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Lawless M, Byrns K, Bednarz BP, Meudt J, Shanmuganayagam D, Shah J, McMillan A, Li K, Pirasteh A, Miller J. Feasibility of identifying proliferative active bone marrow with fat fraction MRI and multi-energy CT. Phys Med Biol 2024; 69:135007. [PMID: 38876111 DOI: 10.1088/1361-6560/ad58a0] [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: 02/26/2024] [Accepted: 06/14/2024] [Indexed: 06/16/2024]
Abstract
Objective.Active bone marrow (ABM) can serve as both an organ at risk and a target in external beam radiotherapy.18F-fluorothymidine (FLT) PET is the current gold standard for identifying proliferative ABM but it is not approved for human use, and PET scanners are not always available to radiotherapy clinics. Identifying ABM through other, more accessible imaging modalities will allow more patients to receive treatment specific to their ABM distribution. Multi-energy CT (MECT) and fat-fraction MRI (FFMRI) show promise in their ability to characterize bone marrow adiposity, but these methods require validation for identifying proliferative ABM.Approach.Six swine subjects were imaged using FFMRI, fast-kVp switching (FKS) MECT and sequential-scanning (SS) MECT to identify ABM volumes relative to FLT PET-derived ABM volumes. ABM was contoured on FLT PET images as the region within the bone marrow with a SUV above the mean. Bone marrow was then contoured on the FFMRI and MECT images, and thresholds were applied within these contours to determine which threshold produced the best agreement with the FLT PET determined ABM contour. Agreement between contours was measured using the Dice similarity coefficient (DSC).Main results.FFMRI produced the best estimate of the PET ABM contour. Compared to FLT PET ABM volumes, the FFMRI, SS MECT and FKS MECT ABM contours produced average peak DSC of 0.722 ± 0.080, 0.619 ± 0.070, and 0.464 ± 0.080, respectively. The ABM volume was overestimated by 40.51%, 97.63%, and 140.13% by FFMRI, SS MECT and FKS MECT, respectively.Significance.This study explored the ability of FFMRI and MECT to identify the proliferative relative to ABM defined by FLT PET. Of the methods investigated, FFMRI emerged as the most accurate approximation to FLT PET-derived active marrow contour, demonstrating superior performance by both DSC and volume comparison metrics. Both FFMRI and SS MECT show promise for providing patient-specific ABM treatments.
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Affiliation(s)
- M Lawless
- Department of Human Oncology, University of Wisconsin-Madison, 600 Highland Ave, Madison, WI 53792, United States of America
| | - K Byrns
- St. Lukes Radiation Oncology Associates, 915 E 1st St, Duluth, MN 55805, United States of America
| | - B P Bednarz
- Department of Medical Physics, University of Wisconsin-Madison, 1111 Highland Ave, Madison, WI 53705, United States of America
| | - J Meudt
- Department of Animal and Dairy Sciences, University of Wisconsin-Madison, 1675 Observatory Drive, Madison, WI 53706, United States of America
| | - D Shanmuganayagam
- Department of Animal and Dairy Sciences, University of Wisconsin-Madison, 1675 Observatory Drive, Madison, WI 53706, United States of America
| | - J Shah
- Siemens Healthineers, 221 Gregson Dr, Cary, NC 27511, United States of America
| | - A McMillan
- Department of Radiology, University of Wisconsin-Madison, 600 Highland Ave, Madison, WI 53792, United States of America
| | - K Li
- Department of Medical Physics, University of Wisconsin-Madison, 1111 Highland Ave, Madison, WI 53705, United States of America
| | - A Pirasteh
- Department of Radiology, University of Wisconsin-Madison, 600 Highland Ave, Madison, WI 53792, United States of America
| | - J Miller
- Department of Human Oncology, University of Wisconsin-Madison, 600 Highland Ave, Madison, WI 53792, United States of America
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Satoh Y, Funayama S, Onishi H, Kirito K. Semi-automated histogram analysis of normal bone marrow using 18F-FDG PET/CT: correlation with clinical indicators. BMC Med Imaging 2022; 22:31. [PMID: 35197004 PMCID: PMC8867739 DOI: 10.1186/s12880-022-00757-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 02/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is increasingly applied to the diagnosis of bone marrow failure such as myeloproliferative neoplasm, aplastic anemia, and myelodysplastic syndrome, as well as malignant lymphoma and multiple myeloma. However, few studies have shown a normal FDG uptake pattern. This study aimed to establish a standard of bone marrow FDG uptake by a reproducible quantitative method with fewer steps using deep learning-based organ segmentation. Methods Bone marrow PET images were obtained using segmented whole-spine and pelvic bone marrow cavity CT as mask images using a commercially available imaging workstation that implemented an automatic organ segmentation algorithm based on deep learning. The correlation between clinical indicators and quantitative PET parameters, including histogram features, was evaluated. Results A total of 98 healthy adults were analyzed. The volume of bone marrow PET extracted in men was significantly higher than that in women (p < 0.0001). Univariate and multivariate regression analyses showed that mean of standardized uptake value corrected by lean body mass (SULmean) and entropy in both men and women were inversely correlated with age (all p < 0.0001), and SULmax in women were also inversely correlated with age (p = 0.011). Conclusion A normal FDG uptake pattern was demonstrated by simplified FDG PET/CT bone marrow quantification.
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Affiliation(s)
- Yoko Satoh
- Yamanashi PET Imaging Clinic, Shimokato 3046-2, Chuo City, Yamanashi Prefecture, 409-3821, Japan. .,Department of Radiology, University of Yamanashi, Shimokato 1110, Chuo City, Yamanashi Prefecture, 409-3898, Japan.
| | - Satoshi Funayama
- Department of Radiology, University of Yamanashi, Shimokato 1110, Chuo City, Yamanashi Prefecture, 409-3898, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, Shimokato 1110, Chuo City, Yamanashi Prefecture, 409-3898, Japan
| | - Keita Kirito
- Department of Hematology and Oncology, University of Yamanashi, Shimokato 1110, Chuo City, Yamanashi Prefecture, 409-3898, Japan
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Myocardial Metabolic Response Predicts Chemotherapy Curative Potential on Hodgkin Lymphoma: A Proof-of-Concept Study. Biomedicines 2021; 9:biomedicines9080971. [PMID: 34440175 PMCID: PMC8393404 DOI: 10.3390/biomedicines9080971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/01/2021] [Accepted: 08/02/2021] [Indexed: 11/16/2022] Open
Abstract
Genome sharing between cancer and normal tissues might imply a similar susceptibility to chemotherapy toxicity. The present study aimed to investigate whether curative potential of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) is predicted by the metabolic response of normal tissues in patients with Hodgkin lymphoma (HL). METHODS According to current guidelines, 86 patients with advanced-stage (IIB-IVB) HL, prospectively enrolled in the HD0607 trial (NCT00795613), underwent 18 F-fluorodeoyglucose PET/CT imaging at diagnosis and, at interim, after two ABVD courses, to decide regimen maintenance or its escalation. In both scans, myocardial FDG uptake was binarized according to its median value. Death and disease relapse were recorded to estimate progression-free survival (PFS) during a follow-up with median duration of 43.8 months (range 6.97-60). RESULTS Four patients (4.6%) died, while six experienced disease relapse (7%). Complete switch-off of cancer lesions and cardiac lighting predicted a favorable outcome at Kaplan-Mayer analyses. The independent nature and additive predictive value of their risk prediction were confirmed by the multivariate Cox regression analysis. CONCLUSION Susceptibility of HL lesions to chemotherapy is at least partially determined by factors featuring the host who developed it.
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Computed tomography-based skeletal segmentation for quantitative PET metrics of bone involvement in multiple myeloma. Nucl Med Commun 2021; 41:377-382. [PMID: 32058446 PMCID: PMC7077955 DOI: 10.1097/mnm.0000000000001165] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Purpose Quantifications in nuclear medicine are occasionally limited by the lack of standardization for defining volumes of interest (VOIs) on functional images. In the present article, we propose the use of computed tomography (CT)–based skeletal segmentation to determine anatomically the VOI in order to calculate quantitative parameters of fluorine 18 fluorodeoxyglucose (18F-FDG) PET/CT images from patients with multiple myeloma. Methods We evaluated 101 whole-body 18F-FDG PET/CTs of 58 patients with multiple myeloma. An initial subjective visual analysis of the PET images was used to classify the bone involvement as negative/mild, moderate, or marked. Then, a fully automated CT–based segmentation of the skeleton was performed on PET images. The maximum, mean, and SD of the standardized uptake values (SUVmax, SUVmean, and SDSUV) were calculated for bone tissue and compared with the visual analysis. Results Forty-five (44.5%), 32 (31.7%), and 24 (23.8%) PET images were, respectively, classified as negative/mild, moderate, or marked bone involvement. All quantitative parameters were significantly related to the visual assessment of bone involvement. This association was stronger for the SUVmean [odds ratio (OR): 10.52 (95% confidence interval (CI), 5.68–19.48); P < 0.0001] and for the SDSUV [OR: 5.58 (95% CI, 3.31–9.42); P < 0.001) than for the SUVmax [OR: 1.01 (95% CI, 1.003–1.022); P = 0.003]. Conclusion CT–based skeletal segmentation allows for automated and therefore reproducible calculation of PET quantitative parameters of bone involvement in patients with multiple myeloma. Using this method, the SUVmean and its respective SD correlated better with the visual analysis of 18F-FDG PET images than SUVmax. Its value in staging and evaluating therapy response needs to be evaluated.
