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1.
Dalton A. dos Anjos Angelita Habr-Gama Bruna B. Vailati Cecilia B. Rossi Adelina E. Coturel Rodrigo O. Perez Guilherme P. São Julião João B. de Sousa Carlos A. Buchpiguel 《Annals of nuclear medicine》2016,30(8):513-517
Purpose
PET/CT has been considered limited for the evaluation of mucinous colorectal tumors due to low 18F-FDG uptake. The aim of our study was to compare PET/CT variables in mucinous (MC) and nonmucinous (NMC) rectal adenocarcinomas.Methods
Consecutive patients with cT2-4N0-2M0 rectal cancer included in a prospective clinical trial were reviewed. PET/CT was performed for primary baseline staging. Visual and quantitative analysis included SUVmax and SUVmean, metabolic tumor volume (MTV) and total lesion glycolysis (TLG). PET/CT parameters were compared according to histological subtypes.Results
Overall, 73 patients were included (18 mucinous and 55 nonmucinous). SUVmax values were similar between MC and NMC (19.7 vs. 16.6; p = 0.5). MTV and TLG values were greater in the MC group (103.9 vs. 54.1; p = 0.007 and 892.5 vs. 358.8; p = 0.020) due to larger tumor volumes of MC.Conclusions
Metabolic parameters at baseline PET/CT for patients with rectal cancer are similar in mucinous and nonmucinous histological subtypes.2.
Kazuhiro Kitajima Kazuhito Fukushima Yasuo Miyoshi Takayuki Katsuura Yoko Igarashi Yusuke Kawanaka Miya Mouri Kaoru Maruyama Toshiko Yamano Hiroshi Doi Koichiro Yamakado Seiichi Hirota Shozo Hirota 《Japanese journal of radiology》2016,34(3):220-228
Purpose
To investigate the diagnostic and prognostic value of 18F-FDG-PET/CT for axillary lymph node (LN) staging in breast cancer patients, employing histologic evaluation as the reference.Methods
Among 196 patients with biopsy-proven breast cancer who had undergone 18F-FDG-PET/CT before mastectomy or breast-conserving surgery with sentinel LN biopsy and/or axillary LN dissection, 200 axillae were retrospectively analyzed by visual assessment and quantitatively using SUVmax. LN SUVmax as well as other clinicopathological features were assessed for their prognostic value using the log-rank test and Cox method.Results
Metastasis was diagnosed histopathologically in 56 (28 %) axillae. The sensitivity, specificity, and accuracy of visual PET/CT for diagnosing node metastasis were 55.4, 95.8, and 84.5 %, respectively. When the optimal discriminative SUVmax cutoff was 1.5, these figures were 51.8, 97.2, and 84.5 %, respectively. Fourteen of 55 patients (25.5 %) with LN metastases suffered a recurrence during follow-up (median 39 months). Patients with a high nodal SUVmax (≥1.7) had a significantly lower progression-free survival rate than those with a low SUVmax (p = 0.0499). Axillary nodal and primary tumor SUVmax as well as estrogen receptor status were significantly associated with recurrence.Conclusion
Axillary nodal SUVmax may be a prognostic indicator of disease recurrence in patients with axillary LN metastases.3.
Shuai Liu Hao Wen Zhaoxia Jiang Herong Pan Lei Zhang Xingzhu Ju Xiaojun Chen Xiaohua Wu 《Japanese journal of radiology》2018,36(9):544-550
Purpose
This study aimed to explore the clinical and prognostic significance of 18F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) in epithelial ovarian cancer (EOC).Methods
We retrospectively investigated 48 EOC patients who underwent preoperative 18F-FDG PET/CT and primary cytoreductive surgery at our hospital between January 2010 and June 2015. None of these patients received neoadjuvant chemotherapy. PET/CT parameters including the maximum and average standardized uptake value (SUVmax, SUVavg), the metabolic tumor volume (MTV) were measured. Tumor proliferation marker Ki67 was evaluated using immunohistochemistry. The relationships between the PET/CT parameters and chemosensitivity, tumor proliferation, and overall survival (OS) were analyzed, respectively.Results
The median (range) SUVmax, SUVavg, and MTV values were 11.42 (3.14–20.20), 4.8 (2.55–9.47), and 150.11 (0.19–792.46), respectively. Overall, 93.8% (45/48) of patients had high-grade serous ovarian cancer. The SUVmax value had a positive correlation with the Ki67 index (P?=?0.030, r?=?0.314), and a higher SUVmax level was associated with chemosensitivity (P?=?0.026). However, neither SUVavg nor MTV had associations with the patients’ clinicopathological parameters. None of these three PET/CT parameters were found to be potential predictors of OS.Conclusions
Preoperative 18F-FDG PET/CT had a predictive value on chemosensitivity and proliferation after primary debulking surgery in EOC patients noninvasively.4.
