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Gennari A, Brain E, De Censi A, Nanni O, Wuerstlein R, Frassoldati A, Cortes J, Rossi V, Palleschi M, Alberini JL, Matteucci F, Piccardo A, Sacchetti G, Ilhan H, D'Avanzo F, Ruffilli B, Nardin S, Monti M, Puntoni M, Fontana V, Boni L, Harbeck N. Early prediction of endocrine responsiveness in ER+/HER2-negative metastatic breast cancer (MBC): Pilot study with 18F-Fluoroestradiol (18F-FES) CT/PET. Ann Oncol 2024:S0923-7534(24)00057-7. [PMID: 38423389 DOI: 10.1016/j.annonc.2024.02.007] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 01/15/2024] [Accepted: 02/20/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND 18F-FES PET/CT is considered an accurate diagnostic tool to determine whole-body endocrine responsiveness. In the ET-FES trial, we evaluated 18F-FES PET/CT as a predictive tool in ER+/HER2- metastatic breast cancer (MBC). METHODS Eligible patients underwent a 18F-FES PET/CT at baseline. Patients with SUV≥2 received single agent ET until PD; patients with SUV<2 were randomized to single agent ET (Arm A) or chemotherapy (CT) (Arm B). Primary objective was to compare the activity of first line ET versus CT in patients with 18F-FES SUV <2. RESULTS Overall, 147 patients were enrolled; 117 presented with 18F-FES SUV≥2 and received ET; 30 pts with SUV<2 were randomized to ET or CT. After a median follow up of 62.4 months, 104 patients (73.2%) had disease progression and 53 died (37.3%). Median PFS was 12.4 months (95%CI 3.1-59.6) in patients with SUV <2 randomised to Arm A versus 23.0 months (95%CI 7.7-30.0) in Arm B, (HR = 0.71, 95%CI 0.3 - 1.7); median PFS was 18.0 months (95%CI 11.2-23.1) in patients with SUV≥2 treated with ET. Median OS was 28.2 months (95%CI 14.2-NE) in patients with SUV <2 randomized to ET (Arm A) versus 52.8 months (95%CI 16.2-NE) in Arm B (CT). Median OS was not reached in patients with SUV≥2. 60-month OS rate was 41.6% (95%CI 10.4-71.1%) in Arm A, 42.0% (95%CI 14.0-68.2%) in Arm B and 59.6% (95%CI 48.6-69.0%) in patients with SUV≥2. In patients with SUV≥2, 60-months OS rate was 72.6% if treated with aromatase inhibitors versus 40.6% in case of fulvestrant or tamoxifen (p<0.005). CONCLUSIONS The ET-FES trial demonstrated that ER+/HER2- MBC patients are a heterogeneous population, with different levels of endocrine responsiveness based on 18F-FES CT/PET SUV.
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Affiliation(s)
- A Gennari
- Department of Traslational Medicine, University of Piemonte Orientale, Novara, Italy;; Division of Medical Oncology, Maggiore University Hospital, Novara, Italy.
