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Al-Ibraheem A, Allouzi S, Abdlkadir AS, Mikhail-Lette M, Al-Rabi K, Ma'koseh M, Knoll P, Abdelrhman Z, Shahin O, Juweid ME, Paez D, Lopci E. PET/CT in leukemia: utility and future directions. Nucl Med Commun 2024:00006231-990000000-00289. [PMID: 38646840 DOI: 10.1097/mnm.0000000000001846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
2-Deoxy-2-[18F]fluoro-d-glucose PET/computed tomography ([18F]FDG PET/CT) has proven to be a sensitive method for the detection and evaluation of hematologic malignancies, especially lymphoma. The increasing incidence and mortality rates of leukemia have raised significant concerns. Through the utilization of whole-body imaging, [18F]FDG PET/CT provides a thorough assessment of the entire bone marrow, complementing the limited insights provided by biopsy samples. In this regard, [18F]FDG PET/CT has the ability to assess diverse types of leukemia The utilization of [18F]FDG PET/CT has been found to be effective in evaluating leukemia spread beyond the bone marrow, tracking disease relapse, identifying Richter's transformation, and assessing the inflammatory activity associated with acute graft versus host disease. However, its role in various clinical scenarios in leukemia remains unacknowledged. Despite their less common use, some novel PET/CT radiotracers are being researched for potential use in specific scenarios in leukemia patients. Therefore, the objectives of this review are to provide a thorough assessment of the current applications of [18F]FDG PET/CT in the staging and monitoring of leukemia patients, as well as the potential for an expanding role of PET/CT in leukemia patients.
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Affiliation(s)
- Akram Al-Ibraheem
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC)
- Department of Radiology and Nuclear Medicine, School of Medicine, University of Jordan, Amman, Jordan
| | - Sudqi Allouzi
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC)
| | | | - Miriam Mikhail-Lette
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Kamal Al-Rabi
- Department of Medical Oncology, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Mohammad Ma'koseh
- Department of Medical Oncology, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Peter Knoll
- Dosimetry and Medical Radiation Physics Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Zaid Abdelrhman
- Department of Medical Oncology, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Omar Shahin
- Department of Medical Oncology, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Malik E Juweid
- Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan
| | - Diana Paez
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Egesta Lopci
- Department of Nuclear Medicine, IRCCS - Humanitas Clinical and Research Hospital, Rozzano (MI), Italy
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Piccardo A, Treglia G, Fiz F, Bar-Sever Z, Bottoni G, Biassoni L, Borgwardt L, de Keizer B, Jehanno N, Lopci E, Kurch L, Massollo M, Nadel H, Roca Bielsa I, Shulkin B, Vali R, De Palma D, Cecchin D, Santos AI, Zucchetta P. The evidence-based role of catecholaminergic PET tracers in Neuroblastoma. A systematic review and a head-to-head comparison with mIBG scintigraphy. Eur J Nucl Med Mol Imaging 2024; 51:756-767. [PMID: 37962616 PMCID: PMC10796700 DOI: 10.1007/s00259-023-06486-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/21/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Molecular imaging is pivotal in staging and response assessment of children with neuroblastoma (NB). [123I]-metaiodobenzylguanidine (mIBG) is the standard imaging method; however, it is characterised by low spatial resolution, time-consuming acquisition procedures and difficult interpretation. Many PET catecholaminergic radiotracers have been proposed as a replacement for [123I]-mIBG, however they have not yet made it into clinical practice. We aimed to review the available literature comparing head-to-head [123I]-mIBG with the most common PET catecholaminergic radiopharmaceuticals. METHODS We searched the PubMed database for studies performing a head-to-head comparison between [123I]-mIBG and PET radiopharmaceuticals including meta-hydroxyephedrine ([11C]C-HED), 18F-18F-3,4-dihydroxyphenylalanine ([18F]DOPA) [124I]mIBG and Meta-[18F]fluorobenzylguanidine ([18F]mFBG). Review articles, preclinical studies, small case series (< 5 subjects), case reports, and articles not in English were excluded. From each study, the following characteristics were extracted: bibliographic information, technical parameters, and the sensitivity of the procedure according to a patient-based analysis (PBA) and a lesion-based analysis (LBA). RESULTS Ten studies were selected: two regarding [11C]C-HED, four [18F]DOPA, one [124I]mIBG, and three [18F]mFBG. These studies included 181 patients (range 5-46). For the PBA, the superiority of the PET method was reported in two out of ten studies (both using [18F]DOPA). For LBA, PET detected significantly more lesions than scintigraphy in seven out of ten studies. CONCLUSIONS PET/CT using catecholaminergic tracers shows superior diagnostic performance than mIBG scintigraphy. However, it is still unknown if such superiority can influence clinical decision-making. Nonetheless, the PET examination appears promising for clinical practice as it offers faster image acquisition, less need for sedation, and a single-day examination.
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Affiliation(s)
- Arnoldo Piccardo
- Department of Nuclear Medicine, E.O. "Ospedali Galliera", Mura Delle Cappuccine 14, 16128, Genoa, Italy.
| | - Giorgio Treglia
- Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
| | - Francesco Fiz
- Department of Nuclear Medicine, E.O. "Ospedali Galliera", Mura Delle Cappuccine 14, 16128, Genoa, Italy
- Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital, Tübingen, Germany
| | - Zvi Bar-Sever
- Department of Nuclear Medicine, Schneider Children's Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Gianluca Bottoni
- Department of Nuclear Medicine, E.O. "Ospedali Galliera", Mura Delle Cappuccine 14, 16128, Genoa, Italy
| | - Lorenzo Biassoni
- Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Lise Borgwardt
- Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Bart de Keizer
- Department of Nuclear Medicine and Radiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Nina Jehanno
- Department of Nuclear Medicine, Institut Curie Paris, Paris, France
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS-Humanitas Research Hospital, Rozzano, Milano, Italy
| | - Lars Kurch
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Michela Massollo
- Department of Nuclear Medicine, E.O. "Ospedali Galliera", Mura Delle Cappuccine 14, 16128, Genoa, Italy
| | - Helen Nadel
- Department of Pediatric Nuclear Medicine, Lucile Packard Children's Hospital of Stanford (CA), Palo Alto, USA
| | | | - Barry Shulkin
- St Jude Children's Research Hospital, Memphis, TN, USA
| | - Reza Vali
- Division of Nuclear Medicine, Department of Diagnostic Imaging, The Hospital for Sick Children of Toronto, Toronto, Canada
| | - Diego De Palma
- Nuclear Medicine Unit, Ospedale Di Circolo of Varese, Varese, Italy
| | - Diego Cecchin
- Nuclear Medicine Unit, Department of Medicine - DIMED, University Hospital of Padova, Padua, Italy
| | - Ana Isabel Santos
- Department of Nuclear Medicine, Hospital Garcia de Orta, Almada, Portugal
| | - Pietro Zucchetta
- Nuclear Medicine Unit, Department of Medicine - DIMED, University Hospital of Padova, Padua, Italy
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Abstract
In the last years, PSMA-PET imaging and multiparametric MRI (mpMRI) have improved the clinical management of prostate cancer (PCa) patients. Currently, mpMRI is recommended by the EAU (European Association of Urology) guidelines for the primary diagnosis of PCa, whereas PSMA-PET is reserved for disease staging, particularly in high risk localized or locally advanced disease, as well as for biochemical recurrence after surgery. Nevertheless, several studies have explored the added value of PSMA-PET in other clinical scenarios, including primary diagnosis and especially for the detection of clinically significant PCa (csPCa). In the present contribution, we will provide an overview and an update on the current literature on imaging detection of csPCa, with a particular focus on mpMRI, PSMA-PET and their comparison.
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Affiliation(s)
- Matteo Caracciolo
- Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy
| | - Angelo Castello
- Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS - Humanitas Research Hospital, Rozzano, Milan, Italy.
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4
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De Re V, Lopci E, Brisotto G, Elia C, Mussolin L, Mascarin M, d’Amore ESG. Preliminary Study of the Relationship between Osteopontin and Relapsed Hodgkin's Lymphoma. Biomedicines 2023; 12:31. [PMID: 38275392 PMCID: PMC10813762 DOI: 10.3390/biomedicines12010031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 01/27/2024] Open
Abstract
The primary objective of this study was to investigate the potential role of tissue osteopontin, also known as secreted phosphoprotein 1 (SPP1), as a contributing factor to an unfavorable prognosis in classical Hodgkin's lymphoma (HL) patients who received the same treatment protocol. The study involved 44 patients aged 4-22 years, with a median follow-up period of 3 years. Patients with higher levels of SPP1 were associated with tissue necrosis and inflammation, and there was a trend toward a poorer prognosis in this group. Before therapy, we found a correlation between positron emission tomography (PET) scans and logarithmic SPP1 levels (p = 0.035). However, the addition of SPP1 levels did not significantly enhance the predictive capacity of PET scans for recurrence or progression. Elevated SPP levels were associated with tissue mRNA counts of chemotactic and inflammatory chemokines, as well as specific monocyte/dendritic cell subtypes, defined by IL-17RB, PLAUR, CXCL8, CD1A, CCL13, TREM1, and CCL24 markers. These findings contribute to a better understanding of the potential factors influencing the prognosis of HL patients and the potential role of SPP1 in the disease. While the predictive accuracy of PET scans did not substantially improve during the study, the results underscore the complexity of HL and highlight the relationships between SPP1 and other factors in the context of HL relapse.
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Affiliation(s)
- Valli De Re
- Immunopatologia e Biomarcatori Oncologici, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico, IRCCS, 33081 Aviano, Italy
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS—Humanitas Research Hospital, Rozzano, 20089 Milano, Italy
| | - Giulia Brisotto
- Immunopatologia e Biomarcatori Oncologici, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico, IRCCS, 33081 Aviano, Italy
| | - Caterina Elia
- AYA Oncology and Pediatric Radiotherapy Unit, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico, IRCCS, 33081 Aviano, Italy
| | - Lara Mussolin
- Pediatric Hemato-Oncology Unit, Department of Women’s and Children’s Health, University of Padua, 35122 Padua, Italy
- Clinica di Oncoematologia Pediatrica, Azienda Ospedaliera—Università di Padova, 35128 Padova, Italy
| | - Maurizio Mascarin
- AYA Oncology and Pediatric Radiotherapy Unit, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico, IRCCS, 33081 Aviano, Italy
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Linguanti F, Abenavoli EM, Calabretta R, Berti V, Lopci E. ImmunoPET Targeting Receptor Tyrosine Kinase: Clinical Applications. Cancers (Basel) 2023; 15:5886. [PMID: 38136430 PMCID: PMC10741542 DOI: 10.3390/cancers15245886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023] Open
Abstract
Receptor tyrosine kinases, or RTKs, are one large family of cell surface receptors involved in signal transduction, which represent an integral part of the signaling pathways. They play a crucial role in most important cellular processes, starting with the cell cycle, proliferation and differentiation, as well as cell migration, metabolism and survival. The introduction of ImmunoPET evaluating the expression of RTKs by specific monoclonal antibodies (mAbs) or antibody fragments is regarded as a promising tool for imaging treatment efficacy and developing anticancer therapeutics. Our review focuses mainly on the current clinical research regarding ImmunoPET targeting RTKs, with particular interest in the epidermal growth factor family, or HER family, and vascular endothelial-derived growth factor/receptor.
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Affiliation(s)
- Flavia Linguanti
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy; (F.L.); (V.B.)
- Nuclear Medicine Department, Ospedale San Donato, 52100 Arezzo, Italy
| | | | - Raffaella Calabretta
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria
| | - Valentina Berti
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy; (F.L.); (V.B.)
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS—Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
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Higgins H, Nakhla A, Lotfalla A, Khalil D, Doshi P, Thakkar V, Shirini D, Bebawy M, Ammari S, Lopci E, Schwartz LH, Postow M, Dercle L. Recent Advances in the Field of Artificial Intelligence for Precision Medicine in Patients with a Diagnosis of Metastatic Cutaneous Melanoma. Diagnostics (Basel) 2023; 13:3483. [PMID: 37998619 PMCID: PMC10670510 DOI: 10.3390/diagnostics13223483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/27/2023] [Accepted: 10/31/2023] [Indexed: 11/25/2023] Open
Abstract
Standard-of-care medical imaging techniques such as CT, MRI, and PET play a critical role in managing patients diagnosed with metastatic cutaneous melanoma. Advancements in artificial intelligence (AI) techniques, such as radiomics, machine learning, and deep learning, could revolutionize the use of medical imaging by enhancing individualized image-guided precision medicine approaches. In the present article, we will decipher how AI/radiomics could mine information from medical images, such as tumor volume, heterogeneity, and shape, to provide insights into cancer biology that can be leveraged by clinicians to improve patient care both in the clinic and in clinical trials. More specifically, we will detail the potential role of AI in enhancing detection/diagnosis, staging, treatment planning, treatment delivery, response assessment, treatment toxicity assessment, and monitoring of patients diagnosed with metastatic cutaneous melanoma. Finally, we will explore how these proof-of-concept results can be translated from bench to bedside by describing how the implementation of AI techniques can be standardized for routine adoption in clinical settings worldwide to predict outcomes with great accuracy, reproducibility, and generalizability in patients diagnosed with metastatic cutaneous melanoma.
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Affiliation(s)
- Hayley Higgins
- Department of Clinical Medicine, Touro College of Osteopathic Medicine, Middletown, NY 10940, USA; (A.L.); (M.B.)
| | - Abanoub Nakhla
- Department of Clinical Medicine, American University of the Caribbean School of Medicine, 33027 Cupecoy, Sint Maarten, The Netherlands;
| | - Andrew Lotfalla
- Department of Clinical Medicine, Touro College of Osteopathic Medicine, Middletown, NY 10940, USA; (A.L.); (M.B.)
| | - David Khalil
- Department of Clinical Medicine, Campbell University School of Osteopathic Medicine, Lillington, NC 27546, USA; (D.K.); (P.D.); (V.T.)
| | - Parth Doshi
- Department of Clinical Medicine, Campbell University School of Osteopathic Medicine, Lillington, NC 27546, USA; (D.K.); (P.D.); (V.T.)
| | - Vandan Thakkar
- Department of Clinical Medicine, Campbell University School of Osteopathic Medicine, Lillington, NC 27546, USA; (D.K.); (P.D.); (V.T.)
| | - Dorsa Shirini
- Department of Radiology, Shahid Beheshti University of Medical Sciences, Tehran 1981619573, Iran;
| | - Maria Bebawy
- Department of Clinical Medicine, Touro College of Osteopathic Medicine, Middletown, NY 10940, USA; (A.L.); (M.B.)
| | - Samy Ammari
- Département d’Imagerie Médicale Biomaps, UMR1281 INSERM, CEA, CNRS, Gustave Roussy, Université Paris-Saclay, 94800 Villejuif, France;
- ELSAN Département de Radiologie, Institut de Cancérologie Paris Nord, 95200 Sarcelles, France
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy;
| | - Lawrence H. Schwartz
- Department of Radiology, New York-Presbyterian, Columbia University Irving Medical Center, New York, NY 10032, USA;
| | - Michael Postow
- Melanoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Weill Cornell Medical College, New York, NY 10065, USA
| | - Laurent Dercle
- Department of Radiology, Shahid Beheshti University of Medical Sciences, Tehran 1981619573, Iran;
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7
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Al-Ibraheem A, Abdlkadir AS, Shagera QA, Saraireh O, Al-Adhami D, Al-Rashdan R, Anwar F, Moghrabi S, Mohamad I, Muylle K, Estrada E, Paez D, Mansour A, Lopci E. The Diagnostic and Predictive Value of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Laryngeal Squamous Cell Carcinoma. Cancers (Basel) 2023; 15:5461. [PMID: 38001720 PMCID: PMC10670341 DOI: 10.3390/cancers15225461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/11/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023] Open
Abstract
This retrospective study examines the diagnostic accuracy of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and neck magnetic resonance imaging (MRI) in detecting nodal metastasis for patients with laryngeal squamous cell carcinoma (LSCC) and assesses the predictive values of metabolic and structural features derived from 18F-FDG PET/CT. By involving 66 patients from 2014 to 2021, the sensitivity and specificity of both modalities were calculated. 18F-FDG PET/CT outperforms neck MRI for nodal disease detection, with 89% sensitivity, 65% specificity, and 77% accuracy for nodal metastasis (p = 0.03). On the other hand, neck MRI had 66% sensitivity, 62% specificity, and 64% accuracy. Approximately 11% of patients witnessed a change in their therapy intent when relying on 18F-FDG PET/CT nodal staging results. Analyzing the cohort for PET-derived metabolic and morphological parameters, a total of 167 lymph nodes (LN) were visualized. Parameters such as the LN maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and LN size were computed. Logistic regression and receiver operating characteristic (ROC) analyses were performed. Among the 167 identified cervical LNs, 111 were histopathologically confirmed as positive. ROC analysis revealed the highest area under the curve for LN MTV (0.89; p < 0.01), followed by LN size (0.87; p < 0.01). Both MTV and LN size independently predicted LN metastasis through multivariate analysis. In addition, LN MTV can reliably predict false-positive LNs in preoperative staging, offering a promising imaging-based approach for further exploration.
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Affiliation(s)
- Akram Al-Ibraheem
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman 11941, Jordan; (A.S.A.); (D.A.-A.); (F.A.)
- School of Medicine, University of Jordan, Amman 11942, Jordan
| | - Ahmed Saad Abdlkadir
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman 11941, Jordan; (A.S.A.); (D.A.-A.); (F.A.)
| | - Qaid Ahmed Shagera
- Nuclear Medicine Department, Institut Jules Bordet, Erasme Hospital, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, 1070 Brussels, Belgium;
| | - Omar Saraireh
- Department of Surgical Oncology, King Hussein Cancer Center (KHCC), Amman 11941, Jordan;
| | - Dhuha Al-Adhami
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman 11941, Jordan; (A.S.A.); (D.A.-A.); (F.A.)
| | - Rakan Al-Rashdan
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman 11941, Jordan; (A.S.A.); (D.A.-A.); (F.A.)
| | - Farah Anwar
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman 11941, Jordan; (A.S.A.); (D.A.-A.); (F.A.)
- Department of Nuclear Medicine, Warith International Cancer Institute, Karbala 56001, Iraq
| | - Serin Moghrabi
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman 11941, Jordan; (A.S.A.); (D.A.-A.); (F.A.)
| | - Issa Mohamad
- Department of Radiation Oncology, King Hussein Cancer Center (KHCC), Amman 11941, Jordan;
| | - Kristoff Muylle
- Department of Nuclear Medicine, AZ Delta, 8800 Roeselare, Belgium;
| | - Enrique Estrada
- Nuclear Medicine and Diagnostic Imaging Section, Department of Nuclear Sciences and Applications, International Atomic Energy Agency (IAEA), 6CM8+ Vienna, Austria; (E.E.); (D.P.)
| | - Diana Paez
- Nuclear Medicine and Diagnostic Imaging Section, Department of Nuclear Sciences and Applications, International Atomic Energy Agency (IAEA), 6CM8+ Vienna, Austria; (E.E.); (D.P.)
| | - Asem Mansour
- Department of Diagnostic Radiology, King Hussein Cancer Center (KHCC), Amman 11941, Jordan
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS, Humanitas Clinical and Research Hospital, Via Manzoni56, 20089 Milan, Italy;
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8
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Prendergast CM, Lopci E, Seban RD, De Jong D, Ammari S, Aneja S, Lévy A, Sajan A, Salvatore MM, Cappacione KM, Schwartz LH, Deutsch E, Dercle L. Integrating [ 18F]-Fluorodeoxyglucose Positron Emission Tomography with Computed Tomography with Radiation Therapy and Immunomodulation in Precision Therapy for Solid Tumors. Cancers (Basel) 2023; 15:5179. [PMID: 37958353 PMCID: PMC10648321 DOI: 10.3390/cancers15215179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 11/15/2023] Open
Abstract
[18F]-FDG positron emission tomography with computed tomography (PET/CT) imaging is widely used to enhance the quality of care in patients diagnosed with cancer. Furthermore, it holds the potential to offer insight into the synergic effect of combining radiation therapy (RT) with immuno-oncological (IO) agents. This is achieved by evaluating treatment responses both at the RT and distant tumor sites, thereby encompassing the phenomenon known as the abscopal effect. In this context, PET/CT can play an important role in establishing timelines for RT/IO administration and monitoring responses, including novel patterns such as hyperprogression, oligoprogression, and pseudoprogression, as well as immune-related adverse events. In this commentary, we explore the incremental value of PET/CT to enhance the combination of RT with IO in precision therapy for solid tumors, by offering supplementary insights to recently released joint guidelines.
