Diagnostic accuracy of <Superscript>18</Superscript>F-fluorodeoxyglucose positron emission tomography/computed tomography in differentiated thyroid cancer patients with elevated thyroglobulin and negative <Superscript>131</Superscript>I whole body scan: evaluation by thyroglobulin level

Background  

To evaluate the diagnostic accuracy of ¹⁸F-FDG PET/CT in detection of recurrent differentiated thyroid cancer (DTC) in patients with elevated stimulated thyroglobulin (Tg) or anti-Tg antibody (Ab) levels, and negative ¹³¹I whole body scan according to the Tg level.     

Implementation of the European multicentre database of healthy controls for [<Superscript>123</Superscript>I]FP-CIT SPECT increases diagnostic accuracy in patients with clinically uncertain parkinsonian syndromes

Purpose

Even though [¹²³I]FP-CIT SPECT provides high accuracy in detecting nigrostriatal cell loss in neurodegenerative parkinsonian syndromes (PS), some patients with an inconclusive diagnosis remain. We investigated whether the diagnostic accuracy in patients with clinically uncertain PS with previously inconclusive findings can be improved by the use of iterative reconstruction algorithms and an improved semiquantitative evaluation which additionally implemented a correction algorithm for patient age and gamma camera dependency (EARL-BRASS; Hermes Medical Solutions, Sweden).

Methods

We identified 101 patients with inconclusive findings who underwent an [¹²³I]FP-CIT SPECT between 2003 and 2010 as part of the diagnostic process of suspected PS at the University of Munich, and re-evaluated these scans using iterative reconstruction algorithms and the new corrected EARL-BRASS. Clinical follow-up was obtained in 62 out of the 101 patients and constituted the gold standard for the re-evaluation to assess the possible improvement in diagnostic accuracy.

Results

Clinical follow-up confirmed the diagnosis of PS in 11 of the 62 patients. In patients in whom both visual and semiquantitative analysis showed concordant findings (48 patients), a high negative predictive value (93 %), positive predictive value (100 %) and accuracy (94 %) were found, and thus a correct diagnosis was obtained in 45 of the 48 patients. Among the 14 patients with discordant findings, the additional semiquantitative analysis correctly identified all five of nine patients patients without PS by nonpathological semiquantitative findings in visually pathological or inconclusive scans. In contrast, four of the remaining five patients with decreased semiquantitative values but visually normal scans did not show a PS during follow-up.

Conclusion

The age-corrected and camera-corrected mode of evaluation using EARL-BRASS provided a notable improvement in the diagnostic accuracy of [¹²³I]FP-CIT SPECT in PS patients with previously inconclusive findings. The gain in accuracy might be achieved by better discrimination between physiological low striatal [¹²³I]FP-CIT binding due to age-related loss of the dopamine transporter or pathological loss of binding.

     

Detection of bone metastases in patients with lung cancer: <Superscript>99m</Superscript>Tc-MDP planar bone scintigraphy, <Superscript>18</Superscript>F-fluoride PET or <Superscript>18</Superscript>F-FDG PET/CT

Purpose  

The aim of the study was to compare the diagnostic accuracy of ¹⁸F-fluorodeoxyglucose (FDG) PET/CT versus standard planar bone scintigraphy (BS) and ¹⁸F-labelled NaF (¹⁸F) PET for the detection of bone metastases (BM) in non-small cell lung cancer (NSCLC).     

Preclinical characterization of <Superscript>18</Superscript>F-D-FPHCys,a new amino acid-based PET tracer

Purpose  

The imaging potential of a new ¹⁸F-labelled methionine derivative, S-(3-[¹⁸F]fluoropropyl)-d-homocysteine (¹⁸F-D-FPHCys), and its selectivity for amino acid transporter subtypes were investigated in vitro and by imaging of human tumour xenografts.     

Double-phase <Superscript>131</Superscript>I whole body scan and <Superscript>131</Superscript>I SPECT-CT images in patients with differentiated thyroid cancer: their effectiveness for accurate identification

Objective  

This study aims to determine whether a ¹³¹I double-phase whole body scan (WBS) and SPECT-CT images have added value over a single-phase WBS image in identifying benign and malignant lesions in patients with well-differentiated thyroid cancer (DTC) at their first radioactive iodine (RAI) treatment.     

Age-related effects and gender differences in Japanese healthy controls for [<Superscript>123</Superscript>I] FP-CIT SPECT

Objective

Dopamine transporter (DAT) imaging with [¹²³I]FP-CIT (DaTSCAN) is a widely used diagnostic tool for Parkinsonism and dementia. Since it was approved by the Japanese Ministry of Health, Labor, and Welfare in 2013, there have been no articles focusing on a Japanese normal population. The aim of this study was to examine the effect of aging and gender on DAT availability in Japanese people.

