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Ghafouri M, Duque L, Rodriguez LP, Philbrick KL, Savica R, Pazdernik VK, Port JD, Rummans TA, Singh B. Identifying clinical predictors for considering brain FDG-PET imaging in patients with catatonia: A case-control study. Schizophr Res 2024; 267:138-140. [PMID: 38537394 PMCID: PMC11102829 DOI: 10.1016/j.schres.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/18/2024] [Accepted: 03/14/2024] [Indexed: 05/21/2024]
Affiliation(s)
- Mohammad Ghafouri
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Laura Duque
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA; Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | | | - Kemuel L Philbrick
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - John D Port
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Teresa A Rummans
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA; Department of Psychiatry, Mayo Clinic, Jacksonville, FL, USA
| | - Balwinder Singh
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
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An R, Ma X, Wang Y. The value of 18F-FDG PET/CT in Langerhans cell histiocytosis. Ann Nucl Med 2024; 38:238-245. [PMID: 38217750 DOI: 10.1007/s12149-023-01892-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/03/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVE To investigate the value of 18F-FDG PET/CT in diagnosis and disease evaluation of Langerhans cell histiocytosis (LCH). METHODS A retrospective analysis of 31 patients with LCH confirmed by histopathology was performed. A systematic analysis of the PET/CT imaging manifestations of LCH was performed, recording patients who were treated and receiving PET/CT for efficacy evaluation. In addition, clinical and laboratory data of LCH patients were collected, and the correlation between these data and PET/CT metabolic parameters was initially investigated. RESULTS Of the 31 patients, thirty had at least 1 PET/CT positive lesions (96.7%), and one had only skin damage without abnormalities on PET/CT. Of 31 patients, fifteen (48.4%) had single system (SS) disease (9 cases with a single site and 6 cases with multiple sites) and 16 (51.6%) had multisystem (MS) disease (6 low risk and 10 high risk cases). The incidence of LCH lesions in the bone, lymphatic system, pituitary gland, liver, soft tissue, thyroid gland, thymus, and lungs was 20 cases (64.5%), 12 cases (38.7%), 3 cases (9.7%), 2 cases (6.5%), 2 cases (6.5%), 1 case (3.2%), 1 case (3.2%), and 8 cases (25.8%), respectively. A total of 21 PET/CT follow-up scanning were performed in 13 patients receiving chemotherapy, with 13 (61.9%) partial metabolic remission (PMR), 6 (28.6%) progressive metabolic disease (PMD), and 2 (9.5%) stable metabolic disease (SMD), according to PET Response Evaluation Criteria in Solid Tumors (PRECIST) 1.0. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and Lactic Dehydrogenase (LDH) were positively correlated with TTLG (total TLG) (R2 = 0.3256, 0.2409, 0.4205, P < 0.05). The Re-examine SUVmax is positively correlated with re-examine LDH (R2 = 0.7285, P < 0.05). CONCLUSIONS 18F-FDG PET/CT is an effective way to diagnose and evaluate LCH. PET metabolic parameters were associated with laboratory inflammatory markers, suggesting that 18F-FDG PET/CT may be helpful in evaluating disease activity of LCH.
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Affiliation(s)
- Rongchen An
- Department of Nuclear Medicine, The Second Xiangya Hospital, Central South University, 139# Renmin Middle Road Changsha, Changsha, 410011, Hunan, China
| | - Xiaowei Ma
- Department of Nuclear Medicine, The Second Xiangya Hospital, Central South University, 139# Renmin Middle Road Changsha, Changsha, 410011, Hunan, China
| | - Yunhua Wang
- Department of Nuclear Medicine, The Second Xiangya Hospital, Central South University, 139# Renmin Middle Road Changsha, Changsha, 410011, Hunan, China.
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Mavi ME, Amini F, Ilgan S. Exceptionally Rare Isolated Thyroidal Metastasis of Pulmonary Carcinosarcoma: A Tale of 18F-FDG-positive Thyroid Nodule. Mol Imaging Radionucl Ther 2024; 33:63-65. [PMID: 38390824 PMCID: PMC10899742 DOI: 10.4274/mirt.galenos.2023.74507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/15/2023] [Indexed: 02/24/2024] Open
Abstract
Pulmonary carcinosarcomas (PCS) are uncommon and aggressive malignant tumors with epithelial and mesenchymal components and have a worse prognosis than other non-small-cell lung cancers. Metastases of non-thyroidal malignancies to the thyroid are rare. We reported a unique case of isolated thyroidal metastasis of PCS and discussed 18F-fluorodeoxyglucose (18F-FDG) positivity in incidentally found thyroid nodules on 18F-FDG positron emission tomography scan.
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Affiliation(s)
- Mehmet Emin Mavi
- Karaman Training and Research Hospital, Clinic of Nuclear Medicine, Karaman, Türkiye
| | - Fariba Amini
- Güven Hospital, Clinic of Pathology, Ankara, Türkiye
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Mavi ME, Bozkurt MF. 18F-FDG PET/CT Imaging for Treatment Response Assessment of Cardiac Primitive Neuroectodermal Tumor. Mol Imaging Radionucl Ther 2024; 33:50-53. [PMID: 38390790 PMCID: PMC10899740 DOI: 10.4274/mirt.galenos.2023.91259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024] Open
Abstract
Primitive neuroectodermal tumors (PNETs) are rare and aggressive members of the small round cell carcinoma family. Generally, PNETs are classified into two main groups: PNETs of the central nervous system and PNETs of the peripheral nervous system. Herein, we report the therapy response assessment of a rare case of isolated cardiac PNET using 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) imaging. Given that physiological cardiac FDG uptake is typically observed, assessing FDG avid lesions in the myocardium presents a challenge for FDG PET/CT. This case holds significance because of the rarity of the disease and the challenging nature of the site for FDG PET/CT imaging.
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Affiliation(s)
- Mehmet Emin Mavi
- Hacettepe University Faculty of Medicine, Department of Nuclear Medicine, Ankara, Türkiye
| | - Murat Fani Bozkurt
- Hacettepe University Faculty of Medicine, Department of Nuclear Medicine, Ankara, Türkiye
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Trieu H, De Silva S, Manoukian S, Rajan A, Mannan R, Liang Y, Lee JK, Lin J, Kidambi TD. Endoscopic Evaluation of PET/CT Abnormalities in the Gastrointestinal Tract: Yield and Approach. Dig Dis Sci 2024; 69:552-561. [PMID: 38104053 DOI: 10.1007/s10620-023-08231-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 12/04/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Unexpected hypermetabolic activity is often encountered in the gastrointestinal tract when PET/CT is performed for various indications, prompting endoscopic evaluation. Our aim was to characterize the types of lesions seen in segments of the gastrointestinal tract with unexpected PET/CT abnormalities as well as clinically significant lesions seen on endoscopy which did not produce a PET/CT abnormality to guide the endoscopist tasked with evaluating these imaging findings. METHODS We retrospectively reviewed a database of endoscopies performed at City of Hope Comprehensive Cancer Center between January 1, 2016 and September 30, 2021 for an indication of "abnormal PET." We divided the gastrointestinal tract into segments and defined categories of endoscopic/histologic findings for each segment. We counted the number of segments with an abnormal PET/CT finding and corresponding endoscopic/histologic abnormality as well as the number of segments with an endoscopic/histologic abnormality but normal PET/CT. RESULTS PET/CT identified 209 segments with hypermetabolic activity, 109 of which had corresponding endoscopic/histologic abnormalities. In the jejunum and ileum, all corresponding lesions were malignant. Seventy-three percent of corresponding lesions in the stomach were H. pylori positive. PET/CT failed to detect 34.7% of clinically significant lesions diagnosed endoscopically, including 1 malignancy in the transverse colon and many inflammatory or low-risk premalignant lesions. CONCLUSION PET/CT abnormalities seen in the small bowel should be evaluated urgently as nearly all correlates were malignant, while abnormalities in the stomach should prompt workup for H. pylori. Most lesions missed by PET/CT were inflammatory or low-risk premalignant yet clinically significant, confirming the need to inspect the entirety of the upper or lower gastrointestinal tract during endoscopy.
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Affiliation(s)
- Harry Trieu
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sadie De Silva
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Saro Manoukian
- Department of Radiology, City of Hope National Medical Center, Duarte, CA, USA
| | - Anand Rajan
- Department of Gastroenterology, University of California San Francisco at Fresno, Fresno, CA, USA
| | - Rifat Mannan
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Yu Liang
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Jeffrey K Lee
- Department of Gastroenterology, Kaiser Permanente San Francisco Medical Center, San Francisco, CA, USA
| | - James Lin
- Department of Gastroenterology, City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA, 91010, USA
| | - Trilokesh D Kidambi
- Department of Gastroenterology, City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA, 91010, USA.
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Shinohara Y, Ibaraki M, Matsubara K, Sato K, Yamamoto H, Kinoshita T. Visualization of small brain nuclei with a high-spatial resolution, clinically available whole-body PET scanner. Ann Nucl Med 2024; 38:154-161. [PMID: 37989801 PMCID: PMC10822807 DOI: 10.1007/s12149-023-01886-1] [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: 08/06/2023] [Accepted: 10/30/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE To verify the visibility of physiological 18F-fluorodeoxyglucose (18F-FDG) uptake in nuclei in and around the brainstem by a whole-body (WB) silicon photomultiplier positron emission tomography (SiPM-PET) scanner with point-spread function (PSF) reconstruction using various iteration numbers. METHODS Ten healthy subjects (5 men, 5 women; mean age, 56.0 ± 5.0 years) who underwent 18F-FDG PET/CT using a WB SiPM-PET scanner and magnetic resonance imaging (MRI) of the brain including a spin-echo three-dimensional sampling perfection with application-optimized contrasts using different flip angle evolutions fluid-attenuated inversion recovery (3D-FLAIR) and a 3D-T1 magnetization-prepared rapid gradient-echo (T1-MPRAGE) images were enrolled. Each acquired PET image was reconstructed using ordered-subset expectation maximization (OSEM) with iteration numbers of 4, 16, 64, and 256 (subset 5 fixed) + time-of-flight (TOF) + PSF. The reconstructed PET images and 3D-FLAIR images for each subject were registered to individual T1-MPRAGE volumes using normalized mutual information criteria. For each MR-coregistered individual PET image, the pattern of FDG uptake in the inferior olivary nuclei (ION), dentate nuclei (DN), midbrain raphe nuclei (MRN), inferior colliculi (IC), mammillary bodies (MB), red nuclei (RN), subthalamic nuclei (STN), lateral geniculate nuclei (LGN), medial geniculate nuclei (MGN), and superior colliculi (SC) was visually classified into the following three categories: good, clearly distinguishable FDG accumulation; fair, obscure contour of FDG accumulation; poor, FDG accumulation indistinguishable from surrounding uptake. RESULTS Among individual 18F-FDG PET images with OSEM iterations of 4, 16, 64, and 256 + TOF + PSF, the iteration numbers that showed the best visibility in each structure were as follows: ION, MRN, LGN, MGN, and SC, iteration 64; DN, iteration 16; IC, iterations 16, 64, and 256; MB, iterations 64 and 256; and RN and STN, iterations 16 and 64, respectively. Of the four iterations, the 18F-FDG PET image of iteration 64 visualized FDG accumulation in small structures in and around the brainstem most clearly (good, 98 structures; fair, 2 structures). CONCLUSIONS A clinically available WB SiPM-PET scanner is useful for visualizing physiological FDG uptake in small brain nuclei, using a sufficiently high number of iterations for OSEM with TOF and PSF reconstructions.
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Affiliation(s)
- Yuki Shinohara
- Department of Radiology and Nuclear Medicine, Research Institute for Brain and Blood Vessels-Akita, 6-10 Senshu-kubota-machi, Akita, 010-0874, Japan.
| | - Masanobu Ibaraki
- Department of Radiology and Nuclear Medicine, Research Institute for Brain and Blood Vessels-Akita, 6-10 Senshu-kubota-machi, Akita, 010-0874, Japan
| | - Keisuke Matsubara
- Department of Radiology and Nuclear Medicine, Research Institute for Brain and Blood Vessels-Akita, 6-10 Senshu-kubota-machi, Akita, 010-0874, Japan
- Department of Management Science and Engineering, Faculty of System Science and Technology, Akita Prefectural University, Yurihonjo, Japan
| | - Kaoru Sato
- Department of Radiology and Nuclear Medicine, Research Institute for Brain and Blood Vessels-Akita, 6-10 Senshu-kubota-machi, Akita, 010-0874, Japan
| | - Hiroyuki Yamamoto
- Department of Radiology and Nuclear Medicine, Research Institute for Brain and Blood Vessels-Akita, 6-10 Senshu-kubota-machi, Akita, 010-0874, Japan
| | - Toshibumi Kinoshita
- Department of Radiology and Nuclear Medicine, Research Institute for Brain and Blood Vessels-Akita, 6-10 Senshu-kubota-machi, Akita, 010-0874, Japan
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Liu W, Ji B, Bai L, Gao S. PET/CT-aided biopsy of lung lesions enhances diagnostic efficacy, especially for lesions >3cm. Front Oncol 2024; 14:1296553. [PMID: 38357204 PMCID: PMC10865498 DOI: 10.3389/fonc.2024.1296553] [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: 09/18/2023] [Accepted: 01/08/2024] [Indexed: 02/16/2024] Open
Abstract
Objectives The purpose of this study was to compare the diagnostic efficacy of PET/CT-aided CT-guided and routine CT-guided transthoracic needle biopsy for lung lesions. Methods A total of 458 patients with suspicious lung lesions were referred for CT-guided biopsy, with 227 patients assigned to the PET/CT group and 231 patients assigned to the CT group. The clinical characteristics and diagnostic yield were compared between the two groups. Furthermore, conducting subgroup analysis to evaluate the differences of diagnostic success or failure between the two groups. Results The sensitivity and diagnostic accuracy rate differed significantly (P = 0.035, P = 0.048). In the PET/CT group, the values were 95.7% and 96.3%, respectively, while in the CT group, they were 90.1% and 91.9%. When considering non-diagnostic cases, the overall diagnostic success rate increased markedly in PET/CT group (93.0% vs. 83.1%, P = 0.001). In our subgroup analysis, the PET/CT group demonstrated superiority in detecting lesions larger than 3 cm (OR, 4.81; 95CI%, 2.03 - 11.36), while showing a moderate effect in lesions smaller than 3 cm (OR, 1.09; 95CI%, 0.42 - 2.81). Significant effect modification was observed in large lesions in the PET/CT group (P for interaction = 0.023). Conclusions 18F-FDG-PET/CT enhances the diagnostic efficacy of CT-guided transthoracic needle biopsy for lung lesions, and the incremental value can be modified by lesion size, particularly when the diameter is larger than 3 cm.