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Bauckneht M, Lai R, Miceli A, Schenone D, Cossu V, Donegani MI, Raffa S, Borra A, Marra S, Campi C, Orengo A, Massone AM, Tagliafico A, Caponnetto C, Cabona C, Cistaro A, Chiò A, Morbelli S, Nobili F, Sambuceti G, Piana M, Marini C. Spinal cord hypermetabolism extends to skeletal muscle in amyotrophic lateral sclerosis: a computational approach to [18F]-fluorodeoxyglucose PET/CT images. EJNMMI Res 2020; 10:23. [PMID: 32201914 PMCID: PMC7085992 DOI: 10.1186/s13550-020-0607-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 02/10/2020] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease leading to neuromuscular palsy and death. We propose a computational approach to [18F]-fluorodeoxyglucose (FDG) PET/CT images to analyze the structure and metabolic pattern of skeletal muscle in ALS and its relationship with disease aggressiveness. MATERIALS AND METHODS A computational 3D method was used to extract whole psoas muscle's volumes and average attenuation coefficient (AAC) from CT images obtained by FDG PET/CT performed in 62 ALS patients and healthy controls. Psoas average standardized uptake value (normalized on the liver, N-SUV) and its distribution heterogeneity (defined as N-SUV variation coefficient, VC-SUV) were also extracted. Spinal cord and brain motor cortex FDG uptake were also estimated. RESULTS As previously described, FDG uptake was significantly higher in the spinal cord and lower in the brain motor cortex, in ALS compared to controls. While psoas AAC was similar in patients and controls, in ALS a significant reduction in psoas volume (3.6 ± 1.02 vs 4.12 ± 1.33 mL/kg; p < 0.01) and increase in psoas N-SUV (0.45 ± 0.19 vs 0.29 ± 0.09; p < 0.001) were observed. Higher heterogeneity of psoas FDG uptake was also documented in ALS (VC-SUV 8 ± 4%, vs 5 ± 2%, respectively, p < 0.001) and significantly predicted overall survival at Kaplan-Meier analysis. VC-SUV prognostic power was confirmed by univariate analysis, while the multivariate Cox regression model identified the spinal cord metabolic activation as the only independent prognostic biomarker. CONCLUSION The present data suggest the existence of a common mechanism contributing to disease progression through the metabolic impairment of both second motor neuron and its effector.
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Affiliation(s)
- Matteo Bauckneht
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Rita Lai
- Department of Mathematics (DIMA), University of Genoa, Genoa, Italy
| | - Alberto Miceli
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Daniela Schenone
- Department of Mathematics (DIMA), University of Genoa, Genoa, Italy
| | - Vanessa Cossu
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | | | - Stefano Raffa
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Anna Borra
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Stefano Marra
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Cristina Campi
- Department of Medicine-DIMED, Padova University Hospital, Padua, Italy
| | - Annamaria Orengo
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Alberto Tagliafico
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Claudia Caponnetto
- Neurology Clinic, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Corrado Cabona
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | | | - Adriano Chiò
- ALS Center, Rita Levi Montalcini Department of Neuroscience, University of Turin, Turin, Italy.,AUO Città della Salute e della Scienza, Turin, Italy
| | - Silvia Morbelli
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Flavio Nobili
- Neurology Clinic, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Gianmario Sambuceti
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Michele Piana
- Department of Mathematics (DIMA), University of Genoa, Genoa, Italy
| | - Cecilia Marini
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,CNR Institute of Molecular Bioimaging and Physiology (IBFM), Segrate (MI), Italy
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Schwenck J, Schörg B, Fiz F, Sonanini D, Forschner A, Eigentler T, Weide B, Martella M, Gonzalez-Menendez I, Campi C, Sambuceti G, Seith F, Quintanilla-Martinez L, Garbe C, Pfannenberg C, Röcken M, Fougere CL, Pichler BJ, Kneilling M. Cancer immunotherapy is accompanied by distinct metabolic patterns in primary and secondary lymphoid organs observed by non-invasive in vivo 18F-FDG-PET. Am J Cancer Res 2020; 10:925-937. [PMID: 31903160 PMCID: PMC6929998 DOI: 10.7150/thno.35989] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 09/02/2019] [Indexed: 12/21/2022] Open
Abstract
Purpose: Cancer immunotherapy depends on a systemic immune response, but the basic underlying mechanisms are still largely unknown. Despite the very successful and widespread use of checkpoint inhibitors in the clinic, the majority of cancer patients do not benefit from this type of treatment. In this translational study, we investigated whether noninvasive in vivo positron emission tomography (PET) imaging using 2-[18F]fluoro-2-deoxy-D-glucose (18F-FDG) is capable of detecting immunotherapy-associated metabolic changes in the primary and secondary lymphoid organs and whether this detection enables the prediction of a successful anti-cancer immune response. Methods: RIP1-Tag2 mice with progressed endogenous insular cell carcinomas underwent a combined cancer immunotherapy consisting of CD4+ T cells plus monoclonal antibodies (mAbs) against programmed death ligand-1 (PD-L1) and lymphocyte activation gene-3 (LAG-3) or a sham treatment after radiation-mediated immune cell depletion. A second cohort of RIP1-Tag2 mice underwent exclusive checkpoint inhibitor therapy (CIT) using anti-PD-L1/LAG-3 mAbs or sham treatment without initial immune cell depletion to mimic the clinical situation. All mice were monitored by 18F-FDG-PET combined with anatomical magnetic resonance imaging (MRI). In addition, we retrospectively analyzed PET / computed tomography (CT) scans (PET/CT) regarding 18F-FDG uptake of CIT-treated metastatic melanoma patients in the spleen (n=23) and bone marrow (BM; n=20) as well as blood parameters (n=17-21). Results: RIP1-Tag2 mice with advanced insular cell carcinomas treated with combination immunotherapy exhibited significantly increased 18F-FDG uptake in the spleen compared to sham-treated mice. Histopathology of the spleens from treated mice revealed atrophy of the white pulp with fewer germinal centers and an expanded red pulp with hyperplasia of neutrophils than those of sham-treated mice. Immunohistochemistry and flow cytometry analyses of the spleens revealed a lower number of T cells and a higher number of neutrophils compared to those in the spleens of sham-treated mice. Flow cytometry of the BM showed enhanced activation of T cells following the treatment schemes that included checkpoint inhibitors. The ratio of 18F-FDG uptake at baseline to the uptake at follow-up in the spleens of exclusively CIT-treated RIP1-Tag2 mice was significantly enhanced, but the ratio was not enhanced in the spleens of the sham-treated littermates. Flow cytometry analysis confirmed a reduced number of T cells in the spleens of exclusively CIT-treated mice compared to that of sham-treated mice. A retrospective analysis of clinical 18F-FDG-PET/CT scans revealed enhanced 18F-FDG uptake in the spleens of some successfully CIT-treated patients with metastatic melanoma, but there were no significant differences between responders and non-responders. The analysis of the BM in clinical 18F-FDG-PET/CT scans with a computational segmentation tool revealed significantly higher baseline 18F-FDG uptake in patients who responded to CIT than in non-responders, and this relationship was independent of bone metastasis, even in the baseline scan. Conclusions: Thus, we are presenting the first translational study of solid tumors focusing on the metabolic patterns of primary and secondary lymphoid organs induced by the systemic immune response after CIT. We demonstrate that the widely available 18F-FDG-PET modality is an applicable translational tool that has high potential to stratify patients at an early time point.
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Marini C, Morbelli S, Cistaro A, Campi C, Caponnetto C, Bauckneht M, Bellini A, Buschiazzo A, Calamia I, Beltrametti MC, Margotti S, Fania P, Poggi I, Cabona C, Capitanio S, Piva R, Calvo A, Moglia C, Canosa A, Massone A, Nobili F, Mancardi G, Chiò A, Piana M, Sambuceti G. Interplay between spinal cord and cerebral cortex metabolism in amyotrophic lateral sclerosis. Brain 2019; 141:2272-2279. [PMID: 30730551 PMCID: PMC6061793 DOI: 10.1093/brain/awy152] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 04/10/2018] [Indexed: 11/15/2022] Open
Abstract
We recently reported the potential of Hough transform in delineating spinal cord metabolism by 18F-fluorodeoxyglucose PET/CT scanning in amyotrophic lateral sclerosis. The present study aimed to verify the relationship between spinal cord and brain metabolism in 44 prospectively recruited patients affected by amyotrophic lateral sclerosis submitted to 18F-fluorodeoxyglucose brain and whole-body PET/CT. Patients were studied to highlight the presence of brain hypo- or hypermetabolism with respect to healthy controls, and multiple regression analysis was performed to evaluate the correlation between spinal cord and brain metabolism. Our results confirmed higher 18F-fluorodeoxyglucose uptake in both cervical and dorsal spinal cord in patients with amyotrophic lateral sclerosis with respect to controls. This finding was paralleled by the opposite pattern in the brain cortex that showed a generalized reduction in tracer uptake. This hypometabolism was particularly evident in wide regions of the frontal-dorsolateral cortex while it did not involve the midbrain. Bulbar and spinal disease onset was associated with similar degree of metabolic activation in the spinal cord. However, among spinal onset patients, upper limb presentation was associated with a more pronounced metabolic activation of cervical segment. Obtained data suggest a differential neuro-pathological state or temporal sequence in disease progression.