Methods

SPECT imaging of 30 healthy Japanese controls (17 males, 13 females; range 50–86 years, mean 70 years) was performed. SPECT images were reconstructed using a three-dimensional order subset expectation maximization (OSEM) algorithm with correction of the point spread function and scatter correction, without attenuation correction. The specific binding ratio (SBR) was calculated by DATview software. Statistical analyses were performed using linear regression analysis, analysis of variance, and multiple comparison analysis.

Results

A strong correlation between the SBR and age was observed. The correlation coefficient in males and females were ?0.566 and ?0.502, respectively. The analysis of variance revealed that aging led to a decline of the SBR, and a significant difference (p?=?0.005) was observed among generations. Gender also affected the SBR, and there was a significant difference between males and females (p?=?0.036). The SBR in females was higher than in males. Consequently, the multiple comparison revealed a significant difference between 50s and 70s (p?=?0.015) and 50s and 80s (p?=?0.006).

Conclusions

This is the first [¹²³I]FP-CIT SPECT study on subjects with normal dopamine function in Asian countries. This study provides a database of [¹²³I]FP-CIT SPECT in Japanese healthy controls. Higher DAT availability was found in women than in men. An average age-related decline in DAT availability of 8.9% was found in both genders. The data collected in this study would be helpful for Japanese physicians to make a differential diagnosis in Parkinsonian syndrome.The registration identification number for this study is UMIN000018045.

     

The comparison of <Superscript>131</Superscript>I whole-body scans on the third and tenth day after <Superscript>131</Superscript>I therapy in patients with well-differentiated thyroid cancer: preliminary report

Objective  

The purpose of the present study was to evaluate the clinical usefulness of the delayed post-therapeutic ¹³¹I scan in patients with well-differentiated thyroid cancer by comparing the early scanned images with the delayed images.     

Reliability of striatal [<Superscript>11</Superscript>C]raclopride binding in smokers wearing transdermal nicotine patches

Purpose  

In studies where [¹¹C]raclopride (RAC) positron emission tomography (PET) is used to assess changes in striatal dopamine, it is important to control for cognitive states, such as drug craving, that could alter dopamine levels. In cigarette smokers, transdermal nicotine patches (TNP) can control nicotine craving, but the effects of nicotine patches on RAC binding are unknown. Thus, we sought to determine the test-retest reliability of RAC binding in the presence of nicotine patches.     

A meta-analysis of <Superscript>18</Superscript>FDG-PET,MRI and bone scintigraphy for diagnosis of bone metastases in patients with breast cancer

Objective  

To perform a meta-analysis comparing the diagnostic value of ¹⁸FDG-PET, MRI, and bone scintigraphy (BS) in detecting bone metastases in patients with breast cancer.     

Effect of the positron range of <Superscript>18</Superscript>F, <Superscript>68</Superscript>Ga and <Superscript>124</Superscript>I on PET/CT in lung-equivalent materials

Purpose  

The aim of this study was to investigate the effect of positron range on visualization and quantification in ¹⁸F, ⁶⁸Ga and ¹²⁴I positron emission tomography (PET)/CT of lung-like tissue.     

Comparison of parameters of <Superscript>123</Superscript>I-metaiodobenzylguanidine scintigraphy for differential diagnosis in patients with parkinsonism: correlation with clinical features

Objectives  

The purpose of this study was to estimate the diagnostic accuracy of ¹²³I-metaiodobenzylguanidine (MIBG) scintigraphy to diagnose Lewy body disease (LBD), including Parkinson’s disease (PD) and dementia with Lewy bodies, and to clarify the relationship between MIBG parameters and the clinical findings.     

Dopamine transporter density of basal ganglia assessed with [<Superscript>123</Superscript>I]IPT SPET in obsessive-compulsive disorder