| | - E Brain
- Department of Medical Oncology, Institut Curie - Hôpital René Huguenin, Saint-Cloud, France
| | - A De Censi
- Medical Oncology, E.O. "Ospedali Galliera, Genova, Italy
| | - O Nanni
- Biostatistics and Clinical Trials Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - R Wuerstlein
- Department of Obstetrics and Gynecology and CCC Munich, LMU University Hospital, Munich, Germany
| | - A Frassoldati
- Clinical Oncology, S. Anna University Hospital, Ferrara, Italy
| | - J Cortes
- International Breast Cancer Center (IBCC), Pangaea Oncology, Quironsalud Group, Barcelona, Spain; Faculty of Biomedical and Health Sciences, Department of Medicine, Universidad Europea de Madrid, Madrid, Spain
| | - V Rossi
- Division of Medical Oncology, Maggiore University Hospital, Novara, Italy
| | - M Palleschi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - J L Alberini
- Nuclear Medicine Department Centre Georges-Francois Leclerc, Dijon Cedex, France
| | - F Matteucci
- Nuclear Medicine Unit, IRCCS Istituto Romagnolo per lo studio dei tumori (IRST)- Dino Amadori, Meldola, Italy
| | - A Piccardo
- Department of Nuclear Medicine, E.O. "Ospedali Galliera, Genova, Italy
| | - G Sacchetti
- Division of Nuclear Medicine Unit, Maggiore University Hospital, Novara, Italy
| | - H Ilhan
- Department of Nuclear Medicine, LMU University Hospital, Munich, Germany
| | - F D'Avanzo
- Division of Medical Oncology, Maggiore University Hospital, Novara, Italy
| | - B Ruffilli
- Department of Traslational Medicine, University of Piemonte Orientale, Novara, Italy
| | - S Nardin
- Medical Oncology Unit 1, IRCCS - Ospedale Policlinico San Martino, Genoa, Italy
| | - M Monti
- Biostatistics and Clinical Trials Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - M Puntoni
- Clinical and Epidemiological Research Unit, University Hospital of Parma, Parma, Italy
| | - V Fontana
- Department of Clinical Epidemiology, IRCSS Ospedale Policlinico San Martino, Genoa 20900, Italy
| | - L Boni
- Department of Clinical Epidemiology, IRCSS Ospedale Policlinico San Martino, Genoa 20900, Italy
| | - N Harbeck
- Department of Obstetrics and Gynecology and CCC Munich, LMU University Hospital, Munich, Germany
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Boughdad S, Champion L, Becette V, Cherel P, Fourme E, Edeline V, Lemonnier J, Lerebours F, Alberini JL. Abstract P4-01-03: Predictive value of FDG-PET/CT after neoadjuvant endocrine treatment in breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-01-03] [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: 11/16/2022]
Abstract
Abstract
Background: Neaodjuvant endocrine therapy (NET) has demonstrated efficacy in terms of clinical response and outcome in hormone-receptor positive (HR+) post-menopausal patients (pts) with breast cancer (BC) not eligible for primary breast conservative surgery (BCS). However, the monitoring of tumor response to NET is challenging and clinical response is the current gold standard. The aim of the present study was to investigate the contribution of the early metabolic response (eMR) at one month in FDG-PET/CT in a NET setting for post-menopausal pts with HR+, HER2- BC compared to morphological and pathological responses. We also aimed to evaluate the prognostic value of eMR.
Methods: This was a prospective and ancillary study of CARMINA 02, UCBG0609 (Cancer in press), a phase II clinical trial evaluating the efficacy of 4 to 6 months neoadjuvant anastrozole or fulvestrant. FDG-PET/CT exams were performed at baseline (M0), after 1 month of treatment (M1: eMR) and pre-Op (late metabolic response: lMR) in 11 pts (74.2 years ± 3.6) from 2007 to 2010. Pts were classified “metabolic responders” (mR) if SUVmax values decrease was ≥ 40% at M1 and “non-metabolic responders” (mNR) if otherwise; lMR was also assessed in mR and mNR groups defined at M1. We compared eMR to morphological response (clinical, breast US and MRI) at M1 and pre-op, to the pathological response according to Sataloff classification and to Ki67 score variation during treatment. Early metabolic response was also correlated with the PEPI (Preoperative Endocrine Prognostic Index) score and survival (overall survival, OS and relapse free survival, RFS).
Results: Main results are summarized in Table I. There was a significant difference between mR and mNR pts at M1 (eMR) and pre-op (lMR). One patient with a complete metabolic response at pre-op had the best pathological response (Sataloff TB). Also, mR pts had a better clinical response: 2 partial response (PR) in mR vs 1 in mNR group and 2 mNR patients were classified PD (progressive disease). There was a trend toward better survival for mR pts in OS and RFS (Kaplan-Meier p=0.18 and 0.06, respectively) and all the pejorative events occurred in the mNR group: 3 deaths and 3 metastatic progressions. Besides, no difference in eMR was observed regarding the histological subtype (ductal or lobular; p>0.05) nor the treatment group (p>0.05).
