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Muehlberg F, Mohnike K, Grosser OS, Pech M, Goldschmidt J, Smalla KH, Seidensticker R, Ümütlü MR, Deniz S, Ricke J, Steffen IG, Öcal O, Seidensticker M. In vivo evaluation of tumor uptake and bio-distribution of 99mTc-labeled 1-thio-β-D-glucose and 5-thio-D-glucose in mice model. EJNMMI Radiopharm Chem 2024; 9:26. [PMID: 38551764 PMCID: PMC10980667 DOI: 10.1186/s41181-024-00253-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 03/15/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND To investigate the capacity of 99mTc-labeled 1-thio-β-D-glucose (1-TG) and 5-thio-D-glucose (5-TG) to act as a marker for glucose consumption in tumor cells in vivo as well as to evaluate the biodistribution of 1-TG and 5-TG. We investigated the biodistribution, including tumor uptake, of 1-TG and 5-TG at various time points after injection (0.5, 2 and 4 h) in human colorectal carcinoma (HCT-116) and human lung adenocarcinoma (A549) xenograft bearing nude mice (N = 4 per tracer and time point). RESULTS Ex vivo biodistribution studies revealed a moderate uptake with a maximum tumor-to-muscle ratio of 4.22 ± 2.7 and 2.2 ± 1.3 (HCT-116) and of 3.2 ± 1.1 and 4.1 ± 1.3 (A549) for 1-TG and 5-TG, respectively, with a peak at 4 h for 1-TG and 5-TG. Biodistribution revealed a significantly higher uptake compared to blood in kidneys (12.18 ± 8.77 and 12.69 ± 8.93%ID/g at 30 min) and liver (2.6 ± 2.8%ID/g) for 1-TG and in the lung (7.24 ± 4.1%ID/g), liver (6.38 ± 2.94%ID/g), and kidneys (4.71 ± 1.97 and 4.81 ± 1.91%ID/g) for 5-TG. CONCLUSIONS 1-TG and 5-TG showed an insufficient tumor uptake with a moderate tumor-to-muscle ratio, not reaching the levels of commonly used tracer, for diagnostic use in human colorectal carcinoma and human lung adenocarcinoma xenograft model.
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Affiliation(s)
- Fabian Muehlberg
- Department of Cardiology, MSB Medical School Berlin, Hochschule für Gesundheit und Medizin & HELIOS Hospital Berlin-Buch, Berlin, Germany
| | - Konrad Mohnike
- Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
- MVZ DTZ Diagnostisch Therapeutisches Zentrum Am Frankfurter Tor Und MVZ DTZ Diagnostisch Therapeutisches Zentrum Am Onkozentrum Berlin OZB, Berlin, Germany
| | - Oliver S Grosser
- Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
- Research Campus STIMULATE, Otto-Von-Guericke University, Magdeburg, Germany
| | - Maciej Pech
- Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
| | - Juergen Goldschmidt
- Leibniz Institute for Neurobiology, Department of Neurochemistry and Molecular Biology, Magdeburg, Germany
| | - Karl-Heinz Smalla
- Leibniz Institute for Neurobiology, Research Group Neuroplasticity, Magdeburg, Germany
- Institute for Pharmacology and Toxicology, Medical Faculty, Otto-Von-Guericke University, Magdeburg, Germany
- Center for Behavioral Brain Sciences - CBBS, Otto-Von-Guericke-Universität Magdeburg, Magdeburg, Germany
| | | | | | - Sinan Deniz
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Jens Ricke
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Ingo G Steffen
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Nuclear Medicine, Charite Universitätsmedizin Berlin, Berlin, Germany
| | - Osman Öcal
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Max Seidensticker
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany.
- LMU Klinikum München, Klinik Und Poliklinik Für Radiologie, Marchioninistr 15, 81377, Munich, Germany.
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2
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Pakula RJ, Scott PJH. Applications of radiolabeled antibodies in neuroscience and neuro-oncology. J Labelled Comp Radiopharm 2023; 66:269-285. [PMID: 37322805 DOI: 10.1002/jlcr.4049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 05/25/2023] [Accepted: 05/30/2023] [Indexed: 06/17/2023]
Abstract
Positron emission tomography (PET) is a powerful tool in medicine and drug development, allowing for non-invasive imaging and quantitation of biological processes in live organisms. Targets are often probed with small molecules, but antibody-based PET is expanding because of many benefits, including ease of design of new antibodies toward targets, as well as the very strong affinities that can be expected. Application of antibodies to PET imaging of targets in the central nervous system (CNS) is a particularly nascent field, but one with tremendous potential. In this review, we discuss the growth of PET in imaging of CNS targets, present the promises and progress in antibody-based CNS PET, explore challenges faced by the field, and discuss questions that this promising approach will need to answer moving forward for imaging and perhaps even radiotherapy.
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Affiliation(s)
- Ryan J Pakula
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Peter J H Scott
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
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3
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Nahrjou N, Ghosh A, Tanasova M. Targeting of GLUT5 for Transporter-Mediated Drug-Delivery Is Contingent upon Substrate Hydrophilicity. Int J Mol Sci 2021; 22:ijms22105073. [PMID: 34064801 PMCID: PMC8150966 DOI: 10.3390/ijms22105073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 04/28/2021] [Accepted: 05/08/2021] [Indexed: 12/14/2022] Open
Abstract
Specific link between high fructose uptake and cancer development and progression highlighted fructose transporters as potential means to achieve GLUT-mediated discrimination between normal and cancer cells. The gained expression of fructose-specific transporter GLUT5 in various cancers offers a possibility for developing cancer-specific imaging and bioactive agents. Herein, we explore the feasibility of delivering a bioactive agent through cancer-relevant fructose-specific transporter GLUT5. We employed specific targeting of GLUT5 by 2,5-anhydro-D-mannitol and investigated several drug conjugates for their ability to induce cancer-specific cytotoxicity. The proof-of-concept analysis was carried out for conjugates of chlorambucil (CLB) in GLUT5-positive breast cancer cells and normal breast cells. The cytotoxicity of conjugates was assessed over 24 h and 48 h, and significant dependence between cancer-selectivity and conjugate size was observed. The differences were found to relate to the loss of GLUT5-mediated uptake upon increased conjugate size and hydrophobicity. The findings provide information on the substrate tolerance of GLUT5 and highlight the importance of maintaining appropriate hydrophilicity for GLUT-mediated delivery.
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Affiliation(s)
- Nazanin Nahrjou
- Chemistry Department, Michigan Technological University, Houghton, MI 49931, USA; (N.N.); (A.G.)
| | - Avik Ghosh
- Chemistry Department, Michigan Technological University, Houghton, MI 49931, USA; (N.N.); (A.G.)
| | - Marina Tanasova
- Chemistry Department, Michigan Technological University, Houghton, MI 49931, USA; (N.N.); (A.G.)
- Health Research Institute, Michigan Technological University, Houghton, MI 49931, USA
- Correspondence:
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4
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Wahl RL, Hicks RJ. PET Diagnosis and Response Monitoring in Oncology. Mol Imaging 2021. [DOI: 10.1016/b978-0-12-816386-3.00048-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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5
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Yen YA, Wu LC, Lu NM, Lee CH. Pigmented villous nodular synovitis mimicking metastases on 18F-FDG PET/CT in a patient with rectal mucosal melanoma: a case report. BMC Musculoskelet Disord 2020; 21:13. [PMID: 31914975 PMCID: PMC6950986 DOI: 10.1186/s12891-019-3034-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 12/30/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Mucosal melanomas are rare and have a high potential for metastasizing. Surgical resection is the treatment of choice for single distant metastases. Malignant melanoma usually shows the highest uptake of fluorine-18 fluorodeoxyglucose (18F-FDG). 18F- FDG positron emission tomography /computed tomography (PET/CT) is usually used for melanoma staging. An extensive literature review revealed only 4 published case reports and an original paper involving 8 cases (12 cases in total) of patients with skin melanomas in whom pigmented villous nodular synovitis (PVNS) mimicked metastatic melanoma, however, none of the melanomas reported were of rectal mucosal origin. CASE PRESENTATION A 60-year-old woman presented with recent diagnosis of rectal mucosal melanoma, two additional 18F-FDG-avid lesions in the left ankle and left foot were detected on 18F-FDG PET/CT. Metastases were initially suspected; however, the final diagnosis was PVNS. CONCLUSIONS This is the first report of PVNS mimicking metastases on 18F-FDG PET/CT in a patient with rectal mucosal melanoma. Although high 18F-FDG-avid lesions in patients with rectal mucosal melanoma are highly suspected to be metastasis and warrant an meticulous examination, the present case is a reminder that in such patients, not all lesions with high 18F-FDG uptake, especially those near a joint, are metastases and that more extensive resection is unnecessary.
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Affiliation(s)
- Yu-An Yen
- Department of Nuclear Medicine, Chi Mei Medical Center, 901, Zhonghua Rd., Yongkang Dist, Tainan City, 710, Taiwan
| | - Li-Chun Wu
- Department of Nuclear Medicine, Chi Mei Medical Center, 901, Zhonghua Rd., Yongkang Dist, Tainan City, 710, Taiwan
| | - Na-Mi Lu
- Department of Pathology, Liouying Chi Mei Hospital, Tainan, Taiwan
| | - Chiang Hsuan Lee
- Department of Nuclear Medicine, Chi Mei Medical Center, 901, Zhonghua Rd., Yongkang Dist, Tainan City, 710, Taiwan.