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Affiliation(s)
- Conor M. Prendergast
- Department of Radiology, NewYork-Presbyterian, Columbia University Irving Medical Center, New York, NY 10032, USA (M.M.S.); (K.M.C.)
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS—Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Romain-David Seban
- Department of Nuclear Medicine, Institut Curie, 92210 Saint-Cloud, France
- Laboratory of Translational Imaging in Oncology, Inserm, Institut Curie, 91401 Orsay, France
| | - Dorine De Jong
- RefleXion Medical, Inc., Hayward, CA 94545, USA
- Center for Cell Engineering, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Samy Ammari
- Department of Medical Imaging, Institut Gustave Roussy, 94805 Villejuif, France
| | - Sanjay Aneja
- Department of Radiation Oncology, Smilow Cancer Hospital, Yale School of Medicine, New Haven, CT 06519, USA
| | - Antonin Lévy
- Department of Radiation Oncology, Gustave Roussy, 94805 Villejuif, France
| | - Abin Sajan
- Department of Radiology, NewYork-Presbyterian, Columbia University Irving Medical Center, New York, NY 10032, USA (M.M.S.); (K.M.C.)
| | - Mary M. Salvatore
- Department of Radiology, NewYork-Presbyterian, Columbia University Irving Medical Center, New York, NY 10032, USA (M.M.S.); (K.M.C.)
| | - Kathleen M. Cappacione
- Department of Radiology, NewYork-Presbyterian, Columbia University Irving Medical Center, New York, NY 10032, USA (M.M.S.); (K.M.C.)
| | - Lawrence H. Schwartz
- Department of Radiology, NewYork-Presbyterian, Columbia University Irving Medical Center, New York, NY 10032, USA (M.M.S.); (K.M.C.)
| | - Eric Deutsch
- Department of Radiation Oncology, Gustave Roussy, 94805 Villejuif, France
| | - Laurent Dercle
- Department of Radiology, NewYork-Presbyterian, Columbia University Irving Medical Center, New York, NY 10032, USA (M.M.S.); (K.M.C.)
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9
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Holzgreve A, Unterrainer M, Calais J, Adams T, Oprea-Lager DE, Goffin K, Lopci E, Unterrainer LM, Kramer KKM, Schmidt-Hegemann NS, Casuscelli J, Stief CG, Ricke J, Bartenstein P, Kunz WG, Mehrens D. Is PSMA PET/CT cost-effective for the primary staging in prostate cancer? First results for European countries and the USA based on the proPSMA trial. Eur J Nucl Med Mol Imaging 2023; 50:3750-3754. [PMID: 37428216 PMCID: PMC10547650 DOI: 10.1007/s00259-023-06332-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/04/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE The proPSMA trial at ten Australian centers demonstrated increased sensitivity and specificity for PSMA PET/CT compared to conventional imaging regarding metastatic status in primary high-risk prostate cancer patients. A cost-effectiveness analysis showed benefits of PSMA PET/CT over conventional imaging for the Australian setting. However, comparable data for other countries are lacking. Therefore, we aimed to verify the cost-effectiveness of PSMA PET/CT in several European countries as well as the USA. METHODS Clinical data on diagnostic accuracy were derived from the proPSMA trial. Costs for PSMA PET/CT and conventional imaging were taken from reimbursements of national health systems and individual billing information of selected centers in Belgium, Germany, Italy, the Netherlands, and the USA. For comparability, scan duration and the decision tree of the analysis were adopted from the Australian cost-effectiveness study. RESULTS In contrast to the Australian setting, PSMA PET/CT was primarily associated with increased costs in the studied centers in Europe and the USA. Mainly, the scan duration had an impact on the cost-effectiveness. However, costs for an accurate diagnosis using PSMA PET/CT seemed reasonably low compared to the potential consequential costs of an inaccurate diagnosis. CONCLUSION We assume that the use of PSMA PET/CT is appropriate from a health economic perspective, but this will need to be verified by a prospective evaluation of patients at initial diagnosis.
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Affiliation(s)
- Adrien Holzgreve
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany.
| | - Marcus Unterrainer
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Jérémie Calais
- Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, UCLA, California, Los Angeles, USA
| | - Thaiza Adams
- Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, UCLA, California, Los Angeles, USA
| | - Daniela E Oprea-Lager
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Karolien Goffin
- Division of Nuclear Medicine, University Hospital Leuven and KU Leuven, Leuven, Belgium
| | - Egesta Lopci
- Nuclear Medicine Department, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy
| | - Lena M Unterrainer
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, UCLA, California, Los Angeles, USA
| | - Kristina K M Kramer
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
| | | | | | - Christian G Stief
- Department of Urology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Jens Ricke
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Wolfgang G Kunz
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Dirk Mehrens
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
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10
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McGale J, Hama J, Yeh R, Vercellino L, Sun R, Lopci E, Ammari S, Dercle L. Artificial Intelligence and Radiomics: Clinical Applications for Patients with Advanced Melanoma Treated with Immunotherapy. Diagnostics (Basel) 2023; 13:3065. [PMID: 37835808 PMCID: PMC10573034 DOI: 10.3390/diagnostics13193065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/01/2023] [Accepted: 09/06/2023] [Indexed: 10/15/2023] Open
Abstract
Immunotherapy has greatly improved the outcomes of patients with metastatic melanoma. However, it has also led to new patterns of response and progression, creating an unmet need for better biomarkers to identify patients likely to achieve a lasting clinical benefit or experience immune-related adverse events. In this study, we performed a focused literature survey covering the application of artificial intelligence (AI; in the form of radiomics, machine learning, and deep learning) to patients diagnosed with melanoma and treated with immunotherapy, reviewing 12 studies relevant to the topic published up to early 2022. The most commonly investigated imaging modality was CT imaging in isolation (n = 9, 75.0%), while patient cohorts were most frequently recruited retrospectively and from single institutions (n = 7, 58.3%). Most studies concerned the development of AI tools to assist in prognostication (n = 5, 41.7%) or the prediction of treatment response (n = 6, 50.0%). Validation methods were disparate, with two studies (16.7%) performing no validation and equal numbers using cross-validation (n = 3, 25%), a validation set (n = 3, 25%), or a test set (n = 3, 25%). Only one study used both validation and test sets (n = 1, 8.3%). Overall, promising results have been observed for the application of AI to immunotherapy-treated melanoma. Further improvement and eventual integration into clinical practice may be achieved through the implementation of rigorous validation using heterogeneous, prospective patient cohorts.
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Affiliation(s)
- Jeremy McGale
- Department of Radiology, New York-Presbyterian Hospital, New York, NY 10032, USA
| | - Jakob Hama
- Queens Hospital Center, Icahn School of Medicine at Mt. Sinai, Queens, NY 10029, USA
| | - Randy Yeh
- Molecular Imaging and Therapy Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Laetitia Vercellino
- Nuclear Medicine Department, INSERM UMR S942, Hôpital Saint-Louis, Assistance-Publique, Hôpitaux de Paris, Université Paris Cité, 75010 Paris, France
| | - Roger Sun
- Department of Radiation Oncology, Gustave Roussy, 94800 Villejuif, France
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS—Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Samy Ammari
- Department of Medical Imaging, BIOMAPS, UMR1281 INSERM, CEA, CNRS, Gustave Roussy, Université Paris-Saclay, 94800 Villejuif, France
- ELSAN Department of Radiology, Institut de Cancérologie Paris Nord, 95200 Sarcelles, France
| | - Laurent Dercle
- Department of Radiology, New York-Presbyterian Hospital, New York, NY 10032, USA
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11
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Caracciolo M, Castello A, Urso L, Borgia F, Marzola MC, Uccelli L, Cittanti C, Bartolomei M, Castellani M, Lopci E. Comparison of MRI vs. [ 18F]FDG PET/CT for Treatment Response Evaluation of Primary Breast Cancer after Neoadjuvant Chemotherapy: Literature Review and Future Perspectives. J Clin Med 2023; 12:5355. [PMID: 37629397 PMCID: PMC10455346 DOI: 10.3390/jcm12165355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/11/2023] [Accepted: 08/12/2023] [Indexed: 08/27/2023] Open
Abstract
The purpose of this systematic review was to investigate the diagnostic accuracy of [18F]FDG PET/CT and breast MRI for primary breast cancer (BC) response assessment after neoadjuvant chemotherapy (NAC) and to evaluate future perspectives in this setting. We performed a critical review using three bibliographic databases (i.e., PubMed, Scopus, and Web of Science) for articles published up to the 6 June 2023, starting from 2012. The Quality Assessment of Diagnosis Accuracy Study (QUADAS-2) tool was adopted to evaluate the risk of bias. A total of 76 studies were identified and screened, while 14 articles were included in our systematic review after a full-text assessment. The total number of patients included was 842. Eight out of fourteen studies (57.1%) were prospective, while all except one study were conducted in a single center. In the majority of the included studies (71.4%), 3.0 Tesla (T) MRI scans were adopted. Three out of fourteen studies (21.4%) used both 1.5 and 3.0 T MRI and only two used 1.5 T. [18F]FDG was the radiotracer used in every study included. All patients accepted surgical treatment after NAC and each study used pathological complete response (pCR) as the reference standard. Some of the studies have demonstrated the superiority of [18F]FDG PET/CT, while others proved that MRI was superior to PET/CT. Recent studies indicate that PET/CT has a better specificity, while MRI has a superior sensitivity for assessing pCR in BC patients after NAC. The complementary value of the combined use of these modalities represents probably the most important tool to improve diagnostic performance in this setting. Overall, larger prospective studies, possibly randomized, are needed, hopefully evaluating PET/MR and allowing for new tools, such as radiomic parameters, to find a proper place in the setting of BC patients undergoing NAC.
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Affiliation(s)
- Matteo Caracciolo
- Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, 44124 Ferrara, Italy
| | - Angelo Castello
- Nuclear Medicine Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Luca Urso
- Department of Nuclear Medicine PET/CT Centre, S. Maria della Misericordia Hospital, 45100 Rovigo, Italy
| | - Francesca Borgia
- Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, 44124 Ferrara, Italy
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
| | - Maria Cristina Marzola
- Department of Nuclear Medicine PET/CT Centre, S. Maria della Misericordia Hospital, 45100 Rovigo, Italy
| | - Licia Uccelli
- Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, 44124 Ferrara, Italy
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
| | - Corrado Cittanti
- Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, 44124 Ferrara, Italy
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
| | - Mirco Bartolomei
- Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, 44124 Ferrara, Italy
| | - Massimo Castellani
- Nuclear Medicine Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS—Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
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12
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Pasquier D, Bidaut L, Oprea-Lager DE, deSouza NM, Krug D, Collette L, Kunz W, Belkacemi Y, Bau MG, Caramella C, De Geus-Oei LF, De Caluwé A, Deroose C, Gheysens O, Herrmann K, Kindts I, Kontos M, Kümmel S, Linderholm B, Lopci E, Meattini I, Smeets A, Kaidar-Person O, Poortmans P, Tsoutsou P, Hajjaji N, Russell N, Senkus E, Talbot JN, Umutlu L, Vandecaveye V, Verhoeff JJC, van Oordt WMVDH, Zacho HD, Cardoso F, Fournier L, Van Duijnhoven F, Lecouvet FE. Designing clinical trials based on modern imaging and metastasis-directed treatments in patients with oligometastatic breast cancer: a consensus recommendation from the EORTC Imaging and Breast Cancer Groups. Lancet Oncol 2023; 24:e331-e343. [PMID: 37541279 DOI: 10.1016/s1470-2045(23)00286-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 06/06/2023] [Accepted: 06/09/2023] [Indexed: 08/06/2023]
Abstract
Breast cancer remains the most common cause of cancer death among women. Despite its considerable histological and molecular heterogeneity, those characteristics are not distinguished in most definitions of oligometastatic disease and clinical trials of oligometastatic breast cancer. After an exhaustive review of the literature covering all aspects of oligometastatic breast cancer, 35 experts from the European Organisation for Research and Treatment of Cancer Imaging and Breast Cancer Groups elaborated a Delphi questionnaire aimed at offering consensus recommendations, including oligometastatic breast cancer definition, optimal diagnostic pathways, and clinical trials required to evaluate the effect of diagnostic imaging strategies and metastasis-directed therapies. The main recommendations are the introduction of modern imaging methods in metastatic screening for an earlier diagnosis of oligometastatic breast cancer and the development of prospective trials also considering the histological and molecular complexity of breast cancer. Strategies for the randomisation of imaging methods and therapeutic approaches in different subsets of patients are also addressed.
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Affiliation(s)
- David Pasquier
- Academic Department of Radiation Oncology, Centre Oscar Lambret, Lille, France; University of Lille and CNRS, Centrale Lille, UMR 9189-CRIStAL, Lille, France.
| | - Luc Bidaut
- College of Science, University of Lincoln, Lincoln, UK
| | - Daniela Elena Oprea-Lager
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Nandita M deSouza
- The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - David Krug
- Department of Radiation Oncology, Universitaetsklinikum Schleswig-Holstein-Campus Kiel, Kiel, Germany
| | - Laurence Collette
- Former European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - Wolfgang Kunz
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Yazid Belkacemi
- AP-HP, Radiation Oncology Department, Henri Mondor University Hospital, Créteil, France; INSERM Unit 955 (-Bio), IMRB, University of Paris-Est (UPEC), Créteil, France
| | - Maria Grazia Bau
- Azienda Ospedaliera Città della Salute e della Scienza di Torino, Ospedale Sant'Anna, Turin, Italy
| | - Caroline Caramella
- Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - Lioe-Fee De Geus-Oei
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands; Biomedical Photonic Imaging Group, University of Twente, Enschede, Netherlands; Department of Radiation Science and Technology, Delft University of Technology, Delft, Netherlands
| | - Alex De Caluwé
- Radiotherapy Department, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Olivier Gheysens
- Department of Nuclear Medicine, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, Institut du Cancer Roi Albert II, UCLouvain, Brussels, Belgium
| | - Ken Herrmann
- Department of Nuclear Medicine, University of Duisburg-Essen, Essen, Germany; German Cancer Consortium (DKTK), University Hospital Essen, Essen, Germany
| | - Isabelle Kindts
- Department of Radiation Oncology, Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium
| | - Michalis Kontos
- National and Kapodistrian University of Athens, Athens, Greece
| | - Sherko Kümmel
- Breast Unit, Kliniken Essen-Mitte, Essen, Germany; Charité - Universitätsmedizin Berlin, Department of Gynecology with Breast Center, Berlin, Germany
| | - Barbro Linderholm
- Department of Oncolgy, Sahlgrenska University Hospital, Gothenburg, Sweden; Institution of Clinical Sciences, Department of Oncology, Sahlgrenska Academy at Gothenburg University, Gothenburg , Sweden
| | | | - Icro Meattini
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy; Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Ann Smeets
- Department of Surgical Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Orit Kaidar-Person
- Oncology Institute, Sheba Tel Hashomer, Ramat Gan, Israel; Tel-Aviv University, Tel-Aviv, Israel
| | - Philip Poortmans
- Department of Radiation Oncology, Iridium Netwerk, Antwerp, Belgium; University of Antwerp, Antwerp, Belgium
| | - Pelagia Tsoutsou
- Hôpitaux Universitaires de Genève, Site de Cluse-Roseraie, Geneva, Switzerland
| | - Nawale Hajjaji
- Medical Oncology Department, Centre Oscar Lambret, Lille, France; Laboratoire Protéomique, Réponse Inflammatoire, et Spectrométrie De Masse (PRISM), Inserm U1192, Lille, France
| | - Nicola Russell
- Department of Radiotherapy, The Netherlands Cancer Institute-Antoni Van Leeuwenhoekziekenhuis, Amsterdam, Netherlands
| | | | - Jean-Noël Talbot
- Institut National des Sciences et Techniques Nucléaires, CEA-Saclay, Paris, France
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | | | - Joost J C Verhoeff
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Helle D Zacho
- Department of Nuclear Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Fatima Cardoso
- Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, Lisbon, Portugal
| | - Laure Fournier
- Université Paris Descartes Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Frederieke Van Duijnhoven
- Department of Surgical Oncology, The Netherlands Cancer Institute-Antoni Van Leeuwenhoekziekenhuis, Amsterdam, Netherlands
| | - Frédéric E Lecouvet
- Department of Radiology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, Institut du Cancer Roi Albert II, UCLouvain, Brussels, Belgium
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13
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Lopci E, Mascarin M. Role of volumetric analyses on [ 18F]FDG PET/CT in pediatric Hodgkin lymphoma. Expert Rev Hematol 2023; 16:629-631. [PMID: 37453051 DOI: 10.1080/17474086.2023.2238125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/10/2023] [Accepted: 07/14/2023] [Indexed: 07/18/2023]
Affiliation(s)
- Egesta Lopci
- Nuclear Medicine, IRCCS - Humanitas Research Hospital, Rozzano, MI, Italy
| | - Maurizio Mascarin
- AYA Oncology and Pediatric Radiotherapy Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, PN, Italy
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14
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Nanni C, Kobe C, Baeßler B, Baues C, Boellaard R, Borchmann P, Buck A, Buvat I, Chapuy B, Cheson BD, Chrzan R, Cottereau AS, Dührsen U, Eikenes L, Hutchings M, Jurczak W, Kraeber-Bodéré F, Lopci E, Luminari S, MacLennan S, Mikhaeel NG, Nijland M, Rodríguez-Otero P, Treglia G, Withofs N, Zamagni E, Zinzani PL, Zijlstra JM, Herrmann K, Kunikowska J. European Association of Nuclear Medicine (EANM) Focus 4 consensus recommendations: molecular imaging and therapy in haematological tumours. Lancet Haematol 2023; 10:e367-e381. [PMID: 37142345 DOI: 10.1016/s2352-3026(23)00030-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/23/2022] [Accepted: 01/18/2023] [Indexed: 05/06/2023]
Abstract
Given the paucity of high-certainty evidence, and differences in opinion on the use of nuclear medicine for hematological malignancies, we embarked on a consensus process involving key experts in this area. We aimed to assess consensus within a panel of experts on issues related to patient eligibility, imaging techniques, staging and response assessment, follow-up, and treatment decision-making, and to provide interim guidance by our expert consensus. We used a three-stage consensus process. First, we systematically reviewed and appraised the quality of existing evidence. Second, we generated a list of 153 statements based on the literature review to be agreed or disagreed with, with an additional statement added after the first round. Third, the 154 statements were scored by a panel of 26 experts purposively sampled from authors of published research on haematological tumours on a 1 (strongly disagree) to 9 (strongly agree) Likert scale in a two-round electronic Delphi review. The RAND and University of California Los Angeles appropriateness method was used for analysis. Between one and 14 systematic reviews were identified on each topic. All were rated as low to moderate quality. After two rounds of voting, there was consensus on 139 (90%) of 154 of the statements. There was consensus on most statements concerning the use of PET in non-Hodgkin and Hodgkin lymphoma. In multiple myeloma, more studies are required to define the optimal sequence for treatment assessment. Furthermore, nuclear medicine physicians and haematologists are awaiting consistent literature to introduce volumetric parameters, artificial intelligence, machine learning, and radiomics into routine practice.
