1
|
Westphal K, Eiber M, Henninger M, Scheidhauer K, Beer AJ, Thaiss W, Rischpler C. Diagnostic significance of MRI versus CT using identical PET data in patients with recurrent differentiated thyroid cancer: A PET/MRI study. Medicine (Baltimore) 2023; 102:e33533. [PMID: 37083773 PMCID: PMC10118350 DOI: 10.1097/md.0000000000033533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/24/2023] [Indexed: 04/22/2023] Open
Abstract
In this retrospective study we compared magnet resonance imaging (MRI) and computed tomography (CT) each combined with identical 2-deoxy-2-[18F] fluoro-D-glucose or 2-[18F] F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) data in patients with recurrent differentiated thyroid cancer (DTC). In total 42 patients with DTC were examined. All patients underwent FDG PET/MRI and CT, the latter originating from one of the following examinations: I-131 single photon emission computed tomography/CT (32/42), low dose FDG PET/CT (5/42) or diagnostic FDG PET/CT (5/42). Two readers assessed FDG PET/MRI as well as FDG PET/CT, with the latter CT coming from one of the above examinations performed at a maximum temporal interval of 5 days from PET/MRI. Local recurrence, cervical lymph node - and pulmonary metastases were assessed in a consensus read. Lesions rated with a high malignancy score (score 4 or 5) were further analyzed. Every malignant lesion was verified if it was identified by one of both or by both modalities. In 20 of 42 patients altogether 100 malignant lesions were present. In 11/20 patients in total 15 local recurrences (15 in MRI/ 9 in CT: 9 CT/MRI, 6 MRI only, 0 CT only; P = .04) were found with a statistically significant better performance of MRI. Regarding lymph node metastases, in total 13 lesions (12 in MRI/ 8 in CT: 7 CT/MRI, 5 MRI only, 1 CT only; P = .22) in 8/20 patients were found with no significant difference between both modalities. Furthermore, in 9/20 patients in total 72 lung lesions (40 in MRI/ 63 in CT: 31 CT/MRI, 9 MRI only, 32 CT only; P = .001) were found with a statistically significant better performance of CT. In 33/42 patients follow up was available and supported the observations. In patients with recurrent DTC, PET/MRI showed superiority compared to PET/CT in evaluation of the neck region. PET/MRI was inferior to PET/CT in evaluation of the lung. PET/MRI in combination with a low dose CT of the lung may thus represent the ideal staging tool in patients with recurrent DTC.
Collapse
Affiliation(s)
- Korbinian Westphal
- Department of Nuclear Medicine, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany
| | - Matthias Eiber
- Department of Nuclear Medicine, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany
| | - Martin Henninger
- Department of Nuclear Medicine, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany
| | - Klemens Scheidhauer
- Department of Nuclear Medicine, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany
| | - Ambros J. Beer
- Department of Nuclear Medicine, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany
- Department of Nuclear Medicine, Ulm University Hospital, Ulm, Germany
| | - Wolfgang Thaiss
- Department of Nuclear Medicine, Ulm University Hospital, Ulm, Germany
- Department of Radiology, Ulm University Hospital, Ulm, Germany
| | - Christoph Rischpler
- Department of Nuclear Medicine, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany
- Clinic for Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Department of Nuclear Medicine, Klinikum Stuttgart, Stuttgart, Germany
| |
Collapse
|
2
|
Grafe H, Lindemann ME, Weber M, Kirchner J, Binse I, Umutlu L, Herrmann K, Quick HH. Intra-Individual Comparison of 124I-PET/CT and 124I-PET/MR Hybrid Imaging of Patients with Resected Differentiated Thyroid Carcinoma: Aspects of Attenuation Correction. Cancers (Basel) 2022; 14:cancers14133040. [PMID: 35804811 PMCID: PMC9264885 DOI: 10.3390/cancers14133040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/03/2022] [Accepted: 06/15/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary This study evaluates the qualitative and quantitative differences between 124-iodine PET/CT and PET/MR in oncologic patients with differentiated thyroid carcinoma after thyroidectomy. The impact of improved MR-based attenuation correction (AC) using a bone atlas was analysed in PET/MR data. Despite different patient positioning and AC methods PET/CT and PET/MR provide overall comparable results in a clinical setting. The overall number of detected 124I-active lesions and the measured average SUVmean values for congruent lesions were higher for PET/MR when compared to PET/CT. The addition of bone to the MR-based AC in PET/MR slightly increased the SUVmean values for all detected lesions. Abstract Background: This study evaluates the quantitative differences between 124-iodine (I) positron emission tomography/computed tomography (PET/CT) and PET/magnetic resonance imaging (PET/MR) in patients with resected differentiated thyroid carcinoma (DTC). Methods: N = 43 124I PET/CT and PET/MR exams were included. CT-based attenuation correction (AC) in PET/CT and MR-based AC in PET/MR with bone atlas were compared concerning bone AC in the head-neck region. AC-map artifacts (e.g., dentures) were noted. Standardized uptake values (SUV) were measured in lesions in each PET data reconstruction. Relative differences in SUVmean were calculated between PET/CT and PET/MR with bone atlas. Results: Overall, n = 111 124I-avid lesions were detected in all PET/CT, while n = 132 lesions were detected in PET/MR. The median in SUVmean for n = 98 congruent lesions measured in PET/CT was 12.3. In PET/MR, the median in SUVmean was 16.6 with bone in MR-based AC. Conclusions: 124I-PET/CT and 124I-PET/MR hybrid imaging of patients with DTC after thyroidectomy provides overall comparable quantitative results in a clinical setting despite different patient positioning and AC methods. The overall number of detected 124I-avid lesions was higher for PET/MR compared to PET/CT. The measured average SUVmean values for congruent lesions were higher for PET/MR.
Collapse
Affiliation(s)
- Hong Grafe
- Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany; (M.W.); (I.B.); (K.H.)
- Correspondence: ; Tel.: +49-201-723-2033
| | - Maike E. Lindemann
- High-Field and Hybrid MR Imaging, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (M.E.L.); (H.H.Q.)
| | - Manuel Weber
- Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany; (M.W.); (I.B.); (K.H.)
| | - Julian Kirchner
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Hospital Dusseldorf, 40225 Dusseldorf, Germany;
| | - Ina Binse
- Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany; (M.W.); (I.B.); (K.H.)
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany;
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany; (M.W.); (I.B.); (K.H.)
| | - Harald H. Quick
- High-Field and Hybrid MR Imaging, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany; (M.E.L.); (H.H.Q.)