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6
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Fann LY, Chen Y, Chu DC, Weng SJ, Chu HC, Wu ATH, Lee JF, Ali AAA, Chen TC, Huang HS, Ma KH. Identification and preclinical evaluation of the small molecule, NSC745887, for treating glioblastomas via suppressing DcR3-associated signaling pathways. Oncotarget 2017; 9:11922-11937. [PMID: 29552282 PMCID: PMC5844718 DOI: 10.18632/oncotarget.23714] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 12/11/2017] [Indexed: 11/25/2022] Open
Abstract
The small-molecule naphtha [2,3-f]quinoxaline-7,12-dione (NSC745887) can effectively inhibit the proliferation of various cancers by trapping DNA-topoisomerase cleavage. The aim of this study was to elucidate cellular responses of NSC745887 in human glioblastoma multiforme (GBM, U118MG and U87MG cells) and investigate the underlying molecular mechanisms. NSC745887 reduced the cell survival rate and increased the sub-G1 population in dose- and time-dependent manners in GBM cells. Moreover, NSC745887 increased expression of γH2AX and caused DNA fragmentation leading to DNA damage. Furthermore, Annexin V/propidium iodide and Br-dTP staining showed the apoptotic effect of NSC745887 in GBM cells. DNA repair proteins of ataxia-telangiectasia mutated (ATM), ATM and Rad3-related, and decoy receptor 3 also decreased with NSC745887 treatment. In addition, NSC745887 caused apoptosis by the caspase-8/9-caspase-3-poly(ADP-ribose) polymerase cascade. An in vivo study indicated that NSC745887 suppressed the [18F]-FDG-specific uptake value in brain tumors. Histological staining also indicated a decrease in Ki-67 and increases in γH2AX and cleaved caspase-3 in the brain tumor area. These data provide preclinical evidence for NSC745887 as a potential new small molecule drug for managing glioblastomas.
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Affiliation(s)
- Li-Yun Fann
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC.,Department of Nursing and Department of Neurosurgery, Taipei City Hospital, Taipei, Taiwan, ROC.,Graduate Institute for Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan, ROC
| | - Ying Chen
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC.,Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Da-Chen Chu
- Department of Nursing and Department of Neurosurgery, Taipei City Hospital, Taipei, Taiwan, ROC
| | - Shao-Ju Weng
- Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Heng-Cheng Chu
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
| | - Alexander T H Wu
- The PhD Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan, ROC
| | - Jiann-Fong Lee
- Graduate Institute for Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan, ROC
| | - Ahmed Atef Ahmed Ali
- Graduate Institute for Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan, ROC
| | - Tsung-Chih Chen
- Graduate Institute for Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan, ROC
| | - Hsu-Shan Huang
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC.,Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan, ROC.,Graduate Institute for Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan, ROC
| | - Kuo-Hsing Ma
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC.,Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan, ROC
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7
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Aktan M, Kanyilmaz G, Yavuz BB, Koc M, Eryılmaz MA, Adli M. Prognostic value of pre-treatment 18F-FDG PET uptake for nasopharyngeal carcinoma. LA RADIOLOGIA MEDICA 2017:10.1007/s11547-017-0837-4. [PMID: 29177728 DOI: 10.1007/s11547-017-0837-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 11/14/2017] [Indexed: 02/01/2023]
Abstract
PURPOSE To evaluate the prognostic value of maximal standardized uptake values (SUVmax) from serial fluor-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in patients with nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS Fifty-two patients with NPC who underwent 18F-FDG PET/CT scan before radiotherapy with/without chemotherapy were reviewed retrospectively. Twenty-seven patients (52%) were applied 3-D conformal radiotherapy and 25 patients (48%) applied intensity-modulated radiotherapy (IMRT). Fourteen (27%) patients were given neoadjuvant chemotherapy and forty-four (84.6%) patients were given concomitant and adjuvant chemotherapy. RESULTS Median follow-up time was 34 months (range 5.6-66.4 months). Forty-four (84.6%) patients were alive at last follow-up and eight (15.4%) had died. The best cut-off value of the SUVmax for the primary tumor site (SUVmax-PT) was 13 and 9 for the lymph nodes (SUVmax-LN). Patients with SUVmax-PT ≥ 13.0 and SUVmax-LN ≥ 9 had a significantly higher risk for the development of the distant metastases (p = 0.044 and p = 0.038). DFS was affected in patients with SUVmax-PT ≥ 13 (log rank χ 2 = 2.54, p = 0.017) and was significantly lower in patients with SUVmax-LN ≥ 9 for the lymph nodes (log rank χ 2 = 5.81, p = 0.013). OS was not affected by SUV levels. A multivariate Cox proportional hazard model of DFS included age (≥ 40), SUVmax-LN (< 9), T stage (T1-2) and neoadjuvant chemotherapy are significantly better prognosis for the DFS. CONCLUSION 18F-FDG PET/CT uptake before treatment, as determined by SUVmax, may be a valuable tool to evaluate prognosis in NPC patients.
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Affiliation(s)
- Meryem Aktan
- Department of Radiation Oncology, Faculty of Medicine, Necmettin Erbakan University, 42090, Konya, Turkey.
| | - Gul Kanyilmaz
- Department of Radiation Oncology, Faculty of Medicine, Necmettin Erbakan University, 42090, Konya, Turkey
| | - Berrin Benli Yavuz
- Department of Radiation Oncology, Faculty of Medicine, Necmettin Erbakan University, 42090, Konya, Turkey
| | - Mehmet Koc
- Department of Radiation Oncology, Faculty of Medicine, Necmettin Erbakan University, 42090, Konya, Turkey
| | - Mehmet Akif Eryılmaz
- Department of Otorhinolaryngology, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Mustafa Adli
- Department of Radiation Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
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8
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Abstract
Facilitative carbohydrate transporters-Gluts-have received wide attention over decades due to their essential role in nutrient uptake and links with various metabolic disorders, including diabetes, obesity, and cancer. Endeavors directed towards understanding the mechanisms of Glut-mediated nutrient uptake have resulted in a multidisciplinary research field spanning protein chemistry, chemical biology, organic synthesis, crystallography, and biomolecular modeling. Gluts became attractive targets for cancer research and medicinal chemistry, leading to the development of new approaches to cancer diagnostics and providing avenues for cancer-targeting therapeutics. In this review, the current state of knowledge of the molecular interactions behind Glut-mediated sugar uptake, Glut-targeting probes, therapeutics, and inhibitors are discussed.
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Affiliation(s)
- Marina Tanasova
- Department of Chemistry, Michigan Technological University, 1400 Townsend Drive, Houghton, MI, 49931, USA
| | - Joseph R Fedie
- Department of Chemistry, Michigan Technological University, 1400 Townsend Drive, Houghton, MI, 49931, USA
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9
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Capitanio S, Nordin AJ, Noraini AR, Rossetti C. PET/CT in nononcological lung diseases: current applications and future perspectives. Eur Respir Rev 2017; 25:247-58. [PMID: 27581824 DOI: 10.1183/16000617.0051-2016] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 07/05/2016] [Indexed: 12/22/2022] Open
Abstract
Positron emission tomography (PET) combined with computed tomography (CT) is an established diagnostic modality that has become an essential imaging tool in oncological practice. However, thanks to its noninvasive nature and its capability to provide physiological information, the main applications of this technique have significantly expanded.(18)F-labelled fluorodeoxyglucose (FDG) is the most commonly used radiopharmaceutical for PET scanning and demonstrates metabolic activity in various tissues. Since activated inflammatory cells, like malignant cells, predominantly metabolise glucose as a source of energy and increase expression of glucose transporters when activated, FDG-PET/CT can be successfully used to detect and monitor a variety of lung diseases, such as infections and several inflammatory conditions.The added value of FDG-PET/CT as a molecular imaging technique relies on its capability to identify disease in very early stages, long before the appearance of structural changes detectable by conventional imaging. Furthermore, by detecting the active phase of infectious or inflammatory processes, disease progression and treatment efficacy can be monitored.This review will focus on the clinical use of FDG-PET/CT in nonmalignant pulmonary diseases.