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Affiliation(s)
| | | | - Lin Bai
- Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Shi Gao
- Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, Changchun, China
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Wu Y, Fu F, Meng N, Wang Z, Li X, Bai Y, Zhou Y, Liang D, Zheng H, Yang Y, Wang M, Sun T. The role of dynamic, static, and delayed total-body PET imaging in the detection and differential diagnosis of oncological lesions. Cancer Imaging 2024; 24:2. [PMID: 38167538 PMCID: PMC10759379 DOI: 10.1186/s40644-023-00649-5] [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: 09/12/2023] [Accepted: 12/11/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVES Commercialized total-body PET scanners can provide high-quality images due to its ultra-high sensitivity. We compared the dynamic, regular static, and delayed 18F-fluorodeoxyglucose (FDG) scans to detect lesions in oncologic patients on a total-body PET/CT scanner. MATERIALS & METHODS In all, 45 patients were scanned continuously for the first 60 min, followed by a delayed acquisition. FDG metabolic rate was calculated from dynamic data using full compartmental modeling, whereas regular static and delayed SUV images were obtained approximately 60- and 145-min post-injection, respectively. The retention index was computed from static and delayed measures for all lesions. Pearson's correlation and Kruskal-Wallis tests were used to compare parameters. RESULTS The number of lesions was largely identical between the three protocols, except MRFDG and delayed images on total-body PET only detected 4 and 2 more lesions, respectively (85 total). FDG metabolic rate (MRFDG) image-derived contrast-to-noise ratio and target-to-background ratio were significantly higher than those from static standardized uptake value (SUV) images (P < 0.01), but this is not the case for the delayed images (P > 0.05). Dynamic protocol did not significantly differentiate between benign and malignant lesions just like regular SUV, delayed SUV, and retention index. CONCLUSION The potential quantitative advantages of dynamic imaging may not improve lesion detection and differential diagnosis significantly on a total-body PET/CT scanner. The same conclusion applied to delayed imaging. This suggested the added benefits of complex imaging protocols must be weighed against the complex implementation in the future. CLINICAL RELEVANCE Total-body PET/CT was known to significantly improve the PET image quality due to its ultra-high sensitivity. However, whether the dynamic and delay imaging on total-body scanner could show additional clinical benefits is largely unknown. Head-to-head comparison between two protocols is relevant to oncological management.
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Affiliation(s)
- Yaping Wu
- Department of Medical Imaging, Henan Provincial People's Hospital and the People's Hospital of Zhengzhou, University of Zhengzhou, Zhengzhou, Henan, People's Republic of China
| | - Fangfang Fu
- Department of Medical Imaging, Henan Provincial People's Hospital and the People's Hospital of Zhengzhou, University of Zhengzhou, Zhengzhou, Henan, People's Republic of China
| | - Nan Meng
- Department of Medical Imaging, Henan Provincial People's Hospital and the People's Hospital of Zhengzhou, University of Zhengzhou, Zhengzhou, Henan, People's Republic of China
| | - Zhenguo Wang
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, People's Republic of China
| | - Xiaochen Li
- Department of Medical Imaging, Henan Provincial People's Hospital and the People's Hospital of Zhengzhou, University of Zhengzhou, Zhengzhou, Henan, People's Republic of China
| | - Yan Bai
- Department of Medical Imaging, Henan Provincial People's Hospital and the People's Hospital of Zhengzhou, University of Zhengzhou, Zhengzhou, Henan, People's Republic of China
| | - Yun Zhou
- School of Biomedical Engineering, Shanghai Tech University, Shanghai, People's Republic of China
| | - Dong Liang
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, People's Republic of China
| | - Hairong Zheng
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, People's Republic of China
| | - Yongfeng Yang
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, People's Republic of China
| | - Meiyun Wang
- Department of Medical Imaging, Henan Provincial People's Hospital and the People's Hospital of Zhengzhou, University of Zhengzhou, Zhengzhou, Henan, People's Republic of China
- Laboratory of Brain Science and Brain-Like Intelligence TechnologyInstitute for Integrated Medical Science and Engineering, Henan Academy of Sciences, Zhengzhou, Henan, People's Republic of China
| | - Tao Sun
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, People's Republic of China.
- Research Institute of Innovative Medical Equipment, United Imaging, Shenzhen, Guangdong, China.
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Norikane T, Mitamura K, Yamamoto Y, Manabe Y, Murao M, Arai-Okuda H, Hatakeyama T, Miyake K, Nishiyama Y. Comparative evaluation of 11C-methionine and 18F-fluorodeoxyglucose positron emission tomography for distinguishing between primary central nervous system lymphoma and isocitrate dehydrogenase-wildtype glioblastoma. J Neurooncol 2024; 166:195-201. [PMID: 38160415 DOI: 10.1007/s11060-023-04534-w] [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: 11/12/2023] [Accepted: 12/07/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE Distinguishing between primary central nervous system lymphoma (PCNSL) and isocitrate dehydrogenase (IDH)-wildtype glioblastoma is important for therapeutic decision-making. This study aimed to compare the performance of 11C-methionine (MET) and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) for distinguishing between these two major malignant brain tumors. METHODS We retrospectively conducted qualitative and semiquantitative analyses of pre-treatment MET and FDG PET/computed tomography (CT) images of 22 patients with PCNSL and 64 patients with IDH-wildtype glioblastoma. For semiquantitative analysis, we calculated the tumor-to-normal tissue (T/N) ratio by dividing the maximum standardized uptake value (SUV) for the tumor (T) by the average SUV for the normal tissue (N). For performance evaluation, we employed receiver operating characteristic curve analysis and calculated the areas under the curve (AUC) values. RESULTS In the qualitative analysis, all PCNSLs and IDH-wildtype glioblastomas were MET-positive, while 95% and 84% of PCNSLs and IDH-wildtype glioblastomas, respectively, were FDG-positive. Eleven patients were excluded from the FDG PET/CT semiquantitative analysis because of hyperglycemia. There was no difference in MET T/N ratio between PCNSL and IDH-wildtype glioblastoma (p = 0.37). FDG T/N ratio was significantly higher in PCNSL than in IDH-wildtype glioblastoma (p < 0.001). The AUC value for distinguishing PCNSL from IDH-wildtype glioblastoma was significantly higher for the FDG T/N ratio (0.871) than for the MET T/N ratio (0.565) (p = 0.0027). CONCLUSION MET PET could detect both PCNSL and IDH-wildtype glioblastoma, but unlike FDG PET, it could not distinguish between these two major malignant brain tumors.
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Affiliation(s)
- Takashi Norikane
- Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Katsuya Mitamura
- Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Yuka Yamamoto
- Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan.
| | - Yuri Manabe
- Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Mitsumasa Murao
- Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Hanae Arai-Okuda
- Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Tetsuhiro Hatakeyama
- Department of Neurological Surgery, Faculty of Medicine, Kagawa University, Miki-cho, Kagawa, Japan
| | - Keisuke Miyake
- Department of Neurological Surgery, Faculty of Medicine, Kagawa University, Miki-cho, Kagawa, Japan
| | - Yoshihiro Nishiyama
- Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
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Xie L, Liu Z, Chen Y. Primary Pulmonary Enteric Adenocarcinoma: Rare Imaging Findings. Curr Med Imaging 2024; 20:1-4. [PMID: 38389377 DOI: 10.2174/0115734056272178231129103111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 11/16/2023] [Accepted: 11/21/2023] [Indexed: 02/24/2024]
Abstract
INTRODUCTION Pulmonary enteric adenocarcinoma (PEAC) is an extremely rare variant of lung adenocarcinoma characterized by pathological features similar to those of colorectal adenocarcinoma. It is mostly observed on computed tomography (CT) and positron emission tomography (PET)/CT as solitary or multiple nodules/masses in the lung. It tends to grow rapidly and is difficult to distinguish from lung metastatic colorectal cancer. Herein, we have presented a case of PEAC with special imaging findings. CASE PRESENTATION A chest CT scan of a 72-year-old man with suspected chronic pneumonia revealed a well-defined consolidation in the upper lobe of the left lung. The lesion was slightly enlarged at the 9-month follow-up, and low FDG accumulation was subsequently observed using 18F-fluorodeoxyglucose (18F-FDG) PET/CT scans. The patient was later diagnosed with PEAC through percutaneous lung biopsy. CONCLUSION Our case has demonstrated specific imaging findings of PEAC.
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Affiliation(s)
- Lixuan Xie
- Department of Nuclear Medicine, General Hospital of Central Theater Command, Hubei 430079, China
| | - Zhijun Liu
- Department of Nuclear Medicine, General Hospital of Central Theater Command, Hubei 430079, China
| | - Yousan Chen
- Department of Radiology, Hubei Provincial Hospital of Traditional Chinese Medicine, Hubei 430079, China
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Bang JI, Park S, Kim K, Seo Y, Chong A, Hong CM, Choi M, Lee SW, Oh SW. The Diagnostic Value of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Differentiated Thyroid Cancer Patients with Elevated Thyroglobulin/Thyroglobulin Antibody Levels and Negative Iodine Scintigraphy: A Systematic Review and Meta-Analysis. Thyroid 2023; 33:1224-1236. [PMID: 37597200 DOI: 10.1089/thy.2023.0264] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/21/2023]
Abstract
Background: The objective of this study is to evaluate the diagnostic accuracy of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in detecting recurrence in patients with differentiated thyroid cancer (DTC) who have negative whole-body scans (WBSs) but elevated serum thyroglobulin (Tg) or thyroglobulin antibody (TgAb) levels. Methods: This systematic review/meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Diagnostic Test Accuracy criteria (International Prospective Register of Systematic Reviews registration number: CRD42022340924). A comprehensive search of the MEDLINE, EMBASE, and Cochrane databases identified articles reporting the diagnostic accuracy of FDG PET/CT for the detection of recurrence in patients with DTC with negative WBS and elevated serum Tg or TgAb levels published between January 2012 and June 2023. Meta-analyses were performed to determine the diagnostic accuracy of FDG PET/CT on the total target population as well as on subgroups stratified by serum Tg or TgAb, and thyrotropin (TSH) stimulation status at the time of FDG PET/CT. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework was applied to evaluate the quality of evidence and the strength of recommendations to facilitate translation of the meta-analysis results into practical recommendations for clinical guidelines. Results: A total of 24 studies involving 1988 patients were included for analysis. The overall pooled sensitivity and specificity values were 0.87 (95% confidence interval [CI] = 0.83-0.92; I2 = 75%) and 0.84 (CI = 0.80-0.89; I2 = 44%), respectively. Subgroup analyses revealed no significant differences in the diagnostic accuracy of FDG PET/CT in patients stratified by serum Tg or TgAb levels, and TSH stimulation status at the time of PET/CT. Treatment plans were changed following FDG PET/CT imaging in 40% (CI = 34-47%; I2 = 39%) of cases. The quality level of evidence for using FDG PET/CT was moderate in both sensitivity and specificity according to the GRADE system. Conclusion: There is moderate quality evidence demonstrating the high diagnostic accuracy of FDG PET/CT in detecting recurrence in patients with DTC with negative WBS and elevated serum Tg or TgAb levels. This evidence corroborates the current guidelines' endorsement of FDG PET/CT as a diagnostic tool in such patients.
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Affiliation(s)
- Ji-In Bang
- Department of Nuclear Medicine, CHA Bundang Medical Center, CHA University, Gyeonggi-do, Republic of Korea
| | - Sohyun Park
- Department of Nuclear Medicine, National Cancer Center Hospital, Gyeonggi-do, Republic of Korea
| | - Keunyoung Kim
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital and School of Medicine, Pusan National University, Pusan, Republic of Korea
| | - Youngduk Seo
- Department of Nuclear Medicine, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Ari Chong
- Department of Nuclear Medicine, College of Medicine, Chosun University, Gwangju, Korea
| | - Chae Moon Hong
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Miyoung Choi
- Division for Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Sang-Woo Lee
- Department of Nuclear Medicine, Kyungpook National University, School of Medicine and Chilgok Hospital, Daegu, Republic of Korea
| | - So Won Oh
- Department of Nuclear Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
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12
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Sharma P. Isolated Solitary Asymptomatic Skeletal Muscle Relapse of High-Grade Lymphoma Detected on Surveillance 18F- Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography. Indian J Nucl Med 2023; 38:396-397. [PMID: 38390533 PMCID: PMC10880861 DOI: 10.4103/ijnm.ijnm_49_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/08/2023] [Accepted: 05/29/2023] [Indexed: 02/24/2024] Open
Abstract
While extranodal involvement of diffuse large B-cell lymphoma (DLBCL) is common, skeletal muscle involvement is extremely rare. Isolated skeletal muscle involvement in lymphoma is even rarer. We present here the case of a 26-year-old woman, who was diagnosed to have a solitary isolated skeletal muscle relapse of DLBCL on surveillance 18F-fluorodeoxyglucose positron emission tomography-computed tomography, after completing first-line treatment, that was subsequently confirmed with biopsy.