Table I: Metabolic, morphological and pathological response at M1, Pre-Op and on the surgical specimen. MR : 5ptsmNR : 6ptsP valueM1SUVmax2.6±1.13.9±1.40.00017 Clinical size42.5mm±11.951.7mm±7.50.19 US size22.6mm±6.334.2mm±2.40.02 MRI size21.2mm±4.239.7mm±4.79.16 E-5 Ki 673.6%±1.98.2%±80.19Pre-OpSUVmax2±1.33.3±1.40.018 Clinical size31mm±12.448.3mm±10.80.035 US size18.5mm±7.331.3mm±9.50.07 MRI size17.9mm±7.134.8mm±7.70.003Surgical SpecimenSataloff (TA+TB vs TC+TD)20% vs 80%0 vs 100%1 PEPI score (I+II vs III)80% vs 20%33 vs 67%0.048 Ki 678.6%±9.812.3%±7.90.41
Conclusions: These preliminary results showed the value of the early metabolic response in FDG- PET/CT in a NET setting compared to the morphological or the pathological responses alone. Early metabolic responders patients had better OS, RFS and PEPI scores.
Citation Format: Boughdad S, Champion L, Becette V, Cherel P, Fourme E, Edeline V, Lemonnier J, Lerebours F, Alberini JL. Predictive value of FDG-PET/CT after neoadjuvant endocrine treatment in breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-01-03.
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Affiliation(s)
- S Boughdad
- Institut Curie-Hôpital René Huguenin, Saint-Cloud, France; Unicancer, Paris, France
| | - L Champion
- Institut Curie-Hôpital René Huguenin, Saint-Cloud, France; Unicancer, Paris, France
| | - V Becette
- Institut Curie-Hôpital René Huguenin, Saint-Cloud, France; Unicancer, Paris, France
| | - P Cherel
- Institut Curie-Hôpital René Huguenin, Saint-Cloud, France; Unicancer, Paris, France
| | - E Fourme
- Institut Curie-Hôpital René Huguenin, Saint-Cloud, France; Unicancer, Paris, France
| | - V Edeline
- Institut Curie-Hôpital René Huguenin, Saint-Cloud, France; Unicancer, Paris, France
| | - J Lemonnier
- Institut Curie-Hôpital René Huguenin, Saint-Cloud, France; Unicancer, Paris, France
| | - F Lerebours
- Institut Curie-Hôpital René Huguenin, Saint-Cloud, France; Unicancer, Paris, France
| | - JL Alberini
- Institut Curie-Hôpital René Huguenin, Saint-Cloud, France; Unicancer, Paris, France
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Decaudin D, Kadouche J, Levy R, Belhamiche M, Arnaud P, Alberini JL, Lokiec FM, Pecking AP. Radioimmunotherapy (RIT) of refractory or relapsed Hodgkin’s lymphoma with 90Yttrium-labeled antiferritin antibody. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.2534] [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: 11/20/2022] Open
Abstract
2534 Background: The aims of this study were to evaluate (1) the tumor targeting of 111Indium-labeled rabbit polyclonal antiferritin antibody (Ab) and (2) the therapeutic efficacy of 90Yttrium-labeled antiferritin Ab in relapsed or refractory Hodgkin’s lymphoma (HL) patients (pts). Methods: After obtention of the patients’ consent, the protocol included a first intravenous injection of 2 mg of antiferritin Ab labeled to 111 MBq (3 mCi) of 111Indium followed by immunoscintigraphy at time 24 and 48 hours and, in case of tumor targeting, one or more intravenous injections of 90Yttrium-labeled antiferritin Ab at various activities. Results: Ten patients were included in the study: median age 32 years (range: 18–43 years); sex ratio M/F 9; stages III and IV at the time of RIT 1 and 9 pts, respectively; median number of chemotherapy regimens 3 (range: 2–4); number of autografted pts 8; number of previously irradiated pts 9; response to last chemotherapy: 6 PR and 4 progressions. All immunoscintigraphies showed a tumor targeting by 111Indium-labeled antiferritin Ab. Nine patients were treated, one case died of HL evolution. Five pts received one 90Yttrium-labeled antiferritin Ab injection, three pts 2 injections (0.5, 5 et 14 months after the first one), and one pt 4 injections (3, 9 et 16 months after the first one). Median injected activity was 13 MBq/kg (0.35 mCi/kg)(range: 7–15 MBq). Among the 9 treated pts, 1 CR, 6 PR, 1 stable disease, and 1 tumor progression were observed (ORR 78%). The median duration of