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Affiliation(s)
- Cecilia Marini
- CNR Institute of Molecular Bioimaging and Physiology (IBFM), Milan, 20019, Italy.,Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, 16132, Italy
| | - Silvia Morbelli
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, 16132, Italy.,Department of Health Science, University of Genoa, Genoa, 16132, Italy
| | - Angelina Cistaro
- Positron Emission Tomography Centre IRMET S.p.A., Affidea, Turin, 10120, Italy
| | - Cristina Campi
- Department of Medicine-DIMED, Padova University Hospital, Via Giustiniani 2, 35128 Padua, Italy
| | - Claudia Caponnetto
- Department of Neuroscience, IRCCS Ospedale Policlinico San Martino, Genoa, 16132, Italy.,DINOGMI University of Genoa, Genoa, 16132, Italy
| | - Matteo Bauckneht
- Department of Health Science, University of Genoa, Genoa, 16132, Italy
| | | | - Ambra Buschiazzo
- Department of Health Science, University of Genoa, Genoa, 16132, Italy
| | - Iolanda Calamia
- Department of Health Science, University of Genoa, Genoa, 16132, Italy
| | | | - Simone Margotti
- Positron Emission Tomography Centre IRMET S.p.A., Affidea, Turin, 10120, Italy
| | - Piercarlo Fania
- Positron Emission Tomography Centre IRMET S.p.A., Affidea, Turin, 10120, Italy
| | - Ilaria Poggi
- Department of Neuroscience, IRCCS Ospedale Policlinico San Martino, Genoa, 16132, Italy.,DINOGMI University of Genoa, Genoa, 16132, Italy
| | - Corrado Cabona
- Department of Neuroscience, IRCCS Ospedale Policlinico San Martino, Genoa, 16132, Italy.,DINOGMI University of Genoa, Genoa, 16132, Italy
| | - Selene Capitanio
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, 16132, Italy
| | - Roberta Piva
- Department of Health Science, University of Genoa, Genoa, 16132, Italy
| | - Andrea Calvo
- ALS Center, Rita Levi Montalcini Department of Neuroscience, University of Turin, Turin, 10120, Italy.,AUO Città della Salute e della Scienza, Turin, 10120, Italy
| | - Cristina Moglia
- ALS Center, Rita Levi Montalcini Department of Neuroscience, University of Turin, Turin, 10120, Italy.,AUO Città della Salute e della Scienza, Turin, 10120, Italy
| | - Antonio Canosa
- ALS Center, Rita Levi Montalcini Department of Neuroscience, University of Turin, Turin, 10120, Italy.,AUO Città della Salute e della Scienza, Turin, 10120, Italy
| | | | - Flavio Nobili
- Department of Neuroscience, IRCCS Ospedale Policlinico San Martino, Genoa, 16132, Italy.,DINOGMI University of Genoa, Genoa, 16132, Italy
| | - Gianluigi Mancardi
- Department of Neuroscience, IRCCS Ospedale Policlinico San Martino, Genoa, 16132, Italy.,DINOGMI University of Genoa, Genoa, 16132, Italy
| | - Adriano Chiò
- ALS Center, Rita Levi Montalcini Department of Neuroscience, University of Turin, Turin, 10120, Italy.,AUO Città della Salute e della Scienza, Turin, 10120, Italy
| | - Michele Piana
- Department of Mathematics (DIMA), University of Genoa, Genoa, 16132, Italy.,SPIN Institute, CNR, Genoa, 16132, Italy
| | - Gianmario Sambuceti
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, 16132, Italy.,Department of Health Science, University of Genoa, Genoa, 16132, Italy
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Automated Definition of Skeletal Disease Burden in Metastatic Prostate Carcinoma: A 3D Analysis of SPECT/CT Images. Cancers (Basel) 2019; 11:cancers11060869. [PMID: 31234424 PMCID: PMC6627119 DOI: 10.3390/cancers11060869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 06/16/2019] [Accepted: 06/19/2019] [Indexed: 01/02/2023] Open
Abstract
To meet the current need for skeletal tumor-load estimation in castration-resistant prostate cancer (CRPC), we developed a novel approach based on adaptive bone segmentation. In this study, we compared the program output with existing estimates and with the radiological outcome. Seventy-six whole-body single-photon emission computed tomographies/x-ray computed tomography with 3,3-diphosphono-1,2-propanedicarboxylic acid from mCRPC patients were analyzed. The software identified the whole skeletal volume (SVol) and classified the voxels metastases (MVol) or normal bone (BVol). SVol was compared with the estimation of a commercial software. MVol was compared with manual assessment and with prostate specific antigen (PSA) levels. Counts/voxel were extracted from MVol and BVol. After six cycles of 223RaCl2-therapy every patient was re-evaluated as having progressive disease (PD), stable disease (SD), or a partial response (PR). SVol correlated with that of the commercial software (R = 0.99, p < 0.001). MVol correlated with the manually-counted lesions (R = 0.61, p < 0.001) and PSA (R = 0.46, p < 0.01). PD had a lower counts/voxel in MVol than PR/SD (715 ± 190 vs. 975 ± 215 and 1058 ± 255, p < 0.05 and p < 0.01) and BVol (PD 275 ± 60, PR 515 ± 188 and SD 528 ± 162 counts/voxel, p < 0.001). Segmentation-based tumor load correlated with radiological/laboratory indices. Uptake was linked with the clinical outcome, suggesting that metastases in PD patients have a lower affinity for bone-seeking radionuclides and might benefit less from bone-targeted radioisotope therapies.
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Fukuda T, Huang M, Janardhanan A, Schweitzer ME, Huang C. Correlation of bone marrow cellularity and metabolic activity in healthy volunteers with simultaneous PET/MR imaging. Skeletal Radiol 2019; 48:527-534. [PMID: 30194581 DOI: 10.1007/s00256-018-3058-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 08/21/2018] [Accepted: 08/27/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the correlation between bone marrow cellularity (BMC) and metabolic activity in healthy subjects and to see whether yellow marrow is indeed metabolically quiescent. Because metabolic activity can be assumed to reflect vascularity, we assessed the relationship between regional metabolic activity and geographic frequency of metastases as noted in the literature. MATERIALS AND METHODS Two hundred and twenty locations (ten in each side of the pelvis and proximal femur) were evaluated in 11 consecutive healthy volunteers with simultaneous PET/MR. BMC was calculated through precise water-fat fraction quantification with a 6-echo gradient echo. We analyzed correlations between cellularity and SUVr, age, and R2*. We also looked at the relation between our results and the reported prevalence of metastases. RESULTS There was moderate but statistically significant correlation between BMC and metabolic activity (r = 0.636, p < 0.0001). Interestingly, the iliac and sacrum had higher metabolic activity relative to cellularity, whereas the femoral neck and lesser trochanter showed lower SUVr than other regions with the similar cellularity. The relatively lower metabolic status of the femoral neck conflicted with its reported high frequency of metastasis. Excluding regions with almost no remaining red marrow, cellularity showed inverse relationship with age (r = 0.476, p < 0.0001) and direct relationship with R2* (r = 0.532, p < 0.0010). CONCLUSIONS Metabolic activity of bone marrow was largely dependent on BMC while yellow marrow seems metabolically quiescent. The discrepancy between the assumed vascularity as determined by metabolic activity and reported sites of metastasis suggested that the process of bone metastasis may not depend entirely on vascularity.
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Affiliation(s)
- Takeshi Fukuda
- Department of Radiology, Stony Brook University, Stony Brook, NY, USA
| | - Mingqian Huang
- Department of Radiology, Stony Brook University, Stony Brook, NY, USA
| | | | - Mark E Schweitzer
- Department of Radiology, Stony Brook University, Stony Brook, NY, USA
| | - Chuan Huang
- Department of Radiology, Stony Brook University, Stony Brook, NY, USA. .,Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA.
