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Chaban A, Waschulzik B, Bernhardt D, Delbridge C, Schmidt-Graf F, Wagner A, Wiestler B, Weber W, Yakushev I. Amino acid PET vs. RANO MRI for prediction of overall survival in patients with recurrent high grade glioma under bevacizumab therapy. Eur J Nucl Med Mol Imaging 2024; 51:1698-1702. [PMID: 38228970 PMCID: PMC11043199 DOI: 10.1007/s00259-024-06601-4] [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: 09/20/2023] [Accepted: 01/01/2024] [Indexed: 01/18/2024]
Abstract
PURPOSE To summarize evidence on the comparative value of amino acid (AA) PET and conventional MRI for prediction of overall survival (OS) in patients with recurrent high grade glioma (rHGG) under bevacizumab therapy. METHODS Medical databases were screened for studies with individual data on OS, follow-up MRI, and PET findings in the same patient. MRI images were assessed according to the RANO criteria. A receiver operating characteristic curve analysis was used to predict OS at 9 months. RESULTS Five studies with a total of 72 patients were included. Median OS was significantly lower in the PET-positive than in the PET-negative group. PET findings predicted OS with a pooled sensitivity and specificity of 76% and 71%, respectively. Corresponding values for MRI were 32% and 82%. Area under the curve and sensitivity were significantly higher for PET than for MRI. CONCLUSION For monitoring of patients with rHGG under bevacizumab therapy, AA-PET should be preferred over RANO MRI.
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Affiliation(s)
- Artem Chaban
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Birgit Waschulzik
- Institute of AI and Informatics in Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Denise Bernhardt
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Radiation Oncology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Claire Delbridge
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Pathology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Friederike Schmidt-Graf
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Neurology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Arthur Wagner
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Neurosurgery, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Benedikt Wiestler
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Wolfgang Weber
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Igor Yakushev
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
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Moser R, Pfeiffer S, Cala L, Klein E, Kiechle M, Behzadi ST, Fallenberg E, Combs SE, Weber W, Borm KJ. Detecting Metastatic Patterns of Oligometastatic Breast Cancer: A Comparative Analysis of 18F-FDG PET/CT and Conventional CT Imaging. J Nucl Med 2024:jnumed.123.266925. [PMID: 38637138 DOI: 10.2967/jnumed.123.266925] [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: 10/23/2023] [Revised: 03/05/2024] [Indexed: 04/20/2024] Open
Abstract
Metastasis-directed therapy has the potential to improve progression-free and overall survival in oligometastatic disease (OMD). For breast cancer, however, randomized trials have failed so far to confirm this finding. Because the concept of metastasis-directed therapy in OMD is highly dependent on the accuracy of the imaging modality, we aimed to assess the impact of 18F-FDG PET/CT on the definition of OMD in breast cancer patients. Methods: Eighty patients with a total of 150 18F-FDG PET/CT images (between October 2006 and January 2022) were enrolled in this retrospective study at the Technical University of Munich. The inclusion criteria were OMD, defined as 1-5 distant metastases, at the time of 18F-FDG PET/CT. For the current study, we systemically compared the metastatic pattern on 18F-FDG PET/CT with conventional CT. Results: At the time of 18F-FDG PET/CT, 21.3% of patients (n = 32) had a first-time diagnosis of metastatic disease, 40.7% (n = 61) had a previous history of OMD, and 38% (n = 57) had a previous history of polymetastatic disease. In 45.3% of cases, the imaging modality (18F-FDG PET/CT vs. conventional CT) had an impact on the assessment of whether OMD was present. An identical metastatic pattern was observed in only 32% of cases.18F-FDG PET/CT detected additional metastases in 33.3% of cases, mostly in the nonregional lymph node system. Conclusion: The use of 18F-FDG PET/CT had a substantial impact on the definition of OMD and detection of metastatic pattern in breast cancer. Our results emphasize the importance of establishing a standardized definition for imaging modalities in future trials and clinical practices related to metastasis-directed therapy in breast cancer patients.
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Affiliation(s)
- Rebecca Moser
- Department of Radiation Oncology, Klinikum Rechts der Isar, TUM School of Medicine and Health, Technical University Munich, Munich, Germany
| | - Sophie Pfeiffer
- Department of Radiation Oncology, Klinikum Rechts der Isar, TUM School of Medicine and Health, Technical University Munich, Munich, Germany
| | - Lisena Cala
- Department of Nuclear Medicine, Klinikum Rechts der Isar, TUM School of Medicine and Health, Technical University Munich, Munich, Germany
| | - Evelyn Klein
- Department of Obstetrics and Gynecology, Klinikum Rechts der Isar, TUM School of Medicine and Health, Technical University Munich, Munich
| | - Marion Kiechle
- Department of Obstetrics and Gynecology, Klinikum Rechts der Isar, TUM School of Medicine and Health, Technical University Munich, Munich
| | - Sophie T Behzadi
- Department of Radiation Oncology, Klinikum Rechts der Isar, TUM School of Medicine and Health, Technical University Munich, Munich, Germany
| | - Eva Fallenberg
- Department of Obstetrics and Gynecology, Klinikum Rechts der Isar, TUM School of Medicine and Health, Technical University Munich, Munich
| | - Stephanie E Combs
- Department of Radiation Oncology, Klinikum Rechts der Isar, TUM School of Medicine and Health, Technical University Munich, Munich, Germany
- Department of Radiation Sciences, Germany Institute of Innovative Radiotherapy, Helmholtz Zentrum München, Oberschleißheim, Germany; and
- German Consortium for Translational Cancer Research, Munich, Germany
| | - Wolfgang Weber
- Department of Nuclear Medicine, Klinikum Rechts der Isar, TUM School of Medicine and Health, Technical University Munich, Munich, Germany
| | - Kai J Borm
- Department of Radiation Oncology, Klinikum Rechts der Isar, TUM School of Medicine and Health, Technical University Munich, Munich, Germany;
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Gammel MCM, Hansen K, Weber W, Rauscher I. When Exercise Echoes: Unusual Tc99m HDP Uptake in Thigh Adductors Post-Workout. Nuklearmedizin 2024. [PMID: 38580312 DOI: 10.1055/a-2289-4301] [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: 04/07/2024]
Affiliation(s)
| | - Kimberley Hansen
- Department of Nuclear Medicine, Klinikum rechts der Isar der Technischen Universitat Munchen, Munich, Germany
| | - Wolfgang Weber
- Department of Nuclear Medicine, Klinikum rechts der Isar der Technischen Universitat Munchen, Munich, Germany
| | - Isabel Rauscher
- Department of Nuclear Medicine, Klinikum rechts der Isar der Technischen Universitat Munchen, Munich, Germany
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Wurzer A, De Rose F, Fischer S, Schwaiger M, Weber W, Nekolla S, Wester HJ, Eiber M, D'Alessandria C. Preclinical comparison of [ 177Lu]Lu-rhPSMA-10.1 and [ 177Lu]Lu-rhPSMA-10.2 for endoradiotherapy of prostate cancer: biodistribution and dosimetry studies. EJNMMI Radiopharm Chem 2024; 9:18. [PMID: 38407630 PMCID: PMC10897098 DOI: 10.1186/s41181-024-00246-2] [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: 01/18/2024] [Accepted: 02/20/2024] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND Radiohybrid PSMA-targeted ligands (rhPSMA) have been introduced as a novel platform for theranostic applications. Among a variety of rhPSMA-ligands developed for radioligand therapy, two stereoisomers [177Lu]Lu-rhPSMA-10.1 and -10.2 have been synthesized and initially characterized in preclinical experiments with the aim to provide an optimized binding profile to human serum albumin, a reduction of charge, and thus accelerated kidney excretion, and unaffected or even improved tumor uptake. As both isomers showed similar in vitro characteristics and tumor uptake at 24 h post injection in tumor bearing mice and in order to identify the isomer with the most favorable pharmacokinetics for radioligand therapy, we carried out in-depth biodistribution and dosimetry studies in tumor-bearing and healthy mice. RESULTS rhPSMA-10.1 and -10.2 were radiolabeled with lutetium-177 according to the established procedures of other DOTA-based PSMA ligands and displayed a high and comparable stability in all buffers and human serum (> 97%, 24 h). Biodistribution studies revealed fast clearance from the blood pool (0.3-0.6%ID/g at 1 h) and other background tissues within 48 h. Distinctive differences were found in the kidneys, where [177Lu]Lu-rhPSMA-10.1 displayed lower initial uptake and faster excretion kinetics compared to [177Lu]Lu-rhPSMA-10.2 expressed by a 1.5-fold and ninefold lower uptake value at 1 h and 24 h in healthy animals, respectively. Tumor uptake was comparable and in the range of 8.6-11.6%ID/g for both isomers over 24 h and was maintained up to 168 h at a level of 2.2 ± 0.8 and 4.1 ± 1.4%ID/g for [177Lu]Lu-rhPSMA-10.1 and [177Lu]Lu-rhPSMA-10.2, respectively. CONCLUSION Our preclinical data on biodistribution and dosimetry indicate a more favorable profile of [177Lu]Lu-rhPSMA-10.1 compared to [177Lu]Lu-rhPSMA-10.2 for PSMA-targeted radioligand therapy. [177Lu]Lu-rhPSMA-10.1 shows fast kidney clearance kinetics resulting in excellent tumor-to-organ ratios over a therapy relevant time course. Meanwhile, [177Lu]Lu-rhPSMA-10.1 is currently being investigated in clinical phase I/II studies in patients with mCRPC (NCT05413850), in patients with high-risk localized PC (NCT06066437, Nautilus Trial) and after external beam radiotherapy (NCT06105918).
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Affiliation(s)
- Alexander Wurzer
- Department of Nuclear Medicine, University Hospital rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany.
| | - Francesco De Rose
- Department of Nuclear Medicine, University Hospital rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Sebastian Fischer
- Chair of Pharmaceutical Radiochemistry, Technical University of Munich, Garching, Germany
| | - Markus Schwaiger
- Department of Nuclear Medicine, University Hospital rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Wolfgang Weber
- Department of Nuclear Medicine, University Hospital rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Stephan Nekolla
- Department of Nuclear Medicine, University Hospital rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Hans-Jürgen Wester
- Chair of Pharmaceutical Radiochemistry, Technical University of Munich, Garching, Germany
| | - Matthias Eiber
- Department of Nuclear Medicine, University Hospital rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Calogero D'Alessandria
- Department of Nuclear Medicine, University Hospital rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
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5
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Puttini I, Kapalla M, Braune A, Michler E, Kröger J, Lutz B, Sakhalihasan N, Trenner M, Biro G, Weber W, Rössel T, Reeps C, Eckstein HH, Wolk S, Knappich C, Notohamiprodjo S, Busch A. Aortic Vascular Graft and Endograft Infection-Patient Outcome Cannot Be Determined Based on Pre-Operative Characteristics. J Clin Med 2024; 13:269. [PMID: 38202276 PMCID: PMC10779700 DOI: 10.3390/jcm13010269] [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: 10/29/2023] [Revised: 12/01/2023] [Accepted: 12/31/2023] [Indexed: 01/12/2024] Open
Abstract
Vascular graft/endograft infection (VGEI) is a serious complication after aortic surgery. This study investigates VGEI and patient characteristics, PET/CT quantification before surgical or conservative management of VGEI and post-intervention outcomes in order to identify patients who might benefit from such a procedure. PET standard uptake values (SUV) were quantitatively assessed and compared to a non-VGEI cohort. The primary endpoints were in-hospital mortality and aortic reintervention-free survival at six months. Ninety-three patients (75% male, 65 ± 10 years, 82% operated) were included. The initial operation was mainly for aneurysm (67.7%: 31% EVAR, 12% TEVAR, 57% open aortic repair). Thirty-two patients presented with fistulae. PET SUVTLR (target-to-liver ratio) showed 94% sensitivity and 89% specificity. Replacement included silver-coated Dacron (21.3%), pericardium (61.3%) and femoral vein (17.3%), yet the material did not influence the overall survival (p = 0.745). In-hospital mortality did not differ between operative and conservative treatment (19.7% vs. 17.6%, p = 0.84). At six months, 50% of the operated cohort survived without aortic reintervention. Short- and midterm morbidity and mortality remained high after aortic graft removal. Neither preoperative characteristics nor the material used for reconstruction influenced the overall survival, and, with limitations, both the in-hospital and midterm survival were similar between the surgically and conservatively managed patients.
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Affiliation(s)
- Ilaria Puttini
- Department for Vascular and Endovascular Surgery, Klinikum Rechts der Isar, Technical University of Munich, 80333 Munich, Germany
| | - Marvin Kapalla
- Division of Vascular and Endovascular Surgery, Department for Visceral, Thoracic and Vascular Surgery, Medical Faculty Carl Gustav Carus, University Hospital, Technical University of Dresden, 01307 Dresden, Germany
| | - Anja Braune
- Nuclear Medicine Department, University Hospital Carl Gustav Carus, Technical University of Dresden, 01307 Dresden, Germany
| | - Enrico Michler
- Nuclear Medicine Department, University Hospital Carl Gustav Carus, Technical University of Dresden, 01307 Dresden, Germany
| | - Joselyn Kröger
- Division of Vascular and Endovascular Surgery, Department for Visceral, Thoracic and Vascular Surgery, Medical Faculty Carl Gustav Carus, University Hospital, Technical University of Dresden, 01307 Dresden, Germany
| | - Brigitta Lutz
- Division of Vascular and Endovascular Surgery, Department for Visceral, Thoracic and Vascular Surgery, Medical Faculty Carl Gustav Carus, University Hospital, Technical University of Dresden, 01307 Dresden, Germany
| | - Natzi Sakhalihasan
- Department of Cardiovascular and Thoracic Surgery, University of Liège, 4000 Liège, Belgium
| | - Matthias Trenner
- Division of Vascular Medicine, St. Josefs-Hospital Wiesbaden, 65189 Wiesbaden, Germany
| | - Gabor Biro
- Department for Vascular and Endovascular Surgery, Klinikum Rechts der Isar, Technical University of Munich, 80333 Munich, Germany
| | - Wolfgang Weber
- Department of Nuclear Medicine, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Thomas Rössel
- Department of Anaesthesiology and Critical Care Medicine, University Hospital Carl Gustav Carus Dresden, Technical University of Dresden, 01307 Dresden, Germany
| | - Christian Reeps
- Division of Vascular and Endovascular Surgery, Department for Visceral, Thoracic and Vascular Surgery, Medical Faculty Carl Gustav Carus, University Hospital, Technical University of Dresden, 01307 Dresden, Germany
| | - Hans-Henning Eckstein
- Department for Vascular and Endovascular Surgery, Klinikum Rechts der Isar, Technical University of Munich, 80333 Munich, Germany
| | - Steffen Wolk
- Division of Vascular and Endovascular Surgery, Department for Visceral, Thoracic and Vascular Surgery, Medical Faculty Carl Gustav Carus, University Hospital, Technical University of Dresden, 01307 Dresden, Germany
| | - Christoph Knappich
- Department for Vascular and Endovascular Surgery, Klinikum Rechts der Isar, Technical University of Munich, 80333 Munich, Germany
| | - Susan Notohamiprodjo
- Department of Nuclear Medicine, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Albert Busch
- Department for Vascular and Endovascular Surgery, Klinikum Rechts der Isar, Technical University of Munich, 80333 Munich, Germany
- Division of Vascular and Endovascular Surgery, Department for Visceral, Thoracic and Vascular Surgery, Medical Faculty Carl Gustav Carus, University Hospital, Technical University of Dresden, 01307 Dresden, Germany
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Uzuegbunam BC, Li J, Paslawski W, Weber W, Svenningsson P, Ågren H, Hooshyar Yousefi B. In Silico and In Vitro Study towards the Rational Design of 4,4'-Disarylbisthiazoles as a Selective α-Synucleinopathy Biomarker. Int J Mol Sci 2023; 24:16445. [PMID: 38003637 PMCID: PMC10671360 DOI: 10.3390/ijms242216445] [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: 10/17/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
The α-synucleinopathies are a group of neurodegenerative diseases characterized by the deposition of α-synuclein aggregates (α-syn) in the brain. Currently, there is no suitable tracer to enable a definitive early diagnosis of these diseases. We reported candidates based on 4,4'-disarylbisthiazole (DABTA) scaffold with a high affinity towards α-syn and excellent selectivity over Aβ and tau fibrils. Based on prior in silico studies, a focused library of 23 halogen-containing and O-methylated DABTAs was prepared. The DABTAs were synthesized via a modified two-step Hantzsch thiazole synthesis, characterized, and used in competitive binding assays against [3H]PiB and [3H]DCVJ. The DABTAs were obtained with an overall chemical yield of 15-71%, and showed a calculated lipophilicity of 2.5-5.7. The ligands demonstrated an excellent affinity to α-syn with both [3H]PiB and [3H]DCVJ: Ki 0.1-4.9 nM and up to 20-3900-fold selectivity over Aβ and tau fibrils. It could be concluded that in silico simulation is useful for the rational design of a new generation of DABTAs. Further investigation of the leads in the next step is encouraged: radiolabeling of the ligands with radioisotopes such as fluorine-18 or carbon-11 for in vivo, ex vivo, and translational research and for further in vitro experiments on human-derived protein aggregates.