responses were 8 months (range: 7–12 months). Toxicity was mainly hematological, with neutropenia and anemia of grades 1 or 2, and thrombopenia of grades 2 and 3; one pt presented a generalized convulsive crisis 24 hours after the therapeutic injection, without etiologic evidence. Conclusion: These results confirmed those that have been reported by Vriesendorp and Quadri and showed that rabbit polyclonal antiferritin Ab targeted HL tumor sites and had an important therapeutic potential in this discrepancy situation. They warranted therefore further multicentric prospective trials. [Table: see text]
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Affiliation(s)
- D. Decaudin
- Institut Curie, Paris, France; MAT Biopharma, Evry, France; Centre René Huguenin, Saint Cloud, France
| | - J. Kadouche
- Institut Curie, Paris, France; MAT Biopharma, Evry, France; Centre René Huguenin, Saint Cloud, France
| | - R. Levy
- Institut Curie, Paris, France; MAT Biopharma, Evry, France; Centre René Huguenin, Saint Cloud, France
| | - M. Belhamiche
- Institut Curie, Paris, France; MAT Biopharma, Evry, France; Centre René Huguenin, Saint Cloud, France
| | - P. Arnaud
- Institut Curie, Paris, France; MAT Biopharma, Evry, France; Centre René Huguenin, Saint Cloud, France
| | - J. L. Alberini
- Institut Curie, Paris, France; MAT Biopharma, Evry, France; Centre René Huguenin, Saint Cloud, France
| | - F. M. Lokiec
- Institut Curie, Paris, France; MAT Biopharma, Evry, France; Centre René Huguenin, Saint Cloud, France
| | - A. P. Pecking
- Institut Curie, Paris, France; MAT Biopharma, Evry, France; Centre René Huguenin, Saint Cloud, France
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Abad S, Meyssonier V, Allali J, Gouya H, Giraudet AL, Monnet D, Parc C, Tenenbaum F, Alberini JL, Grabar S, Pesce F, Rollot F, Sicard D, Dhote R, Blanche P, Brézin AP. Association of peripheral multifocal choroiditis with sarcoidosis: a study of thirty-seven patients. ACTA ACUST UNITED AC 2005; 51:974-82. [PMID: 15593175 DOI: 10.1002/art.20839] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.0] [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: 11/07/2022]
Abstract
OBJECTIVE To assess the clinical spectrum of peripheral multifocal choroiditis (PMC) and its association with sarcoidosis. METHODS Thirty-seven patients examined between November 1997 and November 2001 who met all diagnostic criteria for PMC were included in this retrospective study. Patients were assessed for the following signs of sarcoidosis: typical changes on chest radiography or computed tomography; predominantly CD4 lymphocytosis in bronchoalveolar lavage fluid; elevated serum angiotensin-converting enzyme levels; elevated gallium uptake; and noncaseating granuloma on biopsy. RESULTS Most of the patients were female (30 of 37; 81%) and white (30 of 37; 81%). Mean +/- SD age at onset was 57.5 +/- 18.7 years. Seven (19%) of the 37 patients had biopsy-proven sarcoidosis and 18 patients (49%) with presumed sarcoidosis met at least 2 of the above-mentioned criteria for sarcoidosis but had normal biopsy results. Twelve patients (32%) had an indeterminate diagnosis. Patients with presumed sarcoidosis did not differ from those with proven sarcoidosis as regards the above-mentioned criteria, except for noncaseating granuloma, implying that more than two-thirds of patients (predominantly whites) had underlying sarcoidosis. Most patients with positive gallium scintigraphy had increased mediastinal uptake, as described in sarcoidosis. Patients with underlying sarcoidosis had more severe visual impairment due to cystoid macular edema (CME). Weekly methotrexate (0.3 mg/kg) seemed to control CME. CONCLUSION White patients with PMC should be considered to have sarcoidosis. The identification of sarcoidosis in patients with severe ocular disease can help with therapeutic choices.
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Affiliation(s)
- S Abad
- Hôpital Cochin-St. Vincent de Paul, Paris, France.