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, 45141 Essen, Germany
| |
Collapse
|
3
|
PET imaging in thyroid cancer. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00170-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
4
|
Kersting D, Jentzen W, Sraieb M, Costa PF, Conti M, Umutlu L, Antoch G, Nader M, Herrmann K, Fendler WP, Rischpler C, Weber M. Comparing lesion detection efficacy and image quality across different PET system generations to optimize the iodine-124 PET protocol for recurrent thyroid cancer. EJNMMI Phys 2021; 8:14. [PMID: 33587222 PMCID: PMC7884562 DOI: 10.1186/s40658-021-00361-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/28/2021] [Indexed: 12/13/2022] Open
Abstract
Background In recurrent differentiated thyroid cancer patients, detectability in 124I PET is limited for lesions with low radioiodine uptake. We assess the improvements in lesion detectability and image quality between three generations of PET scanners with different detector technologies. The results are used to suggest an optimized protocol. Methods Datasets of 10 patients with low increasing thyroglobulin or thyroglobulin antibody levels after total thyroidectomy and radioiodine therapies were included. PET data were acquired and reconstructed on a Biograph mCT PET/CT (whole-body, 4-min acquisition time per bed position; OSEM, OSEM-TOF, OSEM-TOF+PSF), a non-TOF Biograph mMR PET/MR (neck region, 4 min and 20 min; OSEM), and a new generation Biograph Vision PET/CT (whole-body, 4 min; OSEM, OSEM-TOF, OSEM-TOF+PSF). The 20-min image on the mMR was used as reference to calculate the detection efficacy in the neck region. Image quality was rated on a 5-point scale. Results All detected lesions were in the neck region. Detection efficacy was 8/9 (Vision OSEM-TOF and OSEM-TOF+PSF), 4/9 (Vision OSEM), 3/9 (mMR OSEM and mCT OSEM-TOF+PSF), and 2/9 (mCT OSEM and OSEM-TOF). Median image quality was 4 (Vision OSEM-TOF and OSEM-TOF+PSF), 3 (Vision OSEM, mCT OSEM-TOF+PSF, and mMR OSEM 20-min), 2 (mCT OSEM-TOF), 1.5 (mCT OSEM), and 1 (mMR OSEM 4 min). Conclusion At a clinical standard acquisition time of 4 min per bed position, the new generation Biograph Vision using a TOF-based image reconstruction demonstrated the highest detectability and image quality and should, if available, be preferably used for imaging of low-uptake lesions. A prolonged acquisition time for the mostly affected neck region can be useful. Supplementary Information The online version contains supplementary material available at 10.1186/s40658-021-00361-y.
Collapse
Affiliation(s)
- David Kersting
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany. .,West German Cancer Center (WTZ), Essen, Germany. .,German Cancer Consortium (DKTK), Essen and Dusseldorf, Germany.
| | - Walter Jentzen
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.,West German Cancer Center (WTZ), Essen, Germany.,German Cancer Consortium (DKTK), Essen and Dusseldorf, Germany
| | - Miriam Sraieb
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.,West German Cancer Center (WTZ), Essen, Germany.,German Cancer Consortium (DKTK), Essen and Dusseldorf, Germany
| | - Pedro Fragoso Costa
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.,West German Cancer Center (WTZ), Essen, Germany.,German Cancer Consortium (DKTK), Essen and Dusseldorf, Germany
| | | | - Lale Umutlu
- West German Cancer Center (WTZ), Essen, Germany.,German Cancer Consortium (DKTK), Essen and Dusseldorf, Germany.,Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, 45147, Essen, Germany
| | - Gerald Antoch
- German Cancer Consortium (DKTK), Essen and Dusseldorf, Germany.,Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, 40225, Dusseldorf, Germany
| | - Michael Nader
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.,West German Cancer Center (WTZ), Essen, Germany.,German Cancer Consortium (DKTK), Essen and Dusseldorf, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.,West German Cancer Center (WTZ), Essen, Germany.,German Cancer Consortium (DKTK), Essen and Dusseldorf, Germany
| | - Wolfgang Peter Fendler
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.,West German Cancer Center (WTZ), Essen, Germany.,German Cancer Consortium (DKTK), Essen and Dusseldorf, Germany
| | - Christoph Rischpler
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.,West German Cancer Center (WTZ), Essen, Germany.,German Cancer Consortium (DKTK), Essen and Dusseldorf, Germany
| | - Manuel Weber
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.,West German Cancer Center (WTZ), Essen, Germany.,German Cancer Consortium (DKTK), Essen and Dusseldorf, Germany
| |
Collapse
|
5
|
Cho SJ, Suh CH, Baek JH, Chung SR, Choi YJ, Lee JH. Diagnostic performance of MRI to detect metastatic cervical lymph nodes in patients with thyroid cancer: a systematic review and meta-analysis. Clin Radiol 2020; 75:562.e1-562.e10. [PMID: 32303337 DOI: 10.1016/j.crad.2020.03.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 03/11/2020] [Indexed: 02/02/2023]
Abstract
AIM To evaluate the diagnostic performance of magnetic resonance imaging (MRI) in the diagnosis of metastatic cervical lymph nodes. MATERIALS AND METHODS Ovid-MEDLINE and EMBASE databases were searched up until 12 June 2018. Eleven articles were included in the qualitative systematic review and nine of the 11 in the quantitative analysis. Two radiologists independently performed data extraction and methodological quality assessment using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A qualitative systematic review and quantitative analysis were performed, followed by a meta-regression analysis to determine factors causing heterogeneity. RESULTS The pooled sensitivity and specificity in the diagnosis of metastatic cervical lymph nodes were 80% (95% confidence interval [CI]: 68-88%) and 85% (95% CI: 63-95%), respectively. The sensitivity and false-positive rate (correlation coefficient, 0.655) showed a positive correlation due to a threshold effect, which was responsible for heterogeneity across the studies, as indicated by a Q-test (p<0.01) and Higgins I2 statistic (sensitivity, I2=90.11%; specificity, I2=92.49%). In the meta-regression analysis, fat-suppressed imaging, and the analysis method were significant factors influencing the heterogeneity in diagnostic performance. CONCLUSIONS MRI shows moderate diagnostic performance in the diagnosis of metastatic lymph nodes in patients with thyroid cancer in the neck. MRI may be an optional or complementary imaging method to ultrasound or computed tomography (CT) in thyroid cancer patients.
Collapse
Affiliation(s)
- S J Cho
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea; Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - C H Suh
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
| | - J H Baek
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea.