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Shen G, Liang M, Su M, Kuang A. Physiological uptake of 18F-FDG in the vertebral bone marrow in healthy adults on PET/CT imaging. Acta Radiol 2018; 59:1487-1493. [PMID: 29486597 DOI: 10.1177/0284185118762245] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND 18F-fluorodeoxyglucose *Equal contributors. positron emission tomography/computed tomography (18F-FDG PET/CT) has proven to be a valuable imaging modality for the assessment of bone marrow condition. PURPOSE To investigate the physiological uptake of 18F-FDG in the vertebral bone marrow in healthy adults on PET/CT imaging, and correlate the appearance with clinical factors including gender, body mass index, and age. MATERIAL AND METHODS A total of 64 healthy individuals underwent PET/CT scan, and for each vertebral body, the mean and maximum standardized uptake value (SUVmean and SUVmax) were determined in the central slice of vertebral body on the transversal fused PET/CT image. For each individual, the FDG uptake of the four regions was obtained by averaging the SUVmean and SUVmax of the vertebrae in individual regions. RESULTS The FDG uptake from thoracic to sacral vertebrae showed an upward trend first, then a downward trend, while that of cervical vertebrae was relatively stable. The SUVmax and SUVmean values of bone marrow in the old group (age ≥ 50 years) were significantly lower than those in the young group (age < 50 years) in all regions of the spine ( P < 0.05). FDG uptake of the whole spine showed significant negative correlation with age, and the strongest correlation was observed in lumbar spine (SUVmean: r = -0.364, P < 0.05; SUVmax: r = -0.344, P < 0.05). CONCLUSION FDG uptake showed a tendency to increase first then decrease from thoracic to sacral vertebrae while the tendency was not obvious in cervical vertebrae. In addition, the glycolytic metabolism of all the four regions decreased with advancing age.
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Affiliation(s)
- Guohua Shen
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
| | - Meng Liang
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, PR China
| | - Minggang Su
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
| | - Anren Kuang
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
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11
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Fiz F, Dittman H, Campi C, Morbelli S, Marini C, Brignone M, Bauckneht M, Piva R, Massone AM, Piana M, Sambuceti G, la Fougère C. Assessment of Skeletal Tumor Load in Metastasized Castration-Resistant Prostate Cancer Patients: A Review of Available Methods and an Overview on Future Perspectives. Bioengineering (Basel) 2018; 5:bioengineering5030058. [PMID: 30060546 PMCID: PMC6163573 DOI: 10.3390/bioengineering5030058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 07/23/2018] [Accepted: 07/26/2018] [Indexed: 11/16/2022] Open
Abstract
Metastasized castration-resistant prostate cancer (mCRPC), is the most advanced form of prostate neoplasia, where massive spread to the skeletal tissue is frequent. Patients with this condition are benefiting from an increasing number of treatment options. However, assessing tumor response in patients with multiple localizations might be challenging. For this reason, many computational approaches have been developed in the last decades to quantify the skeletal tumor burden and treatment response. In this review, we analyzed the progressive development and diffusion of such approaches. A computerized literature search of the PubMed/Medline was conducted, including articles between January 2008 and March 2018. The search was expanded by manually reviewing the reference list of the chosen articles. Thirty-five studies were identified. The number of eligible studies greatly increased over time. Studies could be categorized in the following categories: automated analysis of 2D scans, SUV-based thresholding, hybrid CT- and SUV-based thresholding, and MRI-based thresholding. All methods are discussed in detail. Automated analysis of bone tumor burden in mCRPC is a growing field of research; when choosing the appropriate method of analysis, it is important to consider the possible advantages as well as the limitations thoroughly.
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Affiliation(s)
- Francesco Fiz
- Nuclear Medicine Unit, Department of Radiology, Uni-Klinikum Tübingen, 72076 Tübingen, Germany.
- Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy.
| | - Helmut Dittman
- Nuclear Medicine Unit, Department of Radiology, Uni-Klinikum Tübingen, 72076 Tübingen, Germany.
| | - Cristina Campi
- Nuclear Medicine Unit, Department of Medicine-DIMED, University Hospital of Padua, 35128 Padua, Italy.
| | - Silvia Morbelli
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, 16132 Genoa, Italy.
| | | | - Massimo Brignone
- Department of Engineering, University of Genoa, Pole of Savona, 17100 Savona, Italy.
| | - Matteo Bauckneht
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, 16132 Genoa, Italy.
| | - Roberta Piva
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, 16132 Genoa, Italy.
| | - Anna Maria Massone
- National Council of Research-SPIN, 16152 Genoa, Italy.
- Department of Mathematics, University of Genoa, 16146 Genoa, Italy.
| | - Michele Piana
- National Council of Research-SPIN, 16152 Genoa, Italy.
- Department of Mathematics, University of Genoa, 16146 Genoa, Italy.
| | - Gianmario Sambuceti
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, 16132 Genoa, Italy.
| | - Christian la Fougère
- Nuclear Medicine Unit, Department of Radiology, Uni-Klinikum Tübingen, 72076 Tübingen, Germany.
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Williams KM, Holter-Chakrabarty J, Lindenberg L, Duong Q, Vesely SK, Nguyen CT, Havlicek JP, Kurdziel K, Gea-Banacloche J, Lin FI, Avila DN, Selby G, Kanakry CG, Li S, Scordino T, Adler S, Bollard CM, Choyke P, Gress RE. Imaging of subclinical haemopoiesis after stem-cell transplantation in patients with haematological malignancies: a prospective pilot study. Lancet Haematol 2018; 5:e44-e52. [PMID: 29248669 PMCID: PMC5770195 DOI: 10.1016/s2352-3026(17)30215-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 10/26/2017] [Accepted: 10/26/2017] [Indexed: 01/15/2023]
Abstract
BACKGROUND Haemopoietic stem-cell transplantation (HSCT) eradicates host haemopoiesis before venous infusion of haemopoietic stem cells (HSCs). The pathway to cellular recovery has been difficult to study in human beings because of risks associated with interventions during aplasia. We investigated whether 18F-fluorothymidine (18F-FLT) imaging was safe during allogenic HSCT and allowed visualisation of early cellular proliferation and detection of patterns of cellular engraftment after HSCT. METHODS Eligible patients were aged 18-55 years, had high-risk haematological malignancies. All patients underwent myeloablation followed by HSCT. The imaging primary endpoint was detection of early subclinical engraftment after HSCT with 18F-FLT PET or CT. Imaging was done 1 day before and 5 or 9, and 28 days, and 1 year after HSCT. This study is registered with ClinicalTrials.gov, number NCT01338987. FINDINGS Between April 1, 2014, and Dec 31, 2015, 23 patients were enrolled and assessable for toxic effects after completing accrual. 18F-FLT was not associated with any adverse events or delayed engraftment. 18F-FLT imaging objectively identified subclinical bone-marrow recovery within 5 days of HSC infusion, which was up to 20 days before engraftment became clinically evident. Quantitatively, 18F-FLT intensity differed significantly between myeloablative infusion before HSCT and subclinical HSC recovery (p=0·00031). 18F-FLT biodistribution over time revealed a previously unknown path of cellular recovery of haemopoiesis in vivo that mirrored fetal ontogeny. INTERPRETATION 18F-FLT allowed quantification and tracking of subclinical bone-marrow repopulation in human beings and revealed new insights into the biology of HSC recovery after HSCT. FUNDING National Institutes of Health, Ben's Run/Ben's Gift, Albert and Elizabeth Tucker Foundation, Mex Frates Leukemia Fund, Jones Family fund, and Oklahoma Center for Adult Stem Cell Research.
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Affiliation(s)
- Kirsten M Williams
- Children's Research Institute, Children's National Health System, Washington, DC, USA.
| | | | - Liza Lindenberg
- Molecular Imaging Branch, National Cancer Institute, and National Institutes of Health, Bethesda, MD, USA
| | - Quyen Duong
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Sara K Vesely
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Chuong T Nguyen
- School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK, USA
| | - Joseph P Havlicek
- School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK, USA
| | - Karen Kurdziel
- Molecular Imaging Branch, National Cancer Institute, and National Institutes of Health, Bethesda, MD, USA
| | | | - Frank I Lin
- Cancer Imaging Program, National Cancer Institute, and National Institutes of Health, Bethesda, MD, USA
| | - Daniele N Avila
- Experimental Transplantation and Immunology Branch, National Cancer Institute, and National Institutes of Health, Bethesda, MD, USA
| | - George Selby
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Christopher G Kanakry
- Experimental Transplantation and Immunology Branch, National Cancer Institute, and National Institutes of Health, Bethesda, MD, USA
| | - Shibo Li
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Teresa Scordino
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Stephen Adler
- Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research, National Cancer Institute Campus at Frederick, Frederick, MD, USA
| | - Catherine M Bollard
- Children's Research Institute, Children's National Health System, Washington, DC, USA
| | - Peter Choyke
- Molecular Imaging Branch, National Cancer Institute, and National Institutes of Health, Bethesda, MD, USA
| | - Ronald E Gress
- Experimental Transplantation and Immunology Branch, National Cancer Institute, and National Institutes of Health, Bethesda, MD, USA
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Tumor Burden and Intraosseous Metabolic Activity as Predictors of Bone Marrow Failure during Radioisotope Therapy in Metastasized Prostate Cancer Patients. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3905216. [PMID: 29435457 PMCID: PMC5757096 DOI: 10.1155/2017/3905216] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 12/06/2017] [Indexed: 11/26/2022]
Abstract
Rationale Radium-223-Dichloride (Ra-223) is an alpha-emitter, used to treat bone metastases. Patients with high metastatic burden and/or with increased trabecular bone uptake could present a higher incidence of hematologic toxicity. We hypothesized that these two factors are predictors of bone marrow failure. Material and Methods A computer algorithm discriminated between trabecular bone (BVol) and tumor metastases (MVol) within pretherapeutic whole-body skeletal SPECT/CT (N = 47). The program calculated the metastatic invasion percent (INV%) as the MVol/(MVol + BVol) ratio and extracted the BVol mean counts. BVol counts were correlated to % drop of hemoglobin (Hb), leukocytes (WBC), and platelets (PLT) after 3/6 Ra-223 cycles. Patient-specific and computational-derived parameters were tested as predictors of hematologic toxicity with MANOVA. Results BVol counts correlated with drop of Hb (R = 0,65, p < 0.01) and PLT (R = 0,45, p < 0.01). Appendicular BVol counts showed a better correlation (p < 0.05, p < 0.01, and p < 0.001 for Hb, WBC, and PLT, resp.). INV% directly correlated with BVol counts (R = 0.68, p < 0.001). At MANOVA, grade III/IV toxicity was predicted by INV% (p < 0.01), by long-bone invasion (p < 0.005), and by BVol counts (p < 0.05). Conclusions In patients with significant bone tumor burden, degree of bone invasion and trabecular bone uptake are predictors of subsequent bone marrow failure.