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Alberini JL, Belhocine T, Hustinx R, Daenen F, Rigo P. Whole-body positron emission tomography using fluorodeoxyglucose in patients with metastases of unknown primary tumours (CUP syndrome). Nucl Med Commun 2004; 24:1081-6. [PMID: 14508164 DOI: 10.1097/00006231-200310000-00008] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [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: 11/25/2022]
Abstract
The aim of this study was to evaluate the clinical performances of whole body 2-[18F]fluorodeoxyglucose positron emission tomography (FDG PET) imaging for the detection of the primary tumour in patients with metastases of unknown origin. Forty-one patients, without previous history of known cancer (18 women and 23 men; average age 64.1 years) with metastasis confirmed by histopathological analysis were included in a retrospective study. Results of PET were compared with those of techniques used in the current conventional diagnostic procedure. All known metastatic lesions were detected by PET. There were 26 true-positive and two false-negative results. Primary tumour remained undetermined in eight patients after conventional investigations and PET. PET was superior to conventional diagnostic procedure in 11 patients and led to modify treatment in 11 patients. Sensitivity of PET was superior than computed tomography in detecting abdominal primary tumours. FDG PET is useful in patients with unknown primary tumour because its sensitivity is good and it could modify the disease management. Otherwise, PET allows the evaluation of the extent of the disease and could be used to monitor treatment efficiency. Its contribution has to be evaluated particularly in patients with primary tumour with a specific treatment.
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Affiliation(s)
- J L Alberini
- Nuclear Medicine Department, University Hospital, Sart Tilman, Liege, Belgium.
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Bertherat J, Tenenbaum F, Perlemoine K, Videau C, Alberini JL, Richard B, Dousset B, Bertagna X, Epelbaum J. Somatostatin receptors 2 and 5 are the major somatostatin receptors in insulinomas: an in vivo and in vitro study. J Clin Endocrinol Metab 2003; 88:5353-60. [PMID: 14602773 DOI: 10.1210/jc.2002-021895] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Somatostatin (SRIF) receptors (sst) are present on normal pancreatic endocrine beta-cells. However, the use of SRIF analogs in the scintigraphic imaging of insulinomas and in the medical management of these tumors seems to be restricted to a subgroup of patients. The aim of this study was to determine the prevalence of sst expression in vitro and characterize sst subtype binding in insulinomas and its correlation with in vivo sst receptor scintigraphy (SRS). In vitro studies were performed on 27 insulinomas from 25 patients: 22 with benign and three with malignant tumors. Semiquantitative RT-PCR of sst mRNAs was performed for 20 of these insulinomas. Sst2 and sst5 were expressed in 70%, sst1 in 50%, and sst3 and sst4 subtypes only in 15-20% of the tumors. (125)I-Tyr(0)DTrp(8)SRIF(14) binding was assessed by quantitative autoradiography in 18 insulinomas, and competition experiments were performed with SRIF(14) and L797-591, L779-976, L796-778, L803-087, L817-818, selective agonists of the five sst subtypes, and BIM23244, a selective agonist of sst2 and sst5. Significant specific binding was observed in 72% of the insulinomas. Displacement experiments with ligands of higher affinity for each of the sst receptors revealed significant binding with the sst2 and sst5 ligands in 72%, sst3 in 44%, sst1 in 44%, and sst4 in 28% of cases. All insulinomas displaying sst2 binding were also sst5 sensitive. However, the ratio of sst5/sst2 displacement was variable and only equal to that for SRIF(14) in experiments with the sst2/sst5 agonist BIM23244. SRS was performed 10 times in nine patients; it detected 60% of the tumors, including metastases of a malignant insulinoma. All the tumors detected by SRS displayed high levels of (125)I-Tyr(0)DTrp(8)SRIF(14) binding. The mechanisms underlying the loss of expression of sst2/sst5 in a third of insulinomas remains to be determined, but this loss of expression may be involved in beta-cell dysfunction.
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Affiliation(s)
- J Bertherat
- Department of Endocrinology, Cochin Hospital, Paris, France.