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Affiliation(s)
- Bright C. Uzuegbunam
- Department of Nuclear Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Junhao Li
- Department of Physics and Astronomy, Uppsala University, 751 20 Uppsala, Sweden
| | - Wojciech Paslawski
- Department of Clinical Neuroscience, Karolinska Institute, 171 76 Stockholm, Sweden
| | - Wolfgang Weber
- Department of Nuclear Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Per Svenningsson
- Department of Clinical Neuroscience, Karolinska Institute, 171 76 Stockholm, Sweden
| | - Hans Ågren
- Department of Physics and Astronomy, Uppsala University, 751 20 Uppsala, Sweden
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Choi W, Liu CJ, Alam SR, Oh JH, Vaghjiani R, Humm J, Weber W, Adusumilli PS, Deasy JO, Lu W. Preoperative 18F-FDG PET/CT and CT radiomics for identifying aggressive histopathological subtypes in early stage lung adenocarcinoma. Comput Struct Biotechnol J 2023; 21:5601-5608. [PMID: 38034400 PMCID: PMC10681940 DOI: 10.1016/j.csbj.2023.11.008] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 12/02/2023] Open
Abstract
Lung adenocarcinoma (ADC) is the most common non-small cell lung cancer. Surgical resection is the primary treatment for early-stage lung ADC while lung-sparing surgery is an alternative for non-aggressive cases. Identifying histopathologic subtypes before surgery helps determine the optimal surgical approach. Predominantly solid or micropapillary (MIP) subtypes are aggressive and associated with a higher likelihood of recurrence and metastasis and lower survival rates. This study aims to non-invasively identify these aggressive subtypes using preoperative 18F-FDG PET/CT and diagnostic CT radiomics analysis. We retrospectively studied 119 patients with stage I lung ADC and tumors ≤ 2 cm, where 23 had aggressive subtypes (18 solid and 5 MIPs). Out of 214 radiomic features from the PET/CT and CT scans and 14 clinical parameters, 78 significant features (3 CT and 75 PET features) were identified through univariate analysis and hierarchical clustering with minimized feature collinearity. A combination of Support Vector Machine classifier and Least Absolute Shrinkage and Selection Operator built predictive models. Ten iterations of 10-fold cross-validation (10 ×10-fold CV) evaluated the model. A pair of texture feature (PET GLCM Correlation) and shape feature (CT Sphericity) emerged as the best predictor. The radiomics model significantly outperformed the conventional predictor SUVmax (accuracy: 83.5% vs. 74.7%, p = 9e-9) and identified aggressive subtypes by evaluating FDG uptake in the tumor and tumor shape. It also demonstrated a high negative predictive value of 95.6% compared to SUVmax (88.2%, p = 2e-10). The proposed radiomics approach could reduce unnecessary extensive surgeries for non-aggressive subtype patients, improving surgical decision-making for early-stage lung ADC patients.
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Affiliation(s)
- Wookjin Choi
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Chia-Ju Liu
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Sadegh Riyahi Alam
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Jung Hun Oh
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Raj Vaghjiani
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - John Humm
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Wolfgang Weber
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Prasad S. Adusumilli
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Joseph O. Deasy
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Wei Lu
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
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8
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Naghavi-Behzad M, Gerke O, Kodahl AR, Vogsen M, Asmussen JT, Weber W, Hildebrandt MG, Kidholm K. Cost-effectiveness of 2-[ 18F]FDG-PET/CT versus CE-CT for response monitoring in patients with metastatic breast cancer: a register-based comparative study. Sci Rep 2023; 13:16315. [PMID: 37770525 PMCID: PMC10539314 DOI: 10.1038/s41598-023-43446-7] [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: 06/07/2023] [Accepted: 09/24/2023] [Indexed: 09/30/2023] Open
Abstract
We evaluated the cost-effectiveness of 2-[18F]FDG-PET/CT compared to CE-CT for response monitoring in metastatic breast cancer (MBC) patients. The study included 300 biopsy-verified MBC patients treated at Odense University Hospital (Denmark). CE-CT was used in 144 patients, 83 patients underwent 2-[18F]FDG-PET/CT, and 73 patients received a combination of both. Hospital resource-based costs (2007-2019) were adjusted to the 2019 level. The incremental cost-effectiveness ratio (ICER) was calculated by comparing average costs per patient and gained survival with CE-CT. During a median follow-up of 33.0 months, patients in the 2-[18F]FDG-PET/CT group had more short admissions (median 6 vs. 2) and fewer overnight admissions (5 vs. 12) compared to the CE-CT group. The mean total cost per patient was €91,547 for CE-CT, €83,965 for 2-[18F]FDG-PET/CT, and €165,784 for the combined group. The ICER for 2-[18F]FDG-PET/CT compared to CE-CT was €-527/month, indicating gaining an extra month of survival at a lower cost (€527). 2-[18F]FDG-PET/CT was more cost-effective in patients with favorable prognostic factors (oligometastatic or estrogen receptor-positive disease), while CE-CT was more cost-effective in poor prognosis patients (liver/lung metastases or performance status ≥ 2 at baseline). In conclusion, our study suggests that 2-[18F]FDG-PET/CT is a cost-effective modality for response monitoring in metastatic breast cancer.
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Affiliation(s)
- Mohammad Naghavi-Behzad
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nuclear Medicine, Odense University Hospital, Kløvervænget 15, 5000, Odense, Denmark
- Centre for Personalized Response Monitoring in Oncology, Odense University Hospital, Odense, Denmark
| | - Oke Gerke
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nuclear Medicine, Odense University Hospital, Kløvervænget 15, 5000, Odense, Denmark
| | - Annette Raskov Kodahl
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | - Marianne Vogsen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nuclear Medicine, Odense University Hospital, Kløvervænget 15, 5000, Odense, Denmark
- Centre for Personalized Response Monitoring in Oncology, Odense University Hospital, Odense, Denmark
- Department of Oncology, Odense University Hospital, Odense, Denmark
- Open Patient Data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Jon Thor Asmussen
- Department of Radiology, Odense University Hospital, Odense, Denmark
| | - Wolfgang Weber
- Department of Nuclear Medicine, Technical University of Munich, Munich, Germany
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Malene Grubbe Hildebrandt
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
- Department of Nuclear Medicine, Odense University Hospital, Kløvervænget 15, 5000, Odense, Denmark.
- Centre for Personalized Response Monitoring in Oncology, Odense University Hospital, Odense, Denmark.
- Department of Radiology, Odense University Hospital, Odense, Denmark.
- Centre for Innovative Medical Technology, Odense University Hospital, Odense, Denmark.
| | - Kristian Kidholm
- Centre for Innovative Medical Technology, Odense University Hospital, Odense, Denmark
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Tauber R, Knorr K, Retz M, Rauscher I, Grigorascu S, Hansen K, D'Alessandria C, Wester HJ, Gschwend J, Weber W, Eiber M, Langbein T. Safety and Efficacy of [ 177Lu]-PSMA-I&T Radioligand Therapy in Octogenarians with Metastatic Castration-Resistant Prostate Cancer: Report on 80 Patients over the Age of 80 Years. J Nucl Med 2023:jnumed.122.265259. [PMID: 37321824 DOI: 10.2967/jnumed.122.265259] [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: 12/06/2022] [Revised: 03/14/2023] [Indexed: 06/17/2023] Open
Abstract
177Lu-labeled prostate-specific membrane antigen (PSMA) radioligand therapy (RLT) is a new treatment option for metastatic castration-resistant prostate cancer (mCRPC). Its low toxicity profile favors use in elderly patients or in patients with critical comorbidities. The purpose of this analysis was to evaluate the efficacy and safety of [177Lu]-PSMA RLT in mCRPC patients at least 80 y old. Methods: Eighty mCRPC patients at least 80 y old underwent [177Lu]-PSMA-I&T RLT and were retrospectively selected. The patients were previously treated by androgen receptor-directed therapy, received taxane-based chemotherapy, or were chemotherapy-ineligible. The best prostate-specific antigen (PSA) response was calculated, as well as clinical progression-free survival (cPFS) and overall survival (OS). Toxicity data were acquired until 6 mo after the last treatment cycle. Results: Of 80 patients, 49 (61.3%) were chemotherapy-naïve and 16 (20%) had visceral metastases. The median number of previous mCRPC treatment regimens was 2. In total, 324 cycles (median, 4 cycles; range, 1-12) with a median cumulative activity of 23.8 GBq (interquartile range, 14.8-42.2) were applied. A PSA decline of 50% was achieved in 37 (46.3%) patients. Chemotherapy-naïve patients showed higher 50% PSA response rates than chemotherapy-pretreated patients (51.0% vs. 38.7%, respectively). Overall, median cPFS and OS were 8.7 and 16.1 mo, respectively. The median cPFS and OS of chemotherapy-naïve patients were significantly longer than those of chemotherapy-pretreated patients (10.5 vs. 6.5 mo and 20.7 vs. 11.8 mo, respectively, P < 0.05). A lower hemoglobin level and higher lactate dehydrogenase level at baseline were independent predictors of shorter cPFS and OS. Treatment-emergent grade 3 toxicities were anemia in 4 patients (5%), thrombocytopenia in 3 patients (3.8%), and renal impairment in 4 patients (5%). No nonhematologic grade 3 and no grade 4 toxicities were observed. The most frequent clinical side effects were grade 1-2 xerostomia, fatigue, and inappetence. Conclusion: [177Lu]-PSMA-I&T RLT in mCRPC patients at least 80 y old is safe and effective, comparable to previously published data on non-age-selected cohorts with a low rate of high-grade toxicities. Chemotherapy-naïve patients showed a better and longer response to therapy than taxane-pretreated patients. [177Lu]-PSMA RLT seems to be a meaningful treatment option for older patients.
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Affiliation(s)
- Robert Tauber
- Department of Urology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany;
| | - Karina Knorr
- Department of Nuclear Medicine, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany; and
| | - Margitta Retz
- Department of Urology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Isabel Rauscher
- Department of Nuclear Medicine, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany; and
| | - Sonia Grigorascu
- Department of Nuclear Medicine, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany; and
| | - Kimberley Hansen
- Department of Nuclear Medicine, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany; and
| | - Calogero D'Alessandria
- Department of Nuclear Medicine, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany; and
| | | | - Jürgen Gschwend
- Department of Urology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Wolfgang Weber
- Department of Nuclear Medicine, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany; and
| | - Matthias Eiber
- Department of Nuclear Medicine, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany; and
| | - Thomas Langbein
- Department of Nuclear Medicine, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany; and
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10
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Flegar L, Thoduka SG, Librizzi D, Luster M, Zacharis A, Heers H, Eisenmenger N, Ahmadzadehfar H, Eiber M, Weber W, Groeben C, Huber J. Adoption of Lutetium- 177 PSMA radioligand therapy for metastatic castration resistant prostate cancer: a total population analysis in Germany from 2016 to 2020. Eur J Nucl Med Mol Imaging 2023; 50:2188-2195. [PMID: 36826478 PMCID: PMC10199877 DOI: 10.1007/s00259-023-06139-x] [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: 12/19/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE This study is to investigate the adoption and current trends of Lutetium-177 PSMA RLT for mCRPC in Germany. METHODS We analyzed data from the reimbursement.INFO tool based on German hospitals' quality reports for Lutetium-177 PSMA RLT from 2016 to 2020 and from the nationwide German hospital billing database (Destatis) for general therapy with open radionuclides in combination with prostate cancer from 2006 to 2020. For validation of these billing data, we included the 177Lu-PSMA RLT cycles from two participating institutions from 2016 to 2020. For detection of trends over time we applied linear regression models. RESULTS General therapy with open radionuclides increased from 2006 to 2020. We identified a total of 12,553 177Lu-PSMA RLT cycles. The number of 177Lu-PSMA RLTs steadily increased from a total of 1026 therapies in 2016 to 3328 therapies in 2020 (+ 576 RLT/year; p < 0.005). In 2016, 25 departments of nuclear medicine offered this treatment, which increased to 44 nuclear medicine departments in 2020. In 2016, 16% of nuclear medicine departments (4/25) performed more than 100 177Lu-PSMA RLTs, which increased to 36% (16/44) in 2020 (p < 0.005). In 2016, 88% (22/25) of 177Lu-PSMA RLTs were performed at a university hospital, which decreased to 70% (31/44) in 2020. The proportion of patients older than 65 years receiving 177Lu-PSMA RLT increased from 78% in 2016 to 81% in 2020. CONCLUSION Treatment of mCRPC with 177Lu-PSMA RLT has been rapidly increasing in Germany in the recent years providing an additional therapy option. This development is remarkable, because of outstanding formal EMA approval.
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Affiliation(s)
- Luka Flegar
- Department of Urology, Philipps-University Marburg, Baldinger Street, 35043, Marburg, Germany.
| | - Smita George Thoduka
- Department of Nuclear Medicine, Philipps-University Marburg, Baldinger Street, 35043, Marburg, Germany
| | - Damiano Librizzi
- Department of Nuclear Medicine, Philipps-University Marburg, Baldinger Street, 35043, Marburg, Germany
| | - Markus Luster
- Department of Nuclear Medicine, Philipps-University Marburg, Baldinger Street, 35043, Marburg, Germany
| | - Aristeidis Zacharis
- Department of Urology, Philipps-University Marburg, Baldinger Street, 35043, Marburg, Germany
| | - Hendrik Heers
- Department of Urology, Philipps-University Marburg, Baldinger Street, 35043, Marburg, Germany
| | | | | | - Matthias Eiber
- Department of Nuclear Medicine, Technische Universität Munich, Munich, Germany
| | - Wolfgang Weber
- Department of Nuclear Medicine, Technische Universität Munich, Munich, Germany
| | - Christer Groeben
- Department of Urology, Philipps-University Marburg, Baldinger Street, 35043, Marburg, Germany
| | - Johannes Huber
- Department of Urology, Philipps-University Marburg, Baldinger Street, 35043, Marburg, Germany
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11
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Buvat I, Weber W. Nuclear Medicine from a Novel Perspective: Buvat and Weber Talk with OpenAI's ChatGPT. J Nucl Med 2023; 64:505-507. [PMID: 36958855 DOI: 10.2967/jnumed.123.265636] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 02/23/2023] [Indexed: 03/25/2023] Open
Affiliation(s)
- Irène Buvat
- Inserm Laboratory of Translational Imaging in Oncology, Institut Curie, France
| | - Wolfgang Weber
- University Hospital, Technische Universität München, Germany
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12
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Barton AK, Tzolos E, Bing R, Singh T, Weber W, Schwaiger M, Varasteh Z, Slart RHJA, Newby DE, Dweck MR. Emerging molecular imaging targets and tools for myocardial fibrosis detection. Eur Heart J Cardiovasc Imaging 2023; 24:261-275. [PMID: 36575058 PMCID: PMC9936837 DOI: 10.1093/ehjci/jeac242] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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] [Received: 10/13/2022] [Accepted: 11/20/2022] [Indexed: 12/29/2022] Open
Abstract
Myocardial fibrosis is the heart's common healing response to injury. While initially seeking to optimize the strength of diseased tissue, fibrosis can become maladaptive, producing stiff poorly functioning and pro-arrhythmic myocardium. Different patterns of fibrosis are associated with different myocardial disease states, but the presence and quantity of fibrosis largely confer adverse prognosis. Current imaging techniques can assess the extent and pattern of myocardial scarring, but lack specificity and detect the presence of established fibrosis when the window to modify this process may have ended. For the first time, novel molecular imaging methods, including gallium-68 (68Ga)-fibroblast activation protein inhibitor positron emission tomography (68Ga-FAPI PET), may permit highly specific imaging of fibrosis activity. These approaches may facilitate earlier fibrosis detection, differentiation of active vs. end-stage disease, and assessment of both disease progression and treatment-response thereby improving patient care and clinical outcomes.
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Affiliation(s)
- Anna K Barton
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Chancellor’s Building, Little France Crescent, Edinburgh EH16 4SB, UK
| | - Evangelos Tzolos
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Chancellor’s Building, Little France Crescent, Edinburgh EH16 4SB, UK
| | - Rong Bing
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Chancellor’s Building, Little France Crescent, Edinburgh EH16 4SB, UK
| | - Trisha Singh
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Chancellor’s Building, Little France Crescent, Edinburgh EH16 4SB, UK
| | - Wolfgang Weber
- Department of Nuclear Medicine, Clinikum rechts der Isar, Technical University of Munich, Ismaniger Straße 22, 81675 Munich, Germany
| | - Markus Schwaiger
- Department of Nuclear Medicine, Clinikum rechts der Isar, Technical University of Munich, Ismaniger Straße 22, 81675 Munich, Germany
| | - Zohreh Varasteh
- Department of Nuclear Medicine, Clinikum rechts der Isar, Technical University of Munich, Ismaniger Straße 22, 81675 Munich, Germany
| | - Riemer H J A Slart
- Faculty of Medical Sciences, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - David E Newby
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Chancellor’s Building, Little France Crescent, Edinburgh EH16 4SB, UK
| | - Marc R Dweck
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Chancellor’s Building, Little France Crescent, Edinburgh EH16 4SB, UK
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13
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Prexler C, Knape MS, Erlewein-Schweizer J, Roll W, Specht K, Woertler K, Weichert W, von Luettichau I, Rossig C, Hauer J, Richter GHS, Weber W, Burdach S. Correlation of Transcriptomics and FDG-PET SUVmax Indicates Reciprocal Expression of Stemness-Related Transcription Factor and Neuropeptide Signaling Pathways in Glucose Metabolism of Ewing Sarcoma. Cancers (Basel) 2022; 14:cancers14235999. [PMID: 36497479 PMCID: PMC9735504 DOI: 10.3390/cancers14235999] [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: 10/18/2022] [Revised: 11/25/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In Ewing sarcoma (EwS), long-term treatment effects and poor survival rates for relapsed or metastatic cases require individualization of therapy and the discovery of new treatment methods. Tumor glucose metabolic activity varies significantly between patients, and FDG-PET signals have been proposed as prognostic factors. However, the biological basis for the generally elevated but variable glucose metabolism in EwS is not well understood. METHODS We retrospectively included 19 EwS samples (17 patients). Affymetrix gene expression was correlated with maximal standardized uptake value (SUVmax) using machine learning, linear regression modelling, and gene set enrichment analyses for functional annotation. RESULTS Expression of five genes correlated (MYBL2, ELOVL2, NETO2) or anticorrelated (FAXDC2, PLSCR4) significantly with SUVmax (adjusted p-value ≤ 0.05). Additionally, we identified 23 genes with large SUVmax effect size, which were significantly enriched for "neuropeptide Y receptor activity (GO:0004983)" (adjusted p-value = 0.0007). The expression of the members of this signaling pathway (NPY, NPY1R, NPY5R) anticorrelated with SUVmax. In contrast, three transcription factors associated with maintaining stemness displayed enrichment of their target genes with higher SUVmax: RNF2, E2F family, and TCF3. CONCLUSION Our large-scale analysis examined comprehensively the correlations between transcriptomics and tumor glucose utilization. Based on our findings, we hypothesize that stemness may be associated with increased glucose uptake, whereas neuroectodermal differentiation may anticorrelate with glucose uptake.
