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Minekawa TB, Santos AO, Moraes AG, Sasse A, Silva CA, Lima MT, Camacho M, Lima MC, Etchebehere E. Erratum: Single-center developing country analysis of radium-223 therapy in prostate cancer-preliminary results. Am J Nucl Med Mol Imaging 2023; 13:126. [PMID: 37457327 PMCID: PMC10349289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 07/18/2023]
Abstract
[This corrects the article on p. 352 in vol. 11, PMID: 34754606.].
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Affiliation(s)
- Thaís B Minekawa
- Division of Nuclear Medicine of The Department of Radiology, University of Campinas (UNICAMP)Campinas, Brazil
| | - Allan O Santos
- Division of Nuclear Medicine of The Department of Radiology, University of Campinas (UNICAMP)Campinas, Brazil
- Medicina Nuclear de Campinas (grupoMND)Campinas, Brazil
| | | | | | - Cleide A Silva
- Department of Statistics, University of Campinas (UNICAMP)Campinas, Brazil
| | - Marcelo T Lima
- Department of Statistics, University of Campinas (UNICAMP)Campinas, Brazil
| | | | - Mariana C Lima
- Division of Nuclear Medicine of The Department of Radiology, University of Campinas (UNICAMP)Campinas, Brazil
- Medicina Nuclear de Campinas (grupoMND)Campinas, Brazil
| | - Elba Etchebehere
- Division of Nuclear Medicine of The Department of Radiology, University of Campinas (UNICAMP)Campinas, Brazil
- Medicina Nuclear de Campinas (grupoMND)Campinas, Brazil
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2
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Coutinho AM, Ghilardi MG, Campos ACP, Etchebehere E, Fonoff FC, Cury RG, Pagano RL, Martinez RCR, Fonoff ET. Does TRODAT-1 SPECT Uptake Correlate with Cerebrospinal Fluid α-Synuclein Levels in Mid-Stage Parkinson's Disease? Biomedicines 2023; 11:biomedicines11020296. [PMID: 36830833 PMCID: PMC9952987 DOI: 10.3390/biomedicines11020296] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 12/10/2022] [Revised: 01/06/2023] [Accepted: 01/11/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD) is characterized by a progressive loss of nigrostriatal dopaminergic neurons with impaired motor and non-motor symptoms. It has been suggested that motor asymmetry could be caused due to an imbalance in dopamine levels, as visualized by dopamine transporter single emission computed tomography test (DAT-SPECT), which might be related to indirect measures of neurodegeneration, evaluated by the Montreal Cognitive Assessment (MOCA) and α-synuclein levels in the cerebrospinal fluid (CSF). Therefore, this study aimed to understand the correlation between disease laterality, DAT-SPECT, cognition, and α-synuclein levels in PD. METHODS A total of 28 patients in the moderate-advanced stage of PD were subjected to neurological evaluation, TRODAT-1-SPECT/CT imaging, MOCA, and quantification of the levels of α-synuclein. RESULTS We found that α-synuclein in the CSF was correlated with global cognition (positive correlation, r2 = 0.3, p = 0.05) and DAT-SPECT concentration in the putamen (positive correlation, r2 = 0.4, p = 0.005), and striatum (positive correlation, r2 = 0.2, p = 0.03), thus working as a neurodegenerative biomarker. No other correlations were found between DAT-SPECT, CSF α-synuclein, and cognition, thus suggesting that they may be lost with disease progression. CONCLUSIONS Our data highlight the importance of understanding the dysfunction of the dopaminergic system in the basal ganglia and its complex interactions in modulating cognition.
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Affiliation(s)
- Artur M. Coutinho
- Division of Neuroscience, Hospital Sírio-Libanês, Sao Paulo 01308-060, SP, Brazil
- Laboratory of Nuclear Medicine (LIM 43), Department of Radiology and Oncology, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo 05403-010, SP, Brazil
- Division of Nuclear Medicine and PET/CT, Hospital Sírio-Libanês, Sao Paulo 01308-050, SP, Brazil
| | - Maria Gabriela Ghilardi
- Department of Neurology, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo 05403-010, SP, Brazil
| | | | - Elba Etchebehere
- Division of Nuclear Medicine, University of Campinas (UNICAMP), Campinas 13083-888, SP, Brazil
| | - Fernanda C. Fonoff
- Department of Neurology, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo 05403-010, SP, Brazil
| | - Rubens G. Cury
- Department of Neurology, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo 05403-010, SP, Brazil
| | - Rosana L. Pagano
- Division of Neuroscience, Hospital Sírio-Libanês, Sao Paulo 01308-060, SP, Brazil
| | - Raquel C. R. Martinez
- Division of Neuroscience, Hospital Sírio-Libanês, Sao Paulo 01308-060, SP, Brazil
- LIM/23—Institute of Psychiatry, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo 05403-903, SP, Brazil
- Correspondence:
| | - Erich T. Fonoff
- Division of Neuroscience, Hospital Sírio-Libanês, Sao Paulo 01308-060, SP, Brazil
- Department of Neurology, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Sao Paulo 05403-010, SP, Brazil
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Carvalho MS, Alvim MKM, Etchebehere E, Santos ADO, Ramos CD, Argenton JLP, Cendes F, Amorim BJ. Interictal and postictal 18F-FDG PET/CT in epileptogenic zone localization. Radiol Bras 2022; 55:273-279. [PMID: 36320375 PMCID: PMC9620847 DOI: 10.1590/0100-3984.2021.0141] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 12/22/2021] [Indexed: 11/25/2022] Open
Abstract
Objective To evaluate the performance of 18F-fluorodeoxyglucose
positron-emission tomography/computed tomography ( 18F-FDG
PET/CT) in localizing epileptogenic zones, comparing 18F-FDG
injection performed in the traditional interictal period with that performed
near the time of a seizure. Materials and Methods We evaluated patients with refractory epilepsy who underwent
18F-FDG PET/CT. The reference standards for localization of the
epileptogenic zone were histopathology and follow-up examinations (in
patients who underwent surgery) or serial electroencephalography (EEG)
recordings, long-term video EEG, and magnetic resonance imaging (in patients
who did not). The 18F-FDG injection was performed whether the
patient had an epileptic seizure during the EEG monitoring period or not.