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Pecking AP, Mechelany-Corone C, Bertrand-Kermorgant F, Alberini JL, Floiras JL, Goupil A, Pichon MF. Detection of occult disease in breast cancer using fluorodeoxyglucose camera-based positron emission tomography. Clin Breast Cancer 2001; 2:229-34. [PMID: 11899417 DOI: 10.3816/cbc.2001.n.026] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [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: 11/20/2022]
Abstract
An isolated increase of blood tumor marker CA 15.3 in breast cancer is considered a sensitive indicator for occult metastatic disease but by itself is not sufficient for initiating therapeutic intervention. We investigated the potential of camera-based positron emission tomography (PET) imaging using [18F]-fluorodeoxyglucose (FDG) to detect clinically occult recurrences in 132 female patients (age, 35-69 years) treated for breast cancer, all presenting with an isolated increase in blood tumor marker CA 15.3 without any other evidence of metastatic disease. FDG results were correlated to pathology results or to a sequentially guided conventional imaging method. One hundred nineteen patients were eligible for correlations. Positive FDG scans were obtained for 106 patients, including 89 with a single lesion and 17 with 2 or more lesion. There were 92 true-positive and 14 false-positive cases, 10 of which became true positive within 1 year. Among the 13 negative cases, 7 were false negative and 6 were true negative. Camera-based PET using FDG has successfully identified clinically occult disease with an overall sensitivity of 93.6% and a positive predictive value of 96.2%. The smallest detected size was 6 mm for a lymph node metastasis (tumor to nontumor ratio, 4:2). FDG camera-based PET localized tumors in 85.7% of cases suspected for clinically occult metastatic disease on the basis of a significant increase in blood tumor marker. A positive FDG scan associated with an elevated CA 15.3 level is most consistent with metastatic relapse of breast cancer.
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Affiliation(s)
- A P Pecking
- Nuclear Medicine Department, Centre René Huguenin, 35 rue Dailly, 92210 Saint-Cloud, France.
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Belhocine T, Bolle S, Alberini JL, Daenen F, Rutten I, Rigo P. A case of cerebral metastases of unknown origin: utility of F-18 FDG positron emission tomography to localize the primary tumor. Clin Nucl Med 2001; 26:793. [PMID: 11507305 DOI: 10.1097/00003072-200109000-00016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- T Belhocine
- Division of Nuclear Medicine, University Hospital of Liege, Sart Tilman-Bât.35, 4000 Liege, Belgium.
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Alberini JL, Badran A, Freneaux E, Hadji S, Kalifa G, Devaux JY, Dupont T. Technetium-99m HMPAO-labeled leukocyte imaging compared with endoscopy, ultrasonography, and contrast radiology in children with inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2001; 32:278-86. [PMID: 11345176 DOI: 10.1097/00005176-200103000-00009] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND The purpose of this study was to evaluate retrospectively the value of leukocyte-labeled scintigraphy, ultrasonography, and contrast radiography compared with endoscopy in children suspected of having inflammatory bowel disease (IBD). METHODS Twenty-eight children (17 boys; mean age, 10.2 years) with IBD based on standard colonoscopic, histologic, and radiologic criteria (16 with Crohn's disease, 5 with ulcerative colitis, 5 with nonspecific colitis, I with granulomatous disease, and I with Beh,cet's disease) were included. Endoscopic, ultrasonographic, and contrast radiologic examinations were realized for 28, 23, and 19 children respectively. RESULTS Sensitivity and specificity were 75% and 92% for leukocyte-labeled scintigraphy, 39% and 90% for ultrasonography, and 58% and 83% for contrast radiography. The authors noted discontinuous uptake for 14 of 15 true-positive results for patients with Crohn's disease and continuous uptake for 4 of 4 true-positive results for patients with ulcerative colitis. A negative correlation between scan activity index and Lloyd-Still clinical score was found for 11 patients with Crohn's disease (r = -0.77). CONCLUSIONS Leukocyte-labeled scintigraphy, a noninvasive and reproducible technique, is a useful tool in the diagnosis and therapeutic strategy of IBD, and provides information on the presence, the intensity, and the extent of the disease, particularly in the terminal ileum. Leukocyte-labeled scintigraphy may not replace colonoscopy with biopsies for diagnosis confirmation. Its reliability seems higher than that of ultrasonography.
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Affiliation(s)
- J L Alberini
- Service de Médecine Nucléaire, Groupe Hospitalier Cochin-Saint Vincent de Paul, Paris, France.
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Alberini JL, Pavin D, Daubert JC, Bourguet P. False-positive antimyosin imaging caused by cardioversion-induced skeletal muscle uptake. Clin Nucl Med 1999; 24:519-20. [PMID: 10402007 DOI: 10.1097/00003072-199907000-00010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- J L Alberini
- Department of Medical Imaging, Centre de Recherche et de Lutte Contre le Cancer, Rennes, France
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