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Affiliation(s)
- Carolin Prexler
- Department of Pediatrics and Children’s Cancer Research Center, Kinderklinik München Schwabing, Klinikum Rechts der Isar, Fakultät für Medizin, Technische Universität München, 80804 Munich, Germany
| | - Marie Sophie Knape
- Department of Pediatrics and Children’s Cancer Research Center, Kinderklinik München Schwabing, Klinikum Rechts der Isar, Fakultät für Medizin, Technische Universität München, 80804 Munich, Germany
| | | | - Wolfgang Roll
- Department of Nuclear Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1 A1, 48149 Munster, Germany
| | - Katja Specht
- Institute of Pathology, Technische Universität München, 81675 Munich, Germany
| | - Klaus Woertler
- Musculoskeletal Radiology Section, Klinikum Rechts der Isar, Technische Universität München, 81675 Munich, Germany
| | - Wilko Weichert
- Institute of Pathology, Technische Universität München, 81675 Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, 81675 Munich, Germany
| | - Irene von Luettichau
- Department of Pediatrics and Children’s Cancer Research Center, Kinderklinik München Schwabing, Klinikum Rechts der Isar, Fakultät für Medizin, Technische Universität München, 80804 Munich, Germany
- ERN PaedCan, 1090 Vienna, Austria
| | - Claudia Rossig
- Department of Pediatric Hematology and Oncology, University Children’s Hospital Muenster, 48149 Muenster, Germany
- Cells-in-Motion Cluster of Excellence (EXC 1003-CiM), University of Muenster, 48149 Muenster, Germany
| | - Julia Hauer
- Department of Pediatrics and Children’s Cancer Research Center, Kinderklinik München Schwabing, Klinikum Rechts der Isar, Fakultät für Medizin, Technische Universität München, 80804 Munich, Germany
| | - Guenther H. S. Richter
- Department of Pediatrics, Division of Oncology and Hematology, Charite–Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
- German Cancer Consortium (DKTK), Partner Site Berlin, 13353 Berlin, Germany
| | - Wolfgang Weber
- German Cancer Consortium (DKTK), Partner Site Munich, 81675 Munich, Germany
- Department of Nuclear Medicine, Klinikum Rechts der Isar, Technische Universität München, 81675 Munich, Germany
| | - Stefan Burdach
- Department of Pediatrics and Children’s Cancer Research Center, Kinderklinik München Schwabing, Klinikum Rechts der Isar, Fakultät für Medizin, Technische Universität München, 80804 Munich, Germany
- Institute of Pathology, Technische Universität München, 81675 Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, 81675 Munich, Germany
- Academy of Translational Medicine and Department of Molecular Oncology–British Columbia Cancer Research Centre, University of British Columbia, 675 West 10th Avenue, Vancouver, BC V5Z 1L3, Canada
- Correspondence:
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14
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Schlürmann T, Waschulzik B, Combs S, Gempt J, Wiestler B, Weber W, Yakushev I. Diagnostic utility of amino acid PET in the differential diagnosis of recurrent brain metastases and treatment-related changes: a meta-analysis. J Nucl Med 2022; 64:816-821. [PMID: 36460343 DOI: 10.2967/jnumed.122.264803] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 12/27/2021] [Revised: 11/28/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022] Open
Abstract
Amino acid PET is an established method to assist differential diagnosis of therapy-related changes versus recurrence in gliomas. However, its diagnostic value in brain metastases is yet to be determined. The goal of this study was to summarize evidence on the diagnostic utility of amino acid PET in recurrent brain metastases. Methods: The medical databases MEDLINE, EMBASE, and the Cochrane Library were screened for English-language studies with at least 10 patients who had undergone first-line treatment including radiotherapy and in whom a final diagnosis had been determined by histologic examination or imaging and clinical follow-up. Pooled estimates with 95% CIs were calculated. Heterogeneity was assessed using I2 statistics. Results: Following the above criteria, 12 studies with the tracers methyl-[11C]-methionine (n = 6), O-(2-[18F]fluoroethyl)-l-tyrosine (n = 3), methyl-[11C]-methionine and O-(2-[18F]fluoroethyl)-l-tyrosine (n = 1), and 6-[18F]fluoro-L-dopa (n = 2), with a total of 547 lesions in 397 patients, were included. Pooled sensitivity and specificity were 82% (95% CI, 76-86) and 84% (95% CI, 79-88), respectively. Pooled positive and negative predictive values were 84% (95% CI, 77-90) and 83% (95% CI, 77-88), respectively. Positive and negative likelihood ratios, and diagnostic odds ratio were 3.8 (95% CI 3.0-4.8), 0.3 (95% CI 0.2-0.3), and 16.7 (95% CI 10.8-25.9), respectively. Heterogeneity was overall low. Conclusion: The present meta-analysis indicates a good accuracy of amino acid PET in the differential diagnosis of recurrent brain metastases. In particular, specificity of 84% suggests that amino acid PET may reduce the number of invasive procedures and overtreatment in patients with treatment-related changes. This study provides class IIa evidence on the utility of amino acid PET in the differential diagnosis of recurrent brain metastases.
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Affiliation(s)
- Timo Schlürmann
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Birgit Waschulzik
- Institute of AI and Informatics in Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Stephanie Combs
- Department of Radiation Oncology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Institute of Radiation Medicine at Helmholtz Zentrum München (HMGU), Oberschleißheim, Germany
- Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partner Sites Munich, Freiburg, and Heidelberg
| | - Jens Gempt
- Department of Neurosurgery, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany; and
| | - Benedikt Wiestler
- Department of Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Wolfgang Weber
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Igor Yakushev
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany;
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15
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Wu H, Kumar M, Fray E, Siliciano R, Smedley J, Meyers G, Maziarz R, Burwitz B, Stanton J, Sacha J, Weber W, Waytashek C, Boyle C, Bateman K, Reed J, Hwang J, Shriver-Munsch C, Northrup M, Armantrout K, Price H, Robertson-LeVay M, Uttke S, Junell S, Moats C, Bochart R, Sciurba J, Bimber B, Sullivan M, Dozier B, MacAllister R, Hobbs T, Martin L, Siliciano J, Axthelm M. OP 6.7 – 00044 Long-term ART-free SIV Remission Following Allogeneic Hematopoietic Cell Transplantation in Mauritian Cynomolgus Macaques. J Virus Erad 2022. [DOI: 10.1016/j.jve.2022.100252] [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: 12/24/2022] Open
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16
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Chowrira B, Kandpal L, Lamblin M, Ngassam F, Kouakou CA, Zafar T, Mertz D, Vileno B, Kieber C, Versini G, Gobaut B, Joly L, Ferté T, Monteblanco E, Bahouka A, Bernard R, Mohapatra S, Prima Garcia H, Elidrissi S, Gavara M, Sternitzky E, Da Costa V, Hehn M, Montaigne F, Choueikani F, Ohresser P, Lacour D, Weber W, Boukari S, Alouani M, Bowen M. Quantum Advantage in a Molecular Spintronic Engine that Harvests Thermal Fluctuation Energy. Adv Mater 2022; 34:e2206688. [PMID: 36177716 DOI: 10.1002/adma.202206688] [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] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/25/2022] [Indexed: 06/16/2023]
Abstract
Recent theory and experiments have showcased how to harness quantum mechanics to assemble heat/information engines with efficiencies that surpass the classical Carnot limit. So far, this has required atomic engines that are driven by cumbersome external electromagnetic sources. Here, using molecular spintronics, an implementation that is both electronic and autonomous is proposed. The spintronic quantum engine heuristically deploys several known quantum assets by having a chain of spin qubits formed by the paramagnetic Co center of phthalocyanine (Pc) molecules electronically interact with electron-spin-selecting Fe/C60 interfaces. Density functional calculations reveal that transport fluctuations across the interface can stabilize spin coherence on the Co paramagnetic centers, which host spin flip processes. Across vertical molecular nanodevices, enduring dc current generation, output power above room temperature, two quantum thermodynamical signatures of the engine's processes, and a record 89% spin polarization of current across the Fe/C60 interface are measured. It is crucially this electron spin selection that forces, through demonic feedback and control, charge current to flow against the built-in potential barrier. Further research into spintronic quantum engines, insight into the quantum information processes within spintronic technologies, and retooling the spintronic-based information technology chain, can help accelerate the transition to clean energy.
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Affiliation(s)
- Bhavishya Chowrira
- Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504 CNRS, Université de Strasbourg, 23 Rue du Lœss, BP 43, Strasbourg, 67034, France
- Synchrotron SOLEIL, L'Orme des Merisiers, Saint-Aubin, BP 48, Gif-sur-Yvette, 91192, France
| | - Lalit Kandpal
- Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504 CNRS, Université de Strasbourg, 23 Rue du Lœss, BP 43, Strasbourg, 67034, France
| | - Mathieu Lamblin
- Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504 CNRS, Université de Strasbourg, 23 Rue du Lœss, BP 43, Strasbourg, 67034, France
| | - Franck Ngassam
- Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504 CNRS, Université de Strasbourg, 23 Rue du Lœss, BP 43, Strasbourg, 67034, France
| | - Charles-Ambroise Kouakou
- Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504 CNRS, Université de Strasbourg, 23 Rue du Lœss, BP 43, Strasbourg, 67034, France
| | - Talha Zafar
- Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504 CNRS, Université de Strasbourg, 23 Rue du Lœss, BP 43, Strasbourg, 67034, France
| | - Damien Mertz
- Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504 CNRS, Université de Strasbourg, 23 Rue du Lœss, BP 43, Strasbourg, 67034, France
| | - Bertrand Vileno
- Institut de Chimie, UMR 7177 CNRS, Université de Strasbourg, 4 Rue Blaise Pascal, CS 90032, Strasbourg, 67081, France
| | - Christophe Kieber
- Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504 CNRS, Université de Strasbourg, 23 Rue du Lœss, BP 43, Strasbourg, 67034, France
| | - Gilles Versini
- Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504 CNRS, Université de Strasbourg, 23 Rue du Lœss, BP 43, Strasbourg, 67034, France
| | - Benoit Gobaut
- Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504 CNRS, Université de Strasbourg, 23 Rue du Lœss, BP 43, Strasbourg, 67034, France
| | - Loïc Joly
- Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504 CNRS, Université de Strasbourg, 23 Rue du Lœss, BP 43, Strasbourg, 67034, France
| | - Tom Ferté
- Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504 CNRS, Université de Strasbourg, 23 Rue du Lœss, BP 43, Strasbourg, 67034, France
| | - Elmer Monteblanco
- Institut Jean Lamour UMR 7198 CNRS, Université de Lorraine, BP 70239, Vandœuvre les Nancy, 54506, France
| | - Armel Bahouka
- IREPA LASER, Institut Carnot MICA, Parc d'innovation - Pole API, Illkirch, 67400, France
| | - Romain Bernard
- Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504 CNRS, Université de Strasbourg, 23 Rue du Lœss, BP 43, Strasbourg, 67034, France
| | - Sambit Mohapatra
- Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504 CNRS, Université de Strasbourg, 23 Rue du Lœss, BP 43, Strasbourg, 67034, France
| | - Helena Prima Garcia
- Instituto de Ciencia Molecular (ICMol), Universidad de Valencia, Catedrático Jose Beltrán 2, Paterna, 46980, Spain
| | - Safaa Elidrissi
- Instituto de Ciencia Molecular (ICMol), Universidad de Valencia, Catedrático Jose Beltrán 2, Paterna, 46980, Spain
| | - Miguel Gavara
- Instituto de Ciencia Molecular (ICMol), Universidad de Valencia, Catedrático Jose Beltrán 2, Paterna, 46980, Spain
| | - Emmanuel Sternitzky
- Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504 CNRS, Université de Strasbourg, 23 Rue du Lœss, BP 43, Strasbourg, 67034, France
| | - Victor Da Costa
- Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504 CNRS, Université de Strasbourg, 23 Rue du Lœss, BP 43, Strasbourg, 67034, France
| | - Michel Hehn
- Institut Jean Lamour UMR 7198 CNRS, Université de Lorraine, BP 70239, Vandœuvre les Nancy, 54506, France
| | - François Montaigne
- Institut Jean Lamour UMR 7198 CNRS, Université de Lorraine, BP 70239, Vandœuvre les Nancy, 54506, France
| | - Fadi Choueikani
- Synchrotron SOLEIL, L'Orme des Merisiers, Saint-Aubin, BP 48, Gif-sur-Yvette, 91192, France
| | - Philippe Ohresser
- Synchrotron SOLEIL, L'Orme des Merisiers, Saint-Aubin, BP 48, Gif-sur-Yvette, 91192, France
| | - Daniel Lacour
- Institut Jean Lamour UMR 7198 CNRS, Université de Lorraine, BP 70239, Vandœuvre les Nancy, 54506, France
| | - Wolfgang Weber
- Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504 CNRS, Université de Strasbourg, 23 Rue du Lœss, BP 43, Strasbourg, 67034, France
| | - Samy Boukari
- Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504 CNRS, Université de Strasbourg, 23 Rue du Lœss, BP 43, Strasbourg, 67034, France
| | - Mebarek Alouani
- Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504 CNRS, Université de Strasbourg, 23 Rue du Lœss, BP 43, Strasbourg, 67034, France
| | - Martin Bowen
- Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504 CNRS, Université de Strasbourg, 23 Rue du Lœss, BP 43, Strasbourg, 67034, France
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Stelzhammer P, Weber W, Binder H, Sagel U, Aspöck C, Trautinger F. The bacterial pathogen and resistance spectrum in a dermatological inpatient ward: a six-year, retrospective, epidemiological study. GMS Hyg Infect Control 2022; 17:Doc16. [PMID: 36157381 PMCID: PMC9487974 DOI: 10.3205/dgkh000419] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Aim Treatment of bacterial soft tissue infections is an essential part of clinical dermatology, and the choice of antibiotic therapy is often empirical. The aim of this longitudinal retrospective study was to evaluate bacterial epidemiology, resistance patterns and antibiotic consumption in a dermatological inpatient ward. Method Bacterial isolates and antimicrobial susceptibility testing from a dermatological inpatient ward were recorded retrospectively from 2011 to 2016. The antibiotic consumption was evaluated and given as the assumed defined daily dose [DDD] per 100 days of covering per year. Results A total of 4,800 bacterial isolates were included (skin, mucous membrane and wounds 87%, urine 9.5%, blood 1.7%, tissue and tissue fluids 1.6%). The proportion of Gram-positive bacteria was 58% (Staphy loc occus aureus 37.8%, coagulase-negative staphylococci 21.5%, Enterococcus spp. 16.7%). Pseudomonas aeruginosa (27.2%), Escherichia coli (17.5%) and Proteus spp. (13.1%) were the most common Gram-negative bacteria. The proportion of multi-resistant pathogens was 5.8% for methicillin-resistant S. aureus, 0.9%, 0.8% and 1.8% for multi-resis tant P. aeruginosa, ESBL-producing E. coli and ESBL-producing Klebsiella pneumoniae of all isolates. Beta-lactam antibiotics were the most used drugs (14.4, 10.8, and 9.6 DDD/100 for aminopenicillins, cefalexin, and penicillin G), followed by clindamycin (9.0 DDD/100 patient days). Conclusion In view of the frequency of bacterial soft tissue infections and their need for inpatient treatment with mostly empirically chosen antibiotics, systematic microbiological surveillance should be recommended for dermatological inpatient wards.
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Affiliation(s)
- Philipp Stelzhammer
- Department of Dermatology and Venereology, University Hospital St. Poelten, St. Poelten, Austria,Karl Landsteiner Institute of Dermatological Research, St. Poelten, Austria,*To whom correspondence should be addressed: Philipp Stelzhammer, , E-mail:
| | - Wolfgang Weber
- Institute for Hygiene and Microbiology, University Hospital St. Poelten, Karl Landsteiner Private University of Health Sciences, St. Poelten, Austria
| | - Hermine Binder
- Hospital Pharmacy, University Hospital St. Poelten, St. Poelten, Austria
| | - Ulrich Sagel
- LADR MVZ Dres. Bachg, Haselhorst & colleagues, Recklinghausen, Germany
| | - Christoph Aspöck
- Institute for Hygiene and Microbiology, University Hospital St. Poelten, Karl Landsteiner Private University of Health Sciences, St. Poelten, Austria
| | - Franz Trautinger
- Department of Dermatology and Venereology, University Hospital St. Poelten, St. Poelten, Austria,Karl Landsteiner Institute of Dermatological Research, St. Poelten, Austria
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18
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Tauber R, Retz M, Knorr K, D’Alessandria C, Grigorascu S, Hansen K, Wester HJ, Gschwend J, Weber W, Eiber M, Langbein T. 1414P Treatment efficacy and safety of 177Lu-PSMA radioligand therapy in octogenarians with metastatic castration-resistant prostate cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1900] [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: 11/01/2022] Open
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19
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Krönke M, Eilers C, Dimova D, Köhler M, Buschner G, Schweiger L, Konstantinidou L, Makowski M, Nagarajah J, Navab N, Weber W, Wendler T. Tracked 3D ultrasound and deep neural network-based thyroid segmentation reduce interobserver variability in thyroid volumetry. PLoS One 2022; 17:e0268550. [PMID: 35905038 PMCID: PMC9337648 DOI: 10.1371/journal.pone.0268550] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/02/2022] [Indexed: 11/29/2022] Open
Abstract
Thyroid volumetry is crucial in the diagnosis, treatment, and monitoring of thyroid diseases. However, conventional thyroid volumetry with 2D ultrasound is highly operator-dependent. This study compares 2D and tracked 3D ultrasound with an automatic thyroid segmentation based on a deep neural network regarding inter- and intraobserver variability, time, and accuracy. Volume reference was MRI. 28 healthy volunteers (24—50 a) were scanned with 2D and 3D ultrasound (and by MRI) by three physicians (MD 1, 2, 3) with different experience levels (6, 4, and 1 a). In the 2D scans, the thyroid lobe volumes were calculated with the ellipsoid formula. A convolutional deep neural network (CNN) automatically segmented the 3D thyroid lobes. 26, 6, and 6 random lobe scans were used for training, validation, and testing, respectively. On MRI (T1 VIBE sequence) the thyroid was manually segmented by an experienced MD. MRI thyroid volumes ranged from 2.8 to 16.7ml (mean 7.4, SD 3.05). The CNN was trained to obtain an average Dice score of 0.94. The interobserver variability comparing two MDs showed mean differences for 2D and 3D respectively of 0.58 to 0.52ml (MD1 vs. 2), −1.33 to −0.17ml (MD1 vs. 3) and −1.89 to −0.70ml (MD2 vs. 3). Paired samples t-tests showed significant differences for 2D (p = .140, p = .002 and p = .002) and none for 3D (p = .176, p = .722 and p = .057). Intraobsever variability was similar for 2D and 3D ultrasound. Comparison of ultrasound volumes and MRI volumes showed a significant difference for the 2D volumetry of all MDs (p = .002, p = .009, p <.001), and no significant difference for 3D ultrasound (p = .292, p = .686, p = 0.091). Acquisition time was significantly shorter for 3D ultrasound. Tracked 3D ultrasound combined with a CNN segmentation significantly reduces interobserver variability in thyroid volumetry and increases the accuracy of the measurements with shorter acquisition times.