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Affiliation(s)
- Selene Capitanio
- Nuclear Medicine, ASST Grande Ospedale Metropolitano Niguarda, Dept of Advanced Diagnostic Therapeutic Technologies, Milan, Italy
| | - Abdul Jalil Nordin
- Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | | | - Claudio Rossetti
- Nuclear Medicine, ASST Grande Ospedale Metropolitano Niguarda, Dept of Advanced Diagnostic Therapeutic Technologies, Milan, Italy
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10
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Cho SY, Lipson EJ, Im HJ, Rowe SP, Gonzalez EM, Blackford A, Chirindel A, Pardoll DM, Topalian SL, Wahl RL. Prediction of Response to Immune Checkpoint Inhibitor Therapy Using Early-Time-Point 18F-FDG PET/CT Imaging in Patients with Advanced Melanoma. J Nucl Med 2017; 58:1421-1428. [PMID: 28360208 DOI: 10.2967/jnumed.116.188839] [Citation(s) in RCA: 168] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 03/13/2017] [Indexed: 12/25/2022] Open
Abstract
The purpose of this study was to evaluate 18F-FDG PET/CT scanning as an early predictor of response to immune checkpoint inhibitors (ICIs) in patients with advanced melanoma. Methods: Twenty patients with advanced melanoma receiving ICI prospectively underwent 18F-FDG PET/CT at 3 scan intervals: before treatment initiation (SCAN-1), at days 21-28 (SCAN-2), and at 4 mo (SCAN-3). This study was approved by the institutional review board, and informed consent was received from all patients who were enrolled between April 2012 and December 2013. Tumor response at each posttreatment time point was assessed according to RECIST 1.1, immune-related response criteria, PERCIST (PERCIST 1.0), and European Organization for Research and Treatment of Cancer (EORTC) criteria. Performance characteristics of each metric to predict best overall response (BOR) at ≥ 4 mo were assessed. Results: Twenty evaluable patients were treated with ipilimumab (n = 16), BMS-936559 (n = 3), or nivolumab (n = 1). BOR at ≥ 4 mo included complete response (n = 2), partial response (n = 2), stable disease (n = 1), and progressive disease (n = 15). Response evaluations at SCAN-2 using RECIST 1.1, immune-related response criteria, PERCIST, and EORTC criteria demonstrated accuracies of 75%, 70%, 70%, and 65%, respectively, to predict BOR at ≥ 4 mo. Interestingly, the optimal PERCIST and EORTC threshold values at SCAN-2 to predict BOR were >15.5% and >14.7%, respectively. By combining anatomic and functional imaging data collected at SCAN-2, we developed criteria to predict eventual response to ICI with 100% sensitivity, 93% specificity, and 95% accuracy. Conclusion: Combining functional and anatomic imaging parameters from 18F-FDG PET/CT scans performed early in ICI appears predictive for eventual response in patients with advanced melanoma. These findings require validation in larger cohorts.
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Affiliation(s)
- Steve Y Cho
- Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland .,University of Wisconsin School of Medicine and Public Health and Carbone Comprehensive Cancer Center, Madison, Wisconsin
| | - Evan J Lipson
- Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland
| | - Hyung-Jun Im
- University of Wisconsin School of Medicine and Public Health and Carbone Comprehensive Cancer Center, Madison, Wisconsin.,Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea; and
| | - Steven P Rowe
- Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland
| | - Esther Mena Gonzalez
- Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland
| | - Amanda Blackford
- Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland
| | - Alin Chirindel
- Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland
| | - Drew M Pardoll
- Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland
| | - Suzanne L Topalian
- Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland
| | - Richard L Wahl
- Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland.,Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
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11
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Wahl R. Star Trek Meets the Operating Room: Nurse Scotty, Beam Me Up—A Tricorder. Ann Surg Oncol 2016; 23:9028-9031. [PMID: 16972012 DOI: 10.1245/aso.2006.03.901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2006] [Accepted: 04/04/2006] [Indexed: 11/18/2022]
Affiliation(s)
- Richard Wahl
- Division of Nuclear Medicine/PET, Johns Hopkins University, 601 North Caroline Street, Room 3223, Baltimore, Maryland, 21287-0817.
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12
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Sawada S, Suehisa H, Ueno T, Sugimoto R, Yamashita M. Monitoring and management of lung cancer patients following curative-intent treatment: clinical utility of 2-deoxy-2-[fluorine-18]fluoro-d-glucose positron emission tomography/computed tomography. LUNG CANCER-TARGETS AND THERAPY 2016; 7:45-51. [PMID: 28210160 PMCID: PMC5310700 DOI: 10.2147/lctt.s83644] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
A large number of studies have demonstrated that 2-deoxy-2-[fluorine-18]fluoro-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) is superior to conventional modalities for the diagnosis of lung cancer and the evaluation of the extent of the disease. However, the efficacy of PET/CT in a follow-up surveillance setting following curative-intent treatments for lung cancer has not yet been established. We reviewed previous papers and evaluated the potential efficacy of PET-CT in the setting of follow-up surveillance. The following are our findings: 1) PET/CT is considered to be superior or equivalent to conventional modalities for the detection of local recurrence. However, inflammatory changes and fibrosis after treatments in local areas often result in false-positive findings; 2) the detection of asymptomatic distant metastasis is considered to be an advantage of PET/CT in a follow-up setting. However, it should be noted that detection of brain metastasis with PET/CT has some limitation, similar to its use in pretreatment staging; 3) additional radiation exposure and higher medical cost arising from the use of PET/CT should be taken into consideration, particularly in patients who might not have cancer after curative-intent treatment and are expected to have a long lifespan. The absence of any data regarding survival benefits and/or improvements in quality of life is another critical issue. In summary, PET/CT is considered to be more accurate and sensitive than conventional modalities for the detection of asymptomatic recurrence after curative-intent treatments. These advantages could modify subsequent management in patients with suspected recurrence and might contribute to the selection of appropriate treatments for recurrence. Therefore, PET/CT may be an alternative to conventional follow-up modalities. However, several important issues remain to be solved. PET/CT in a follow-up surveillance setting is generally not recommended in clinical practice at the moment.
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Affiliation(s)
- Shigeki Sawada
- Department of Thoracic Surgery, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Hiroshi Suehisa
- Department of Thoracic Surgery, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Tsuyoshi Ueno
- Department of Thoracic Surgery, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Ryujiro Sugimoto
- Department of Thoracic Surgery, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Motohiro Yamashita
- Department of Thoracic Surgery, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
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13
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14
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Meng L, Xiu Y, Li Y, Xu X, Li S, Li X, Pak KY, Shi H, Cheng D. Investigations of (99m)Tc-labeled glucarate as a SPECT radiotracer for non-small cell lung cancer (NSCLC) and potential tumor uptake mechanism. Nucl Med Biol 2015; 42:608-13. [PMID: 25890861 DOI: 10.1016/j.nucmedbio.2015.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 02/28/2015] [Accepted: 02/28/2015] [Indexed: 12/25/2022]
Abstract
This study attempted to evaluate the feasibility of (99m)Tc-labeled glucarate ((99m)Tc-GLA) imaging in non-small cell lung cancer (NSCLC) and the potential tumor uptake mechanism. Cell lysates from two NSCLC cell lines, H292 and H1975, were immunoblotted with anti-glucose transporter 5 (GLUT5) antibody for Western blotting. Thereafter, the two cell lines were used to examine cellular uptake of (99m)Tc-GLA with or without fructose. SPECT/CT imaging studies were performed on small animals bearing H292 and H1975 tumors. Biodistribution studies were also conducted to achieve accurate tissue uptake of this tracer in two tumor models. Hematoxylin & eosin (H&E) staining and GLUT5, Ki67 and cytokeratin-7 (CK-7) immunohistochemistry (IHC) analysis were further investigated on tumor tissues. In Western blotting, H292 cells showed higher levels of GLUT5 compared to the H1975 cells. Meanwhile, the in vitro cell assays indicated GLUT5-dependent uptake of (99m)Tc-GLA in H292 and H1975 cells. The fructose competition assays showed a significant decrease in (99m)Tc-GLA uptake by H292 and H1975 cells when fructose was added. The (99m)Tc-GLA accumulation was as much as two-fold higher in H292 implanted tumors than in H1975 implanted tumors. (99m)Tc-GLA exhibited rapid clearance pharmacokinetics and reasonable uptake in human NSCLC H292 (1.69±0.37 ID%/g) and H1975 (0.89±0.06 ID%/g) implanted tumors at 30min post injection. Finally, the expression of GLUT5, Ki67 and CK-7 on tumor tissues also exhibited positive correlation with the in vitro cell test results and in vivo SPECT/CT imaging results in xenograft tumors. Both in vitro and ex vivo studies demonstrated that the uptake of (99m)Tc-GLA in NSCLC is highly related to GLUT5 expression. Imaging and further IHC results support that (99m)Tc-GLA could be a promising SPECT imaging agent for NSCLC diagnosis and prognosis evaluation.
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Affiliation(s)
- Lanfang Meng
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Institute of Nuclear Medicine, Fudan University, Shanghai 200032, China
| | - Yan Xiu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Institute of Nuclear Medicine, Fudan University, Shanghai 200032, China
| | - Yanli Li
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Institute of Nuclear Medicine, Fudan University, Shanghai 200032, China
| | - Xiaobo Xu
- Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Shanqun Li
- Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Xiao Li
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Institute of Nuclear Medicine, Fudan University, Shanghai 200032, China
| | - Koon Y Pak
- Molecular Targeting Technologies, Inc, West Chester, PA 19380, USA
| | - Hongcheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Institute of Nuclear Medicine, Fudan University, Shanghai 200032, China
| | - Dengfeng Cheng
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Institute of Nuclear Medicine, Fudan University, Shanghai 200032, China.