Purpose
To evaluate the diagnostic potential of whole-body PET/CT using a 68Ga-labelled PSMA ligand in renal cell carcinoma (RCC).Methods
Six patients with histopathologically proven RCC underwent 68Ga-PSMA PET/CT. Each PET/CT scan was evaluated in relation to lesion count, location and dignity. SUVmax was measured in primary tumours and PET-positive metastases. Tumour-to-background SUVmax ratios (TBRSUVmax) were calculated for primary RCCs in relation to the surrounding normal renal parenchyma. Metastasis-to-background SUVmax ratios (MBRSUVmax) were calculated for PET-positive metastases in relation to gluteal muscle.Results
Five primary RCCs and 16 metastases were evaluated. The mean SUVmax of the primary RCCs was 9.9?±?9.2 (range 1.7?–?27.2). Due to high uptake in the surrounding renal parenchyma, the mean TBRSUVmax of the primary RCCs was only 0.2?±?0.3 (range 0.02?–?0.7). Eight metastases showed focal 68Ga-PSMA uptake (SUVmax 9.9?±?8.3, range 3.4?–?25.6). The mean MBRSUVmax of these PET-positive metastases was 11.7?±?0.2 (range 4.4?–?28.1). All PET-negative metastases were subcentimetre lung metastases.Conclusion
68Ga-PSMA PET/CT appears to be a promising method for detecting RCC metastases. However, no additional diagnostic value in assessing the primary tumour was found.5.
Kyoung Sook Won Du Hwan Kim Duk Hyun Sung Bong-Il Song Hae Won Kim Kwang-Soon Song Si-Wook Lee Chul-Hyun Cho 《Annals of nuclear medicine》2017,31(3):211-217
Objective
Because positron emission tomography/computed tomography (PET/CT) using fluorine-18-fluorodeoxyglucose (18F-FDG) can be used to visualize inflammation of the musculoskeletal system, it may help elucidate the pathophysiology of frozen shoulder (FS). The purpose of this study was to characterize the uptake pattern on 18F-FDG PET/CT in patients with idiopathic FS and to determine if there is a correlation between its metabolic parameters and clinical findings.Methods
18F-FDG PET/CT was conducted to 35 patients with unilateral idiopathic FS. Clinical data including pain, functional scores, and passive range of motion (ROM) were collected. Maximum standardized uptake values (SUVmax) were measured at the four regions of interest (ROIs): rotator interval (RI), anterior joint capsule (AJC), axillary recess (AR), and posterior joint capsule (PJC) from the attenuation-corrected axial images.Results
Mean SUVmax values for four ROIs of the affected shoulder were significantly higher than those of the unaffected shoulder. Mean SUVmax values of RI and AR were significantly higher than those of AJC and PJC and mean SUVmax of AJC was significantly higher than that of PJC in the affected side. Three recognizable patterns of increased uptake were noted: (1) AR dominant type (15 patients); (2) RI dominant type (9 patients); (3) both RI and AR dominant type (11 patients). The SUVmax of AR showed negative correlation with abduction and forward flexion. The SUVmax of RI showed negative correlation with external rotation and internal rotation. The SUVmax of AJC showed negative correlation with all ROMs. However, there was no significant correlation between the SUVmax of PJC and any ROM.Conclusion
Our study demonstrates that the anterior–inferior capsular portion, including RI and AR, is the main pathologic site of idiopathic FS and reveals significant correlations between ROM and metabolic parameters on 18F-FDG PET/CT. These results imply that AR and RI lesions are related to elevational limitations and rotational limitations, respectively.6.