The 18F-FDG PET/CT results were categorized as concordant or
discordant with the reference standards. Results Of the 110 patients evaluated, 10 were in a postictal group (FDG injection
after a seizure) and 100 were in the interictal group. The
18F-FDG PET/CT was concordant with the reference standards in
nine (90%) of the postictal group patients and in 60 (60%) of the interictal
group patients. Among the nine postictal group patients in whom the results
were concordant, the 18F-FDG PET/CT showed hypermetabolism and
hypometabolism in the epileptogenic zone in four (44.4%) and five (55.6%),
respectively. Conclusion Our data indicate that 18F-FDG PET/CT is a helpful tool for
localization of the epileptogenic zone and that EEG monitoring is an
important means of correlating the findings. In addition, postictal
18F-FDG PET/CT is able to identify the epileptogenic zone by
showing either hypometabolism or hypermetabolism.
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Etchebehere E, Andrade R, Camacho M, Lima M, Brink A, Cerci JJ, Nadel H, Bal C, Rangarajan V, Pfluger T, Kagna O, Alonso O, Begum FK, Mir KB, Magboo VP, Menezes LJ, Paez D, Pascual T. VALIDATION OF CONVOLUTIONAL NEURAL NETWORK FOR FAST DETERMINATION OF WHOLE-BODY METABOLIC TUMOR BURDEN IN PEDIATRIC LYMPHOMA. J Nucl Med Technol 2022; 50:256-262. [PMID: 35440476 DOI: 10.2967/jnmt.121.262900] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 02/10/2022] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION: 18F-FDG PET/CT whole-body tumor burden in lymphoma is not routinely performed due to the lack of fast quantification methods. Although the semi-automatic method is fast, it still lacks the necessary speed required to quantify tumor burden in daily clinical practice. PURPOSE: To evaluate the performance of the convolutional neural networks (CNN) software to localize neoplastic lesions in whole-body 18F-FDG PET/CT images of pediatric lymphoma patients. METHODS: This retrospective image data set, derived from the data pool under the IAEA (CRP# E12017), included 102 baseline staging 18F-FDG PET/CTs of pediatric lymphoma patients (mean age 11 yrs). Images were quantified to determine the whole-body (wb) tumor burden (wbMTV and wbTLG) using a semi-automatic (SEMI) software and an CNN-based software. Both were displayed as wbMTVSEMI & wbTLGSEMI and wbMTVCNN & TLGCNN. The intraclass correlation coefficient (ICC) was applied to evaluate concordance between the CNN-based software and the SEMI software. RESULTS: Twenty-six patients were excluded from the analyses because the software was unable to perform calculation. In the remaining 76 patients, wbMTVCNN and wbMTVSEMI whole-body tumor burden metrics were highly correlated (ICC=0.993; 95%CI: 0.989 -0.996; p-value<0.0001) as were wbTLGCNN and wbTLGSEMI (ICC=0.999; 95%CI: 0.998-0.999; p-value<0.0001). However, the time spent calculating these metrics was significantly (<0.0001) faster by CNN (mean = 19 seconds; 11 - 50 seconds) compared to the semi-automatic method (mean = 21.6 minutes; 3.2 - 62.1 minutes), especially in patients with advanced disease. CONCLUSION: Determining whole-body tumor burden in pediatric lymphoma patients using CNN is fast and feasible in clinical practice.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Omar Alonso
- Clinical Hospital of the University of Uruguay, Uruguay
| | - Fatima K Begum
- National Institute of Nuclear Medicine and Allied Sciences, Bangladesh
| | | | | | | | - Diana Paez
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, International Atomic Energy Agency, Austria
| | - Thomas Pascual
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, International Atomic Energy Agency, Austria
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5
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Etchebehere E, Munhoz RR, Casali A, Etchebehere M. PET/CT in soft tissue sarcomas. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00115-0] [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: 11/27/2022] Open
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6
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Camacho M, Carvalho M, Munhoz R, Etchebehere M, Etchebehere E. FDG PET/CT in bone sarcomas. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00062-4] [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: 11/16/2022] Open
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7
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Minekawa TB, Santos AO, Moraes AG, Sasse A, Silva CA, Lima MT, Camacho M, Lima MC, Etchebehere E. Single-center developing country analysis of radium-223 therapy in prostate cancer-preliminary results. Am J Nucl Med Mol Imaging 2021; 11:352-362. [PMID: 34754606 PMCID: PMC8569335] [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] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/21/2021] [Indexed: 06/13/2023]
Abstract
We reviewed the records of mCRPC patients treated with off-label use of Ra-223. Ra-223 efficiency in this non-study population was correlated to outcome measures overall survival (OS), progression-free survival (PFS), bone event-free survival, bone marrow failure (BMF), and disease-related biomarkers. There were no limits regarding the number of prior hormonal agents or chemotherapy received before or during Ra-223. Exclusion criteria consisted of baseline platelet counts below 50,000/mm3 and/or absolute neutrophil counts below 1,500/mm3. Twenty-eight patients received 130 cycles of Ra-223 between 2017 and 2018. The overall median OS was 15.6 months. However, in patients submitted to 4 or fewer cycles, the median OS was 9.1 months; in contrast, the median OS was 18.5 months in patients submitted to 5 or 6 cycles. There was a significant inverse correlation between the number of cycles and the occurrence of bone events (76.2% of the patients that completed 6 cycles did not present bone events, while 71.4% of the patients that had skeletal-related events were submitted to less than 6 cycles). 82.1% of the patients were submitted to concomitant therapies with no significant side effects. There was also a decrease in ALP and LDH levels throughout treatment. Radium-223 increased OS and decreased bone events, especially when patients were able to complete 5-6 cycles. The proper selection of patients is crucial to improve outcomes.