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Tumor Cell Uptake of 99mTc-Labeled 1-Thio-β-d-Glucose and 5-Thio-d-Glucose in Comparison with 2-Deoxy-2-[18 F]Fluoro-d-Glucose In Vitro: Kinetics, Dependencies, Blockage and Cell Compartment of Accumulation. Mol Imaging Biol 2013; 16:189-98. [DOI: 10.1007/s11307-013-0690-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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Silvestri GA, Gonzalez AV, Jantz MA, Margolis ML, Gould MK, Tanoue LT, Harris LJ, Detterbeck FC. Methods for staging non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013; 143:e211S-e250S. [PMID: 23649440 DOI: 10.1378/chest.12-2355] [Citation(s) in RCA: 945] [Impact Index Per Article: 85.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Correctly staging lung cancer is important because the treatment options and prognosis differ significantly by stage. Several noninvasive imaging studies and invasive tests are available. Understanding the accuracy, advantages, and disadvantages of the available methods for staging non-small cell lung cancer is critical to decision-making. METHODS Test accuracies for the available staging studies were updated from the second iteration of the American College of Chest Physicians Lung Cancer Guidelines. Systematic searches of the MEDLINE database were performed up to June 2012 with the inclusion of selected meta-analyses, practice guidelines, and reviews. Study designs and results are summarized in evidence tables. RESULTS The sensitivity and specificity of CT scanning for identifying mediastinal lymph node metastasis were approximately 55% and 81%, respectively, confirming that CT scanning has limited ability either to rule in or exclude mediastinal metastasis. For PET scanning, estimates of sensitivity and specificity for identifying mediastinal metastasis were approximately 77% and 86%, respectively. These findings demonstrate that PET scanning is more accurate than CT scanning, but tissue biopsy is still required to confirm PET scan findings. The needle techniques endobronchial ultrasound-needle aspiration, endoscopic ultrasound-needle aspiration, and combined endobronchial ultrasound/endoscopic ultrasound-needle aspiration have sensitivities of approximately 89%, 89%, and 91%, respectively. In direct comparison with surgical staging, needle techniques have emerged as the best first diagnostic tools to obtain tissue. Based on randomized controlled trials, PET or PET-CT scanning is recommended for staging and to detect unsuspected metastatic disease and avoid noncurative resections. CONCLUSIONS Since the last iteration of the staging guidelines, PET scanning has assumed a more prominent role both in its use prior to surgery and when evaluating for metastatic disease. Minimally invasive needle techniques to stage the mediastinum have become increasingly accepted and are the tests of first choice to confirm mediastinal disease in accessible lymph node stations. If negative, these needle techniques should be followed by surgical biopsy. All abnormal scans should be confirmed by tissue biopsy (by whatever method is available) to ensure accurate staging. Evidence suggests that more complete staging improves patient outcomes.
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Affiliation(s)
| | - Anne V Gonzalez
- Montreal Chest Institute, McGill University Health Centre, Montreal, QC, Canada
| | - Michael A Jantz
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Florida, Gainesville, FL
| | | | - Michael K Gould
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Lynn T Tanoue
- Section of Pulmonary and Critical Care Medicine, New Haven, CT
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17
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Tanasova M, Plutschack M, Muroski ME, Sturla SJ, Strouse GF, McQuade DT. Fluorescent THF-based fructose analogue exhibits fructose-dependent uptake. Chembiochem 2013; 14:1263-70. [PMID: 23784717 DOI: 10.1002/cbic.201300164] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Indexed: 12/22/2022]
Abstract
Recent publications suggest that high dietary fructose might play a significant role in cancer metabolism and can exacerbate a number of aspects of metabolic syndrome. Addressing the role that fructose plays in human health is a controversial question and requires a detailed understanding of many factors including the mechanism of fructose transport into healthy and diseased cells. Fructose transport into cells is thought to be largely mediated by the passive hexose transporters Glut2 and Glut5. To date, no probes that can be selectively transported by one of these enzymes but not by the other have been identified. The data presented here indicate that, in MCF-7 cells, a 1-amino-2,5-anhydro-D-mannitol-based fluorescent NBDM probe is transported twice as efficiently as fructose and that this takes place with the aid of Glut5. Its Glut5 specificity and differential uptake in cancer cells and in normal cells suggest this NBDM probe as a potentially useful tool for cross-cell-line correlation of Glut5 transport activity.
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Affiliation(s)
- Marina Tanasova
- Department of Health Sciences and Technology, Swiss Federal Institute of Technology ETH Zürich, Schmelzbergstrasse 9, 8092 Zürich, Switzerland
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18
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Diffuse cutaneous uptake of 18F-flurodeoxyglucose is associated with adverse prognosis in patients with melanoma. Nucl Med Commun 2012. [DOI: 10.1097/mnm.0b013e328358d9e0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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An evaluation of 2-deoxy-2-[18F]fluoro-D-glucose and 3'-deoxy-3'-[18F]-fluorothymidine uptake in human tumor xenograft models. Mol Imaging Biol 2012; 14:355-65. [PMID: 21761255 DOI: 10.1007/s11307-011-0504-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim of this study is to assess the variability of 2-deoxy-2-[(18)F]fluoro-D: -glucose ([(18)F]-FDG) and 3'-deoxy-3'-[(18)F]-fluorothymidine ([(18)F]-FLT) uptake in pre-clinical tumor models and examine the relationship between imaging data and related histological biomarkers. PROCEDURES [(18)F]-FDG and [(18)F]-FLT studies were carried out in nine human tumor xenograft models in mice. A selection of the models underwent histological analysis for endpoints relevant to radiotracer uptake. Comparisons were made between in vitro uptake, in vivo imaging, and ex vivo histopathology data using quantitative and semi-quantitative analysis. RESULTS In vitro data revealed that [1-(14)C]-2-deoxy-D: -glucose ([(14)C]-2DG) uptake in the tumor cell lines was variable. In vivo, [(18)F]-FDG and [(18)F]-FLT uptake was highly variable across tumor types and uptake of one tracer was not predictive for the other. [(14)C]-2DG uptake in vitro did not predict for [(18)F]-FDG uptake in vivo. [(18)F]-FDG SUV was inversely proportional to Ki67 and necrosis levels and positively correlated with HKI. [(18)F]-FLT uptake positively correlated with Ki67 and TK1. CONCLUSION When evaluating imaging biomarkers in response to therapy, the choice of tumor model should take into account in vivo baseline radiotracer uptake, which can vary significantly between models.
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A multicenter prospective evaluation of the clinical utility of F-18 FDG-PET/CT in patients with AJCC stage IIIB or IIIC extremity melanoma. Ann Surg 2012; 256:350-6. [PMID: 22691370 DOI: 10.1097/sla.0b013e318256d1f5] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE/BACKGROUND There is a high risk of relapse in stage IIIB/IIIC melanoma. The utility of 2-[fluorine-18]-fluoro-2-deoxy-D-glucose positron emission tomography integrated with computed tomography (FDG-PET/CT) in these patients to evaluate response to treatment or for surveillance after treatment is currently not well defined. METHODS Prospective data from 2 centers identified 97 patients with stage IIIB/IIIC extremity melanoma undergoing isolated limb infusion (ILI) who had whole body FDG-PET/CT scans before and every 3 months after treatment. Clinical response was determined at 3 months by Response Evaluation Criteria In Solid Tumors. RESULTS Complete response (CR) after ILI occurred in 33% (32/97) of patients. FDG-PET/CT accurately identified 59% of patients who were CRs (19/32), whereas 41% (13/32) had residual metabolic activity in the extremity that was histologically negative for melanoma. The 3-year disease-free rate was 62.2% (95% CI: 40.1%-96.4%) for those patients who were CRs by both clinical/pathologic examination and FDG-PET/CT (n = 19) compared to only 29.4% (95% CI: 9.9%-87.2%) of those CRs who still had residual FDG-PET/CT activity (n = 13). FDG-PET/CT was utilized for surveillance of disease recurrence outside the regional field of treatment. Fifty-two percent (51/97) of patients developed disease outside the extremity at a median time of 212 days from pre-ILI FDG-PET/CT. In 47% (29/62) of these cases, the recurrence was resected. CONCLUSIONS Although FDG-PET/CT does not appear to accurately identify patients who appear to be CRs to ILI, it does appear to identify a subgroup of patients whose regional progression-free survival is markedly worse. However, FDG-PET/CT appears to be an excellent method for surveillance in stage IIIB/IIIC patients after ILI with ability to identify surgically resectable recurrent disease in these high-risk patients.
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21
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Preoperative FDG-PET/CT Is an Important Tool in the Management of Patients with Thick (T4) Melanoma. Dermatol Res Pract 2012; 2012:614349. [PMID: 22654898 PMCID: PMC3359680 DOI: 10.1155/2012/614349] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Revised: 03/03/2012] [Accepted: 03/06/2012] [Indexed: 01/29/2023] Open
Abstract
The yield of preoperative PET/CT (PET/CT) for regional and distant metastases for thin/intermediate thickness melanoma is low. Objective of this study is to determine if PET/CT performed for T4 melanomas helps guide management and alter treatment plans. Methods. Retrospective cohort of 216 patients with T4 melanomas treated at two tertiary institutions. Fifty-six patients met our inclusion criteria (T4 lesion, PET/CT and no clinical evidence of metastatic disease). Results. Fifty-six patients (M: 32, F: 24) with median tumor thickness of 6 mm were identified. PET/CT recognized twelve with regional and four patients with metastatic disease. Melanoma-related treatment plan was altered in 11% of the cases based on PET/CT findings. PET/CT was negative 60% of the time, in 35% of the cases; it identified incidental findings that required further evaluation. Conclusion. Patients with T4 lesions, PET/CT changed the treatment plan 18% of the time. Regional findings changed the surgical treatment plan in 11% and the adjuvant plan in 7% of our cases due to the finding of metastatic disease. Additionally 20 patients had incidental findings that required further workup. In this subset of patients, we feel there is a benefit to PET/CT, and further studies should be performed to validate our findings.