It has been suggested that dopamine, as well as serotonin, is associated with the pathophysiology of obsessive-compulsive disorder (OCD). Thus, many studies have been performed on brain regions associated with dopamine in patients with OCD. In the present study, we investigated the DAT density of the basal ganglia using iodine-123 labelled N-(3-iodopropen-2-yl)-2-carbomethoxy-3-(4-chlorophenyl) tropane ([¹²³I]IPT) single-photon emission tomography (SPET) and evaluated the activity of the presynaptic dopamine function in patients with OCD. Fifteen patients with OCD and 19 normal control adults were included in the study. We performed brain SPET 2 h after the intravenous administration of [¹²³I]IPT and carried out both quantitative and qualitative analyses using the obtained SPET data, which were reconstructed for the assessment of the specific/non-specific dopamine transporter (DAT) binding ratio in the basal ganglia. We then investigated the correlation between the severity scores of OCD symptoms assessed with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the specific/non-specific DAT binding ratio of the basal ganglia. Compared with normal control adults, patients with OCD showed a significantly increased specific/non-specific DAT binding ratio in the right basal ganglia and a tendency towards an increased specific/non-specific DAT binding ratio in the left basal ganglia. No significant correlation was found between the total scores on the Y-BOCS and the specific/non-specific DAT binding ratio of the basal ganglia. These findings suggest that the dopaminergic neurotransmitter system of the basal ganglia in patients with OCD could be involved in the pathophysiology of OCD.     

Effects of therapy with [<Superscript>177</Superscript>Lu-DOTA<Superscript>0</Superscript>,Tyr<Superscript>3</Superscript>]octreotate on endocrine function

Purpose  

Peptide receptor radionuclide therapy (PRRT) with radiolabelled somatostatin analogues is a novel therapy for patients with somatostatin receptor-positive tumours. We determined the effects of PRRT with [¹⁷⁷Lu-DOTA⁰,Tyr³]octreotate (¹⁷⁷Lu-octreotate) on glucose homeostasis and the pituitary-gonadal, pituitary-thyroid and pituitary-adrenal axes.     

Combined therapy with <Superscript>131</Superscript>I and retinoic acid in Korean patients with radioiodine-refractory papillary thyroid cancer

Purpose  

The aim of this study was to assess the clinical outcome of redifferentiation therapy using retinoic acid (RA) in combination with ¹³¹I therapy, and to identify biological parameters that predict therapeutic response in Korean patients with radioiodine-refractory papillary thyroid carcinoma (PTC).     

<Superscript>18</Superscript>F-FDG PET independently predicts survival in patients with cholangiocellular carcinoma treated with <Superscript>90</Superscript>Y microspheres

Purpose  

⁹⁰Y radioembolization has emerged as a valuable therapy for intrahepatic cholangiocellular carcinomas (ICC). We aimed to evaluate the prognostic power of FDG PET/CT and that of pretherapeutic scintigraphy with ^99mTc-labelled macroagglutinated albumin (MAA), an index of tumour vascularization.     

PET imaging of hepatocellular carcinoma with <Superscript>18</Superscript>F-fluoroethylcholine and <Superscript>11</Superscript>C-choline

Purpose  

Choline-based radiotracers have been studied for PET imaging of hepatocellular carcinoma (HCC). Using an ¹⁸F-labeled choline analog, instead of the ¹¹C-labeled native choline, would facilitate its widespread use in the clinic. In this study, PET with ¹⁸F-fluoroethylcholine (FEC) and ¹¹C-choline (CHOL) were compared using an animal model of HCC. The effects of fasting on the performance of choline-based tracers were also investigated.     

<Superscript>177</Superscript>Lu-immunotherapy of experimental peritoneal carcinomatosis shows comparable effectiveness to <Superscript>213</Superscript>Bi-immunotherapy,but causes toxicity not observed with <Superscript>213</Superscript>Bi

Purpose  

²¹³Bi-d9MAb-immunoconjugates targeting gastric cancer cells have effectively cured peritoneal carcinomatosis in a nude mouse model following intraperitoneal injection. Because the β-emitter ¹⁷⁷Lu has proven to be beneficial in targeted therapy, ¹⁷⁷Lu-d9MAb was investigated in this study in order to compare its therapeutic efficacy and toxicity with those of ²¹³Bi-d9MAb.     

Exhalation of <Superscript>131</Superscript>I after radioiodine therapy: measurements in exhaled air

Purpose  

A considerable amount of radioiodine is exhaled after radioiodine therapy leading to unwanted radiation exposure through inhalation. This study focused on the concentration of radioactivity exhaled and its chemical nature.     

<Superscript>123</Superscript>I-MIBG scintigraphy/SPECT versus <Superscript>18</Superscript>F-FDG PET in paediatric neuroblastoma

Purpose  

To analyse different uptake patterns in ¹²³I-MIBG scintigraphy/SPECT imaging and ¹⁸F-FDG PET in paediatric neuroblastoma patients.     

<Superscript>18</Superscript>F-FDG PET/CT for detection and localization of residual or recurrent disease in patients with multiple myeloma after stem cell transplantation

Purpose  

The aim of the study was to determine the diagnostic performance of ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT for the detection and localization of residual or recurrent disease in patients with multiple myeloma (MM) after stem cell transplantation.