 39% (range, 16%-71%) of patients. Seven of 14 studies differentiated between inter- and intramodality changes, with most changes being intermodality (77%; intramodality, 23%).
The management was changed in more than one third of patients undergoing SSTR PET/CT even when performed after an
In-Octreotide scan. Intermodality changes were 3 times more likely than intramodality changes, underlining the clinical impact of SSTR PET/CT.</description><subject>Biotechnology</subject><subject>Computed tomography</subject><subject>Endocrine system</subject><subject>Humans</subject><subject>Management</subject><subject>Medical imaging</subject><subject>Meta-analysis</subject><subject>Molecular Imaging - statistics & numerical data</subject><subject>Neuroendocrine tumors</subject><subject>Neuroendocrine Tumors - diagnostic imaging</subject><subject>Neuroendocrine Tumors - metabolism</subject><subject>Neuroendocrine Tumors - therapy</subject><subject>Octreotide</subject><subject>Organometallic Compounds - pharmacokinetics</subject><subject>Patient Care Management - statistics & numerical data</subject><subject>Patients</subject><subject>Positron emission</subject><subject>Positron emission tomography</subject><subject>Positron Emission Tomography Computed Tomography - methods</subject><subject>Positron Emission Tomography Computed Tomography - statistics & numerical data</subject><subject>Prevalence</subject><subject>Radiology, Nuclear Medicine & Medical Imaging</subject><subject>Radiopharmaceuticals - pharmacokinetics</subject><subject>Receptors, Somatostatin - metabolism</subject><subject>Reproducibility of Results</subject><subject>Risk Factors</subject><subject>Sensitivity and Specificity</subject><subject>Somatostatin</subject><subject>Somatostatin receptors</subject><subject>Systematic review</subject><subject>Tomography</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><issn>0161-5505</issn><issn>1535-5667</issn><issn>2159-662X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkcFuEzEURS0EoqHwAWyQBRs2k9oztsdmF4UClVqoaFhbHs8b4ihjB9tDld_gi3GYdsPKT_K59-m-i9BrSpa1Eu3Fzk8j9EtKxZJKzmX7BC0ob3jFhWifogWhglacE36GXqS0I4QIKeVzdFZLImvWyAX6s9kCvhoPxmYcBnwXRpNDyiY7j7-DhUMOsfroItgMPb693FysNzh4nIvsxnjzE0bw_6S3RVPGhO9d3uKvMMUAvg82Og94M40hfsArfHdMGcoOZ4v9bwf32Pge30A21cqb_TG59BI9G8w-wauH9xz9-HS5WX-prr99vlqvrivbKJUraTtmWkoUUZbQriOWDLYnXdvUNVNAGB8aNgxdB6YemJWGC9k3fT0oZa0RtjlHb2ffktfpZF0Gu7XB-5JVlzO2lNcFej9Dhxh-TZCyHl2ysN8bD2FKmkpBGWetUgV99x-6C1MsoQqlBOO1YPRE0ZmyMaQUYdCH6EYTj5oSfWpVz63q0qqeWy2aNw_OU3f6elQ81tj8BbINn-8</recordid><startdate>20170501</startdate><enddate>20170501</enddate><creator>Barrio, Martin</creator><creator>Czernin, Johannes</creator><creator>Fanti, Stefano</creator><creator>Ambrosini, Valentina</creator><creator>Binse, Ina</creator><creator>Du, Lin</creator><creator>Eiber, Matthias</creator><creator>Herrmann, Ken</creator><creator>Fendler, Wolfgang P</creator><general>Society of Nuclear Medicine</general><general>Society of Nuclear Medicine and Molecular Imaging</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>4T-</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>20170501</creationdate><title>The Impact of Somatostatin Receptor-Directed PET/CT on the Management of Patients with Neuroendocrine Tumor: A Systematic Review and Meta-Analysis</title><author>Barrio, Martin ; Czernin, Johannes ; Fanti, Stefano ; Ambrosini, Valentina ; Binse, Ina ; Du, Lin ; Eiber, Matthias ; Herrmann, Ken ; Fendler, Wolfgang P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c399t-8cb4a710909c01bb0c0fcd0b732249e045f34ffbbea2f4c8a568d3d2f99cca6c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Biotechnology</topic><topic>Computed tomography</topic><topic>Endocrine system</topic><topic>Humans</topic><topic>Management</topic><topic>Medical imaging</topic><topic>Meta-analysis</topic><topic>Molecular Imaging - statistics & numerical data</topic><topic>Neuroendocrine tumors</topic><topic>Neuroendocrine Tumors - diagnostic imaging</topic><topic>Neuroendocrine Tumors - metabolism</topic><topic>Neuroendocrine Tumors - therapy</topic><topic>Octreotide</topic><topic>Organometallic Compounds - pharmacokinetics</topic><topic>Patient Care Management - statistics & numerical data</topic><topic>Patients</topic><topic>Positron emission</topic><topic>Positron emission tomography</topic><topic>Positron Emission Tomography Computed Tomography - methods</topic><topic>Positron Emission Tomography Computed Tomography - statistics & numerical data</topic><topic>Prevalence</topic><topic>Radiology, Nuclear Medicine & Medical Imaging</topic><topic>Radiopharmaceuticals - pharmacokinetics</topic><topic>Receptors, Somatostatin - metabolism</topic><topic>Reproducibility of Results</topic><topic>Risk Factors</topic><topic>Sensitivity and Specificity</topic><topic>Somatostatin</topic><topic>Somatostatin receptors</topic><topic>Systematic review</topic><topic>Tomography</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Barrio, Martin</creatorcontrib><creatorcontrib>Czernin, Johannes</creatorcontrib><creatorcontrib>Fanti, Stefano</creatorcontrib><creatorcontrib>Ambrosini, Valentina</creatorcontrib><creatorcontrib>Binse, Ina</creatorcontrib><creatorcontrib>Du, Lin</creatorcontrib><creatorcontrib>Eiber, Matthias</creatorcontrib><creatorcontrib>Herrmann, Ken</creatorcontrib><creatorcontrib>Fendler, Wolfgang