An update on the role of PET/CT and PET/MRI in ovarian cancer

This review article summarizes the role of PET/CT and PET/MRI in ovarian cancer. With regard to the diagnosis of ovarian cancer, the presence of FDG uptake within the ovary of a postmenopausal woman raises the concern for ovarian cancer. Multiple studies show that FDG PET/CT can detect lymph node and distant metastasis in ovarian cancer with high accuracy and may, therefore, alter the management to obtain better clinical outcomes. Although PET/CT staging is superior for N and M staging of ovarian cancer, its role is limited for T staging. Additionally, FDG PET/CT is of great benefit in evaluating treatment response and has prognostic value in patients with ovarian cancer. FDG PET/CT also has value to detect recurrent disease, particularly in patients with elevated serum CA-125 levels and negative or inconclusive conventional imaging test results. PET/MRI may beneficial for tumor staging because MRI has higher soft tissue contrast and no ionizing radiation exposure compared to CT. Some non-FDG PET radiotracers such as ¹⁸F-fluorothymidine (FLT) or ¹¹C-methionine (MET) have been studied in preclinical and clinical studies as well and may play a role in the evaluation of patients with ovarian cancer.     

Riluzole in augmentation of fluvoxamine for moderate to severe obsessive–compulsive disorder: Randomized,double‐blind,placebo‐controlled study

Aim

The aim of the present randomized, double‐blind, placebo‐controlled, 8‐week trial was to assess the efficacy and tolerability of riluzole augmentation of fluvoxamine in treatment of patients with moderate to severe obsessive–compulsive disorder.

Methods

Patients were randomized into two parallel groups to receive fluvoxamine plus placebo or fluvoxamine plus riluzole (50 mg twice daily). All patients, regardless of their treatment group, received fluvoxamine at 100 mg/day for the initial 4 weeks of the study followed by 200 mg/day of fluvoxamine for the rest of the trial course. A total of 50 patients (25 in each group) were evaluated for response to treatment using the Yale–Brown Obsessive Compulsive Scale (Y‐BOCS) at baseline and at weeks 4, 8 and 10. Side‐effects were recorded using predesigned checklists in each visit. Repeated‐measure analysis of variance showed a significant effect for time × treatment interaction in the Y‐BOCS total score and a significant effect for time × treatment interaction in the Y‐BOCS Compulsive subscale score between the two groups.

Results

Repeated‐measure analysis of variance showed a significant effect for time × treatment interaction (Greenhouse–Geisser corrected: F = 4.07, d.f. = 1.22, P = 0.04) in the Y‐BOCS total score and a significant effect for time × treatment interaction (Greenhouse–Geisser corrected: F = 4.45, d.f. = 1.33, P = 0.028) in the Y‐BOCS Compulsive subscale score between the two groups. Riluzole augmentation therapy demonstrated higher, partial or complete treatment response according to the Y‐BOCS total scores.

Conclusion

Riluzole may be of clinical use as an adjuvant agent to fluvoxamine in treatment of moderate to severe obsessive–compulsive disorder.     

Proceedings of the World Molecular Imaging Congress 2019, Montreal Quebec,Canada September 4-7, 2019: General Abstracts

Molecular Imaging and Biology - The applications of 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography/X-ray computed tomography (PET/CT) in the management of patients with breast cancer...     

Evolving Role of Molecular Imaging with <Superscript>18</Superscript>F-Sodium Fluoride PET as a Biomarker for Calcium Metabolism

¹⁸F-sodium fluoride (NaF) as an imaging tracer portrays calcium metabolic activity either in the osseous structures or in soft tissue. Currently, clinical use of NaF-PET is confined to detecting metastasis to the bone, but this approach reveals indirect evidence for disease activity and will have limited use in the future in favor of more direct approaches that visualize cancer cells in the read marrow where they reside. This has proven to be the case with FDG-PET imaging in most cancers. However, a variety of studies support the application of NaF-PET to assess benign osseous diseases. In particular, bone turnover can be measured from NaF uptake to diagnose osteoporosis. Several studies have evaluated the efficacy of bisphosphonates and their lasting effects as treatment for osteoporosis using bone turnover measured by NaF-PET. Additionally, NaF uptake in vessels tracks calcification in the plaques at the molecular level, which is relevant to coronary artery disease. Also, NaF-PET imaging of diseased joints is able to project disease progression in osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. Further studies suggest potential use of NaF-PET in domains such as back pain, osteosarcoma, stress-related fracture, and bisphosphonate-induced osteonecrosis of the jaw. The critical role of NaF-PET in disease detection and characterization of many musculoskeletal disorders has been clearly demonstrated in the literature, and these methods will become more widespread in the future. The data from PET imaging are quantitative in nature, and as such, it adds a major dimension to assessing disease activity.