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15
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Marini C, Bruno S, Fiz F, Campi C, Piva R, Cutrona G, Matis S, Nieri A, Miglino M, Ibatici A, Maria Orengo A, Maria Massone A, Neumaier CE, Totero DD, Giannoni P, Bauckneht M, Pennone M, Tenca C, Gugiatti E, Bellini A, Borra A, Tedone E, Efetürk H, Rosa F, Emionite L, Cilli M, Bagnara D, Brucato V, Bruzzi P, Piana M, Fais F, Sambuceti G. Functional Activation of Osteoclast Commitment in Chronic Lymphocytic Leukaemia: a Possible Role for RANK/RANKL Pathway. Sci Rep 2017; 7:14159. [PMID: 29074954 PMCID: PMC5658396 DOI: 10.1038/s41598-017-12761-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 09/14/2017] [Indexed: 01/18/2023] Open
Abstract
Skeletal erosion has been found to represent an independent prognostic indicator in patients with advanced stages of chronic lymphocytic leukaemia (CLL). Whether this phenomenon also occurs in early CLL phases and its underlying mechanisms have yet to be fully elucidated. In this study, we prospectively enrolled 36 consecutive treatment-naïve patients to analyse skeletal structure and bone marrow distribution using a computational approach to PET/CT images. This evaluation was combined with the analysis of RANK/RANKL loop activation in the leukemic clone, given recent reports on its role in CLL progression. Bone erosion was particularly evident in long bone shafts, progressively increased from Binet stage A to Binet stage C, and was correlated with both local expansion of metabolically active bone marrow documented by FDG uptake and with the number of RANKL + cells present in the circulating blood. In immune-deficient NOD/Shi-scid, γcnull (NSG) mice, administration of CLL cells caused an appreciable compact bone erosion that was prevented by Denosumab. CLL cell proliferation in vitro correlated with RANK expression and was impaired by Denosumab-mediated disruption of the RANK/RANKL loop. This study suggests an interaction between CLL cells and stromal elements able to simultaneously impair bone structure and increase proliferating potential of leukemic clone.
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Affiliation(s)
- Cecilia Marini
- CNR Institute of Bioimages and Molecular Physiology, Milan, Italy.
- Nuclear Medicine IRCCS AOU San Martino-IST, Genoa, Italy.
- Nuclear Medicine, Department of Health Science, University of Genova, Genoa, Italy.
| | - Silvia Bruno
- Department of Experimental Medicine, University of Genoa, Genoa, Italy
| | - Francesco Fiz
- Nuclear Medicine, Department of Health Science, University of Genova, Genoa, Italy
- Nuclear Medicine Unit, Department of Radiology, Uni-Klinikum Tuebingen, Germany
| | | | - Roberta Piva
- Nuclear Medicine, Department of Health Science, University of Genova, Genoa, Italy
| | | | - Serena Matis
- Molecular Pathology, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Alberto Nieri
- Nuclear Medicine, Department of Health Science, University of Genova, Genoa, Italy
| | - Maurizio Miglino
- Department of Internal Medicine, University of Genoa, Genoa, Italy
| | | | | | | | | | | | - Paolo Giannoni
- Stem Cell Laboratory, Department of Experimental Medicine, University of Genova, Genoa, Italy
| | - Matteo Bauckneht
- Nuclear Medicine, Department of Health Science, University of Genova, Genoa, Italy
| | | | - Claudya Tenca
- Department of Experimental Medicine, University of Genoa, Genoa, Italy
| | - Elena Gugiatti
- Department of Experimental Medicine, University of Genoa, Genoa, Italy
| | - Alessandro Bellini
- Nuclear Medicine, Department of Health Science, University of Genova, Genoa, Italy
| | - Anna Borra
- Nuclear Medicine, Department of Health Science, University of Genova, Genoa, Italy
| | | | - Hülya Efetürk
- Nuclear Medicine IRCCS AOU San Martino-IST, Genoa, Italy
- Nuclear Medicine, Department of Health Science, University of Genova, Genoa, Italy
| | | | - Laura Emionite
- Animal Facility, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Michele Cilli
- Animal Facility, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Davide Bagnara
- Department of Experimental Medicine, University of Genoa, Genoa, Italy
- Karches Center for Oncology Research, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Valerio Brucato
- Department of Civil, Environmental, Aerospace, Materials Engineering, Aten Center, CHAB pole, University of Palermo, Viale delle Scienze, 6, Palermo, 90128, Italy
| | - Paolo Bruzzi
- Epidemiology and Clinical trial Service, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Michele Piana
- SPIN Institute, CNR, Genoa, Italy
- Department of Mathematics (DIMA), University of Genoa, Genoa, Italy
| | - Franco Fais
- Department of Experimental Medicine, University of Genoa, Genoa, Italy
- Molecular Pathology, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Gianmario Sambuceti
- Nuclear Medicine IRCCS AOU San Martino-IST, Genoa, Italy
- Nuclear Medicine, Department of Health Science, University of Genova, Genoa, Italy
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van der Bruggen W, Glaudemans AW, Vellenga E, Slart RH. PET in Benign Bone Marrow Disorders. Semin Nucl Med 2017; 47:397-407. [DOI: 10.1053/j.semnuclmed.2017.02.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Bauckneht M, Ferrarazzo G, Fiz F, Morbelli S, Sarocchi M, Pastorino F, Ghidella A, Pomposelli E, Miglino M, Ameri P, Emionite L, Ticconi F, Arboscello E, Buschiazzo A, Massimelli EA, Fiordoro S, Borra A, Cossu V, Bozzano A, Ibatici A, Ponzoni M, Spallarossa P, Gallamini A, Bruzzi P, Sambuceti G, Marini C. Doxorubicin Effect on Myocardial Metabolism as a Prerequisite for Subsequent Development of Cardiac Toxicity: A Translational 18F-FDG PET/CT Observation. J Nucl Med 2017. [PMID: 28646013 DOI: 10.2967/jnumed.117.191122] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
The present translational study aimed to verify whether serial 18F-FDG PET/CT predicts doxorubicin cardiotoxicity. Methods: Fifteen athymic mice were treated intravenously with saline (n = 5) or with 5 or 7.5 mg of doxorubicin per kilogram (n = 5 each) and underwent dynamic small-animal PET beforehand and afterward to estimate left ventricular (LV) metabolic rate of glucose (MRGlu). Thereafter, we retrospectively identified 69 patients who had been successfully treated with a regimen of doxorubicin, bleomycin, vinblastine, and dacarbazine for Hodgkin disease (HD) and had undergone 4 consecutive 18F-FDG PET/CT scans. Volumes of interest were drawn on LV myocardium to quantify mean SUV. All patients were subsequently interviewed by telephone (median follow-up, 30 mo); 36 of them agreed to undergo electrocardiography and transthoracic echocardiography. Results: In mice, LV MRGlu was 17.9 ± 4.4 nmol × min-1 × g-1 at baseline. Doxorubicin selectively and dose-dependently increased this value in the standard-dose (27.9 ± 9 nmol × min-1 × g-1, P < 0.05 vs. controls) and high-dose subgroups (37.2 ± 7.8 nmol × min-1 × g-1, P < 0.01 vs. controls, P < 0.05 vs. standard-dose). In HD patients, LV SUV showed a progressive increase during doxorubicin treatment that persisted at follow-up. New-onset cardiac abnormalities appeared in 11 of 36 patients (31%). In these subjects, pretherapy LV SUV was markedly lower with respect to the remaining patients (1.53 ± 0.9 vs. 3.34 ± 2.54, respectively, P < 0.01). Multivariate analysis confirmed the predictive value of baseline LV SUV for subsequent cardiac abnormalities. Conclusion: Doxorubicin dose-dependently increases LV MRGlu, particularly in the presence of low baseline 18F-FDG uptake. These results imply that low myocardial 18F-FDG uptake before the initiation of doxorubicin chemotherapy in HD patients may predict the development of chemotherapy-induced cardiotoxicity, suggesting that prospective clinical trials are warranted to test this hypothesis.