P</creatorcontrib><creatorcontrib>Univ. of California, Los Angeles, CA (United States)</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Docstoc</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>Journal of Nuclear Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Barrio, Martin</au><au>Czernin, Johannes</au><au>Fanti, Stefano</au><au>Ambrosini, Valentina</au><au>Binse, Ina</au><au>Du, Lin</au><au>Eiber, Matthias</au><au>Herrmann, Ken</au><au>Fendler, Wolfgang P</au><aucorp>Univ. of California, Los Angeles, CA (United States)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Impact of Somatostatin Receptor-Directed PET/CT on the Management of Patients with Neuroendocrine Tumor: A Systematic Review and Meta-Analysis</atitle><jtitle>Journal of Nuclear Medicine</jtitle><addtitle>J Nucl Med</addtitle><date>2017-05-01</date><risdate>2017</risdate><volume>58</volume><issue>5</issue><spage>756</spage><epage>761</epage><pages>756-761</pages><issn>0161-5505</issn><eissn>1535-5667</eissn><eissn>2159-662X</eissn><abstract>Somatostatin receptor (SSTR) imaging is widely used for guiding the management of neuroendocrine tumor (NET) patients.
Ga-DOTATATE approval by the U.S. Food and Drug Administration has triggered widespread clinical interest in SSTR PET/CT throughout the United States. Here, we performed a systematic review and meta-analysis to evaluate the impact of SSTR PET/CT on the management of patients with NETs.
A comprehensive literature search was performed using The National Center for Biotechnology Information PubMed online database, applying the following key words: "management" AND "PET" AND "neuroendocrine". Fourteen of 190 studies were deemed suitable based on the following inclusion criteria: original research, cohort study, number of patients 10 or more, and reported change in management after SSTR PET/CT. Change in management across studies was determined by a random-effects model.
A total of 1,561 patients were included. Overall, change in management occurred in 44% (range, 16%-71%) of NET patients after SSTR PET/CT. In 4 of 14 studies, SSTR PET/CT was performed after an
In-Octreotide scan. In this subgroup, additional information by SSTR PET/CT led to a change in management in 39% (range, 16%-71%) of patients. Seven of 14 studies differentiated between inter- and intramodality changes, with most changes being intermodality (77%; intramodality, 23%).
The management was changed in more than one third of patients undergoing SSTR PET/CT even when performed after an
In-Octreotide scan. Intermodality changes were 3 times more likely than intramodality changes, underlining the clinical impact of SSTR PET/CT.</abstract><cop>United States</cop><pub>Society of Nuclear Medicine</pub><pmid>28082438</pmid><doi>10.2967/jnumed.116.185587</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0161-5505 |
| ispartof | Journal of Nuclear Medicine, 2017-05, Vol.58 (5), p.756-761 |
| issn | 0161-5505 1535-5667 2159-662X |
| language | eng |
| recordid | cdi_osti_scitechconnect_1537152 |
| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Biotechnology Computed tomography Endocrine system Humans Management Medical imaging Meta-analysis Molecular Imaging - statistics & numerical data Neuroendocrine tumors Neuroendocrine Tumors - diagnostic imaging Neuroendocrine Tumors - metabolism Neuroendocrine Tumors - therapy Octreotide Organometallic Compounds - pharmacokinetics Patient Care Management - statistics & numerical data Patients Positron emission Positron emission tomography Positron Emission Tomography Computed Tomography - methods Positron Emission Tomography Computed Tomography - statistics & numerical data Prevalence Radiology, Nuclear Medicine & Medical Imaging Radiopharmaceuticals - pharmacokinetics Receptors, Somatostatin - metabolism Reproducibility of Results Risk Factors Sensitivity and Specificity Somatostatin Somatostatin receptors Systematic review Tomography Treatment Outcome Tumors |
| title | The Impact of Somatostatin Receptor-Directed PET/CT on the Management of Patients with Neuroendocrine Tumor: A Systematic Review and Meta-Analysis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-04T08%3A14%3A22IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_osti_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20Impact%20of%20Somatostatin%20Receptor-Directed%20PET/CT%20on%20the%20Management%20of%20Patients%20with%20Neuroendocrine%20Tumor:%20A%20Systematic%20Review%20and%20Meta-Analysis&rft.jtitle=Journal%20of%20Nuclear%20Medicine&rft.au=Barrio,%20Martin&rft.aucorp=Univ.%20of%20California,%20Los%20Angeles,%20CA%20(United%20States)&rft.date=2017-05-01&rft.volume=58&rft.issue=5&rft.spage=756&rft.epage=761&rft.pages=756-761&rft.issn=0161-5505&rft.eissn=1535-5667&rft_id=info:doi/10.2967/jnumed.116.185587&rft_dat=%3Cproquest_osti_%3E1964526419%3C/proquest_osti_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1964526419&rft_id=info:pmid/28082438&rfr_iscdi=true |