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22
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Francis CL, Nalley C, Fan C, Bodenner D, Stack BC. 18F-fluorodeoxyglucose and 131I radioguided surgical management of thyroid cancer. Otolaryngol Head Neck Surg 2011; 146:26-32. [PMID: 21952355 DOI: 10.1177/0194599811423007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To describe a technique that assists in the surgical management of recurrent local regional well-differentiated thyroid cancer (WDTC). STUDY DESIGN Case series with chart review. SETTING Two academic health centers from 2001 to 2009. SUBJECTS AND METHODS Patients operated upon by the senior surgeon (BCS) for recurrent WDTC. RESULTS Thirteen patients with recurrent WDTC were operated upon with radioguided surgical (RGS) technique to indentify recurrence for excision. Eight patients had iodine avid disease and were candidates for RGS with (131)I. The remaining 5 patients had cancer with a proven loss of iodine avidity and were, therefore, operated upon with a fluorodeoxygluocose (FDG) RGS technique. CONCLUSION RGS is a feasible approach to identify recurrent disease in an operated field and ensure its successful excision. Although focal disease may be identified with this technique, this is not a tool for limited excisions ("berry picking").
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Affiliation(s)
- Carrie L Francis
- Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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23
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Choi SH, Paeng JC, Sohn CH, Pagsisihan JR, Kim YJ, Kim KG, Jang JY, Yun TJ, Kim JH, Han MH, Chang KH. Correlation of 18F-FDG uptake with apparent diffusion coefficient ratio measured on standard and high b value diffusion MRI in head and neck cancer. J Nucl Med 2011; 52:1056-62. [PMID: 21680692 DOI: 10.2967/jnumed.111.089334] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
UNLABELLED Although the clinical applications of (18)F-FDG PET/CT and diffusion-weighted MRI (DWI) are similar to each other in head and neck cancer, the image acquisition methods in the 2 modalities are significantly different. (18)F-FDG PET/CT traces glucose metabolism, a nonspecific process essential for tumor growth. On the other hand, DWI provides information on Brownian motion of water molecules in tissues, which represents cellularity. The aim of our study was to investigate whether apparent diffusion coefficient (ADC) values at b = 1,000 (ADC(1,000)) and 2,000 (ADC(2,000)) s/mm(2) or whether the change (ADC(ratio)) of ADC values from b = 1,000 to 2,000 s/mm(2) has any significant correlation with the standardized uptake value (SUV) in patients with head and neck squamous cell carcinoma (HNSCC). METHODS Our hospital's institutional review board approved this retrospective study. We included 47 patients (32 men and 15 women) with histopathologically proven HNSCC, who underwent both DWI (at both b = 1,000 s/mm(2) and b = 2,000 s/mm(2)) and (18)F-FDG PET/CT in the 2 wk before treatment. ADC(ratio) maps were generated using a pixel-by-pixel computation for which ADC(ratio) is (ADC(2,000)/ADC(1,000)) × 100. The mean ADC(1,000), ADC(2,000), and ADC(ratio) values were evaluated within a manually placed polygonal region of interest within the main tumor on every slice of the ADC(1,000), ADC(2,000), and ADC(ratio) maps, respectively. In addition, the maximal SUV (SUV(max)) and mean SUV (SUV(mean)) were measured for the entire tumor region of interest. Comparisons were made using Pearson correlation analysis, and partial correlation coefficients were derived. RESULTS No significant correlation was found between the mean ADC(1,000) and SUV(mean) (r = -0.222, P = 0.1325) or the mean ADC(2,000) and SUV(mean) (r = -0.1214, P = 0.4163). However, the ADC(ratio) was significantly and positively correlated to both the SUV(mean) (r = 0.667, P < 0.001) and SUV(max) (r = 0.5855, P < 0.001). CONCLUSION The ADC(ratio) and SUV were significantly correlated with each other in primary HNSCC patients, possibly because of a higher-cellularity region as a result of relatively increased tumor proliferation. Further studies are warranted to investigate the possible complementary role of DWI and PET/CT in various clinical settings, including staging and treatment response.
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Affiliation(s)
- Seung Hong Choi
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
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24
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Performance of beta- and high-energy gamma probes for the detection of cancer tissue in experimental surgical resection beds. Ann Nucl Med 2011; 25:486-93. [DOI: 10.1007/s12149-011-0492-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Accepted: 03/30/2011] [Indexed: 11/25/2022]
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25
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Choi SJ, Kim SH, Kang HY, Lee J, Bhak JH, Sohn I, Jung SH, Choi YS, Kim HK, Han J, Huh N, Lee G, Kim BC, Kim J. Mutational hotspots in the mitochondrial genome of lung cancer. Biochem Biophys Res Commun 2011; 407:23-7. [DOI: 10.1016/j.bbrc.2011.02.078] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Accepted: 02/15/2011] [Indexed: 11/29/2022]
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Tseng JR, Stuart D, Aardalen K, Kaplan A, Aziz N, Hughes NP, Gambhir SS. Use of DNA microarray and small animal positron emission tomography in preclinical drug evaluation of RAF265, a novel B-Raf/VEGFR-2 inhibitor. Neoplasia 2011; 13:266-75. [PMID: 21390189 PMCID: PMC3050869 DOI: 10.1593/neo.101466] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 12/06/2010] [Accepted: 12/08/2010] [Indexed: 01/22/2023]
Abstract
Positron emission tomography (PET) imaging has become a useful tool for assessing early biologic response to cancer therapy and may be particularly useful in the development of new cancer therapeutics. RAF265, a novel B-Raf/vascular endothelial growth factor receptor-2 inhibitor, was evaluated in the preclinical setting for its ability to inhibit the uptake of PET tracers in the A375M(B-Raf(V600E)) human melanoma cell line. RAF265 inhibited 2-deoxy-2-[(18)F]fluoro-d-glucose (FDG) accumulation in cell culture at 28 hours in a dose-dependent manner. RAF265 also inhibited FDG accumulation in tumor xenografts after 1 day of drug treatment. This decrease persisted for the remaining 2 weeks of treatment. DNA microarray analysis of treated tumor xenografts revealed significantly decreased expression of genes regulating glucose and thymidine metabolism and revealed changes in apoptotic genes, suggesting that the imaging tracers FDG, 3-deoxy-3-[(18)F]fluorothymidine, and annexin V could serve as potential imaging biomarkers for RAF265 therapy monitoring. We concluded that RAF265 is highly efficacious in this xenograft model of human melanoma and decreases glucose metabolism as measured by DNA microarray analysis, cell culture assays, and small animal FDG PET scans as early as 1 day after treatment. Our results support the use of FDG PET in clinical trials with RAF265 to assess early tumor response. DNA microarray analysis and small animal PET studies may be used as complementary technologies in drug development. DNA microarray analysis allows for analysis of drug effects on multiple pathways linked to cancer and can suggest corresponding imaging tracers for further analysis as biomarkers of tumor response.
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MESH Headings
- Animals
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Drug Evaluation, Preclinical
- Enzyme Inhibitors/therapeutic use
- Female
- Fluorodeoxyglucose F18
- Gene Expression Profiling
- Glucose/metabolism
- Humans
- Imidazoles/therapeutic use
- Immunoenzyme Techniques
- Leukemia, Myeloid, Acute/diagnostic imaging
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/pathology
- Melanoma/diagnostic imaging
- Melanoma/drug therapy
- Melanoma/pathology
- Mice
- Mice, Nude
- Oligonucleotide Array Sequence Analysis
- Proto-Oncogene Proteins B-raf/antagonists & inhibitors
- Pyridines/therapeutic use
- RNA, Messenger/genetics
- Radionuclide Imaging
- Radiopharmaceuticals
- Reverse Transcriptase Polymerase Chain Reaction
- Thymidine/metabolism
- Tumor Cells, Cultured
- Vascular Endothelial Growth Factor Receptor-2/antagonists & inhibitors
- Xenograft Model Antitumor Assays
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Affiliation(s)
- Jeffrey R Tseng
- Molecular Imaging Program at Stanford, Bio-X Program, Department of Radiology, Stanford University, Stanford, CA, USA
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27
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Liapi E, Geschwind JFH, Vali M, Khwaja AA, Prieto-Ventura V, Buijs M, Vossen JA, Ganapathy S, Wahl RL. Assessment of tumoricidal efficacy and response to treatment with 18F-FDG PET/CT after intraarterial infusion with the antiglycolytic agent 3-bromopyruvate in the VX2 model of liver tumor. J Nucl Med 2011; 52:225-30. [PMID: 21233194 PMCID: PMC4337871 DOI: 10.2967/jnumed.110.083162] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
UNLABELLED The purpose of this study was to determine the effects of 3-bromopyruvate (3-BrPA) on tumor glucose metabolism as imaged with (18)F-FDG PET/CT at multiple time points after treatment and compare them with those after intraarterial control injections of saline. METHODS Twenty-three New Zealand White rabbits implanted intrahepatically with VX2 tumors were assigned to 1 of 2 groups: 14 rabbits were assigned to the treatment group (TG) and 9 to the saline control group (SG). All animals were infused with 25 mL of either 1.75 mM 3-BrPA or saline over 1 h via a 2-French catheter, which was secured in the hepatic artery. For PET/CT, the animals were injected with 37 MBq of (18)F-FDG at 1 d before treatment and 2 h, 24 h, and 1 wk after treatment. Tumor size, tumor and liver maximal standardized uptake value (SUV(max)), and tumor-to-background ratios were calculated for all studies. Seven TG and 5 SG animals were sacrificed at 1 wk after treatment for histopathologic analysis. RESULTS Intense (18)F-FDG uptake was seen in untreated tumors. A significant reduction in tumor SUV(max) was noted in TG animals, when compared with SG animals, at 1 wk after treatment (P = 0.006). The tumor-to-liver background ratio in the TG animals, compared with the SG animals, was significantly reduced as early as 24 h after treatment (P = 0.01) and remained reduced at 1 wk (P = 0.003). Tumor SUV(max) increased from the baseline levels at 7 d in controls (P = 0.05). The histopathologic analysis of explanted livers revealed increased tumor necrosis in all TG samples. There was a significant inverse correlation (r(2) = 0.538, P = 0.005) between the percentage of tumor necrosis on histopathology and tumor SUV(max) on (18)F-FDG PET at 7 d after treatment with 3-BrPA. CONCLUSION Intraarterial injection of 3-BrPA resulted in markedly decreased (18)F-FDG uptake as imaged by PET/CT and increased tumor necrosis on histopathology at 1 wk after treatment in the VX2 rabbit liver tumor. PET/CT appears to be a useful means to follow antiglycolytic therapy with 3-BrPA.