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Affiliation(s)
- Markus Krönke
- Department of Radiology and Nuclear Medicine, German Heart Center, Technical University of Munich, Munich, Germany
- Department of Nuclear Medicine, School of Medicine, Technical University of Munich, Munich, Germany
| | - Christine Eilers
- Chair for Computer Aided Medical Procedures and Augmented Reality, Department of Computer Science, Technical University of Munich, Garching Near Munich, Germany
- * E-mail:
| | - Desislava Dimova
- Chair for Computer Aided Medical Procedures and Augmented Reality, Department of Computer Science, Technical University of Munich, Garching Near Munich, Germany
| | - Melanie Köhler
- Chair for Computer Aided Medical Procedures and Augmented Reality, Department of Computer Science, Technical University of Munich, Garching Near Munich, Germany
- Medical Faculty, Technical University of Munich, Munich, Germany
| | - Gabriel Buschner
- Department of Nuclear Medicine, School of Medicine, Technical University of Munich, Munich, Germany
| | - Lilit Schweiger
- Department of Nuclear Medicine, School of Medicine, Technical University of Munich, Munich, Germany
| | - Lemonia Konstantinidou
- Chair for Computer Aided Medical Procedures and Augmented Reality, Department of Computer Science, Technical University of Munich, Garching Near Munich, Germany
| | - Marcus Makowski
- Department of Radiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - James Nagarajah
- Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nassir Navab
- Chair for Computer Aided Medical Procedures and Augmented Reality, Department of Computer Science, Technical University of Munich, Garching Near Munich, Germany
- Chair for Computer Aided Medical Procedures, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, United States of America
| | - Wolfgang Weber
- Department of Nuclear Medicine, School of Medicine, Technical University of Munich, Munich, Germany
| | - Thomas Wendler
- Chair for Computer Aided Medical Procedures and Augmented Reality, Department of Computer Science, Technical University of Munich, Garching Near Munich, Germany
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20
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Xue S, Gafita A, Dong C, Zhao Y, Tetteh G, Menze BH, Ziegler S, Weber W, Afshar-Oromieh A, Rominger A, Eiber M, Shi K. Application of machine learning to pretherapeutically estimate dosimetry in men with advanced prostate cancer treated with 177Lu-PSMA I&T therapy. Eur J Nucl Med Mol Imaging 2022; 49:4064-4072. [PMID: 35771265 PMCID: PMC9525373 DOI: 10.1007/s00259-022-05883-w] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/16/2022] [Indexed: 12/01/2022]
Abstract
Purpose Although treatment planning and individualized dose application for emerging prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT) are generally recommended, it is still difficult to implement in practice at the moment. In this study, we aimed to prove the concept of pretherapeutic prediction of dosimetry based on imaging and laboratory measurements before the RLT treatment. Methods Twenty-three patients with metastatic castration-resistant prostate cancer (mCRPC) treated with 177Lu-PSMA I&T RLT were included retrospectively. They had available pre-therapy 68 Ga-PSMA-HEBD-CC PET/CT and at least 3 planar and 1 SPECT/CT imaging for dosimetry. Overall, 43 cycles of 177Lu-PSMA I&T RLT were applied. Organ-based standard uptake values (SUVs) were obtained from pre-therapy PET/CT scans. Patient dosimetry was calculated for the kidney, liver, spleen, and salivary glands using Hermes Hybrid Dosimetry 4.0 from the planar and SPECT/CT images. Machine learning methods were explored for dose prediction from organ SUVs and laboratory measurements. The uncertainty of these dose predictions was compared with the population-based dosimetry estimates. Mean absolute percentage error (MAPE) was used to assess the prediction uncertainty of estimated dosimetry. Results An optimal machine learning method achieved a dosimetry prediction MAPE of 15.8 ± 13.2% for the kidney, 29.6% ± 13.7% for the liver, 23.8% ± 13.1% for the salivary glands, and 32.1 ± 31.4% for the spleen. In contrast, the prediction based on literature population mean has significantly larger MAPE (p < 0.01), 25.5 ± 17.3% for the kidney, 139.1% ± 111.5% for the liver, 67.0 ± 58.3% for the salivary glands, and 54.1 ± 215.3% for the spleen. Conclusion The preliminary results confirmed the feasibility of pretherapeutic estimation of treatment dosimetry and its added value to empirical population-based estimation. The exploration of dose prediction may support the implementation of treatment planning for RLT. Supplementary Information The online version contains supplementary material available at 10.1007/s00259-022-05883-w.
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Affiliation(s)
- Song Xue
- Dept. Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andrei Gafita
- Dept. Nuclear Medicine, Technical University of Munich, Munich, Germany.,Dept. Molecular & Medical Pharmacology, University of California, Los Angeles, CA, USA
| | - Chao Dong
- Dept. Electrical Engineering, Technical University of Munich, Munich, Germany
| | - Yu Zhao
- Dept. Informatics, Technical University of Munich, Munich, Germany
| | - Giles Tetteh
- Dept. Informatics, Technical University of Munich, Munich, Germany
| | - Bjoern H Menze
- Dept. Informatics, Technical University of Munich, Munich, Germany
| | - Sibylle Ziegler
- Dept. Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Wolfgang Weber
- Dept. Nuclear Medicine, Technical University of Munich, Munich, Germany
| | - Ali Afshar-Oromieh
- Dept. Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Axel Rominger
- Dept. Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Matthias Eiber
- Dept. Nuclear Medicine, Technical University of Munich, Munich, Germany
| | - Kuangyu Shi
- Dept. Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. .,Dept. Informatics, Technical University of Munich, Munich, Germany.
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21
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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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Kirsch D, Preston A, Tretyak V, Le V, Weber W, Strakowski S, Lippard E. Neural functional connectivity changes to psychosocial stress in young adults with bipolar disorder and preliminary associations with clinical trajectories. Bipolar Disord 2022; 24:298-309. [PMID: 34532945 PMCID: PMC8926937 DOI: 10.1111/bdi.13127] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 07/06/2021] [Accepted: 09/12/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Stress-related mechanisms are implicated in the pathophysiology of bipolar disorder and may contribute to heterogeneity in illness course. Yet, there is a lack of study investigating the neural mechanisms underlying the stress response in this condition. This study investigated changes in amygdala activation and functional connectivity in response to acute psychosocial stress in young adults with bipolar disorder and explored relations with clinical phenotype and prospective mood symptoms. METHODS 42 young adults [19 with bipolar disorder, agemean ± SD =21.4 ± 2.2 years] completed a modified version of the Montreal Imaging Stress Task. Amygdala activation and functional connectivity with prefrontal cortex (PFC) regions of interest was calculated for control and stress conditions. Main effects of group, condition, and group by condition interaction on amygdala activation and connectivity were modeled. A subset of bipolar participants completed 1-year follow-up assessments. Relations between neural responses to stress with concurrent substance use and prospective mood symptoms were explored. RESULTS There were no between-group differences in amygdala activation or functional connectivity during the control condition. Increased right amygdala-right rostral PFC (rPFC) functional connectivity to stress was observed in bipolar disorder, compared to typically developing controls. In bipolar disorder, greater increase in right amygdala-right rPFC functional connectivity to stress was associated with less frequent cannabis use, and prospectively with shorter duration and lower severity of depression symptoms over follow-up. CONCLUSION Results from this preliminary study suggest differences in frontolimbic functional connectivity responses to stress in young adults with bipolar disorder and associations with cannabis use and prospective mood symptoms.
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Affiliation(s)
- D.E. Kirsch
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, TX, USA,Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA,Institute for Neuroscience, University of Texas, Austin, TX, USA
| | - A. Preston
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, TX, USA
| | - V. Tretyak
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, TX, USA,Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA,Department of Psychology, University of Texas, Austin, TX, USA
| | - V. Le
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, TX, USA
| | - W. Weber
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, TX, USA
| | - S.M. Strakowski
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, TX, USA,Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA,Institute for Neuroscience, University of Texas, Austin, TX, USA,Department of Psychology, University of Texas, Austin, TX, USA
| | - E.T.C. Lippard
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, TX, USA,Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA,Institute for Neuroscience, University of Texas, Austin, TX, USA,Department of Psychology, University of Texas, Austin, TX, USA,Institute of Early Life Adversity Research, University of Texas, Austin, TX, USA
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23
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Uzuegbunam BC, Li J, Paslawski W, Weber W, Svenningsson P, Ågren H, Yousefi BH. Toward Novel [18F]Fluorine-Labeled Radiotracers for the Imaging of α-Synuclein Fibrils. Front Aging Neurosci 2022; 14:830704. [PMID: 35572127 PMCID: PMC9099256 DOI: 10.3389/fnagi.2022.830704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/27/2022] [Indexed: 12/05/2022] Open
Abstract
The accumulation of α-synuclein aggregates (α-syn) in the human brain is an occurrence common to all α-synucleinopathies. Non-invasive detection of these aggregates in a living brain with a target-specific radiotracer is not yet possible. We have recently discovered that the inclusion of a methylenedioxy group in the structure of diarylbisthiazole (DABTA)-based tracers improves binding affinity and selectivity to α-syn. Subsequently, complementary in silico modeling and machine learning (ML) of tracer–protein interactions were employed to predict surface sites and structure–property relations for the binding of the ligands. Based on this observation, we developed a small focused library of DABTAs from which 4-(benzo[d][1,3]dioxol-5-yl)-4′-(3-[18F]fluoro-4-methoxyphenyl)-2,2′-bithiazole [18F]d2, 6-(4′-(3-[18F]fluoro-4-methoxyphenyl)-[2,2′-bithiazol]-4-yl)-[1,3]dioxolo[4,5-b]pyridine [18F]d4, 4-(benzo [d][1,3]dioxol-5-yl)-4′-(6-[18F]fluoropyridin-3-yl)-2,2′-bithiazole [18F]d6, and 6-(4′-(6-[18F]fluoropyridin-3-yl)-[2,2′-bithiazol]-4-yl)-[1,3]dioxolo[4,5-b]pyridine [18F]d8 were selected based on their high binding affinity to α-syn and were further evaluated. Binding assay experiments carried out with the non-radioactive versions of the above tracers d2, d4, d6, and d8 showed high binding affinity of the ligands to α-syn: 1.22, 0.66, 1.21, and 0.10 nM, respectively, as well as excellent selectivity over β-amyloid plaques (Aβ) and microtubular tau aggregates (>200-fold selectivity). To obtain the tracers, their precursors were radiolabeled either via an innovative ruthenium-mediated (SNAr) reaction ([18F]d2 and [18F]d4) or typical SNAr reaction ([18F]d6 and [18F]d8) with moderate-to-high radiochemical yields (13% – 40%), and high molar activity > 60 GBq/μmol. Biodistribution experiments carried out with the tracers in healthy mice revealed that [18F]d2 and [18F]d4 showed suboptimal brain pharmacokinetics: 1.58 and 4.63 %ID/g at 5 min post-injection (p.i.), and 1.93 and 3.86 %ID/g at 60 min p.i., respectively. However, [18F]d6 and [18F]d8 showed improved brain pharmacokinetics: 5.79 and 5.13 %ID/g at 5 min p.i.; 1.75 and 1.07 %ID/g at 60 min p.i.; and 1.04 and 0.58 %ID/g at 120 min p.i., respectively. The brain uptake kinetics of [18F]d6 and [18F]d8 were confirmed in a dynamic PET study. Both tracers also showed no brain radiometabolites at 20 min p.i. in initial in vivo stability experiments carried out in healthy mice. [18F]d8 seems very promising based on its binding properties and in vivo stability, thus encouraging further validation of its usefulness as a radiotracer for the in vivo visualization of α-syn in preclinical and clinical settings. Additionally, in silico and ML-predicted values correlated with the experimental binding affinity of the ligands.
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Affiliation(s)
| | - Junhao Li
- Department of Physics and Astronomy, Uppsala University, Uppsala, Sweden
| | - Wojciech Paslawski
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Wolfgang Weber
- Department of Nuclear Medicine, Technical University of Munich, Munich, Germany
| | - Per Svenningsson
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Hans Ågren
- Department of Physics and Astronomy, Uppsala University, Uppsala, Sweden
| | - Behrooz Hooshyar Yousefi
- Department of Nuclear Medicine, Philipps University of Marburg, Marburg, Germany
- *Correspondence: Behrooz Hooshyar Yousefi,
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Borm KJ, Ernst L, Voppichler J, Oechsner M, Düsberg M, Buschner G, Weber W, Combs SE, Duma MN. Comparison of the distribution of lymph node metastases compared to healthy lymph nodes in breast cancer. Radiat Oncol 2022; 17:27. [PMID: 35123538 PMCID: PMC8818136 DOI: 10.1186/s13014-021-01964-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 12/07/2021] [Indexed: 12/02/2022] Open
Abstract
Background Current literature lacks a comparison of lymph node metastases and non-pathological lymph nodes distribution in breast cancer patients. The aim of the current retrospective study was to generate a comprehensive atlas of the lymph node system. Methods 143 breast cancer patients underwent F-18-FDG-PET/CT (PET/CT) imaging for staging purposes and were diagnosed with regional lymph node metastases. Based on the PET/CT data set a total of 326 lymph node metastases and 1826 non-pathological lymph nodes were detected and contoured manually in the patient collective. Using rigid and deformable registration algorithms all structures were transferred to a template planning CT of a standard patient. Subsequently, a 3D-atlas of the distribution of lymph node metastases and non-pathological lymph nodes were generated and compared to each other. Results Both, lymph node metastases and non-pathological lymph nodes, accumulated in certain areas (“hot-spots”) within the lymphatic drainage system. However large differences regarding the distribution patterns were detected: lymph node metastases hot spots occurred in close proximity to the subclavian vein in level I-III, whereas the non-pathological lymph nodes accumulated mostly (within a wider range) in level I. In level II and III lymph node metastases exceeded clearly the areas in which non-pathological lymph nodes occurred. Conclusion Lymph node metastases and non-pathological lymph node distribution within the lymph node system differ clearly. Based on our results, an individual adjustment of the CTV in order to include visible lymph nodes in level II and III should be discussed.
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Knorr K, Oh SW, Krönke M, Wurzer A, D'Alessandria C, Herz M, Weber W, Wester HJ, Eiber M, Yusufi N, Nekolla S. Preclinical biodistribution and dosimetry and human biodistribution comparing 18F-rhPSMA-7 and single isomer 18F-rhPSMA-7.3. EJNMMI Res 2022; 12:8. [PMID: 35119557 PMCID: PMC8816989 DOI: 10.1186/s13550-021-00872-w] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 12/06/2021] [Indexed: 12/03/2022] Open
Abstract
Background Radiohybrid prostate-specific membrane antigen (rhPSMA) ligands such as 18F-rhPSMA-7 are a new class of theranostic agents in clinical development for prostate cancer. We compared preclinical dosimetry and human biodistribution of 18F-rhPSMA-7 with that of single diastereoisomer form, 18F-rhPSMA-7.3. Methods Preclinical dosimetry was performed with SCID-mice sacrificed at multiple timepoints (10–300 min) post-injection of 25.6 ± 3.6 MBq 18F-rhPSMA-7 or 28.5 ± 4.8 MBq 18F-rhPSMA-7.3 (n = 3–6 mice per timepoint). Heart, lung, liver, spleen, pancreas, fat, stomach, small intestine, large intestine, kidney, muscle, bone, bladder, testicles, tail, and brain tissue were harvested, and urine and blood samples collected. Percentage of injected dose per gram was calculated. Absorbed doses were estimated with OLINDA/EXM 1.0. 18F-rhPSMA-7 (n = 47) and 18F-rhPSMA-7.3 (n = 33) PET/CT exams were used to estimate human biodistribution. Mean (range) injected activities were 324 (236–424) MBq versus 345 (235–420) MBq, and acquisition times were 84 (42–166) versus 76 (59–122) minutes for 18F-rhPSMA-7 versus 18F-rhPSMA-7.3, respectively. SUVmean was determined for background (gluteal muscle), normal organs (salivary glands, blood pool, lung, liver, spleen, pancreas, duodenum, kidney, bladder, bone) and up to three representative tumour lesions. Qualitative analyses assessed image quality, non-specific blood pool activity, and background uptake in bone/marrow using 3/4-point scales. Results Preclinical dosimetry revealed that at 3.5 h and 1 h bladder voiding intervals, the extrapolated total effective doses were 26.6 and 12.2 µSv/MBq for 18F-rhPSMA-7 and 21.7 and 12.8 µSv/MBq for 18F-rhPSMA-7.3 respectively. Human biodistribution of both agents was typical of other PSMA-ligands and broadly similar to each other; SUVmean were 16.9 versus 16.2 (parotid gland), 19.6 versus 19.9 (submandibular gland), 2.0 versus 1.9 (blood pool, p < 0.005), 0.7 versus 0.7 (lungs), 7.0 versus 7.3 (liver), 9.1 versus 8.4 (spleen), 32.4 versus 35.7 (kidney), 2.5 versus 2.8 (pancreas), 10.9 versus 11.0 (duodenum), 1.1 versus 1.3 (bone) and 4.6 versus 2.0 (bladder; p < 0.001) for 18F-rhPSMA-7 versus 18F-rhPSMA-7.3, respectively. Tumour SUVmean was higher for 18F-rhPSMA-7.3 (32.5 ± 42.7, n = 63 lesions) than for 18F-rhPSMA-7 (20.0 ± 20.2, n = 89 lesions). Conclusions Radiation dosimetry is favourable for both agents. Radiation exposure, assuming a 1 h voiding interval, is less than 5 mSv after injection of 370 MBq. 18F-rhPSMA-7.3 showed significantly lower bladder uptake, and a higher uptake trend in tumours compared with 18F-rhPSMA-7. Supplementary Information The online version contains supplementary material available at 10.1186/s13550-021-00872-w.