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Affiliation(s)
- Cristina Nanni
- Medicina Nucleare, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
| | - Carsten Kobe
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Bettina Baeßler
- Institute of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany
| | - Christian Baues
- Department of Radiooncology, Radiotherapy and CyberKnife Center, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - Ronald Boellaard
- Radiology & Nuclear Medicine, Amsterdam UMC, VUMC Cancer Center Amsterdam, Amsterdam, Netherlands; Nuclear Medicine & Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Peter Borchmann
- Department of Haematology and Oncology, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - Andreas Buck
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Irène Buvat
- Laboratory of Translational Imaging in Oncology, Institut Curie, Inserm, PSL University, Orsay, France
| | - Björn Chapuy
- Department of Hematology, Oncology and Tumorimmunology, Charité University Medical Center Berlin, Benjamin Franklin Campus, Berlin, Germany
| | | | - Robert Chrzan
- Department of Radiology, Jagiellonian University Medical College, Krakow, Poland
| | | | - Ulrich Dührsen
- Klinik für Hämatologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Germany
| | - Live Eikenes
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Martin Hutchings
- Department of Haematology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Wojciech Jurczak
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Kraków, Poland
| | - Françoise Kraeber-Bodéré
- Service de Médecine Nucléaire, University Hospital Hôtel-Dieu, Nantes, France; CRCI2NA, INSERM, CNRS, Université d'Angers, Nantes Université, Nantes, France
| | - Egesta Lopci
- Nuclear Medicine, IRCCS-Humanitas Research Hospital, Milan, Italy
| | - Stefano Luminari
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine Department, University of Modena and Reggio Emilia, Reggio Emilia, Italy; Hematology Unit, Azienda USL IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Steven MacLennan
- Academic Urology Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - N George Mikhaeel
- Department of Clinical Oncology, Guy's Cancer Centre, Guy's and St Thomas' NHS Trust, London, UK; School of Cancer & Pharmaceutical Sciences, King's College, University of London, London, UK
| | - Marcel Nijland
- Department of Hematology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | | | - Giorgio Treglia
- Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; Faculty of Biomedical sciences, Università della Svizzera italiana, Lugano, Switzerland; Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Nadia Withofs
- Division of Nuclear Medicine and Oncological Imaging, Department of Medical Physics, CHU of Liege, Liege, Belgium; GIGA-CRC In Vivo Imaging, University of Liege, Liege, Belgium
| | - Elena Zamagni
- Istituto di Ematologia "Seràgnoli", IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Pier Luigi Zinzani
- Istituto di Ematologia "Seràgnoli", IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Josée M Zijlstra
- Department of Hematology, Amsterdam UMC, VUMC Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Ken Herrmann
- Department of Nuclear Medicine, University of Duisburg-Essen, Essen, Germany; German Cancer Consortium (DKTK), University Hospital Essen, Essen, Germany
| | - Jolanta Kunikowska
- Department of Nuclear Medicine, Medical University of Warsaw, Warsaw, Poland
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15
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Urso L, Bonatto E, Nieri A, Castello A, Maffione AM, Marzola MC, Cittanti C, Bartolomei M, Panareo S, Mansi L, Lopci E, Florimonte L, Castellani M. The Role of Molecular Imaging in Patients with Brain Metastases: A Literature Review. Cancers (Basel) 2023; 15:cancers15072184. [PMID: 37046845 PMCID: PMC10093739 DOI: 10.3390/cancers15072184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/28/2023] [Accepted: 04/03/2023] [Indexed: 04/14/2023] Open
Abstract
Over the last several years, molecular imaging has gained a primary role in the evaluation of patients with brain metastases (BM). Therefore, the "Response Assessment in Neuro-Oncology" (RANO) group recommends amino acid radiotracers for the assessment of BM. Our review summarizes the current use of positron emission tomography (PET) radiotracers in patients with BM, ranging from present to future perspectives with new PET radiotracers, including the role of radiomics and potential theranostics approaches. A comprehensive search of PubMed results was conducted. All studies published in English up to and including December 2022 were reviewed. Current evidence confirms the important role of amino acid PET radiotracers for the delineation of BM extension, for the assessment of response to therapy, and particularly for the differentiation between tumor progression and radionecrosis. The newer radiotracers explore non-invasively different biological tumor processes, although more consistent findings in larger clinical trials are necessary to confirm preliminary results. Our review illustrates the role of molecular imaging in patients with BM. Along with magnetic resonance imaging (MRI), the gold standard for diagnosis of BM, PET is a useful complementary technique for processes that otherwise cannot be obtained from anatomical MRI alone.
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Affiliation(s)
- Luca Urso
- Department of Nuclear Medicine PET/CT Centre, S. Maria della Misericordia Hospital, 45100 Rovigo, Italy
| | - Elena Bonatto
- Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Alberto Nieri
- Nuclear Medicine Unit, Oncological Medical and Specialist Department, University Hospital of Ferrara, 44124 Cona, Italy
| | - Angelo Castello
- Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Anna Margherita Maffione
- Department of Nuclear Medicine PET/CT Centre, S. Maria della Misericordia Hospital, 45100 Rovigo, Italy
| | - Maria Cristina Marzola
- Department of Nuclear Medicine PET/CT Centre, S. Maria della Misericordia Hospital, 45100 Rovigo, Italy
| | - Corrado Cittanti
- Nuclear Medicine Unit, Oncological Medical and Specialist Department, University Hospital of Ferrara, 44124 Cona, Italy
- Department of Translational Medicine, University of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
| | - Mirco Bartolomei
- Nuclear Medicine Unit, Oncological Medical and Specialist Department, University Hospital of Ferrara, 44124 Cona, Italy
| | - Stefano Panareo
- Nuclear Medicine Unit, Oncology and Haematology Department, University Hospital of Modena, 41125 Modena, Italy
| | - Luigi Mansi
- Interuniversity Research Center for the Sustainable Development (CIRPS), 00152 Rome, Italy
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS-Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
| | - Luigia Florimonte
- Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Massimo Castellani
- Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
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16
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Prendergast CM, Capaccione KM, Lopci E, Das JP, Shoushtari AN, Yeh R, Amin D, Dercle L, De Jong D. More than Just Skin-Deep: A Review of Imaging's Role in Guiding CAR T-Cell Therapy for Advanced Melanoma. Diagnostics (Basel) 2023; 13:992. [PMID: 36900136 PMCID: PMC10000712 DOI: 10.3390/diagnostics13050992] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 03/08/2023] Open
Abstract
Advanced melanoma is one of the deadliest cancers, owing to its invasiveness and its propensity to develop resistance to therapy. Surgery remains the first-line treatment for early-stage tumors but is often not an option for advanced-stage melanoma. Chemotherapy carries a poor prognosis, and despite advances in targeted therapy, the cancer can develop resistance. CAR T-cell therapy has demonstrated great success against hematological cancers, and clinical trials are deploying it against advanced melanoma. Though melanoma remains a challenging disease to treat, radiology will play an increasing role in monitoring both the CAR T-cells and response to therapy. We review the current imaging techniques for advanced melanoma, as well as novel PET tracers and radiomics, in order to guide CAR T-cell therapy and manage potential adverse events.
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Affiliation(s)
- Conor M. Prendergast
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Kathleen M. Capaccione
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Egesta Lopci
- Department of Nuclear Medicine, IRCSS Humanitas Research Hospital, 20089 Milan, Italy
| | - Jeeban P. Das
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | | | - Randy Yeh
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Daniel Amin
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Laurent Dercle
- Department of Radiology, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Dorine De Jong
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
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17
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Mangas Losada M, Romero Robles L, Mendoza Melero A, García Megías I, Villanueva Torres A, Garrastachu Zumarán P, Boulvard Chollet X, Lopci E, Ramírez Lasanta R, Delgado Bolton RC. [ 18F]FDG PET/CT in the Evaluation of Melanoma Patients Treated with Immunotherapy. Diagnostics (Basel) 2023; 13:978. [PMID: 36900122 PMCID: PMC10000458 DOI: 10.3390/diagnostics13050978] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/25/2023] [Accepted: 03/01/2023] [Indexed: 03/08/2023] Open
Abstract
Immunotherapy is based on manipulation of the immune system in order to act against tumour cells, with growing evidence especially in melanoma patients. The challenges faced by this new therapeutic tool are (i) finding valid evaluation criteria for response assessment; (ii) knowing and distinguishing between "atypical" response patterns; (iii) using PET biomarkers as predictive and response evaluation parameters and (iv) diagnosis and management of immunorelated adverse effects. This review is focused on melanoma patients analysing (a) the role of [18F]FDG PET/CT in the mentioned challenges; (b) the evidence of its efficacy. For this purpose, we performed a review of the literature, including original and review articles. In summary, although there are no clearly established or globally accepted criteria, modified response criteria are potentially appropriate for evaluation of immunotherapy benefit. In this context, [18F]FDG PET/CT biomarkers appear to be promising parameters in prediction and assessment of response to immunotherapy. Moreover, immunorelated adverse effects are recognized as predictors of early response to immunotherapy and may be associated with better prognosis and clinical benefit.
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Affiliation(s)
- María Mangas Losada
- Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja (CIBIR), 26006 Logroño, Spain
| | - Leonardo Romero Robles
- Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja (CIBIR), 26006 Logroño, Spain
| | - Alejandro Mendoza Melero
- Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja (CIBIR), 26006 Logroño, Spain
| | - Irene García Megías
- Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja (CIBIR), 26006 Logroño, Spain
| | - Amós Villanueva Torres
- Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja (CIBIR), 26006 Logroño, Spain
| | - Puy Garrastachu Zumarán
- Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja (CIBIR), 26006 Logroño, Spain
| | - Xavier Boulvard Chollet
- Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja (CIBIR), 26006 Logroño, Spain
| | - Egesta Lopci
- Nuclear Medicine, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Rafael Ramírez Lasanta
- Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja (CIBIR), 26006 Logroño, Spain
| | - Roberto C. Delgado Bolton
- Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja (CIBIR), 26006 Logroño, Spain
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18
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Dercle L, Sun S, Seban RD, Mekki A, Sun R, Tselikas L, Hans S, Bernard-Tessier A, Bouvier FM, Aide N, Vercellino L, Rivas A, Girard A, Mokrane FZ, Manson G, Houot R, Lopci E, Yeh R, Ammari S, Schwartz LH. Emerging and Evolving Concepts in Cancer Immunotherapy Imaging. Radiology 2023; 306:e239003. [PMID: 36803004 DOI: 10.1148/radiol.239003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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19
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Lopci E, Castello A, Filippi L. Novelties from the Joint EANM/SNMMI/ANZSNM Guidelines on Immunotherapy. Cancer Biother Radiopharm 2023; 38:211-215. [PMID: 36730788 DOI: 10.1089/cbr.2022.0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
In the past decade, the implementation of immunotherapy with checkpoint inhibitors has determined a major change in the management of oncological patients. The challenges associated to the new therapeutic regimen have promoted adapted criteria for response assessment to interpret imaging findings and atypical patterns of response. Parallel to the new morphological criteria, also 18fluoro-deoxyglucose positron emission/computed tomography imaging has required novel approaches and specific guidelines on how to perform, interpret, and report the scan in patients with solid tumors under immune checkpoint inhibitors therapy. A summary of the novelties related to the new joint international European Association of Nuclear Medicine (EANM)/Society of Nuclear Medicine and Molecular Imaging (SNMMI)/Australian and New Zealand Society of Nuclear Medicine (ANZSNM) guidelines on immunotherapy is provided herein to elucidate most critical aspects in image interpretation.
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Affiliation(s)
- Egesta Lopci
- Nuclear Medicine Unit, IRCCS-Humanitas Research Hospital, Rozzano, Italy
| | - Angelo Castello
- Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Luca Filippi
- Department of Nuclear Medicine, Santa Maria Goretti Hospital, Latina, Italy
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20
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Lopci E, Lazzeri M, Disconzi L, Maffei D, Fasulo V, Avolio P, Paciotti M, Pasini L, Benetti A, Hurle R, Saita A, Colombo P, Marzo K, Leonardi L, Balzarini L, Chiti A, Guazzoni G, Casale P, Buffi N, Lughezzani G. Prospective comparison of PSMA PET/CT vs. mpMRI in patients with a high suspicion of prostate cancer and previously negative biopsy: Preliminary data from PROSPET-BX trial. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01013-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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21
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Lopci E, Lazzeri M, Colombo P, Casale P, Buffi NM, Saita A, Peschechera R, Hurle R, Marzo K, Leonardi L, Morenghi E, Balzarini L, Disconzi L, Guazzoni G, Chiti A, Lughezzani G. Diagnostic Performance and Clinical Impact of PSMA PET/CT versus mpMRI in Patients with a High Suspicion of Prostate Cancer and Previously Negative Biopsy: A Prospective Trial (PROSPET-BX). Urol Int 2023; 107:433-439. [PMID: 36724746 DOI: 10.1159/000528720] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 12/12/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND This prospective single-arm study is designed to compare in parallel 68Ga-PSMA PET/TRUS (transrectal or transperineal) fusion biopsy ("experimental test") with multiparametric MRI (mpMRI)/TRUS fusion prostate biopsy ("standard test") in men with a high suspicion of prostate cancer (PCa) after at least one negative biopsy. The primary objective was to evaluate the diagnostic performance of 68Ga-PSMA PET/TRUS fusion prostate biopsy in comparison to mpMRI/TRUS fusion prostate biopsy analyzed in parallel. Secondarily, we aimed to determine the relationship between the "experimental test" and the histopathological characteristics of the specimen, along with the clinical utility of the "experimental test" compared to the "standard test." SUMMARY To test the superiority of 68Ga-PSMA PET/CT compared to mpMRI, we will enroll a minimum cohort of 128 patients. Inclusion criteria comprise: age >18 years; blood PSA level >4.0 ng/mL; free-to-total PSA ratio <20%; progressive rise of PSA levels in two consecutive blood samples despite antibiotics; serum blood tests suspicious for PCa; at least one previous negative biopsy; ASAP and/or high-grade PIN; negative digital rectal examination. All eligible patients will undergo 68Ga-PSMA PET/CT and mpMRI scans within 1 month's distance from each other, followed by biopsy session to be completed within 1 month's distance. Targeted TRUS fusion needle biopsy will be performed for all lesions detected with PET and mpMRI. The total duration of the study is 36 months. KEY MESSAGES By comparing the "experimental test" and the "standard test" in parallel, we will be able to determine the superior diagnostic performance of 68Ga-PSMA PET/CT over mpMRI in detecting PCa, and in particular clinically significant PCa, in the specific cohort of patients with a high suspicion of PCa who are candidates to re-biopsy. The clinical impact of the "experimental test" will be subsequently analyzed in terms of the number of prostate biopsies that could be spared, time-consuming, patient friendliness, and cost-effectiveness.
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Affiliation(s)
- Egesta Lopci
- Nuclear Medicine Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Massimo Lazzeri
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | | | - Paolo Casale
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Nicolo M Buffi
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Alberto Saita
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | | | - Rodolfo Hurle
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Katia Marzo
- Nuclear Medicine Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Lorenzo Leonardi
- Nuclear Medicine Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Emanuela Morenghi
- Biostatistics Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Luca Balzarini
- Department of Radiology, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Luca Disconzi
- Department of Radiology, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Giorgio Guazzoni
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Arturo Chiti
- Nuclear Medicine Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Giovanni Lughezzani
- Nuclear Medicine Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
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22
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Dercle L, Sun S, Seban RD, Mekki A, Sun R, Tselikas L, Hans S, Bernard-Tessier A, Mihoubi Bouvier F, Aide N, Vercellino L, Rivas A, Girard A, Mokrane FZ, Manson G, Houot R, Lopci E, Yeh R, Ammari S, Schwartz LH. Emerging and Evolving Concepts in Cancer Immunotherapy Imaging. Radiology 2023; 306:32-46. [PMID: 36472538 DOI: 10.1148/radiol.210518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Criteria based on measurements of lesion diameter at CT have guided treatment with historical therapies due to the strong association between tumor size and survival. Clinical experience with immune checkpoint modulators shows that editing immune system function can be effective in various solid tumors. Equally, novel immune-related phenomena accompany this novel therapeutic paradigm. These effects of immunotherapy challenge the association of tumor size with response or progression and include risks and adverse events that present new demands for imaging to guide treatment decisions. Emerging and evolving approaches to immunotherapy highlight further key issues for imaging evaluation, such as dissociated response following local administration of immune checkpoint modulators, pseudoprogression due to immune infiltration in the tumor environment, and premature death due to hyperprogression. Research that may offer tools for radiologists to meet these challenges is reviewed. Different modalities are discussed, including immuno-PET, as well as new applications of CT, MRI, and fluorodeoxyglucose PET, such as radiomics and imaging of hematopoietic tissues or anthropometric characteristics. Multilevel integration of imaging and other biomarkers may improve clinical guidance for immunotherapies and provide theranostic opportunities.
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Affiliation(s)
- Laurent Dercle
- From the Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, 630 W 168th St, New York, NY 10032 (L.D., S.S., L.H.S.); Department of Nuclear Medicine, Institut Curie, Paris, France (R.D.S.); DMU Smart Imaging, Department of Medical Imaging, Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Raymond Poincaré Teaching Hospital, Garches, France (A.M.); Gustave Roussy-Centrale Supélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France (R.S.); Radiomics Team, Molecular Radiation Therapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France (R.S.); Departments of Radiation Oncology (R.S.) and Interventional Radiology (L.T.), Gustave Roussy Cancer Campus, Villejuif, France; Department of Oncology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France (S.H.); Drug Development Department (DITEP), Gustave Roussy, Université Paris-Saclay, Villejuif, France (A.B.T.); Department of Radiology, Cochin Hospital, APHP, France (F.M.B.); Department of Nuclear Medicine, University Hospital, INSERM 1199 ANTICIPE, Normandy University, Caen, France (N.A.); Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France (L.V., A.R.); Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, Rennes, France (A.G.); Department of Radiology, Rangueil University Hospital, Toulouse, France (F.Z.M.); Department of Hematology, University Hospital of Rennes, U1236, INSERM, Rennes, France (G.M., R.H.); EANM Oncology Committee, Vienna, Austria (E.L.); Department of Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy (E.L.); Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY (R.Y.); and Department of Medical Imaging, Diagnostic Imaging Service, Gustave Roussy, Université Paris Saclay, Villejuif, France (S.A.)
| | - Shawn Sun
- From the Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, 630 W 168th St, New York, NY 10032 (L.D., S.S., L.H.S.); Department of Nuclear Medicine, Institut Curie, Paris, France (R.D.S.); DMU Smart Imaging, Department of Medical Imaging, Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Raymond Poincaré Teaching Hospital, Garches, France (A.M.); Gustave Roussy-Centrale Supélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France (R.S.); Radiomics Team, Molecular Radiation Therapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France (R.S.); Departments of Radiation Oncology (R.S.) and Interventional Radiology (L.T.), Gustave Roussy Cancer Campus, Villejuif, France; Department of Oncology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France (S.H.); Drug Development Department (DITEP), Gustave Roussy, Université Paris-Saclay, Villejuif, France (A.B.T.); Department of Radiology, Cochin Hospital, APHP, France (F.M.B.); Department of Nuclear Medicine, University Hospital, INSERM 1199 ANTICIPE, Normandy University, Caen, France (N.A.); Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France (L.V., A.R.); Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, Rennes, France (A.G.); Department of Radiology, Rangueil University Hospital, Toulouse, France (F.Z.M.); Department of Hematology, University Hospital of Rennes, U1236, INSERM, Rennes, France (G.M., R.H.); EANM Oncology Committee, Vienna, Austria (E.L.); Department of Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy (E.L.); Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY (R.Y.); and Department of Medical Imaging, Diagnostic Imaging Service, Gustave Roussy, Université Paris Saclay, Villejuif, France (S.A.)