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Affiliation(s)
- Thaís B Minekawa
- Division of Nuclear Medicine of The Department of Radiology, University of Campinas (UNICAMP)Campinas, Brazil
| | - Allan O Santos
- Division of Nuclear Medicine of The Department of Radiology, University of Campinas (UNICAMP)Campinas, Brazil
- Medicina Nuclear de Campinas (grupoMND)Campinas, Brazil
| | | | | | - Cleide A Silva
- Department of Statistics, University of Campinas (UNICAMP)Campinas, Brazil
| | - Marcelo T Lima
- Department of Statistics, University of Campinas (UNICAMP)Campinas, Brazil
| | | | - Mariana C Lima
- Division of Nuclear Medicine of The Department of Radiology, University of Campinas (UNICAMP)Campinas, Brazil
- Medicina Nuclear de Campinas (grupoMND)Campinas, Brazil
| | - Elba Etchebehere
- Division of Nuclear Medicine of The Department of Radiology, University of Campinas (UNICAMP)Campinas, Brazil
- Medicina Nuclear de Campinas (grupoMND)Campinas, Brazil
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8
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Oliveira FRA, Santos ADO, de Lima MDCL, Toro IFC, de Souza TF, Amorim BJ, Barbeiro AS, Etchebehere E. The ratio between the whole-body and primary tumor burden, measured on 18F-FDG PET/CT studies, as a prognostic indicator in advanced non-small cell lung cancer. Radiol Bras 2021; 54:289-294. [PMID: 34602663 PMCID: PMC8475165 DOI: 10.1590/0100-3984.2020.0054] [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: 05/08/2020] [Accepted: 09/01/2020] [Indexed: 11/22/2022] Open
Abstract
Objective To determine whether the whole-body tumor burden, as quantified by 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (18F-FDG PET/CT), is a prognostic indicator in advanced (stage III or IV) non-small cell lung cancer (NSCLC). Materials and Methods This was a prospective study in which we evaluated 18F-FDG PET/CT staging parameters to quantify tumor burdens in patients with stage III or IV NSCLC. The following parameters were evaluated for the whole body (including the primary tumor) and for the primary tumor alone, respectively: maximum standardized uptake volume (wbSUVmax and tuSUVmax); metabolic tumor volume (wbMTV and tuMTV); and total lesion glycolysis (wbTLG and tuTLG). To determine whether the 18F-FDG PET/CT parameters were associated with overall survival (OS) and progression-free survival (PFS), we evaluated the wbSUVmax/tuSUVmax, wbMTV/tuMTV, and wbTLG/tuTLG ratios. Results 18F-FDG PET/CT was performed for staging in 52 patients who were followed for a median of 11.0 months (mean, 11.7 months). The estimated median PFS and OS were 9.6 months and 11.6 months, respectively. In the univariate analysis, OS was found to correlate significantly with wbTLG (hazard ratio [HR] = 1.001; 95% confidence interval [95 CI]: 1.000-1.001; p = 0.0361) and with the wbTLG/tuTLG ratio (HR = 1.705; 95% CI: 1.232-2.362; p = 0.0013). In the multivariate analysis, only the wbTLG/tuTLG ratio was independently associated with OS (HR = 1.660; 95% CI: 1.193-2.310; p = 0.0027). Conclusion The wbTLG/tuTLG ratio is an independent prognostic indicator of OS in advanced-stage NSCLC.
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Affiliation(s)
| | - Allan de Oliveira Santos
- Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-Unicamp), Campinas, SP, Brazil
| | | | | | - Thiago Ferreira de Souza
- Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-Unicamp), Campinas, SP, Brazil
| | - Bárbara Juarez Amorim
- Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-Unicamp), Campinas, SP, Brazil
| | | | - Elba Etchebehere
- Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-Unicamp), Campinas, SP, Brazil
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9
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Santos A, Mattiolli A, Carvalheira JB, Ferreira U, Camacho M, Silva C, Costa F, Matheus W, Lima M, Etchebehere E. PSMA whole-body tumor burden in primary staging and biochemical recurrence of prostate cancer. Eur J Nucl Med Mol Imaging 2021; 48:493-500. [PMID: 32789680 DOI: 10.1007/s00259-020-04981-x] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE The objective of this study was to evaluate whether 68Ga-PSMA PET/CT whole-body tumor burden (PSMAwbtb) is associated with clinical parameters and laboratory parameters in prostate cancer patients. METHODS We retrospectively evaluated prostate cancer patients submitted to PSMA PET/CT for primary staging purposes or due to biochemical recurrence (BR). PSMAwbtb metrics (total volume of PSMA-avid tumor (PSMA-TV)) and total uptake of PSMA-avid lesions (PSMA-TL) were calculated semi-automatically. Spearman's rank correlations between PSMAwbtb metrics and clinical, laboratory parameters (age, time-to-BR, years of diagnosis of prostate cancer, free and total serum PSA levels, and the Gleason score) and with the highest SUVmax of a lesion (hSUVmax) were analyzed. RESULTS Among the 257 PSMA PET/CT studies, there were 46 scans (17.9%) performed for primary staging and 211 (82.1%) for BR. PSMA-TV and PSMA-TL were calculated for the 157 positive scans (58.8%), which were 43 patients (93.5%) in the primary staging group and 114 patients (54.0%) in the BR group. In the primary staging group, we observed a significant correlation between PSMA-TL and hSUVmax (p = 0.0021). In the BR group, there was a significant direct correlation between PSMA-TL and the variables age (p = 0.0031), total serum PSA values (p = < 0.0001), free serum PSA values (p = < 0.0001), and the hSUVmax (p = < 0.0001). Similar results were obtained for PSMA-TV. CONCLUSION PSMAwbtb has a direct and positive correlation with serum PSA values and age in prostate cancer patients with BR.
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Affiliation(s)
- Allan Santos
- Medicina Nuclear de Campinas, Campinas, São Paulo, Brazil
- Division of Nuclear Medicine of the Department of Radiology, Campinas State University (UNICAMP), Rua Vital Brazil 251, Campinas, 13083-888, Brazil
| | | | - José Bc Carvalheira
- Division of Oncology of the Department of Internal Medicine, Campinas State University (UNICAMP), Campinas, Brazil
| | - Ubirajara Ferreira
- Division of Urology of the Department of Surgery, Campinas State University (UNICAMP), Campinas, Brazil
| | | | - Cleide Silva
- Department of Biostatistics, Campinas State University (UNICAMP), Campinas, Brazil
| | | | - Wagner Matheus
- Division of Urology of the Department of Surgery, Campinas State University (UNICAMP), Campinas, Brazil
| | - Mariana Lima
- Medicina Nuclear de Campinas, Campinas, São Paulo, Brazil
- Division of Nuclear Medicine of the Department of Radiology, Campinas State University (UNICAMP), Rua Vital Brazil 251, Campinas, 13083-888, Brazil
| | - Elba Etchebehere
- Medicina Nuclear de Campinas, Campinas, São Paulo, Brazil.