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Affiliation(s)
- Punit Sharma
- Department of Nuclear Medicine and PET-CT, Apollo Multispecialty Hospital, Kolkata, West Bengal, India
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13
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Buchert R, Wegner F, Huppertz HJ, Berding G, Brendel M, Apostolova I, Buhmann C, Dierks A, Katzdobler S, Klietz M, Levin J, Mahmoudi N, Rinscheid A, Rogozinski S, Rumpf JJ, Schneider C, Stöcklein S, Spetsieris PG, Eidelberg D, Wattjes MP, Sabri O, Barthel H, Höglinger G. Automatic covariance pattern analysis outperforms visual reading of 18 F-fluorodeoxyglucose-positron emission tomography (FDG-PET) in variant progressive supranuclear palsy. Mov Disord 2023; 38:1901-1913. [PMID: 37655363 DOI: 10.1002/mds.29581] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/19/2023] [Accepted: 07/31/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND To date, studies on positron emission tomography (PET) with 18 F-fluorodeoxyglucose (FDG) in progressive supranuclear palsy (PSP) usually included PSP cohorts overrepresenting patients with Richardson's syndrome (PSP-RS). OBJECTIVES To evaluate FDG-PET in a patient sample representing the broad phenotypic PSP spectrum typically encountered in routine clinical practice. METHODS This retrospective, multicenter study included 41 PSP patients, 21 (51%) with RS and 20 (49%) with non-RS variants of PSP (vPSP), and 46 age-matched healthy controls. Two state-of-the art methods for the interpretation of FDG-PET were compared: visual analysis supported by voxel-based statistical testing (five readers) and automatic covariance pattern analysis using a predefined PSP-related pattern. RESULTS Sensitivity and specificity of the majority visual read for the detection of PSP in the whole cohort were 74% and 72%, respectively. The percentage of false-negative cases was 10% in the PSP-RS subsample and 43% in the vPSP subsample. Automatic covariance pattern analysis provided sensitivity and specificity of 93% and 83% in the whole cohort. The percentage of false-negative cases was 0% in the PSP-RS subsample and 15% in the vPSP subsample. CONCLUSIONS Visual interpretation of FDG-PET supported by voxel-based testing provides good accuracy for the detection of PSP-RS, but only fair sensitivity for vPSP. Automatic covariance pattern analysis outperforms visual interpretation in the detection of PSP-RS, provides clinically useful sensitivity for vPSP, and reduces the rate of false-positive findings. Thus, pattern expression analysis is clinically useful to complement visual reading and voxel-based testing of FDG-PET in suspected PSP. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Ralph Buchert
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Florian Wegner
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | | | - Georg Berding
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital of Munich, LMU, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Ivayla Apostolova
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carsten Buhmann
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexander Dierks
- Department of Nuclear Medicine, University Hospital Augsburg, Augsburg, Germany
| | - Sabrina Katzdobler
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Department of Neurology, University Hospital of Munich, LMU, Munich, Germany
| | - Martin Klietz
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Johannes Levin
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Department of Neurology, University Hospital of Munich, LMU, Munich, Germany
| | - Nima Mahmoudi
- Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | - Andreas Rinscheid
- Medical Physics and Radiation Protection, University Hospital Augsburg, Augsburg, Germany
| | | | | | - Christine Schneider
- Department of Neurology and Clinical Neurophysiology, University Hospital Augsburg, Augsburg, Germany
| | - Sophia Stöcklein
- Department of Radiology, University Hospital of Munich, LMU, Munich, Germany
| | - Phoebe G Spetsieris
- The Feinstein Institutes for Medical Research Manhasset, Manhasset, New York, USA
| | - David Eidelberg
- The Feinstein Institutes for Medical Research Manhasset, Manhasset, New York, USA
| | - Mike P Wattjes
- Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Günter Höglinger
- Department of Neurology, Hannover Medical School, Hannover, Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany
- Department of Neurology, University Hospital of Munich, LMU, Munich, Germany
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Rathore H, Thaker N. Chronic Inflammatory Demyelinating Polyradiculoneuropathy as a Presentation of Plasmacytoma. Indian J Nucl Med 2023; 38:379-380. [PMID: 38390530 PMCID: PMC10880843 DOI: 10.4103/ijnm.ijnm_44_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/13/2023] [Accepted: 05/29/2023] [Indexed: 02/24/2024] Open
Abstract
Polyneuropathy, organomegaly, endocrinopathy, M protein elevation, and skin changes (POEMS) syndrome is one of the rare paraneoplastic disorders of the multiorgan association whose initialism describes the principal clinical features as polyneuropathy, organomegaly, endocrinopathy, M-protein elevation, and skin changes caused by an underlying plasma cell disorder, one of the major diagnostic criteria for which is the presence of an osseous lesion. We present a case of POEMS syndrome with nearly all signs and symptoms on clinical and hematological examinations, which was further investigated with MRI of the whole spine and 18F-fluorodeoxyglucose positron emission tomography/computed tomography scan, as the latter is a very useful imaging modality for evaluation of any paraneoplastic syndromes, including myeloproliferative disorders such as plasmacytoma or multiple myeloma, and lymphoproliferative or other malignancies.
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Affiliation(s)
- Hemant Rathore
- Department of Nuclear Medicine and PET CT, Bombay Hospital and Medical Research Centre, Mumbai, Maharashtra, India
| | - Nirav Thaker
- Department of Radiodiagnosis, Bombay Hospital and Medical Research Centre, Mumbai, Maharashtra, India
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15
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Wu CY, Lin YH, Hsieh HH, Chung YH, Hsu ST, Peng SL. The effect of estrogen therapy on cerebral metabolism in diabetic female rats. Comput Struct Biotechnol J 2023; 21:4769-4776. [PMID: 37841332 PMCID: PMC10570627 DOI: 10.1016/j.csbj.2023.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 09/20/2023] [Accepted: 09/24/2023] [Indexed: 10/17/2023] Open
Abstract
The impact of estrogen on brain function, especially in individuals with diabetes, remains uncertain. This study aims to compare cerebral glucose metabolism levels in intact rats, ovariectomized (OVX) rats, and 17β-estradiol (E2)-treated OVX diabetic female rats. Sixteen rats were administered a single intraperitoneal injection of 70 mg/kg streptozotocin (STZ) to induce diabetes (intact, n = 6; OVX, n = 6; OVX+E2-treated, n = 4). Additionally, 18 rats received an equivalent solvent dose via intraperitoneal injection (intact, n = 6; OVX, n = 6; OVX+E2-treated, n = 6). After 4 weeks of STZ or solvent administration, positron emission tomography scans with 18F-fluorodeoxyglucose (18F-FDG) injection were employed to assess cerebral glucose metabolism. The diabetic rats exhibited substantial reductions in 18F-FDG uptake across all brain regions (all P < 0.01), in contrast to the control rats. Moreover, intact and OVX + E2-treated diabetic female rats displayed more pronounced decreases in cerebral glucose metabolism in the amygdala and hippocampus compared to OVX diabetic female rats (P < 0.05). These findings suggest that diabetes creates an environment wherein estrogen exacerbates neuropathology and intensifies neuronal activity.
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Affiliation(s)
- Chun-Yi Wu
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei Branch, Taipei, Taiwan
| | - Yu-Hsin Lin
- Department of Pharmacy, National Yang Ming Chiao Tung University, Taipei Branch, Taipei, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Hsin-Hua Hsieh
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei Branch, Taipei, Taiwan
| | - Yi-Hsiu Chung
- Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shih-Ting Hsu
- Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shin-Lei Peng
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
- Neuroscience and Brain Disease Center, China Medical University, Taiwan
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16
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Lim CH, Choi JY, Choi JH, Lee JH, Lee J, Lim CW, Kim Z, Woo SK, Park SB, Park JM. Development and External Validation of 18F-FDG PET-Based Radiomic Model for Predicting Pathologic Complete Response after Neoadjuvant Chemotherapy in Breast Cancer. Cancers (Basel) 2023; 15:3842. [PMID: 37568658 PMCID: PMC10417050 DOI: 10.3390/cancers15153842] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/21/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
The aim of our retrospective study is to develop and externally validate an 18F-FDG PET-derived radiomics model for predicting pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) in breast cancer patients. A total of 87 breast cancer patients underwent curative surgery after NAC at Soonchunhyang University Seoul Hospital and were randomly assigned to a training cohort and an internal validation cohort. Radiomic features were extracted from pretreatment PET images. A radiomic-score model was generated using the LASSO method. A combination model incorporating significant clinical variables was constructed. These models were externally validated in a separate cohort of 28 patients from Soonchunhyang University Buscheon Hospital. The model performances were assessed using area under the receiver operating characteristic (AUC). Seven radiomic features were selected to calculate the radiomic-score. Among clinical variables, human epidermal growth factor receptor 2 status was an independent predictor of pCR. The radiomic-score model achieved good discriminability, with AUCs of 0.963, 0.731, and 0.729 for the training, internal validation, and external validation cohorts, respectively. The combination model showed improved predictive performance compared to the radiomic-score model alone, with AUCs of 0.993, 0.772, and 0.906 in three cohorts, respectively. The 18F-FDG PET-derived radiomic-based model is useful for predicting pCR after NAC in breast cancer.
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Affiliation(s)
- Chae Hong Lim
- Department of Nuclear Medicine, Soonchunhyang University Seoul Hospital, Seoul 04401, Republic of Korea;
| | - Joon Young Choi
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea;
| | - Joon Ho Choi
- Department of Nuclear Medicine, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Republic of Korea
| | - Jun-Hee Lee
- Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul 04401, Republic of Korea
| | - Jihyoun Lee
- Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul 04401, Republic of Korea
| | - Cheol Wan Lim
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Republic of Korea
| | - Zisun Kim
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Republic of Korea
| | - Sang-Keun Woo
- Division of Applied RI, Korea Institutes of Radiological and Medical Sciences, Seoul 01812, Republic of Korea
| | - Soo Bin Park
- Department of Nuclear Medicine, Soonchunhyang University Seoul Hospital, Seoul 04401, Republic of Korea;
| | - Jung Mi Park
- Department of Nuclear Medicine, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Republic of Korea
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17
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Ball J, Sinnott J, Fox DL, Burgess C. Incidental head and neck findings on 18 F-fluorodeoxyglucose positron emission tomography-computed tomography: Diagnostic outcomes and cost analysis. Clin Otolaryngol 2023; 48:709-714. [PMID: 37308456 DOI: 10.1111/coa.14055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 01/15/2023] [Accepted: 03/05/2023] [Indexed: 06/14/2023]
Affiliation(s)
- Jessica Ball
- Department of Otolaryngology, Head and Neck Surgery, Cambridge University Hospital, Cambridge, UK
| | - Joseph Sinnott
- Department of Otolaryngology, Head and Neck Surgery, Great Western Hospital, Swindon, UK
| | - Danial L Fox
- Department of Radiology, Musgrove Park Hospital, Taunton, Somerset, UK
| | - Christopher Burgess
- Department of Otolaryngology, Head and Neck Surgery, Musgrove Park Hospital, Taunton, Somerset, UK
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18
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Zhang W, Liu Z, Duan X, Li Y, Shen C, Guo Y, Yang J. Differentiating malignant and benign pleural effusion in patients with lung cancer: an 18F-FDG PET/CT retrospectively study. Front Oncol 2023; 13:1192870. [PMID: 37456249 PMCID: PMC10348711 DOI: 10.3389/fonc.2023.1192870] [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: 03/24/2023] [Accepted: 06/16/2023] [Indexed: 07/18/2023] Open
Abstract
Rationale To explore the clinical role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in differentiating malignant pleural effusion (MPE) from benign pleural effusion (BPE) in patients with lung cancer. Methods Over a 8-year period, we retrospectively reviewed PET/CT data of lung cancer patients with pleural effusion, with 237 participants enrolled for analysis. The nature of pleural effusion was confirmed using pleural cytology or biopsy. MPE versus BPE comparison and multiple regression analysis were performed. Receiver operating characteristic (ROC) curve analysis was used for evaluating the diagnostic performance. Results Of the 237 participants, 170 had MPEs and 67 had BPEs. Compared with BPEs, MPEs had higher pleural SUVmax and thicker pleura and were more common among non-small cell lung cancers, peripheral tumors, and women (p < 0.05). BPEs had larger and higher 18F-FDG uptake thoracic lymph nodes and more complications of pneumonia (p < 0.05) than MPEs. Multiple regression analysis was used to identify the pleural SUVmax (odds ratio, OR = 38.8), sex (OR = 0.033), and mediastinal lymphoid node size (OR = 0.86) as independent risk factors for MPEs. The sensitivity, specificity, and area under the ROC curve (AUC) in the combined ROC curve analysis by using the three factors were 95.3%, 95.5%, and 0.989, respectively. Conclusion 18F-FDG PET/CT integrated imaging is an effective non-invasive method for differential diagnosis of MPE in patients with lung cancer. Pleural SUVmax combined with thoracic lymph nodes and sex has high diagnostic value.
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Affiliation(s)
- Weishan Zhang
- PET/CT Department of the First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Zhe Liu
- Radiology Department of the First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Xiaoyi Duan
- PET/CT Department of the First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Yan Li
- PET/CT Department of the First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Cong Shen
- PET/CT Department of the First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Youmin Guo
- PET/CT Department of the First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Jian Yang
- Radiology Department of the First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi, China
- Department of Biomedical Engineering, The Key Laboratory of Biomedical Information Engineering of the Ministry of Education, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, Shaanxi, China
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Feng Y, Wang P, Liu Y, Dai W. PET/CT imaging of giant primary pulmonary meningioma: a case report and literature review. J Cardiothorac Surg 2023; 18:171. [PMID: 37138316 PMCID: PMC10157941 DOI: 10.1186/s13019-023-02276-4] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 04/05/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND An ectopic meningioma, such as a primary pulmonary meningioma (PPM), is a rare type of tumor that primarily originates outside of the central nervous system. The most common presentation of PPM is isolated pulmonary nodules or masses, and most of them are benign. Only sporadic cases have been reported. This case reported a giant primary pulmonary meningioma and systematically reviewed previously reported cases in the literature. CASE PRESENTATION A 55-year-old female suffered from asthma after activity, chest tightness, and a persistent dry cough for 2 months. Chest computed tomography (CT) showed a huge mass with calcification in the left lower lobe. And positron emission tomography (PET)/CT revealed mild FDG accumulation of the mass. The mass was finally surgically removed and PPM was confirmed according to histopathologic examinations. CONCLUSION PPM is a rare disease with heterogeneity not only in CT features but also in glucose metabolism. FDG uptake levels do not identify benign from malignant, benign PPM may have high FDG uptake and malignant may have low.
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Affiliation(s)
- Yawen Feng
- Department of Nuclear Medicine, the First College of Clinical Medical Science, China Three Gorges University, Yichang, 443003, Hubei, China
| | - Peng Wang
- Department of Nuclear Medicine, the First College of Clinical Medical Science, China Three Gorges University, Yichang, 443003, Hubei, China
| | - Yufei Liu
- Department of Pathology, The First College of Clinical Medical Science of China, Three Gorges University and Yichang Central People's Hospital, No. 183, Yiling Avenue, Yichang, 443000, China
| | - Wenli Dai
- Department of Nuclear Medicine, the First College of Clinical Medical Science, China Three Gorges University, Yichang, 443003, Hubei, China.
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Lee D, Yun H, Yun T, Koo Y, Chae Y, Nam H, Kang S, Lee H, Chang D, Yang MP, Kang BT, Kim H. 18F-fluorodeoxyglucose positron emission tomography findings of peripheral nerve sheath tumour of the nasal cavity in a dog. Vet Med Sci 2023; 9:584-590. [PMID: 36626300 PMCID: PMC10029900 DOI: 10.1002/vms3.1069] [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] [Indexed: 01/11/2023] Open
Abstract
An 8-year-old Miniature Poodle presented with chronic sneezing and unilateral epistaxis. A left-sided intranasal mass was identified on computed tomography. 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) was performed to evaluate the metabolic activity of the mass. The intranasal mass showed mildly increased 18F-FDG uptake. The maximal and mean standardized uptake values (SUVs) of the mass were 3.4 and 2.6, respectively. The maximal SUV of the mass/mean SUV of the normal liver was 2.5. The 7-cm soft, pink mass was easily removed through rhinoscopy, with subsequent dramatic improvement in clinical signs. Histopathological and immunohistochemical analyses determined that the mass was an intermediate-grade malignant peripheral nerve sheath tumour (PNST). This is the first report of 18F-FDG PET findings in a PNST in dogs.