| | - S R Chung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
| | - Y J Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
| | - J H Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
| |
Collapse
|
6
|
Samanci C, Onal Y, Sager S, Asa S, Ustabasioglu FE, Alis D, Akman C, Sonmezoglu K. Diagnostic Capabilities of MRI Versus 18F FDG PET-CT in Postoperative Patients with Thyroglobulin Positive, 131I-negative Local Recurrent or Metastatic Thyroid Cancer. Curr Med Imaging 2020; 15:956-964. [PMID: 32008523 DOI: 10.2174/1573405614666180718124739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 06/12/2018] [Accepted: 06/29/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND The detection of recurrence or metastasis might be challenging in patients, who underwent total thyroidectomy and radioactive iodine therapy for Differentiated Thyroid Carcinoma (DTC), with increased serum Thyroglobulin (Tg) levels and negative 131I whole body scan (131I-WBS) results. AIMS The purpose of this study was to compare the ability of Magnetic Resonance Imaging (MRI) and 18F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (18F FDG PET-CT) to detect recurrence or cervical and upper mediastinal metastases in postoperative DTC patients who had negative 131I-WBS despite elevated serum Tg levels. STUDY DESIGN This study has a retrospective study design. METHODS We evaluated cervical and upper mediastinal MRI and 18F FDG PET-CT of 32 postoperative patients with DTC (26 patients with papillary thyroid carcinoma and 6 patients with follicular thyroid carcinoma). RESULTS We evaluated 44 lesions in 32 patients. For all lesions, the Positive Predictive Value, (PPV) Negative Predictive Value (NPV), sensitivity, specificity, and accuracy of MRI were 81.4%, 76.4%, 84.6%, 72.2%, and 79.5% respectively. The PPV, NPV, sensitivity, specificity, and accuracy of 18F FDG PET-CT were 100.0%, 85.7%, 88.4%, 100.0%, and 93.1%, respectively. CONCLUSION Although we could not replace 18F FDG PET-CT, MRI might be used as an adjunct to 18F FDG PET-CT for the evaluation of recurrent or cervical and upper mediastinal metastatic thyroid cancers; however, MRI is inadequate for the detection of metastases in small lymph nodes.
Collapse
Affiliation(s)
- Cesur Samanci
- Department of Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Yilmaz Onal
- Department of Radiology, İstanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sait Sager
- Department of Nuclear Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sertac Asa
- Department of Nuclear Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Fethi Emre Ustabasioglu
- Department of Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Deniz Alis
- Department of Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Canan Akman
- Department of Radiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Kerim Sonmezoglu
- Department of Nuclear Medicine, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| |
Collapse
|
7
|
Weber M, Binse I, Nagarajah J, Bockisch A, Herrmann K, Jentzen W. The role of 124I PET/CT lesion dosimetry in differentiated thyroid cancer. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF RADIOPHARMACEUTICAL CHEMISTRY AND BIOLOGY 2019; 63:235-252. [DOI: 10.23736/s1824-4785.19.03201-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
|
8
|
Samnick S, Al-Momani E, Schmid JS, Mottok A, Buck AK, Lapa C. Initial Clinical Investigation of [18F]Tetrafluoroborate PET/CT in Comparison to [124I]Iodine PET/CT for Imaging Thyroid Cancer. Clin Nucl Med 2018; 43:162-167. [PMID: 29356744 DOI: 10.1097/rlu.0000000000001977] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIM Recently, [F]tetrafluoroborate ([F]TFB) has been introduced as a versatile PET probe for imaging the human sodium/iodide symporter activity. This pilot study aimed to compare [F]TFB-PET/CT with [I]NaI-PET/CT imaging in thyroid cancer patients. METHODS Nine patients with newly diagnosed differentiated thyroid cancer underwent both [F]TFB- and [I]NaI-PET/CT after total thyroidectomy. PET/CT scans were visually analyzed for the presence of remnant thyroid tissue and for metastatic lesions on a patient and lesion basis. For semiquantitative analysis, thyroid remnant/tumor to blood pool ratios were calculated. RESULTS All patients presented with positive [F]TFB and [I]NaI-PET/CT scans. Retention of I in remnant thyroid tissue was significantly higher as compared with [F]TFB (P < 0.01). In a lesion-based analysis, both tracers identified an almost equal number of foci with [F]TFB depicting a total of 41 foci and I a total of 40 foci, respectively. In 6 of 9 patients, both radiopharmaceuticals returned an identical number of foci. Two I-positive benign thyroid remnants were missed by [F]TFB-PET/CT in a single patient. In another case, both tracers identified different thyroid remnant tissues in the cervical region. Notably, [F]TFB demonstrated additional (I-negative) cervical lymph node metastases in 2 patients, leading to an overall agreement between the radiotracers of 91% (74/81 foci). DISCUSSION In this pilot study, [F]TFB-PET was not inferior to [I]NaI-PET for detecting thyroid cancer and its metastases and was able to detect [I]NaI-PET-negative viable differentiated thyroid cancer metastases. Further clinical evaluation as a PET tracer for imaging thyroid pathophysiology and human sodium/iodide symporter expressing neoplasms is highly warranted.
Collapse
|
9
|
PET/MR Imaging in Head and Neck Cancer: Current Applications and Future Directions. Magn Reson Imaging Clin N Am 2018; 26:167-178. [PMID: 29128003 DOI: 10.1016/j.mric.2017.08.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Clinical PET/MR imaging is being implemented at institutions worldwide as part of the standard-of-care imaging for select oncology patients. This article focuses on oncologic applications of PET/MR imaging in cancers of the head and neck. Although current published literature is relatively sparse, the potential benefits of a hybrid modality of PET/MR imaging are discussed along with several possible areas of research. With the increasing number of PET/MR imaging scanners in clinical use and ongoing research, the role of PET/MR imaging in the management of head and neck cancer is likely to become more evident in the near future.
Collapse
|
10
|
Rosenbaum-Krumme S, Nagarajah J, Ruhlmann M, Bockisch A, Jentzen W. 124I-PET/CT images of differentiated thyroid cancer patients. Nuklearmedizin 2017; 51:213-6. [DOI: 10.3413/nukmed-0481-12-02] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Accepted: 07/06/2012] [Indexed: 11/20/2022]
Abstract
SummaryFor an adequate therapy planning and staging of patients with differentiated thyroid cancer (DTC), the correct assignment of thyroid remnants (TRs) and lymph node metastases (LMs) is important. Patients, method: We retrospectively analyzed whether kinetic quantities can help improving LM assignment using serial 124I-PET/CT data. 127 patients with a total of 317 lesions (TR: n = 265; LM: n = 52) received pre-therapy 124I-PET/CT lesion dosimetry using images 24 h and > 96 h after 124I administration. For each lesion, maximum activity concentration (MAC) at 24 h and effective half-life (EHL) were determined. Moreover, the product of MAC and EHL was also investigated as a quantity and is referred to CAQ (cumulated activity proportional quantity). In addition, differences between endogenous and exogenous thyroid-stimulating hormone (TSH) stimulation and between papillary (PTC) and follicular thyroid cancer (FTC) were investigated. Results, conclusion: The median MAC, EHL, and CAQ values in TR were significantly higher than in LM but a clinically relevant cut-off value could not be determined because of high overlapping regions. No significant differences for the three quantities were found for the mode of TSH stimulations, but a significant difference for MAC and CAQ between PTC and FTC.
