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Costanzo R, Scalia G, Strigari L, Ippolito M, Paolini F, Brunasso L, Sciortino A, Iacopino DG, Maugeri R, Ferini G, Viola A, Zagardo V, Cosentino S, Umana GE. Nuclear medicine imaging modalities to detect incidentalomas and their impact on patient management: a systematic review. J Cancer Res Clin Oncol 2024; 150:368. [PMID: 39052066 PMCID: PMC11272692 DOI: 10.1007/s00432-024-05891-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 07/12/2024] [Indexed: 07/27/2024]
Abstract
PURPOSE This systematic review aims to investigate the role of nuclear imaging techniques in detecting incidentalomas and their impact on patient management. METHODS Following PRISMA guidelines, a comprehensive literature search was conducted from February to May 2022. Studies in English involving patients undergoing nuclear medicine studies with incidental tumor findings were included. Data on imaging modalities, incidentaloma characteristics, management changes, and follow-up were extracted and analyzed. RESULTS Ninety-two studies involving 64.884 patients were included. Incidentalomas were detected in 611 cases (0.9%), with thyroid being the most common site. PET/CT with FDG and choline tracers showed the highest incidentaloma detection rates. Detection of incidentalomas led to a change in therapeutic strategy in 59% of cases. Various radiotracers demonstrated high sensitivity for incidentaloma detection, particularly in neuroendocrine tumors and prostate cancer. CONCLUSION Nuclear imaging techniques play a crucial role in detecting incidentalomas, leading to significant changes in patient management. The high sensitivity of these modalities highlights their potential in routine oncology follow-up protocols. Future directions may include enhancing spatial resolution and promoting theranostic approaches for improved patient care.
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Affiliation(s)
- Roberta Costanzo
- Department of Biomedicine Neurosciences and Advanced Diagnostics, Neurosurgical Clinic, AOUP "Paolo Giaccone", School of Medicine, University of Palermo, Palermo, Italy
| | - Gianluca Scalia
- Neurosurgery Unit, Department of Head and Neck Surgery, Garibaldi Hospital, Catania, Italy.
| | - Lidia Strigari
- Department of Medical Physics, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Massimiliano Ippolito
- Department of Advanced Technologies, Nuclear Medicine and PET, Cannizzaro Hospital, Catania, Italy
| | - Federica Paolini
- Department of Biomedicine Neurosciences and Advanced Diagnostics, Neurosurgical Clinic, AOUP "Paolo Giaccone", School of Medicine, University of Palermo, Palermo, Italy
| | - Lara Brunasso
- Department of Biomedicine Neurosciences and Advanced Diagnostics, Neurosurgical Clinic, AOUP "Paolo Giaccone", School of Medicine, University of Palermo, Palermo, Italy
| | - Andrea Sciortino
- Department of Biomedicine Neurosciences and Advanced Diagnostics, Neurosurgical Clinic, AOUP "Paolo Giaccone", School of Medicine, University of Palermo, Palermo, Italy
| | - Domenico Gerardo Iacopino
- Department of Biomedicine Neurosciences and Advanced Diagnostics, Neurosurgical Clinic, AOUP "Paolo Giaccone", School of Medicine, University of Palermo, Palermo, Italy
| | - Rosario Maugeri
- Department of Biomedicine Neurosciences and Advanced Diagnostics, Neurosurgical Clinic, AOUP "Paolo Giaccone", School of Medicine, University of Palermo, Palermo, Italy
| | - Gianluca Ferini
- Radiation Oncology Unit, REM Radioterapia Srl, Viagrande, Italy
| | - Anna Viola
- Radiation Oncology Unit, REM Radioterapia Srl, Viagrande, Italy
| | | | - Sebastiano Cosentino
- Department of Advanced Technologies, Nuclear Medicine and PET, Cannizzaro Hospital, Catania, Italy
| | - Giuseppe E Umana
- Department of Neurosurgery, Trauma and Gamma-Knife Center, Cannizzaro Hospital, Catania, Italy
- Department of Medicine and Surgery, Kore University of Enna, Enna, Italy
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Roland A, Drouet C, Boulahdour H, Cochet A, De Bari B. Unusual uptakes on 18F-fluorocholine positron emission tomography/computed tomography (PET/CT): a retrospective study of 368 prostate cancer patients referred for a biochemical recurrence or an initial staging. Quant Imaging Med Surg 2021; 11:172-182. [PMID: 33392020 DOI: 10.21037/qims-19-981] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background 18F-fluorocholine positron emission tomography/computed tomography (F-choline PET/CT) is considered a cornerstone in the staging and restaging of patients with prostate cancer (PCa). The aim of this study was to retrospectively assess unusual uptakes in patients who underwent a F-choline PET/CT for the initial staging or for the restaging of a relapsing PCa. Methods Three hundred and sixty-eight PCa patients were staged or restaged using F-choline PET/CT. Unusual uptakes were defined as uptakes occurring outside the usual paths of diffusion of PCa or as uptake in bone with a clear morphological evidence of nonmetastatic lesion. Results We found unusual uptakes in 47/368 patients (12.8%). Among them, 41/47 presented with benign F-choline uptake, usually within lymph nodes, due to inflammatory processes (22/47). Other benign processes were found in: thyroid (3/47), adrenal gland (3/47), brain (2/47), liver (1/47), bowel (3/47), frontal sinus (1/47), lungs (4/47), parotid gland (1/47) and bone (1/47). The six remaining patients presented with a second cancer, including lymphoma (1/47), non-small cell lung cancer (4/47) and neuroendocrine tumor (1/47). Conclusions unusual uptakes on F-choline PET/CT are quite frequent and should be explored since they may correspond to non-PCa.