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Affiliation(s)
- Dohee Lee
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Hyejin Yun
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Taesik Yun
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Yoonhoi Koo
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Yeon Chae
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Hyeyeon Nam
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Seonggweon Kang
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Hayoon Lee
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Dongwoo Chang
- Department of Veterinary Imaging, Veterinary Teaching Hospital, College of Veterinary Medicine, Cheongju, Chungbuk, Republic of Korea
| | - Mhan-Pyo Yang
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Byeong-Teck Kang
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Hakhyun Kim
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
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Liu FT, Lu JY, Sun YM, Li L, Yang YJ, Zhao J, Ge JJ, Wu P, Jiang JH, Wu JJ, Zuo CT, Wang J. Dopaminergic Dysfunction and Glucose Metabolism Characteristics in Parkin-Induced Early-Onset Parkinson's Disease Compared to Genetically Undetermined Early-Onset Parkinson's Disease. Phenomics 2023; 3:22-33. [PMID: 36939793 PMCID: PMC9883374 DOI: 10.1007/s43657-022-00077-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 09/06/2022] [Accepted: 09/09/2022] [Indexed: 01/28/2023]
Abstract
While early-onset Parkinson's disease (EOPD) caused by mutations in the parkin gene (PRKN) tends to have a relatively benign course compared to genetically undetermined (GU)-EOPD, the exact underlying mechanisms remain elusive. We aimed to search for the differences between PRKN-EOPD and GU-EOPD by dopamine transporter (DAT) and glucose metabolism positron-emission-tomography (PET) imaging. Twelve patients with PRKN-EOPD and 16 with GU-EOPD who accepted both 11C-2b-carbomethoxy-3b-(4-trimethylstannylphenyl) tropane (11C-CFT) and 18F-fluorodeoxyglucose PET were enrolled. The 11C-CFT uptake was analyzed on both regional and voxel levels, whereas glucose metabolism was assessed in a voxel-wise fashion. Correlations between DAT and glucose metabolism imaging, DAT imaging and clinical severity, as well as glucose metabolism imaging and clinical severity were explored. Both clinical symptoms and DAT-binding patterns in the posterior putamen were highly symmetrical in patients with PRKN-EOPD, and dopaminergic dysfunction in the ipsilateral putamen was severer in patients with PRKN-EOPD than GU-EOPD. Meanwhile, the DAT binding was associated with the severity of motor dysfunction in patients with GU-EOPD only. Patients with PRKN-EOPD showed increased glucose metabolism in the contralateral medial frontal gyrus (supplementary motor area (SMA)), contralateral substantia nigra, contralateral thalamus, and contralateral cerebellum. Notably, glucose metabolic activity in the contralateral medial frontal gyrus was inversely associated with regional DAT binding in the bilateral putamen. Patients with PRKN-EOPD showed enhanced metabolic connectivity within the bilateral putamen, ipsilateral paracentral and precentral lobules, and the ipsilateral SMA. Collectively, compared to GU-EOPD, PRKN-EOPD is characterized by symmetrical, more severe dopaminergic dysfunction and relative increased glucose metabolism. Meanwhile, SMA with elevated glucose metabolism and enhanced connectivity may act as compensatory mechanisms in PRKN-EOPD. Supplementary Information The online version contains supplementary material available at 10.1007/s43657-022-00077-8.
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Affiliation(s)
- Feng-Tao Liu
- Department of Neurology, National Clinical Research Center for Aging and Medicine & National Center for Neurological Disorders, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040 China
| | - Jia-Ying Lu
- Department of Nuclear Medicine & PET Center, National Clinical Research Center for Aging and Medicine & National Center for Neurological Disorders, Huashan Hospital, Fudan University, 518 East Wuzhong Road, Shanghai, 200235 China
| | - Yi-Min Sun
- Department of Neurology, National Clinical Research Center for Aging and Medicine & National Center for Neurological Disorders, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040 China
| | - Ling Li
- Department of Nuclear Medicine & PET Center, National Clinical Research Center for Aging and Medicine & National Center for Neurological Disorders, Huashan Hospital, Fudan University, 518 East Wuzhong Road, Shanghai, 200235 China
| | - Yu-Jie Yang
- Department of Neurology, National Clinical Research Center for Aging and Medicine & National Center for Neurological Disorders, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040 China
| | - Jue Zhao
- Department of Neurology, National Clinical Research Center for Aging and Medicine & National Center for Neurological Disorders, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040 China
| | - Jing-Jie Ge
- Department of Nuclear Medicine & PET Center, National Clinical Research Center for Aging and Medicine & National Center for Neurological Disorders, Huashan Hospital, Fudan University, 518 East Wuzhong Road, Shanghai, 200235 China
| | - Ping Wu
- Department of Nuclear Medicine & PET Center, National Clinical Research Center for Aging and Medicine & National Center for Neurological Disorders, Huashan Hospital, Fudan University, 518 East Wuzhong Road, Shanghai, 200235 China
| | - Jie-Hui Jiang
- Institute of Biomedical Engineering, School of Life Sciences, Shanghai University, Shanghai, 200444 China
| | - Jian-Jun Wu
- Department of Neurology, National Clinical Research Center for Aging and Medicine & National Center for Neurological Disorders, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040 China
| | - Chuan-Tao Zuo
- Department of Nuclear Medicine & PET Center, National Clinical Research Center for Aging and Medicine & National Center for Neurological Disorders, Huashan Hospital, Fudan University, 518 East Wuzhong Road, Shanghai, 200235 China
- Human Phenome Institute, Fudan University, Shanghai, 200433 China
| | - Jian Wang
- Department of Neurology, National Clinical Research Center for Aging and Medicine & National Center for Neurological Disorders, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040 China
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Imataki O, Kubo H, Fujita H, Uemura M. Metabolic Steal of the Myocardium by Primary Cardiac Lymphoma. Case Rep Oncol 2023; 16:7-12. [PMID: 36743878 PMCID: PMC9894000 DOI: 10.1159/000527638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 10/13/2022] [Indexed: 01/18/2023] Open
Abstract
Less than 1.0% of malignant lymphomas are primary cardiac lymphoma (PCL), a rare malignant lymphoma. Due to its infrequency, the metabolic dynamics of the treatment have not been completely analyzed. A 62-year-old man who had been complaining of exertional dyspnea for a month arrived at our emergency room. He developed right cardiac failure as a result of a mass in the right atrium, according to a computed tomography (CT) scan. According to an echocardiogram, the mass was obstructing his blood flow and affecting how his heart worked. The lump was pathologically determined to be diffuse large B-cell lymphoma after he underwent urgent heart surgery. The lesion was only localized in the heart, according to a postoperative 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET)/CT scan, indicating that the disease was in clinical stage IE. An 18F-FDG-PET/CT scan showed a thickness of the right atrial wall as residual disease despite the majority of the cardiac lymphomatous mass being removed during surgery; it also showed that the usual uptake of 18F-FDG in healthy myocardium had diminished. Following chemotherapy, 18F-FDG uptake recovered in the patient's normal myocardium of the heart in remission. In conclusion, a sort of "metabolic steal phenomenon" that may be connected to PCL is the difference in uptake between tumor-involved and healthy myocardium.
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Affiliation(s)
- Osamu Imataki
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Takamatsu, Japan
| | - Hiroyuki Kubo
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Takamatsu, Japan
| | - Haruyuki Fujita
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Takamatsu, Japan
| | - Makiko Uemura
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Takamatsu, Japan
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Abstract
The use of positron emission tomography imaging with 18F-fluorodeoxyglucose in the diagnostic workup of patients with suspected prosthetic valve endocarditis and cardiac device infection (implantable electronic device and left ventricular assist device) is gaining momentum in clinical practice. However, in the absence of prospective randomized trials, guideline recommendations about 18F-fluorodeoxyglucose positron emission tomography in this setting are currently largely based on expert opinion. Measurement of aortic valve microcalcification occurring as a healing response to valvular inflammation using 18F-sodium fluoride positron emission tomography represents another promising clinical approach, which is associated with both the risk of native valve stenosis progression and bioprosthetic valve degeneration in research trials. In this review, we consider the role of molecular imaging in cardiac valvular diseases, including aortic stenosis and valvular endocarditis, as well as cardiac device infections.
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Affiliation(s)
- Jason M Tarkin
- Heart and Lung Research Institute, University of Cambridge, UK (J.M.T.)
| | - Wengen Chen
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, MD (W.C., V.D.)
| | - Marc R Dweck
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, UK (M.R.D.)
| | - Vasken Dilsizian
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, MD (W.C., V.D.)
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Otani T, Ikushima H, Bando Y, Yamashita M, Kuwahara K, Otsuka H, Kondo K, Miyoshi H. Early Prediction of Radiotherapeutic Efficacy in a Mouse Model of Non-Small Cell Lung Carcinoma Using 18F-FLT and 18F-FDG PET/CT. J Med Invest 2023; 70:361-368. [PMID: 37940520 DOI: 10.2152/jmi.70.361] [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] [Indexed: 11/10/2023]
Abstract
This study investigated the usefulness of [18F]-3'-deoxy-3'-fluorothymidine (18F-FLT) and [18F]-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) imaging for predicting the therapeutic efficacy of non-small cell lung cancer (NSCLC) irradiation at an early stage after radiation treatment. Mice were xenografted with the human lung adenocarcinoma line A549 or large cell lung cancer line FT821. Tumour uptake of 18F-FLT and 18F-FDG was imaged using PET/CT before and 1 week after irradiation. In A549 tumours, 18F-FLT uptake was significantly decreased, and 18F-FDG uptake was unchanged post-irradiation compared with pre-irradiation. In FT821 tumours, uptake of both 18F-FLT and 18F-FDG uptake was substantially decreased post-irradiation compared with pre-irradiation. In both xenografts, tumour volumes in the irradiated groups were significantly decreased compared with those in the control group. 18F-FLT is expected to contribute to individual NSCLC therapy because it accurately evaluates the decrease in tumour activity that cannot be captured by 18F-FDG. 18F-FDG may be useful for evaluating surviving cells without being affected by the inflammatory reaction at an extremely early stage, approximately 1 week after irradiation. Combined use of 18F-FLT and 18F-FDG PET/CT imaging may increase the accurate prediction of radiotherapy efficacy, which may lead to improved patient outcomes and minimally invasive personalised therapy. J. Med. Invest. 70 : 361-368, August, 2023.
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Affiliation(s)
- Tamaki Otani
- Advance Radiation Research, Education, and Management Center, Tokushima University, Tokushima, Japan
| | - Hitoshi Ikushima
- Department of Therapeutic Radiology, Institute of Biomedical Science, Tokushima University, Tokushima, Japan
| | - Yoshimi Bando
- Department of Pathology and Laboratory Medicine, Institute of Biomedical Science, Tokushima University, Tokushima, Japan
| | - Michiko Yamashita
- Department of Analytical Pathology, Institute of Biomedical Science, Tokushima University, Tokushima, Japan
| | - Kenmei Kuwahara
- Faculty of Health Science, Tokushima University Graduate School of Medicine, Tokushima University, Tokushima, Japan
| | - Hideki Otsuka
- Department of Medical Imaging/Nuclear Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Kazuya Kondo
- Department of Oncological Medical Services, Institute of Biomedical Science, Tokushima University, Tokushima, Japan
| | - Hirokazu Miyoshi
- Advance Radiation Research, Education, and Management Center, Tokushima University, Tokushima, Japan
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25
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Xie L, Liu Z, Zhang P, Chen Y. A rare case of Erdheim-Chester disease with esophageal involvement: unusual imaging findings. Am J Transl Res 2023; 15:2103-2108. [PMID: 37056827 PMCID: PMC10086890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 01/21/2023] [Indexed: 04/15/2023]
Abstract
Erdheim-Chester disease (ECD) is an uncommon non-Langerhan cell histiocytosis that affects multiple systems and most commonly involves the bones. A 34-year-old patient with a three-month history of progressive dysphagia, underwent the gastroscopy which revealed esophageal mucosal constriction 34 cm from the incisor and external pressure stenosis. Enhanced computed tomography (CT), magnetic resonance imaging (MRI), and 2-[fluorine-18] fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomography (PET)/CT findings confirmed diffuse soft-tissue infiltration filled periesophageal space and excluded lesions involving the bone and other organs within the scanning range. The patient was later diagnosed with esophageal involvement of ECD by thoracotomy surgery and paraesophageal soft tissue biopsy. Progressive dysphagia, a rare clinical manifestation of ECD, has been reported in only two cases. It is the first demonstration of MRI and PET/CT imaging findings of ECD esophageal invasion as far as we known. Through the comparison of multiple images, we have a preliminary recognition of characteristic radiological features of gastrointestinal infiltration in ECD.