Collapse
|
11
|
Wierts R, Jentzen W, Quick HH, Wisselink HJ, Pooters INA, Wildberger JE, Herrmann K, Kemerink GJ, Backes WH, Mottaghy FM. Quantitative performance evaluation of 124I PET/MRI lesion dosimetry in differentiated thyroid cancer. Phys Med Biol 2017; 63:015014. [PMID: 29116052 DOI: 10.1088/1361-6560/aa990b] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The aim was to investigate the quantitative performance of 124I PET/MRI for pre-therapy lesion dosimetry in differentiated thyroid cancer (DTC). Phantom measurements were performed on a PET/MRI system (Biograph mMR, Siemens Healthcare) using 124I and 18F. The PET calibration factor and the influence of radiofrequency coil attenuation were determined using a cylindrical phantom homogeneously filled with radioactivity. The calibration factor was 1.00 ± 0.02 for 18F and 0.88 ± 0.02 for 124I. Near the radiofrequency surface coil an underestimation of less than 5% in radioactivity concentration was observed. Soft-tissue sphere recovery coefficients were determined using the NEMA IEC body phantom. Recovery coefficients were systematically higher for 18F than for 124I. In addition, the six spheres of the phantom were segmented using a PET-based iterative segmentation algorithm. For all 124I measurements, the deviations in segmented lesion volume and mean radioactivity concentration relative to the actual values were smaller than 15% and 25%, respectively. The effect of MR-based attenuation correction (three- and four-segment µ-maps) on bone lesion quantification was assessed using radioactive spheres filled with a K2HPO4 solution mimicking bone lesions. The four-segment µ-map resulted in an underestimation of the imaged radioactivity concentration of up to 15%, whereas the three-segment µ-map resulted in an overestimation of up to 10%. For twenty lesions identified in six patients, a comparison of 124I PET/MRI to PET/CT was performed with respect to segmented lesion volume and radioactivity concentration. The interclass correlation coefficients showed excellent agreement in segmented lesion volume and radioactivity concentration (0.999 and 0.95, respectively). In conclusion, it is feasible that accurate quantitative 124I PET/MRI could be used to perform radioiodine pre-therapy lesion dosimetry in DTC.
Collapse
Affiliation(s)
- R Wierts
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, Netherlands
| | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Stokke C, Gabiña PM, Solný P, Cicone F, Sandström M, Gleisner KS, Chiesa C, Spezi E, Paphiti M, Konijnenberg M, Aldridge M, Tipping J, Wissmeyer M, Brans B, Bacher K, Kobe C, Flux G. Dosimetry-based treatment planning for molecular radiotherapy: a summary of the 2017 report from the Internal Dosimetry Task Force. EJNMMI Phys 2017; 4:27. [PMID: 29164483 PMCID: PMC5698234 DOI: 10.1186/s40658-017-0194-3] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 11/06/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The European directive on basic safety standards (Council directive 2013/59 Euratom) mandates dosimetry-based treatment planning for radiopharmaceutical therapies. The directive comes into operation February 2018, and the aim of a report produced by the Internal Dosimetry Task Force of the European Association of Nuclear Medicine is to address this aspect of the directive. A summary of the report is presented. RESULTS A brief review of five of the most common therapy procedures is included in the current text, focused on the potential to perform patient-specific dosimetry. In the full report, 11 different therapeutic procedures are included, allowing additional considerations of effectiveness, references to specific literature on quantitative imaging and dosimetry, and existing evidence for absorbed dose-effect correlations for each treatment. Individualized treatment planning with tracer diagnostics and verification of the absorbed doses delivered following therapy is found to be scientifically feasible for almost all procedures investigated, using quantitative imaging and/or external monitoring. Translation of this directive into clinical practice will have significant implications for resource requirements. CONCLUSIONS Molecular radiotherapy is undergoing a significant expansion, and the groundwork for dosimetry-based treatment planning is already in place. The mandated individualization is likely to improve the effectiveness of the treatments, although must be adequately resourced.
Collapse
Affiliation(s)
- Caroline Stokke
- Department of Diagnostic Physics, Oslo University Hospital, Oslo, Norway.
| | - Pablo Minguez Gabiña
- Department of Medical Physics and Radiation Protection, Gurutzeta/Cruces University Hospital, Barakaldo, Spain
| | - Pavel Solný
- Department of Dosimetry and Application of Ionizing Radiation, Czech Technical University in Prague, Prague, Czech Republic
| | - Francesco Cicone
- Nuclear Medicine, Sant'Andrea Hospital, Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Mattias Sandström
- Section of Nuclear Medicine and PET, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | | | - Carlo Chiesa
- Nuclear Medicine Division, Foundation IRCCS istituto nazionale Tumori, Milan, Italy
| | | | - Maria Paphiti
- Department of Medical Physics, Pammakaristos Hospital, Athens, Greece
| | - Mark Konijnenberg
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Matt Aldridge
- Nuclear Medicine/Radiotherapy Physics, UCL Institute of Nuclear Medicine and UCL Hospitals NHS Foundation Trust, London, UK
| | - Jill Tipping
- The Christie NHS Foundation Trust, Nuclear Medicine, Manchester, UK
| | - Michael Wissmeyer
- Department of Nuclear Medicine, University Hospital of Geneva, Geneva, Switzerland
| | - Boudewijn Brans
- Department of Nuclear Medicine and PET Center, University Hospital, Ghent, Belgium
| | - Klaus Bacher
- Department of Basic Medical Sciences, Division of Medical Physics, Ghent University, Ghent, Belgium
| | - Carsten Kobe
- Department for Nuclear Medicine, University Hospital of Cologne, Cologne, Germany
| | - Glenn Flux
- Joint Department of Physics, Royal Marsden Hospital and Institute of Cancer Research, Sutton, UK
| |
Collapse
|
13
|
Dercle L, Deandreis D, Terroir M, Leboulleux S, Lumbroso J, Schlumberger M. Evaluation of (124)I PET/CT and (124)I PET/MRI in the management of patients with differentiated thyroid cancer. Eur J Nucl Med Mol Imaging 2017; 43:1006-10. [PMID: 26928579 DOI: 10.1007/s00259-016-3334-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Laurent Dercle
- Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy and University Paris Saclay, 114 rue Edouard Vaillant, 94800, Villejuif Cédex, France
| | - Désirée Deandreis
- Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy and University Paris Saclay, 114 rue Edouard Vaillant, 94800, Villejuif Cédex, France
| | - Marie Terroir
- Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy and University Paris Saclay, 114 rue Edouard Vaillant, 94800, Villejuif Cédex, France
| | - Sophie Leboulleux
- Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy and University Paris Saclay, 114 rue Edouard Vaillant, 94800, Villejuif Cédex, France
| | - Jean Lumbroso
- Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy and University Paris Saclay, 114 rue Edouard Vaillant, 94800, Villejuif Cédex, France
| | - Martin Schlumberger
- Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy and University Paris Saclay, 114 rue Edouard Vaillant, 94800, Villejuif Cédex, France.