| | - Romain-David Seban
- From the Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, 630 W 168th St, New York, NY 10032 (L.D., S.S., L.H.S.); Department of Nuclear Medicine, Institut Curie, Paris, France (R.D.S.); DMU Smart Imaging, Department of Medical Imaging, Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Raymond Poincaré Teaching Hospital, Garches, France (A.M.); Gustave Roussy-Centrale Supélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France (R.S.); Radiomics Team, Molecular Radiation Therapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France (R.S.); Departments of Radiation Oncology (R.S.) and Interventional Radiology (L.T.), Gustave Roussy Cancer Campus, Villejuif, France; Department of Oncology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France (S.H.); Drug Development Department (DITEP), Gustave Roussy, Université Paris-Saclay, Villejuif, France (A.B.T.); Department of Radiology, Cochin Hospital, APHP, France (F.M.B.); Department of Nuclear Medicine, University Hospital, INSERM 1199 ANTICIPE, Normandy University, Caen, France (N.A.); Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France (L.V., A.R.); Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, Rennes, France (A.G.); Department of Radiology, Rangueil University Hospital, Toulouse, France (F.Z.M.); Department of Hematology, University Hospital of Rennes, U1236, INSERM, Rennes, France (G.M., R.H.); EANM Oncology Committee, Vienna, Austria (E.L.); Department of Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy (E.L.); Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY (R.Y.); and Department of Medical Imaging, Diagnostic Imaging Service, Gustave Roussy, Université Paris Saclay, Villejuif, France (S.A.)
| | - Ahmed Mekki
- From the Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, 630 W 168th St, New York, NY 10032 (L.D., S.S., L.H.S.); Department of Nuclear Medicine, Institut Curie, Paris, France (R.D.S.); DMU Smart Imaging, Department of Medical Imaging, Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Raymond Poincaré Teaching Hospital, Garches, France (A.M.); Gustave Roussy-Centrale Supélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France (R.S.); Radiomics Team, Molecular Radiation Therapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France (R.S.); Departments of Radiation Oncology (R.S.) and Interventional Radiology (L.T.), Gustave Roussy Cancer Campus, Villejuif, France; Department of Oncology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France (S.H.); Drug Development Department (DITEP), Gustave Roussy, Université Paris-Saclay, Villejuif, France (A.B.T.); Department of Radiology, Cochin Hospital, APHP, France (F.M.B.); Department of Nuclear Medicine, University Hospital, INSERM 1199 ANTICIPE, Normandy University, Caen, France (N.A.); Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France (L.V., A.R.); Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, Rennes, France (A.G.); Department of Radiology, Rangueil University Hospital, Toulouse, France (F.Z.M.); Department of Hematology, University Hospital of Rennes, U1236, INSERM, Rennes, France (G.M., R.H.); EANM Oncology Committee, Vienna, Austria (E.L.); Department of Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy (E.L.); Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY (R.Y.); and Department of Medical Imaging, Diagnostic Imaging Service, Gustave Roussy, Université Paris Saclay, Villejuif, France (S.A.)
| | - Roger Sun
- From the Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, 630 W 168th St, New York, NY 10032 (L.D., S.S., L.H.S.); Department of Nuclear Medicine, Institut Curie, Paris, France (R.D.S.); DMU Smart Imaging, Department of Medical Imaging, Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Raymond Poincaré Teaching Hospital, Garches, France (A.M.); Gustave Roussy-Centrale Supélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France (R.S.); Radiomics Team, Molecular Radiation Therapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France (R.S.); Departments of Radiation Oncology (R.S.) and Interventional Radiology (L.T.), Gustave Roussy Cancer Campus, Villejuif, France; Department of Oncology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France (S.H.); Drug Development Department (DITEP), Gustave Roussy, Université Paris-Saclay, Villejuif, France (A.B.T.); Department of Radiology, Cochin Hospital, APHP, France (F.M.B.); Department of Nuclear Medicine, University Hospital, INSERM 1199 ANTICIPE, Normandy University, Caen, France (N.A.); Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France (L.V., A.R.); Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, Rennes, France (A.G.); Department of Radiology, Rangueil University Hospital, Toulouse, France (F.Z.M.); Department of Hematology, University Hospital of Rennes, U1236, INSERM, Rennes, France (G.M., R.H.); EANM Oncology Committee, Vienna, Austria (E.L.); Department of Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy (E.L.); Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY (R.Y.); and Department of Medical Imaging, Diagnostic Imaging Service, Gustave Roussy, Université Paris Saclay, Villejuif, France (S.A.)
| | - Lambros Tselikas
- From the Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, 630 W 168th St, New York, NY 10032 (L.D., S.S., L.H.S.); Department of Nuclear Medicine, Institut Curie, Paris, France (R.D.S.); DMU Smart Imaging, Department of Medical Imaging, Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Raymond Poincaré Teaching Hospital, Garches, France (A.M.); Gustave Roussy-Centrale Supélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France (R.S.); Radiomics Team, Molecular Radiation Therapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France (R.S.); Departments of Radiation Oncology (R.S.) and Interventional Radiology (L.T.), Gustave Roussy Cancer Campus, Villejuif, France; Department of Oncology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France (S.H.); Drug Development Department (DITEP), Gustave Roussy, Université Paris-Saclay, Villejuif, France (A.B.T.); Department of Radiology, Cochin Hospital, APHP, France (F.M.B.); Department of Nuclear Medicine, University Hospital, INSERM 1199 ANTICIPE, Normandy University, Caen, France (N.A.); Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France (L.V., A.R.); Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, Rennes, France (A.G.); Department of Radiology, Rangueil University Hospital, Toulouse, France (F.Z.M.); Department of Hematology, University Hospital of Rennes, U1236, INSERM, Rennes, France (G.M., R.H.); EANM Oncology Committee, Vienna, Austria (E.L.); Department of Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy (E.L.); Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY (R.Y.); and Department of Medical Imaging, Diagnostic Imaging Service, Gustave Roussy, Université Paris Saclay, Villejuif, France (S.A.)
| | - Sophie Hans
- From the Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, 630 W 168th St, New York, NY 10032 (L.D., S.S., L.H.S.); Department of Nuclear Medicine, Institut Curie, Paris, France (R.D.S.); DMU Smart Imaging, Department of Medical Imaging, Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Raymond Poincaré Teaching Hospital, Garches, France (A.M.); Gustave Roussy-Centrale Supélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France (R.S.); Radiomics Team, Molecular Radiation Therapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France (R.S.); Departments of Radiation Oncology (R.S.) and Interventional Radiology (L.T.), Gustave Roussy Cancer Campus, Villejuif, France; Department of Oncology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France (S.H.); Drug Development Department (DITEP), Gustave Roussy, Université Paris-Saclay, Villejuif, France (A.B.T.); Department of Radiology, Cochin Hospital, APHP, France (F.M.B.); Department of Nuclear Medicine, University Hospital, INSERM 1199 ANTICIPE, Normandy University, Caen, France (N.A.); Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France (L.V., A.R.); Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, Rennes, France (A.G.); Department of Radiology, Rangueil University Hospital, Toulouse, France (F.Z.M.); Department of Hematology, University Hospital of Rennes, U1236, INSERM, Rennes, France (G.M., R.H.); EANM Oncology Committee, Vienna, Austria (E.L.); Department of Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy (E.L.); Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY (R.Y.); and Department of Medical Imaging, Diagnostic Imaging Service, Gustave Roussy, Université Paris Saclay, Villejuif, France (S.A.)
| | - Alice Bernard-Tessier
- From the Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, 630 W 168th St, New York, NY 10032 (L.D., S.S., L.H.S.); Department of Nuclear Medicine, Institut Curie, Paris, France (R.D.S.); DMU Smart Imaging, Department of Medical Imaging, Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Raymond Poincaré Teaching Hospital, Garches, France (A.M.); Gustave Roussy-Centrale Supélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France (R.S.); Radiomics Team, Molecular Radiation Therapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France (R.S.); Departments of Radiation Oncology (R.S.) and Interventional Radiology (L.T.), Gustave Roussy Cancer Campus, Villejuif, France; Department of Oncology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France (S.H.); Drug Development Department (DITEP), Gustave Roussy, Université Paris-Saclay, Villejuif, France (A.B.T.); Department of Radiology, Cochin Hospital, APHP, France (F.M.B.); Department of Nuclear Medicine, University Hospital, INSERM 1199 ANTICIPE, Normandy University, Caen, France (N.A.); Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France (L.V., A.R.); Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, Rennes, France (A.G.); Department of Radiology, Rangueil University Hospital, Toulouse, France (F.Z.M.); Department of Hematology, University Hospital of Rennes, U1236, INSERM, Rennes, France (G.M., R.H.); EANM Oncology Committee, Vienna, Austria (E.L.); Department of Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy (E.L.); Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY (R.Y.); and Department of Medical Imaging, Diagnostic Imaging Service, Gustave Roussy, Université Paris Saclay, Villejuif, France (S.A.)
| | - Fadila Mihoubi Bouvier
- From the Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, 630 W 168th St, New York, NY 10032 (L.D., S.S., L.H.S.); Department of Nuclear Medicine, Institut Curie, Paris, France (R.D.S.); DMU Smart Imaging, Department of Medical Imaging, Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Raymond Poincaré Teaching Hospital, Garches, France (A.M.); Gustave Roussy-Centrale Supélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France (R.S.); Radiomics Team, Molecular Radiation Therapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France (R.S.); Departments of Radiation Oncology (R.S.) and Interventional Radiology (L.T.), Gustave Roussy Cancer Campus, Villejuif, France; Department of Oncology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France (S.H.); Drug Development Department (DITEP), Gustave Roussy, Université Paris-Saclay, Villejuif, France (A.B.T.); Department of Radiology, Cochin Hospital, APHP, France (F.M.B.); Department of Nuclear Medicine, University Hospital, INSERM 1199 ANTICIPE, Normandy University, Caen, France (N.A.); Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France (L.V., A.R.); Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, Rennes, France (A.G.); Department of Radiology, Rangueil University Hospital, Toulouse, France (F.Z.M.); Department of Hematology, University Hospital of Rennes, U1236, INSERM, Rennes, France (G.M., R.H.); EANM Oncology Committee, Vienna, Austria (E.L.); Department of Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy (E.L.); Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY (R.Y.); and Department of Medical Imaging, Diagnostic Imaging Service, Gustave Roussy, Université Paris Saclay, Villejuif, France (S.A.)
| | - Nicolas Aide
- From the Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, 630 W 168th St, New York, NY 10032 (L.D., S.S., L.H.S.); Department of Nuclear Medicine, Institut Curie, Paris, France (R.D.S.); DMU Smart Imaging, Department of Medical Imaging, Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Raymond Poincaré Teaching Hospital, Garches, France (A.M.); Gustave Roussy-Centrale Supélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France (R.S.); Radiomics Team, Molecular Radiation Therapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France (R.S.); Departments of Radiation Oncology (R.S.) and Interventional Radiology (L.T.), Gustave Roussy Cancer Campus, Villejuif, France; Department of Oncology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France (S.H.); Drug Development Department (DITEP), Gustave Roussy, Université Paris-Saclay, Villejuif, France (A.B.T.); Department of Radiology, Cochin Hospital, APHP, France (F.M.B.); Department of Nuclear Medicine, University Hospital, INSERM 1199 ANTICIPE, Normandy University, Caen, France (N.A.); Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France (L.V., A.R.); Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, Rennes, France (A.G.); Department of Radiology, Rangueil University Hospital, Toulouse, France (F.Z.M.); Department of Hematology, University Hospital of Rennes, U1236, INSERM, Rennes, France (G.M., R.H.); EANM Oncology Committee, Vienna, Austria (E.L.); Department of Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy (E.L.); Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY (R.Y.); and Department of Medical Imaging, Diagnostic Imaging Service, Gustave Roussy, Université Paris Saclay, Villejuif, France (S.A.)
| | - Laetitia Vercellino
- From the Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, 630 W 168th St, New York, NY 10032 (L.D., S.S., L.H.S.); Department of Nuclear Medicine, Institut Curie, Paris, France (R.D.S.); DMU Smart Imaging, Department of Medical Imaging, Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Raymond Poincaré Teaching Hospital, Garches, France (A.M.); Gustave Roussy-Centrale Supélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France (R.S.); Radiomics Team, Molecular Radiation Therapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France (R.S.); Departments of Radiation Oncology (R.S.) and Interventional Radiology (L.T.), Gustave Roussy Cancer Campus, Villejuif, France; Department of Oncology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France (S.H.); Drug Development Department (DITEP), Gustave Roussy, Université Paris-Saclay, Villejuif, France (A.B.T.); Department of Radiology, Cochin Hospital, APHP, France (F.M.B.); Department of Nuclear Medicine, University Hospital, INSERM 1199 ANTICIPE, Normandy University, Caen, France (N.A.); Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France (L.V., A.R.); Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, Rennes, France (A.G.); Department of Radiology, Rangueil University Hospital, Toulouse, France (F.Z.M.); Department of Hematology, University Hospital of Rennes, U1236, INSERM, Rennes, France (G.M., R.H.); EANM Oncology Committee, Vienna, Austria (E.L.); Department of Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy (E.L.); Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY (R.Y.); and Department of Medical Imaging, Diagnostic Imaging Service, Gustave Roussy, Université Paris Saclay, Villejuif, France (S.A.)
| | - Alexia Rivas
- From the Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, 630 W 168th St, New York, NY 10032 (L.D., S.S., L.H.S.); Department of Nuclear Medicine, Institut Curie, Paris, France (R.D.S.); DMU Smart Imaging, Department of Medical Imaging, Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Raymond Poincaré Teaching Hospital, Garches, France (A.M.); Gustave Roussy-Centrale Supélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France (R.S.); Radiomics Team, Molecular Radiation Therapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France (R.S.); Departments of Radiation Oncology (R.S.) and Interventional Radiology (L.T.), Gustave Roussy Cancer Campus, Villejuif, France; Department of Oncology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France (S.H.); Drug Development Department (DITEP), Gustave Roussy, Université Paris-Saclay, Villejuif, France (A.B.T.); Department of Radiology, Cochin Hospital, APHP, France (F.M.B.); Department of Nuclear Medicine, University Hospital, INSERM 1199 ANTICIPE, Normandy University, Caen, France (N.A.); Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France (L.V., A.R.); Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, Rennes, France (A.G.); Department of Radiology, Rangueil University Hospital, Toulouse, France (F.Z.M.); Department of Hematology, University Hospital of Rennes, U1236, INSERM, Rennes, France (G.M., R.H.); EANM Oncology Committee, Vienna, Austria (E.L.); Department of Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy (E.L.); Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY (R.Y.); and Department of Medical Imaging, Diagnostic Imaging Service, Gustave Roussy, Université Paris Saclay, Villejuif, France (S.A.)
| | - Antoine Girard
- From the Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, 630 W 168th St, New York, NY 10032 (L.D., S.S., L.H.S.); Department of Nuclear Medicine, Institut Curie, Paris, France (R.D.S.); DMU Smart Imaging, Department of Medical Imaging, Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Raymond Poincaré Teaching Hospital, Garches, France (A.M.); Gustave Roussy-Centrale Supélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France (R.S.); Radiomics Team, Molecular Radiation Therapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France (R.S.); Departments of Radiation Oncology (R.S.) and Interventional Radiology (L.T.), Gustave Roussy Cancer Campus, Villejuif, France; Department of Oncology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France (S.H.); Drug Development Department (DITEP), Gustave Roussy, Université Paris-Saclay, Villejuif, France (A.B.T.); Department of Radiology, Cochin Hospital, APHP, France (F.M.B.); Department of Nuclear Medicine, University Hospital, INSERM 1199 ANTICIPE, Normandy University, Caen, France (N.A.); Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France (L.V., A.R.); Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, Rennes, France (A.G.); Department of Radiology, Rangueil University Hospital, Toulouse, France (F.Z.M.); Department of Hematology, University Hospital of Rennes, U1236, INSERM, Rennes, France (G.M., R.H.); EANM Oncology Committee, Vienna, Austria (E.L.); Department of Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy (E.L.); Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY (R.Y.); and Department of Medical Imaging, Diagnostic Imaging Service, Gustave Roussy, Université Paris Saclay, Villejuif, France (S.A.)
| | - Fatima-Zohra Mokrane
- From the Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, 630 W 168th St, New York, NY 10032 (L.D., S.S., L.H.S.); Department of Nuclear Medicine, Institut Curie, Paris, France (R.D.S.); DMU Smart Imaging, Department of Medical Imaging, Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Raymond Poincaré Teaching Hospital, Garches, France (A.M.); Gustave Roussy-Centrale Supélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France (R.S.); Radiomics Team, Molecular Radiation Therapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France (R.S.); Departments of Radiation Oncology (R.S.) and Interventional Radiology (L.T.), Gustave Roussy Cancer Campus, Villejuif, France; Department of Oncology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France (S.H.); Drug Development Department (DITEP), Gustave Roussy, Université Paris-Saclay, Villejuif, France (A.B.T.); Department of Radiology, Cochin Hospital, APHP, France (F.M.B.); Department of Nuclear Medicine, University Hospital, INSERM 1199 ANTICIPE, Normandy University, Caen, France (N.A.); Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France (L.V., A.R.); Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, Rennes, France (A.G.); Department of Radiology, Rangueil University Hospital, Toulouse, France (F.Z.M.); Department of Hematology, University Hospital of Rennes, U1236, INSERM, Rennes, France (G.M., R.H.); EANM Oncology Committee, Vienna, Austria (E.L.); Department of Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy (E.L.); Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY (R.Y.); and Department of Medical Imaging, Diagnostic Imaging Service, Gustave Roussy, Université Paris Saclay, Villejuif, France (S.A.)
| | - Guillaume Manson
- From the Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, 630 W 168th St, New York, NY 10032 (L.D., S.S., L.H.S.); Department of Nuclear Medicine, Institut Curie, Paris, France (R.D.S.); DMU Smart Imaging, Department of Medical Imaging, Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Raymond Poincaré Teaching Hospital, Garches, France (A.M.); Gustave Roussy-Centrale Supélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France (R.S.); Radiomics Team, Molecular Radiation Therapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France (R.S.); Departments of Radiation Oncology (R.S.) and Interventional Radiology (L.T.), Gustave Roussy Cancer Campus, Villejuif, France; Department of Oncology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France (S.H.); Drug Development Department (DITEP), Gustave Roussy, Université Paris-Saclay, Villejuif, France (A.B.T.); Department of Radiology, Cochin Hospital, APHP, France (F.M.B.); Department of Nuclear Medicine, University Hospital, INSERM 1199 ANTICIPE, Normandy University, Caen, France (N.A.); Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France (L.V., A.R.); Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, Rennes, France (A.G.); Department of Radiology, Rangueil University Hospital, Toulouse, France (F.Z.M.); Department of Hematology, University Hospital of Rennes, U1236, INSERM, Rennes, France (G.M., R.H.); EANM Oncology Committee, Vienna, Austria (E.L.); Department of Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy (E.L.); Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY (R.Y.); and Department of Medical Imaging, Diagnostic Imaging Service, Gustave Roussy, Université Paris Saclay, Villejuif, France (S.A.)
| | - Roch Houot
- From the Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, 630 W 168th St, New York, NY 10032 (L.D., S.S., L.H.S.); Department of Nuclear Medicine, Institut Curie, Paris, France (R.D.S.); DMU Smart Imaging, Department of Medical Imaging, Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Raymond Poincaré Teaching Hospital, Garches, France (A.M.); Gustave Roussy-Centrale Supélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France (R.S.); Radiomics Team, Molecular Radiation Therapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France (R.S.); Departments of Radiation Oncology (R.S.) and Interventional Radiology (L.T.), Gustave Roussy Cancer Campus, Villejuif, France; Department of Oncology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France (S.H.); Drug Development Department (DITEP), Gustave Roussy, Université Paris-Saclay, Villejuif, France (A.B.T.); Department of Radiology, Cochin Hospital, APHP, France (F.M.B.); Department of Nuclear Medicine, University Hospital, INSERM 1199 ANTICIPE, Normandy University, Caen, France (N.A.); Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France (L.V., A.R.); Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, Rennes, France (A.G.); Department of Radiology, Rangueil University Hospital, Toulouse, France (F.Z.M.); Department of Hematology, University Hospital of Rennes, U1236, INSERM, Rennes, France (G.M., R.H.); EANM Oncology Committee, Vienna, Austria (E.L.); Department of Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy (E.L.); Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY (R.Y.); and Department of Medical Imaging, Diagnostic Imaging Service, Gustave Roussy, Université Paris Saclay, Villejuif, France (S.A.)