- Division of Nuclear Medicine of the Department of Radiology, Campinas State University (UNICAMP), Rua Vital Brazil 251, Campinas, 13083-888, Brazil.
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Souza S, Delamain M, Tobar N, Castro V, Frasson F, Amorim B, Etchebehere E, Mariana K, Mengatti J, Araujo E, Perini E, Souza CD, Santos A, Lorant-Metze I, Ramos C. Comparison of 68ga-psma and 18f-fdg pet/ct uptake in different lymphoma. Hematol Transfus Cell Ther 2020. [DOI: 10.1016/j.htct.2020.09.086] [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: 10/23/2022] Open
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11
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Mourato FA, Almeida MA, Brito AET, Leal ALG, Almeida Filho P, Etchebehere E. FDG PET/CT versus somatostatin receptor PET/CT in TENIS syndrome: a systematic review and meta-analysis. Clin Transl Imaging 2020. [DOI: 10.1007/s40336-020-00390-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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12
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Almeida LS, Santos AO, Martins GH, Eloy L, Lima ML, Etchebehere E. 18F-FDG PET/CT images defined the true extent of a urothelial bladder carcinoma. Urol Case Rep 2020; 33:101289. [PMID: 32528854 PMCID: PMC7276442 DOI: 10.1016/j.eucr.2020.101289] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/19/2020] [Accepted: 05/20/2020] [Indexed: 11/27/2022] Open
Abstract
A patient was referred, after neoadjuvant chemotherapy, for pre-surgical evaluation of urothelial bladder carcinoma (single lesion). Two thickenings in the left ureter wall identified on the CT scan were equivocal for malignancy. 18F-FDG PET/CT with delayed pelvic images, hyperhydration, and furosemide showed hypermetabolic ureteral metastases and multifocal bladder tumors. There were no lymph nodes or distant metastases. These 18F-FDG PET/CT findings completely altered the surgical treatment. The patient underwent left nephroureterectomy, radical cystoprostatectomy, and lymphadenectomy, followed by a urinary transit reconstruction. Histopathology confirmed multifocal high-grade urothelial carcinoma in the bladder walls and left ureter and benign lymph nodes.
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Affiliation(s)
- L S Almeida
- Division of Nuclear Medicine, Department of Radiology, Campinas State University (UNICAMP), Campinas, Brazil
| | - A O Santos
- Division of Nuclear Medicine, Department of Radiology, Campinas State University (UNICAMP), Campinas, Brazil
| | - G H Martins
- Division of Nuclear Medicine, Department of Radiology, Campinas State University (UNICAMP), Campinas, Brazil
| | - L Eloy
- Department of Pathology, Campinas State University (UNICAMP), Campinas, Brazil
| | - M L Lima
- Division of Urology, Department of Surgery, Campinas State University (UNICAMP), Campinas, Brazil
| | - E Etchebehere
- Division of Nuclear Medicine, Department of Radiology, Campinas State University (UNICAMP), Campinas, Brazil
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Abstract
Radium-223 dichloride (223Ra) is an α-emitter radionuclide approved for treatment of osteoblastic metastases in castrate-resistant prostate cancer (mCRPC) patients. 223Ra increases overall survival, improves bone pain, increases the median time to the first skeletal-related event, reduces the use of external beam radiation therapy for bone pain palliation, reduces the rates of spinal cord compression, and hospitalization. 223Ra therapy has minimal side effects; the most common hematological side effects are anemia, thrombocytopenia and neutropenia while the nonhematological side effects that may occur are bone pain flare, nausea, fatigue, and diarrhea. Alongside 223Ra therapy there are currently a variety of first-line therapeutic options available to treat mCRPC patients and much debate regarding the appropriate treatment algorithm for these patients and the possible combination of therapies among the ones available. In this article, we review the rationale behind 223Ra therapy as well as 223Ra mechanisms of action, biodistribution and dosimetry, optimal timing possibilities to initiate 223Ra in contrast to other treatments available, the association of 223Ra with other therapies and the means of evaluating patients in order to properly deliver to 223Ra therapy. Furthermore, we will discuss 223Ra dose administration possibilities, patient and dose preparation and the challenges of treatment response evaluation during and after 223Ra.
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Affiliation(s)
- Ana Emília Brito
- Real Nuclear, Real Hospital Português de Beneficência em Pernambuco, Recife, Brazil
| | - Elba Etchebehere
- Division of Nuclear Medicine, The University of Campinas (UNICAMP), Campinas, Brazil.
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14
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Takahashi MES, Mosci C, Souza EM, Brunetto SQ, Etchebehere E, Santos AO, Camacho MR, Miranda E, Lima MCL, Amorim BJ, de Souza C, Pericole FV, Lorand-Metze I, Ramos CD. Proposal for a Quantitative 18F-FDG PET/CT Metabolic Parameter to Assess the Intensity of Bone Involvement in Multiple Myeloma. Sci Rep 2019; 9:16429. [PMID: 31712729 PMCID: PMC6848137 DOI: 10.1038/s41598-019-52740-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 10/21/2019] [Indexed: 12/13/2022] Open
Abstract
Many efforts have been made to standardize the interpretation of 18F-FDG PET/CT in multiple myeloma (MM) with qualitative visual analysis or with quantitative metabolic parameters using various methods for lesion segmentation of PET images. The aim of this study was to propose a quantitative method for bone and bone marrow evaluation of 18F-FDG PET/CT considering the extent and intensity of bone 18F-FDG uptake: Intensity of Bone Involvement (IBI). Whole body 18F-FDG PET/CT of 59 consecutive MM patients were evaluated. Compact bone tissue was segmented in PET images using a global threshold for HU of the registered CT image. A whole skeleton mask was created and the percentage of its volume with 18F-FDG uptake above hepatic uptake was calculated (Percentage of Bone Involvement - PBI). IBI was defined by multiplying PBI by mean SUV above hepatic uptake. IBI was compared with visual analysis performed by two experienced nuclear medicine physicians. IBI calculation was feasible in all images (range:0.00–1.35). Visual analysis categorized PET exams into three groups (negative/mild, moderate and marked bone involvement), that had different ranges of IBI (multi comparison analysis, p < 0.0001). There was an inverse correlation between the patients’ hemoglobin values and IBI (r = −0.248;p = 0.02). IBI score is an objective measure of bone and bone marrow involvement in MM, allowing the categorization of patients in different degrees of aggressiveness of the bone disease. The next step is to validate IBI in a larger group of patients, before and after treatment and in a multicentre setting.