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Affiliation(s)
- Karina Knorr
- School of Medicine, Klinikum Rechts der Isar, Department of Nuclear Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany.
| | - So Won Oh
- School of Medicine, Klinikum Rechts der Isar, Department of Nuclear Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany.,Department of Nuclear Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Markus Krönke
- School of Medicine, Klinikum Rechts der Isar, Department of Nuclear Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany.,School of Medicine, Klinikum Rechts der Isar, Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
| | | | - Calogero D'Alessandria
- School of Medicine, Klinikum Rechts der Isar, Department of Nuclear Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Michael Herz
- School of Medicine, Klinikum Rechts der Isar, Department of Nuclear Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Wolfgang Weber
- School of Medicine, Klinikum Rechts der Isar, Department of Nuclear Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | | | - Matthias Eiber
- School of Medicine, Klinikum Rechts der Isar, Department of Nuclear Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Nahid Yusufi
- School of Medicine, Klinikum Rechts der Isar, Department of Nuclear Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Stephan Nekolla
- School of Medicine, Klinikum Rechts der Isar, Department of Nuclear Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
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Reuter U, Jayaram A, Rezkalla M, Weber W. A novel approach for automatic detection of linear and nonlinear dependencies between data by means of autoencoders. Neurocomputing 2022. [DOI: 10.1016/j.neucom.2021.10.079] [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: 10/20/2022]
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Solari EL, Gafita A, Schachoff S, Bogdanović B, Villagrán Asiares A, Amiel T, Hui W, Rauscher I, Visvikis D, Maurer T, Schwamborn K, Mustafa M, Weber W, Navab N, Eiber M, Hatt M, Nekolla SG. The added value of PSMA PET/MR radiomics for prostate cancer staging. Eur J Nucl Med Mol Imaging 2022; 49:527-538. [PMID: 34255130 PMCID: PMC8803696 DOI: 10.1007/s00259-021-05430-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [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: 01/14/2021] [Accepted: 05/24/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE To evaluate the performance of combined PET and multiparametric MRI (mpMRI) radiomics for the group-wise prediction of postsurgical Gleason scores (psGSs) in primary prostate cancer (PCa) patients. METHODS Patients with PCa, who underwent [68 Ga]Ga-PSMA-11 PET/MRI followed by radical prostatectomy, were included in this retrospective analysis (n = 101). Patients were grouped by psGS in three categories: ISUP grades 1-3, ISUP grade 4, and ISUP grade 5. mpMRI images included T1-weighted, T2-weighted, and apparent diffusion coefficient (ADC) map. Whole-prostate segmentations were performed on each modality, and image biomarker standardization initiative (IBSI)-compliant radiomic features were extracted. Nine support vector machine (SVM) models were trained: four single-modality radiomic models (PET, T1w, T2w, ADC); three PET + MRI double-modality models (PET + T1w, PET + T2w, PET + ADC), and two baseline models (one with patient data, one image-based) for comparison. A sixfold stratified cross-validation was performed, and balanced accuracies (bAcc) of the predictions of the best-performing models were reported and compared through Student's t-tests. The predictions of the best-performing model were compared against biopsy GS (bGS). RESULTS All radiomic models outperformed the baseline models. The best-performing (mean ± stdv [%]) single-modality model was the ADC model (76 ± 6%), although not significantly better (p > 0.05) than other single-modality models (T1w: 72 ± 3%, T2w: 73 ± 2%; PET: 75 ± 5%). The overall best-performing model combined PET + ADC radiomics (82 ± 5%). It significantly outperformed most other double-modality (PET + T1w: 74 ± 5%, p = 0.026; PET + T2w: 71 ± 4%, p = 0.003) and single-modality models (PET: p = 0.042; T1w: p = 0.002; T2w: p = 0.003), except the ADC-only model (p = 0.138). In this initial cohort, the PET + ADC model outperformed bGS overall (82.5% vs 72.4%) in the prediction of psGS. CONCLUSION All single- and double-modality models outperformed the baseline models, showing their potential in the prediction of GS, even with an unbalanced cohort. The best-performing model included PET + ADC radiomics, suggesting a complementary value of PSMA-PET and ADC radiomics.
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Affiliation(s)
- Esteban Lucas Solari
- School of Medicine, Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University Munich, Munich, Germany.
| | - Andrei Gafita
- School of Medicine, Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Sylvia Schachoff
- School of Medicine, Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Borjana Bogdanović
- School of Medicine, Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Alberto Villagrán Asiares
- School of Medicine, Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Thomas Amiel
- School of Medicine, Department of Urology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Wang Hui
- School of Medicine, Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Isabel Rauscher
- School of Medicine, Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | | | - Tobias Maurer
- Department of Urology and Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Kristina Schwamborn
- School of Medicine, Institute of Pathology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Mona Mustafa
- School of Medicine, Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Wolfgang Weber
- School of Medicine, Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Nassir Navab
- School of Computer Science, Computer Aided Medical Procedures and Augmented Reality, Technical University Munich, Munich, Germany
| | - Matthias Eiber
- School of Medicine, Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Mathieu Hatt
- INSERM, UMR 1101, LaTIM, Univ Brest, Brest, France
| | - Stephan G Nekolla
- School of Medicine, Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
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Mohapatra S, Beaurepaire E, Weber W, Bowen M, Boukari S, Da Costa V. Accessing nanoscopic polarization reversal processes in an organic ferroelectric thin film. Nanoscale 2021; 13:19466-19473. [PMID: 34792081 DOI: 10.1039/d1nr05957b] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Towards eliminating toxic substances from electronic devices, Croconic Acid (CA) has great potential as a sublimable organic ferroelectric material. While studies on CA thin films are just beginning to emerge, its capability to be integrated in nanodevices remains unexplored. We demonstrate at the laterally nanoscopic scale robust ferroelectric switching of a stable enduring polarization at room temperature in CA thin films, without leakage. The challenging ferroelectric characterization at the nanoscale is performed using a unique combination of piezoresponse force microscopy, polarization switching current spectroscopy and concurrent strain response. This helps rationalize the otherwise asymmetric polarization-voltage hysteresis due to background noise limited undetectable switching currents, which are statistically averaged in macrojunctions but become prevalent at the nanoscale. Apart from successfully estimating the nanoscopic polarization in CA thin films, we show that CA is a promising lead-free organic ferroelectric towards nanoscale device integration. Our results, being valid irrespective of the ferroelectrics' nature; organic or inorganic, pave the way for fundamental understandings and technological applications of nanoscopic polarization reversal mechanisms.
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Affiliation(s)
- Sambit Mohapatra
- Université de Strasbourg, CNRS, Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504, F-67000 Strasbourg, France.
| | - Eric Beaurepaire
- Université de Strasbourg, CNRS, Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504, F-67000 Strasbourg, France.
| | - Wolfgang Weber
- Université de Strasbourg, CNRS, Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504, F-67000 Strasbourg, France.
| | - Martin Bowen
- Université de Strasbourg, CNRS, Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504, F-67000 Strasbourg, France.
| | - Samy Boukari
- Université de Strasbourg, CNRS, Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504, F-67000 Strasbourg, France.
| | - Victor Da Costa
- Université de Strasbourg, CNRS, Institut de Physique et Chimie des Matériaux de Strasbourg, UMR 7504, F-67000 Strasbourg, France.
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Röder M, Wiacek C, Lankamp F, Kreyer J, Weber W, Ueberham E. Improved Sensitivity of Allergen Detection by Immunoaffinity LC-MS/MS Using Ovalbumin as a Case Study. Foods 2021; 10:foods10122932. [PMID: 34945483 PMCID: PMC8700968 DOI: 10.3390/foods10122932] [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: 10/27/2021] [Revised: 11/18/2021] [Accepted: 11/24/2021] [Indexed: 12/12/2022] Open
Abstract
Food allergies are caused by severe hypersensitivity to specific food allergens such as the egg protein ovalbumin. It is therefore important to test food products for the presence of allergens to protect allergic people from accidental ingestion. For egg detection, ELISA is the only reasonable commercially available test format, although the recognition of target allergens can be affected by food processing, which may lead to false negative results. Current mass spectrometry-based detection methods may overcome this issue, but these approaches are often less sensitive. Here we combined the advantages of antibody-based and MS-based methods by developing an immunoaffinity LC-MS/MS technique to detect the common egg allergen Gal d 2. We investigated the principal functionality of this method with incurred cookie material containing whole egg powder. We found that the new method matched easily the sensitivity of egg specific ELISA tests. Further western blot experiments indicated that this strategy may be unaffected by food processing, providing an important alternative strategy for the detection and quantification of allergens in food.
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Affiliation(s)
- Martin Röder
- ifp Institut für Produktqualität GmbH, Wagner-Régeny-Str. 8, 12489 Berlin, Germany; (M.R.); (F.L.); (W.W.)
| | - Claudia Wiacek
- Institute of Food Hygiene, Leipzig University, An den Tierkliniken 1, 04103 Leipzig, Germany; (C.W.); (J.K.)
| | - Frauke Lankamp
- ifp Institut für Produktqualität GmbH, Wagner-Régeny-Str. 8, 12489 Berlin, Germany; (M.R.); (F.L.); (W.W.)
| | - Jonathan Kreyer
- Institute of Food Hygiene, Leipzig University, An den Tierkliniken 1, 04103 Leipzig, Germany; (C.W.); (J.K.)
| | - Wolfgang Weber
- ifp Institut für Produktqualität GmbH, Wagner-Régeny-Str. 8, 12489 Berlin, Germany; (M.R.); (F.L.); (W.W.)
| | - Elke Ueberham
- Fraunhofer Institute for Cell Therapy and Immunology (IZI), Perlickstr. 1, 04103 Leipzig, Germany
- Correspondence:
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Birindelli G, Drobnjakovic M, Morath V, Steiger K, D'Alessandria C, Gourni E, Afshar-Oromieh A, Weber W, Rominger A, Eiber M, Shi K. In silico study on radiobiological efficacy of Ac-225 and Lu-177 for PSMA-guided radiotherapy. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:4497-4500. [PMID: 34892217 DOI: 10.1109/embc46164.2021.9630297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The good efficacy of radioligand therapy (RLT) targeting prostate specific-membrane antigen (PSMA) for the treatment of metastatic castration-resistant prostate cancer (mCRPC) has been recently demonstrated in several clinical studies. However, the treatment effect of 177Lu-PSMA-ligands is still suboptimal for a significant fraction of patients. In contrast to external beam radiotherapy, the radiation dose distribution itself is strongly influenced by the heterogeneous tumour microenvironment. Although microdosimetry is critical for RLT treatment outcome, it is difficult to clinically or experimentally establish the quantitative relation. We propose an in silico approach to quantitatively investigate the microdosimetry and its influence on treatment outcome for PSMA-directed RLT of two different radioisotopes 177Lu and 225 Ac. The ultimate goal is optimize the combined 177 Lu and 225 Ac-PSMA therapy and maximize the anti-tumour effect, while minimizing irradiation of off-target tissues.Clinical relevance- With the proposed hybrid model we show that 177Lu-PSMA-ligands treatment assures a more homogeneously distributed dose and a lower dependency of the treatment outcome on the domain vascularisation. On the other hand, the 225Ac-PSMA-ligands treatment shows a much stronger efficacy in killing tumor cells with an equivalent mean dose distribution even in an hypoxic environment.
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Lapa C, Nestle U, Albert NL, Baues C, Beer A, Buck A, Budach V, Bütof R, Combs SE, Derlin T, Eiber M, Fendler WP, Furth C, Gani C, Gkika E, Grosu AL, Henkenberens C, Ilhan H, Löck S, Marnitz-Schulze S, Miederer M, Mix M, Nicolay NH, Niyazi M, Pöttgen C, Rödel CM, Schatka I, Schwarzenboeck SM, Todica AS, Weber W, Wegen S, Wiegel T, Zamboglou C, Zips D, Zöphel K, Zschaeck S, Thorwarth D, Troost EGC. Correction to: Value of PET imaging for radiation therapy. Strahlenther Onkol 2021; 198:80-82. [PMID: 34617130 DOI: 10.1007/s00066-021-01851-9] [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: 11/24/2022]
Affiliation(s)
- Constantin Lapa
- Nuclear Medicine, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Ursula Nestle
- Department of Radiation Oncology, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany.,German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany.,Department of Radiation Oncology, Kliniken Maria Hilf, Mönchengladbach, Germany
| | - Nathalie L Albert
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Christian Baues
- Department of Radiation Oncology, Cyberknife and Radiotherapy, Medical Faculty, University Hospital Cologne, Cologne, Germany
| | - Ambros Beer
- Department of Nuclear Medicine, Ulm University Hospital, Ulm, Germany
| | - Andreas Buck
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Volker Budach
- Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
| | - Rebecca Bütof
- Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,OncoRay-National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - Stephanie E Combs
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany.,Department of Radiation Oncology, Technical University of Munich (TUM), Klinikum rechts der Isar, Munich, Germany.,Department of Radiation Sciences (DRS), Institute of Radiation Medicine (IRM), Neuherberg, Germany
| | - Thorsten Derlin
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
| | - Matthias Eiber
- Department of Nuclear Medicine, Technical University of Munich (TUM), Klinikum rechts der Isar, Munich, Germany
| | - Wolfgang P Fendler
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Christian Furth
- Department of Nuclear Medicine, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Cihan Gani
- German Cancer Consortium (DKTK), Partner Site Tübingen, and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Radiation Oncology, University of Tübingen, Tübingen, Germany
| | - Eleni Gkika
- Department of Radiation Oncology, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany
| | - Anca-L Grosu
- Department of Radiation Oncology, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany.,German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany
| | - Christoph Henkenberens
- Department of Radiotherapy and Special Oncology, Medical School Hannover, Hannover, Germany
| | - Harun Ilhan
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Steffen Löck
- Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,OncoRay-National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - Simone Marnitz-Schulze
- Department of Radiation Oncology, Cyberknife and Radiotherapy, Medical Faculty, University Hospital Cologne, Cologne, Germany
| | - Matthias Miederer
- Department of Nuclear Medicine, University Hospital Mainz, Mainz, Germany
| | - Michael Mix
- Department of Nuclear Medicine, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Nils H Nicolay
- Department of Radiation Oncology, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany.,German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany
| | - Maximilian Niyazi
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany.,German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Christoph Pöttgen
- Department of Radiation Oncology, West German Cancer Centre, University of Duisburg-Essen, Essen, Germany
| | - Claus M Rödel
- German Cancer Consortium (DKTK), Partner Site Frankfurt, and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Radiotherapy and Oncology, Goethe-University Frankfurt, Frankfurt, Germany
| | - Imke Schatka
- Department of Nuclear Medicine, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | | | - Andrei S Todica
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Wolfgang Weber
- Department of Nuclear Medicine, Technical University of Munich (TUM), Klinikum rechts der Isar, Munich, Germany
| | - Simone Wegen
- Department of Radiation Oncology, Cyberknife and Radiotherapy, Medical Faculty, University Hospital Cologne, Cologne, Germany
| | - Thomas Wiegel
- Department of Radiation Oncology, Ulm University Hospital, Ulm, Germany
| | - Constantinos Zamboglou
- Department of Radiation Oncology, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany.,German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany
| | - Daniel Zips
- German Cancer Consortium (DKTK), Partner Site Tübingen, and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Radiation Oncology, University of Tübingen, Tübingen, Germany
| | - Klaus Zöphel
- OncoRay-National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany.,National Center for Tumor Diseases (NCT), Partner Site Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany, Helmholtz Association/Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany.,German Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Nuclear Medicine, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,Department of Nuclear Medicine, Klinikum Chemnitz gGmbH, Chemnitz, Germany
| | - Sebastian Zschaeck
- Department of Radiation Oncology, Charité-Universitätsmedizin Berlin, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Daniela Thorwarth
- German Cancer Consortium (DKTK), Partner Site Tübingen, and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Section for Biomedical Physics, Department of Radiation Oncology, University of Tübingen, Tübingen, Germany
| | - Esther G C Troost
- Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. .,OncoRay-National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany. .,National Center for Tumor Diseases (NCT), Partner Site Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany, Helmholtz Association/Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany. .,German Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany. .,Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology-OncoRay, Dresden, Germany.