| |
Collapse
|
14
|
Hybrid PET/MR: Updated Clinical Use and Potential Applications. CURRENT RADIOLOGY REPORTS 2016. [DOI: 10.1007/s40134-016-0191-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
15
|
Hempel JM, Kloeckner R, Krick S, Pinto Dos Santos D, Schadmand-Fischer S, Boeßert P, Bisdas S, Weber MM, Fottner C, Musholt TJ, Schreckenberger M, Miederer M. Impact of combined FDG-PET/CT and MRI on the detection of local recurrence and nodal metastases in thyroid cancer. Cancer Imaging 2016; 16:37. [PMID: 27809936 PMCID: PMC5093960 DOI: 10.1186/s40644-016-0096-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 10/25/2016] [Indexed: 12/19/2022] Open
Abstract
Background Suspected recurrence of thyroid carcinoma is a diagnostic challenge when findings of both a radio iodine whole body scan and ultrasound are negative. PET/CT and MRI have shown to be feasible for detection of recurrent disease. However, the added value of a consensus reading by the radiologist and the nuclear medicine physician, which has been deemed to be helpful in clinical routines, has not been investigated. This study aimed to investigate the impact of combined FDG-PET/ldCT and MRI on detection of locally recurrent TC and nodal metastases in high-risk patients with special focus on the value of the multidisciplinary consensus reading. Materials and methods Forty-six patients with suspected locally recurrent thyroid cancer or nodal metastases after thyroidectomy and radio-iodine therapy were retrospectively selected for analysis. Inclusion criteria comprised elevated thyroglobulin blood levels, a negative ultrasound, negative iodine whole body scan, as well as combined FDG-PET/ldCT and MRI examinations. Neck compartments in FDG-PET/ldCT and MRI examinations were independently analyzed by two blinded observers for local recurrence and nodal metastases of thyroid cancer. Consecutively, the scans were read in consensus. To explore a possible synergistic effect, FDG-PET/ldCT and MRI results were combined. Histopathology or long-term follow-up served as a gold standard. For method comparison, sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy were calculated. Results FDG-PET/ldCT was substantially more sensitive and more specific than MRI in detection of both local recurrence and nodal metastases. Inter-observer agreement was substantial both for local recurrence (κ = 0.71) and nodal metastasis (κ = 0.63) detection in FDG-PET/ldCT. For MRI, inter-observer agreement was substantial for local recurrence (κ = 0.69) and moderate for nodal metastasis (κ = 0.55) detection. In contrast, FDG-PET/ldCT and MRI showed only slight agreement (κ = 0.21). However, both imaging modalities identified different true positive results. Thus, the combination created a synergistic effect. The multidisciplinary consensus reading further increased sensitivity, specificity, and diagnostic accuracy. Conclusions FDG-PET/ldCT and MRI are complementary imaging modalities and should be combined to improve detection of local recurrence and nodal metastases of thyroid cancer in high-risk patients. The multidisciplinary consensus reading is a key element in the diagnostic approach. Electronic supplementary material The online version of this article (doi:10.1186/s40644-016-0096-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Johann-Martin Hempel
- Department of Radiology, Diagnostic and Interventional Neuroradiology, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, D-72076, Tübingen, Germany. .,Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University Medical Center, Langenbeckstr. 1, D-55131, Mainz, Germany.
| | - Roman Kloeckner
- Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University Medical Center, Langenbeckstr. 1, D-55131, Mainz, Germany
| | - Sandra Krick
- Department of Nuclear Medicine, Johannes Gutenberg-University Medical Center, Langenbeckstr. 1, D-55131, Mainz, Germany
| | - Daniel Pinto Dos Santos
- Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University Medical Center, Langenbeckstr. 1, D-55131, Mainz, Germany
| | - Simin Schadmand-Fischer
- Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University Medical Center, Langenbeckstr. 1, D-55131, Mainz, Germany
| | - Patrick Boeßert
- Department of Otolaryngology and Head and Neck Surgery, AMEOS Hospital Haldensleben, Kiefholzstr. 4 & 27, D-39340, Haldensleben, Germany
| | - Sotirios Bisdas
- Department of Radiology, Diagnostic and Interventional Neuroradiology, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, D-72076, Tübingen, Germany.,Department of Neuroradiology, National Hospital of Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom
| | - Matthias M Weber
- Department of Endocrinology and Metabolism, I. Medical Clinic, Johannes Gutenberg-University Medical Center, Langenbeckstr. 1, D-55131, Mainz, Germany
| | - Christian Fottner
- Department of Endocrinology and Metabolism, I. Medical Clinic, Johannes Gutenberg-University Medical Center, Langenbeckstr. 1, D-55131, Mainz, Germany
| | - Thomas J Musholt
- Clinic of General, Visceral- and Transplantation Surgery, Endocrine Surgery Section, Johannes Gutenberg-University Medical Center, Langenbeckstr. 1, D-55131, Mainz, Germany
| | - Mathias Schreckenberger
- Department of Nuclear Medicine, Johannes Gutenberg-University Medical Center, Langenbeckstr. 1, D-55131, Mainz, Germany
| | - Matthias Miederer
- Department of Nuclear Medicine, Johannes Gutenberg-University Medical Center, Langenbeckstr. 1, D-55131, Mainz, Germany
| |
Collapse
|
16
|
Lamartina L, Deandreis D, Durante C, Filetti S. ENDOCRINE TUMOURS: Imaging in the follow-up of differentiated thyroid cancer: current evidence and future perspectives for a risk-adapted approach. Eur J Endocrinol 2016; 175:R185-202. [PMID: 27252484 DOI: 10.1530/eje-16-0088] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 05/31/2016] [Indexed: 12/18/2022]
Abstract
The clinical and epidemiological profiles of differentiated thyroid cancers (DTCs) have changed in the last three decades. Today's DTCs are more likely to be small, localized, asymptomatic papillary forms. Current practice is, though, moving toward more conservative approaches (e.g. lobectomy instead of total thyroidectomy, selective use of radioiodine). This evolution has been paralleled and partly driven by rapid technological advances in the field of diagnostic imaging. The challenge of contemporary DTCs follow-up is to tailor a risk-of-recurrence-based management, taking into account the dynamic nature of these risks, which evolve over time, spontaneously and in response to treatments. This review provides a closer look at the evolving evidence-based views on the use and utility of imaging technology in the post-treatment staging and the short- and long-term surveillance of patients with DTCs. The studies considered range from cervical US with Doppler flow analysis to an expanding palette of increasingly sophisticated second-line studies (cross-sectional, functional, combined-modality approaches), which can be used to detect disease that has spread beyond the neck and, in some cases, shed light on its probable outcome.