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Affiliation(s)
- Maria E S Takahashi
- School of Medical Sciences, University of Campinas, Campinas, Brazil.,Gleb Wataghin Physics Institute, University of Campinas, Campinas, Brazil
| | - Camila Mosci
- Division of Nuclear Medicine, University of Campinas, Campinas, Brazil
| | - Edna M Souza
- Division of Nuclear Medicine, University of Campinas, Campinas, Brazil.,Center of Biomedical Engineering, University of Campinas, Campinas, Brazil
| | - Sérgio Q Brunetto
- Division of Nuclear Medicine, University of Campinas, Campinas, Brazil.,Center of Biomedical Engineering, University of Campinas, Campinas, Brazil
| | - Elba Etchebehere
- Division of Nuclear Medicine, University of Campinas, Campinas, Brazil
| | - Allan O Santos
- Division of Nuclear Medicine, University of Campinas, Campinas, Brazil
| | - Mariana R Camacho
- School of Medical Sciences, University of Campinas, Campinas, Brazil.,Division of Nuclear Medicine, University of Campinas, Campinas, Brazil
| | - Eliana Miranda
- Center of Hematology and Hemotherapy, University of Campinas, Campinas, Brazil
| | - Mariana C L Lima
- Division of Nuclear Medicine, University of Campinas, Campinas, Brazil
| | - Barbara J Amorim
- Division of Nuclear Medicine, University of Campinas, Campinas, Brazil
| | - Carmino de Souza
- School of Medical Sciences, University of Campinas, Campinas, Brazil.,Center of Hematology and Hemotherapy, University of Campinas, Campinas, Brazil
| | - Fernando V Pericole
- Center of Hematology and Hemotherapy, University of Campinas, Campinas, Brazil
| | - Irene Lorand-Metze
- School of Medical Sciences, University of Campinas, Campinas, Brazil.,Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Celso D Ramos
- School of Medical Sciences, University of Campinas, Campinas, Brazil. .,Division of Nuclear Medicine, University of Campinas, Campinas, Brazil.
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15
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Camacho MR, Etchebehere E, Tardelli N, Delamain MT, Vercosa AF, Takahashi ME, Brunetto SQ, Metze IG, Souza CA, Cerci JJ, Ramos CD. Validation of a Multifocal Segmentation Method for Measuring Metabolic Tumor Volume in Hodgkin Lymphoma. J Nucl Med Technol 2019; 48:30-35. [DOI: 10.2967/jnmt.119.231118] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 08/21/2019] [Indexed: 12/14/2022] Open
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16
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Birelli B, Oliveira M, Santos ADO, Manso W, Vicente A, Etchebehere E. SPECT/CT with 99mTc-sestamibi for the evaluation of skeletal muscle perfusion after electrical muscle stimulation in athletes. Radiol Bras 2019; 52:92-96. [PMID: 31019337 PMCID: PMC6472863 DOI: 10.1590/0100-3984.2018.0006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023] Open
Abstract
Objective The purpose of this study was to evaluate the effects of electrical muscle
stimulation (EMS) on muscles, using 99mTc-sestamibi SPECT/CT. Materials and Methods We prospectively enrolled 20 consecutive male professional water polo
players. The mean age was 25 years (range, 18-36 years). All athletes
underwent 99mTc-sestamibi SPECT/CT of the thigh (rectus femoris
and vastus medialis muscle groups) before and after EMS. Images were
quantified to identify increases in perfusion after EMS. Results Before EMS, there were no significant differences between the right and left
thigh (rectus femoris and vastus medialis muscles) in terms of perfusion
(p = 0.4). However, the comparison between the pre- and
post-EMS analyses of the same muscle groups showed significant differences
in radiotracer uptake (p < 0.001), with a mean increase
in perfusion of 128% for the rectus femoris muscle group (95% CI: 0.86-1.61)
and 118% for the vastus medialis muscle group (95% CI: 0.96-1.79). Conclusion 99mTc-sestamibi SPECT/CT is an objective means of evaluating blood
flow in muscles submitted to EMS, which appears to promote significant
increases in such blood flow.
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Affiliation(s)
| | | | | | | | | | - Elba Etchebehere
- Campinas State University, Brazil; Sírio-Libanês Hospital, Brazil
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17
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Romanato J, Menezes MR, Santos ADO, Bezerra ROF, Lima MCL, Etchebehere E. 18F-FDG PET/CT performed immediately after percutaneous ablation to evaluate outcomes of the procedure: preliminary results. Radiol Bras 2019; 52:24-32. [PMID: 30804612 PMCID: PMC6383533 DOI: 10.1590/0100-3984.2018.0010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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] [Indexed: 11/22/2022] Open
Abstract
Objective To determine whether 18F-fluorodeoxyglucose positron emission
tomography/computed tomography performed immediately after percutaneous
ablation (iPA18F-FDG PET/CT) is useful in evaluating
the outcomes of the procedure. Materials and Methods This was a retrospective study of 20 patients (13 males, 7 females; mean age,
65.8 ± 12.1 years) submitted to percutaneous ablation of metastases.
All of the lesions treated had shown focal uptake on a 18F-FDG
PET/CT scan obtained at baseline. The primary tumors were mainly colorectal
cancer (in 45%) or lung cancer (in 40%). iPA18F-FDG
PET/CT was performed to identify any residual viable tumor cells. The
treatment was considered a success (no viable tumor cells present) if no
uptake of 18F-FDG was noted on the
iPA18F-FDG PET/CT scan. Results Twenty-six lesions were submitted to percutaneous ablation with either
cryoablation (n = 7) or radiofrequency ablation (n = 19). The mean lesion
diameter was 2.52 ± 1.49 cm. For the detection of viable tumor cells,
iPA18F-FDG PET/CT had a sensitivity, specificity,
accuracy, positive predictive value, and negative predictive value of 66.7%,
95%, 88.5%, 80%, and 90.5%, respectively. There was a significant
correlation between the iPA18F-FDG PET/CT findings and
the results of the follow-up studies (kappa = 0.66; p <
0.01). Conclusion iPA18F-FDG PET/CT studies appear to constitute a useful
means of evaluating the outcomes of percutaneous ablation. By detecting
residual viable tumor cells, this strategy might allow early
re-intervention, thus reducing morbidity. Studies involving larger numbers
of patients are needed in order to confirm our findings.