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Leung D, Bonacorsi S, Smith RA, Weber W, Hayes W. Molecular Imaging and the PD-L1 Pathway: From Bench to Clinic. Front Oncol 2021; 11:698425. [PMID: 34497758 PMCID: PMC8420047 DOI: 10.3389/fonc.2021.698425] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 04/21/2021] [Accepted: 07/22/2021] [Indexed: 01/24/2023] Open
Abstract
Programmed death-1 (PD-1) and programmed death ligand 1 (PD-L1) inhibitors target the important molecular interplay between PD-1 and PD-L1, a key pathway contributing to immune evasion in the tumor microenvironment (TME). Long-term clinical benefit has been observed in patients receiving PD-(L)1 inhibitors, alone and in combination with other treatments, across multiple tumor types. PD-L1 expression has been associated with response to immune checkpoint inhibitors, and treatment strategies are often guided by immunohistochemistry-based diagnostic tests assessing expression of PD-L1. However, challenges related to the implementation, interpretation, and clinical utility of PD-L1 diagnostic tests have led to an increasing number of preclinical and clinical studies exploring interrogation of the TME by real-time imaging of PD-(L)1 expression by positron emission tomography (PET). PET imaging utilizes radiolabeled molecules to non-invasively assess PD-(L)1 expression spatially and temporally. Several PD-(L)1 PET tracers have been tested in preclinical and clinical studies, with clinical trials in progress to assess their use in a number of cancer types. This review will showcase the development of PD-(L)1 PET tracers from preclinical studies through to clinical use, and will explore the opportunities in drug development and possible future clinical implementation.
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Affiliation(s)
- David Leung
- Translational Medicine, Bristol Myers Squibb, Princeton, NJ, United States
| | - Samuel Bonacorsi
- Translational Medicine, Bristol Myers Squibb, Princeton, NJ, United States
| | - Ralph Adam Smith
- Translational Medicine, Bristol Myers Squibb, Princeton, NJ, United States
| | - Wolfgang Weber
- Technische Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Wendy Hayes
- Translational Medicine, Bristol Myers Squibb, Princeton, NJ, United States
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Wang H, Amiel T, Würnschimmel C, Langbein T, Steiger K, Rauscher I, Horn T, Maurer T, Weber W, Wester HJ, Knorr K, Eiber M. PSMA-ligand uptake can serve as a novel biomarker in primary prostate cancer to predict outcome after radical prostatectomy. EJNMMI Res 2021; 11:76. [PMID: 34417907 PMCID: PMC8380207 DOI: 10.1186/s13550-021-00818-2] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 07/28/2021] [Indexed: 01/21/2023] Open
Abstract
Background The prostate-specific membrane antigen (PSMA) is a relevant target in prostate cancer, and immunohistochemistry studies showed associations with outcome. PSMA-ligand positron emission tomography (PET) is increasingly used for primary prostate cancer staging, and the molecular imaging TNM classification (miTNM) standardizes its reporting. We aimed to investigate the potential of PET-imaging to serve as a noninvasive imaging biomarker to predict disease outcome in primary prostate cancer after radical prostatectomy (RP). Methods In this retrospective analysis, 186 primary prostate cancer patients treated with RP who had undergone a 68Ga-PSMA-11 PET up to three months prior to the surgery were included. Maximum standardized uptake value (SUVmax), SUVmean, tumor volume (TV) and total lesion (TL) were collected from PET-imaging. Moreover, clinicopathological information, including age, serum prostate-specific antigen (PSA) level, and pathological characteristics, was assessed for disease outcome prediction. A stage group system for PET-imaging findings based on the miTNM framework was developed. Results At a median follow-up after RP of 38 months (interquartile range (IQR) 22–53), biochemical recurrence (BCR) was observed in 58 patients during the follow-up period. A significant association between a positive surgical margin and miN status (miN1 vs. miN0, odds ratio (OR): 5.428, p = 0.004) was detected. miT status (miT ≥ 3a vs. miT < 3, OR: 2.696, p = 0.003) was identified as an independent predictor for Gleason score (GS) ≥ 8. Multivariate Cox regression analysis indicated that PSA level (hazard ratio (HR): 1.024, p = 0.014), advanced GS (GS ≥ 8 vs. GS < 8, HR: 3.253, p < 0.001) and miT status (miT ≥ 3a vs. miT < 3, HR: 1.941, p = 0.035) were independent predictors for BCR. For stage I disease as determined by PET-imaging, a shorter BCR-free survival was observed in the patients with higher SUVmax (IA vs. IB stage, log-rank, p = 0.022). Conclusion Preoperative miTNM classification from 68Ga-PSMA-11 PET correlates with postoperative GS, surgical margin status and time to BCR. The association between miTNM staging and outcome proposes 68Ga-PSMA-11 PET as a novel non-invasive imaging biomarker and potentially serves for ancillary pre-treatment stratification. Supplementary Information The online version contains supplementary material available at 10.1186/s13550-021-00818-2.
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Affiliation(s)
- Hui Wang
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Thomas Amiel
- Department of Urology, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Christoph Würnschimmel
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Thomas Langbein
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Katja Steiger
- Institute of Pathology, School of Medicine, Technical University Munich, Trogerstr. 18, 81675, Munich, Germany
| | - Isabel Rauscher
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Thomas Horn
- Department of Urology, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Tobias Maurer
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.,Department of Urology, University Hospital Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Wolfgang Weber
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Hans-Juergen Wester
- Pharmaceutical Radiochemistry, Technical University of Munich, Walther-Meißner-Str. 3, 85748, Garching, Germany
| | - Karina Knorr
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Matthias Eiber
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany
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Lewis R, Habringer S, Kircher M, Hefter M, Peuker CA, Werner R, Ademaj-Kospiri V, Gäble A, Weber W, Wester HJ, Buck A, Herhaus P, Lapa C, Keller U. Investigation of spleen CXCR4 expression by [ 68Ga]Pentixafor PET in a cohort of 145 solid cancer patients. EJNMMI Res 2021; 11:77. [PMID: 34417915 PMCID: PMC8380222 DOI: 10.1186/s13550-021-00822-6] [Citation(s) in RCA: 15] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/07/2021] [Indexed: 02/08/2023] Open
Abstract
Background The chemokine receptor CXCR4 is frequently overexpressed and associated with adverse prognosis in most hematopoietic malignancies and solid cancers. Recently, CXCR4 molecular imaging using the CXCR4-specific positron emission tomography (PET) tracer Pentixafor ([68Ga]Pentixafor) has become a well-established method to non-invasively measure CXCR4 expression in vivo. In previous Pentixafor imaging studies, highly variable CXCR4 tracer uptake to the spleen was observed.
Results We investigated the hypothesis that enhanced spleen [68Ga]Pentixafor uptake and thus CXCR4 expression in patients with solid tumors would indicate an activated spleen state and/or an association with clinical and prognostic features and survival parameters. In this retrospective study, [68Ga]Pentixafor-PET images and patient records of 145 solid tumor patients representing 27 cancer entities were investigated for an association of spleen [68Ga]Pentixafor uptake and clinical characteristics and outcome. Based on this assessment, we did not observe differences in clinical outcomes, measured by progression-free survival, overall survival and remission status neither within the entire cohort nor within subgroups of adrenal cancer, desmoplastic small round cell tumor, neuroendocrine tumors, non-small cell lung cancer, small cell lung cancer and pancreatic adenocarcinoma patients. No tumor entity showed especially high levels of spleen [68Ga]Pentixafor uptake compared to others or a control cohort. However, when investigating laboratory parameters, there was a positive correlation of high spleen [68Ga]Pentixafor uptake with leukocyte and/or platelet counts in neuroendocrine tumors, non-small cell lung cancer and small cell lung cancer. Conclusion Spleen [68Ga]Pentixafor uptake was not associated with stage of disease and clinical outcomes in solid tumor patients. We identified positively associated platelet and/or leukocyte counts with spleen [68Ga]Pentixafor uptake in neuroendocrine tumors, non-small cell lung cancer and small cell lung cancer, suggesting that splenic CXCR4 expression could possibly play a role in systemic immunity/inflammation in some types of solid tumors or a subgroup of patients within solid tumor entities. Supplementary Information The online version contains supplementary material available at 10.1186/s13550-021-00822-6.
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Affiliation(s)
- Richard Lewis
- Department of Hematology, Oncology and Cancer Immunology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Stefan Habringer
- Department of Hematology, Oncology and Cancer Immunology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Malte Kircher
- Nuclear Medicine, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Maike Hefter
- Clinic and Policlinic for Internal Medicine III, School of Medicine, Technical University of Munich, Munich, Germany
| | - Caroline Anna Peuker
- Department of Hematology, Oncology and Cancer Immunology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Rudolf Werner
- Department of Nuclear Medicine, University of Würzburg, Würzburg, Germany
| | - Valëza Ademaj-Kospiri
- Clinic for Nuclear Medicine, School of Medicine, Technical University of Munich, Munich, Germany
| | - Alexander Gäble
- Nuclear Medicine, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Wolfgang Weber
- Clinic for Nuclear Medicine, School of Medicine, Technical University of Munich, Munich, Germany
| | - Hans-Jürgen Wester
- Chair of Pharmaceutical Chemistry, Technical University of Munich, Garching, Germany
| | - Andreas Buck
- Department of Nuclear Medicine, University of Würzburg, Würzburg, Germany
| | - Peter Herhaus
- Clinic and Policlinic for Internal Medicine III, School of Medicine, Technical University of Munich, Munich, Germany
| | - Constantin Lapa
- Nuclear Medicine, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Ulrich Keller
- Department of Hematology, Oncology and Cancer Immunology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany. .,German Cancer Consortium (DKTK), Partner Site Berlin; and German Cancer Research Center (DKFZ), Heidelberg, Germany. .,Max-Delbrück-Center for Molecular Medicine, Berlin, Germany.
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Yusufi N, Wurzer A, Herz M, D'Alessandria C, Feuerecker B, Weber W, Wester HJ, Nekolla S, Eiber M. Comparative Preclinical Biodistribution, Dosimetry, and Endoradiotherapy in Metastatic Castration-Resistant Prostate Cancer Using 19F/ 177Lu-rhPSMA-7.3 and 177Lu-PSMA I&T. J Nucl Med 2021; 62:1106-1111. [PMID: 33443072 DOI: 10.2967/jnumed.120.254516] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/04/2020] [Indexed: 12/29/2022] Open
Abstract
Radiohybrid prostate-specific membrane antigen (rhPSMA) ligands are applicable as radiochemical twins for both diagnostic PET imaging and endoradiotherapy. On the basis of preliminary data as a diagnostic ligand, the isomer rhPSMA-7.3 is a promising candidate for potential endoradiotherapy. The aim of this preclinical evaluation was to assess the biodistribution, dosimetry, and therapeutic efficacy of 19F/177Lu-rhPSMA-7.3 in comparison to the established therapeutic agent 177Lu-PSMA I&T (imaging and therapy). Methods: The biodistribution of 19F/177Lu-rhPSMA-7.3 and 177Lu-PSMA I&T was determined in LNCaP tumor-bearing severe combined immunodeficiency (SCID) mice after sacrifice at defined time points up to 7 d (n = 5). Organs and tumors were dissected, percentage injected dose per gram (%ID/g) was determined, and dosimetry was calculated using OLINDA/EXM, version 1.0. The therapeutic efficacy of a single 30-MBq dose of 19F/177Lu-rhPSMA-7.3 (n = 7) was compared with that of 177Lu-PSMA I&T in treatment groups (n = 7) and control groups (n = 6-7) using C4-2 tumor-bearing SCID mice by evaluating tumor growth and survival over 6 wk after treatment. Results: The biodistribution of 19F/177Lu-rhPSMA-7.3 revealed fast blood clearance (0.63 %ID/g at 1 h after injection), and the highest activity uptake was in the spleen and kidneys, particularly in the first hour (33.25 %ID/g and 207.6 %ID/g, respectively, at 1 h after injection), indicating a renal excretion pathway. Compared with 177Lu-PSMA I&T, 19F/177Lu-rhPSMA-7.3 exhibited an initial (1 h) 2.6-fold higher tumor uptake in LNCaP xenografts and a longer retention (4.5 %ID/g vs. 0.9 %ID/g at 168 h). The tumor dose of 19F/177Lu-rhPSMA-7.3 was substantially higher (e.g., 7.47 vs. 1.96 µGy/MBq at 200 mm3) than that of 177Lu-PSMA I&T. In most organs, absorbed doses were higher for 177Lu-PSMA I&T. A significantly greater tumor size reduction was shown for a single dose of 19F/177Lu-rhPSMA-7.3 than for 177Lu-PSMA I&T at the end of the experiment (P = 0.0167). At the predefined termination of the experiment at 6 wk, 7 of 7 and 3 of 7 mice were still alive in the 19F/177Lu-rhPSMA-7.3 and 177Lu-PSMA I&T groups, respectively, compared with the respective control groups, with 0 of 7 and 0 of 6 mice. Conclusion: Compared with 177Lu-PSMA I&T, 19F/177Lu-rhPSMA-7.3 can be considered a suitable candidate for clinical translation because it has similar clearance kinetics and a similar radiation dose to healthy organs but superior tumor uptake and retention. Preliminary treatment experiments showed a favorable antitumor response.
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Affiliation(s)
- Nahid Yusufi
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; and
| | - Alexander Wurzer
- Chair for Pharmaceutical Radiochemistry, Technical University of Munich, Garching, Germany
| | - Michael Herz
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; and
| | - Calogero D'Alessandria
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; and
| | - Benedikt Feuerecker
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; and
| | - Wolfgang Weber
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; and
| | - Hans-Jürgen Wester
- Chair for Pharmaceutical Radiochemistry, Technical University of Munich, Garching, Germany
| | - Stephan Nekolla
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; and
| | - Matthias Eiber
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; and
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Lapa C, Nestle U, Albert NL, Baues C, Beer A, Buck A, Budach V, Bütof R, Combs SE, Derlin T, Eiber M, Fendler WP, Furth C, Gani C, Gkika E, Grosu AL, Henkenberens C, Ilhan H, Löck S, Marnitz-Schulze S, Miederer M, Mix M, Nicolay NH, Niyazi M, Pöttgen C, Rödel CM, Schatka I, Schwarzenboeck SM, Todica AS, Weber W, Wegen S, Wiegel T, Zamboglou C, Zips D, Zöphel K, Zschaeck S, Thorwarth D, Troost EGC. Value of PET imaging for radiation therapy. Strahlenther Onkol 2021; 197:1-23. [PMID: 34259912 DOI: 10.1007/s00066-021-01812-2] [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: 06/01/2021] [Accepted: 06/09/2021] [Indexed: 12/13/2022]
Abstract
This comprehensive review written by experts in their field gives an overview on the current status of incorporating positron emission tomography (PET) into radiation treatment planning. Moreover, it highlights ongoing studies for treatment individualisation and per-treatment tumour response monitoring for various primary tumours. Novel tracers and image analysis methods are discussed. The authors believe this contribution to be of crucial value for experts in the field as well as for policy makers deciding on the reimbursement of this powerful imaging modality.
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Affiliation(s)
- Constantin Lapa
- Nuclear Medicine, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Ursula Nestle
- Department of Radiation Oncology, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany
- German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany
- Department of Radiation Oncology, Kliniken Maria Hilf, Mönchengladbach, Germany
| | - Nathalie L Albert
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Christian Baues
- Department of Radiation Oncology, Cyberknife and Radiotherapy, Medical Faculty, University Hospital Cologne, Cologne, Germany
| | - Ambros Beer
- Department of Nuclear Medicine, Ulm University Hospital, Ulm, Germany
| | - Andreas Buck
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Volker Budach
- Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
| | - Rebecca Bütof
- Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- OncoRay-National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - Stephanie E Combs
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
- Department of Radiation Oncology, Technical University of Munich (TUM), Klinikum rechts der Isar, Munich, Germany
- Department of Radiation Sciences (DRS), Institute of Radiation Medicine (IRM), Neuherberg, Germany
| | - Thorsten Derlin
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
| | - Matthias Eiber
- Department of Nuclear Medicine, Technical University of Munich (TUM), Klinikum rechts der Isar, Munich, Germany
| | - Wolfgang P Fendler
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Christian Furth
- Department of Nuclear Medicine, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Cihan Gani
- German Cancer Consortium (DKTK), Partner Site Tübingen, and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, University of Tübingen, Tübingen, Germany
| | - Eleni Gkika
- Department of Radiation Oncology, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany
| | - Anca-L Grosu
- Department of Radiation Oncology, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany
- German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany
| | - Christoph Henkenberens
- Department of Radiotherapy and Special Oncology, Medical School Hannover, Hannover, Germany
| | - Harun Ilhan
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Steffen Löck
- Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- OncoRay-National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - Simone Marnitz-Schulze
- Department of Radiation Oncology, Cyberknife and Radiotherapy, Medical Faculty, University Hospital Cologne, Cologne, Germany
| | - Matthias Miederer
- Department of Nuclear Medicine, University Hospital Mainz, Mainz, Germany
| | - Michael Mix
- Department of Nuclear Medicine, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Nils H Nicolay
- Department of Radiation Oncology, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany
- German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany
| | - Maximilian Niyazi
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Christoph Pöttgen
- Department of Radiation Oncology, West German Cancer Centre, University of Duisburg-Essen, Essen, Germany
| | - Claus M Rödel
- German Cancer Consortium (DKTK), Partner Site Frankfurt, and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiotherapy and Oncology, Goethe-University Frankfurt, Frankfurt, Germany
| | - Imke Schatka
- Department of Nuclear Medicine, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | | | - Andrei S Todica
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Wolfgang Weber
- Department of Nuclear Medicine, Technical University of Munich (TUM), Klinikum rechts der Isar, Munich, Germany
| | - Simone Wegen
- Department of Radiation Oncology, Cyberknife and Radiotherapy, Medical Faculty, University Hospital Cologne, Cologne, Germany
| | - Thomas Wiegel
- Department of Radiation Oncology, Ulm University Hospital, Ulm, Germany
| | - Constantinos Zamboglou
- Department of Radiation Oncology, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany
- German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany
| | - Daniel Zips
- German Cancer Consortium (DKTK), Partner Site Tübingen, and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, University of Tübingen, Tübingen, Germany
| | - Klaus Zöphel
- OncoRay-National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
- National Center for Tumor Diseases (NCT), Partner Site Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany, Helmholtz Association/Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany
- German Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Department of Nuclear Medicine, Klinikum Chemnitz gGmbH, Chemnitz, Germany
| | - Sebastian Zschaeck
- Department of Radiation Oncology, Charité-Universitätsmedizin Berlin, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Daniela Thorwarth
- German Cancer Consortium (DKTK), Partner Site Tübingen, and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Section for Biomedical Physics, Department of Radiation Oncology, University of Tübingen, Tübingen, Germany
| | - Esther G C Troost
- Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
- OncoRay-National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany.