Collapse
Affiliation(s)
- Livia Lamartina
- Department of Internal Medicine and Medical SpecialtiesUniversity of Rome Sapienza, Rome, Italy
| | - Désirée Deandreis
- Department of Nuclear Medicine and Endocrine OncologyGustave Roussy and University Paris Saclay, Villejuif, France
| | - Cosimo Durante
- Department of Internal Medicine and Medical SpecialtiesUniversity of Rome Sapienza, Rome, Italy
| | - Sebastiano Filetti
- Department of Internal Medicine and Medical SpecialtiesUniversity of Rome Sapienza, Rome, Italy
| |
Collapse
|
17
|
Menezes ME, Das SK, Minn I, Emdad L, Wang XY, Sarkar D, Pomper MG, Fisher PB. Detecting Tumor Metastases: The Road to Therapy Starts Here. Adv Cancer Res 2016; 132:1-44. [PMID: 27613128 DOI: 10.1016/bs.acr.2016.07.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Metastasis is the complex process by which primary tumor cells migrate and establish secondary tumors in an adjacent or distant location in the body. Early detection of metastatic disease and effective therapeutic options for targeting these detected metastases remain impediments to effectively treating patients with advanced cancers. If metastatic lesions are identified early, patients might maximally benefit from effective early therapeutic interventions. Further, monitoring patients whose primary tumors are effectively treated for potential metastatic disease onset is also highly valuable. Finally, patients with metastatic disease can be monitored for efficacy of specific therapeutic interventions through effective metastatic detection techniques. Thus, being able to detect and visualize metastatic lesions is key and provides potential to greatly improve overall patient outcomes. In order to achieve these objectives, researchers have endeavored to mechanistically define the steps involved in the metastatic process as well as ways to effectively detect metastatic progression. We presently overview various preclinical and clinical in vitro and in vivo assays developed to more efficiently detect tumor metastases, which provides the foundation for developing more effective therapies for this invariably fatal component of the cancerous process.
Collapse
Affiliation(s)
- M E Menezes
- Virginia Commonwealth University, School of Medicine, Richmond, VA, United States
| | - S K Das
- Virginia Commonwealth University, School of Medicine, Richmond, VA, United States; VCU Institute of Molecular Medicine, Virginia Commonwealth University, School of Medicine, Richmond, VA, United States; VCU Massey Cancer Center, Virginia Commonwealth University, School of Medicine, Richmond, VA, United States
| | - I Minn
- The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - L Emdad
- Virginia Commonwealth University, School of Medicine, Richmond, VA, United States; VCU Institute of Molecular Medicine, Virginia Commonwealth University, School of Medicine, Richmond, VA, United States; VCU Massey Cancer Center, Virginia Commonwealth University, School of Medicine, Richmond, VA, United States
| | - X-Y Wang
- Virginia Commonwealth University, School of Medicine, Richmond, VA, United States; VCU Institute of Molecular Medicine, Virginia Commonwealth University, School of Medicine, Richmond, VA, United States; VCU Massey Cancer Center, Virginia Commonwealth University, School of Medicine, Richmond, VA, United States
| | - D Sarkar
- Virginia Commonwealth University, School of Medicine, Richmond, VA, United States; VCU Institute of Molecular Medicine, Virginia Commonwealth University, School of Medicine, Richmond, VA, United States; VCU Massey Cancer Center, Virginia Commonwealth University, School of Medicine, Richmond, VA, United States
| | - M G Pomper
- The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - P B Fisher
- Virginia Commonwealth University, School of Medicine, Richmond, VA, United States; VCU Institute of Molecular Medicine, Virginia Commonwealth University, School of Medicine, Richmond, VA, United States; VCU Massey Cancer Center, Virginia Commonwealth University, School of Medicine, Richmond, VA, United States.
| |
Collapse
|
18
|
Wierts R, Brans B, Havekes B, Kemerink GJ, Halders SG, Schaper NN, Backes WH, Mottaghy FM, Jentzen W. Dose–Response Relationship in Differentiated Thyroid Cancer Patients Undergoing Radioiodine Treatment Assessed by Means of 124I PET/CT. J Nucl Med 2016; 57:1027-32. [DOI: 10.2967/jnumed.115.168799] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 02/05/2016] [Indexed: 11/16/2022] Open
|
19
|
Binse I, Poeppel TD, Ruhlmann M, Gomez B, Umutlu L, Bockisch A, Rosenbaum-Krumme SJ. Imaging with (124)I in differentiated thyroid carcinoma: is PET/MRI superior to PET/CT? Eur J Nucl Med Mol Imaging 2015; 43:1011-7. [PMID: 26686334 DOI: 10.1007/s00259-015-3288-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 12/09/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE The aim of this study was to compare integrated PET/CT and PET/MRI for their usefulness in detecting and categorizing cervical iodine-positive lesions in patients with differentiated thyroid cancer using (124)I as tracer. METHODS The study group comprised 65 patients at high risk of iodine-positive metastasis who underwent PET/CT (low-dose CT scan, PET acquisition time 2 min; PET/CT2) followed by PET/MRI of the neck 24 h after (124)I administration. PET images from both modalities were analysed for the numbers of tracer-positive lesions. Two different acquisition times were used for the comparisons, one matching the PET/CT2 acquisition time (2 min, PET/MRI2) and the other covering the whole MRI scan time (30 min, PET/MRI30). Iodine-positive lesions were categorized as metastasis, thyroid remnant or inconclusive according to their location on the PET/CT images. Morphological information provided by MRI was considered for evaluation of lesions on PET/MRI and for volume information. RESULTS PET/MRI2 detected significantly more iodine-positive metastases and thyroid remnants than PET/CT2 (72 vs. 60, p = 0.002, and 100 vs. 80, p = 0.001, respectively), but the numbers of patients with at least one tumour lesion identified were not significantly different (21/65 vs. 17/65 patients). PET/MRI30 tended to detect more PET-positive metastases than PET/MRI2 (88 vs. 72), but the difference was not significant (p = 0.07). Of 21 lesions classified as inconclusive on PET/CT, 5 were assigned to metastasis or thyroid remnant when evaluated by PET/MRI. Volume information was available in 34 % of iodine-positive metastases and 2 % of thyroid remnants on PET/MRI. CONCLUSIONS PET/MRI of the neck was found to be superior to PET/CT in detecting iodine-positive lesions. This was attributed to the higher sensitivity of the PET component, Although helpful in some cases, we found no substantial advantage of PET/MRI over PET/CT in categorizing iodine-positive lesions as either metastasis or thyroid remnant. Volume information provided by MRI for some iodine-positive lesions might be useful in dosimetry.
Collapse
Affiliation(s)
- I Binse
- Medical Faculty, Department of Nuclear Medicine, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany.