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Affiliation(s)
| | | | - Allan de Oliveira Santos
- Hospital Sírio-Libanês, São Paulo, SP, Brazil.,Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brazil
| | | | - Mariana Cunha Lopes Lima
- Hospital Sírio-Libanês, São Paulo, SP, Brazil.,Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brazil
| | - Elba Etchebehere
- Hospital Sírio-Libanês, São Paulo, SP, Brazil.,Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brazil
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Abstract
Objective To determine whether an interim 18F-fluoride positron-emission tomography/computed tomography (PET/CT) study performed after the third cycle of radium-223 dichloride (223RaCl2) therapy is able to identify patients that will not respond to treatment. Materials and Methods We retrospectively reviewed 34 histologically confirmed cases of hormone-refractory prostate cancer with bone metastasis in patients submitted to 223RaCl2 therapy. All of the patients underwent baseline and interim 18F-fluoride PET/CT studies. The interim study was performed immediately prior to the fourth cycle of 223RaCl2. The skeletal tumor burden-expressed as the total lesion fluoride uptake above a maximum standardized uptake value of 10 (TLF10)-was calculated for the baseline and the interim studies. The percent change in TLF10 between the baseline and interim studies (%TFL10) was calculated as follows: %TFL10 = interim TLF10 - baseline TLF10 / baseline TLF10. End points were overall survival, progression-free survival, and skeletal-related events. Results The mean age of the patients was 72.4 ± 10.2 years (range, 43.3-88.8 years). The %TLF10 was not able to predict overall survival (p = 0.6320; hazard ratio [HR] = 0.753; 95% confidence interval [CI]: 0.236-2.401), progression-free survival (p = 0.5908; HR = 1.248; 95% CI: 0.557-2.797) nor time to a bone event (p = 0.5114; HR = 1.588; 95% CI: 0.399-6.312). Conclusion The skeletal tumor burden on an interim 18F-fluoride PET/CT, performed after three cycles of 223RaCl2, is not able to predict overall survival, progression-free survival, or time to bone event, and should not be performed to monitor response at this time.
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Affiliation(s)
- Elba Etchebehere
- Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brazil
| | - Ana Emília Brito
- Real Hospital Português de Beneficência em Pernambuco - Real Nuclear, Recife, PE, Brazil
| | - Kalevi Kairemo
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Eric Rohren
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - John Araujo
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Homer Macapinlac
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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19
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Mattiolli AB, Santos A, Vicente A, Queiroz M, Bastos D, Herchenhorn D, Srougi M, Peixoto FA, Morikawa L, da Silva JLF, Etchebehere E. Impact of 68GA-PSMA PET / CT on treatment of patients with recurrent / metastatic high risk prostate cancer - a multicenter study. Int Braz J Urol 2018; 44:892-899. [PMID: 30088720 PMCID: PMC6237542 DOI: 10.1590/s1677-5538.ibju.2017.0632] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 12/26/2017] [Accepted: 05/31/2018] [Indexed: 11/22/2022] Open
Abstract
Purpose: The purpose of our study was to evaluate the clinical impact of 68Ga-PSMA PET / CT in the setting of biochemical recurrence of prostate cancer. Materials and Methods: We retrospectively evaluated 125 prostate cancer patients submitted to the 68Ga-PSMA PET / CT due to biochemical recurrence. The parameters age, Gleason score, PSA levels, and the highest SUVmax were correlated to potential treatment changes. The highest SUVmax values were correlated with age and Gleason score. The median follow-up time was 24 months. Results: 68Ga-PSMA PET / CT led to a treatment change in 66 / 104 (63.4%) patients (twenty-one patients were lost to follow-up). There was a significant change of treatment plan in patients with a higher Gleason score (P = 0.0233), higher SUVmax (p = 0.0306) and higher PSA levels (P < 0.0001; median PSA = 2.55 ng / mL). Conclusion: 68Ga-PSMA PET / CT in prostate cancer patients with biochemical recurrence has a high impact in patient management.
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Affiliation(s)
| | - Allan Santos
- Universidade Estadual de Campinas (UNICAMP), Campinas, Brasil.,Medicina Nuclear de Campinas, Campinas, SP, Brasil.,Hospital Sírio - Libanês, São Paulo, SP, Brasil
| | | | | | | | | | | | - Fabio A Peixoto
- Grupo Américas Centro de Oncologia Integrado, Rio de Janeiro, RJ, Brasil
| | - Lisa Morikawa
- Centro de Oncologia de D'Or, Rio de Janeiro, RJ, Brasil.,Grupo Américas Centro de Oncologia Integrado, Rio de Janeiro, RJ, Brasil
| | | | - Elba Etchebehere
- Universidade Estadual de Campinas (UNICAMP), Campinas, Brasil.,Medicina Nuclear de Campinas, Campinas, SP, Brasil.,Hospital Sírio - Libanês, São Paulo, SP, Brasil
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20
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Kairemo K, Milton DR, Etchebehere E, Rohren EM, Macapinlac HA. Final Outcome of 223Ra-therapy and the Role of 18F-fluoride-PET in Response Evaluation in Metastatic Castration-resistant Prostate Cancer-A Single Institution Experience. Curr Radiopharm 2018; 11:147-152. [PMID: 29956640 DOI: 10.2174/1874471011666180629145030] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 04/09/2018] [Revised: 06/18/2018] [Accepted: 06/22/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND 223Ra was the first therapeutic alpha-emitting radionuclide registered for clinical practice. This radionuclide is targeting actively bone-forming cells, and it is approved for treating metastatic skeletal disease in prostate cancer. 18F-PET is used to detect skeletal metastatic disease based on osteoblastic activity. The aim of this study was to analyze, if 18F-PET can be used assessing the results of 223Ra therapy, and to report final median overall survival in a total of 773 therapy cycles. METHODS A 161 men with castration-resistant prostate cancer were included in a single institution study (Protocol#: PA14-0848) and they received a total of 773 223Ra therapy cycles. RESULTS The median overall survival (95% CI) was 12.4 (9.1, 16.1) months in patient population. Interim Na18F-PET imaging was applied in 14 patients at baseline, after 3 cycles and after 6 cycles. TLF10 (skeletal disease burden at SUV-values >10 on Na18F -PET) were calculated in all these PET studies, and there was no significant association between change in TLF10 after 3 cycles and TLF10 after 6 cycles (p=0.20). CONCLUSION From these results, we conclude that interim imaging does not help in assessing the final outcome of 223Ra therapy. The survival benefit of 223Ra therapy alone is more than a year in a high-risk group of advanced prostate cancer.