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Affiliation(s)
- Eleni Liapi
- Division of Interventional Radiology, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Jean-Francois H. Geschwind
- Division of Interventional Radiology, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Mustafa Vali
- Division of Interventional Radiology, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Afsheen A. Khwaja
- Division of Interventional Radiology, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Veronica Prieto-Ventura
- Division of Interventional Radiology, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Manon Buijs
- Division of Interventional Radiology, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Josephina A. Vossen
- Division of Interventional Radiology, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Shanmugasudaram Ganapathy
- Division of Interventional Radiology, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Richard L. Wahl
- Division of Nuclear Medicine, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, Maryland
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Park JH, Han JY, Hyun IY, Lee BI, Moon YS. Case of uterine leiomyoma showing fludeoxyglucose uptake on F-18 fludeoxyglucose positron emission tomography/computed tomography. J Obstet Gynaecol Res 2010; 36:1261-4. [PMID: 21083837 DOI: 10.1111/j.1447-0756.2010.01307.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In order not to over treat uterine leiomyoma and to avoid overlooking uterine leiomyosarcoma, a highly reliable diagnostic method has been thought. Occasionally, it is difficult to discriminate uterine leiomyoma from uterine leiomyosarcoma. Recently positron emission tomography/computed tomography (PET/CT) has been proved useful in assessing pelvic malignancies. We experienced a case of uterine leiomyoma showing increased F-18 fludeoxyglucose uptake on PET/CT in a postmenopausal woman. However, histological analysis demonstrated benign leiomyoma by the hysterectomy. Immunohistochemical analysis of glucose transporter-1 showed negative in leiomyoma. Our case indicates that uterine leiomyoma in a postmenopausal woman may show false positive result of PET/CT.
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Affiliation(s)
- Jee Hyun Park
- Department of Obstetrics and Gynecology, Laboratory Medicine, College of Medicine, Inha University, Incheon, Korea
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Wahl RL, Javadi MS, Eslamy H, Shruti A, Bristow R. The Roles of Fluorodeoxyglucose-PET/Computed Tomography in Ovarian Cancer: Diagnosis, Assessing Response, and Detecting Recurrence. PET Clin 2010; 5:447-61. [PMID: 27157972 DOI: 10.1016/j.cpet.2010.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The potential roles of fluorodeoxyglucose positron emission tomography/computed tomography imaging in ovarian cancer include noninvasive characterization of an ovarian mass, staging, and treatment planning. This article assesses these roles for predicting and monitoring response to treatment, restaging, and early diagnosis of recurrence.
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Affiliation(s)
- Richard L Wahl
- Division of Nuclear Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Mehrbod Som Javadi
- Division of Nuclear Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Hedieh Eslamy
- Division of Nuclear Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Aditi Shruti
- Division of Nuclear Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Robert Bristow
- Division of Gynecological Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Akizawa H, Zhao S, Takahashi M, Nishijima KI, Kuge Y, Tamaki N, Seki KI, Ohkura K. In vitro and in vivo evaluations of a radioiodinated thymidine phosphorylase inhibitor as a tumor diagnostic agent for angiogenic enzyme imaging. Nucl Med Biol 2010; 37:427-32. [PMID: 20447553 DOI: 10.1016/j.nucmedbio.2010.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2009] [Revised: 01/25/2010] [Accepted: 01/31/2010] [Indexed: 11/29/2022]
Affiliation(s)
- Hiromichi Akizawa
- Faculty of Pharmaceutical Sciences, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido 061-0293, Japan
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Goorden MC, Beekman FJ. High-resolution tomography of positron emitters with clustered pinhole SPECT. Phys Med Biol 2010; 55:1265-77. [DOI: 10.1088/0031-9155/55/5/001] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Khan N, Oriuchi N, Yoshizaki A, Kanuma T, Higuchi T, Endo K. Diagnostic accuracy of FDG PET imaging for the detection of recurrent or metastatic gynecologic cancer. Ann Nucl Med 2009; 19:137-45. [PMID: 15909494 DOI: 10.1007/bf03027393] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE This study evaluated the diagnostic role and accuracy of positron emission tomography (PET) using 2-[F-18]fluoro-2-deoxy-D-glucose (FDG) for the detection of tumor foci in patients with suspected recurrent or metastatic lesions of gynecologic cancers. MATERIALS AND METHODS FDG PET imaging was performed on 51 patients with a previous history of gynecologic cancer who were referred for a clinical suspicion of recurrent disease. PET acquisition was started 50-60 min after the intravenous injection of 5-6 MBq/kg FDG in all patients. The PET images were interpreted visually, and tracer uptake was quantitated as the standardized uptake value adjusted to body weight (SUV) in the lesions showing FDG uptake. The accuracy of the PET results was assessed by a consensual verdict based on histology, cytology, other imaging and clinical follow-up. RESULTS FDG PET correctly diagnosed 33 of 36 patients with recurrent disease and 12 of 15 patients without recurrence. On patient-based analysis, the sensitivity, specificity and accuracy of FDG PET were 91.7%, 80.0% and 88.2%, respectively, depending on the selected scheme for visual scoring of the lesions. The area index in receiver-operating characteristic analysis was 0.95 for patient detection. Malignant lesions accumulated significantly more FDG than the benign ones (the mean SUVs were 3.7 +/- 1.9 and 1.6 +/- 1.1, respectively, p = 0.004). The sensitivity and specificity in correct identification of tumor recurrence or metastases using a threshold SUV 1.9 were 88.8% and 66.7% in contrast to the visual analysis (sensitivity 96.4%, specificity 50%) on a lesion-based analysis. The partial volume effect of SUV in a few small lesions and the presence of bone lesions in which FDG uptake was relatively low might be the reason for the lower sensitivity in SUV analysis. FDG PET was valuable when CT/MRI was negative or inconclusive, and in patients with elevated tumor marker levels as well as with normal tumor marker levels when recurrence was suspected clinically. However, PET failed to visualize some small metastatic lesions in lung and bone, and showed falsely high FDG uptake in some benign lesions. CONCLUSION The results indicated that FDG PET is a reliable and accurate diagnostic method for detecting recurrent or metastatic gynecologic cancer particularly lymph node metastases. Although the sensitivity of PET for detecting small metastases was relatively limited, the overall sensitivity of FDG PET was significantly higher than morphologic imaging.
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Affiliation(s)
- Nasim Khan
- Department of Nuclear Medicine and Diagnostic Radiology, Gunma University Graduate School of Medicine, Japan
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Orlacchio A, Schillaci O, Fusco N, Broccoli P, Maurici M, Yamgoue M, Danieli R, D'Urso S, Simonetti G. Role of PET/CT in the detection of liver metastases from colorectal cancer. Radiol Med 2009; 114:571-85. [PMID: 19444590 DOI: 10.1007/s11547-009-0393-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2008] [Accepted: 07/08/2008] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was to compare the diagnostic accuracy of 2-[fluorine-18] fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG-PET) and computed tomography (CT) with PET/CT in the detection of liver metastases during tumour staging in patients suffering from colorectal carcinoma for the purposes of correct surgical planning and follow-up. MATERIALS AND METHODS A total of 467 patients underwent a PET/CT scan using an iodinated contrast medium. We compared images obtained by the single PET scan, the single CT scan and by the fusion of the two procedures (PET/CT). The final diagnosis was obtained by histological examination and/or by the follow-up of all patients, including those who did not undergo surgery or biopsy. RESULTS The PET scan had 94.05% sensitivity, 91.60% specificity and 93.36% accuracy; the CT scan had 91.07% sensitivity, 95.42% specificity and 92.29% accuracy. The combined procedures (PET/CT) had the following values: sensitivity 97.92%, specificity 97.71% and accuracy 97.86%. CONCLUSIONS This study indicates that PET/CT is very useful in staging and restaging patients suffering from colorectal cancer. It was particularly useful when recurrences could not be visualised either clinically or by imaging despite increasing tumour markers, as it guaranteed an earlier diagnosis. PET/CT not only provides high diagnostic performance in terms of sensitivity and specificity, enabling modification of patient treatment, but it is also a unique, high-profile procedure that can produce cost savings.