| | - T D Poeppel
- Medical Faculty, Department of Nuclear Medicine, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - M Ruhlmann
- Medical Faculty, Department of Nuclear Medicine, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - B Gomez
- Medical Faculty, Department of Nuclear Medicine, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - L Umutlu
- Medical Faculty, Department of Radiology, University of Duisburg-Essen, Essen, Germany
| | - A Bockisch
- Medical Faculty, Department of Nuclear Medicine, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - S J Rosenbaum-Krumme
- Medical Faculty, Department of Nuclear Medicine, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| |
Collapse
|
20
|
Kist JW, de Keizer B, van der Vlies M, Brouwers AH, Huysmans DA, van der Zant FM, Hermsen R, Stokkel MP, Hoekstra OS, Vogel WV. 124I PET/CT to Predict the Outcome of Blind 131I Treatment in Patients with Biochemical Recurrence of Differentiated Thyroid Cancer: Results of a Multicenter Diagnostic Cohort Study (THYROPET). J Nucl Med 2015; 57:701-7. [DOI: 10.2967/jnumed.115.168138] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 11/11/2015] [Indexed: 11/16/2022] Open
|
21
|
Tian J, Fu L, Yin D, Zhang J, Chen Y, An N, Xu B. Does the novel integrated PET/MRI offer the same diagnostic performance as PET/CT for oncological indications? PLoS One 2014; 9:e90844. [PMID: 24603857 PMCID: PMC3946212 DOI: 10.1371/journal.pone.0090844] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 02/04/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND We compared PET/MRI with PET/CT in terms of lesion detection and quantitative measurement to verify the feasibility of the novel integrated imaging modality for oncological applications. METHODOLOGY/PRINCIPAL FINDINGS In total, 285 patients referred to our PET/CT center for oncological indications voluntarily participated in this same-day PET/CT and PET/MRI comparative study. PET/CT images were acquired and reconstructed following routine protocols, and then PET/MRI was performed at a mean time interval of 28±11 min (range 15-45 min). PET/MRI covered the body trunk with a sequence combination of transverse T1WI 3D-volumetric interpolated breath-hold, T2WI turbo spin echo with fat saturation, diffusion-weighted imaging with double b values (50 and 800 s/mm2), and simultaneous PET acquisition over 45 min/5 bed positions. The maximum standardized uptake value (SUVmax) was assessed by manually drawn regions of interest over fluorodeoxyglucose-positive lesions. Among 285 cases, 57 showed no abnormalities, and 368 lesions (278 malignant, 68 benign and 22 undetermined) were detected in 228 patients. When stand-alone modalities were evaluated, PET revealed 31 and 12 lesions missed by CT and MRI, respectively, and CT and MRI revealed 38 and 61 more lesions, respectively, than PET. Compared to CT, MRI detected 40 more lesions and missed 8. In the integrated mode, PET/CT correctly detected 6 lesions misdiagnosed by PET/MRI, but was false-negative in 30 cases that were detected by PET/MRI. The overall diagnosis did not differ between integrated PET/MRI and PET/CT. SUVmax for lesions were slightly higher from PET/MRI than PET/CT but correlated well (ρ = 0.85-0.91). CONCLUSIONS/SIGNIFICANCE The novel integrated PET/MRI performed comparatively to PET/CT in lesion detection and quantitative measurements. PET from either scanner modality offered almost the same information despite differences in hardware. Further study is needed to explore features of integrated PET/MRI not addressed in this study.
Collapse
Affiliation(s)
- Jiahe Tian
- Department of Nuclear Medicine, General Hospital of the Chinese People's Liberation Army, Beijing, China
- * E-mail:
| | - Liping Fu
- Department of Nuclear Medicine, General Hospital of the Chinese People's Liberation Army, Beijing, China
| | - Dayi Yin
- Department of Nuclear Medicine, General Hospital of the Chinese People's Liberation Army, Beijing, China
| | - Jinming Zhang
- Department of Nuclear Medicine, General Hospital of the Chinese People's Liberation Army, Beijing, China
| | - Yingmao Chen
- Department of Nuclear Medicine, General Hospital of the Chinese People's Liberation Army, Beijing, China
| | - Ningyu An
- Department of Radiology, Xiyuan, General Hospital of the Chinese People's Liberation Army, Beijing, China
| | - Baixuan Xu
- Department of Nuclear Medicine, General Hospital of the Chinese People's Liberation Army, Beijing, China
| |
Collapse
|
22
|
Lee SJ, Seo HJ, Cheon GJ, Kim JH, Kim EE, Kang KW, Paeng JC, Chung JK, Lee DS. Usefulness of Integrated PET/MRI in Head and Neck Cancer: A Preliminary Study. Nucl Med Mol Imaging 2013; 48:98-105. [PMID: 24900149 PMCID: PMC4028474 DOI: 10.1007/s13139-013-0252-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 11/04/2013] [Accepted: 11/07/2013] [Indexed: 01/01/2023] Open
Abstract
PURPOSE The new modality of an integrated positron emission tomography/magnetic resonance imaging (PET/MRI) has recently been introduced but not validated. Our objective was to evaluate clinical performance of (18)F-fluoro-2-deoxyglucose ((18)F-FDG) PET/MRI in patients with head and neck cancer. METHODS This retrospective study was conducted between January 2013 and February 2013. Ten patients (eight men, two women; mean age, 61.4 ± 13.4 years) with histologically proven head and neck tumors were enrolled. Whole-body PET/MRI and regional positron emission tomography (PET) with dedicated MRI were sequentially obtained. Maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume, total lesion glycolysis and contrast enhancement were analyzed. A total of ten whole-body positron emission tomography (PET), ten regional positron emission tomography (PET), ten dedicated MRI and ten regional PET/gadolinium-enhanced T1-weighted (Gd)-MRI images were analyzed for initial staging. Two nuclear medicine physicians analyzed positron emission tomography (PET) and PET/MRI with a consensus. One radiologist analyzed dedicated MRI. The primary lesions and number of metastatic lymph nodes analyzed from each image were compared. RESULTS Eight patients were diagnosed with head and neck cancer (one tongue cancer, four tonsillar cancers, one nasopharyngeal cancer and two hypopharyngeal cancers) by histological diagnosis. Two benign tumors (pleomorphic adenoma and Warthin tumor) were diagnosed with surgical operation. Whole-body positron emission tomography (PET) and regional positron emission tomography (PET) attenuated by MRI showed good image quality for the lesion detection. Whole-body positron emission tomography (PET) and regional positron emission tomography (PET) detected ten primary sites and compensated for a missed lesion on dedicated MRI. A discordant number of suspicious lymph node metastases was noted according to the different images; 22, 16, 39 and 40 in the whole-body positron emission tomography (PET) only, dedicated MR, regional positron emission tomography (PET) only and regional PET/Gd-MRI, respectively. There was no distant metastasis based on analysis of whole-body positron emission tomography (PET) and whole-body PET/Dixon-volume interpolated breathhold examination (VIBE) MRI. Regional PET/Gd-MRI combined with whole-body PET/MRI modified staging in three patients. Lesions of primary tumor and suspicious metastasis were well detected on both value of SUVmax and visual analysis. The regional PET/Gd-MRI combined with whole-body PET/MRI showed convenient clinical staging performance compared with positron emission tomography (PET) and MRI alone. CONCLUSION In this preliminary study, PET attenuated by MRI showed good image quality to detect lesions. And whole-body PET/MRI as a single modality was feasible for staging in a clinical setting. Whole-body positron emission tomography (PET), regional positron emission tomography (PET), dedicated MRI and regional PET/Gd-MRI showed discordant results in lesion detection. These discordant results might be synergistic effect for accurate staging.
