Molecular Imaging and Radionuclide Therapy

Molecular Imaging and Radionuclide Therapy

Basic info

  • Publisher: Galenos Publishing House
  • Country of publisher: turkey
  • Date added to EuroPub: 2019/Aug/08

Subject and more

  • LCC Subject Category: Medicine
  • Publisher's keywords: Molecular Imaging, Multimodality Imaging, Nuclear Medicine, Radionuclide Therapy, Radiopharmacy, Medical Physics, Dosimetry, Radiobiology
  • Language of fulltext: english

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  • Article Processing Charges (APCs): No
  • Submission charges: No
  • Waiver policy for charges? No

Editorial information

Open access & licensing

  • Type of License: CC BY-NC-ND
  • License terms
  • Open Access Statement: Yes
  • Year open access content began: 2011
  • Does the author retain unrestricted copyright? False
  • Does the author retain publishing rights? False

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  • Permanent article identifier: DOI
  • Content digitally archived in: Nopolicy
  • Deposit policy registered in: None

This journal has '16' articles

Comparison of SUVmax Values Obtained from F-18 FDG PET/CT and Cell-free DNA Levels Measured from Plasma in Oncology Patients

Comparison of SUVmax Values Obtained from F-18 FDG PET/CT and Cell-free DNA Levels Measured from Plasma in Oncology Patients

Authors: Fatmanur Çelik, Yusuf Ziya Tan, Semra Özdemir, Fatma Sılan
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Abstract

Objectives: The aim of this study was to compare the quantitative value of standardized uptake value (SUV) SUVmax obtained from F-18 FDG positron emission tomography/computed tomography (PET/CT) imaging of oncology patients with the cell-free DNA (cfDNA) amounts measured in plasma of patients and thus investigate if cfDNA is a significant marker to identify the presence of malignancy in the early period. Methods: A total of 184 patients were included in the study. The clinical, histopathologic, laboratory and treatment parameters were extracted from patient files. SUVmax and cfDNA quantities were assessed. Results: There was no statistically significant difference in plasma cfDNA values between patient and control groups. The comparison of SUVmax and cfDNA values in the study showed that there was a weak correlation between SUVmax and cfDNA. There was a significant difference between tumor size and SUVmax values. However, there was no statistically significant difference between tumor size and cfDNA. Conclusion: cfDNA measurements in the blood as a screening test have provided hope for early diagnosis and monitoring of cancer patients. Comparison of cfDNA levels obtained from plasma and quantitative parameters from PET/CT images of oncology patients in detailed advanced studies with larger patient series are required.

Keywords: F-18 FDG PET/CT, SUVmax, cell-free DNA
Evaluation of Myocardial Perfusion Imaging SPECT Parameters and Pharmacologic Stress Test with Adenosine Versus Coronary Angiography Findings: Are They Diagnostically Concordant?

Evaluation of Myocardial Perfusion Imaging SPECT Parameters and Pharmacologic Stress Test with Adenosine Versus Coronary Angiography Findings: Are They Diagnostically Concordant?

Authors: Zekiye Hasbek, Seyit Ahmet Ertürk, Ali Çakmakçılar, İbrahim Gül, Ahmet Yılmaz
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Abstract

Objectives: In this study our first aim was to evaluate the diagnostic concordance of myocardial perfusion scintigraphy (MPS) by pharmacological stress test with adenosine (APST) with coronary angiography (CAG). The secondary aim of this study was to evaluate the correlation between CAG findings and automated analysis parameters such as left ventricular ejection fraction, summed stress score (SSS), summed rest score, summed difference score (SDS), stress MPS defect percentage ratio (extent) and transient ischemic dilation (TID) obtained by myocardial perfusion imaging single-photon emission computed tomography (SPECT). Methods: A total of 129 patients (62 male, 67 female, median age: 60.02) undergoing MPS due to suspicion of coronary ischemia who also underwent subsequent CAG in the last year were included in this study, their MPS data and CAG results were compared. Results: There was no statistically significant diagnostic concordance when visual evaluation of MPS, quantitative MPS parameters and exercise treadmill test (ETT) electrocardiography results were used alone. In fact, diagnostic concordance was higher when automated analysis parameters like TID, SSS and extent values were added to MPS SPECT visual analyses. There was diagnostic concordance in 57.9% of APST patients and 41.7% of ETT patients. There was diagnostic concordance in 75.8% of APST patients and 52.6% of ETT patients who were older than 65 years of age. Conclusion: In our study, we found that the use of APST during MPS increases diagnostic concordance with CAG. Therefore, we think that it would be appropriate to use APST in women and elderly patients with limited exercise habits. The CAG diagnostic mismatch is far above what it should be when MPS reporting is only done with visual data, and it is not supported by quantitative data such as TID, SSS, SDS and extent.