- National Center for Tumor Diseases (NCT), Partner Site Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany, Helmholtz Association/Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany.
- German Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany.
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology-OncoRay, Dresden, Germany.
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Lapa C, Nestle U, Albert NL, Baues C, Beer A, Buck A, Budach V, Bütof R, Combs SE, Derlin T, Eiber M, Fendler WP, Furth C, Gani C, Gkika E, Grosu AL, Henkenberens C, Ilhan H, Löck S, Marnitz-Schulze S, Miederer M, Mix M, Nicolay NH, Niyazi M, Pöttgen C, Rödel CM, Schatka I, Schwarzenboeck SM, Todica AS, Weber W, Wegen S, Wiegel T, Zamboglou C, Zips D, Zöphel K, Zschaeck S, Thorwarth D, Troost EGC. Value of PET imaging for radiation therapy. Nuklearmedizin 2021; 60:326-343. [PMID: 34261141 DOI: 10.1055/a-1525-7029] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This comprehensive review written by experts in their field gives an overview on the current status of incorporating positron emission tomography (PET) into radiation treatment planning. Moreover, it highlights ongoing studies for treatment individualisation and per-treatment tumour response monitoring for various primary tumours. Novel tracers and image analysis methods are discussed. The authors believe this contribution to be of crucial value for experts in the field as well as for policy makers deciding on the reimbursement of this powerful imaging modality.
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Affiliation(s)
- Constantin Lapa
- Nuclear Medicine, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Ursula Nestle
- Department of Radiation Oncology, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany.,German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany.,Department of Radiation Oncology, Kliniken Maria Hilf, Mönchengladbach, Germany
| | - Nathalie L Albert
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Christian Baues
- Department of Radiation Oncology, Cyberknife and Radiotherapy, Medical Faculty, University Hospital Cologne, Cologne, Germany
| | - Ambros Beer
- Department of Nuclear Medicine, Ulm University Hospital, Ulm, Germany
| | - Andreas Buck
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Volker Budach
- Department of Radiation Oncology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
| | - Rebecca Bütof
- Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - Stephanie E Combs
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany.,Department of Radiation Oncology, Technical University of Munich (TUM), Klinikum rechts der Isar, Munich, Germany.,Department of Radiation Sciences (DRS), Institute of Radiation Medicine (IRM), Neuherberg, Germany
| | - Thorsten Derlin
- Department of Nuclear Medicine, Hannover Medical School, Germany
| | - Matthias Eiber
- Department of Nuclear Medicine, Technical University of Munich (TUM), Klinikum rechts der Isar, Munich, Germany
| | - Wolfgang P Fendler
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Christian Furth
- Department of Nuclear Medicine, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Cihan Gani
- German Cancer Consortium (DKTK), Partner Site Tübingen, and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Radiation Oncology, University of Tübingen, Tübingen, Germany
| | - Eleni Gkika
- Department of Radiation Oncology, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany
| | - Anca L Grosu
- Department of Radiation Oncology, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany.,German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany
| | | | - Harun Ilhan
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Steffen Löck
- Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - Simone Marnitz-Schulze
- Department of Radiation Oncology, Cyberknife and Radiotherapy, Medical Faculty, University Hospital Cologne, Cologne, Germany
| | - Matthias Miederer
- Department of Nuclear Medicine, University Hospital Mainz, Mainz, Germany
| | - Michael Mix
- Department of Nuclear Medicine, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Nils H Nicolay
- Department of Radiation Oncology, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany.,German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany
| | - Maximilian Niyazi
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany.,German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Christoph Pöttgen
- Department of Radiation Oncology, West German Cancer Centre, University of Duisburg-Essen, Essen, Germany
| | - Claus M Rödel
- German Cancer Consortium (DKTK), Partner Site Frankfurt, and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Radiotherapy and Oncology, Goethe University Frankfurt, Frankfurt, Germany
| | - Imke Schatka
- Department of Nuclear Medicine, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | | | - Andrei S Todica
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Wolfgang Weber
- Department of Nuclear Medicine, Technical University of Munich (TUM), Klinikum rechts der Isar, Munich, Germany
| | - Simone Wegen
- Department of Radiation Oncology, Cyberknife and Radiotherapy, Medical Faculty, University Hospital Cologne, Cologne, Germany
| | - Thomas Wiegel
- Department of Radiation Oncology, Ulm University Hospital, Ulm, Germany
| | - Constantinos Zamboglou
- Department of Radiation Oncology, Faculty of Medicine, University Medical Center Freiburg, Freiburg, Germany.,German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany
| | - Daniel Zips
- German Cancer Consortium (DKTK), Partner Site Tübingen, and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Radiation Oncology, University of Tübingen, Tübingen, Germany
| | - Klaus Zöphel
- OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany.,National Center for Tumor Diseases (NCT), Partner Site Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Helmholtz Association/Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany.,German Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Nuclear Medicine, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,Department of Nuclear Medicine, Klinikum Chemnitz gGmbH, Chemnitz, Germany
| | - Sebastian Zschaeck
- Department of Radiation Oncology, Charité-Universitätsmedizin Berlin, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Daniela Thorwarth
- German Cancer Consortium (DKTK), Partner Site Tübingen, and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Section for Biomedical Physics, Department of Radiation Oncology, University of Tübingen, Tübingen, Germany
| | - Esther G C Troost
- Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany.,National Center for Tumor Diseases (NCT), Partner Site Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Helmholtz Association/Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany.,German Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology - OncoRay, Dresden, Germany
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Chantadisai M, Buschner G, Krönke M, Rauscher I, Langbein T, Nekolla SG, Schiller K, Heck MM, Maurer T, Wurzer A, Wester HJ, D'Alessandria C, Weber W, Eiber M. Positive Predictive Value and Correct Detection Rate of 18F-rhPSMA-7 PET in Biochemically Recurrent Prostate Cancer Validated by Composite Reference Standard. J Nucl Med 2021; 62:968-974. [PMID: 33188151 DOI: 10.2967/jnumed.120.255661] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/19/2020] [Indexed: 11/16/2022] Open
Abstract
The objective of this retrospective study was to assess the detection rate (DR), positive predictive value (PPV), and correct detection rate (CDR) of 18F-rhPSMA-7 PET/CT in biochemical recurrence (BCR) of prostate cancer (PCa) after radical prostatectomy (RP) using composite validation. Methods: 18F-rhPSMA-7 PET/CT scans of patients with BCR between July 2017 and June 2018 were retrospectively reviewed. All suspicious lesions were recorded. The reference standard was histopathology or combinations of histopathology, imaging, or prostate-specific antigen (PSA) follow up, defined as composite reference standard. DR was calculated as the proportion of PSMA PET-positive patients to all patients independent of the reference standard, whereas the CDR was the percentage of patients who had at least 1 true-positive PSMA PET lesion localized that corresponded with the reference standard. The PPV was defined as the proportion of patients who had true-positive to all positive findings. The correlation between DR and patient characteristics was evaluated. Results: A total of 532 patients with a median PSA level of 0.97 ng/mL (interquartile range: 0.41-2.46 ng/mL) were included. Of these, 162 patients had composite follow-up at a median duration of 5.6 mo (range: 1.1-14.2 mo). The proportion of patients who had no lesion visualized on PET/CT, localized disease, and any distant metastases (M1) were 20%, 43%, and 37%, respectively. PET DR among all patients was 80%. On a per-patient basis, the PPV of 18F-rhPSMA-7 PET/CT in the composite cohort was 88%, and the CDR was 70%. The PPV in the histopathology-proven cohort was 91%, and the CDR in this subgroup was 73%. In patients with PSA levels ≥ 1 ng/mL the DR and PPV were 90% and 91%, respectively, resulting in a CDR of 82%. In patients with PSA levels < 1 ng/mL, the DR and PPV were 69% and 85%, respectively, resulting in a CDR of 59%. There was a significant positive correlation between 18F-rhPSMA-7 PET/CT detection efficacy and stratified PSA levels (P = 0.005), as well as PSA nadir after prostatectomy (P < 0.001). Conclusion: 18F-rhPSMA-7 PET/CT offers high PPV in BCR after RP. Its CDR is dependent on the prescan PSA value with excellent CDR in patients with PSA ≥ 1 ng/mL.
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Affiliation(s)
- Maythinee Chantadisai
- School of Medicine, Department of Nuclear Medicine, Technical University Munich, Munich, Germany; .,Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | - Gabriel Buschner
- School of Medicine, Department of Nuclear Medicine, Technical University Munich, Munich, Germany
| | - Markus Krönke
- School of Medicine, Department of Nuclear Medicine, Technical University Munich, Munich, Germany
| | - Isabel Rauscher
- School of Medicine, Department of Nuclear Medicine, Technical University Munich, Munich, Germany
| | - Thomas Langbein
- School of Medicine, Department of Nuclear Medicine, Technical University Munich, Munich, Germany
| | - Stephan G Nekolla
- School of Medicine, Department of Nuclear Medicine, Technical University Munich, Munich, Germany
| | - Kilian Schiller
- School of Medicine, Department of Radiation Oncology, Technical University Munich, Munich, Germany
| | - Matthias M Heck
- School of Medicine, Department of Urology, Technical University Munich, Munich, Germany
| | - Tobias Maurer
- School of Medicine, Department of Urology, Technical University Munich, Munich, Germany.,Martini-Klinik and Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany; and
| | | | | | - Calogero D'Alessandria
- School of Medicine, Department of Nuclear Medicine, Technical University Munich, Munich, Germany
| | - Wolfgang Weber
- School of Medicine, Department of Nuclear Medicine, Technical University Munich, Munich, Germany
| | - Matthias Eiber
- School of Medicine, Department of Nuclear Medicine, Technical University Munich, Munich, Germany
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Burgos-Morales O, Gueye M, Lacombe L, Nowak C, Schmachtenberg R, Hörner M, Jerez-Longres C, Mohsenin H, Wagner H, Weber W. Synthetic biology as driver for the biologization of materials sciences. Mater Today Bio 2021; 11:100115. [PMID: 34195591 PMCID: PMC8237365 DOI: 10.1016/j.mtbio.2021.100115] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 03/05/2021] [Revised: 05/16/2021] [Accepted: 05/18/2021] [Indexed: 01/16/2023] Open
Abstract
Materials in nature have fascinating properties that serve as a continuous source of inspiration for materials scientists. Accordingly, bio-mimetic and bio-inspired approaches have yielded remarkable structural and functional materials for a plethora of applications. Despite these advances, many properties of natural materials remain challenging or yet impossible to incorporate into synthetic materials. Natural materials are produced by living cells, which sense and process environmental cues and conditions by means of signaling and genetic programs, thereby controlling the biosynthesis, remodeling, functionalization, or degradation of the natural material. In this context, synthetic biology offers unique opportunities in materials sciences by providing direct access to the rational engineering of how a cell senses and processes environmental information and translates them into the properties and functions of materials. Here, we identify and review two main directions by which synthetic biology can be harnessed to provide new impulses for the biologization of the materials sciences: first, the engineering of cells to produce precursors for the subsequent synthesis of materials. This includes materials that are otherwise produced from petrochemical resources, but also materials where the bio-produced substances contribute unique properties and functions not existing in traditional materials. Second, engineered living materials that are formed or assembled by cells or in which cells contribute specific functions while remaining an integral part of the living composite material. We finally provide a perspective of future scientific directions of this promising area of research and discuss science policy that would be required to support research and development in this field.
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Affiliation(s)
- O. Burgos-Morales
- École Supérieure de Biotechnologie de Strasbourg - ESBS, University of Strasbourg, Illkirch, 67412, France
- Faculty of Biology, University of Freiburg, Freiburg, 79104, Germany
| | - M. Gueye
- École Supérieure de Biotechnologie de Strasbourg - ESBS, University of Strasbourg, Illkirch, 67412, France
| | - L. Lacombe
- École Supérieure de Biotechnologie de Strasbourg - ESBS, University of Strasbourg, Illkirch, 67412, France
| | - C. Nowak
- École Supérieure de Biotechnologie de Strasbourg - ESBS, University of Strasbourg, Illkirch, 67412, France
- Faculty of Biology, University of Freiburg, Freiburg, 79104, Germany
| | - R. Schmachtenberg
- École Supérieure de Biotechnologie de Strasbourg - ESBS, University of Strasbourg, Illkirch, 67412, France
- Faculty of Biology, University of Freiburg, Freiburg, 79104, Germany
| | - M. Hörner
- Faculty of Biology, University of Freiburg, Freiburg, 79104, Germany
- Signalling Research Centres BIOSS and CIBSS, University of Freiburg, Freiburg, 79104, Germany
| | - C. Jerez-Longres
- Faculty of Biology, University of Freiburg, Freiburg, 79104, Germany
- Signalling Research Centres BIOSS and CIBSS, University of Freiburg, Freiburg, 79104, Germany
- Spemann Graduate School of Biology and Medicine - SGBM, University of Freiburg, Freiburg, 79104, Germany
| | - H. Mohsenin
- Faculty of Biology, University of Freiburg, Freiburg, 79104, Germany
- Signalling Research Centres BIOSS and CIBSS, University of Freiburg, Freiburg, 79104, Germany
| | - H.J. Wagner
- Faculty of Biology, University of Freiburg, Freiburg, 79104, Germany
- Signalling Research Centres BIOSS and CIBSS, University of Freiburg, Freiburg, 79104, Germany
- Department of Biosystems Science and Engineering - D-BSSE, ETH Zurich, Basel, 4058, Switzerland
| | - W. Weber
- Faculty of Biology, University of Freiburg, Freiburg, 79104, Germany
- Signalling Research Centres BIOSS and CIBSS, University of Freiburg, Freiburg, 79104, Germany
- Spemann Graduate School of Biology and Medicine - SGBM, University of Freiburg, Freiburg, 79104, Germany
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Wahl RL, Chareonthaitawee P, Clarke B, Drzezga A, Lindenberg L, Rahmim A, Thackeray J, Ulaner GA, Weber W, Zukotynski K, Sunderland J. Mars Shot for Nuclear Medicine, Molecular Imaging, and Molecularly Targeted Radiopharmaceutical Therapy. J Nucl Med 2021; 62:6-14. [PMID: 33334911 DOI: 10.2967/jnumed.120.253450] [Citation(s) in RCA: 9] [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: 07/13/2020] [Accepted: 09/23/2020] [Indexed: 02/06/2023] Open
Abstract
The Society of Nuclear Medicine and Molecular Imaging created the Value Initiative in 2017 as a major component of its strategic plan to further demonstrate the value of molecular imaging and molecularly targeted radiopharmaceutical therapy to patients, physicians, payers, and funding agencies. The research and discovery domain, 1 of 5 under the Value Initiative, has a goal of advancing the research and development of diagnostic and therapeutic nuclear medicine. Research and discovery efforts and achievements are essential to ensure a bright future for NM and to translate science to practice. Given the remarkable progress in the field, leaders from the research and discovery domain and society councils identified 5 broad areas of opportunity with potential for substantive growth and clinical impact. This article discusses these 5 growth areas, identifying specific areas of particularly high importance for future study and development. As there was an understanding that goals should be both visionary yet achievable, this effort was called the Mars shot for nuclear medicine.
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Affiliation(s)
- Richard L Wahl
- Mallinckrodt Institute of Radiology, Washington University St. Louis, Missouri
| | | | - Bonnie Clarke
- Research and Discovery, Society of Nuclear Medicine and Molecular Imaging, Reston, Virginia
| | - Alexander Drzezga
- Department of Nuclear Medicine, University of Cologne, Cologne, Germany, German Center for Neurodegenerative Diseases, Bonn-Cologne, Germany, and Institute of Neuroscience and Medicine, Molecular Organization of the Brain, Forschungszentrum Jülich, Jülich, Germany
| | - Liza Lindenberg
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Arman Rahmim
- Departments of Radiology and Physics, University of British Columbia, Vancouver, British Columbia, Canada; Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, British Columbia, Canada
| | - James Thackeray
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
| | - Gary A Ulaner
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, and Molecular Imaging and Therapy, Hoag Cancer Center, Newport Beach, California
| | - Wolfgang Weber
- Department of Nuclear Medicine, Technical University Munich, Munich, Germany
| | - Katherine Zukotynski
- Departments of Medicine and Radiology, McMaster University, Hamilton, Ontario, Canada; and
| | - John Sunderland
- Departments of Radiology and Physics, University of Iowa, Iowa City, Iowa
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Maurer T, Gesterkamp H, Nguyen N, Westenfelder K, Gschwend JE, Budäus L, Rauscher I, Vag T, Weber W, Eiber M. [68Ga-PSMA-11 PET/mpMRI for local detection of primary prostate cancer in men with a negative prior biopsy]. Aktuelle Urol 2021; 52:143-148. [PMID: 32854128 DOI: 10.1055/a-1198-2305] [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: 10/23/2022]
Abstract
INTRODUCTION AND OBJECTIVE Multiparametric MRI (mpMRI) represents the current gold standard for the detection of primary prostate cancer (PC) after a negative biopsy. PSMA PET imaging has been introduced in the diagnostic work-up of PC with high accuracy, but is currently mainly utilised in the setting of biochemical recurrence. This study aimed to determine the efficacy of combined 68Ga-PSMA-11 PET/mpMRI imaging to detect PC in patients with previously negative prostate biopsies. METHODS A total of 57 patients who had undergone at least one prior negative prostate biopsy were included in this retrospective analysis. All patients underwent 68Ga-PSMA-11 PET/mpMRI imaging of the prostate. mpMRI was evaluated according to the PIRADS classification system and 68Ga-PSMA-11 PET was rated on a 5-point Likert scale (1: PC highly unlikely; 2: PC unlikely; 3: presence of PC is equivocal; 4: PC likely; 5: PC highly likely). All patients received a systematic random biopsy as well as a targeted transrectal biopsy of lesions suspicious on imaging. Imaging and histological biopsy outcomes were compared on a per-patient basis. RESULTS In the histological analysis, 35/57 (61.4 %) patients harboured PC lesions. In patients with biopsy-proven PC, 21/35 (60.0 %) had a PI-RADS 4 or 5 lesion on mpMRI and 28 /35 (80.0 %) had a PET rating of 4 or 5. Combined 68Ga-PSMA-11 PET/mpMRI missed only one patient with a Gleason score (GS) 7a tumour (rating of 1 or 2 in both PET and mpMRI). Limitations include the retrospective analysis as well as possible false negative biopsy results even in a fusion biopsy setting. CONCLUSION In this initial analysis, the combined 68Ga-PSMA-11 PET/mpMRI proved to be a valuable imaging tool to guide prostate biopsies for the detection of PC in patients with a negative prior biopsy. In this approach, 68Ga-PSMA-11 PET and mpMRI show partially complementary findings that enhance the detection of PC lesions.