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Affiliation(s)
- Matteo Bauckneht
- Nuclear Medicine, IRCCS-AOU San Martino-IST and University of Genoa, Genoa, Italy
| | - Giulia Ferrarazzo
- Nuclear Medicine, IRCCS-AOU San Martino-IST and University of Genoa, Genoa, Italy
| | - Francesco Fiz
- Nuclear Medicine, IRCCS-AOU San Martino-IST and University of Genoa, Genoa, Italy.,Nuclear Medicine Unit, Department of Radiology, Tübingen, Germany
| | - Silvia Morbelli
- Nuclear Medicine, IRCCS-AOU San Martino-IST and University of Genoa, Genoa, Italy
| | - Matteo Sarocchi
- Clinic of Cardiovascular Diseases, IRCCS-AOU San Martino-IST, Genoa, Italy
| | - Fabio Pastorino
- Unit of Experimental Therapy in Oncology, IRCCS Gaslini, Genoa, Italy
| | - Alberto Ghidella
- Clinic of Cardiovascular Diseases, IRCCS-AOU San Martino-IST, Genoa, Italy
| | - Elena Pomposelli
- Nuclear Medicine, IRCCS-AOU San Martino-IST and University of Genoa, Genoa, Italy
| | - Maurizio Miglino
- Haematology Clinic, University of Genoa, IRCCS-AOU San Martino-IST, Genoa, Italy
| | - Pietro Ameri
- Clinic of Cardiovascular Diseases, IRCCS-AOU San Martino-IST, Genoa, Italy
| | - Laura Emionite
- Animal Facility, IRCCS-AOU San Martino-IST, Genoa, Italy
| | - Flavia Ticconi
- Nuclear Medicine, IRCCS-AOU San Martino-IST and University of Genoa, Genoa, Italy
| | | | - Ambra Buschiazzo
- Nuclear Medicine, IRCCS-AOU San Martino-IST and University of Genoa, Genoa, Italy
| | | | - Salvatore Fiordoro
- Nuclear Medicine, IRCCS-AOU San Martino-IST and University of Genoa, Genoa, Italy
| | - Anna Borra
- Nuclear Medicine, IRCCS-AOU San Martino-IST and University of Genoa, Genoa, Italy
| | - Vanessa Cossu
- Nuclear Medicine, IRCCS-AOU San Martino-IST and University of Genoa, Genoa, Italy
| | - Annalisa Bozzano
- Nuclear Medicine, IRCCS-AOU San Martino-IST and University of Genoa, Genoa, Italy
| | - Adalberto Ibatici
- Haematology Clinic, University of Genoa, IRCCS-AOU San Martino-IST, Genoa, Italy
| | - Mirco Ponzoni
- Unit of Experimental Therapy in Oncology, IRCCS Gaslini, Genoa, Italy
| | - Paolo Spallarossa
- Clinic of Cardiovascular Diseases, IRCCS-AOU San Martino-IST, Genoa, Italy
| | - Andrea Gallamini
- Department of Research, Innovation, and Statistics, Lacassagne Cancer Centre, Nice, France
| | - Paolo Bruzzi
- Epidemiology Unit, IRCCS-AOU San Martino-IST, Genoa, Italy; and
| | - Gianmario Sambuceti
- Nuclear Medicine, IRCCS-AOU San Martino-IST and University of Genoa, Genoa, Italy
| | - Cecilia Marini
- CNR Institute of Bioimaging and Molecular Physiology, Section of Genoa, Milan, Italy
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Andreychenko A, Kroon PS, Maspero M, Jürgenliemk-Schulz I, De Leeuw AAC, Lam MGEH, Lagendijk JJW, van den Berg CAT. The feasibility of semi-automatically generated red bone marrow segmentations based on MR-only for patients with gynecologic cancer. Radiother Oncol 2017; 123:164-168. [PMID: 28238449 DOI: 10.1016/j.radonc.2017.01.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 01/26/2017] [Accepted: 01/29/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE For patients with cervical cancer the delivery of chemotherapy with radiotherapy improves survival compared with radiotherapy alone. However, high rates of acute hematologic toxicity occur when combining both therapies due to the damage of the red bone marrow (RBM). This study aimed to reduce the radiation damage to the RBM. A tool has been developed for semi-automatic delineation of the red bone marrow based on MR-only. This delineation can be included into the treatment planning process to reduce the volume of RBM irradiated in patients receiving pelvic radiation therapy. METHODS 13 patients with cervical cancer were enrolled. All the patients underwent MR, CT and FDG-PET imaging. A tool for RBM determination from water and fat MR images was developed. Our MR-based RBM tool was optimized and validated with the FDG-PET scans of the patients. RESULTS Our tool identified RBM regions in the pelvic area. The mean total volume of these regions was 34% of the pelvic bone marrow. The corresponding SUV values based on the FDG-PET scans were above the reported threshold of active/red bone marrow. CONCLUSION This study shows that delineations of the RBM for the radiotherapy with RBM sparing can be generated semi-automatically using MR scans only.
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Affiliation(s)
- Anna Andreychenko
- Department of Radiotherapy, Center for Image Sciences, University Medical Center Utrecht, The Netherlands.
| | - Petra S Kroon
- Department of Radiotherapy, Center for Image Sciences, University Medical Center Utrecht, The Netherlands
| | - Matteo Maspero
- Department of Radiotherapy, Center for Image Sciences, University Medical Center Utrecht, The Netherlands
| | - Ina Jürgenliemk-Schulz
- Department of Radiotherapy, Center for Image Sciences, University Medical Center Utrecht, The Netherlands
| | - Astrid A C De Leeuw
- Department of Radiotherapy, Center for Image Sciences, University Medical Center Utrecht, The Netherlands
| | - Marnix G E H Lam
- Department of Nuclear Medicine, Center for Image Sciences, University Medical Center Utrecht, The Netherlands
| | - Jan J W Lagendijk
- Department of Radiotherapy, Center for Image Sciences, University Medical Center Utrecht, The Netherlands
| | - Cornelis A T van den Berg
- Department of Radiotherapy, Center for Image Sciences, University Medical Center Utrecht, The Netherlands
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Quantification and three-dimensional microanatomical organization of the bone marrow. Blood Adv 2017; 1:407-416. [PMID: 29296956 DOI: 10.1182/bloodadvances.2016003194] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 01/05/2017] [Indexed: 12/21/2022] Open
Abstract
Bone marrow (BM) constitutes one of the largest organs in mice and humans, continuously generating, in a highly regulated manner, red blood cells, platelets, and white blood cells that together form the majority of cells of the body. In this review, we provide a quantitative overview of BM cellular composition, we summarize emerging knowledge on its structural organization and cellular niches, and we argue for the need of multidimensional approaches such as recently developed imaging techniques to uncover the complex spatial logic that underlies BM function in health and disease.
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Lee AY, Golden DW, Bazan JG, Kopec M, Pelizzari CA, Aggarwal S, Chang DT, Liauw SL. Hematologic Nadirs During Chemoradiation for Anal Cancer: Temporal Characterization and Dosimetric Predictors. Int J Radiat Oncol Biol Phys 2016; 97:306-312. [PMID: 28068238 DOI: 10.1016/j.ijrobp.2016.10.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 10/03/2016] [Accepted: 10/12/2016] [Indexed: 12/19/2022]
Abstract
PURPOSE Pelvic bone marrow (BM) constraints may offer a means to reduce the toxicity commonly associated with chemoradiation for anal cancer. We conducted a bi-institutional analysis of dose-volume metrics in a time-sensitive fashion to devise practical metrics to minimize hematologic toxicity. METHODS AND MATERIALS Fifty-six anal cancer patients from 2 institutions received definitive radiation therapy (median primary dose of 54 Gy) using intensity modulated radiation therapy (IMRT, n=49) or 3-dimensional (3D) conformal therapy (n=7) with concurrent 5-fluorouracil (5-FU) and mitomycin C. Weekly blood counts were retrospectively plotted to characterize the time course of cytopenias. Dose-volume parameters were correlated with blood counts at a standardized time point to identify predictors of initial blood count nadirs. RESULTS Leukocytes, neutrophils, and platelets reached a nadir at week 3 of treatment. Smaller volumes of the pelvic BM correlated most strongly with lower week 3 blood counts, more so than age, sex, body mass index (BMI), or dose metrics. Patients who had ≥750 cc of pelvic BM spared from doses of ≥30 Gy had 0% grade 3+ leukopenia or neutropenia at week 3. Higher V40 Gy to the lower pelvic BM (LP V40) also correlated with cytopenia. Patients with an LP V40 >23% had higher rates of grade 3+ leukopenia (29% vs 4%, P=.02), grade 3+ neutropenia (33% vs 8%, P=.04), and grade 2+ thrombocytopenia (32% vs 7%, P=.04) at week 3. On multivariate analysis, pelvic BM volume and LP V40 remained associated with leukocyte count, and all marrow subsite volumes remained associated with neutrophil counts at week 3 (P<.1). CONCLUSIONS Larger pelvic BM volumes correlate with less severe leukocyte and neutrophil nadirs, suggesting that larger total "marrow reserve" can mitigate cytopenias. Sparing a critical marrow reserve and limiting the V40 Gy to the lower pelvis may reduce the risk of hematologic toxicity.