Keywords: Myocardial perfusion, SPECT, adenosine, stress test, quantitative parameters
Significance of Microalbuminuria in Predicting Silent Myocardial Ischemia in Patients with Type 2 Diabetes Using Myocardial Perfusion Imaging

Significance of Microalbuminuria in Predicting Silent Myocardial Ischemia in Patients with Type 2 Diabetes Using Myocardial Perfusion Imaging

Authors: Tayyebeh Emami,Zohreh Naeimei,Azita Salehifard,Zahra Azizmohammadi,Dariush Iranpour,Mohammadreza Kalantarhormozi,Esmail Jafari,Ali Gholamrezanezhad,Ma...
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Abstract

Objectives: In light of increased risk of cardiovascular events and the poor prognosis of coronary artery disease (CAD) in diabetic versus nondiabetic patients and also with respect to the importance of early diagnosis of CAD in this status, the study was aimed to assess the importance of microalbuminuria in predicting silent myocardial ischemia (SMI) in patients with type 2 diabetes using myocardial perfusion imaging (MPI). Methods: This study included 120 patients with diabetes type 2, but without previously known CAD or any cardiac symptoms that were stratified into two groups based on presence/absence of microalbuminuria. All participants underwent CAD evaluation using gated myocardial perfusion single-photon emission computed tomography (MPS) imaging. Other clinical and laboratory indices were also recorded. Results: Studied population consisted of 84 males (70%) and 36 females (30%), totally 120 patients with mean age of 58.61±9.90). In total, asymptomatic ischemia was detected in 78 (65%) of the included diabetic patients. Stress induced ischemia was found in 56 patients (87.5%) of albumin+ (Alb) group and in 22 patients (39.3%) of Alb- group. The frequency of stress induced ischemia was 10.81 times higher in the patients with microalbuminuria compared to Alb- ones [p<0.001, Odds ratio: 10.81, 95% confidence interval: 4.33-26.99]. On the other hand, no relationship was found between the presence of stress induced ischemia and therapy type, diabetes duration, history of evident retinopathy, history of hypertension and also serum levels of hemoglobin A1c (p>0.05). Conclusion: The current study showed that abnormal MPI findings are significantly more common in diabetic patients with microalbuminuria. With respect to low cost and availability of urine Alb detection tests, it might be as a biomarker for prediction of SMI in daibetic population.

Keywords: Microalbuminuria, silent myocardial ischemia, type 2 diabetes, myocardial perfusion imaging
Risk Factors for Predicting Osteoporosis in Patients Who Receive Thyrotropin Suppressive Levothyroxine Treatment for Differentiated Thyroid Carcinoma

Risk Factors for Predicting Osteoporosis in Patients Who Receive Thyrotropin Suppressive Levothyroxine Treatment for Differentiated Thyroid Carcinoma

Authors: Çiğdem Soydal, Elgin Özkan, Demet Nak, Atilla Halil Elhan, Nuriye Özlem Küçük, Metin Kemal Kır
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Abstract