Soyoung Kim Young Tae Kim Sunghoon Kim Sang Wun Kim Jung-Yun Lee Won Jun Kang 《Nuclear Medicine and Molecular Imaging》2018,52(6):445-452
Purpose
This study aimed to compare the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) and magnetic resonance imaging (MRI) in the preoperative evaluation of uterine carcinosarcoma.Methods
Fifty-four women with pathologically confirmed uterine carcinosarcoma who underwent preoperative FDG PET/CT and MRI from June 2006 to November 2016 were included. Pathologic findings from primary tumor lesions, para-aortic and pelvic lymph node (LN) areas, and peritoneal seeding lesions were compared with the FDG PET/CT and MRI findings. The maximum standardized uptake value (SUVmax) of the primary tumor and LN was obtained. The tumor-to-liver ratio (TLR) was calculated by dividing the SUVmax of the primary tumor or LN by the mean SUV of the liver.Results
For detecting primary tumor lesions (n?=?54), the sensitivity and accuracy of FDG PET/CT (53/54) and MRI (53/54) were 98.2%. The sensitivity, specificity, and accuracy of FDG PET/CT versus MRI were as follows: 63.2% (12/19) versus 26.3% (5/19), 100% (35/35) versus 100% (35/35), and 87.0% versus 74.0%, respectively, for pelvic LN areas (p?=?0.016); 85.7% (12/14) versus 42.9% (6/14), 90% (36/40) versus 97.5% (39/40), and 88.9% versus 83.3%, respectively, for para-aortic LN areas (p?=?0.004); and 59.4% (19/32) versus 50% (16/32), 100% (22/22) versus 100% (22/22), and 75.9% versus 70.4%, respectively, for peritoneal seeding lesions (p?=?0.250). For distant metastasis, the sensitivity, specificity, and accuracy of FDG PET/CT were 100 (8/8), 97.8 (45/46), and 98.2%, respectively.Conclusions
FDG PET/CT showed superior diagnostic accuracy compared to MRI in detecting pelvic and para-aortic LN metastasis in patients with uterine carcinosarcoma. Moreover, FDG PET/CT facilitated the identification of distant metastasis.7.
Jongtae Cha Soyoung Kim Jiyoung Wang Mijin Yun Arthur Cho 《Nuclear Medicine and Molecular Imaging》2018,52(1):39-45
Purpose
The purpose of this study was to investigate the value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) parameters in the detection of regional lymph node (LN) metastasis in patients with cutaneous melanoma.Methods
We evaluated patients with cutaneous melanoma who underwent FDG PET/CT for initial staging or recurrence evaluation. A total of 103 patients were enrolled, and 165 LNs were evaluated. LNs that were confirmed pathologically or by follow-up imaging were included in this study. PET parameters, including maximum standardized uptake value (SUVmax), total lesion glycolysis and tumour-to-liver ratio, were used to determine the presence of metastases, and the results were compared with CT-determined LN metastasis. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off values of the FDG PET parameters.Results
A total of 93 LNs were malignant, and 84 LNs were smaller than 10 mm. In all 165 LNs, an SUVmax of >2.51 showed a sensitivity of 73.1%, a specificity of 88.9%, and an accuracy of 80.0% in detecting metastatic LNs. CT showed a higher specificity (87.3%) and lower accuracy (65.5%). For non-enlarged regional LNs (<10 mm), an SUVmax cut-off value of 1.4 showed the highest negative predictive value (81.3%). For enlarged LNs (≥10 mm), an SUVmax cut-off value of 2.4 showed the highest sensitivity (90.7%) and accuracy (88.9%) in detecting metastatic LNs.Conclusions
In patients with cutaneous melanoma, an SUVmax of >2.4 showed a high sensitivity (91%) and accuracy (89%) in detecting metastasis in LNs ≥1 cm, and LNs <1 cm with an SUVmax <1.4 were likely to be benign.8.
Anna Ringheim Guilherme de Carvalho Campos Neto Karine Minaif Martins Taise Vitor Marcelo Livorsi da Cunha Ronaldo Hueb Baroni 《Annals of nuclear medicine》2018,32(8):523-531
Objective
Positron emission tomography in association with magnetic resonance imaging (PET/MR) and 68Ga-PSMA-11 has shown superior detection in recurrent prostate cancer patients as compared to PET/computed tomography (PET/CT). There are, however, several technological differences between PET/CT and PET/MR systems which affect the PET image quality. The objective of this study was to assess the reproducibility of PET/CT and PET/MR SUV’s in recurrent prostate cancer patients. We randomized the patients regarding the order of the PET/CT and PET/MR scans to reduce the influence of tracer uptake as a function of time.Methods
Thirty patients, all with biochemical recurrence after radical prostatectomy, underwent whole-body PET/CT and PET/MR scans after intravenous injection of a single dose of 68Ga-PSMA-11. Fifteen patients underwent PET/CT first and 15 patients underwent PET/MR first. Volumes of interest on tumor lesions were outlined and maximum standardized uptake value (SUVmax) corrected for lean body mass was calculated. Correlation and agreement between scans were assessed by generalized linear mixed-effects models and Bland–Altman analysis. The association between SUV, patient characteristics and imaging parameters was assessed.Results
Eighteen of the 30 evaluated patients had at least one positive lesion, giving an overall detection rate of 60%. In total, there were 34 visible lesions: 5 local recurrences, 22 lymph node metastases and 7 bone metastases. One group acquired PET/CT and PET/MR at median time points of 63.0 and 159.0 min, while the other group acquired PET/MR and PET/CT at median time points of 92.0 and 149.0 min. SUVmax between scans was linearly correlated, described by the equation Y(PET/CT SUVmax)?=?0.75?+?1.00?×?(PET/MR SUVmax), on average 20% higher on PET/CT than on PET/MR. SUV associated significantly only with type of lesion, scan time post-injection and acquisition time per bed position.Conclusions
SUVmax from PET/CT and PET/MR are linearly correlated, on average 20% higher on PET/CT than on PET/MR and should, therefore, not be used interchangeably in patient follow-up.9.