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Affiliation(s)
- A Orlacchio
- Dipartimento di Diagnostica per Immagini, Imaging Molecolare, Radiologia Interventistica e Radioterapia, Policlinico Universitario Tor Vergata, Viale Oxford 81, 00133, Roma, Italy.
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Ong LC, Song IC, Jin Y, Kee IHC, Siew E, Yu S, Thng CH, Huynh H, Chow PKH. Effective inhibition of xenografts of hepatocellular carcinoma (HepG2) by rapamycin and bevacizumab in an intrahepatic model. Mol Imaging Biol 2009; 11:334-42. [PMID: 19330383 PMCID: PMC2719751 DOI: 10.1007/s11307-009-0213-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2008] [Revised: 09/17/2008] [Accepted: 10/24/2008] [Indexed: 02/08/2023]
Abstract
PURPOSE Hepatocellular carcinoma (HCC) displays a characteristic hypervascularity and depends on angiogenesis for tumor growth, which thus provides a potential target for therapeutic approaches to HCC. In this study, through the use of combined micro-positron emission tomography (PET)/computed tomography (CT), we investigate if such a combined targeting of vascular endothelial growth factor (VEGF) activity and expression might retard HCC growth in an orthotopic intrahepatic xenograft model. PROCEDURES Xenograft models were created by intraportal vein injection of HepG2 cell suspensions in severe combined immunodeficient mice. The mice were then treated with (1) rapamycin (RAPA), a mammalian target of rapamycin pathway inhibitor; (2) bevazicumab (BEV), a VEGF monoclonal antibody; and (3) a RAPA/BEV combination. RESULTS Assessment of HCC progression using CT with Omnipaque and PET with 2-deoxy-2-(F-18)-fluoro-D: -glucose showed that mice treated with RAPA/BEV had the lowest standardized uptake values (SUVs). At week 2, mice treated with RAPA/BEV, RAPA, and BEV all showed a marked decrease in the SUV(max) readings with the greatest drop being observed in the RAPA/BEV group (1.33 + 0.26, 1.81 + 0.2, 2.05 + 0.4 vs. vehicle control 2.11 + 0.53). CONCLUSIONS Our results, supported by micro-PET/CT, suggest that RAPA/BEV represents a potential novel antiangiogenic therapy for the treatment of HCC.
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Affiliation(s)
- Lai-Chun Ong
- Singapore General Hospital, Outram Road, Singapore, 169608, Singapore
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Abstract
Cutaneous melanoma (CM) is a common malignancy and imaging, particularly lymphoscintigraphy (LS), positron-emission tomography with 2-fluoro-2-deoxyglucose (FDG-PET), ultrasound, radiography computed tomography (CT) and magnetic resonance imaging have important roles in staging and restaging, surgical guidance, surveillance and assessment of recurrent disease. This review aims to summarize the available data regarding these and other imaging modalities in CM and provide the basis for subsequent formulation of guidelines regarding the use of imaging in CM. PubMed and Medline searches were performed and reference lists from publications were also searched. The published data were reviewed and tabulated. There is level I evidence supporting the use of LS and sentinel lymph node biopsy in nodal staging for CM. There is level III evidence demonstrating the superiority of ultrasound to palpation in the assessment of lymph nodes in CM. There is level IV evidence supporting FDG-PET in American Joint Committee on Cancer stage III/IV and recurrent CM and that FDG-PET/CT may be superior to FDG-PET. Level IV evidence also supports the use of CT in the same group of patients and the role of CT appears to be complementary to FDG-PET. Various imaging modalities, especially LS/sentinel lymph node biopsy and FDG-PET/CT, add incremental information in the management of CM and the various modalities have complementary roles depending on the clinical situation.
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Colavolpe C, Guedj E, Cammilleri S, Taïeb D, Mundler O, Coze C. Utility of FDG-PET/CT in the follow-up of neuroblastoma which became MIBG-negative. Pediatr Blood Cancer 2008; 51:828-31. [PMID: 18680162 DOI: 10.1002/pbc.21594] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We report on the case of a 10-month-old female infant with a metastatic neuroblastoma which became MIBG-negative at time of relapse. We discuss the different hypothesis associated with this particular outcome, and the potential utility of FDG-PET as an alternative to follow up the residual disease at this stage.
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Affiliation(s)
- Cécile Colavolpe
- Department of Nuclear Medicine, University Hospital Centre, Timone, Marseille, France.
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Isles M, McConkey C, Mehanna H. A systematic review and meta-analysis of the role of positron emission tomography in the follow up of head and neck squamous cell carcinoma following radiotherapy or chemoradiotherapy. Clin Otolaryngol 2008; 33:210-22. [DOI: 10.1111/j.1749-4486.2008.01688.x] [Citation(s) in RCA: 236] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lee SW, Nam SY, Im KC, Kim JS, Choi EK, Ahn SD, Park SH, Kim SY, Lee BJ, Kim JH. Prediction of prognosis using standardized uptake value of 2-[18F] fluoro-2-deoxy-d-glucose positron emission tomography for nasopharyngeal carcinomas. Radiother Oncol 2008; 87:211-6. [DOI: 10.1016/j.radonc.2008.01.009] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2007] [Revised: 12/07/2007] [Accepted: 01/12/2008] [Indexed: 10/22/2022]
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[F-18]-Fluorodeoxyglucose PET and PET-CT in diagnostic imaging evaluation of locally recurrent and metastatic bladder transitional cell carcinoma. Int J Clin Oncol 2008; 13:42-7. [PMID: 18307018 DOI: 10.1007/s10147-007-0720-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2007] [Accepted: 09/04/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND Little data is available on the utility of positron emission tomography (PET) and positron emission tomography-computed tomography (PET-CT) with [F-18]-fluorodeoxyglucose (FDG) in patients with bladder cancer. We retrospectively assessed the diagnostic utility of dedicated PET and hybrid PET-CT scans with [F-18]-FDG in the imaging evaluation of recurrent and metastatic bladder transitional cell carcinoma. METHODS The study group included 35 patients who were previously treated for the primary disease. We performed PET in 17 patients and 23 PET-CT scans in 18 patients. Diagnostic validation was by biopsy in 1 patient and clinical and radiological follow-up for up to 5 years in the remaining patients. RESULTS PET and CT were true negative (TN) in 12 patients and true positive (TP) in 19 patients. In 4 patients in this group, both locally recurrent pelvic mass and distant metastases were demonstrated, while in 3 of these patients, unsuspected skeletal and/or nodal metastases were detected by PET-CT and these patients received additional courses of chemotherapy. PET was discordant with CT in 4 patients. PET was negative in 2 of these patients, while post-chemotherapy CT showed enlarged nodes that were determined to represent successfully treated disease. In another patient, a hypometabolic soft-tissue mass was considered to represent a scar, and a wait-and-watch strategy was pursued. In the remaining patient, PET showed random hypermetabolic osseous lesions that represented early marrow metastatic infiltration. The combined diagnostic information provided by PET-CT affected the clinical management in 17% of patients. CONCLUSION FDG PET and PET-CT scanning may improve the imaging evaluation of patients with recurrent and metastatic bladder cancer.
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Präoperatives Staging bei Patienten mit nichtkleinzelligem Bronchialkarzinom. ZEITSCHRIFT FUR HERZ THORAX UND GEFASSCHIRURGIE 2008. [DOI: 10.1007/s00398-008-0607-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Park JY, Kim EN, Kim DY, Suh DS, Kim JH, Kim YM, Kim YT, Nam JH. Comparison of the validity of magnetic resonance imaging and positron emission tomography/computed tomography in the preoperative evaluation of patients with uterine corpus cancer. Gynecol Oncol 2008; 108:486-92. [PMID: 18201753 DOI: 10.1016/j.ygyno.2007.11.044] [Citation(s) in RCA: 123] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2007] [Revised: 11/24/2007] [Accepted: 11/29/2007] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To compare positron emission tomography/computed tomography (PET/CT) with magnetic resonance imaging (MRI) in the preoperative detection of primary lesions and lymph node (LN) and distant metastases in patients with uterine corpus cancer. METHODS The patient cohort consisted of 53 women with uterine corpus cancer who underwent preoperative workup, including both MRI and PET/CT scans, and underwent surgical staging, including pelvic and/or paraaortic LN dissection, between October 2004 and June 2007 at Asan Medical Center, Seoul, Korea. Pathologic data from surgical staging were compared with the preoperative MRI and PET/CT results. For area specific analysis, LNs were divided into paraaortic, right pelvic and left pelvic areas. RESULTS In detecting primary lesions, MRI and PET/CT showed no differences in sensitivity (91.5% vs. 89.4%), specificity (33.3% vs. 50.5%), accuracy (84.9% vs. 84.9%), positive predictive value (PPV) (91.5% vs. 93.3%) and negative predictive value (NPV) (33.3% vs. 37.5%). With MRI, the sensitivity, specificity, accuracy, PPV and NPV for detecting metastatic LNs on LN area-by-area analysis were 46.2%, 87.9%, 83.9%, 28.6% and 94.0%, respectively; With PET/CT, those were 69.2%, 90.3%, 88.3%, 42.9%, and 96.6%, respectively. PET/CT showed higher sensitivity, but it did not reach statistical significance (p=0.250). There were also no differences in specificity, accuracy, PPV and NPV. In detecting distant metastasis, the sensitivity, specificity, accuracy, PPV and NPV of PET/CT were 100%, 93.8%, 92.5%, 62.5% and 100%, respectively. CONCLUSION In patients with uterine corpus cancer, PET/CT had moderate sensitivity, specificity and accuracy in detecting primary lesions and LN metastases, indicating that this method cannot replace surgical staging. The primary benefit of PET/CT is its sensitivity in detecting distant metastases. Because of its high NPV in predicting LN metastasis, PET/CT may also have advantages in selected patients who are poor candidates for surgical staging.