Objectives: Endogenous hyperthyroidism accelerates bone turnover and shortens the normal bone remodeling cycle, which results in reduced bone density. It is estimated that suppressive levothyroxine (LT4) therapy also decreases bone density. The aim of this study was to define risk factors for osteoporosis development in patients under thyrotropin-stimulating hormone (TSH) suppressive treatment for differentiated thyroid cancer (DTC). Methods: Patients with a diagnosis of low or intermediate risk group DTC according to the American Thyroid Association 2015 guidelines and who have been receiving LT4 suppression therapy and were physically fit to undergo femur and lumbar vertebra bone density study were included in the study. Patients lacking information on demographic data, medical history, preoperative thyroid hormone status, or routine follow-up data were excluded from the study. A study form consisting of patient information on possible risk factors for osteoporosis such as gender, age, menopausal status, smoking, family history of osteoporosis, preoperative thyroid hormone status, postoperative hypoparathyroidism history, mean serum TSH levels, and duration of TSH suppression was created and filled out for each participant. Bone mineral densitometries of the femur and lumbar vertebrae were measured along with serum vitamin D and parathyroid hormone levels. Results: During TSH suppression (mean 7.2±4.5 years, range: 1-26), osteoporosis was detected in 89 (9.6%) patients. The mean time to develop osteoporosis was significantly different in patients with or without a family history of osteoporosis (15.3±0.4 versus 20.3±0.6 years; p=0.002). Similarly, the mean time to develop osteoporosis for was found to be significantly shorter in postmenopausal patients than that for premenopausal women (18.6±0.7 versus 20.4±0.4 years; p<0.001). Male gender (p<0.001), a family history of osteoporosis (p=0.001) and menopausal state (p<0.001) were identified as independent predictive factors for developing osteoporosis. Conclusion: Postmenopausal women, men, and patients with a family history who receive TSH-suppression treatment have a tendency to develop osteoporosis.

Keywords: Differentiated thyroid carcinoma, osteoporosis, thyroid-stimulating hormone suppression treatment
Giant Abdominal Aortic Aneurysm in Bone Scan

Giant Abdominal Aortic Aneurysm in Bone Scan

Authors: Derya Çayır, Mehmet Bozkurt, Özdeş Emer, Salih Sinan Gültekin, Alper Özgür Karacalıoğlu
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Abstract

Abdominal aortic aneurysm (AAA) may be incidentally detected in three-phased bone scintigraphy. AAA should be diagnosed prior to the development of symptoms to perform elective repair surgery. We present a rare case who presented with back pain and underwent a 3-phase bone scan with Tc-99m methylene diphosphonate, which revealed a giant AAA on blood-flow and blood-pool phases in addition to bone metastases. F-18-fluorodeoxyglucose positron emission tomography/computed tomography (CT) identified hypermetabolic liver, lung, and bone lesions, and CT component of the study confirmed the diagnosis of AAA with a maximum diameter of 92 mm. The initial two phases of a 3-phase bone scintigraphy are decisive to identify vascular pathologies that may be life-threatening, if left untreated.

Keywords: Whole body scan, Tc-99m methylene diphosphonate, abdominal aortic aneurysm, metastases, PET/CT
Detection of Squamous Cell Carcinoma Foci in a Patient with Dystrophic Epidermolysis Bullosa in 18F-FDG PET/CT

Detection of Squamous Cell Carcinoma Foci in a Patient with Dystrophic Epidermolysis Bullosa in 18F-FDG PET/CT

Authors: Esra Arslan, Tevfik Fikret Çermik, Ayşe Esra Koku Aksu, Mehmet Salih Gürel, Cem Leblebici
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Abstract

Dystrophic epidermolysis bullosa (DEB) is a rare, inherited skin fragility disorder characterized by blister formation in the sublamina densa. DEB is associated with aggressive squamous cell carcinoma (SCC) that has increased risk of metastases and poor prognosis. A 41-year-old woman with DEB underwent 18F-fluoro-2-deoxy-glucose positron emission tomography/computed tomography (18F-FDG PET/BT). PET/CT showed increased 18F-FDG uptakes in multifocal cutaneous lesions in both lower extremities. The patient was diagnosed with SCC via skin biopsy from the left lateral lower thigh. Ten months later, PET/CT showed increased FDG uptakes in the primary tumor area as well as the left inguinal and left supraclavicular lymph node regions. 18F-FDG PET/CT seems to be useful for re-staging and planning appropriate therapeutic strategy in DEB-patients with SCC.