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Affiliation(s)
- Kalevi Kairemo
- Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, United States.,Department of Molecular Radiotherapy and Nuclear Medicine, Docrates Cancer Center, Helsinki, Finland
| | - Denai R Milton
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, United States
| | - Elba Etchebehere
- Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, United States.,Department of Nuclear Medicine, Campinas State University, Campinas, Brazil
| | - Eric M Rohren
- Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, United States.,Baylor School of Medicine, Houston, United States
| | - Homer A Macapinlac
- Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, United States
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21
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Brito AE, Mourato F, Santos A, Mosci C, Ramos C, Etchebehere E. Validation of the Semiautomatic Quantification of 18F-Fluoride PET/CT Whole-Body Skeletal Tumor Burden. J Nucl Med Technol 2018; 46:378-383. [PMID: 30076246 DOI: 10.2967/jnmt.118.211474] [Citation(s) in RCA: 9] [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: 03/13/2018] [Accepted: 06/29/2018] [Indexed: 11/16/2022] Open
Abstract
Our purpose was to validate a semiautomatic quantification of the skeletal tumor burden on 18F-fluoride PET/CT using manual quantification as a reference. Methods: We quantified 51 18F-fluoride PET/CT examinations performed on female breast cancer patients. Clinical information (age; time of disease presentation; presence of visceral metastases; and time to death, progression, or a bone event) was recorded. The total volume of 18F-fluoride-avid skeletal metastases and the total activity of 18F-fluoride-avid metastases were calculated manually and semiautomatically. Results: Manual and semiautomatic metrics correlated strongly (P < 0.0001; 95% confidence interval, 0.9300-0.9769). On multivariable analysis, the semiautomatic measures of total activity for 18F-fluoride-avid metastasis correlated significantly with overall survival (P = 0.0001) and progression-free survival (P = 0.0006). Approximate times for calculating skeletal tumor burden (semiautomatic vs. manual) were, respectively, 30 s versus 321 s in patients with fewer than 5 metastases, 120 s versus 640 s in patients with 5-10 metastases, and 240 s versus 1207s in patients with more than 10 metastases. Conclusion: Semiautomatic quantification of whole-body 18F-fluoride PET/CT skeletal tumor burden can replace manual quantification in breast cancer patients and is a strong independent biomarker of prognosis.
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Affiliation(s)
- Ana E Brito
- Real Nuclear of Real Hospital Português de Beneficência em Pernambuco, Recife, Brazil.,Keizo Asami Immunopathology Laboratory, Federal University of Pernambuco, Recife, Brazil.,Division of Nuclear Medicine, Department of Radiology, University of Campinas, Campinas, Brazil; and
| | - Felipe Mourato
- Real Nuclear of Real Hospital Português de Beneficência em Pernambuco, Recife, Brazil
| | - Allan Santos
- Division of Nuclear Medicine, Department of Radiology, University of Campinas, Campinas, Brazil; and.,MND Campinas, Campinas, Brazil
| | - Camila Mosci
- Division of Nuclear Medicine, Department of Radiology, University of Campinas, Campinas, Brazil; and
| | - Celso Ramos
- Division of Nuclear Medicine, Department of Radiology, University of Campinas, Campinas, Brazil; and.,MND Campinas, Campinas, Brazil
| | - Elba Etchebehere
- Division of Nuclear Medicine, Department of Radiology, University of Campinas, Campinas, Brazil; and .,MND Campinas, Campinas, Brazil
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22
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Brito AE, Amorim BJ, Martello M, Bernardo WM, Etchebehere E. Prostate cancer – Therapy with radium-223. Rev Assoc Med Bras (1992) 2017; 63:1019-1023. [DOI: 10.1590/1806-9282.63.12.1019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2017] [Indexed: 11/22/2022] Open
Affiliation(s)
| | - Bárbara Juarez Amorim
- Universidade Estadual de Campinas, Brazil; Brazilian Society of Nuclear Medicine, Brazil
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Martiniova L, Palatis LD, Etchebehere E, Ravizzini G. Gallium-68 in Medical Imaging. Curr Radiopharm 2017; 9:187-207. [PMID: 27804868 DOI: 10.2174/1874471009666161028150654] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [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: 03/23/2016] [Revised: 10/17/2016] [Accepted: 10/18/2016] [Indexed: 11/22/2022]
Abstract
Over the past several years, Positron Emission Tomography (PET) imaging agents labeled with ;68Gallium (68Ga) have undergone a significant increase in clinical utilization. 68Ga is conveniently produced from a germanium-68/gallium-68 (68Ge/68Ga) generator. Because of the compact size and ease of use of the generator, 68Ga labeled compounds may be more cost-effective than PET radioisotopes that are cyclotron-produced. The convenient half-life of 68Ga (T1/2=68 min) provides sufficient radioactivity for various PET imaging applications, while delivering acceptable radiation doses to patients. This chapter summarizes the emerging clinical utilization of 68Ga-based radiotracers in medical imaging.