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Affiliation(s)
- Lixuan Xie
- Department of Nuclear Medicine, Central Theater Command General Hospital of Chinese People’s Liberation ArmyWuhan 430070, Hubei, China
| | - Zhijun Liu
- Department of Nuclear Medicine, Central Theater Command General Hospital of Chinese People’s Liberation ArmyWuhan 430070, Hubei, China
| | - Peng Zhang
- Department of Pathology, Central Theater Command General Hospital of Chinese People’s Liberation ArmyWuhan 430070, Hubei, China
| | - Yousan Chen
- Department of Radiology, Hubei Provincial Hospital of Traditional Chinese MedicineWuhan 430061, Hubei, China
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26
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de Alencar NRG, Machado MAD, Mourato FA, de Oliveira ML, Moraes TF, Mattos Junior LAR, Chang TMC, de Azevedo CRAS, Brandão SCS. Exploratory analysis of radiomic as prognostic biomarkers in 18F-FDG PET/CT scan in uterine cervical cancer. Front Med (Lausanne) 2022; 9:1046551. [PMID: 36569127 PMCID: PMC9769204 DOI: 10.3389/fmed.2022.1046551] [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: 09/16/2022] [Accepted: 11/10/2022] [Indexed: 12/05/2022] Open
Abstract
Objective To evaluate the performance of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET/CT) radiomic features to predict overall survival (OS) in patients with locally advanced uterine cervical carcinoma. Methods Longitudinal and retrospective study that evaluated 50 patients with cervical epidermoid carcinoma (clinical stage IB2 to IVA according to FIGO). Segmentation of the 18F-FDG PET/CT tumors was performed using the LIFEx software, generating the radiomic features. We used the Mann-Whitney test to select radiomic features associated with the clinical outcome (death), excluding the features highly correlated with each other with Spearman correlation. Subsequently, ROC curves and a Kaplan-Meier analysis were performed. A p-value < 0.05 were considered significant. Results The median follow-up was 23.5 months and longer than 24 months in all surviving patients. Independent predictors for OS were found-SUVpeak with an AUC of 0.74, sensitivity of 77.8%, and specificity of 72.7% (p = 0.006); and the textural feature gray-level run-length matrix GLRLM_LRLGE, with AUC of 0.74, sensitivity of 72.2%, and specificity of 81.8% (p = 0.005). When we used the derived cut-off points from these ROC curves (12.76 for SUVpeak and 0.001 for GLRLM_LRLGE) in a Kaplan-Meier analysis, we can see two different groups (one with an overall survival probability of approximately 90% and the other with 30%). These biomarkers are independent of FIGO staging. Conclusion By radiomic 18F-FDG PET/CT data analysis, SUVpeak and GLRLM_LRLGE textural feature presented the best performance to predict OS in patients with cervical cancer undergoing chemo-radiotherapy and brachytherapy.
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Affiliation(s)
- Nadja Rolim Gonçalves de Alencar
- Master of Science Surgery Post-Graduation Program, Federal University of Pernambuco, Recife, Pernambuco, Brazil,Department of Radiology and Nuclear Medicine, Hospital das Clínicas, Federal University of Pernambuco, Recife, Pernambuco, Brazil,*Correspondence: Nadja Rolim Gonçalves de Alencar,
| | - Marcos Antônio Dórea Machado
- Department of Radiology, Complexo Hospitalar Universitário Professor Edgard Santos/Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Felipe Alves Mourato
- Master of Science Surgery Post-Graduation Program, Federal University of Pernambuco, Recife, Pernambuco, Brazil,Department of Radiology and Nuclear Medicine, Hospital das Clínicas, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | | | | | | | - Tien-Man Cabral Chang
- Nuclear Medicine Service, Instituto de Medicina Integrada Fernandes Figueira, Recife, Pernambuco, Brazil
| | | | - Simone Cristina Soares Brandão
- Master of Science Surgery Post-Graduation Program, Federal University of Pernambuco, Recife, Pernambuco, Brazil,Department of Radiology and Nuclear Medicine, Hospital das Clínicas, Federal University of Pernambuco, Recife, Pernambuco, Brazil,Clinical Medicine, Center for Medical Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil
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27
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Mori M, Fujioka T, Ichikawa R, Inomata R, Katsuta L, Yashima Y, Yamaga E, Tsuchiya J, Hayashi K, Kumaki Y, Oda G, Nakagawa T, Onishi I, Kubota K, Tateishi U. Comparison of 18F-fluorothymidine Positron Emission Tomography/Computed Tomography and 18F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Patients with Breast Cancer. Tomography 2022; 8:2533-46. [PMID: 36287810 DOI: 10.3390/tomography8050211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 10/08/2022] [Accepted: 10/09/2022] [Indexed: 11/07/2022] Open
Abstract
The uptake of 18F-fluorothymidine (18F-FLT) depends on cells' proliferative rates. We compared the characteristics of 18F-FLT positron emission tomography/computed tomography (PET/CT) with those of 18F-fluorodeoxyglucose (18F-FDG) PET/CT for breast cancer. We prospectively diagnosed patients with breast cancer who underwent 18F-FLT PET/CT and 18F-FDG PET/CT. Subsequently, significant differences and correlation coefficients of the maximum standardized uptake value (SUVmax) in primary breast cancer and axillary lymph nodes were statistically evaluated. We enrolled eight patients with breast cancer. In six treatment-naive patients, the SUVmax for primary lesions showed a significant difference (mean, 2.1 vs. 4.1, p = 0.031) and a strong correlation (r = 0.969) between 18F-FLT and 18F-FDG. Further, although the SUVmax for the axillary lymph nodes did not show a significant difference between 18F-FLT and 18F-FDG (P = 0.246), there was a strong correlation between the two (r = 0.999). In a patient-by-patient study, there were cases in which only 18F-FDG uptake was observed in lymph nodes and normal breasts. Bone metastases demonstrated lower accumulation than bone marrow on the 18F-FLT PET/CT. In conclusion, a strong correlation was observed between the 18F-FLT PET/CT and 18F-FDG PET/CT uptake. Differences in the biochemical characteristics of 18F-FLT and 18F-FDG were reflected in the accumulation differences for breast cancer, metastatic lesions, and normal organs.
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28
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Satoh Y, Imai M, Ikegawa C, Hirata K, Abo N, Kusuzaki M, Oyama-Manabe N, Onishi H. Effect of radioactivity outside the field of view on image quality of dedicated breast positron emission tomography: preliminary phantom and clinical studies. Ann Nucl Med 2022; 36:1010-1018. [PMID: 36207497 DOI: 10.1007/s12149-022-01789-7] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/20/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Semi-quantitative positron emission tomography (PET) values, such as the maximum standardized uptake value (SUVmax), are widely used to identify malignant lesions and evaluate the response to treatment. The image quality of ring-shaped dedicated breast positron emission tomography (dbPET) has been known to decrease the closer it is to the detector's edge. This study aimed to investigate the effect of radioactivity (RI) outside the detector field of view (FOV) on the image quality of the ring-shaped dbPET. METHODS A breast phantom containing the left myocardium, which was prepared using a 3D printer, filled with 18F-fluorodeoxyglucose (FDG) solution with various RI concentration ratios (RCRs) of myocardium to background and scanned with the edge of an apex positioned exactly in line with the edge of the FOV of the dbPET scanner. The phantom image quality was visually and quantitatively evaluated. Following the phantom study, left-right breast differences (the left breast uptake ratio to the right breast (LUR)) on clinical dbPET images of 74 women were quantitatively evaluated. The relationships between these parameters, clinical indices, and FDG uptake in the left myocardium on PET/computed tomography (CT) images were analyzed. RESULTS The phantom study showed that the higher the RCR of the myocardium and the closer it is to the top edge of the phantom, the higher is the pixel value of the dbPET images. In a clinical study, LUR was significantly correlated with myocardial SUVmax (r = 0.96, p < 0.0001) and metabolic myocardial volume (r = 0.63, p = 0.001) for whole-body PET/CT imaging. Although no significant correlations were found between LUR and age (r = 0.05, p = 0.6865), body mass index (r = 0.03, p = 0.8178), or distance between the left myocardial apex and chest wall (r = 0.16, p = 0.1667). CONCLUSIONS FDG uptake in the myocardium affected dbPET images of the left breast, especially near the chest wall. Further, the effect of RI outside the FOV, such as in the myocardium, must be considered in the quantitative evaluation of breast cancer using dbPET.
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Affiliation(s)
- Yoko Satoh
- Yamanashi PET Imaging Clinic, Chuo City, Yamanashi Prefecture, Japan.
- Department of Radiology, University of Yamanashi, Chuo City, Yamanashi Prefecture, 409-3821, Japan.
| | - Masamichi Imai
- Yamanashi PET Imaging Clinic, Chuo City, Yamanashi Prefecture, Japan
| | - Chihiro Ikegawa
- Yamanashi PET Imaging Clinic, Chuo City, Yamanashi Prefecture, Japan
| | - Kenji Hirata
- Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Norifumi Abo
- Central Institute of Isotope Science, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Mao Kusuzaki
- Research Institute for Electronic Science, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Noriko Oyama-Manabe
- Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, Chuo City, Yamanashi Prefecture, 409-3821, Japan
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Zhang A, Meng X, Yao Y, Zhou X, Yan S, Fei W, Zhou N, Zhang Y, Kong H, Li N. Predictive Value of 18 F-FDG PET/MRI for Pleural Invasion in Solid and Subsolid Lung Adenocarcinomas Smaller Than 3 cm. J Magn Reson Imaging 2022; 57:1367-1375. [PMID: 36066210 DOI: 10.1002/jmri.28422] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 04/28/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Positron emission tomography (PET)/MRI combines the characteristics of metabolism imaging and high soft tissue resolution, and could provide high diagnostic efficacy for assessment of pleural invasion (PI) of lung cancer. PURPOSE To investigate the application of 18 F-fluorodeoxyglucose (FDG) PET/MRI for predicting PI of lung cancer with the maximum diameter ≤3 cm. STUDY TYPE Prospective. POPULATION A total of 44 patients with non-small cell lung cancer (NSCLC), age from 39 to 79 years old, including 19 (56.82%) females. FIELD STRENGTH/SEQUENCE A 3-T, hybrid PET/MRI including axial fast spin echo respiratory-triggered T2 fat-suppressed imaging (T2FS) and echo planar imaging diffusion-weighted imaging (DWI). ASSESSMENT The maximum standardized uptake value (SUVmax) of all lesions was measured on PET images. Localized effusion outside the contact between the nodules and the pleura on T2FS and signal at the contact between the nodules and the pleura on DWI were evaluated by experienced physicians through visual assessment of the MRI sequences. STATISTICAL TESTS Three models (models 1-3) were developed, incorporating CT, CT and PET, PET and MRI features, and Lasso regression was used in feature selection. The receiver operating characteristic (ROC) curve for PI diagnosis was visualized for each model, and the area under the curve (AUC) was calculated. The DeLong test was used to compare the different AUCs. A P value < 0.05 was considered statistically significant. RESULTS The AUC of models 1-3 was 0.762, 0.829, and 0.915, respectively. The DeLong test showed a statistically significant difference between the AUCs of model 1 vs. model 3, while the differences between the AUCs of model 1 vs. model 2 (P = 0.253) and model 2 vs. model 3 (P = 0.075) were not statistically significant. DATA CONCLUSION 18 F-FDG PET/MRI might show high predictive value for lung adenocarcinoma smaller than 3 cm with PI. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Annan Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Haidian, Beijing, China
| | - Xiangxi Meng
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Haidian, Beijing, China
| | - Yuan Yao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Haidian, Beijing, China
| | - Xin Zhou
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Haidian, Beijing, China
| | - Shuo Yan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, Haidian, Beijing, China
| | - Wang Fei
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Haidian, Beijing, China
| | - Nina Zhou
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Haidian, Beijing, China
| | - Yan Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Haidian, Beijing, China
| | - Hanjing Kong
- Beijing United Imaging Research Institute of Intelligent Imaging, UIH Group, Beijing, China
| | - Nan Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Haidian, Beijing, China
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30
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Gandhi A, Tang R, Seo Y, Bhargava A. Organ-Specific Glucose Uptake: Does Sex Matter? Cells 2022; 11:2217. [PMID: 35883660 DOI: 10.3390/cells11142217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 02/04/2023] Open
Abstract
Glucose uptake by peripheral organs is essential for maintaining blood glucose levels within normal range. Impaired glucose uptake is a hallmark of type 2 diabetes (T2D) and metabolic syndrome and is characterized by insulin resistance. Male sex is an independent risk factor for the development of T2D. We tested whether sex and diet are independent variables for differential glucose uptake by various organs. Here, in a longitudinal study, we used 18F-fluorodeoxyglucose (FDG) and positron emission tomography (PET) to determine baseline differences in whole-body glucose uptake in young male and female mice on chow and high-fat diets. We report that sex and diet are important independent variables that account for differential glucose uptake in brown fat, skeletal muscle, liver, heart, kidney, and the stomach, but not the brain, lungs, pancreas, small intestine, or perigonadal adipose. Of the seven organs analyzed, two organs, namely brown fat, and the heart had the highest concentrations of FDG, followed by the brain, kidneys, and skeletal muscle on chow diet. Young female mice had 47% greater FDG uptake in the brown fat compared to male mice, whereas skeletal muscle FDG uptake was 49% greater in male mice. The high-fat diet inhibited FDG uptake in brown fat, skeletal muscle, and the heart, three major organs involved in uptake, whereas brain uptake was enhanced in both sexes. These foundational and groundbreaking findings suggest that mechanisms of glucose homeostasis are context- and organ-dependent and highlight the need to study sex-specific outcomes and mechanisms for diseases such as T2D, obesity, and metabolic syndrome.
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Spelta LEW, Real CC, Buchpiguel CA, de Paula Faria D, Marcourakis T. [ 18 F]FDG brain uptake of C57Bl/6 male mice is affected by locomotor activity after cocaine use: A small animal positron emission tomography study. J Neurosci Res 2022; 100:1876-1889. [PMID: 35779255 DOI: 10.1002/jnr.25102] [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: 03/22/2022] [Revised: 06/09/2022] [Accepted: 06/20/2022] [Indexed: 11/12/2022]
Abstract
We verified if cocaine-induced peripheral activation might disrupt [18 F]FDG brain uptake after a cocaine challenge and suggested an optimal protocol to measure cocaine-induced brain metabolic alterations in mice. C57Bl/6 male mice were injected with [18 F]FDG and randomly separated into three groups. Groups 1 and 2 were kept conscious after [18 F]FDG administration and after 5 min received saline or cocaine (20 mg/kg). The animals in group 1 (n = 5) were then evaluated in the open field for 30 min and those from group 2 (n = 6) were kept alone in a home cage for the same period. Forty-five minutes after [18 F]FDG administration, images were acquired for 30 min. Group 3 (n = 6) was kept anesthetized and image acquisition started immediately after tracer injection, for 75 min. Saline (Day 1) or cocaine (Day 2) was injected 5 min after starting acquisition. Another set of animals (n = 5) were treated with cocaine every other day for 10 days or saline (n = 6) and were scanned with the dynamic protocol to verify its efficacy. [18 F]FDG uptake increased after cocaine administration when compared to baseline only in animals kept under anesthesia. No brain effect of cocaine was observed in animals submitted to the open field or kept in the home cage. The use of anesthesia is essential to visualize cocaine-induced changes in brain metabolism by [18 F]FDG PET, providing an interesting preclinical approach to investigate naïve subjects and enabling a bidirectional translational science approach for better understanding of cocaine use disorder.