Keywords: 18F-FDG PET/CT, dystrophic epidermolysis bullosa, squamous cell carcinoma
Striking Visualization of Diffuse Congenital Nesidioblastosis on Ga-68 DOTATATE PET/CT

Striking Visualization of Diffuse Congenital Nesidioblastosis on Ga-68 DOTATATE PET/CT

Authors: Fevziye Canbaz, Murat Aydın, Bilge Can Meydan, Meltem Ceyhan Bilgici, Ender Arıtürk
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Abstract

“Nesidioblastosis”, later renamed as “persistent hyperinsulinemic hypoglycemia of infancy” presents as either focal or diffuse neo-differentiation of pancreatic Langerhans islet cells from the ductal epithelium. Differentiation of focal disease from diffuse involvement is crucial for optimal disease management. The current methods used to differentiate the two forms pre-operatively are invasive techniques. The definite role of imaging modalities to differentiate diffuse versus focal form has not yet been proven. Herein, we report a 15 day-old infant having diffuse nesidioblastosis, successfully demonstrated by Ga-68 DOTATATE positron emission tomography/computed tomography imaging that was histopathologically confirmed.

Keywords: Nesidioblastosis, hyperinsulinemic hypoglycemia, differential diagnosis, Ga-68 DOTATATE PET/CT
Incidental Hydroxyapatite Ocular Implant Uptake on Bone Scan Done for Prostate Cancer Staging: Case Report and Brief Review

Incidental Hydroxyapatite Ocular Implant Uptake on Bone Scan Done for Prostate Cancer Staging: Case Report and Brief Review

Authors: Guillaume Chaussé, Jerome Laufer, Gad Abikhzer, Stephan Probst
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Abstract

A 74-year-old man recently diagnosed with high-risk prostate cancer with high serum prostate specific antigen was referred to nuclear medicine for a technetium-99m-methylene diphosphonate (Tc-99m MDP) bone scan. On delayed three-hour anterior planar image, an unexpected round focus of intense uptake was found overlying the right orbit. Single-photon emission computed tomography/computed tomography localized the uptake to an ocular prosthesis. The hydroxyapatite composition of the ocular implant can be recognized by its bone-like density and its intense accumulation of Tc-99m MDP. Review of the patient’s history revealed remote right eye evisceration secondary to a complication of cataract surgery, consistent with the findings.

Keywords: Tc-99m MDP, bone scan, ocular implant, artificial eye, eye prosthesis, hydroxyapatite
Diagnostic Value of Bone SPECT/CT in Patients with Suspected Osteomyelitis

Diagnostic Value of Bone SPECT/CT in Patients with Suspected Osteomyelitis

Authors: Pelin Arıcan, Berna Okudan, Rıza Şefizade, Seniha Naldöken
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Abstract

Objectives: The aim of our retrospective study was to evaluate the contribution of single photon emission computed tomography/computed tomography (SPECT/CT) to three phase bone scintigraphy/SPECT for the assessment of osteomyelitis (OM) and patient’s management. Methods: Eighty-five patients who were suspected as having OM were included in this study. Tc-99m MDP three phase bone scintigraphy and SPECT/CT were performed to the region of suspected OM. SPECT/CT findings were compared with the findings of planar images/SPECT. Both planar bone scan/SPECT and SPECT/CT findings were divided into two groups: With OM and without OM. In all patients, scintigraphic diagnosis was confirmed by clinical follow up, laboratory findings, microscopic-bacteriological examinations, radiological, surgical, and pathological findings. Results: SPECT/CT changed the diagnosis and treatment planning in 14/85 (16.5%) patients. SPECT/CT was significantly superior to planar scan/SPECT imaging for determining OM (kappa value was 0.626 for planar scan/SPECT, 0.929 for SPECT/CT). SPECT/CT was statistically more successful in detection of chronic OM, and useful in differentiating chronic OM from acute OM (kappa value was 0.541 for planar scan/SPECT, 0.944 for SPECT/CT). Conclusion: SPECT/CT increases accuracy of the diagnosis in the evaluation of OM when it is compared to three phase bone scintigraphy/SPECT. SPECT/CT can change the diagnosis and management of the patients.