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Affiliation(s)
- Jeong-Yeol Park
- Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, #388-1 Poongnap-dong, Songpa-Ku, Seoul, 138-736, South Korea
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The Relevance of PET in Diagnostic Oncology. Clin Nucl Med 2008. [DOI: 10.1007/978-3-540-28026-2_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Affiliation(s)
- M J Reinhardt
- Pius-Hospital Klinik für Nuklearmedizin, Oldenburg, Germany
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44
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Positron Emission Tomography and Cancer. Oncology 2007. [DOI: 10.1007/0-387-31056-8_33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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Malik V, Keogan M, Gilham C, Duffy G, Ravi N, Reynolds JV. FDG-PET scanning in the management of cancer of the oesophagus and oesophagogastric junction: early experience with 100 consecutive cases. Ir J Med Sci 2007; 175:48-54. [PMID: 17312829 DOI: 10.1007/bf03167967] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND The aim was to evaluate the impact of FDG-PET scan on tumour staging and management decisions in oesophageal cancer. METHODS One-hundred consecutive patients referred for consideration of surgery underwent a whole body FDG-PET scan in addition to CT imaging. RESULTS Based on CT scan, a curative approach could be considered in 62 patients. The PET scan altered regional nodal (N) staging in 16 patients overall, but did not alter management decisions. Metastatic status (M) was increased in 14 patients, with altered management in 10/62 (16%). Nine were downstaged, with management changed in 3/38 (8%). Seventeen patients underwent 19 additional tests to clarify findings on PET, in 15 patients (88%) the tests revealed no pathology. CONCLUSION FDG-PET alters M stage in 23% of patients and may impact on surgical decision-making. The spurious investigations and cost of the high false-positive rate of further tests is of concern.
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Affiliation(s)
- V Malik
- Dept of Clinical Surgery, St James's Hospital and Trinity College Dublin
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Silvestri GA, Gould MK, Margolis ML, Tanoue LT, McCrory D, Toloza E, Detterbeck F. Noninvasive staging of non-small cell lung cancer: ACCP evidenced-based clinical practice guidelines (2nd edition). Chest 2007; 132:178S-201S. [PMID: 17873168 DOI: 10.1378/chest.07-1360] [Citation(s) in RCA: 399] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Correctly staging lung cancer is important because the treatment options and the prognosis differ significantly by stage. Several noninvasive imaging studies including chest CT scanning and positron emission tomography (PET) scanning are available. Understanding the test characteristics of these noninvasive staging studies is critical to decision making. METHODS Test characteristics for the noninvasive staging studies were updated from the first iteration of the lung cancer guidelines using systematic searches of the MEDLINE, HealthStar, and Cochrane Library databases up to May 2006, including selected metaanalyses, practice guidelines, and reviews. Study designs and results are summarized in evidence tables. RESULTS The pooled sensitivity and specificity of CT scanning for identifying mediastinal lymph node metastasis were 51% (95% confidence interval [CI], 47 to 54%) and 85% (95% CI, 84 to 88%), respectively, confirming that CT scanning has limited ability either to rule in or exclude mediastinal metastasis. For PET scanning, the pooled estimates of sensitivity and specificity for identifying mediastinal metastasis were 74% (95% CI, 69 to 79%) and 85% (95% CI, 82 to 88%), respectively. These findings demonstrate that PET scanning is more accurate than CT scanning. If the clinical evaluation in search of metastatic disease is negative, the likelihood of finding metastasis is low. CONCLUSIONS CT scanning of the chest is useful in providing anatomic detail, but the accuracy of chest CT scanning in differentiating benign from malignant lymph nodes in the mediastinum is poor. PET scanning has much better sensitivity and specificity than chest CT scanning for staging lung cancer in the mediastinum, and distant metastatic disease can be detected by PET scanning. With either test, abnormal findings must be confirmed by tissue biopsy to ensure accurate staging.
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Affiliation(s)
- Gerard A Silvestri
- Medical University of South Carolina, Department of Pulmonary and Critical Care Medicine, 171 Ashley Ave, Room 812-CSB, Charleston, SC 29425-2220, USA.
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Piert M, Burian M, Meisetschläger G, Stein HJ, Ziegler S, Nährig J, Picchio M, Buck A, Siewert JR, Schwaiger M. Positron detection for the intraoperative localisation of cancer deposits. Eur J Nucl Med Mol Imaging 2007; 34:1534-44. [PMID: 17431612 PMCID: PMC2562440 DOI: 10.1007/s00259-007-0430-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2006] [Accepted: 02/22/2007] [Indexed: 11/30/2022]
Abstract
Purpose The study investigated the feasibility of a positron-sensitive hand-held detector system for the intraoperative localisation of tumour deposits resulting from intravenous [18F]FDG administration. Methods A total of 17 patients (12 receiving preoperative [18F]FDG PET imaging) with various histologically proven malignancies were included. Radioactivity from tumours and surrounding normal tissue was measured on average 3 h after administration of 36–110 MBq [18F]FDG and the tumour-to-background (T/B) ratio was calculated. In addition, phantom studies were performed to evaluate the spatial resolution and sensitivity of the probe. Results All known targeted tumour sites were identified by the positron probe. T/B ratios were generally high, with a mean T/B ratio of 6.6, allowing easy identification of most tumour sites. In one case of a hepatic metastasis, the T/B ratio of 1.34 was below expectations, since the preoperative [18F]FDG PET scan was positive. The probe was instrumental in the localisation of three additional tumour lesions (two lymph nodes, one anastomotic ring) that were not immediately apparent at surgery. Phantom studies revealed that [18F]FDG-containing gel (simulating tumour tissue), having 10 times more [18F]FDG than surrounding “normal” background gel, was clearly detectable in quantities as low as 15 mg. As measured in two cases, the absorbed radiation doses ranged from 2.5 to 8.6 μSv/h for the surgical team to 0.8 μSv/h for the aesthetician. Conclusion [18F]FDG-accumulating tumour tissues can be localised with positron probes intraoperatively with a low radiation burden to the patient and medical personnel. The methodology holds promise for further clinical testing.
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Affiliation(s)
- Morand Piert
- Department of Nuclear Medicine, Technische Universität München, Ismaningerstrasse 22, 81675 Munich, Germany.
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Falk MS, Truitt AK, Coakley FV, Kashani-Sabet M, Hawkins RA, Franc B. Interpretation, accuracy and management implications of FDG PET/CT in cutaneous malignant melanoma. Nucl Med Commun 2007; 28:273-80. [PMID: 17325590 DOI: 10.1097/mnm.0b013e3280708ecf] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate the accuracy of different interpretative approaches and to evaluate the management implications of fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in cutaneous malignant melanoma. METHODS We retrospectively identified 60 consecutive patients who underwent 76 PET/CT scans for cutaneous malignant melanoma. PET/CT reports were classified as positive, negative, or equivocal for regional and distant disease. Scan indication (staging, restaging, surveillance, or therapeutic monitoring), tumour stage, presence or absence of regional or distant disease, and post-scan management changes were determined by review of all available medical records. Maximum standardized uptake values (SUV(max)) of all findings were noted. Diagnostic accuracy of PET/CT was compared using either a high or low threshold interpretation (i.e. subtle, but indeterminate findings coded negative or positive, respectively). The frequency of management changes was compared between patient subgroups (stratified by tumour stage or indication). RESULTS Using a high threshold interpretative approach, the overall accuracy of PET/CT for disease was 72.4% (55/76), which was significantly (P<0.05) greater than the accuracy of 53.9% (41/76) seen when using a low threshold approach. Per scan accuracy by staging site was 92.1% (70/76) for regional and 76.3% (58/76) for distant disease. PET/CT changed management in 21 of 76 studies (27.6%). When stratified by stage and indication, management changes occurred in all patient subgroups, except for stage I patients (0 of 5). CONCLUSION When interpreted with a high threshold approach, PET/CT demonstrates high accuracy for the diagnosis of both regional and distant disease in cutaneous malignant melanoma and frequently changes management in patients with stage II-IV disease referred for a variety of indications.
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Affiliation(s)
- Matthew S Falk
- Department of Radiology, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143-0628, USA
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Abstract
Positron emission tomography (PTE) is a technique that allows imaging of the temporal and spatial distribution of positron-emitting radionuclides. The purpose of this article is to outline the current clinical use for PET imaging in the brain and other radiopharmaceutical used for assessing various physiologic parameters pertaining to tumor metabolism.
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Affiliation(s)
- Homer A Macapinlac
- Department of Nuclear Medicine, Division of Diagnostic Imaging, University of Texas, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Box 83, Houston, TX 77030, USA.
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