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Affiliation(s)
- Lidia Emmanuela Wiazowski Spelta
- Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Caroline Cristiano Real
- Laboratory of Nuclear Medicine, Department of Radiology and Oncology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Carlos Alberto Buchpiguel
- Laboratory of Nuclear Medicine, Department of Radiology and Oncology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Daniele de Paula Faria
- Laboratory of Nuclear Medicine, Department of Radiology and Oncology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Tania Marcourakis
- Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
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Almeida LS, de Souza SPM, de Souza FVP, Reis F, Ramos CD. Multimodality Molecular Imaging in Arthropathy Associated with Multiple Myeloma. Indian J Nucl Med 2022; 37:290-292. [PMID: 36686291 PMCID: PMC9855246 DOI: 10.4103/ijnm.ijnm_205_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 02/12/2022] [Accepted: 02/23/2022] [Indexed: 11/05/2022] Open
Abstract
We report a patient with multiple myeloma (MM) and polyarthritis of large joints. During the staging of the disease, bone marrow diffusely involved by MM was clearly demonstrated by 99mTc-2-methoxy-isobutyl-isonitrile (MIBI) single-photon emission computed tomography/computed tomography (SPECT/CT) but not by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/CT images. On the other hand, a very intense uptake of 18F-FDG was detected in periarticular tissues of multiple joints, with nonabnormal 99mTc-MIBI accumulation. Rheumatology tests were negative. A subsequent bone scintigraphy demonstrated radiolabeled bisphosphonate accumulation in periarticular tissues, suggesting amyloid arthropathy.
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Affiliation(s)
- Ludmila Santiago Almeida
- Department of Radiology, Division of Nuclear Medicine, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil
| | | | | | - Fabiano Reis
- Department of Radiology, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - Celso Dario Ramos
- Department of Radiology, Division of Nuclear Medicine, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil
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Tatar G, Özkul Ö, Alçin G. The Value of 18F-FDG PET/CT Imaging in the Evaluation of Interim Neoadjuvant Chemotherapy Response in Locally Advanced Breast Cancer. Mol Imaging Radionucl Ther 2022; 31:123-129. [PMID: 35770978 PMCID: PMC9246305 DOI: 10.4274/mirt.galenos.2022.44154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objectives: Neoadjuvant chemotherapy (NAC) is the frequently used treatment option for locally advanced breast cancer (LABC). This study investigated the potential value of 18fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) to estimate the pathological complete response (pCR) using maximum standardized uptake value (SUVmax) and change (ΔSUVmax) after 3-4 cycles of NAC. Additionally, it was established the relationship between PET/CT imaging findings and histopathological features in LABC patients whose treatment response was evaluated with interim PET/CT. Methods: Patients were evaluated with pretreatment and interim PET/CT scans and operated after on NAC. Data on the age of patients, menopausal status, tumor placement, histopathological and molecular subgroups were noted. SUVmax and ΔSUVmax of the primary tumor and axillary lymph node (ALN) were calculated from PET/CT review. Results: Pretherapy mean SUVmax of the primary tumor and ALNs were 8.13±4.25 and 7.22±3.58, respectively. The highest mean primary tumor ΔSUVmax and ALN ΔSUVmax values were observed to be human epidermal growth factor receptor 2 positivity (p<0.001). SUVmax-T, SUVmax-N, ΔSUVmax-T, and ΔSUVmax-N values were significantly correlated with the ki-67 index (p<0.001). ΔSUVmax-T and ΔSUVmax-N values of pCR (+) patients were statistically higher than the ΔSUVmax-T and ΔSUVmax-N values of pCR (-) patients (p<0.001). Conclusion: An earlier and more accurate response to NAC can be performed using interim 18F-FDG PET/CT imaging. ΔSUVmax levels of the breast tumor and ALNs may act as predictive for pCR in LABC patients receiving NAC.
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Affiliation(s)
- Gamze Tatar
- University of Health Sciences Turkey, İstanbul Bağcılar Training and Research Hospital, Clinic of Nuclear Medicine, İstanbul, Turkey
| | - Özlem Özkul
- University of Health Sciences Turkey, İstanbul Bağcılar Training and Research Hospital, Division of Medical Oncology, İstanbul, Turkey
| | - Göksel Alçin
- University of Health Sciences Turkey, İstanbul Training and Research Hospital, Clinic of Nuclear Medicine, İstanbul, Turkey
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Kim N, Park W, Cho WK, Cho YS. Clinical outcomes after positron emission tomography/computed tomography-based image-guided brachytherapy for cervical cancer. Asia Pac J Clin Oncol 2022; 18:743-750. [PMID: 35366364 DOI: 10.1111/ajco.13758] [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] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 01/16/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Although positron-emission tomography (PET) plays an integral role in cervix cancer diagnosis, there are limited data on PET-based image-guided brachytherapy (IGBT). We aimed to report the long-term outcomes of PET-based IGBT. METHODS We reviewed 151 patients treated with definitive radiotherapy (RT), including PET-based IGBT between 2009 and 2018. After median 45 Gy of external beam RT with the four-field technique, a median 24 Gy of high-dose-rate iridium-192 IGBT was delivered in six fractions with Fletcher-Suit tandem and ovoids. All patients underwent 18F-fluorodeoxyglucose-PET/computed tomography planning with a brachytherapy applicator. Multivariable analysis of local control (LC) was performed using Cox regression analysis. RESULTS The median high-risk clinical target volume (HRCTV) and HRCTV D90% were 51.8 (interquartile range [IQR] 35.9-79.4) cm3 and 77.7 (IQR 74.7-81.2) Gy, respectively. With a median follow-up of 57 (IQR 24.3-81.4) months, the 5-year LC rate was 89.2%. HRCTV ≥72 cm3 was associated with inferior LC (hazard ratio, 3.72, p = .017) after multivariable analysis: the 5-year LC rates were 94.0% and 77.9% for HRCTVs ≥72 and < 72 cm3 , respectively (p = .002). The impact of HRCTV D90% ≥70 Gy on LC was significant in patients with an HRCTV ≥72 cm3 compared to that in those with HRCTV < 72 cm3 . Patients with adeno/adenosquamous carcinoma demonstrated inferior LC in both groups. There were 13 (8.6%) and 11 (7.3%) patients with acute and late severe toxicities after RT. CONCLUSION PET-based IGBT leads to favorable LC, and HRCTV ≥72 cm3 requires further dose escalation to improve outcomes.
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Affiliation(s)
- Nalee Kim
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won Park
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won Kyung Cho
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Seok Cho
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Atilgan HI, Yalcin H. Sensitivity of [18F]FDG PET/CT and classification of the primary tumor site in patients with carcinoma of unknown primary. Nucl Med Rev Cent East Eur 2022; 25:1-5. [PMID: 35137930 DOI: 10.5603/nmr.a2022.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 10/27/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The aim of this study is to find the sensitivity of the [18F]FDG PET/CT and the classification of the primary sites of carcinoma of unknown primary (CUP) as a single-center experience. MATERIAL AND METHODS Sixty-eight patients with a mean age of 62.43 ± 12.78 years were included in this study retrospectively. Sixty-five patients had biopsy or surgery after PET/CT, which revealed pathological diagnoses of malign primary tumors, while primary tumor site could not be detected in three patients with histopathological examination. We evaluated the primary site of CUP with [18F]FDG PET/CT. RESULTS Primary sites of three patients were not determined by histopathological examination. Malign lesions indicating the primary site of tumor were identified in 52 of 68 patients with PET/CT correctly. The primary tumor was lung cancer in 14 patients, cholangiocellular cancer in 9 patients, lymphoma in 9 patients, pancreas cancer in 6 patients, gastric cancer in 4 patients, ovary cancer in 4 patients, colon cancer in 4 patients, breast cancer in 3 patients, hepatocellular cancer in 2 patients, rectal cancer in 2 patients, sarcoma in 2 patients, esophagus, renal cell cancer, squamous cell cancer, endometrium cancer, malign melanoma, and multiple myeloma in 1 patient with histopathological examination. PET/CT was false positive in one patient. There were 13 patients in whom primary tumor could not be localized by PET/CT, but was diagnosed by histopathological evaluation. CONCLUSIONS PET/CT should be the first-line diagnostic tool for CUP, other diagnostic imaging tools should be applied after a negative whole-body PET/CT.
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Affiliation(s)
- Hasan Ikbal Atilgan
- Hatay Mustafa Kemal University, Faculty of Medicine, Department of Nuclear Medicine, Hatay, Turkey.
| | - Hulya Yalcin
- Hatay Mustafa Kemal University, Faculty of Medicine, Department of Nuclear Medicine, Hatay, Turkey
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Lim CH, Park SB, Kim HK, Choi YS, Kim J, Ahn YC, Ahn MJ, Choi JY. Clinical Value of Surveillance 18F-fluorodeoxyglucose PET/CT for Detecting Unsuspected Recurrence or Second Primary Cancer in Non-Small Cell Lung Cancer after Curative Therapy. Cancers (Basel) 2022; 14:cancers14030632. [PMID: 35158900 PMCID: PMC8833387 DOI: 10.3390/cancers14030632] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 11/11/2021] [Revised: 01/25/2022] [Accepted: 01/25/2022] [Indexed: 12/19/2022] Open
Abstract
Simple Summary Non-small cell lung cancer (NSCLC) patients are at considerable risk of recurrence or second primary cancer (SPC) after curative therapy. The utility of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) surveillance to detect recurrent lesions in NSCLC patients without suspicion of recurrence has not been established. The aim of our retrospective study was to evaluate the diagnostic value of surveillance FDG PET/CT for detecting clinically unsuspected recurrence or SPC in patients with NSCLC after curative therapy. In a cohort of 2684 NSCLC patients after curative therapy, surveillance FDG PET/CT showed good diagnostic efficacy for detecting clinically unexpected recurrence or SPC. Furthermore, the diagnostic performance was improved in subgroups of patients with advanced stage prior to curative therapy, PET/CT scans performed within 3 years after curative-intent therapy, and curative surgery. Surveillance PET/CT can be more useful when performed soon after therapy in curative surgery recipients and those with an advanced disease stage considering its diagnostic efficacy and yield. Abstract We evaluated the diagnostic value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT surveillance for detecting clinically unsuspected recurrence or second primary cancer (SPC) in patients with non-small cell lung cancer (NSCLC) after curative therapy. A total of 4478 surveillance FDG PET/CT scans from 2864 NSCLC patients without suspicion of recurrence after curative therapy were reviewed retrospectively. In 274 of 2864 (9.6%) patients, recurrent NSCLC or SPC was found by surveillance PET/CT during clinical follow-up. Surveillance PET/CT scans showed sensitivity of 98.9% (274/277), specificity of 98.1% (4122/4201), accuracy of 98.2% (4396/4478), positive predictive value (PPV) of 77.6% (274/353), and negative predictive value of 99.9% (4122/4125). The specificity and accuracy in the curative surgery group were significantly higher than those in the curative radiotherapy group. PPV was significantly improved in subgroups of patients with advanced stage prior to curative therapy, PET/CT scans performed within 3 years after curative-intent therapy, and curative surgery. FDG PET/CT surveillance showed good diagnostic efficacy for detecting clinically unexpected recurrence or SPC in NSCLC patients after curative therapy. It can be more useful when performed soon after therapy in curative surgery recipients and those with an advanced disease stage considering its diagnostic efficacy and yield.
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Affiliation(s)
- Chae Hong Lim
- Department of Nuclear Medicine, Soonchunhyang University Hospital Seoul, Soonchunhyang University College of Medicine, Seoul 04401, Korea; (C.H.L.); (S.B.P.)
| | - Soo Bin Park
- Department of Nuclear Medicine, Soonchunhyang University Hospital Seoul, Soonchunhyang University College of Medicine, Seoul 04401, Korea; (C.H.L.); (S.B.P.)
| | - Hong Kwan Kim
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (H.K.K.); (Y.S.C.); (J.K.)
| | - Yong Soo Choi
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (H.K.K.); (Y.S.C.); (J.K.)
| | - Jhingook Kim
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (H.K.K.); (Y.S.C.); (J.K.)
| | - Yong Chan Ahn
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
| | - Myung-ju Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
| | - Joon Young Choi
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
- Correspondence: ; Tel.: +82-2-3410-2648; Fax: +82-2-3410-2639
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Goto S, Matsusaka Y, Yamane T, Hoshino Y, Kuji I. Diffuse FDG uptake in the bilateral lungs: hypersensitivity pneumonitis supported by low-dose CT findings. Asia Ocean J Nucl Med Biol 2022; 10:43-46. [PMID: 35083349 PMCID: PMC8742853 DOI: 10.22038/aojnmb.2021.56000.1393] [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] [Received: 04/03/2021] [Revised: 05/27/2021] [Accepted: 06/10/2021] [Indexed: 11/06/2022]
Abstract
Hypersensitivity pneumonitis (HP) is an interstitial lung disease resulting from an immune-mediated response in susceptible and sensitized individuals to various inhaled antigens in the environment. Imaging diagnosis is usually based on high-resolution CT findings. Here, we present a 49-year-old man with a history of diffuse large B-cell lymphoma presented with fever and occasional cough. 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) revealed diffuse FDG uptake in the bilateral lungs. Expiratory low-dose CT simultaneously performed in PET scanning revealed centrilobular nodules and air trapping in ground glass opacities (GGO). Our imaging diagnosis was acute hypersensitivity pneumonitis (HP). Based on the results of his clinical course, blood laboratory tests, and bronchoscopy, he was diagnosed with acute HP. Diffuse pulmonary FDG uptake can be seen in the patients with acute HP. In addition, expiratory low-dose CT findings of centrilobular nodules and air trapping in GGO may be helpful for accurate diagnosis of acute HP.