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Affiliation(s)
- Andrew Y Lee
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, Illinois
| | - Daniel W Golden
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, Illinois
| | - Jose G Bazan
- Department of Radiation Oncology, The Ohio State University, Columbus, Ohio
| | - Malgorzata Kopec
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, Illinois
| | - Charles A Pelizzari
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, Illinois
| | - Sonya Aggarwal
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - Daniel T Chang
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - Stanley L Liauw
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, Illinois.
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21
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Makris NE, Boellaard R, Menke CW, Lammertsma AA, Huisman MC. An automatic delineation method for bone marrow absorbed dose estimation in (89)Zr PET/CT studies. EJNMMI Phys 2016; 3:13. [PMID: 27447823 PMCID: PMC4958083 DOI: 10.1186/s40658-016-0149-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 06/30/2016] [Indexed: 11/10/2022] Open
Abstract
Background The study aims to develop and validate an automatic delineation method for estimating red bone marrow (RM) activity concentration and absorbed dose in 89Zr positron emission tomography/computed tomography (PET/CT) studies. Five patients with advanced colorectal cancer received 37.1 ± 0.9 MBq [89Zr] cetuximab within 2 h after administration of a therapeutic dose of 500 mg m−2 unlabelled cetuximab. Per patient, five PET/CT scans were acquired on a Gemini TF-64 PET/CT scanner at 1, 24, 48, 96 and 144 h post injection. Low dose CT data were used to manually generate volumes of interest (VOI) in the lumbar vertebrae (LV). In addition, LV VOI were generated automatically using an active contour method in a low dose CT. RM activity was then determined by mapping the low dose CT-derived RM VOI onto the corresponding PET scans. Finally, these activities were used to derive residence times and, subsequently, the self and total RM absorbed doses using OLINDA/EXM 1.1. Results High correlations (r2 > 0.85) between manual and automated VOI methods were obtained for both RM activity concentrations and total absorbed doses. On average, the automatic method provided values that were lower than 5 % compared to the manual method. Conclusions An automated and efficient VOI method, based on an active contour approach, was developed, enabling accurate estimates of RM activity concentrations and total absorbed doses. Electronic supplementary material The online version of this article (doi:10.1186/s40658-016-0149-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- N E Makris
- Department of Radiology & Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands. .,Present address: CREATIS, CNRS UMR 5220, INSERM U1206, F-69677, Bron, France.
| | - R Boellaard
- Department of Radiology & Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - C W Menke
- Department of Medical Oncology, VU University Medical Center, Amsterdam, the Netherlands
| | - A A Lammertsma
- Department of Radiology & Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - M C Huisman
- Department of Radiology & Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
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22
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Marini C, Cistaro A, Campi C, Calvo A, Caponnetto C, Nobili FM, Fania P, Beltrametti MC, Moglia C, Novi G, Buschiazzo A, Perasso A, Canosa A, Scialò C, Pomposelli E, Massone AM, Bagnara MC, Cammarosano S, Bruzzi P, Morbelli S, Sambuceti G, Mancardi G, Piana M, Chiò A. A PET/CT approach to spinal cord metabolism in amyotrophic lateral sclerosis. Eur J Nucl Med Mol Imaging 2016; 43:2061-71. [PMID: 27421971 PMCID: PMC5007279 DOI: 10.1007/s00259-016-3440-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 06/08/2016] [Indexed: 12/18/2022]
Abstract
Purpose In amyotrophic lateral sclerosis, functional alterations within the brain have been intensively assessed, while progression of lower motor neuron damage has scarcely been defined. The aim of the present study was to develop a computational method to systematically evaluate spinal cord metabolism as a tool to monitor disease mechanisms. Methods A new computational three-dimensional method to extract the spinal cord from 18F-FDG PET/CT images was evaluated in 30 patients with spinal onset amyotrophic lateral sclerosis and 30 controls. The algorithm identified the skeleton on the CT images by using an extension of the Hough transform and then extracted the spinal canal and the spinal cord. In these regions, 18F-FDG standardized uptake values were measured to estimate the metabolic activity of the spinal canal and cord. Measurements were performed in the cervical and dorsal spine and normalized to the corresponding value in the liver. Results Uptake of 18F-FDG in the spinal cord was significantly higher in patients than in controls (p < 0.05). By contrast, no significant differences were observed in spinal cord and spinal canal volumes between the two groups. 18F-FDG uptake was completely independent of age, gender, degree of functional impairment, disease duration and riluzole treatment. Kaplan-Meier analysis showed a higher mortality rate in patients with standardized uptake values above the fifth decile at the 3-year follow-up evaluation (log-rank test, p < 0.01). The independence of this value was confirmed by multivariate Cox analysis. Conclusion Our computational three-dimensional method enabled the evaluation of spinal cord metabolism and volume and might represent a potential new window onto the pathophysiology of amyotrophic lateral sclerosis.
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Affiliation(s)
- Cecilia Marini
- CNR Institute of Bioimages and Molecular Physiology, Milan, Section of Genoa, Italy. .,Nuclear Medicine, IRCCS San Martino IST, and Depth of Health Science, University of Genoa, Genoa, Italy. .,CNR Institute of Bioimages and Molecular Physiology, Section of Genoa, C/o Nuclear Medicine, IRCCS AOU San Martino-IST, 16132, Genoa, Italy.
| | - Angelina Cistaro
- Positron Emission Tomography Centre IRMET, Affidea, Turin, Italy
| | | | - Andrea Calvo
- ALS Center, "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy.,AUO Città della Salute e della Scienza, Turin, Italy
| | - Claudia Caponnetto
- Department of Neuroscience, IRCCS San Martino IST, Genoa, Italy.,DINOGMI University of Genoa, Genoa, Italy
| | - Flavio Mariano Nobili
- Department of Neuroscience, IRCCS San Martino IST, Genoa, Italy.,DINOGMI University of Genoa, Genoa, Italy
| | - Piercarlo Fania
- Positron Emission Tomography Centre IRMET, Affidea, Turin, Italy
| | | | - Cristina Moglia
- ALS Center, "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy.,AUO Città della Salute e della Scienza, Turin, Italy
| | - Giovanni Novi
- Department of Neuroscience, IRCCS San Martino IST, Genoa, Italy.,DINOGMI University of Genoa, Genoa, Italy
| | - Ambra Buschiazzo
- Nuclear Medicine, IRCCS San Martino IST, and Depth of Health Science, University of Genoa, Genoa, Italy
| | | | - Antonio Canosa
- ALS Center, "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy.,AUO Città della Salute e della Scienza, Turin, Italy
| | - Carlo Scialò
- Department of Neuroscience, IRCCS San Martino IST, Genoa, Italy.,DINOGMI University of Genoa, Genoa, Italy
| | - Elena Pomposelli
- Nuclear Medicine, IRCCS San Martino IST, and Depth of Health Science, University of Genoa, Genoa, Italy
| | | | | | - Stefania Cammarosano
- ALS Center, "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy.,AUO Città della Salute e della Scienza, Turin, Italy
| | - Paolo Bruzzi
- Statistics and Epidemiology Unit, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Silvia Morbelli
- Nuclear Medicine, IRCCS San Martino IST, and Depth of Health Science, University of Genoa, Genoa, Italy
| | - Gianmario Sambuceti
- Nuclear Medicine, IRCCS San Martino IST, and Depth of Health Science, University of Genoa, Genoa, Italy
| | - Gianluigi Mancardi
- Department of Neuroscience, IRCCS San Martino IST, Genoa, Italy.,DINOGMI University of Genoa, Genoa, Italy
| | - Michele Piana
- SPIN Institute, CNR, Genoa, Italy.,Department of Mathematics (DIMA), University of Genoa, Genoa, Italy
| | - Adriano Chiò
- ALS Center, "Rita Levi Montalcini" Department of Neuroscience, University of Turin, Turin, Italy.,AUO Città della Salute e della Scienza, Turin, Italy
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23
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Physiological uptake values of 18F-FDG in long bones of the lower extremity on PET/CT imaging. Nucl Med Commun 2016; 37:589-92. [DOI: 10.1097/mnm.0000000000000483] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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24
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Scheller EL, Cawthorn WP, Burr AA, Horowitz MC, MacDougald OA. Marrow Adipose Tissue: Trimming the Fat. Trends Endocrinol Metab 2016; 27:392-403. [PMID: 27094502 PMCID: PMC4875855 DOI: 10.1016/j.tem.2016.03.016] [Citation(s) in RCA: 137] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 03/25/2016] [Accepted: 03/29/2016] [Indexed: 02/07/2023]
Abstract
Marrow adipose tissue (MAT) is a unique fat depot, located in the skeleton, that has the potential to contribute to both local and systemic metabolic processes. In this review we highlight several recent conceptual developments pertaining to the origin and function of MAT adipocytes; consider the relationship of MAT to beige, brown, and white adipose depots; explore MAT expansion and turnover in humans and rodents; and discuss future directions for MAT research in the context of endocrine function and metabolic disease. MAT has the potential to exert both local and systemic effects on metabolic homeostasis, skeletal remodeling, hematopoiesis, and the development of bone metastases. The diversity of these functions highlights the breadth of the potential impact of MAT on health and disease.