Keywords: Bone scintigraphy, osteomyelitis, infection, SPECT, SPECT/CT
Effects of the Use of Automatic Tube Current Modulation on Patient Dose and Image Quality in Computed Tomography

Effects of the Use of Automatic Tube Current Modulation on Patient Dose and Image Quality in Computed Tomography

Authors: Ayşegül Yurt, İsmail Özsoykal, Funda Obuz
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Abstract

Objectives: The frequency of abdominal computed tomography examinations is increasing, leading to a significant level of patient dose. This study aims to quantify and evaluate the effects of automatic tube current modulation (ATCM) technique on patient dose and image quality in contrast-enhanced biphasic abdominal examinations. Methods: Two different scan protocols, based on constant tube current and ATCM technique, were used on 64 patients who visited our radiology department periodically. For three patient groups with different patient size, results from two protocols were compared with respect to patient dose and image quality. Dosimetric evaluations were based on the Computed Tomography Dose Index, dose length product, and effective dose. For the comparison of image qualities between two protocols, Noise Index (NI) and Contrast to Noise Ratio (CNR) values were determined for each image. Additionally, the quality of each image was evaluated subjectively by an experienced radiologist, and the results were compared between the two protocols. Results: Dose reductions of 31% and 21% were achieved by the ATCM protocol in the arterial and portal phases, respectively. On the other hand, NI exhibited an increase between 9% and 46% for liver, fat and aorta. CNR values were observed to decrease between 5% and 19%. All images were evaluated by a radiologist, and no obstacle limiting a reliable diagnostic evaluation was found in any image obtained by either technique. Conclusion: These results showed that the ATCM technique reduces patient dose significantly while maintaining a certain level of image quality.

Keywords: Tomography, radiation protection, abdomen
Correlation of SUVmax and Apparent Diffusion Coefficient Values Detected by Ga-68 PSMA PET/MRI in Primary Prostate Lesions and Their Significance in Lymph Node Metastasis: Preliminary Results of an On-going Study

Correlation of SUVmax and Apparent Diffusion Coefficient Values Detected by Ga-68 PSMA PET/MRI in Primary Prostate Lesions and Their Significance in Lymph Node Metastasis: Preliminary Results of an On-going Study

Authors: Lebriz Uslu-Beşli, Barış Bakır, Sertaç Asa, Ekrem Güner, Çetin Demirdağ, Onur Erdem Şahin, Emre Karayel, Muhammet Sait Sağer, Haluk Burçak Sayman, Ker...
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Abstract

Objectives: Gallium-68 (Ga-68) prostate specific membrane antigen (PSMA) positron emission tomography (PET) has been shown to be more accurate than multiparametric prostate magnetic resonance imaging (MRI) in detection of primary prostate lesions. Using hybrid PET/MRI we aim to detect the correlation between SUVmax and apparent diffusion coefficient (ADC) in primary prostate lesions and to assess their prognostic value in detection of lymph node (LN) metastasis. Methods: Twenty-six patients, who were diagnosed as having prostate cancer with biopsy and underwent Ga-68 PSMA PET/MRI together with biparametric prostate MRI (bpMRI) were included. SUVmax, SUVmean and ADC were recorded for index lesions drawing a region of interest (ROI) of 1 cm2 around the pixel with the highest SUVmax (ROI-1) and another ROI following borders of prostate tumor detected by bpMRI (ROI-2). Presence of LN metastasis was recorded according to PSMA PET/MRI. Results: SUVmax was inversely correlated with ADC (ROI-1: p=0.010; ROI-2: p=0.017 for b=800). SUVmax and SUVmeans were both higher in patients with LN metastasis and ADC was lower in patients with LN metastasis for ROI-1. SUVmax cut-off value of 19.8 for ROI-1 and 20.9 for ROI-2 had sensitivity and specificity of 77.8% and 76.5%, respectively for detection of LN metastasis, whereas ADC (b=800) cut-off value of 0.92x10-3 mm2/s had sensitivity and specificity of 87.5% and 76.5%, respectively. SUVmax/ADC (b=800) ratio increased the sensitivity and specificity to 100% and 82.4%, respectively. Conclusion: SUV and ADC values are inversely correlated in primary prostate lesions and the combined use of both values increases the diagnostic accuracy of hybrid PET/MRI in the detection of primary prostate lesions.