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Affiliation(s)
- Tobias Maurer
- Urologische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
- Martini-Klinik und Klinik und Poliklinik für Urologie, Universität Hamburg-Eppendorf
| | - Hannah Gesterkamp
- Urologische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
| | - Noemi Nguyen
- Urologische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
| | - Kay Westenfelder
- Urologische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
| | - Jürgen E. Gschwend
- Urologische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
| | - Lars Budäus
- Martini-Klinik und Klinik und Poliklinik für Urologie, Universität Hamburg-Eppendorf
| | - Isabel Rauscher
- Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
| | - Tibor Vag
- Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
| | - Wolfgang Weber
- Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
| | - Matthias Eiber
- Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
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Zimmer S, Maus V, Maurer C, Berlis A, Weber W, Fischer S. Widening the Indications for Intrasaccular Flow Disruption: WEB 17 in the Treatment of Aneurysm Locations Different from Those in the Good Clinical Practice Trials. AJNR Am J Neuroradiol 2021; 42:524-529. [PMID: 33509918 DOI: 10.3174/ajnr.a6946] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 10/12/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND PURPOSE The safety and efficacy of the Woven EndoBridge (WEB) device has been shown in multiple good clinical practice trials, whereas aneurysm locations in these trials were restricted to bifurcation aneurysms located at the circle of Willis (MCA bifurcation, ICA bifurcation, anterior communicating artery, basilar artery tip). Our aim was to evaluate angiographic and clinical results with the WEB 17 in aneurysm locations that were excluded from the good clinical practice trials, assuming that the angiographic and clinical results are similar to those of the good clinical practice trials for aneurysms in traditional locations. MATERIALS AND METHODS We performed retrospective analysis of immediate and follow-up results of aneurysms in locations outside the good clinical practice trials in which the WEB 17 was used on an intention-to-treat approach. RESULTS Between June 2017 and May 2020, forty-seven aneurysms in 44 patients met the inclusion criteria. Aneurysm locations were the ICA posterior communicating artery in 19 (40.3%), the ICA paraophthalmic or choroidal locations in 4 (8.6%), anterior cerebral artery A2 segment in 13 (27.7%), MCA M1 segment in 2 (4.3%), posterior cerebral artery P2 segment in 2 (4.3%), PICA in 3 (6.4%), and the superior cerebellar artery in 4 (8.4%) cases. The procedure-related morbidity and mortality rates in the entire series were 0.0%. The early and late (<12 and >12 months) complete occlusion rates were 63.9% (23/36) and 77.8% (14/18), respectively. CONCLUSIONS The WEB 17 is safe and effective in aneurysm locations different from the traditional bifurcation aneurysms included in the good clinical practice trials. Further studies will help to define the entire spectrum of aneurysm morphologies and locations suitable for the WEB 17.
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Affiliation(s)
- S Zimmer
- From the Institut für Diagnostische und Interventionelle Radiologie, Neuroradiologie, Nuklearmedizin (S.Z., V.M., W.W., S.F.), Universitätsklinik, Knappschaftskrankenhaus Bochum-Langendreer, Bochum, Germany
| | - V Maus
- From the Institut für Diagnostische und Interventionelle Radiologie, Neuroradiologie, Nuklearmedizin (S.Z., V.M., W.W., S.F.), Universitätsklinik, Knappschaftskrankenhaus Bochum-Langendreer, Bochum, Germany
| | - C Maurer
- Klinik für Diagnostische Radiologie und Neuroradiologie (C.M., A.B.), Klinikum Augsburg, Augsburg, Germany
| | - A Berlis
- Klinik für Diagnostische Radiologie und Neuroradiologie (C.M., A.B.), Klinikum Augsburg, Augsburg, Germany
| | - W Weber
- From the Institut für Diagnostische und Interventionelle Radiologie, Neuroradiologie, Nuklearmedizin (S.Z., V.M., W.W., S.F.), Universitätsklinik, Knappschaftskrankenhaus Bochum-Langendreer, Bochum, Germany
| | - S Fischer
- From the Institut für Diagnostische und Interventionelle Radiologie, Neuroradiologie, Nuklearmedizin (S.Z., V.M., W.W., S.F.), Universitätsklinik, Knappschaftskrankenhaus Bochum-Langendreer, Bochum, Germany
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Weber W, Czernin J. Reply: Radioguided Surgery. J Nucl Med 2021; 62:592. [PMID: 33547207 DOI: 10.2967/jnumed.121.261917] [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] Open
Affiliation(s)
- Wolfgang Weber
- Technical University of Munich Ismaningerstrasse 22 München 81675, Germany E-mail:
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Afshar-Oromieh A, da Cunha ML, Wagner J, Haberkorn U, Debus N, Weber W, Eiber M, Holland-Letz T, Rauscher I. Performance of [ 68Ga]Ga-PSMA-11 PET/CT in patients with recurrent prostate cancer after prostatectomy-a multi-centre evaluation of 2533 patients. Eur J Nucl Med Mol Imaging 2021; 48:2925-2934. [PMID: 33543325 PMCID: PMC8263399 DOI: 10.1007/s00259-021-05189-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [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: 10/15/2020] [Accepted: 01/02/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate the performance of [68Ga]Ga-PSMA-11 PET/CT in the diagnosis of recurrent prostate cancer (PC) after prostatectomy in a large multicentre cohort. METHODS The centres, which contributed to this study, were the departments of nuclear medicine of Heidelberg (Germany), Technical University of Munich (Germany) and Albert Einstein Hospital of São Paulo (Brazil). A total of 2533 patients who were scanned with [68Ga]Ga-PSMA-11 PET/CT at 1 h p.i. due to recurrent PC after prostatectomy were included in this retrospective analysis. Exclusion criteria were as follows: patients with untreated primary tumour, previous chemotherapy or Xofigo®; those previously treated with exclusively external beam radiation therapy or HIFU; those referred for PSMA-therapy; and those treated with ADT (including first- and second-generation ADT) within the last 6 months. Potential influences of different factors such as PSA level, PSA doubling-time (PSADT), PSA velocity (PSAVel), Gleason Score (GSC, including the separate analysis of 7a and 7b), age and amount of injected tracer were evaluated in a multivariable analysis. RESULTS The rate of pathologic PET/CT-scans was 43% for PSA ≤ 0.2 ng/ml, 58% for PSA > 0.2 to ≤ 0.5, 72% for PSA > 0.5 to ≤ 1.0 and increased to a maximum of 93% for PSA > 10 ng/ml. A pathological PET/CT was significantly (p = 0.001) associated with PSA level and higher GSC. Amount of injected tracer, age, PSADT and PSAVel were not associated with a higher probability of a pathological scan. CONCLUSION [68Ga]Ga-PSMA-11 PET/CT at 1 h p.i. confirmed its high performance in the largest patient cohort yet analysed. Tumour detection showed a clear association with higher PSA and higher GSC. No association was found between a pathological [68Ga]Ga-PSMA-11 PET/CT and age, amount of injected tracer, PSADT or PSAVel.
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Affiliation(s)
- Ali Afshar-Oromieh
- Department of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, Germany. .,Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, CH-3010, Bern, Switzerland.
| | | | - Jairo Wagner
- Department of Nuclear Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Uwe Haberkorn
- Department of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Centre, Heidelberg, Germany
| | - Nils Debus
- Department of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Wolfgang Weber
- Department of Nuclear Medicine, Technical University of Munich, Munich, Germany
| | - Matthias Eiber
- Department of Nuclear Medicine, Technical University of Munich, Munich, Germany
| | - Tim Holland-Letz
- Department of Biostatistics, German Cancer Research Center, Heidelberg, Germany
| | - Isabel Rauscher
- Department of Nuclear Medicine, Technical University of Munich, Munich, Germany
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Rohde S, Weber W, Berlis A, Urbach H, Reimer P, Schramm P. Acute Endovascular Stroke Treatment in Germany in 2019 : Results from a Nationwide Database. Clin Neuroradiol 2021; 31:11-19. [PMID: 33481050 PMCID: PMC7943430 DOI: 10.1007/s00062-020-00989-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 10/20/2020] [Accepted: 12/17/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE Since the incidental discovery and systematic introduction of mechanical endovascular stroke treatment in 2015 there are few reports about the real-life situation in daily clinical practice. The aim of this study was to evaluate the mechanical thrombectomy data documented in the quality assurance database of the German Society for Interventional Radiology and Minimally Invasive Therapy (DeGIR) and the German Society of Neuroradiology (DGNR) in 2019. METHODS We retrospectively analyzed the clinical and procedural data of all mechanical thrombectomies that were entered into the voluntary nationwide database in 2019. The information of each procedure was provided on a standardized web-based data sheet. Data were exported and analyzed by a group of experts on behalf of the DGNR. RESULTS A total of 13,840 data sets from 158 participating centers could be analyzed. Mean age of the patients was 74 ± 13 years; 53.9% were female. Vessel occlusion was located in the anterior circulation in 87.4%, in the posterior circulation in 10.7%. On hospital admission, the median National Institutes of Health Stroke Scale (NIHSS) was 14 (lower/upper quartile 10/19); at hospital discharge, median NIHSS had dropped to 9 (lower/upper quartile 2/12; p < 0.001). Recanalization of the occluded vessel segment was successful (TICI 2b + 3) in 88.4%. The reported complication rate was 7.3%, with subarachnoid hemorrhage as the most frequent complication (3.4%), followed by parenchymal hemorrhage (1.7%) and embolization in new territories (1.2%). Overall, the median time interval from symptom onset to hospital admission was 94 min (quartiles 59/180 min), the median time from hospital admission to groin puncture was 74 min (lower/upper quartile 47/103 min), and the median duration of the procedure 43 min (lower/upper quartile 25.2/73.2 min). A comparison between primary and secondary referral revealed a significant faster symptom-to-intervention time for primary referrals, whereas in-house workflows showed no significant difference. CONCLUSION The analysis represents the largest documented cohort of acute stroke patients treated by thrombectomy. The documentation allows for a detailed evaluation of procedural, clinical, logistic and radiation exposure data and might be used for monitoring the quality of the treatment on a nationwide scale.
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Affiliation(s)
- S Rohde
- Klinik für Radiologie und Neuroradiologie, Klinikum Dortmund gGmbH, Beurhausstr. 40, 44137, Dortmund, Germany.
| | - W Weber
- Institut für Diagnostische Radiologie, Neuroradiologie und Nuklearmedizin, Universitätsklinikum Knappschaftskrankenhaus Bochum, Bochum, Germany
| | - A Berlis
- Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum Augsburg, Augsburg, Germany
| | - H Urbach
- Klinik für Neuroradiologie, Universitätsklinikum Freiburg, Freiburg, Germany
| | - P Reimer
- Diagnostische und Interventionelle Radiologie, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany
| | - P Schramm
- Institut für Neuroradiologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
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Notohamiprodjo S, Varasteh Z, Beer AJ, Niu G, Chen X(S, Weber W, Schwaiger M. Tumor Vasculature. Mol Imaging 2021. [DOI: 10.1016/b978-0-12-816386-3.00090-9] [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: 10/20/2022] Open
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Aarntzen E, Achilefu S, Akam EA, Albaghdadi M, Beer AJ, Bharti S, Bhujwalla ZM, Bischof GN, Biswal S, Boss M, Botnar RM, Brinson Z, Brom M, Buitinga M, Bulte JW, Caravan P, Chan HP, Chandy M, Chaney AM, Chen DL, Chen X(S, Chenevert TL, Coughlin JM, Covington MF, Cumming P, Daldrup-Link HE, Deal EM, de Galan B, Derlin T, Dewhirst MW, Di Paolo A, Drzezga A, Du Y, Thi-Quynh Duong M, Ehman RL, Eriksson O, Galli F, Gatenby RA, Gelovani J, Giehl K, Giger ML, Goel R, Gold G, Gotthardt M, Graham MM, Gropler RJ, Gründer G, Gulhane A, Hadjiiski L, Hajhosseiny R, Hammoud DA, Helfer BM, Hicks RJ, Higuchi T, Hoffman JM, Honer M, Huang SC(H, Hung J, Hwang DW, Jackson IM, Jacobs AH, Jaffer FA, Jain SK, James ML, Jansen T, Johansson L, Joosten L, Kakkad S, Kamson D, Kang SR, Kelly KA, Knopp MI, Knopp MV, Kogan F, Krishnamachary B, Künnecke B, Lee DS, Libby P, Luker GD, Luker KE, Makowski MR, Mankoff DA, Massoud TF, Meyer CR, Miller Z, Min JJ, Mondal SB, Montesi SB, Navin PJ, Nekolla SG, Niu G, Notohamiprodjo S, Ordoñez AA, Osborn EA, Pacheco-Torres J, Pagano G, Palmer GM, Paulmurugan R, Penet MF, Phinikaridou A, Pomper MG, Prieto C, Qi H, Raghunand N, Ramar T, Reynolds F, Ropella-Panagis K, Ross BD, Rowe SP, Rudin M, Sadaghiani MS, Sager H, Samala R, Saraste A, Schelhaas S, Schwaiger M, Schwarz SW, Seiberlich N, Shapiro MG, Shim H, Signore A, Solnes LB, Suh M, Tsien C, van Eimeren T, Varasteh Z, Venkatesh SK, Viel T, Waerzeggers Y, Wahl RL, Weber W, Werner RA, Winkeler A, Wong DF, Wright CL, Wu AM, Wu JC, Yoon D, You SH, Yuan C, Yuan H, Zanzonico P, Zhao XQ, Zhou IY, Zinnhardt B. Contributors. Mol Imaging 2021. [DOI: 10.1016/b978-0-12-816386-3.01004-8] [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: 11/27/2022] Open
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Röther J, Busse O, Berlis A, Dörfler A, Groden C, Hamann G, Jansen O, Meixensberger J, Müller O, Regelsberger J, Steinmetz H, Vatter H, Weber W, Hänggi D, Nabavi D. [Erratum to: Interdisciplinary neurovascular networks: state of the art]. Nervenarzt 2020; 91:1169. [PMID: 33156367 DOI: 10.1007/s00115-020-01016-6] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- J Röther
- Kopf- und Neurozentrum, Neurologische Abteilung mit überregionaler Stroke Unit, Neurophysiologie und Neurologischer Intensivmedizin, Asklepios Klinik Hamburg Altona, Asklepios Campus Hamburg der Semmelweis Universität, Hamburg, Deutschland.
| | - O Busse
- Deutsche Schlaganfall-Gesellschaft, Berlin, Deutschland
| | - A Berlis
- Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklink Augsburg, Augsburg, Deutschland
| | - A Dörfler
- Neuroradiologische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
| | - Ch Groden
- Universitätsklinikum Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland
| | - G Hamann
- Klinik für Neurologie und Neurologische Rehabilitation, Bezirkskrankenhaus Günzburg der Bezirkskliniken Schwaben, Günzburg, Deutschland
| | - O Jansen
- Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein Campus Kiel, Kiel, Deutschland
| | - J Meixensberger
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Leipzig AöR, Leipzig, Deutschland
| | - O Müller
- Klinik für Neurochirurgie, Klinikum Dortmund, Dortmund, Deutschland
| | - J Regelsberger
- Neurochirurgische Klinik, Universitätsklinikum Hamburg Eppendorf, Hamburg, Deutschland
| | - H Steinmetz
- Klinik für Neurologie, Universitätsklinikum, Goethe-Universität Frankfurt, Frankfurt am Main, Deutschland
| | - H Vatter
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Bonn, Deutschland
| | - W Weber
- Institut für Diagnostische und Interventionelle Radiologie, Neuroradiologie und Nuklearmedizin, Universitätsklinikum Knappschaftskrankenhaus Bochum GmbH, Bochum, Deutschland
| | - D Hänggi
- Neurochirurgische Klinik/Department of Neurosurgery, Universitätsklinikum Düsseldorf/Düsseldorf University Hospital, Heinrich-Heine-Universität, Düsseldorf, Deutschland
| | - D Nabavi
- Klinik für Neurologie, Vivantes Klinikum Neukölln, Berlin, Deutschland
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Maus V, Weber W, Berlis A, Maurer C, Fischer S. Initial Experience with Surpass Evolve Flow Diverter in the Treatment of Intracranial Aneurysms. Clin Neuroradiol 2020; 31:681-689. [DOI: 10.1007/s00062-020-00972-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 10/17/2020] [Indexed: 11/29/2022]
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