Collapse
Affiliation(s)
- Soo Jin Lee
- Department of Nuclear Medicine, Seoul National University Hospital, 28 Yeongun-dong, Jongro-gu, Seoul, 110-744 Korea
| | - Hyo Jung Seo
- Department of Nuclear Medicine, Seoul National University Hospital, 28 Yeongun-dong, Jongro-gu, Seoul, 110-744 Korea ; Department of Molecular Medicine and Biopharmaceutical Sciences, WCU Graduate School of Convergence Science and Technology, Seoul National University College of Medicine, Seoul, Korea
| | - Gi Jeong Cheon
- Department of Nuclear Medicine, Seoul National University Hospital, 28 Yeongun-dong, Jongro-gu, Seoul, 110-744 Korea ; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea ; Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yeongun-dong, Jongro-gu, Seoul, 110-744 Korea
| | - Ji Hoon Kim
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - E Edmund Kim
- Department of Molecular Medicine and Biopharmaceutical Sciences, WCU Graduate School of Convergence Science and Technology, Seoul National University College of Medicine, Seoul, Korea ; Department of Radiological Science, University of California at Irvine, Irvine, CA USA
| | - Keon Wook Kang
- Department of Nuclear Medicine, Seoul National University Hospital, 28 Yeongun-dong, Jongro-gu, Seoul, 110-744 Korea ; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Chul Paeng
- Department of Nuclear Medicine, Seoul National University Hospital, 28 Yeongun-dong, Jongro-gu, Seoul, 110-744 Korea
| | - June-Key Chung
- Department of Nuclear Medicine, Seoul National University Hospital, 28 Yeongun-dong, Jongro-gu, Seoul, 110-744 Korea ; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Dong Soo Lee
- Department of Nuclear Medicine, Seoul National University Hospital, 28 Yeongun-dong, Jongro-gu, Seoul, 110-744 Korea ; Department of Molecular Medicine and Biopharmaceutical Sciences, WCU Graduate School of Convergence Science and Technology, Seoul National University College of Medicine, Seoul, Korea ; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
23
|
Beiderwellen K, Gomez B, Buchbender C, Hartung V, Poeppel TD, Nensa F, Kuehl H, Bockisch A, Lauenstein TC. Depiction and characterization of liver lesions in whole body [¹⁸F]-FDG PET/MRI. Eur J Radiol 2013; 82:e669-75. [PMID: 24011443 DOI: 10.1016/j.ejrad.2013.07.027] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 07/26/2013] [Accepted: 07/30/2013] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To assess the value of PET/MRI with [(18)F]-FDG using a whole body protocol for the depiction and characterization of liver lesions in comparison to PET/CT. METHODS 70 patients (31 women, 39 men) with solid tumors underwent [(18)F]-FDG PET/CT and followed by an additional PET/MRI using an integrated scanner. Two readers rated the datasets (PET/CT; PET/MRI) regarding conspicuity of hepatic lesions (4-point ordinal scale) and diagnostic confidence (5-point ordinal scale). Median scores for lesion conspicuity and diagnostic confidence were compared using Wilcoxon's rank sum test. Prior examinations, histopathology and clinical follow-up (116 ± 54 days) served as standard of reference. RESULTS 36 of 70 (51%) patients showed liver lesions. Using PET/CT and PET/MRI all patients with liver metastases could correctly be identified. A total of 97 lesions were found (malignant n=26; benign n=71). For lesion conspicuity significantly higher scores were obtained for PET/MRI in comparison to PET/CT (p<0.001). Significantly better performance for diagnostic confidence was observed in PET/MRI, both for malignant as for benign lesions (p<0.001). CONCLUSIONS PET/MRI, even in the setting of a whole body approach, provides higher lesion conspicuity and diagnostic confidence compared to PET/CT and may therefore evolve as an attractive alternative in oncologic imaging.
Collapse
Affiliation(s)
- Karsten Beiderwellen
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
24
|
|
25
|
Torigian DA, Zaidi H, Kwee TC, Saboury B, Udupa JK, Cho ZH, Alavi A. PET/MR imaging: technical aspects and potential clinical applications. Radiology 2013; 267:26-44. [PMID: 23525716 DOI: 10.1148/radiol.13121038] [Citation(s) in RCA: 176] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
UNLABELLED Instruments that combine positron emission tomography (PET) and magnetic resonance (MR) imaging have recently been assembled for use in humans, and may have diagnostic performance superior to that of PET/computed tomography (CT) for particular clinical and research applications. MR imaging has major strengths compared with CT, including superior soft-tissue contrast resolution, multiplanar image acquisition, and functional imaging capability through specialized techniques such as diffusion-tensor imaging, diffusion-weighted (DW) imaging, functional MR imaging, MR elastography, MR spectroscopy, perfusion-weighted imaging, MR imaging with very short echo times, and the availability of some targeted MR imaging contrast agents. Furthermore, the lack of ionizing radiation from MR imaging is highly appealing, particularly when pediatric, young adult, or pregnant patients are to be imaged, and the safety profile of MR imaging contrast agents compares very favorably with iodinated CT contrast agents. MR imaging also can be used to guide PET image reconstruction, partial volume correction, and motion compensation for more accurate disease quantification and can improve anatomic localization of sites of radiotracer uptake, improve diagnostic performance, and provide for comprehensive regional and global structural, functional, and molecular assessment of various clinical disorders. In this review, we discuss the historical development, software-based registration, instrumentation and design, quantification issues, potential clinical applications, potential clinical roles of image segmentation and global disease assessment, and challenges related to PET/MR imaging. SUPPLEMENTAL MATERIAL http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.13121038/-/DC1.
Collapse
Affiliation(s)
- Drew A Torigian
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104-4283, USA.
| | | | | | | | | | | | | |
Collapse
|
26
|
Abstract
Hybrid PET/magnetic resonance (MR) imaging, which combines the excellent anatomic information and functional MR imaging parameters with the metabolic and molecular information obtained with PET, may be superior to PET/computed tomography or MR imaging alone for a wide range of disease conditions. This review highlights potential clinical applications in neurologic, cardiovascular, and musculoskeletal disease conditions, with special attention to applications in oncologic imaging.
Collapse
|
27
|
Pace L, Nicolai E, Aiello M, Catalano OA, Salvatore M. Whole-body PET/MRI in oncology: current status and clinical applications. Clin Transl Imaging 2013. [DOI: 10.1007/s40336-013-0012-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
28
|
de Pont C, Halders S, Bucerius J, Mottaghy F, Brans B. 124I PET/CT in the pretherapeutic staging of differentiated thyroid carcinoma: comparison with posttherapy 131I SPECT/CT. Eur J Nucl Med Mol Imaging 2013; 40:693-700. [DOI: 10.1007/s00259-012-2331-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 12/18/2012] [Indexed: 01/22/2023]
|
29
|
Silberstein EB, Alavi A, Balon HR, Clarke SE, Divgi C, Gelfand MJ, Goldsmith SJ, Jadvar H, Marcus CS, Martin WH, Parker JA, Royal HD, Sarkar SD, Stabin M, Waxman AD. The SNMMI Practice Guideline for Therapy of Thyroid Disease with 131I 3.0. J Nucl Med 2012; 53:1633-51. [DOI: 10.2967/jnumed.112.105148] [Citation(s) in RCA: 180] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|