Keywords: Gallium-68, prostate specific membrane antigen, positron emission tomography/magnetic resonance imaging, multiparametric prostate magnetic resonance imaging, prostate cancer, lymph node metastasis
Solitary Pulmonary Nodule: Morphological Effects on Metabolic Activity Assessment

Solitary Pulmonary Nodule: Morphological Effects on Metabolic Activity Assessment

Authors: Mehmet Erdoğan, Şehnaz Evrimler, Hüseyin Aydın, Adnan Karaibrahimoğlu, Sevim Süreyya Şengül
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Abstract

Objectives: We aimed to evaluate the effects of morphological characteristics of the solitary pulmonary nodules (SPN) on metabolic activity assessment. To the best of our knowledge, this is the first study to compare the volumetric metabolic activity parameters according to the morphologic parameters of the nodules. Methods: In this retrospective study, 18F-FDG positron emission tomography and computed tomography scans performed between 2011 and 2018 were evaluated by a nuclear and diagnostic radiologist. One hundred thirteen patients with SPNs with biopsy-proven diagnosis were included. SPNs were classified as solid, partially solid (PS), and ground glass opacity (GGO). Results: SPN diameter, SUVmax, metabolic tumor volume (MTV), total lesion glycolysis (TLG), and density were significantly higher in the malignant group. SUVmax, MTV, TLG increased in direct proportion to the diameter. There was no a significant difference between GGO, PS, and solid nodules in terms of SUVmax values. MTV and TLG values increased in parallel with the density of the nodules, but this increase was only significant in the malignant group. There was a significant difference between SPNs <2 cm and SPNs ≥2 cm in terms of MTV, while there was no difference in terms of SUVmax. The cut-off value determined by the ROC curve was found to be 4.39 for SUVmax, 7.33 mL for MTV and 31.88 g for TLG. The cut-off values for SUVmax of solid and subsolid nodules were close to each other, but cut-off values for MTV and TLG were higher in solid nodules. Conclusion: SUVmax, MTV, and TLG are affected by diameter and attenuation. We suggest using different MTV and TLG cut-off values for solid and subsolid nodules, but we suggest using same SUVmax values. MTV can be a more reliable parameter than SUVmax in prediction of malignancy in smaller nodules.

Keywords: Positron emission tomography, solitary pulmonary nodule, metabolic tumor volume, total lesion glycolysis
Minimal Invasive Radioguided Ectopic Parathyroidectomy in Upper Mediastinum

Minimal Invasive Radioguided Ectopic Parathyroidectomy in Upper Mediastinum

Authors: Zehra Pınar Koç, Turgut Karlıdağ, Pelin Özcan Kara, Abdulvahap Akyiğit, Ferda Dağlı
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Abstract

In this study we wanted to present a case with the history of multiple previous neck explorations and persisting upper mediastinal ectopic parathyroid adenoma who underwent a successful operation with radioguided minimal invasive approach.

Keywords: Hyperparathyroidism, adenoma, minimally invasive, radioimmunodetection
Incidental “Urinoma” in 18F-FDG PET/CT Scan

Incidental “Urinoma” in 18F-FDG PET/CT Scan

Authors: Aziz Gültekin, Olga Yaylalı, Tarık Şengöz, Doğangün Yüksel
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Abstract

18F-FDG PET/CT scanning was performed for the primary staging of a 47-year-old man with urothelial carcinoma. The patient underwent biopsy by ureteroscopy 15 days ago and the PET images revealed 18F-FDG accumulation in the right retroperitenal region, compatible with an “urinoma”.

Keywords: Urothelial carcinoma, urinoma, positron emission tomography
PET/CT Findings of a Patient with Cardiac Metastasis of Subungual Malign Melanoma

PET/CT Findings of a Patient with Cardiac Metastasis of Subungual Malign Melanoma

Authors: Özgül Ekmekçioğlu, Pelin Arıcan, Şermin Meşe, Nihal Kaplan, Mesut Kafi, Duygu Şimşek, Mehmet Şükrü Ertürk
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Abstract

A 58-year old patient with a history of subungual malign melanoma was referred to our department for a 18F-FDG positron emission tomography (PET)/computed tomography (CT) whole body scan. An unexpected 18F-FDG uptake in left ventricule which mimicked either trombus or physiological papillary muscle was detected. Filling defect of intravenous contrast in CT images was also demonstrated in left ventricule cavity. Magnetic resonance imaging scan confirmed cardiac mass with metastatic features of malign melanoma in left ventricule.

Keywords: Malign melanoma, PET/CT, subungual, 18F-FDG

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