| | - Egesta Lopci
- From the Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, 630 W 168th St, New York, NY 10032 (L.D., S.S., L.H.S.); Department of Nuclear Medicine, Institut Curie, Paris, France (R.D.S.); DMU Smart Imaging, Department of Medical Imaging, Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Raymond Poincaré Teaching Hospital, Garches, France (A.M.); Gustave Roussy-Centrale Supélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France (R.S.); Radiomics Team, Molecular Radiation Therapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France (R.S.); Departments of Radiation Oncology (R.S.) and Interventional Radiology (L.T.), Gustave Roussy Cancer Campus, Villejuif, France; Department of Oncology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France (S.H.); Drug Development Department (DITEP), Gustave Roussy, Université Paris-Saclay, Villejuif, France (A.B.T.); Department of Radiology, Cochin Hospital, APHP, France (F.M.B.); Department of Nuclear Medicine, University Hospital, INSERM 1199 ANTICIPE, Normandy University, Caen, France (N.A.); Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France (L.V., A.R.); Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, Rennes, France (A.G.); Department of Radiology, Rangueil University Hospital, Toulouse, France (F.Z.M.); Department of Hematology, University Hospital of Rennes, U1236, INSERM, Rennes, France (G.M., R.H.); EANM Oncology Committee, Vienna, Austria (E.L.); Department of Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy (E.L.); Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY (R.Y.); and Department of Medical Imaging, Diagnostic Imaging Service, Gustave Roussy, Université Paris Saclay, Villejuif, France (S.A.)
| | - Randy Yeh
- From the Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, 630 W 168th St, New York, NY 10032 (L.D., S.S., L.H.S.); Department of Nuclear Medicine, Institut Curie, Paris, France (R.D.S.); DMU Smart Imaging, Department of Medical Imaging, Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Raymond Poincaré Teaching Hospital, Garches, France (A.M.); Gustave Roussy-Centrale Supélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France (R.S.); Radiomics Team, Molecular Radiation Therapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France (R.S.); Departments of Radiation Oncology (R.S.) and Interventional Radiology (L.T.), Gustave Roussy Cancer Campus, Villejuif, France; Department of Oncology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France (S.H.); Drug Development Department (DITEP), Gustave Roussy, Université Paris-Saclay, Villejuif, France (A.B.T.); Department of Radiology, Cochin Hospital, APHP, France (F.M.B.); Department of Nuclear Medicine, University Hospital, INSERM 1199 ANTICIPE, Normandy University, Caen, France (N.A.); Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France (L.V., A.R.); Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, Rennes, France (A.G.); Department of Radiology, Rangueil University Hospital, Toulouse, France (F.Z.M.); Department of Hematology, University Hospital of Rennes, U1236, INSERM, Rennes, France (G.M., R.H.); EANM Oncology Committee, Vienna, Austria (E.L.); Department of Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy (E.L.); Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY (R.Y.); and Department of Medical Imaging, Diagnostic Imaging Service, Gustave Roussy, Université Paris Saclay, Villejuif, France (S.A.)
| | - Samy Ammari
- From the Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, 630 W 168th St, New York, NY 10032 (L.D., S.S., L.H.S.); Department of Nuclear Medicine, Institut Curie, Paris, France (R.D.S.); DMU Smart Imaging, Department of Medical Imaging, Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Raymond Poincaré Teaching Hospital, Garches, France (A.M.); Gustave Roussy-Centrale Supélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France (R.S.); Radiomics Team, Molecular Radiation Therapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France (R.S.); Departments of Radiation Oncology (R.S.) and Interventional Radiology (L.T.), Gustave Roussy Cancer Campus, Villejuif, France; Department of Oncology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France (S.H.); Drug Development Department (DITEP), Gustave Roussy, Université Paris-Saclay, Villejuif, France (A.B.T.); Department of Radiology, Cochin Hospital, APHP, France (F.M.B.); Department of Nuclear Medicine, University Hospital, INSERM 1199 ANTICIPE, Normandy University, Caen, France (N.A.); Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France (L.V., A.R.); Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, Rennes, France (A.G.); Department of Radiology, Rangueil University Hospital, Toulouse, France (F.Z.M.); Department of Hematology, University Hospital of Rennes, U1236, INSERM, Rennes, France (G.M., R.H.); EANM Oncology Committee, Vienna, Austria (E.L.); Department of Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy (E.L.); Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY (R.Y.); and Department of Medical Imaging, Diagnostic Imaging Service, Gustave Roussy, Université Paris Saclay, Villejuif, France (S.A.)
| | - Lawrence H Schwartz
- From the Department of Radiology, New York Presbyterian Hospital-Columbia University Medical Center, 630 W 168th St, New York, NY 10032 (L.D., S.S., L.H.S.); Department of Nuclear Medicine, Institut Curie, Paris, France (R.D.S.); DMU Smart Imaging, Department of Medical Imaging, Assistance Publique-Hôpitaux de Paris, GH Université Paris-Saclay, Raymond Poincaré Teaching Hospital, Garches, France (A.M.); Gustave Roussy-Centrale Supélec-Therapanacea Centre of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France (R.S.); Radiomics Team, Molecular Radiation Therapy INSERM U1030, Paris-Sud University, Gustave Roussy Cancer Campus, and University of Paris-Saclay, Villejuif, France (R.S.); Departments of Radiation Oncology (R.S.) and Interventional Radiology (L.T.), Gustave Roussy Cancer Campus, Villejuif, France; Department of Oncology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France (S.H.); Drug Development Department (DITEP), Gustave Roussy, Université Paris-Saclay, Villejuif, France (A.B.T.); Department of Radiology, Cochin Hospital, APHP, France (F.M.B.); Department of Nuclear Medicine, University Hospital, INSERM 1199 ANTICIPE, Normandy University, Caen, France (N.A.); Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France (L.V., A.R.); Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, Rennes, France (A.G.); Department of Radiology, Rangueil University Hospital, Toulouse, France (F.Z.M.); Department of Hematology, University Hospital of Rennes, U1236, INSERM, Rennes, France (G.M., R.H.); EANM Oncology Committee, Vienna, Austria (E.L.); Department of Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy (E.L.); Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY (R.Y.); and Department of Medical Imaging, Diagnostic Imaging Service, Gustave Roussy, Université Paris Saclay, Villejuif, France (S.A.)
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Lopci E, Aide N, Dimitrakopoulou-Strauss A, Dercle L, Iravani A, Seban RD, Sachpekidis C, Humbert O, Gheysens O, Glaudemans AWJM, Weber WA, Van den Abbeele AD, Wahl RL, Scott AM, Pandit-Taskar N, Hicks RJ. Perspectives on joint EANM/SNMMI/ANZSNM practice guidelines/procedure standards for [ 18F]FDG PET/CT imaging during immunomodulatory treatments in patients with solid tumors. Cancer Imaging 2022; 22:73. [PMID: 36539908 PMCID: PMC9769012 DOI: 10.1186/s40644-022-00512-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
Response assessment in the context of immunomodulatory treatments represents a major challenge for the medical imaging community and requires a multidisciplinary approach with involvement of oncologists, radiologists, and nuclear medicine specialists. There is evolving evidence that [18F]FDG PET/CT is a useful diagnostic modality for this purpose. The clinical indications for, and the principal aspects of its standardization in this context have been detailed in the recently published "Joint EANM/SNMMI/ANZSNM practice guidelines/procedure standards on recommended use of [18F]FDG PET/CT imaging during immunomodulatory treatments in patients with solid tumors version 1.0". These recommendations arose from a fruitful collaboration between international nuclear medicine societies and experts in cancer treatment. In this perspective, the key elements of the initiative are reported, summarizing the core aspects of the guidelines for radiologists and nuclear medicine physicians. Beyond the previous guidelines, this perspective adds further commentary on how this technology can advance development of novel therapeutic approaches and guide management of individual patients.
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Affiliation(s)
- E. Lopci
- grid.417728.f0000 0004 1756 8807Nuclear Medicine Unit, IRCCS – Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, MI Italy
| | - N. Aide
- grid.411149.80000 0004 0472 0160Nuclear Medicine Department, University Hospital, Caen, France ,grid.460771.30000 0004 1785 9671INSERM ANTICIPE, Normandie University, Caen, France
| | - A. Dimitrakopoulou-Strauss
- grid.7497.d0000 0004 0492 0584Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69210 Heidelberg, Germany
| | - L. Dercle
- grid.239585.00000 0001 2285 2675Department of Radiology, New York Presbyterian, Columbia University Irving Medical Center, New York, NY USA
| | - A. Iravani
- grid.34477.330000000122986657Department of Radiology, The University of Washington, Seattle, USA ,grid.270240.30000 0001 2180 1622Fred Hutchinson Cancer Center, Seattle, USA
| | - R. D. Seban
- grid.418596.70000 0004 0639 6384Department of Nuclear Medicine and Endocrine Oncology, Institut Curie, 92210 Saint-Cloud, France ,Laboratoire d’Imagerie Translationnelle en Oncologie, Inserm, Institut Curie, 91401 Orsay, France
| | - C. Sachpekidis
- grid.7497.d0000 0004 0492 0584Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69210 Heidelberg, Germany
| | - O. Humbert
- grid.460782.f0000 0004 4910 6551Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d’Azur, Nice, France ,grid.460782.f0000 0004 4910 6551TIRO-UMR E 4320, Université Côte d’Azur, Nice, France
| | - O. Gheysens
- grid.48769.340000 0004 0461 6320Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - A. W. J. M. Glaudemans
- grid.4494.d0000 0000 9558 4598Nuclear Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - W. A. Weber
- grid.6936.a0000000123222966Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - A. D. Van den Abbeele
- grid.38142.3c000000041936754XDepartment of Imaging, Dana-Farber Cancer Institute and Department of Radiology, Mass General Brigham Hospitals, Harvard Medical School, Boston, MA USA
| | - R. L. Wahl
- grid.4367.60000 0001 2355 7002Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO USA
| | - A. M. Scott
- grid.410678.c0000 0000 9374 3516Department of Molecular Imaging and Therapy, Austin Health, Studley Rd, Heidelberg, VIC 3084 Australia ,grid.482637.cOlivia Newton-John Cancer Research Institute, Heidelberg, Australia ,grid.1008.90000 0001 2179 088XFaculty of Medicine, University of Melbourne, Melbourne, Australia ,grid.1018.80000 0001 2342 0938School of Cancer Medicine, La Trobe University, Melbourne, Australia
| | - N. Pandit-Taskar
- grid.51462.340000 0001 2171 9952Molecular Imaging and Therapy Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065 USA ,grid.5386.8000000041936877XWeill Cornell Medical College, New York, NY 10065 USA
| | - R. J. Hicks
- grid.1008.90000 0001 2179 088XThe Department of Medicine, St Vincent’s Medical School, the University of Melbourne, Melbourne, Australia
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De Re V, Repetto O, Mussolin L, Brisotto G, Elia C, Lopci E, d’Amore ESG, Burnelli R, Mascarin M. Promising drugs and treatment options for pediatric and adolescent patients with Hodgkin lymphoma. Front Cell Dev Biol 2022; 10:965803. [PMID: 36506094 PMCID: PMC9729954 DOI: 10.3389/fcell.2022.965803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 11/07/2022] [Indexed: 11/25/2022] Open
Abstract
Currently-available therapies for newly-diagnosed pediatric and adolescent patients with Hodgkin lymphoma result in >95% survival at 5 years. Long-term survivors may suffer from long-term treatment-related side effects, however, so the past 20 years have seen clinical trials for children and adolescents with HL gradually abandon the regimens used in adults in an effort to improve this situation. Narrower-field radiotherapy can reduce long-term toxicity while maintaining good tumor control. Various risk-adapted chemo-radiotherapy strategies have been used. Early assessment of tumor response with interim positron emission tomography and/or measuring metabolic tumor volume has been used both to limit RT in patients with favorable characteristics and to adopt more aggressive therapies in patients with a poor response. Most classical Hodgkin's lymphoma relapses occur within 3 years of initial treatment, while relapses occurring 5 years or more after diagnosis are rare. As the outcome for patients with relapsed/refractory classical Hodgkin lymphoma remains unsatisfactory, new drugs have been proposed for its prevention or treatment. This review summarizes the important advances made in recent years in the management of pediatric and adolescent with classical Hodgkin lymphoma, and the novel targeted treatments for relapsed and refractory classical Hodgkin lymphoma.
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Affiliation(s)
- Valli De Re
- Immunopatologia e Biomarcatori Oncologici, Dipartimento di Ricerca e Diagnostica Avanzata dei Tumori, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico, IRCCS, Aviano, Italy,*Correspondence: Valli De Re, ; Maurizio Mascarin,
| | - Ombretta Repetto
- Immunopatologia e Biomarcatori Oncologici, Dipartimento di Ricerca e Diagnostica Avanzata dei Tumori, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico, IRCCS, Aviano, Italy
| | - Lara Mussolin
- Pediatric Hemato-Oncology Unit, Department of Women’s and Children’s Health, University of Padua, Padua, Italy
| | - Giulia Brisotto
- Immunopatologia e Biomarcatori Oncologici, Dipartimento di Ricerca e Diagnostica Avanzata dei Tumori, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico, IRCCS, Aviano, Italy
| | - Caterina Elia
- AYA Oncology and Pediatric Radiotherapy Unit, Centro di Riferimento Oncologico IRCCS, Aviano, Italy
| | - Egesta Lopci
- Nuclear Medicine, IRCCS—Humanitas Research Hospital, Rozzano, MI, Italy
| | | | - Roberta Burnelli
- Pediatric Hematology-Oncology Unit, Azienda Ospedaliera Universitaria, Ospedale Sant’Anna, Ferrara, Italy
| | - Maurizio Mascarin
- AYA Oncology and Pediatric Radiotherapy Unit, Centro di Riferimento Oncologico IRCCS, Aviano, Italy,*Correspondence: Valli De Re, ; Maurizio Mascarin,
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Lopci E, Elia C, Catalfamo B, Burnelli R, De Re V, Mussolin L, Piccardo A, Cistaro A, Borsatti E, Zucchetta P, Bianchi M, Buffardi S, Farruggia P, Garaventa A, Sala A, Vinti L, Mauz-Koerholz C, Mascarin M. Prospective Evaluation of Different Methods for Volumetric Analysis on [ 18F]FDG PET/CT in Pediatric Hodgkin Lymphoma. J Clin Med 2022; 11:jcm11206223. [PMID: 36294544 PMCID: PMC9605658 DOI: 10.3390/jcm11206223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/27/2022] [Accepted: 10/17/2022] [Indexed: 11/30/2022] Open
Abstract
Rationale: Therapy response evaluation by 18F-fluorodeoxyglucose PET/CT (FDG PET) has become a powerful tool for the discrimination of responders from non-responders in pediatric Hodgkin lymphoma (HL). Recently, volumetric analyses have been regarded as a valuable tool for disease prognostication and biological characterization in cancer. Given the multitude of methods available for volumetric analysis in HL, the AIEOP Hodgkin Lymphoma Study Group has designed a prospective analysis of the Italian cohort enrolled in the EuroNet-PHL-C2 trial. Methods: Primarily, the study aimed to compare the different segmentation techniques used for volumetric assessment in HL patients at baseline (PET1) and during therapy: early (PET2) and late assessment (PET3). Overall, 50 patients and 150 scans were investigated for the current analysis. A dedicated software was used to semi-automatically delineate contours of the lesions by using different threshold methods. More specifically, four methods were applied: (1) fixed 41% threshold of the maximum standardized uptake value (SUVmax) within the respective lymphoma site (V41%), (2) fixed absolute SUV threshold of 2.5 (V2.5); (3) SUVmax(lesion)/SUVmean liver >1.5 (Vliver); (4) adaptive method (AM). All parameters obtained from the different methods were analyzed with respect to response. Results: Among the different methods investigated, the strongest correlation was observed between AM and Vliver (rho > 0.9; p < 0.001 for SUVmean, MTV and TLG at all scan timing), along with V2.5 and AM or Vliver (rho 0.98, p < 0.001 for TLG at baseline; rho > 0.9; p < 0.001 for SUVmean, MTV and TLG at PET2 and PET3, respectively). To determine the best segmentation method, we applied logistic regression and correlated different results with Deauville scores at late evaluation. Logistic regression demonstrated that MTV (metabolic tumor volume) and TLG (total lesion glycolysis) computation according to V2.5 and Vliver significantly correlated to response to treatment (p = 0.01 and 0.04 for MTV and 0.03 and 0.04 for TLG, respectively). SUVmean also resulted in significant correlation as absolute value or variation. Conclusions: The best correlation for volumetric analysis was documented for AM and Vliver, followed by V2.5. The volumetric analyses obtained from V2.5 and Vliver significantly correlated to response to therapy, proving to be preferred thresholds in our pediatric HL cohort.
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Affiliation(s)
- Egesta Lopci
- Nuclear Medicine Unit, IRCCS—Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
- Correspondence: or
| | - Caterina Elia
- AYA and Pediatric Radiotherapy Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy
| | - Barbara Catalfamo
- Nuclear Medicine Unit, University Hospital “Mater Domini, 88100 Catanzaro, Italy
| | - Roberta Burnelli
- Pediatric Onco-Hematologic Unit, University Hospital S. Anna, 44121 Ferrara, Italy
| | - Valli De Re
- Immunopathology and Cancer Biomarkers Unit, Department of Translational Research, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy
| | - Lara Mussolin
- Pediatric Hemato-Oncology Clinic, Department of Women’s and Children’s Health, University of Padua, 35128 Padua, Italy
- Institute of Pediatric Research-Fondazione Città della Speranza, 35127 Padua, Italy
| | - Arnoldo Piccardo
- Department of Nuclear Medicine, Galliera Hospital, 16128 Genoa, Italy
| | - Angelina Cistaro
- Nuclear Medicine Division, Salus Alliance Medical, 16128 Genoa, Italy
| | - Eugenio Borsatti
- Nuclear Medicine Department, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy
| | - Pietro Zucchetta
- Nuclear Medicine Department, Padova University Hospital, 35128 Padua, Italy
| | - Maurizio Bianchi
- Onco-Hematology Division, Regina Margherita Hospital, 10126 Torino, Italy
| | - Salvatore Buffardi
- Department of Oncology, Hospital Santobono-Pausilipon, 80123 Naples, Italy
| | - Piero Farruggia
- Department of Pediatric Onco-Hematology, A.R.N.A.S. Ospedali Civico, 90127 Palermo, Italy
| | - Alberto Garaventa
- Pediatric Oncology Unit, I RCCS G.Gaslini Hospital, 16147 Genoa, Italy
| | - Alessandra Sala
- Pediatric Division, Hospital San Gerardo, 20900 Monza, Italy
| | - Luciana Vinti
- Department of Pediatric Hematology and Oncology, Ospedale Bambino Gesù, IRCSS, 00165 Rome, Italy
| | - Christine Mauz-Koerholz
- Pädiatrische Hämatologie und Onkologie, Zentrum für Kinderheilkunde der Justus-Liebig-Universität Gießen, 35392 Giessen, Germany
- Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg, 06120 Halle, Germany
| | - Maurizio Mascarin
- AYA and Pediatric Radiotherapy Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy
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deSouza NM, van der Lugt A, Deroose CM, Alberich-Bayarri A, Bidaut L, Fournier L, Costaridou L, Oprea-Lager DE, Kotter E, Smits M, Mayerhoefer ME, Boellaard R, Caroli A, de Geus-Oei LF, Kunz WG, Oei EH, Lecouvet F, Franca M, Loewe C, Lopci E, Caramella C, Persson A, Golay X, Dewey M, O'Connor JPB, deGraaf P, Gatidis S, Zahlmann G. Standardised lesion segmentation for imaging biomarker quantitation: a consensus recommendation from ESR and EORTC. Insights Imaging 2022; 13:159. [PMID: 36194301 PMCID: PMC9532485 DOI: 10.1186/s13244-022-01287-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lesion/tissue segmentation on digital medical images enables biomarker extraction, image-guided therapy delivery, treatment response measurement, and training/validation for developing artificial intelligence algorithms and workflows. To ensure data reproducibility, criteria for standardised segmentation are critical but currently unavailable. METHODS A modified Delphi process initiated by the European Imaging Biomarker Alliance (EIBALL) of the European Society of Radiology (ESR) and the European Organisation for Research and Treatment of Cancer (EORTC) Imaging Group was undertaken. Three multidisciplinary task forces addressed modality and image acquisition, segmentation methodology itself, and standards and logistics. Devised survey questions were fed via a facilitator to expert participants. The 58 respondents to Round 1 were invited to participate in Rounds 2-4. Subsequent rounds were informed by responses of previous rounds. RESULTS/CONCLUSIONS Items with ≥ 75% consensus are considered a recommendation. These include system performance certification, thresholds for image signal-to-noise, contrast-to-noise and tumour-to-background ratios, spatial resolution, and artefact levels. Direct, iterative, and machine or deep learning reconstruction methods, use of a mixture of CE marked and verified research tools were agreed and use of specified reference standards and validation processes considered essential. Operator training and refreshment were considered mandatory for clinical trials and clinical research. Items with a 60-74% agreement require reporting (site-specific accreditation for clinical research, minimal pixel number within lesion segmented, use of post-reconstruction algorithms, operator training refreshment for clinical practice). Items with ≤ 60% agreement are outside current recommendations for segmentation (frequency of system performance tests, use of only CE-marked tools, board certification of operators, frequency of operator refresher training). Recommendations by anatomical area are also specified.