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Affiliation(s)
- Shun Goto
- Department of Nuclear Medicine, Saitama Medical University International Medical Center, Saitama, Japan
| | - Yohji Matsusaka
- Department of Nuclear Medicine, Saitama Medical University International Medical Center, Saitama, Japan,Corresponding author: Yohji Matsusaka. Department of Nuclear Medicine, Saitama Medical University International Medical Center. 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan. Tel: +81 42-984-4147; Fax: +81 42-984-4191; E-mail:
| | - Tomohiko Yamane
- Department of Nuclear Medicine, Saitama Medical University International Medical Center, Saitama, Japan
| | - Yuki Hoshino
- Department of Respiratory Medicine, Saitama Medical University Hospital, Saitama, Japan
| | - Ichiei Kuji
- Department of Nuclear Medicine, Saitama Medical University International Medical Center, Saitama, Japan
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Zhang B, He Q, Long Y, Zhang Y, Wang X, Chen Z, Liu J, Zhang X. Comparison of diagnostic efficacy of 18F-FDG PET/CT and 68Ga-DOTANOC PET/CT in ectopic adrenocorticotropic hormone syndrome. Front Endocrinol (Lausanne) 2022; 13:962800. [PMID: 36213295 PMCID: PMC9538925 DOI: 10.3389/fendo.2022.962800] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 09/07/2022] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Fluorine-18 (18F)-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) and gallium-68 (68Ga)-somatostatin analog (SSA) PET/CT imaging have been increasingly used in ectopic adrenocorticotropic hormone syndrome (EAS); however, the diagnostic efficacies of these two methods in patients with EAS remain unclear. Our study aimed to compare the diagnostic efficacies of 18F-FDG PET/CT and 68Ga-DOTANOC PET/CT in EAS. METHODS The clinical and imaging data of 68 patients with EAS who underwent 18F-FDG PET/CT and 68Ga-DOTANOC PET/CT examinations from December 2016 to April 2021 were analyzed retrospectively, and the diagnostic efficacies of these methods were compared. RESULTS In 37 cases, imaging was performed to locate the primary tumor lesion (localization group), and in 31 to evaluate tumor load or metastasis (staging group). Primary tumors were detected in 48.65% (18/37) of the localization group patients. According to scan-based analysis, the tumor lesion detection rates and false positive rates of 18F-FDG PET/CT imaging and 68Ga-DOTANOC PET/CT imaging were 18.92% vs. 45.95% (p < 0.05) and 21.62% vs. 2.70% (p < 0.05) respectively. For lesion-based analysis, the tumor lesion detection rates and false positive rates were 24.13% vs. 58.62% (p >0.05) and 31.04% vs. 3.45% (p < 0.05). In 90.32% (28/31) of the staging group patients, 286 of 292 lesions were confirmed as tumor lesions. Based on scan analysis, the detection rates and false positive rates of 18F-FDG PET/CT imaging and 68Ga-DOTANOC PET/CT imaging were 83.87% vs. 67.74% (p > 0.05) and 12.90% vs. 9.68% (p > 0.05) respectively. Based on lesion analysis, the detection rate and false positive rates were 93.84% vs. 54.80% (p < 0.05) and 1.37% vs. 1.03%(p > 0.05). CONCLUSION 68Ga-DOTANOC PET/CT imaging may be more suitable than 18F-FDG PET/CT for identifying the primary tumor in patients with EAS, while 18F-FDG PET/CT may be more advantageous than 68Ga-DOTANOC PET/CT for patients with suspected metastasis.
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Affiliation(s)
| | | | | | | | | | | | - Jianbo Liu
- *Correspondence: Xiangsong Zhang, ; Jianbo Liu,
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Takahashi MES, Lorand-Metze I, de Souza CA, Mesquita CT, Fernandes FA, Carvalheira JBC, Ramos CD. Metabolic Volume Measurements in Multiple Myeloma. Metabolites 2021; 11:875. [PMID: 34940633 PMCID: PMC8703741 DOI: 10.3390/metabo11120875] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/10/2021] [Accepted: 12/14/2021] [Indexed: 02/07/2023] Open
Abstract
Multiple myeloma (MM) accounts for 10-15% of all hematologic malignancies, as well as 20% of deaths related to hematologic malignant tumors, predominantly affecting bone and bone marrow. Positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (FDG-PET/CT) is an important method to assess the tumor burden of these patients. It is often challenging to classify the extent of disease involvement in the PET scans for many of these patients because both focal and diffuse bone lesions may coexist, with varying degrees of FDG uptake. Different metrics involving volumetric parameters and texture features have been proposed to objectively assess these images. Here, we review some metabolic parameters that can be extracted from FDG-PET/CT images of MM patients, including technical aspects and predicting MM outcome impact. Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) are volumetric parameters known to be independent predictors of MM outcome. However, they have not been adopted in clinical practice due to the lack of measuring standards. CT-based segmentation allows automated, and therefore reproducible, calculation of bone metabolic metrics in patients with MM, such as maximum, mean and standard deviation of the standardized uptake values (SUV) for the entire skeleton. Intensity of bone involvement (IBI) is a new parameter that also takes advantage of this approach with promising results. Other indirect parameters obtained from FDG-PET/CT images, such as visceral adipose tissue glucose uptake and subcutaneous adipose tissue radiodensity, may also be useful to evaluate the prognosis of MM patients. Furthermore, the use and quantification of new radiotracers can address different metabolic aspects of MM and may have important prognostic implications.
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Affiliation(s)
| | - Irene Lorand-Metze
- Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas 13083-888, Brazil;
| | - Carmino Antonio de Souza
- Center of Hematology and Hemotherapy, University of Campinas (UNICAMP), Campinas 13083-878, Brazil;
| | - Claudio Tinoco Mesquita
- Departamento de Radiologia, Faculdade Medicina, Universidade Federal Fluminense (UFF), Niterói 24033-900, Brazil;
- Hospital Universitário Antônio Pedro/EBSERH, Universidade Federal Fluminense (UFF), Niterói 24033-900, Brazil;
| | - Fernando Amorim Fernandes
- Hospital Universitário Antônio Pedro/EBSERH, Universidade Federal Fluminense (UFF), Niterói 24033-900, Brazil;
| | | | - Celso Dario Ramos
- Division of Nuclear Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas 13083-888, Brazil
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Manabe O, Oyama-Manabe N, Aikawa T, Tsuneta S, Tamaki N. Advances in Diagnostic Imaging for Cardiac Sarcoidosis. J Clin Med 2021; 10:jcm10245808. [PMID: 34945105 PMCID: PMC8704832 DOI: 10.3390/jcm10245808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/05/2021] [Accepted: 12/09/2021] [Indexed: 11/16/2022] Open
Abstract
Sarcoidosis is a systemic granulomatous disease of unknown etiology, and its clinical presentation depends on the affected organ. Cardiac sarcoidosis (CS) is one of the leading causes of death among patients with sarcoidosis. The clinical manifestations of CS are heterogeneous, and range from asymptomatic to life-threatening arrhythmias and progressive heart failure due to the extent and location of granulomatous inflammation in the myocardium. Advances in imaging techniques have played a pivotal role in the evaluation of CS because histological diagnoses obtained by myocardial biopsy tend to have lower sensitivity. The diagnosis of CS is challenging, and several approaches, notably those using positron emission tomography and cardiac magnetic resonance imaging (MRI), have been reported. Delayed-enhanced computed tomography (CT) may also be used for diagnosing CS in patients with MRI-incompatible devices and allows acceptable evaluation of myocardial hyperenhancement in such patients. This article reviews the advances in imaging techniques for the evaluation of CS.
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Affiliation(s)
- Osamu Manabe
- Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama 330-8503, Japan; (O.M.); (T.A.)
| | - Noriko Oyama-Manabe
- Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama 330-8503, Japan; (O.M.); (T.A.)
- Correspondence: ; Tel.: +81-48-647-2111
| | - Tadao Aikawa
- Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama 330-8503, Japan; (O.M.); (T.A.)
| | - Satonori Tsuneta
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo 060-8648, Japan;
| | - Nagara Tamaki
- Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan;
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Raynor WY, Park PSU, Borja AJ, Sun Y, Werner TJ, Ng SJ, Lau HC, Høilund-Carlsen PF, Alavi A, Revheim ME. PET-Based Imaging with 18F-FDG and 18F-NaF to Assess Inflammation and Microcalcification in Atherosclerosis and Other Vascular and Thrombotic Disorders. Diagnostics (Basel) 2021; 11:diagnostics11122234. [PMID: 34943473 PMCID: PMC8700072 DOI: 10.3390/diagnostics11122234] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/19/2021] [Accepted: 11/23/2021] [Indexed: 01/13/2023] Open
Abstract
Positron emission tomography (PET) imaging with 18F-fluorodeoxyglucose (FDG) represents a method of detecting and characterizing arterial wall inflammation, with potential applications in the early assessment of vascular disorders such as atherosclerosis. By portraying early-stage molecular changes, FDG-PET findings have previously been shown to correlate with atherosclerosis progression. In addition, recent studies have suggested that microcalcification revealed by 18F-sodium fluoride (NaF) may be more sensitive at detecting atherogenic changes compared to FDG-PET. In this review, we summarize the roles of FDG and NaF in the assessment of atherosclerosis and discuss the role of global assessment in quantification of the vascular disease burden. Furthermore, we will review the emerging applications of FDG-PET in various vascular disorders, including pulmonary embolism, as well as inflammatory and infectious vascular diseases.
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Affiliation(s)
- William Y. Raynor
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; (W.Y.R.); (P.S.U.P.); (A.J.B.); (T.J.W.); (A.A.)
| | - Peter Sang Uk Park
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; (W.Y.R.); (P.S.U.P.); (A.J.B.); (T.J.W.); (A.A.)
- Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA;
| | - Austin J. Borja
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; (W.Y.R.); (P.S.U.P.); (A.J.B.); (T.J.W.); (A.A.)
- Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA;
| | - Yusha Sun
- Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA;
| | - Thomas J. Werner
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; (W.Y.R.); (P.S.U.P.); (A.J.B.); (T.J.W.); (A.A.)
| | - Sze Jia Ng
- Department of Medicine, Crozer-Chester Medical Center, Upland, PA 19013, USA; (S.J.N.); (H.C.L.)
| | - Hui Chong Lau
- Department of Medicine, Crozer-Chester Medical Center, Upland, PA 19013, USA; (S.J.N.); (H.C.L.)
| | - Poul Flemming Høilund-Carlsen
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense C, Denmark;
- Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark
| | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; (W.Y.R.); (P.S.U.P.); (A.J.B.); (T.J.W.); (A.A.)
| | - Mona-Elisabeth Revheim
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; (W.Y.R.); (P.S.U.P.); (A.J.B.); (T.J.W.); (A.A.)
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Problemveien 7, 0315 Oslo, Norway
- Correspondence: or
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Chen BX, Xie B, Zhou Y, Shi L, Wang Y, Zeng L, Liu X, Yang MF. Association of Serum Biomarkers and Cardiac Inflammation in Patients With Atrial Fibrillation: Identification by Positron Emission Tomography. Front Cardiovasc Med 2021; 8:735082. [PMID: 34712708 PMCID: PMC8546267 DOI: 10.3389/fcvm.2021.735082] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 07/02/2021] [Accepted: 09/16/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Peripheral biomarkers may be affected by various factors, their reliability in reflecting local cardiac inflammatory status in patients with atrial fibrillation (AF) needs further exploration. This prospective study was aimed to investigate the relationship between circulating biomarkers and local cardiac inflammation measured by epicardial adipose tissue (EAT) activity via18F-fluorodeoxyglucose (FDG) imaging in AF patients. Methods: From 2017 to 2018, 83 AF patients [43 persistent AF (PsAF) and 40 paroxysmal AF (PAF)] referred for radiofrequency catheter ablation (RFCA) were recruited. Pre- and post-RFCA blood samples were collected to measure IL-6, IL-8, IL-10, IL-18, TNF-α, Hsp27, Hsp60, Hsp70, PDGF-BB, MMP-2, MMP-9, MPO, TGF-β1, Gal-3, and sST2. Pre-RFCA FDG images were obtained to assess EAT activity. Sixty-seven patients (35 PAF and 32 PsAF) received RFCA were regularly followed for 27 (24, 29) months. Results: Higher hsCRP and IL-6 and lower TGF-β1 were demonstrated in PsAF patients compared with PAF patients. Multivariate logistic regression analysis demonstrated that Gal-3 (OR: 1.221, 95% CI: 1.024–1.456, P = 0.026) and MPO (OR: 1.002, 95% CI: 1.001–1.003, P = 0.027) were independently correlated with EAT activity. The percentage decrease of Hsp60 linearly correlated with that of EAT activity post-RFCA (Spearman rs = 0.455, P = 0.019). Seventeen patients (10 PsAF and 7 PAF) had AF recurrence, but none of the selected biomarkers were predictive of post-RFCA recurrence. Conclusion: Our findings demonstrated that in patients with AF, Gal-3 correlated with local cardiac inflammation, and Hsp60 was associated with the alleviation of cardiac inflammation after RFCA.
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Affiliation(s)
- Bi-Xi Chen
- Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Boqia Xie
- Cardiac Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Yang Zhou
- Cardiac Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Liang Shi
- Cardiac Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Yanjiang Wang
- Cardiac Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Lijun Zeng
- Cardiac Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xingpeng Liu
- Cardiac Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Min-Fu Yang
- Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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Sharma P. Irritated seborrhoeic keratosis masquerading as malignancy on 18F-fluorodeoxyglucose positron emission tomography-computed tomography. World J Nucl Med 2021; 20:309-311. [PMID: 34703401 PMCID: PMC8488890 DOI: 10.4103/wjnm.wjnm_109_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/28/2020] [Accepted: 10/09/2020] [Indexed: 11/04/2022] Open
Abstract
Seborrhoeic keratosis is a common benign skin tumor and can have a variable presentation. Irritated seborrhoeic keratosis can clinically mimic cutaneous malignancy and often warrant biopsy. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET-CT) can give false-positive results in many cutaneous pathologies. We present an interesting case of irritated seborrhoeic keratosis masquerading as skin cancer, clinically as well as on18F-FDG PET-CT.
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Affiliation(s)
- Punit Sharma
- Department of Nuclear Medicine and PET-CT, Apollo Gleneagles Hospital, Kolkata, West Bengal, India
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44
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Chen M, Zhang M, Li ZX, Xiang HB, Xiong J. Glucose Metabolic Alteration of Cerebral Cortical Subareas in Rats with Renal Ischemia/Reperfusion Based on Small-Animal Positron Emission Tomography. Curr Med Sci 2021; 41:961-5. [PMID: 34669118 DOI: 10.1007/s11596-021-2450-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/31/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To investigate glucose metabolic alterations in cerebral cortical subareas using 18F-labeled glucose derivative fluorodeoxyglucose (FDG) micro-positron emission tomography (PET) scanning in a rat renal ischemia/reperfusion (RIR) model. METHODS Small-animal PET imaging in vivo was performed with 18F-labeled FDG as a PET tracer to identify glucose metabolic alterations in cerebral cortical subregions using a rat model of RIR. RESULTS We found that the average standardized uptake value (SUVaverage) of the cerebral cortical subareas in the RIR group was significantly increased compared to the sham group (P<0.05). We also found that glucose uptake in different cortical subregions including the left auditory cortex, right medial prefrontal cortex, right para cortex, left retrosplenial cortex, right retrosplenial cortex, and right visual cortex was significantly increased in the RIR group (P<0.05), but there was no significant difference in the SUVaverage of right auditory cortex, left medial prefrontal cortex, left para cortex, and left visual cortex between the two groups. CONCLUSION The 18F-FDG PET data suggests that RIR causes a profound shift in the metabolic machinery of cerebral cortex subregions.