Purpose
We aimed at evaluating the role of 68Ga-PSMA-11 PET/CT-derived metabolic parameters for assessment of whole-body tumor burden and its capability to determine therapeutic response in patients with prostate cancer.Methods
A total of 142 patients with biochemical recurrence of prostate cancer underwent PET/CT with [68Ga]Ga-PSMA-HBED-CC (68Ga-PSMA-11). Quantitative assessment of all 641 68Ga-PSMA-11-positive lesions in the field of view was performed to calculate PSMA-derived parameters, including whole-body PSMA tumor volume (PSMA-TV) and whole-body total lesion PSMA (TL-PSMA), as well as the established SUVmax and SUVmean values. All PET-derived parameters were tested for correlation with serum PSA levels and for association with Gleason scores.In 23 patients who underwent 68Ga-PSMA-11 PET/CT before and after therapy with either external beam radiation, androgen deprivation, or docetaxel chemotherapy, SUVmax and TL-PSMA were compared to radiographic response assessment of CT images based on RECIST 1.1 criteria and to biochemical response determined by changes of serum PSA levels.Results
PSMA-TV and TL-PSMA demonstrated a significant correlation with serum PSA levels (P?<?0.0001) and TL-PSMA was significantly different for different Gleason scores. The agreement rate between TL-PSMA derived from PET and biochemical response was 87% (95% confidence interval, 0.66–0.97; Cohen’s κ?=?0.78; P?< 0.01) and, thus, higher than for SUVmax, which was 74% (95% CI, 0.52–0.90; κ?=?0.55; P?< 0.01). Furthermore, agreement with PSA was higher for TL-PSMA and SUVmax than for CT-based response evaluation. Discordant findings between PET and CT were most likely due to limitations of CT and RECIST in rating small lymph nodes as metastases, as well as bone involvement, which was sometimes not detectable in CT.Conclusion
68Ga-PSMA-11 PET/CT-derived metabolic tumor parameters showed promising results for evaluation of treatment response. Especially, TL-PSMA demonstrated higher agreement rates with biochemical response compared to SUVmax. Larger, ideally prospective trials are needed to help to reveal the full potential of metabolic parameters derived from PET imaging with 68Ga-PSMA-11.10.
Carsten-Oliver Sahlmann Birgit Meller Caroline Bouter Christian Oliver Ritter Philipp Ströbel Joachim Lotz Lutz Trojan Johannes Meller Sameh Hijazi 《European journal of nuclear medicine and molecular imaging》2016,43(5):898-905
Purpose
Binding of 68Ga-PSMA-HBED-CC (68Ga-PSMA) at prostate cancer (PC) cells increases over time. A biphasic protocol may help separating benign from tumor lesions. The aim of this study was the retrospective evaluation of a diagnostic incremental value of a dual-time point (biphasic) 68Ga-PSMA-PET/CT in patients with prostate cancer.Methods
Retrospective analysis of 35 consecutive patients (49–78 years, median 71) with newly diagnosed PC (12/35) or recurrence of PC (23/35). PET/CT (Gemini TF16, Philips) was acquired 1 h and 3 h p. i. of 140–392 MBq (300 MBq median) 68Ga-PSMA, followed by a diagnostic contrast CT. PET findings were correlated with histology or unequivocal CT findings. Semiquantitative PET data (SUVmax, SUV mean) were acquired and target-to-background-ratios (T/B-ratio) were calculated for benign and malign lesions for both time points. Size of lymph nodes (LN) on diagnostic CT was recorded. Statistical analysis was performed for assessment of significant changes of semiquantitative PET-parameters over time and for correlation of size and uptake of lymph nodes.Results
One hundred and four lesions were evaluated. Sixty lesions were referenced by histology or unequivocal CT findings, including eight (13.3 %) histopathologically benign lymph nodes, 12 (20 %) histopathologically lymph node metastases, 12 (20 %) primary tumors, three (5 %) local recurrences, and 25 (41.7 %) bone metastases. Forty-four lesions were axillary LN with normal CT-appearance. Benign lesions had significantly lower SUVmax and T/B-ratios compared with malignant findings. Malign lesions showed a significant increase of both parameters over time compared to benign findings. There was no correlation between LN size and SUVmax. The sensitivity, specificity, the positive predictive value and negative predictive value of PET/CT regarding pelvic LN was 94 %, 99 %, 89 %, and 99.5 %, respectively.Conclusions
In contrast to benign tissues, the uptake of proven tumor lesions increases on 68Ga-PSMA-PET/CT over time. A biphasic PET-study may lead to a better detection of tumor lesions in unequivocal findings.11.