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Affiliation(s)
- Nandita M deSouza
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK.
| | - Aad van der Lugt
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Christophe M Deroose
- Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium.,Nuclear Medicine and Molecular Imaging, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | | | - Luc Bidaut
- College of Science, University of Lincoln, Lincoln, Lincoln, LN6 7TS, UK
| | - Laure Fournier
- INSERM, Radiology Department, AP-HP, Hopital Europeen Georges Pompidou, Université de Paris, PARCC, 75015, Paris, France
| | - Lena Costaridou
- School of Medicine, University of Patras, University Campus, Rio, 26 500, Patras, Greece
| | - Daniela E Oprea-Lager
- Department of Radiology and Nuclear Medicine, Amsterdam, UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Elmar Kotter
- Department of Radiology, University Medical Center Freiburg, Freiburg, Germany
| | - Marion Smits
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Marius E Mayerhoefer
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.,Memorial Sloan Kettering Cancer Centre, New York, NY, USA
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, Amsterdam, UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anna Caroli
- Department of Biomedical Engineering, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Lioe-Fee de Geus-Oei
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Biomedical Photonic Imaging Group, University of Twente, Enschede, The Netherlands
| | - Wolfgang G Kunz
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Edwin H Oei
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Frederic Lecouvet
- Department of Radiology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCLouvain), 10 Avenue Hippocrate, 1200, Brussels, Belgium
| | - Manuela Franca
- Department of Radiology, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas de Abel Salazar, University of Porto, Porto, Portugal
| | - Christian Loewe
- Division of Cardiovascular and Interventional Radiology, Department for Bioimaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Egesta Lopci
- Nuclear Medicine, IRCCS - Humanitas Research Hospital, via Manzoni 56, Rozzano, MI, Italy
| | - Caroline Caramella
- Radiology Department, Hôpital Marie Lannelongue, Institut d'Oncologie Thoracique, Université Paris-Saclay, Le Plessis-Robinson, France
| | - Anders Persson
- Department of Radiology, and Department of Health, Medicine and Caring Sciences, Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Xavier Golay
- Queen Square Institute of Neurology, University College London, London, UK
| | - Marc Dewey
- Department of Radiology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - James P B O'Connor
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | - Pim deGraaf
- Department of Radiology and Nuclear Medicine, Amsterdam, UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sergios Gatidis
- Department of Radiology, University of Tubingen, Tübingen, Germany
| | - Gudrun Zahlmann
- Radiological Society of North America (RSNA), Oak Brook, IL, USA
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Conti Nibali M, Rossi M, Sciortino T, Gay L, Lopci E, Fernandes B, Rudà R, Bello L. P03.08.B Proton Therapy and recurrent Lower Grade Glioma: clinical and radiological aspects, intraoperative findings and histo-pathological features. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Radiation therapy (RT) plays a central role in management of central nervous system disease, in particular in the multimodality management of low(er) and high-grade CNS gliomas. New strategy that involved Proton Therapy (PT) have been experienced in the last years. No data are available about re-surgery of lesion irradiated with protons.
Material and Methods
We reviewed our single Unit experience of re-surgery of Lower-Grade Glioma patients that received, in their neuro-oncological history, a treatment with PT. We collect clinical data, intra-operative findings, histopathological features and oncological and clinical outcome after surgery.
Results
We collected three cases of young with an IDH1-mutated tumor that underwent to Proton Therapy (PT). In two cases PT was performed due to progression of disease, in one case as adjuvant therapy after first surgical treatment. In all cases we performed surgery within three years after PT. All patients complained drug resistant epilepsy after PT with symptom relief after surgery and one patient complained a spine fracture due to corticosteroids intake to control radionecrosis’s symptoms after PT. In the pre-operative work-up all patient performed a 11-C-Methionin PET scan that revealed an increase of tracer uptake in the suspected area of tumor progression. In one case advanced MRI protocol with PWI was performed to further distinguish and sample area of pseudoprogression and tumor progression. In two patients area of gliosis and necrosis was find at the histological examination.
Conclusion
Our experience, although limited to three case, provided a clinical and radiological example of the small cohort of patients that performed surgery after a Prothon Radiotherapy. Clinical presentation was heterogenous except a poor seizure control. Despite time elapsed since PT, areas of radionecrosis were found in the histopathological samples of 2/3 of patients. Moreover, we need to collect more data to draw a complete picture in this complex field.
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Affiliation(s)
| | - M Rossi
- Università degli Studi di Milano , Milano , Italy
| | | | - L Gay
- Università degli Studi di Milano , Milano , Italy
| | - E Lopci
- Humanitas Research Hospital , Milano , Italy
| | - B Fernandes
- Humanitas Research Hospital , Milano , Italy
| | - R Rudà
- Ospedale CastelFranco Veneto , Treviso , Italy
| | - L Bello
- Università degli Studi di Milano , Milano , Italy
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Castello A, Castellani M, Florimonte L, Ciccariello G, Mansi L, Lopci E. PET radiotracers in glioma: a review of clinical indications and evidence. Clin Transl Imaging 2022. [DOI: 10.1007/s40336-022-00523-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Lopci E, Castello A, Mansi L. FDG PET/CT for Staging and Restaging Malignant Mesothelioma. Semin Nucl Med 2022; 52:806-815. [PMID: 35965111 DOI: 10.1053/j.semnuclmed.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 07/19/2022] [Accepted: 07/25/2022] [Indexed: 11/11/2022]
Abstract
Malignant mesothelioma is an aggressive tumor originating from the mesothelial cells and presenting in general with a very poor prognosis. The pleural localization represents the prevailing disease site, while peritoneal involvement is commonly rare. The WHO classifies mesotheliomas into epithelioid, biphasic, and sarcomatoid histotypes, having diverse outcome with the sarcomatoid or biphasic forms showing the poorest prognosis. Given the peculiar rind-like pattern of growth, mesothelioma assessment is rather challenging for medical imagers. Conventional imaging is principally based on contrast-enhanced CT, while the role of functional and metabolic imaging is regarded as complementary. By focusing essentially on the staging and restaging role of [18F]FDG PET/CT in malignant mesotheliomas, the present review will summarize the available data present in literature and provide some hints on alternative imaging and future perspectives. Given the prevailing incidence of pleural disease, the majority of the information will be addressed on malignant pleural mesothelioma, although a summary of principal characteristics and imaging findings in patients with peritoneal mesothelioma will be also provided.
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Affiliation(s)
- Egesta Lopci
- Nuclear Medicine Unit, IRCCS - Humanitas Research Hospital, Milan, Italy.
| | - Angelo Castello
- Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda, Milan, Italy
| | - Luigi Mansi
- Interuniversity Research Center for the Sustainable Development (CIRPS), Rome, Italy
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Lopci E, Prasad V. Editorial: Response assessment of radioligand therapies. Front Oncol 2022; 12:904337. [PMID: 35965585 PMCID: PMC9364693 DOI: 10.3389/fonc.2022.904337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/08/2022] [Indexed: 12/04/2022] Open
Affiliation(s)
- Egesta Lopci
- Nuclear Medicine, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
- *Correspondence: Egesta Lopci, ;;
| | - Vikas Prasad
- Department of Nuclear Medicine, University Hospital Ulm, Ulm, Germany
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Lopci E, Hicks RJ, Dimitrakopoulou-Strauss A, Dercle L, Iravani A, Seban RD, Sachpekidis C, Humbert O, Gheysens O, Glaudemans AWJM, Weber W, Wahl RL, Scott AM, Pandit-Taskar N, Aide N. Joint EANM/SNMMI/ANZSNM practice guidelines/procedure standards on recommended use of [ 18F]FDG PET/CT imaging during immunomodulatory treatments in patients with solid tumors version 1.0. Eur J Nucl Med Mol Imaging 2022; 49:2323-2341. [PMID: 35376991 PMCID: PMC9165250 DOI: 10.1007/s00259-022-05780-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 03/22/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE The goal of this guideline/procedure standard is to assist nuclear medicine physicians, other nuclear medicine professionals, oncologists or other medical specialists for recommended use of [18F]FDG PET/CT in oncological patients undergoing immunotherapy, with special focus on response assessment in solid tumors. METHODS In a cooperative effort between the EANM, the SNMMI and the ANZSNM, clinical indications, recommended imaging procedures and reporting standards have been agreed upon and summarized in this joint guideline/procedure standard. CONCLUSIONS The field of immuno-oncology is rapidly evolving, and this guideline/procedure standard should not be seen as definitive, but rather as a guidance document standardizing the use and interpretation of [18F]FDG PET/CT during immunotherapy. Local variations to this guideline should be taken into consideration. PREAMBLE The European Association of Nuclear Medicine (EANM) is a professional non-profit medical association founded in 1985 to facilitate worldwide communication among individuals pursuing clinical and academic excellence in nuclear medicine. The Society of Nuclear Medicine and Molecular Imaging (SNMMI) is an international scientific and professional organization founded in 1954 to promote science, technology and practical application of nuclear medicine. The Australian and New Zealand Society of Nuclear Medicine (ANZSNM), founded in 1969, represents the major professional society fostering the technical and professional development of nuclear medicine practice across Australia and New Zealand. It promotes excellence in the nuclear medicine profession through education, research and a commitment to the highest professional standards. EANM, SNMMI and ANZSNM members are physicians, technologists, physicists and scientists specialized in the research and clinical practice of nuclear medicine. All three societies will periodically put forth new standards/guidelines for nuclear medicine practice to help advance the science of nuclear medicine and improve service to patients. Existing standards/guidelines will be reviewed for revision or renewal, as appropriate, on their fifth anniversary or sooner, if indicated. Each standard/guideline, representing a policy statement by the EANM/SNMMI/ANZSNM, has undergone a thorough consensus process, entailing extensive review. These societies recognize that the safe and effective use of diagnostic nuclear medicine imaging requires particular training and skills, as described in each document. These standards/guidelines are educational tools designed to assist practitioners in providing appropriate and effective nuclear medicine care for patients. These guidelines are consensus documents based on current knowledge. They are not intended to be inflexible rules or requirements of practice, nor should they be used to establish a legal standard of care. For these reasons and those set forth below, the EANM, SNMMI and ANZSNM caution against the use of these standards/guidelines in litigation in which the clinical decisions of a practitioner are called into question. The ultimate judgment regarding the propriety of any specific procedure or course of action must be made by medical professionals considering the unique circumstances of each case. Thus, there is no implication that an action differing from what is laid out in the guidelines/procedure standards, standing alone, is below standard of care. To the contrary, a conscientious practitioner may responsibly adopt a course of action different from that set forth in the standards/guidelines when, in the reasonable judgment of the practitioner, such course of action is indicated by the condition of the patient, limitations of available resources or advances in knowledge or technology subsequent to publication of the guidelines/procedure standards. The practice of medicine involves not only the science, but also the art of dealing with the prevention, diagnosis, alleviation and treatment of disease. The variety and complexity of human conditions make it impossible for general guidelines to consistently allow for an accurate diagnosis to be reached or a particular treatment response to be predicted. Therefore, it should be recognized that adherence to these standards/ guidelines will not ensure a successful outcome. All that should be expected is that practitioners follow a reasonable course of action, based on their level of training, current knowledge, clinical practice guidelines, available resources and the needs/context of the patient being treated. The sole purpose of these guidelines is to assist practitioners in achieving this objective. The present guideline/procedure standard was developed collaboratively by the EANM, the SNMMI and the ANZSNM, with the support of international experts in the field. They summarize also the views of the Oncology and Theranostics and the Inflammation and Infection Committees of the EANM, as well as the procedure standards committee of the SNMMI, and reflect recommendations for which the EANM and SNMMI cannot be held responsible. The recommendations should be taken into the context of good practice of nuclear medicine and do not substitute for national and international legal or regulatory provisions.
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Affiliation(s)
- E Lopci
- Nuclear Medicine Unit, IRCCS - Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milano, Italy.
| | - R J Hicks
- The Department of Medicine, St Vincent's Medical School, the University of Melbourne, Melbourne, Australia
| | - A Dimitrakopoulou-Strauss
- Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69210, Heidelberg, Germany
| | - L Dercle
- Department of Radiology, New York Presbyterian, Columbia University Irving Medical Center, New York, NY, USA
| | - A Iravani
- Department of Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - R D Seban
- Department of Nuclear Medicine and Endocrine Oncology, Institut Curie, 92210, Saint-Cloud, France
- Laboratoire d'Imagerie Translationnelle en Oncologie, Inserm, Institut Curie, 91401, Orsay, France
| | - C Sachpekidis
- Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69210, Heidelberg, Germany
| | - O Humbert
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France
- TIRO-UMR E 4320, Université Côte d'Azur, Nice, France
| | - O Gheysens
- Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - A W J M Glaudemans
- Nuclear Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - W Weber
- Department of Nuclear Medicine, Klinikum Rechts Der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - R L Wahl
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - A M Scott
- Department of Molecular Imaging and Therapy, Austin Health, Studley Rd, Heidelberg, Victoria, 3084, Australia
- Olivia Newton-John Cancer Research Institute, Heidelberg, Australia
- Faculty of Medicine, University of Melbourne, Melbourne, Australia
- School of Cancer Medicine, La Trobe University, Melbourne, Australia
| | - N Pandit-Taskar
- Nuclear Medicine Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY, 10021, USA
| | - N Aide
- Nuclear Medicine Department, University Hospital, Caen, France
- INSERM ANTICIPE, Normandie University, Caen, France
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32
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Lopci E. Meditating on Cancer Management at the Time of Immunotherapy. J Clin Med 2022; 11:jcm11113025. [PMID: 35683412 PMCID: PMC9181255 DOI: 10.3390/jcm11113025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- Egesta Lopci
- Nuclear Medicine, IRCCS-Humanitas Research Center, Via Manzoni 56, 20089 Rozzano, MI, Italy
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Piccardo A, Albert NL, Borgwardt L, Fahey FH, Hargrave D, Galldiks N, Jehanno N, Kurch L, Law I, Lim R, Lopci E, Marner L, Morana G, Young Poussaint T, Seghers VJ, Shulkin BL, Warren KE, Traub-Weidinger T, Zucchetta P. Joint EANM/SIOPE/RAPNO practice guidelines/SNMMI procedure standards for imaging of paediatric gliomas using PET with radiolabelled amino acids and [ 18F]FDG: version 1.0. Eur J Nucl Med Mol Imaging 2022; 49:3852-3869. [PMID: 35536420 PMCID: PMC9399211 DOI: 10.1007/s00259-022-05817-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/23/2022] [Indexed: 01/18/2023]
Abstract
Positron emission tomography (PET) has been widely used in paediatric oncology. 2-Deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) is the most commonly used radiopharmaceutical for PET imaging. For oncological brain imaging, different amino acid PET radiopharmaceuticals have been introduced in the last years. The purpose of this document is to provide imaging specialists and clinicians guidelines for indication, acquisition, and interpretation of [18F]FDG and radiolabelled amino acid PET in paediatric patients affected by brain gliomas. There is no high level of evidence for all recommendations suggested in this paper. These recommendations represent instead the consensus opinion of experienced leaders in the field. Further studies are needed to reach evidence-based recommendations for the applications of [18F]FDG and radiolabelled amino acid PET in paediatric neuro-oncology. These recommendations are not intended to be a substitute for national and international legal or regulatory provisions and should be considered in the context of good practice in nuclear medicine. The present guidelines/standards were developed collaboratively by the EANM and SNMMI with the European Society for Paediatric Oncology (SIOPE) Brain Tumour Group and the Response Assessment in Paediatric Neuro-Oncology (RAPNO) working group. They summarize also the views of the Neuroimaging and Oncology and Theranostics Committees of the EANM and reflect recommendations for which the EANM and other societies cannot be held responsible.
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Affiliation(s)
- Arnoldo Piccardo
- Department of Nuclear Medicine, E.O. "Ospedali Galliera", Genoa, Italy
| | - Nathalie L Albert
- Department of Nuclear Medicine, University Hospital of LMU Munich, Munich, Germany
| | - Lise Borgwardt
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Frederic H Fahey
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Darren Hargrave
- Department of Paediatric Oncology, Great Ormond Street Hospital NHS Trust, London, UK
| | - Norbert Galldiks
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Institute of Neuroscience and Medicine (INM-3), Research Center Juelich, Juelich, Germany
| | - Nina Jehanno
- Department of Nuclear Medicine, Institut Curie Paris, Paris, France
| | - Lars Kurch
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany.
| | - Ian Law
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ruth Lim
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS-Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milano, Italy
| | - Lisbeth Marner
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Giovanni Morana
- Department of Neurosciences, University of Turin, Turin, Italy
| | - Tina Young Poussaint
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Victor J Seghers
- Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston, TX, USA
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA
| | - Barry L Shulkin
- Nuclear Medicine Department of Diagnostic Imaging St. Jude Children's Research Hospital, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Katherine E Warren
- Department of Pediatric Oncology, Dana Farber Cancer Institute, Boston, MA, USA
| | - Tatjana Traub-Weidinger
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Pietro Zucchetta
- Nuclear Medicine Unit, Department of Medicine - DIMED, University Hospital of Padova, Padua, Italy
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Manson G, Lemchukwu AC, Mokrane FZ, Lopci E, Aide N, Vercellino L, Houot R, Dercle L. Interpretation of 2-[ 18F]FDG PET/CT in Hodgkin lymphoma patients treated with immune checkpoint inhibitors. Eur Radiol 2022; 32:6536-6544. [PMID: 35344061 DOI: 10.1007/s00330-022-08669-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 02/14/2022] [Accepted: 02/17/2022] [Indexed: 11/30/2022]
Abstract
The development of immunotherapy has revolutionized cancer treatment, improving the outcome and survival of many patients. Immune checkpoint inhibitors (ICIs), the most common form of immunotherapy, use antibodies to restore T-cells' anti-tumor activity. Immune checkpoint inhibitors are gaining ground in the therapeutic strategy across various cancers. Although widely used in solid tumors, ICIs have shown remarkable efficacy in patients with Hodgkin lymphoma. 2-[18F]Fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET)/CT is the gold standard to stage and monitor responses in Hodgkin lymphoma. This article reviewed the use of 2-[18F]FDG-PET/CT in patients with Hodgkin lymphoma treated with ICI, focusing on image interpretation for response monitoring and detecting adverse events. Key Points • Immune checkpoint inhibitors have dramatically improved the outcome of patients with cancer. Their mechanisms of action induce inflammatory processes that might translate into a high 2-[18F]FDG uptake visible on 2-[18F]FDG-PET/CT, requiring an adaptation of the evaluation criteria. • PET readers should be aware of new patterns of response observed with immunotherapy in assessing treatment response in HL patients. • -[18F]FDG-PET/CT has an unparalleled ability of assessing tumor response, visualizing signs of immune activation as well as immune-related adverse events in a one-stop-shop examination.