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45
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Nautiyal A, Mondal T, Goel A, Dey SK, Mitra D. Biological Effects Associated with Internal and External Contamination of Diagnostic Nuclear Medicine Sources: An In vitro Study. Indian J Nucl Med 2021; 36:288-292. [PMID: 34658553 PMCID: PMC8481857 DOI: 10.4103/ijnm.ijnm_17_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 05/19/2021] [Accepted: 05/29/2021] [Indexed: 11/19/2022] Open
Abstract
Aim: In a Nuclear Medicine department, the risk of external and internal contamination in radiation workers is much higher than in other medical radiation facilities. The risk associated with both types of contaminations should be quantified to estimate the radiation dose received by the personal. Here, we designed an in vitro model to see the impact of internal and external contamination of F-18 and Technetium-99 m (Tc-99 m) on DNA damages. Methodology: Chinese hamster lung fibroblast V79 was used for all of the experiments. Irradiation was performed internally and externally (scenarios activity is mixed with the cell line [Internal] and activity kept at 1 cm distance from cell line [external]) using two different diagnostic radioactive sources (Tc-99 m and F-18) of known quantity 37 MBq. Total cumulated activity (MBq-min) was calculated up to one half-life of sources for both internal and external setups. An alkaline single gel electrophoresis technique (comet assay) was used for DNA damage analysis. Olive tail moment (OTM) was used to characterize DNA damage. Results: We have not observed any significant difference (P > 0.05) in OTM between internal and external irradiation for cumulated activity presented before one half-life of both diagnostic isotopes. However, a significant difference in OTM was noted between internal and external irradiation for cumulated activity presented at one half-life of radioactive sources (P < 0.05). DNA damage with internal exposure was found to be 17.28% higher for F-18 and 23% higher for Tc-99 m than external exposure at one half-life of radioactive sources. Overall, we noted greater DNA damage in F-18 as compared to Tc-99 m. Conclusions: Our in vitro study practically demonstrated that internal contamination is more hazardous than external exposure.
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Affiliation(s)
- Amit Nautiyal
- Institute of Nuclear Medicine and Molecular Imaging, AMRI Hospitals, Uttar Pradesh, India.,Amity Institute of Nuclear Science and Technology, Amity University, Noida, Uttar Pradesh, India
| | - Tanmoy Mondal
- Department of Biotechnology, Maulana Abul Kalam Azad University of Technology, Kolkata, West Bengal, India
| | - Alpana Goel
- Amity Institute of Nuclear Science and Technology, Amity University, Noida, Uttar Pradesh, India
| | - Subrata Kumar Dey
- Department of Biotechnology, Maulana Abul Kalam Azad University of Technology, Kolkata, West Bengal, India
| | - Deepanjan Mitra
- Institute of Nuclear Medicine and Molecular Imaging, AMRI Hospitals, Uttar Pradesh, India
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Furuya S, Naya M, Manabe O, Hirata K, Ohira H, Aikawa T, Koyanagawa K, Magota K, Tsujino I, Anzai T, Kuge Y, Oyama-Manabe N, Kudo K, Shiga T, Tamaki N. 18F-FMISO PET/CT detects hypoxic lesions of cardiac and extra-cardiac involvement in patients with sarcoidosis. J Nucl Cardiol 2021; 28:2141-2148. [PMID: 31820409 DOI: 10.1007/s12350-019-01976-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 08/22/2019] [Accepted: 11/22/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND 18F-fluoromisonidazole (FMISO) is a hypoxia positron emission tomography (PET) tracer. Here, we evaluated cardiac and extra-cardiac sarcoidosis using both FMISO and 18F-fluorodeoxyglucose (FDG) PET/CT in a prospective cohort of patients with sarcoidosis. METHODS Ten consecutive sarcoidosis patients with suspected cardiac involvement were prospectively enrolled. Each patient fasted overnight (for ≥ 18 hours) preceded by a low-carbohydrate diet before FDG PET/CT but not given special dietary instructions before the FMISO PET/CT scan. We visually and semiquantitatively assessed the uptakes of FMISO and FDG using the maximal standardized uptake value (SUVmax). The metabolic volume (MV) of FDG was calculated as the volume within the boundary determined by the threshold (mean SUV of blood pool × 1.5). RESULTS Nine patients showed focal FDG uptake in the myocardium and were diagnosed with cardiac sarcoidosis. Among the patients with extra-cardiac lesions, FDG uptake was seen in 8 lymph nodes and 3 lung lesions. FMISO uptake was seen in the 7 cardiac (77.8%) and 6 extra-cardiac (54.5%) lesions. None of the patients showed physiological FMISO uptake in the myocardium. The SUVmax values of the lesions with FMISO uptake were higher than those of the lesions without FMISO uptake in both the cardiac (SUVmax: 9.9, IQR: 8.4-10.0 vs 7.3, IQR: 6.3-8.2) and non-cardiac lesions (SUVmax: 17.6, IQR: 14.5-19.3 vs 6.1, IQR: 5.9-6.2; P = 0.006). The MV values of the lesions with FMISO uptake were significantly higher than those of the lesions without FMISO uptake (111.3, IQR: 78.3-135.7 vs 6.4, IQR: 1.9-23.3; P = 0.0009). CONCLUSIONS FMISO showed no physiological myocardial uptake and did not require special preparation. FMISO PET has the potential to detect hypoxic lesions in patients with sarcoidosis.
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Affiliation(s)
- Sho Furuya
- Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Masanao Naya
- Department of Cardiovascular Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Osamu Manabe
- Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.
| | - Kenji Hirata
- Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Hiroshi Ohira
- First Department of Medicine, Hokkaido University School of Medicine, Sapporo, Japan
| | - Tadao Aikawa
- Department of Cardiovascular Medicine, Hokkaido University Hospital, Sapporo, Japan
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kazuhiro Koyanagawa
- Department of Cardiovascular Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Keiichi Magota
- Division of Medical Imaging and Technology, Hokkaido University Hospital, Sapporo, Japan
| | - Ichizo Tsujino
- First Department of Medicine, Hokkaido University School of Medicine, Sapporo, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Yuji Kuge
- Central Institute of Isotope Science, Hokkaido University, Sapporo, Japan
| | - Noriko Oyama-Manabe
- Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Kohsuke Kudo
- Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Tohru Shiga
- Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Nagara Tamaki
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Lim CH, Yoon SE, Kim WS, Lee KH, Kim SJ. Imaging Features and Prognostic Value of FDG PET/CT in Patients with Intravascular Large B-Cell Lymphoma. Cancer Manag Res 2021; 13:7289-7297. [PMID: 34584455 PMCID: PMC8464312 DOI: 10.2147/cmar.s330308] [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: 07/20/2021] [Accepted: 09/09/2021] [Indexed: 12/04/2022] Open
Abstract
Purpose The clinical value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in intravascular large B-cell lymphoma (IVLBCL) is unknown. This study investigated the association between PET/CT features and prognosis in IVLBCL patients. Patients and Methods Subjects were 30 newly diagnosed Asian variant IVLBCL patients at a single institution. Baseline PET/CT was analyzed for the distribution and intensity of FDG lesions, and PET/CT pattern groups were compared for the outcome. Results Eight patients had hypermetabolic lymph node (LN) lesions (Nodal group). The remaining 22 patients with extranodal (EN) involvement were categorized into Deauville score 3–4 (EN/DS3-4; n = 14) and DS5 groups (EN/DS5; n = 8). First-line therapy resulted in a complete or partial response in 75.0%, 64.3%, and 100% of the respective groups. Treatment-related deaths occurred in one nodal group and three EN/DS3-4 group cases, but none among the EN/DS5 group. During 56 months of follow-up, disease progression or relapse occurred in five, four, and one case of respective groups. Cancer-related death occurred more frequently in the Nodal (n = 6) and EN/DS3-4 groups (n = 7) than the EN/DS5 group (n = 1; P = 0.041). Nodal and EN/DS3-4 groups had worse 5-year event-free survival (EFS; 25.0% and 49.0%, respectively, P = 0.010 and 0.076) and overall survival (OS; 33.3% and 48.2%, P = 0.010 and 0.068) compared to the EN/DS5 group (87.5% EFS and 87.5% OS). Conclusion In patients with Asian variant IVLBCL, the distribution and intensity of FDG uptake lesions on PET/CT can be useful for predicting treatment outcomes and survival.
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Affiliation(s)
- Chae Hong Lim
- Department of Nuclear Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Sang Eun Yoon
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won Seog Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung-Han Lee
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea
| | - Seok Jin Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea
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Pavičar B, Davidović J, Petrović B, Vuleta G, Trivić S, Šajinović V, Egeljić-Mihailović N, Todorović N, Predojević B. Nuclear medicine staff exposure to ionising radiation in 18F-FDG PET/CT practice: a preliminary retrospective study. Arh Hig Rada Toksikol 2021; 72:216-24. [PMID: 34587667 DOI: 10.2478/aiht-2021-72-3517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 09/01/2021] [Indexed: 12/15/2022] Open
Abstract
This retrospective study provides an insight into the levels of radiation exposure of six nuclear medicine (NM) staff (four technologists and two nurses) performing routine diagnostic 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET/CT) at the University Clinical Centre of the Republic of Srpska, Department of Nuclear Medicine and Thyroid Disorders, Banja Luka, Bosnia and Herzegovina. Data analysis included monthly staff exposure measured with personal thermoluminescent dosimeters (TLD) between June and December 2018, quantified in terms of normalised dose for the whole body [Hp(10)] and dominant hand [Hp(0.07)] and their comparison between each staff member and between the two groups (technologists and nurses). The study goal was to establish how our Department compared with reports from other PET/CT centres worldwide in terms of annual number of procedures and exposure limits and whether there could be room for further improvements in radiation protection. The number of procedures rose considerably from 208 in 2016 to 876 in 2019 and was 423 in the observed seven-month period. Mean individual whole-body exposure dose per GBq of injected 18F-FDG activity, [Hp(10)/A] was 18.55 μSv/GBq for the four technologists and 15.61 μSv/GBq for the two nurses. Mean dominant-hand exposure dose per GBq of injected 18F-FDG activity [Hp(0.07)/A] was 16.99 μSv/GBq and 25.44 μSv/GBq for the two groups, respectively. The average annual cumulative dose for all staff was (1.06±0.29) mSv for Hp(10) and (1.15±0.32) mSv for Hp(0.07). These results are comparable with those of similar studies. Staff doses were well below the annual limits. Nurses received slightly higher extremity doses than technologists. In view of the increasing trends in the number of PET/CT procedures, dose monitoring should be continued to identify exposure hotspots and maintain doses as low as possible.
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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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50
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Mhlanga J, Haq A, Derenoncourt P, Bhandiwad A, Laforest R, Siegel B, Dehdashti F, Gropler RJ, Schindler TH. 18F-FDG Positron Emission Tomography in Myocardial Viability Assessment: A Practical and Time Efficient Protocol. J Nucl Med 2021; 63:602-608. [PMID: 34503961 DOI: 10.2967/jnumed.121.262432] [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: 04/12/2021] [Revised: 08/13/2021] [Indexed: 11/16/2022] Open
Abstract
We assessed image quality using a practical and time-efficient protocol for intravenous glucose loading and insulin injection prior to administration of 18F-fluorodeoxyglucose (18F-FDG) for PET myocardial viability evaluation in patients with ischemic cardiomyopathy, with and without type 2 diabetes mellitus. Methods: Metabolic preparation period (MPP) or optimal cardiac 18F-FDG uptake was determined from the time of intravenous infusion of 12.5 or 25 gram of 50% dextrose to the time of 18F-FDG injection. Cardiac 18F-FDG image quality was evaluated according to a 5-point scoring system (5=excellent to 1=non-diagnostic) by two independent observers. In cases of disagreement, consensus was achieved in a joint reading. Fifteen patients with ischemic cardiomyopathy, who underwent oral glucose loading and i.v. insulin administration, served as reference for MPP comparisons. Results: 59 consecutive patients (age: 63±10yrs, men n = 48 and women n = 11) underwent rest 99mTc-tetrofosmin SPECT/CT and 18F-FDG PET/CT for the evaluation of myocardial viability. FDG image quality was scored as excellent in 42%, very good in 36%, good in 17%, fair in 3%, and non-diagnostic in 2%. Comparing diabetic and non-diabetic patients, the quality scores were excellent in 29% vs. 76% , very good in 41% vs. 18%, good in 24% vs. 6%, fair in 4% vs. 0% , and non-diagnostic in 2% vs. 0%. The mean (±SD) quality score was 4.12±0.95 and overall it was better in non-diabetic than in diabetic patients (4.71±0.59 vs 3.88±0.96; p<0.0001). Notably, the average MPP was significantly less with i.v. glucose loading when compared to oral glucose loading (51±15 vs. 132±29 min; p<0.0001), paralleled by higher insulin doses (6.3 ± 2.2 vs. 2.0 ± 1.69 U; p<0.001). Conclusion: Using a practical and time efficient protocol for i.v. glucose loading and insulin administration prior to 18F-FDG injection reduces the MPP by 61% as compared to oral glucose challenge that affords good-to-excellent image quality in 95% of ischemic cardiomyopathy patients.
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Affiliation(s)
- Joyce Mhlanga
- Washington University in St Louis School of Medicine, Mallinckrodt Institute of Radiology, Division of Nuclear Medicine, United States
| | - Adeel Haq
- Washington University School of Medicine, Mallinckrodt Institute of Radiology- Division of Nuclear Medicine, United States
| | - Paul Derenoncourt
- Washington University School of Medicine, Mallinckrodt Institute of Radiology- Division of Nuclear Medicine, United States
| | - Anita Bhandiwad
- Washington University School of Medicine, John T. Milliken Department of Internal Medicine, Cardiovascular Division, United States
| | - Richard Laforest
- Washington University in St. Louis, Mallinckrodt Institute of Radiology- Division of Nuclear Medicine, United States
| | - Barry Siegel
- Washington University in St. Louis, Mallinckrodt Institute of Radiology- Division of Nuclear Medicine, United States
| | - Farrokh Dehdashti
- Washington University in St. Louis, Mallinckrodt Institute of Radiology- Division of Nuclear Medicine, United States
| | - Robert J Gropler
- Washington University in St. Louis, Mallinckrodt Institute of Radiology- Division of Nuclear Medicine, United States
| | - Thomas Hellmut Schindler
- Washington University in St. Louis School of Medicine, Mallinckrodt Institute of Radiology, Division of Nuclear Medicine, United States
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