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Affiliation(s)
| | | | | | - Gregory Ravizzini
- University of Texas MD Anderson Cancer Center, 1400 Pressler, Unit Number: 1483, Houston, TX 7703, USA
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Etchebehere E, Brito AE, Rezaee A, Langsteger W, Beheshti M. Therapy assessment of bone metastatic disease in the era of 223radium. Eur J Nucl Med Mol Imaging 2017; 44:84-96. [DOI: 10.1007/s00259-017-3734-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 05/12/2017] [Indexed: 02/05/2023]
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Elimova E, Wang X, Etchebehere E, Shiozaki H, Shimodaira Y, Wadhwa R, Planjery V, Charalampakis N, Blum MA, Hofstetter W, Lee JH, Weston BR, Bhutani MS, Rogers JE, Maru D, Skinner HD, Macapinlac HA, Ajani JA. 18-fluorodeoxy-glucose positron emission computed tomography as predictive of response after chemoradiation in oesophageal cancer patients. Eur J Cancer 2015; 51:2545-52. [PMID: 26321501 DOI: 10.1016/j.ejca.2015.07.044] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [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: 03/28/2015] [Revised: 07/07/2015] [Accepted: 07/30/2015] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The purpose of this study was to evaluate if a baseline, an interim or a post-chemoradiation (CTRT) 18-fluorodeoxy-glucose positron emission computed tomography (18F-FDG PET/CT) studies could provide information on pathologic response to CTRT and overall survival (OS). MATERIALS AND METHODS Thirty-one patients with histologically proven adenocarcinoma or squamous cell carcinoma of the oesophagus, fit for trimodality therapy were prospectively enrolled. Most were men (93.5%), and had a stage III cancer (74.2%). Chemotherapy consisted of oxaliplatin/5-fluorouracil (45.2%) and taxane/5-fluorouracil (54.8%). All patients underwent a baseline, an interim (performed 12 ± 2 days after the onset of CTRT) and a post-CTRT 18F-FDG PET/CT study. The 18F-FDG PET/CT variables evaluated were at baseline, interim and post-CTRT studies maximum standardised uptake value (SUV max) and total lesion glycolysis (TLG). Clinical and 18F-FDG PET/CT parameters were correlated with pathologic complete response (pathCR) and OS. RESULTS Among the 31 patients studied, 61.3% achieved a clinical complete response (cCR) and 87.1% had surgery. The median OS was 35.1 months (95% confidence interval (CI): 19.9-NA). PathCR rate was 22.2%. There was only a marginal association between cCR and pathCR (p = 0.06). None of the other variables was predictive of pathCR. There was association between OS and baseline TLG (p = 0.03) at the optimal cutoff TLG value of 75.15. Additionally, TLG and ΔTLG post-CTRT were also associated with OS (p = 0.01 and 0.03, respectively). CONCLUSION None of the PET parameters is predictive of pathCR but TLG at baseline and post-CTRT are prognostic of OS.
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Affiliation(s)
- Elena Elimova
- Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA
| | - Xuemei Wang
- Department of Biostatistics, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA
| | - Elba Etchebehere
- Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA
| | - Hironori Shiozaki
- Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA
| | - Yusuke Shimodaira
- Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA
| | - Roopma Wadhwa
- Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA
| | - Venkatram Planjery
- Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA
| | - Nikolaos Charalampakis
- Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA
| | - Mariela A Blum
- Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA
| | - Wayne Hofstetter
- Department of Thoracic Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA
| | - Jeff H Lee
- Department of Gastroenterology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA
| | - Brian R Weston
- Department of Gastroenterology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA
| | - Manoop S Bhutani
- Department of Gastroenterology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA
| | - Jane E Rogers
- Department of Clinical Pharmacy, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA
| | - Dipen Maru
- Department of Pathology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA
| | - Heath D Skinner
- Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA
| | - Homer A Macapinlac
- Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA
| | - Jaffer A Ajani
- Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd (FC10.3022), Houston, TX 77030, USA.
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Etchebehere E, Araujo JC, Milton D, Fox PS, Swanston N, Macapinlac HA, Rohren E. Skeletal tumor burden on baseline 18F-fluoride PET/CT to predict bone marrow failure after radium-223. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.11012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - John C. Araujo
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Denai Milton
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Patricia S Fox
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Nancy Swanston
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Eric Rohren
- The University of Texas MD Anderson Cancer Center, Houston, TX
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27
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Bezerra R, Gumz BP, Etchebehere E, Santos AOLIVEIRA, Fernandes RRR, Hoff PM, Strecker R, Menezes M, Costa F. Whole-body diffusion-weighted MRI (DWMR) compared with [68Ga] DOTATOC-PET/CT (68Ga) and OctreoScan (OCT) for staging neuroendocrine tumors (NET). J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.e15167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | - Paulo Marcelo Hoff
- Hospital Sírio-Libanês and Instituto do Cancer do Estado de São Paulo, Universidade de Sao Paulo, São Paulo, Brazil
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Chone CT, Aniteli MB, Magalhães RS, Freitas LL, Altemani A, Ramos CD, Etchebehere E, Crespo AN. Impact of immunohistochemistry in sentinel lymph node biopsy in head and neck cancer. Eur Arch Otorhinolaryngol 2012; 270:313-7. [DOI: 10.1007/s00405-012-2032-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Accepted: 04/20/2012] [Indexed: 02/06/2023]
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Santos A, Pinheiro V, Anjos C, Brandalise S, Fahel F, Lima M, Etchebehere E, Ramos C, Camargo EE. Scintigraphic follow-up of the effects of therapy with hydroxyurea on splenic function in patients with sickle cell disease. Eur J Nucl Med Mol Imaging 2002; 29:536-41. [PMID: 11914893 DOI: 10.1007/s00259-001-0738-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [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
Patients with sickle cell disease (SCD) may develop functional asplenia as a chronic complication, secondary to repeated episodes of polymerisation of haemoglobin S. It is known that increased plasma concentrations of fetal haemoglobin (HbF) reduce the polymerisation of haemoglobin S. Hydroxyurea is a chemotherapeutic agent capable of increasing HbF levels in the red blood cells and its use has recently been proposed in the treatment of SCD. The objective of this study was to evaluate the effects of long-term therapy with hydroxyurea on recovery of splenic function. Twenty-one patients (aged 3-22 years; 14 with SS haemoglobinopathy, 7 with Sbeta(0) haemoglobinopathy) were studied with liver/spleen scintigraphy before and after 6 and 12 months of treatment. All studies were submitted to visual inspection and semi-quantitative analyses using spleen/liver ratios. Imaging prior to treatment demonstrated functional asplenia in nine SS patients and one Sbeta(0) patient and impaired splenic function in five SS patients and six Sbeta(0) patients. After treatment, splenic function improved in ten patients, remained unchanged in eight and worsened in three. Using liver/spleen imaging, it was possible to demonstrate that hydroxyurea is capable of improving splenic function in some SCD patients. Improvement is not always possible and frequently does not lead to a normal splenic function even after 1 year of treatment.
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Affiliation(s)
- Allan Santos
- Serviço de Medicina Nuclear, Hospital das Clínicas da UNICAMP, Cidade Universitária Zeferino Vaz, Caixa Postal 6142, CEP 13081-970 Campinas, SP, Brazil.
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