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Affiliation(s)
- Antoine Roland
- Nuclear Medicine Department, University Hospital of Besançon, Besançon, France
| | - Clément Drouet
- Department of Nuclear Medicine, Georges-François Leclerc Cancer Center, Dijon, France
| | - Hatem Boulahdour
- Nuclear Medicine Department, University Hospital of Besançon, Besançon, France
| | - Alexandre Cochet
- Department of Nuclear Medicine, Georges-François Leclerc Cancer Center, Dijon, France.,ImViA EA 7535, University of Burgundy, Dijon, France
| | - Berardino De Bari
- Radiation Oncology Department, University Hospital of Besançon, Besançon, France
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Xia Y, Wang Z, Zhao Y, Liu H, Chen Y. Valor incremental de la PET/TC con 18F-fluorocolina en comparación con la PET/TC con 68Ga-DOTA en la localización de adenoma suprarrenal en paciente con MEN1. Rev Esp Med Nucl Imagen Mol 2020; 39:45-46. [DOI: 10.1016/j.remn.2019.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 03/20/2019] [Accepted: 03/25/2019] [Indexed: 11/28/2022]
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Welle CL, Cullen EL, Peller PJ, Lowe VJ, Murphy RC, Johnson GB, Binkovitz LA. ¹¹C-Choline PET/CT in Recurrent Prostate Cancer and Nonprostatic Neoplastic Processes. Radiographics 2016; 36:279-92. [PMID: 26761541 DOI: 10.1148/rg.2016150135] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Choline positron emission tomography (PET)/computed tomography (CT), with both carbon 11 ((11)C) choline and fluorine 18 ((18)F) choline, is an increasingly used tool in the evaluation of patients with biochemically recurrent prostate cancer. It has allowed detection and localization of locally recurrent and metastatic lesions that were difficult or impossible to identify using more conventional modalities. Many of the patients followed for their prostate cancer are elderly and have a higher rate of nonprostate cancer lesions or malignancies. As our experience with choline PET/CT has grown, it has become apparent that many of these nonprostate cancer processes, both benign and malignant, can be detected. Invasive thymoma, renal cell carcinoma, papillary thyroid carcinoma, and parathyroid adenoma are a few of the processes that have been incidentally detected with (11)C-choline PET/CT at our institution and have significantly altered subsequent clinical management of the patient. Although most of the secondary lesions are detected due to their increased (11)C-choline avidity, several have been detected due to their decreased or lack of avidity in the background of a highly avid organ. For instance, large liver masses that are relatively non-choline-avid create large activity defects in the otherwise highly active liver. Familiarity with normal (11)C-choline physiologic activity, the most common prostate metastatic patterns, and imaging characteristics of secondary lesions is essential for the detection and correct diagnosis of such lesions so that proper follow-up and management can be recommended.
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Affiliation(s)
- Christopher L Welle
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905-0002 (C.L.W., E.L.C., V.J.L., R.C.M., G.B.J., L.A.B.); and Eka Medical Center-Jakarta, BSD City, Tangerang, Indonesia (P.J.P.)
| | - Ethany L Cullen
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905-0002 (C.L.W., E.L.C., V.J.L., R.C.M., G.B.J., L.A.B.); and Eka Medical Center-Jakarta, BSD City, Tangerang, Indonesia (P.J.P.)
| | - Patrick J Peller
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905-0002 (C.L.W., E.L.C., V.J.L., R.C.M., G.B.J., L.A.B.); and Eka Medical Center-Jakarta, BSD City, Tangerang, Indonesia (P.J.P.)
| | - Val J Lowe
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905-0002 (C.L.W., E.L.C., V.J.L., R.C.M., G.B.J., L.A.B.); and Eka Medical Center-Jakarta, BSD City, Tangerang, Indonesia (P.J.P.)
| | - Robert C Murphy
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905-0002 (C.L.W., E.L.C., V.J.L., R.C.M., G.B.J., L.A.B.); and Eka Medical Center-Jakarta, BSD City, Tangerang, Indonesia (P.J.P.)
| | - Geoffrey B Johnson
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905-0002 (C.L.W., E.L.C., V.J.L., R.C.M., G.B.J., L.A.B.); and Eka Medical Center-Jakarta, BSD City, Tangerang, Indonesia (P.J.P.)
| | - Larry A Binkovitz
- From the Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905-0002 (C.L.W., E.L.C., V.J.L., R.C.M., G.B.J., L.A.B.); and Eka Medical Center-Jakarta, BSD City, Tangerang, Indonesia (P.J.P.)
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