Objectives
To compare the diagnostic performance of 68Ga-DOTATOC PET/MRI and 68Ga-DOTATOC PET/CT in the whole-body staging of patients with neuroendocrine tumours (NET).Methods
Thirty patients with histopathologically confirmed NET underwent PET/CT and PET/MRI in a single-injection protocol. PET/CT and PET/MRI scans were prospectively evaluated with regard to lesion count, localization, nature (NET/non-NET), and conspicuity (four-point scale). Histopathology and follow-up imaging served as the reference standards. The proportions of NET and non-NET lesions rated correctly were compared using McNemar’s chi-squared test. The Wilcoxon test was used to assess differences in SUVmax and lesion conspicuity. The correlation between the SUVmax for the same lesions from each modality was analysed using Pearson’s correlation coefficient (r).Results
According to the reference standard, there were 197 lesions (142 NET, 55 non-NET). Lesion-based analysis showed a higher proportion of correctly rated NET lesions on PET/MRI than on PET/CT (90.8% vs. 86.7%, p?=?0.031), whereas on PET/CT there was a higher proportion of correctly rated non-NET lesions (94.5% vs. 83.6%, p?=?0.031). SUVmax was strongly correlated (r?=?0.86; p?<?0.001) and did not differ significantly (p?=?0.35) between the modalities. Overall conspicuity and NET lesion conspicuity were higher on PET/MRI (both p?<?0.01).Conclusions
Ga-DOTATOC PET/MRI yielded a higher proportion of correctly rated NET lesions and should be regarded as a valuable alternative to 68Ga-DOTATOC PET/CT in whole-body staging of NET patients.Key Points
? 68 Ga-DOTATOC PET/MRI correctly identified more NET lesions than 68 Ga-DOTATOC PET/CT. ? 68 Ga-DOTATOC PET/MRI provides better NET lesion conspicuity than 68 Ga-DOTATOC PET/CT. ? SUVmax values from the two modalities are strongly correlated and do not differ significantly.12.
X. Palard-Novello S. Querellou M. Gouillou A. Saraux T. Marhadour F. Garrigues R. Abgral P. Y. Salaün V. Devauchelle-Pensec 《European journal of nuclear medicine and molecular imaging》2016,43(4):773-779
Purpose
To evaluate the use of 18F-FDG PET/CT for the assessment of tocilizumab (TCZ) as first-line treatment in patients with polymyalgia rheumatica (PMR).Methods
Patients with PMR were prospectively enrolled in a multicentre clinical trial assessing TCZ therapy (the TENOR trial). The patients underwent FDG PET/CT at baseline, after the first infusion of TCZ (TCZ 1) and after the last infusion of TCZ (TCZ 3). Responses to treatment were evaluated in terms of the PMR activity score (PMR-AS), and the C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) laboratory tests. Maximal standardized uptake value (SUVmax) was used for assessment of FDG uptake in regions usually affected in PMR (spinous processes, hips, shoulders, sternoclavicular region and ischial tuberosities). The Wilcoxon test was applied to evaluate the changes in parameters after the infusions and Spearman’s rank correlation test was applied to assess the correlations between SUVmax and PMR-AS, CRP and ESR.Results
Of 21 patients included in the trial, 18 were evaluated. The median bioclinical parameter values decreased after TCZ 1 (PMR-AS from 38.2 to 15.7, CRP from 65.2 to 0.4 mg/l and ESR from 49 to 6.5 mm; all p?<?0.05) as did the median SUVmax (from 5.8 to 5.2; p?<?0.05). All values also decreased after TCZ 3 (PMR-AS from 38.2 to 3.9, CRP from 65.2 to 0.2, ESR from 49 to 2, and SUVmax from 5.8 to 4.7; p?<?0.05). In a region-based analysis, all SUVmax were significantly reduced after TCZ 3, except the values for the cervical spinous processes and shoulder regions. With regard to correlations, few significant differences were found between ?SUVmax and the other parameters including ?PMR-AS, ?CRP and ?ESR in the patient-based and region-based analysis.Conclusion
FDG uptake decreased significantly but moderately after TCZ therapy in PMR patients, and might reflect disease activity.13.