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Affiliation(s)
- Guillaume Manson
- Department of Hematology, University Hospital of Rennes, INSERM U1236, 2 rue Henri le Guilloux, 35 000, Rennes, France.
| | | | | | - Egesta Lopci
- Nuclear Medicine, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, MI, Italy
| | - Nicolas Aide
- Nuclear Medicine Department, Caen University Hospital, Caen, France
| | - Laetitia Vercellino
- Department of Nuclear Medicine, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris (APHP), Paris, France
| | - Roch Houot
- Department of Hematology, University Hospital of Rennes, INSERM U1236, 2 rue Henri le Guilloux, 35 000, Rennes, France
| | - Laurent Dercle
- Department of Radiology, Columbia University Medical Center, New York, NY, USA
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35
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Fournier L, de Geus-Oei LF, Regge D, Oprea-Lager DE, D’Anastasi M, Bidaut L, Bäuerle T, Lopci E, Cappello G, Lecouvet F, Mayerhoefer M, Kunz WG, Verhoeff JJC, Caruso D, Smits M, Hoffmann RT, Gourtsoyianni S, Beets-Tan R, Neri E, deSouza NM, Deroose CM, Caramella C. Twenty Years On: RECIST as a Biomarker of Response in Solid Tumours an EORTC Imaging Group - ESOI Joint Paper. Front Oncol 2022; 11:800547. [PMID: 35083155 PMCID: PMC8784734 DOI: 10.3389/fonc.2021.800547] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 11/30/2021] [Indexed: 12/15/2022] Open
Abstract
Response evaluation criteria in solid tumours (RECIST) v1.1 are currently the reference standard for evaluating efficacy of therapies in patients with solid tumours who are included in clinical trials, and they are widely used and accepted by regulatory agencies. This expert statement discusses the principles underlying RECIST, as well as their reproducibility and limitations. While the RECIST framework may not be perfect, the scientific bases for the anticancer drugs that have been approved using a RECIST-based surrogate endpoint remain valid. Importantly, changes in measurement have to meet thresholds defined by RECIST for response classification within thus partly circumventing the problems of measurement variability. The RECIST framework also applies to clinical patients in individual settings even though the relationship between tumour size changes and outcome from cohort studies is not necessarily translatable to individual cases. As reproducibility of RECIST measurements is impacted by reader experience, choice of target lesions and detection/interpretation of new lesions, it can result in patients changing response categories when measurements are near threshold values or if new lesions are missed or incorrectly interpreted. There are several situations where RECIST will fail to evaluate treatment-induced changes correctly; knowledge and understanding of these is crucial for correct interpretation. Also, some patterns of response/progression cannot be correctly documented by RECIST, particularly in relation to organ-site (e.g. bone without associated soft-tissue lesion) and treatment type (e.g. focal therapies). These require specialist reader experience and communication with oncologists to determine the actual impact of the therapy and best evaluation strategy. In such situations, alternative imaging markers for tumour response may be used but the sources of variability of individual imaging techniques need to be known and accounted for. Communication between imaging experts and oncologists regarding the level of confidence in a biomarker is essential for the correct interpretation of a biomarker and its application to clinical decision-making. Though measurement automation is desirable and potentially reduces the variability of results, associated technical difficulties must be overcome, and human adjudications may be required.
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Affiliation(s)
- Laure Fournier
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- European Society of Oncologic Imaging (ESOI), European Society of Radiology, Vienna, Austria
- Université de Paris, Assistance Publique–Hôpitaux de Paris (AP-HP), Hopital europeen Georges Pompidou, Department of Radiology, Paris Cardiovascular Research Center (PARCC) Unité Mixte de Recherche (UMRS) 970, Institut national de la santé et de la recherche médicale (INSERM), Paris, France
| | - Lioe-Fee de Geus-Oei
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
- Biomedical Photonic Imaging Group, University of Twente, Enschede, Netherlands
| | - Daniele Regge
- European Society of Oncologic Imaging (ESOI), European Society of Radiology, Vienna, Austria
- Department of Surgical Sciences, University of Turin, Turin, Italy
- Radiology Unit, Candiolo Cancer Institute, Fondazione del Piemonte per l’Oncologia-Istituto Di Ricovero e Cura a Carattere Scientifico (FPO-IRCCS), Turin, Italy
| | - Daniela-Elena Oprea-Lager
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Department of Radiology & Nuclear Medicine, Cancer Centre Amsterdam, Amsterdam University Medical Centers [Vrije Universiteit (VU) University], Amsterdam, Netherlands
| | - Melvin D’Anastasi
- European Society of Oncologic Imaging (ESOI), European Society of Radiology, Vienna, Austria
- Medical Imaging Department, Mater Dei Hospital, University of Malta, Msida, Malta
| | - Luc Bidaut
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- College of Science, University of Lincoln, Lincoln, United Kingdom
| | - Tobias Bäuerle
- European Society of Oncologic Imaging (ESOI), European Society of Radiology, Vienna, Austria
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Egesta Lopci
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Nuclear Medicine Unit, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) – Humanitas Research Hospital, Milan, Italy
| | - Giovanni Cappello
- Department of Surgical Sciences, University of Turin, Turin, Italy
- Radiology Unit, Candiolo Cancer Institute, Fondazione del Piemonte per l’Oncologia-Istituto Di Ricovero e Cura a Carattere Scientifico (FPO-IRCCS), Turin, Italy
| | - Frederic Lecouvet
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Department of Radiology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Marius Mayerhoefer
- European Society of Oncologic Imaging (ESOI), European Society of Radiology, Vienna, Austria
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Wolfgang G. Kunz
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- European Society of Oncologic Imaging (ESOI), European Society of Radiology, Vienna, Austria
- Department of Radiology, University Hospital, Ludwig Maximilian University (LMU) Munich, Munich, Germany
| | - Joost J. C. Verhoeff
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Damiano Caruso
- European Society of Oncologic Imaging (ESOI), European Society of Radiology, Vienna, Austria
- Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Marion Smits
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
- Brain Tumour Centre, Erasmus Medical Centre (MC) Cancer Institute, Rotterdam, Netherlands
| | - Ralf-Thorsten Hoffmann
- European Society of Oncologic Imaging (ESOI), European Society of Radiology, Vienna, Austria
- Institute and Policlinic for Diagnostic and Interventional Radiology, University Hospital, Carl-Gustav-Carus Technical University Dresden, Dresden, Germany
| | - Sofia Gourtsoyianni
- European Society of Oncologic Imaging (ESOI), European Society of Radiology, Vienna, Austria
- Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Areteion Hospital, Athens, Greece
| | - Regina Beets-Tan
- European Society of Oncologic Imaging (ESOI), European Society of Radiology, Vienna, Austria
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, Netherlands
- School For Oncology and Developmental Biology (GROW) School for Oncology and Developmental Biology, Maastricht University, Maastricht, Netherlands
| | - Emanuele Neri
- European Society of Oncologic Imaging (ESOI), European Society of Radiology, Vienna, Austria
- Diagnostic and Interventional Radiology, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Nandita M. deSouza
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden National Health Service (NHS) Foundation Trust, London, United Kingdom
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Quantitative Imaging Biomarkers Alliance, Radiological Society of North America, Oak Brook, IL, United States
| | - Christophe M. Deroose
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium
- Nuclear Medicine & Molecular Imaging, Department of Imaging and Pathology, Katholieke Universiteit (KU) Leuven, Leuven, Belgium
| | - Caroline Caramella
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Radiology Department, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph Centre International des Cancers Thoraciques, Université Paris-Saclay, Le Plessis-Robinson, France
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Lopci E, Morbelli S. Advances in Lung Cancer Imaging and Therapy. Cancers (Basel) 2021; 14:cancers14010058. [PMID: 35008219 PMCID: PMC8750401 DOI: 10.3390/cancers14010058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 11/16/2022] Open
Abstract
This series of eight papers (five original articles, two reviews and one meta-analysis) is presented by international leaders covering various aspects of lung cancer management, starting with diagnostic imaging and analyzing the novel perspectives of therapy [...]
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Affiliation(s)
- Egesta Lopci
- Nuclear Medicine, IRCCS Humanitas Research Center, Via Manzoni 56, 20089 Rozzano, Italy
- Correspondence:
| | - Silvia Morbelli
- IRCCS Ospedale Policlinico San Martino, Nuclear Medicine, Largo Rosanna Benzi 10, 16132 Genoa, Italy;
- Department of Health Sciences (DISSAL), University of Genoa, Via Antonio Pastore 1, 16132 Genoa, Italy
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Oprea-Lager DE, Cysouw MC, Boellaard R, Deroose CM, de Geus-Oei LF, Lopci E, Bidaut L, Herrmann K, Fournier LS, Bäuerle T, deSouza NM, Lecouvet FE. Bone Metastases Are Measurable: The Role of Whole-Body MRI and Positron Emission Tomography. Front Oncol 2021; 11:772530. [PMID: 34869009 PMCID: PMC8640187 DOI: 10.3389/fonc.2021.772530] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/04/2021] [Indexed: 12/14/2022] Open
Abstract
Metastatic tumor deposits in bone marrow elicit differential bone responses that vary with the type of malignancy. This results in either sclerotic, lytic, or mixed bone lesions, which can change in morphology due to treatment effects and/or secondary bone remodeling. Hence, morphological imaging is regarded unsuitable for response assessment of bone metastases and in the current Response Evaluation Criteria In Solid Tumors 1.1 (RECIST1.1) guideline bone metastases are deemed unmeasurable. Nevertheless, the advent of functional and molecular imaging modalities such as whole-body magnetic resonance imaging (WB-MRI) and positron emission tomography (PET) has improved the ability for follow-up of bone metastases, regardless of their morphology. Both these modalities not only have improved sensitivity for visual detection of bone lesions, but also allow for objective measurements of bone lesion characteristics. WB-MRI provides a global assessment of skeletal metastases and for a one-step "all-organ" approach of metastatic disease. Novel MRI techniques include diffusion-weighted imaging (DWI) targeting highly cellular lesions, dynamic contrast-enhanced MRI (DCE-MRI) for quantitative assessment of bone lesion vascularization, and multiparametric MRI (mpMRI) combining anatomical and functional sequences. Recommendations for a homogenization of MRI image acquisitions and generalizable response criteria have been developed. For PET, many metabolic and molecular radiotracers are available, some targeting tumor characteristics not confined to cancer type (e.g. 18F-FDG) while other targeted radiotracers target specific molecular characteristics, such as prostate specific membrane antigen (PSMA) ligands for prostate cancer. Supporting data on quantitative PET analysis regarding repeatability, reproducibility, and harmonization of PET/CT system performance is available. Bone metastases detected on PET and MRI can be quantitatively assessed using validated methodologies, both on a whole-body and individual lesion basis. Both have the advantage of covering not only bone lesions but visceral and nodal lesions as well. Hybrid imaging, combining PET with MRI, may provide complementary parameters on the morphologic, functional, metabolic and molecular level of bone metastases in one examination. For clinical implementation of measuring bone metastases in response assessment using WB-MRI and PET, current RECIST1.1 guidelines need to be adapted. This review summarizes available data and insights into imaging of bone metastases using MRI and PET.
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Affiliation(s)
- Daniela E. Oprea-Lager
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Matthijs C.F. Cysouw
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Christophe M. Deroose
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium
- Nuclear Medicine & Molecular Imaging, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Lioe-Fee de Geus-Oei
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
- Biomedical Photonic Imaging Group, University of Twente, Enschede, Netherlands
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS – Humanitas Research Hospital, Milan, Italy
| | - Luc Bidaut
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- College of Science, University of Lincoln, Lincoln, United Kingdom
| | - Ken Herrmann
- Department of Nuclear Medicine, University of Duisburg-Essen, and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Laure S. Fournier
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Paris Cardiovascular Research Center (PARCC), Institut National de la Santé et de la Recherche Médicale (INSERM), Radiology Department, Assistance Publique-Hôpitaux de Paris (AP-HP), Hopital europeen Georges Pompidou, Université de Paris, Paris, France
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
| | - Tobias Bäuerle
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Nandita M. deSouza
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Frederic E. Lecouvet
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Department of Radiology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
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Lopci E. Immunotherapy Monitoring with Immune Checkpoint Inhibitors Based on [ 18F]FDG PET/CT in Metastatic Melanomas and Lung Cancer. J Clin Med 2021; 10:jcm10215160. [PMID: 34768681 PMCID: PMC8584484 DOI: 10.3390/jcm10215160] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 12/15/2022] Open
Abstract
Immunotherapy with checkpoint inhibitors has prompted a major change not only in cancer treatment but also in medical imaging. In parallel with the implementation of new drugs modulating the immune system, new response criteria have been developed, aiming to overcome clinical drawbacks related to the new, unusual, patterns of response characterizing both solid tumors and lymphoma during the course of immunotherapy. The acknowledgement of pseudo-progression, hyper-progression, immune-dissociated response and so forth, has become mandatory for all imagers dealing with this clinical scenario. A long list of acronyms, i.e., irRC, iRECIST, irRECIST, imRECIST, PECRIT, PERCIMT, imPERCIST, iPERCIST, depicts the enormous effort made by radiology and nuclear medicine physicians in the last decade to optimize imaging parameters for better prediction of clinical benefit in immunotherapy regimens. Quite frequently, a combination of clinical-laboratory data with imaging findings has been tested, proving the ability to stratify patients into various risk groups. The next steps necessarily require a large scale validation of the most robust criteria, as well as the clinical implementation of immune-targeting tracers for immuno-PET or the exploitation of radiomics and artificial intelligence as complementary tools during the course of immunotherapy administration. For the present review article, a summary of PET/CT role for immunotherapy monitoring will be provided. By scrolling into various cancer types and applied response criteria, the reader will obtain necessary information for better understanding the potentials and limitations of the modality in the clinical setting.
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Affiliation(s)
- Egesta Lopci
- Nuclear Medicine Unit, IRCCS-Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, MI, Italy
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Lopci E, Colombo P, Lazzeri M. Mismatched Imaging Findings of Prostate Cancer Diagnosis: 68 Ga-PSMA PET/CT vs mpMRI. Nucl Med Mol Imaging 2021; 55:199-202. [PMID: 34422131 DOI: 10.1007/s13139-021-00701-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/10/2021] [Accepted: 05/06/2021] [Indexed: 12/01/2022] Open
Abstract
Multiparametric magnetic resonance imaging (mpMRI) is the modality of choice for initial diagnosis of prostate cancer (PCa), including biopsy-naïve patients. Nevertheless, clinicians must be aware of the possibility that up to one-fourth of clinically significant cancers might be missed by the modality. Acknowledgment of this occurrence and the increased availability of 68 Ga-PSMA PET/CT in clinical routine, open the door to new, fascinating, indications for this functional modality in the context of PCa detection. With the case herein illustrated, we report a paradigmatic example of mismatch findings between PET/CT and mpMRI better elucidating the potential indication.
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Affiliation(s)
- Egesta Lopci
- Nuclear Medicine Unit, IRCCS - Humanitas Research Hospital, Via Manzoni 56, CAP 20089 Rozzano, MI Italy
| | | | - Massimo Lazzeri
- Urology, IRCCS - Humanitas Research Hospital, Rozzano, MI Italy
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Fournier L, Costaridou L, Bidaut L, Michoux N, Lecouvet FE, de Geus-Oei LF, Boellaard R, Oprea-Lager DE, Obuchowski NA, Caroli A, Kunz WG, Oei EH, O'Connor JPB, Mayerhoefer ME, Franca M, Alberich-Bayarri A, Deroose CM, Loewe C, Manniesing R, Caramella C, Lopci E, Lassau N, Persson A, Achten R, Rosendahl K, Clement O, Kotter E, Golay X, Smits M, Dewey M, Sullivan DC, van der Lugt A, deSouza NM, European Society Of Radiology. Incorporating radiomics into clinical trials: expert consensus endorsed by the European Society of Radiology on considerations for data-driven compared to biologically driven quantitative biomarkers. Eur Radiol 2021; 31:6001-6012. [PMID: 33492473 PMCID: PMC8270834 DOI: 10.1007/s00330-020-07598-8] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 11/16/2020] [Accepted: 12/03/2020] [Indexed: 02/07/2023]
Abstract
Existing quantitative imaging biomarkers (QIBs) are associated with known biological tissue characteristics and follow a well-understood path of technical, biological and clinical validation before incorporation into clinical trials. In radiomics, novel data-driven processes extract numerous visually imperceptible statistical features from the imaging data with no a priori assumptions on their correlation with biological processes. The selection of relevant features (radiomic signature) and incorporation into clinical trials therefore requires additional considerations to ensure meaningful imaging endpoints. Also, the number of radiomic features tested means that power calculations would result in sample sizes impossible to achieve within clinical trials. This article examines how the process of standardising and validating data-driven imaging biomarkers differs from those based on biological associations. Radiomic signatures are best developed initially on datasets that represent diversity of acquisition protocols as well as diversity of disease and of normal findings, rather than within clinical trials with standardised and optimised protocols as this would risk the selection of radiomic features being linked to the imaging process rather than the pathology. Normalisation through discretisation and feature harmonisation are essential pre-processing steps. Biological correlation may be performed after the technical and clinical validity of a radiomic signature is established, but is not mandatory. Feature selection may be part of discovery within a radiomics-specific trial or represent exploratory endpoints within an established trial; a previously validated radiomic signature may even be used as a primary/secondary endpoint, particularly if associations are demonstrated with specific biological processes and pathways being targeted within clinical trials. KEY POINTS: • Data-driven processes like radiomics risk false discoveries due to high-dimensionality of the dataset compared to sample size, making adequate diversity of the data, cross-validation and external validation essential to mitigate the risks of spurious associations and overfitting. • Use of radiomic signatures within clinical trials requires multistep standardisation of image acquisition, image analysis and data mining processes. • Biological correlation may be established after clinical validation but is not mandatory.