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Affiliation(s)
- Erica L Scheller
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI 48109, USA; Division of Bone and Mineral Diseases, Department of Internal Medicine, Washington University, Saint Louis, MO 63110, USA.
| | - William P Cawthorn
- University/BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Aaron A Burr
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Mark C Horowitz
- Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Ormond A MacDougald
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI 48109, USA; Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA.
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25
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CT imaging of bone and bone marrow infiltration in malignant melanoma—Challenges and limitations for clinical staging in comparison to 18FDG-PET/CT. Eur J Radiol 2016; 85:732-8. [DOI: 10.1016/j.ejrad.2016.01.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 01/16/2016] [Indexed: 11/19/2022]
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26
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Irradiation of FDG-PET–Defined Active Bone Marrow Subregions and Acute Hematologic Toxicity in Anal Cancer Patients Undergoing Chemoradiation. Int J Radiat Oncol Biol Phys 2016; 94:747-54. [DOI: 10.1016/j.ijrobp.2015.12.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 11/25/2015] [Accepted: 12/08/2015] [Indexed: 12/31/2022]
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27
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Goryawala M, Adjoua M, Güleç S. Proliferative and Glycolytic Assessment of the Whole-Body Bone Marrow Compartment. Mol Imaging Radionucl Ther 2015; 24:71-9. [PMID: 26316472 PMCID: PMC4563173 DOI: 10.4274/mirt.22931] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE Quantitative assessment of active bone marrow (BM) in vivo is yet to be well-defined. This study aims to compare total body BM volume estimations obtained from use of both18F-FLT PET/CT and 18F-FDG PET/CT in order to consolidate higher cellular proliferation rates with imaging the highly active red BM in pancreatic cancer. METHODS This phase I pilot study includes seven patients with pancreatic cancers who underwent both 18F-FLT and 18F-FDG imaging each acquired within a week's duration. A CT-based classifier is used for segmenting bone into cortical and trabecular regions. The total BM volume is determined through statistical thresholding on PET activity found within the trabecular bone. RESULTS Results showed that 18F-FLT measures of red BM volume (RBV) were higher than those obtained from 18F-FDG (∆=89.21 ml). RBV obtained using 18F-FLT in males were found to have high correlation with measured weight (R2=0.61) and BMI (R2=0.70). The red BM fraction obtained from 18F-FLT was significantly different between males and females, with females showing much higher red bone matter within the trabecular bone (p<0.05). In contrast to 18F-FLT, 18F-FDG BM measurements showed that RBV was significantly different between males and females (p<0.05). Results also show that spinal activity SUV threshold for red BM segmentation is significantly different between 18F-FLT PET and 18F-FDG PET (p<0.05). CONCLUSION By combining 18F-FLT-PET and 18F-FDG-PET, this study provides useful insights for in vivo BM estimation through its proliferative and glycolytic activities.
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Affiliation(s)
| | | | - Seza Güleç
- Seza Güleç MD, Florida International University Herbert Wertheim College, Department of Surgery, Miami, USA Phone: +17866930821 E-mail:
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28
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Allogeneic cell transplant expands bone marrow distribution by colonizing previously abandoned areas: an FDG PET/CT analysis. Blood 2015; 125:4095-102. [PMID: 25957389 DOI: 10.1182/blood-2015-01-618215] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 04/30/2015] [Indexed: 12/30/2022] Open
Abstract
Mechanisms of hematopoietic reconstitution after bone marrow (BM) transplantation remain largely unknown. We applied a computational quantification software application to hybrid 18F-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) images to assess activity and distribution of the hematopoietic system throughout the whole skeleton of recently transplanted patients. Thirty-four patients underwent PET/CT 30 days after either adult stem cell transplantation (allogeneic cell transplantation [ACT]; n = 18) or cord blood transplantation (CBT; n = 16). Our software automatically recognized compact bone volume and trabecular bone volume (IBV) in CT slices. Within IBV, coregistered PET data were extracted to identify the active BM (ABM) from the inactive tissue. Patients were compared with 34 matched controls chosen among a published normalcy database. Whole body ABM increased in ACT and CBT when compared with controls (12.4 ± 3 and 12.8 ± 6.8 vs 8.1 ± 2.6 mL/kg of ideal body weight [IBW], P < .001). In long bones, ABM increased three- and sixfold in CBT and ACT, respectively, compared with controls (0.9 ± 0.9 and 1.7 ± 2.5 vs 0.3 ± 0.3 mL/kg IBW, P < .01). These data document an unexpected distribution of transplanted BM into previously abandoned BM sites.
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29
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Schraml C, Schmid M, Gatidis S, Schmidt H, la Fougère C, Nikolaou K, Schwenzer NF. Multiparametric analysis of bone marrow in cancer patients using simultaneous PET/MR imaging: Correlation of fat fraction, diffusivity, metabolic activity, and anthropometric data. J Magn Reson Imaging 2015; 42:1048-56. [DOI: 10.1002/jmri.24865] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 01/22/2015] [Indexed: 11/09/2022] Open
Affiliation(s)
- Christina Schraml
- Diagnostic and Interventional Radiology, University Department of Radiology, University Hospital Tuebingen; Tuebingen Germany
| | - Marinus Schmid
- Diagnostic and Interventional Radiology, University Department of Radiology, University Hospital Tuebingen; Tuebingen Germany
| | - Sergios Gatidis
- Diagnostic and Interventional Radiology, University Department of Radiology, University Hospital Tuebingen; Tuebingen Germany
| | - Holger Schmidt
- Diagnostic and Interventional Radiology, University Department of Radiology, University Hospital Tuebingen; Tuebingen Germany
| | - Christian la Fougère
- Nuclear Medicine; University Department of Radiology; University Hospital Tuebingen; Tuebingen Germany
| | - Konstantin Nikolaou
- Diagnostic and Interventional Radiology, University Department of Radiology, University Hospital Tuebingen; Tuebingen Germany
| | - Nina F. Schwenzer
- Diagnostic and Interventional Radiology, University Department of Radiology, University Hospital Tuebingen; Tuebingen Germany
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30
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Piva R, Fiz F, Piana M, Bongioanni F, Bottoni G, Bacigalupo A, Marini C, Sambuceti G. 18F-fluorodeoxyglucose PET/CT in aplastic anemia: a literature review and the potential of a computational approach. ACTA ACUST UNITED AC 2014. [DOI: 10.2217/cpr.14.55] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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31
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Fiz F, Marini C, Piva R, Miglino M, Massollo M, Bongioanni F, Morbelli S, Bottoni G, Campi C, Bacigalupo A, Bruzzi P, Frassoni F, Piana M, Sambuceti G. Adult Advanced Chronic Lymphocytic Leukemia: Computational Analysis of Whole-Body CT Documents a Bone Structure Alteration. Radiology 2014; 271:805-13. [DOI: 10.1148/radiol.14131944] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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32
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Herman SEM, Niemann CU, Farooqui M, Jones J, Mustafa RZ, Lipsky A, Saba N, Martyr S, Soto S, Valdez J, Gyamfi JA, Maric I, Calvo KR, Pedersen LB, Geisler CH, Liu D, Marti GE, Aue G, Wiestner A. Ibrutinib-induced lymphocytosis in patients with chronic lymphocytic leukemia: correlative analyses from a phase II study. Leukemia 2014; 28:2188-96. [PMID: 24699307 PMCID: PMC4185271 DOI: 10.1038/leu.2014.122] [Citation(s) in RCA: 140] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 02/21/2014] [Accepted: 03/21/2014] [Indexed: 02/06/2023]
Abstract
Ibrutinib and other targeted inhibitors of B-cell receptor signaling achieve impressive clinical results for patients with chronic lymphocytic leukemia (CLL). A treatment-induced rise in absolute lymphocyte count (ALC) has emerged as a class effect of kinase inhibitors in CLL and warrants further investigation. We here report correlative studies in 64 patients with CLL treated with ibrutinib. We quantified tumor burden in blood, lymph nodes, spleen, and bone marrow, assessed phenotypic changes of circulating cells, and measured whole blood viscosity. With just one dose of ibrutinib the average increase in ALC was 66%, and in over 40% of patients the ALC peaked within 24 hours of initiating treatment. Circulating CLL cells on day 2 showed increased Ki67 and CD38 expression, indicating an efflux of tumor cells from the tissue compartments into the blood. The kinetics and degree of the treatment-induced lymphocytosis was highly variable; interestingly in patients with a high baseline ALC the relative increase was mild and resolution rapid. After two cycles of treatment the disease burden in lymph node, bone marrow, and spleen decreased irrespective of the relative change in ALC. Whole blood viscosity was dependent on both ALC and hemoglobin. No adverse events were attributed to the lymphocytosis.
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Affiliation(s)
- S E M Herman
- Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - C U Niemann
- Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - M Farooqui
- Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - J Jones
- 1] Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA [2] Medical Research Scholars Program, National Institutes of Health, Bethesda, MD, USA
| | - R Z Mustafa
- Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - A Lipsky
- Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - N Saba
- Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - S Martyr
- Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - S Soto
- Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - J Valdez
- Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - J A Gyamfi
- Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - I Maric
- Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - K R Calvo
- Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - L B Pedersen
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - C H Geisler
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - D Liu
- Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - G E Marti
- Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - G Aue
- Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - A Wiestner
- Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
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