Objective
To investigate whether machine learning-based analysis of MR radiomics can help improve the performance PI-RADS v2 in clinically relevant prostate cancer (PCa).Methods
This IRB-approved study included 54 patients with PCa undergoing multi-parametric (mp) MRI before prostatectomy. Imaging analysis was performed on 54 tumours, 47 normal peripheral (PZ) and 48 normal transitional (TZ) zone based on histological-radiological correlation. Mp-MRI was scored via PI-RADS, and quantified by measuring radiomic features. Predictive model was developed using a novel support vector machine trained with: (i) radiomics, (ii) PI-RADS scores, (iii) radiomics and PI-RADS scores. Paired comparison was made via ROC analysis.Results
For PCa versus normal TZ, the model trained with radiomics had a significantly higher area under the ROC curve (Az) (0.955 [95% CI 0.923–0.976]) than PI-RADS (Az: 0.878 [0.834–0.914], p?<?0.001). The Az between them was insignificant for PCa versus PZ (0.972 [0.945–0.988] vs. 0.940 [0.905–0.965], p?=?0.097). When radiomics was added, performance of PI-RADS was significantly improved for PCa versus PZ (Az: 0.983 [0.960–0.995]) and PCa versus TZ (Az: 0.968 [0.940–0.985]).Conclusion
Machine learning analysis of MR radiomics can help improve the performance of PI-RADS in clinically relevant PCa.Key Points
? Machine-based analysis of MR radiomics outperformed in TZ cancer against PI-RADS.? Adding MR radiomics significantly improved the performance of PI-RADS.? DKI-derived Dapp and Kapp were two strong markers for the diagnosis of PCa.14.
Background
To report on imaging findings using 68Ga-PSMA-HBED-CC PET in a series of 19 breast carcinoma patients.Methods
68Ga-PSMA-HBED-CC PET imaging results obtained were compared to routinely performed staging examinations and analyzed as to lesion location and progesterone receptor status.Results
Out of 81 tumor lesions identified, 84% were identified on 68Ga-PSMA-HBED-CC PET. 68Ga-PSMA-HBED-CC SUVmean values of distant metastases proved significantly higher (mean, 6.86, SD, 5.68) when compared to those of primary or local recurrences (mean, 2.45, SD, 2.55, p?=?0.04) or involved lymph nodes (mean, 3.18, SD, 1.79, p?=?0.011). SUVmean values of progesterone receptor-positive lesions proved not significantly different from progesterone receptor-negative lesions. SUV values derived from FDG PET/CT, available in seven patients, and 68Ga-PSMA-HBED-CC PET/CT imaging proved weakly correlated (r?=?0.407, p?=?0.015).Conclusions
68Ga-PSMA-HBED-CC PET/CT imaging in breast carcinoma confirms the reported considerable variation of PSMA expression on human solid tumors using immunohistochemistry.15.
Purpose
The incidence of prostate cancer is 60% higher and the mortality rate is two- to three-times greater in black versus white men. We report on differences in 68Ga-PSMA-11 PET/CT imaging findings in 77 black South-African (BSAs) and 18 white South-African (WSAs) treatment-naïve primary prostate carcinoma (PPC) patients.Methods
68Ga-PSMA-11 PET/CT imaging findings were compared to histological, biochemical and morphological imaging data. Patients were grouped into three Gleason grade groups (GG), GG 1 (scores 3 + 3 and 3 + 4), GG2 (scores 4 + 3 and 4 + 4) and GG3 (scores 9 and 10), and the PSA difference among the groups was determined. Inter-racial difference in SUVmax of the primary tumor as well as its correlation with serum PSA were also determined.Results
Ninety-three out of 95 PPC where readily identified on 68Ga-PSMA-11 PET/CT imaging. Median PPC SUVmax and serum PSA values proved significantly higher (p = 0.033 and p = 0.003) in GG3 patients (median 16.4 and 180 ng/ml) when compared to GG1 patients (median 9.6 and 25.1 ng/ml) or GG2 patients (median 8.8 and 46.2 ng/ml). SUVmax significantly correlated with serum PSA-values (r = 0.377 (p = 0.0001)). Age, frequency of lymph node involvement and distant metastases, and GGs (p ≥ 0.153) were similar in BSAs and WSAs, both median serum PSA-values as well as SUVmax values proved significantly higher in BSAs when compared to WSAs, respectively, 81.6 ng/ml versus 14.5 ng/ml (p = 0.0001) and 11.9 versus 4.38 (p = 0.004). Moreover, Gleason-score normalized median SUVmax values proved 2.5 times higher in BSAs when compared to WSAs (p = 0.005).Conclusion
SUVmax values proved significantly related to GG and to be significantly higher in BSAs when compared to WSAs. Also, SUVmax significantly correlated with serum PSA values, which was significantly higher in BSAs when compared with WSAs.16.