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Affiliation(s)
- Laure Fournier
- PARCC, INSERM, Radiology Department, AP-HP, Hopital europeen Georges Pompidou, Université de Paris, F-75015, Paris, France
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
| | - Lena Costaridou
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- School of Medicine, University of Patras, University Campus, Rio, 26 500, Patras, Greece
| | - Luc Bidaut
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- College of Science, University of Lincoln, Lincoln, LN6 7TS, UK
| | - Nicolas Michoux
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Department of Radiology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCLouvain), B-1200, Brussels, Belgium
| | - Frederic E Lecouvet
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Department of Radiology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCLouvain), B-1200, Brussels, Belgium
| | - Lioe-Fee de Geus-Oei
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
- Biomedical Photonic Imaging Group, University of Twente, Enschede, The Netherlands
| | - Ronald Boellaard
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Radiology & Nuclear Medicine, Cancer Centre Amsterdam, Amsterdam University Medical Centers (VU University), Amsterdam, The Netherlands
- Quantitative Imaging Biomarkers Alliance, Radiological Society of North America, Oak Brook, IL, USA
| | - Daniela E Oprea-Lager
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Department of Radiology & Nuclear Medicine, Cancer Centre Amsterdam, Amsterdam University Medical Centers (VU University), Amsterdam, The Netherlands
| | - Nancy A Obuchowski
- Quantitative Imaging Biomarkers Alliance, Radiological Society of North America, Oak Brook, IL, USA
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Anna Caroli
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Biomedical Engineering, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Wolfgang G Kunz
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Edwin H Oei
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - James P B O'Connor
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Division of Cancer Sciences, University of Manchester, Manchester, UK
| | - Marius E Mayerhoefer
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Manuela Franca
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Radiology, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas de Abel Salazar, University of Porto, Porto, Portugal
| | - Angel Alberich-Bayarri
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Quantitative Imaging Biomarkers in Medicine (QUIBIM), Valencia, Spain
| | - Christophe M Deroose
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium
- Nuclear Medicine and Molecular Imaging, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Christian Loewe
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Division of Cardiovascular and Interventional Radiology, Dept. for Bioimaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Rashindra Manniesing
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, 6525 GA, Nijmegen, The Netherlands
| | - Caroline Caramella
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Radiology Department, Hôpital Marie Lannelongue, Institut d'Oncologie Thoracique, Université Paris-Saclay, Le Plessis-Robinson, France
| | - Egesta Lopci
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Nuclear Medicine, Humanitas Clinical and Research Hospital - IRCCS, Rozzano, MI, Italy
| | - Nathalie Lassau
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Quantitative Imaging Biomarkers Alliance, Radiological Society of North America, Oak Brook, IL, USA
- Imaging Department, Gustave Roussy Cancer Campus Grand, Paris, UMR 1281, INSERM, CNRS, CEA, Universite Paris-Saclay, Saint-Aubin, France
| | - Anders Persson
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Radiology, and Department of Health, Medicine and Caring Sciences, Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Rik Achten
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Radiology and Medical Imaging, Ghent University Hospital, Gent, Belgium
| | - Karen Rosendahl
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Radiology, University Hospital of North Norway, Tromsø, Norway
| | - Olivier Clement
- PARCC, INSERM, Radiology Department, AP-HP, Hopital europeen Georges Pompidou, Université de Paris, F-75015, Paris, France
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
| | - Elmar Kotter
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Radiology, University Medical Center Freiburg, Freiburg, Germany
| | - Xavier Golay
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Quantitative Imaging Biomarkers Alliance, Radiological Society of North America, Oak Brook, IL, USA
- Queen Square Institute of Neurology, University College London, London, UK
| | - Marion Smits
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Marc Dewey
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Radiology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Daniel C Sullivan
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Quantitative Imaging Biomarkers Alliance, Radiological Society of North America, Oak Brook, IL, USA
- Dept. of Radiology, Duke University, 311 Research Dr, Durham, NC, 27710, USA
| | - Aad van der Lugt
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Nandita M deSouza
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria.
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium.
- Quantitative Imaging Biomarkers Alliance, Radiological Society of North America, Oak Brook, IL, USA.
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK.
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Abstract
Hematologic malignancies represent a vast group of hematopoietic and lymphoid cancers that typically involve the blood, the bone marrow, and the lymphatic organs. Due to extensive research and well defined and standardized response criteria, the role of [18F]FDG-PET/CT is well defined in these malignancies. Never the less, the reliability of visual and quantitative interpretation of PET/CT may be impaired by several factors including inconsistent scanning protocols and image reconstruction methods. Furthermore, the uptake of [18F]FDG not only reflects tissue glucose consumption by malignant lesions, but also in other situations such as in inflammatory lesions, local and systemic infections, benign tumors, reactive thymic hyperplasia, histiocytic infiltration, among others; or following granulocyte colony stimulating factors therapy, radiation therapy, chemotherapy or surgical interventions, all of which are a potential source of false-positive or negative interpretations. Therefore it is of paramount importance for the Nuclear Medicine Physician to be familiar with, not only the normal distribution of [18F]FDG in the body, but also with the most frequent findings that may hamper a correct interpretation of the scan, which could ultimately alter the patients management. In this review, we describe these myriad of situations so the interpreting physician can be familiar with them, providing tools for their correct identification and interpretation when possible.
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Affiliation(s)
- Patrick Pilkington
- Department of Nuclear Medicine, University Hospital 12 de Octubre, Madrid, Spain.
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS-Humanitas Research Hospital, Rozzano (Milano), Italy
| | - Judit A Adam
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Carsten Kobe
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Karolien Goffin
- Department of Nuclear Medicine, University Hospital Leuven, Division of Nuclear Medicine and Molecular Imaging, KU Leuven, Leuven, Belgium
| | - Ken Herrmann
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen Germany; West German Cancer Center
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Abstract
2-deoxy-2-[18F]fluoro-D-glucose [18F]FDG-PET/CT represents the metabolic imaging of choice in various cancer types. Used either at diagnosis or during treatment response assessment, the modality allows for a more accurate definition of tumor extent compared to morphological imaging and is able to predict the therapeutic benefit earlier in time. Due to the aspecific uptake property of [18F]FDG there is an overlap of its distribution in normal and pathological conditions, which can make the interpretation of the imaging challenging. Lung and pleural neoplasia are no exception to this, thus acknowledging of possible pitfalls and artifacts are mandatory for image interpretation. While most pitfalls and artifacts are common for all indications with metabolic imaging with [18F]FDG-PET/CT, there are specific variants and pitfalls in lung cancer and malignant pleural mesothelioma. The aim of the present article is to shed light on the most frequent and relevant variants and pitfalls in [18F]FDG-PET/CT imaging in lung cancer and malignant pleural mesothelioma.
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Affiliation(s)
- Egesta Lopci
- Nuclear Medicine, IRCCS - Humanitas Research Hospital, Rozzano MI, Italy.
| | - Carsten Kobe
- Department of Nuclear Medicine, University Hospital and Medical Faculty, University of Cologne, Cologne, University of Cologne, Cologne, Germany
| | | | - Judit A Adam
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, AMS, the Netherlands
| | - Lioe-Fee de Geus-Oei
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; Biomedical Photonic Imaging Group, University of Twente, Enschede, the Netherlands
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Evangelista L, Lopci E. Re: Hendrik Van Poppel, Renée Hogenhout, Peter Albers, et al. Early Detection of Prostate Cancer in 2020 and Beyond: Facts and Recommendations for the European Union and the European Commission. Eur Urol 2021;79:327-9: Early Detection of Prostate Cancer in High-risk Patients with Negative Fusion Biopsy. Eur Urol 2021; 80:e24-e27. [PMID: 33947593 DOI: 10.1016/j.eururo.2021.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 04/19/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Laura Evangelista
- Nuclear Medicine Unit, Department of Medicine, Padova University Hospital, Padova, Italy
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy.
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Lopci E, Burnelli R, Elia C, Piccardo A, Castello A, Borsatti E, Zucchetta P, Cistaro A, Mascarin M. Additional value of volumetric and texture analysis on FDG PET assessment in paediatric Hodgkin lymphoma: an Italian multicentric study protocol. BMJ Open 2021; 11:e041252. [PMID: 33782017 PMCID: PMC8009231 DOI: 10.1136/bmjopen-2020-041252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Assessment of response to therapy in paediatric patients with Hodgkin lymphoma (HL) by 18F-fluorodeoxyglucose positron emission tomography/CT has become a powerful tool for the discrimination of responders from non-responders. The addition of volumetric and texture analyses can be regarded as a valuable help for disease prognostication and biological characterisation. Based on these premises, the Hodgkin Lymphoma Study Group of the Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP) has designed a prospective evaluation of volumetric and texture analysis in the Italian cohort of patients enrolled in the EuroNet-PHL-C2. METHODS AND ANALYSIS The primary objective is to compare volumetric assessment in patiens with HL at baseline and during the course of therapy with standard visual and semiquantitative analyses. The secondary objective is to identify the impact of volumetric and texture analysis on bulky masses. The tertiary objective is to determine the additional value of multiparametric assessment in patients having a partial response on morphological imaging.The overall cohort of the study is expected to be round 400-500 patients, with approximately half presenting with bulky masses. All PET scans of the Italian cohort will be analysed for volumetric assessment, comprising metabolic tumour volume and total lesion glycolysis at baseline and during the course of therapy. A dedicated software will delineate semiautomatically contours using different threshold methods, and the impact of each segmentation techniques will be evaluated. Bulky will be defined on contiguous lymph node masses ≥200 mL on CT/MRI. All bulky masses will be outlined and analysed by the same software to provide textural features. Morphological assessment will be based on RECIL 2017 for response definition. ETHICS AND DISSEMINATION The current study has been ethically approved (AIFA/SC/P/27087 approved 09/03/2018; EudraCT 2012-004053-88, EM-04). The results of the different analyses performed during and after study completion the will be actively disseminated through peer-reviewed journals, conference presentations, social media, print media and internet.
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Affiliation(s)
- Egesta Lopci
- Nuclear Medicine Department, IRCCS - Humanitas Research Hospital, Rozzano, Italy
| | - Roberta Burnelli
- Pediatric Onco-hematologic Unit, University Hospital Arcispedale Sant'Anna of Ferrara, Ferrara, Italy
| | - Caterina Elia
- AYA Oncology and Pediatric Radiotherapy Unit, Centro di Riferimento Oncologico, Aviano, Italy
| | - Arnoldo Piccardo
- Nuclear Medicine Department, Ente Ospedaliero Ospedali Galliera, Genova, Italy
| | - Angelo Castello
- Nuclear Medicine Department, IRCCS - Humanitas Research Hospital, Rozzano, Italy
| | - Eugenio Borsatti
- Nuclear Medicine Department, Centro di Riferimento Oncologico, Aviano, Italy
| | - Pietro Zucchetta
- Nuclear Medicine Department, Padua University Hospital, Padova, Italy
| | - Angelina Cistaro
- Nuclear Medicine Department, Ente Ospedaliero Ospedali Galliera, Genova, Italy
| | - Maurizio Mascarin
- AYA Oncology and Pediatric Radiotherapy Unit, Centro di Riferimento Oncologico, Aviano, Italy
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Castello A, Rossi S, Toschi L, Lopci E. Impact of Antibiotic Therapy and Metabolic Parameters in Non-Small Cell Lung Cancer Patients Receiving Checkpoint Inhibitors. J Clin Med 2021; 10:jcm10061251. [PMID: 33803006 PMCID: PMC8002619 DOI: 10.3390/jcm10061251] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/08/2021] [Accepted: 03/11/2021] [Indexed: 01/05/2023] Open
Abstract
Introduction: In the current study, we aimed to assess the impact of antibiotics (ATB) and metabolic parameters on clinical outcome of non-small cell lung carcinoma (NSCLC) patients treated with immune checkpoint inhibitors (ICI). Methods: Data from fifty NSCLC patients referred for ICI between December 2015 and May 2019 were analyzed. All patients underwent 18F-fluorodeoxyglucose positron emission tomography computed tomography (18F-FDG PET/CT) and contrast-enhanced CT at baseline and for response assessment after 6–8 weeks. Patients who received ATB within 1 month before or after the first dose of ICI were compared with those who did not. Response assessment according to iRECIST and EORTC was evaluated, as well as progression-free survival (PFS) and overall survival (OS). For semi-quantitative parameters, we computed metabolic tumor volume (MTV), total lesion glycolysis (TLG) and their variations (∆). Results: Twenty NSCLC cases of 50 (40%) had received ATB. Patients receiving ATB had a higher number of metastases (p = 0.046), and were associated with an elevated tumor burden, expressed by TLG (687 vs. 235.3, p = 0.007) and MTV (125.6 vs. 40.6, p = 0.002), compared to no-ATB patients. According to iRECIST, progressive disease rate was significantly higher for ATB group (64.7% vs. 27.6%, p = 0.029). Likewise, PFS was shorter for ATB compared to no-ATB (median 4.1 vs. 12.4 months, p = 0.004), while no difference for OS was detected. On multivariate analysis, the effect of ATB remained significant for poor PFS along with performance status (ECOG ≥ 1), and ∆SUVmax. Conclusions: ATB therapy seems to be associated with a worse treatment response, PFS, and higher metabolic tumor burden in NSCLC patients treated with ICI.
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Affiliation(s)
- Angelo Castello
- Nuclear Medicine Unit, IRCCS-Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy;
| | - Sabrina Rossi
- Department of Oncology and Hematology, IRCCS-Humanitas Research Center, 20089 Rozzano, Italy; (S.R.); (L.T.)
| | - Luca Toschi
- Department of Oncology and Hematology, IRCCS-Humanitas Research Center, 20089 Rozzano, Italy; (S.R.); (L.T.)
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS-Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy;
- Correspondence: ; Tel.: +39-02-82247542; Fax: +39-02-82246693
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Castello A, Caroli P, Lopci E. Peritoneal carcinomatosis and occult metastasis in prostate cancer: [ 68Ga]PSMA vs. [ 11C]Choline. Rev Esp Med Nucl Imagen Mol 2021. [PMID: 33483299 DOI: 10.1016/j.remn.2020.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- A Castello
- Nuclear Medicine, Humanitas Clinical and Research Hospital- IRCCS , Rozzano, Milán, Italia
| | - P Caroli
- Nuclear Medicine Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italia
| | - E Lopci
- Nuclear Medicine, Humanitas Clinical and Research Hospital- IRCCS , Rozzano, Milán, Italia.
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Riva M, Lopci E, Gay LG, Nibali MC, Rossi M, Sciortino T, Castellano A, Bello L. Advancing Imaging to Enhance Surgery: From Image to Information Guidance. Neurosurg Clin N Am 2021; 32:31-46. [PMID: 33223024 DOI: 10.1016/j.nec.2020.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Conventional magnetic resonance imaging (cMRI) has an established role as a crucial disease parameter in the multidisciplinary management of glioblastoma, guiding diagnosis, treatment planning, assessment, and follow-up. Yet, cMRI cannot provide adequate information regarding tissue heterogeneity and the infiltrative extent beyond the contrast enhancement. Advanced magnetic resonance imaging and PET and newer analytical methods are transforming images into data (radiomics) and providing noninvasive biomarkers of molecular features (radiogenomics), conveying enhanced information for improving decision making in surgery. This review analyzes the shift from image guidance to information guidance that is relevant for the surgical treatment of glioblastoma.
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Affiliation(s)
- Marco Riva
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Via Festa del Perdono 7, Milan 20122, Italy; IRCCS Istituto Ortopedico Galeazzi, U.O. Neurochirurgia Oncologica, Milan, Italy.
| | - Egesta Lopci
- Unit of Nuclear Medicine, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, Rozzano, Milan 20089, Italy. https://twitter.com/LopciEgesta
| | - Lorenzo G Gay
- IRCCS Istituto Ortopedico Galeazzi, U.O. Neurochirurgia Oncologica, Milan, Italy; Department of Oncology and Hemato-Oncology, Via Festa del Perdono 7, Milan 20122, Italy
| | - Marco Conti Nibali
- IRCCS Istituto Ortopedico Galeazzi, U.O. Neurochirurgia Oncologica, Milan, Italy; Department of Oncology and Hemato-Oncology, Via Festa del Perdono 7, Milan 20122, Italy. https://twitter.com/dr_mcn
| | - Marco Rossi
- IRCCS Istituto Ortopedico Galeazzi, U.O. Neurochirurgia Oncologica, Milan, Italy; Department of Oncology and Hemato-Oncology, Via Festa del Perdono 7, Milan 20122, Italy
| | - Tommaso Sciortino
- IRCCS Istituto Ortopedico Galeazzi, U.O. Neurochirurgia Oncologica, Milan, Italy; Department of Oncology and Hemato-Oncology, Via Festa del Perdono 7, Milan 20122, Italy
| | - Antonella Castellano
- Neuroradiology Unit and CERMAC, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan 20123, Italy. https://twitter.com/antocastella
| | - Lorenzo Bello
- IRCCS Istituto Ortopedico Galeazzi, U.O. Neurochirurgia Oncologica, Milan, Italy; Department of Oncology and Hemato-Oncology, Via Festa del Perdono 7, Milan 20122, Italy
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Zaragori T, Castello A, Guedj E, Girard A, Galldiks N, Albert NL, Lopci E, Verger A. Photopenic Defects in Gliomas With Amino-Acid PET and Relative Prognostic Value: A Multicentric 11C-Methionine and 18F-FDOPA PET Experience. Clin Nucl Med 2021; 46:e36-e37. [PMID: 32804767 DOI: 10.1097/rlu.0000000000003240] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim is to explore the concept of photopenic defects in newly diagnosed glioma patients with the 2 widely used C-MET and F-FDOPA PET amino acid tracers. Thirty-two C-MET and 26 F-FDOPA PET scans with amino acid PET-negative gliomas were selected in this European multicentric study. Of these gliomas, 16 C-MET and 10 F-FDOPA PET scans with photopenic defects were identified, exhibiting lower mean tumor-to-background ratio as compared with isometabolic gliomas (P < 0.001). Gliomas with photopenic defects had no different progression-free survival than isometabolic gliomas in the whole population (P = 0.40), but shorter progression-free survival in the subgroup of World Health Organization grade II IDH-mutant astrocytomas (35 vs 68 months; P = 0.047).
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Affiliation(s)
| | - Angelo Castello
- Nuclear Medicine Department, Humanitas Clinical and Research Hospital-IRCCS, Rozzano, Italy
| | | | - Antoine Girard
- Department of Nuclear Medicine, Eugène Marquis Center, Rennes 1 University, Rennes, France
| | | | - Nathalie L Albert
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Egesta Lopci
- Nuclear Medicine Department, Humanitas Clinical and Research Hospital-IRCCS, Rozzano, Italy
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Affiliation(s)
- Nicolas Aide
- Nuclear Medicine Department, Centre Hospitalier Universitaire, Avenue Côte de Nacre, 14000, Caen, France. .,Normandie University, Caen, France. .,INSERM ANTICIPE, Normandie University, Caen, France.
| | | | - Egesta Lopci
- Nuclear Medicine Department, Humanitas Clinical and Research Hospital, Rozzano, Italy
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Castello A, Lopci E. The Role of PET/CT in the Era of Immune Checkpoint Inhibitors: State of Art. Curr Radiopharm 2020; 13:24-31. [PMID: 31749440 DOI: 10.2174/1874471012666191015100106] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 01/09/2019] [Accepted: 07/17/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Immune checkpoint inhibitors (ICI) have achieved astonishing results and improved overall survival (OS) in several types of malignancies, including advanced melanoma. However, due to a peculiar type of anti-cancer activity provided by these drugs, the response patterns during ICI treatment are completely different from that with "old" chemotherapeutic agents. OBJECTIVE To provide an overview of the available literature and potentials of 18F-FDG PET/CT in advanced melanoma during the course of therapy with ICI in the context of treatment response evaluation. METHOD Morphologic criteria, expressed by Response Evaluation Criteria in Solid Tumors (RECIST), immune-related response criteria (irRC), irRECIST, and, more recently, immune-RECIST (iRECIST), along with response criteria based on the metabolic parameters with 18F-Fluorodeoxyglucose (18FFDG), have been explored. RESULTS To overcome the limits of traditional response criteria, new metabolic response criteria have been introduced on time and are being continuously updated, such as the PET/CT Criteria for the early prediction of Response to Immune checkpoint inhibitor Therapy (PECRIT), the PET Response Evaluation Criteria for Immunotherapy (PERCIMT), and "immunotherapy-modified" PET Response Criteria in Solid Tumors (imPERCIST). The introduction of new PET radiotracers, based on monoclonal antibodies combined with radioactive elements ("immune-PET"), are of great interest. CONCLUSION Although the role of 18F-FDG PET/CT in malignant melanoma has been widely validated for detecting distant metastases and recurrences, evidences in course of ICI are still scarce and larger multicenter clinical trials are needed.
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Affiliation(s)
- Angelo Castello
- Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Italy
| | - Egesta Lopci
- Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Italy
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