Rouaa Beshr Kayako Isohashi Tadashi Watabe Sadahiro Naka Genki Horitsugi Victor Romanov Hiroki Kato Shin-Ichi Miyatake Eku Shimosegawa Jun Hatazawa 《Annals of nuclear medicine》2018,32(10):702-708
Objectives
A previous study reported that a differential diagnosis between glioblastoma progression and radiation necrosis by 4-borono-2-[18F]-fluoro-phenylalanine ([18F]FBPA) PET can be made based on lesion-to-normal ratio of [18F]FBPA accumulation. Two-dimensional data acquisition mode PET alone system, with in-plane resolution of 7.9 mm and axial resolution of 13.9 mm, was used. In the current study, we aimed to confirm the differential diagnostic capability of [18F]FBPA PET/CT with higher PET spatial resolution by three-dimensional visual inspection and by measuring mean standardized uptake value (SUVmean), maximum SUV (SUVmax), metabolic tumor volume (MTV), and total lesion (TL) [18F]FBPA uptake.Methods
Twelve patients of glioma (9), malignant meningioma (1), hemangiopericytoma (1), and metastatic brain tumor (1) were enrolled. All had preceding radiotherapy. High-resolution three-dimensional data acquisition mode PET/CT with in-plane resolution of 4.07 mm and axial resolution of 5.41 mm was employed for imaging. Images were three-dimensionally analyzed using the PMOD software. SUVmean and SUVmax of lesion and normal brain were measured. Lesion MTV and TL FBPA uptake were calculated. The diagnostic accuracy of [18F]FBPA PET/CT in detecting recurrence (n?=?6) or necrosis (n?=?6) was verified by clinical follow-up.Results
All parameters showed significantly higher values for tumor recurrence than for necrosis. SUVmean in recurrence was 2.95?±?0.84 vs 1.18?±?0.24 in necrosis (P?=?0.014); SUVmax in recurrence was 4.63?±?1.23 vs 1.93?±?0.44 in necrosis (P?=?0.014); MTV in recurrence was 44.92?±?28.93 mL vs 10.66?±?8.46 mL in necrosis (P?=?0.032); and mean TL FBPA uptake in recurrence was 121.01?±?50.48 g vs 12.36?±?9.70 g in necrosis (P?=?0.0029).Conclusion
In this preliminary feasibility study, we confirmed the possibility of differentiating tumor recurrence from radiation necrosis in patients with irradiated brain tumors by [18F]FBPA PET/CT using indices of SUVmean, SUVmax, MTV, and TL 18FBPA uptake.17.
Tomomi Nobashi Yuji Nakamoto Takeshi Kubo Takayoshi Ishimori Tomohiro Handa Kiminobu Tanizawa Kohei Sano Michiaki Mishima Kaori Togashi 《Annals of nuclear medicine》2016,30(8):544-552
Objective
This study was designed to compare the clinical efficacy of 68Ga-DOTA-Tyr-octreotide (DOTATOC)-positron emission tomography (PET)/computed tomography (CT) with that of conventional 67Ga-scintigraphy (GS), and to correlate quantitative parameters on DOTATOC-PET/CT with clinical data, in patients with sarcoidosis.Methods
Twenty patients who were histologically and/or clinically diagnosed with sarcoidosis and underwent both DOTATOC-PET/CT and GS were analyzed in this study. The numbers of patients with positive findings for each organ were determined. The total numbers of involved nodal areas in the chest, as determined by DOTATOC-PET and gallium single-photon emission tomography (Ga-SPECT), were compared. The correlations between quantitative parameters on PET and clinical laboratory data were evaluated.Results
DOTATOC-PET/CT was positive in 19 patients, being negative in only one patient with chronic inactive sarcoidosis, whereas GS was positive in 17 patients. DOTATOC-PET/CT visualized more lesions in lymph nodes, uvea, and muscles than did Ga-scintigraphy and identified more involved areas than did GS-SPECT (p < 0.0001). Whole-body active lesion volume showed a significant, but moderate correlation with angiotensin-converting enzyme level (ρ = 0.64, p = 0.0044).Conclusions
PET/CT with DOTATOC may be superior to conventional GS in detecting sarcoidosis lesions, especially in lymph nodes, uvea, and muscles. Volumetric parameters in DOTATOC-PET/CT may be helpful in estimating the activity of sarcoidosis.18.
Paola?Caroli Israel?Sandler Federica?Matteucci Ugo?De?Giorgi Licia?Uccelli Monica?Celli Flavia?Foca Domenico?Barone Antonino?Romeo Anna?Sarnelli Giovanni?Paganelli
Purpose
We studied the usefulness of 68Ga-prostate-specific membrane antigen (PSMA) PET/CT for detecting relapse in a prospective series of patients with biochemical recurrence (BCR) of prostate cancer (PCa) after radical treatment.Methods
Patients with BCR of PCa after radical surgery and/or radiotherapy with or without androgen-deprivation therapy were included in the study. 68Ga-PSMA PET/CT scans performed from the top of the head to the mid-thigh 60 min after intravenous injection of 150?±?50 MBq of 68Ga-PSMA were interpreted by two nuclear medicine physicians. The results were correlated with prostate-specific antigen (PSA) levels at the time of the scan (PSApet), PSA doubling time, Gleason score, tumour stage, postsurgery tumour residue, time from primary therapy to BCR, and patient age. When available, 68Ga-PSMA PET/CT scans were compared with negative 18F-choline PET/CT scans routinely performed up to 1 month previously.Results
From November 2015 to October 2017, 314 PCa patients with BCR were evaluated. Their median age was 70 years (range 44–92 years) and their median PSApet was 0.83 ng/ml (range 0.003–80.0 ng/ml). 68Ga-PSMA PET/CT was positive (one or more suspected PCa lesions detected) in 197 patients (62.7%). Lesions limited to the pelvis, i.e. the prostate/prostate bed and/or pelvic lymph nodes (LNs), were detected in 117 patients (59.4%). At least one distant lesion (LNs, bone, other organs, separately or combined with local lesions) was detected in 80 patients (40.6%). PSApet was higher in PET-positive than in PET-negative patients (P?<?0.0001). Of 88 patients negative on choline PET/CT scans, 59 (67%) were positive on 68Ga-PSMA PET/CT.Conclusion
We confirmed the value of 68Ga-PSMA PET/CT in restaging PCa patients with BCR, highlighting its superior performance and safety compared with choline PET/CT. Higher PSApet was associated with a higher relapse detection rate.19.
Ali Afshar-Oromieh Henrik Hetzheim Wolfgang Kübler Clemens Kratochwil Frederik L. Giesel Thomas A. Hope Matthias Eder Michael Eisenhut Klaus Kopka Uwe Haberkorn 《European journal of nuclear medicine and molecular imaging》2016,43(9):1611-1620
Purpose
The clinical introduction of 68Ga-PSMA-11 (“HBED-CC”) ligand targeting the prostate-specific membrane antigen (PSMA) has been regarded as a significant step forward in the diagnosis of prostate cancer (PCa). In this study, we provide human dosimetry and data on optimal timing of PET imaging after injection.Methods
Four patients with recurrent PCa were referred for 68Ga-PSMA-11 PET/CT. Whole-body PET/CTlow-dose scans were conducted at 5 min, and 1, 2, 3, 4 and 5 h after injection of 152–198 MBq 68Ga-PSMA-11. Organs of moderate to high uptake were used as source organs; their total activity was determined at all measured time points. Time–activity curves were created for each source organ as well as for the remainder. The radiation exposure of a 68Ga-PSMA-11 PET was identified using the OLINDA-EXM software. In addition, tracer uptake was measured in 16 sites of metastases.Results
The highest tracer uptake was observed in the kidneys, liver, upper large intestine, and the urinary bladder. Mean organ doses were: kidneys 0.262?±?0.098 mGy/MBq, liver 0.031?±?0.004 mGy/MBq, upper large intestine 0.054?±?0.041 mGy/MBq, urinary bladder 0.13?±?0.059 mGy/MBq. The calculated mean effective dose was 0.023?±?0.004 mSv/MBq (=0.085?±?0.015 rem/mCi). Most tumor lesions (n?=?16) were visible at 3 h p.i., while at all other time points many were not qualitatively present (10/16 visible at 1 h p.i.).Conclusions
The mean effective dose of a 68Ga-PSMA-11 PET is 0.023 mSv/MBq. A 3-h delay after injection was optimal timing for 68Ga-PSMA-11 PET/CT in this patient cohort.20.