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Paparo F, Peirano A, Matos J, Bacigalupo L, Rossi U, Mussetto I, Bottoni G, Ugolini M, Introini C, Ruggieri FG, Rollandi GA, Piccardo A. Diagnostic value of retrospectively fused 64CuCl 2 PET/MRI in biochemical relapse of prostate cancer: comparison with fused 18F-Choline PET/MRI, 64CuCl2 PET/CT, 18F-Choline PET/CT, and mpMRI. Abdom Radiol (NY) 2020; 45:3896-3906. [PMID: 32451674 DOI: 10.1007/s00261-020-02591-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE To assess the diagnostic value of retrospectively fused PET/MRI by comparing the detection rates (DRs) of fused 64CuCl2 PET/MRI vs. fused 18F-Choline PET/MRI in patients with suspected prostatic cancer (PCa) recurrence. The secondary objective was to compare the DRs of fused PET/MRI vs. those of the separate imaging modalities. METHODS We retrospectively evaluated 50 PCa patients with biochemical relapse after radical prostatectomy (RP) or radiotherapy (RT). All patients underwent 64CuCl2 PET/CT, 18F-Choline PET/CT, and multiparametric magnetic resonance imaging (mpMRI) within 15 days. Fused 64CuCl2-PET/MRI and fused 18F-Choline PET/MRI images were obtained by retrospective co-registration of MRI and PET images. Experienced readers interpreted the images, and the DRs of each imaging modality were assessed. RESULTS In the patient-based analysis, overall DRs of fused 64CuCl2 PET/MRI, fused 18F-Choline PET/MRI, 64CuCl2 PET/CT, 18F-Choline PET/CT, and mpMRI were 88%, 68%, 82%, 56%, and 74%, respectively. In the lesion-based analysis, overall DRs of fused 64CuCl2 PET/MRI, fused 18F-Choline PET/MRI, 64CuCl2 PET/CT, 18 F-Choline PET/CT, and mpMRI were 95%, 66%, 87%, 58%, and 71%, respectively. CONCLUSIONS Retrospectively fused PET/MRI is able to overcome the limitations of the separate interpretation of the individual imaging modalities. Fused 64CuCl2 PET/MRI provided the highest diagnostic performance in the detection of PCa local relapse.
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Affiliation(s)
- Francesco Paparo
- Unit of Radiology, Department of Diagnostic Imaging, E.O. Galliera Hospital, Genoa, Italy
| | - Alice Peirano
- DISSAL - Department of Health Sciences, University of Genoa, Via Antonio Pastore, 1, 16132, Genoa, GE, Italy
| | - João Matos
- DISSAL - Department of Health Sciences, University of Genoa, Via Antonio Pastore, 1, 16132, Genoa, GE, Italy.
| | - Lorenzo Bacigalupo
- Unit of Radiology, Department of Diagnostic Imaging, E.O. Galliera Hospital, Genoa, Italy
| | - Umberto Rossi
- Unit of Interventional Radiology, Department of Diagnostic Imaging, E.O. Galliera Hospital, Genoa, Italy
| | - Ilaria Mussetto
- Unit of Radiology, Department of Diagnostic Imaging, E.O. Galliera Hospital, Genoa, Italy
| | - Gianluca Bottoni
- Unit of Nuclear Medicine, Department of Diagnostic Imaging, E.O. Galliera Hospital, Genoa, Italy
| | - Martina Ugolini
- Medical Physics Unit, Department of Diagnostic Imaging, E.O. Galliera Hospital, Genoa, Italy
| | - Carlo Introini
- Prostate Unit, Department of Urology, E.O. Galliera Hospital, Genoa, Italy
| | - Filippo Grillo Ruggieri
- Unit of Radiotherapy, Department of Diagnostic Imaging, E.O. Galliera Hospital, Genoa, Italy
| | - Gian Andrea Rollandi
- Unit of Radiology, Department of Diagnostic Imaging, E.O. Galliera Hospital, Genoa, Italy
| | - Arnoldo Piccardo
- Unit of Nuclear Medicine, Department of Diagnostic Imaging, E.O. Galliera Hospital, Genoa, Italy
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Sultana S, Song DY, Lee J. Deformable registration of PET/CT and ultrasound for disease-targeted focal prostate brachytherapy. J Med Imaging (Bellingham) 2019; 6:035003. [PMID: 31528661 PMCID: PMC6739636 DOI: 10.1117/1.jmi.6.3.035003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 08/20/2019] [Indexed: 12/27/2022] Open
Abstract
We propose a deformable registration algorithm for prostate-specific membrane antigen (PSMA) PET/CT and transrectal ultrasound (TRUS) fusion. Accurate registration of PSMA PET to intraoperative TRUS will allow physicians to customize dose planning based on the regions involved. The inputs to the registration algorithm are the PET/CT and TRUS volumes as well as the prostate segmentations. PET/CT and TRUS volumes are first rigidly registered by maximizing the overlap between the segmented prostate binary masks. Three-dimensional anatomical landmarks are then automatically extracted from the boundary as well as within the prostate. Then, a deformable registration is performed using a regularized thin plate spline where the landmark localization error is optimized between the extracted landmarks that are in correspondence. The proposed algorithm was evaluated on 25 prostate cancer patients treated with low-dose-rate brachytherapy. We registered the postimplant CT to TRUS using the proposed algorithm and computed target registration errors (TREs) by comparing implanted seed locations. Our approach outperforms state-of-the-art methods, with significantly lower ( mean ± standard deviation ) TRE of 1.96 ± 1.29 mm while being computationally efficient (mean computation time of 38 s). The proposed landmark-based PET/CT-TRUS deformable registration algorithm is simple, computationally efficient, and capable of producing quality registration of the prostate boundary as well as the internal gland.
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Affiliation(s)
- Sharmin Sultana
- Johns Hopkins University, Department of Radiation Oncology and Molecular Radiation Sciences, Baltimore, Maryland, United States
| | - Daniel Y. Song
- Johns Hopkins University, Department of Radiation Oncology and Molecular Radiation Sciences, Baltimore, Maryland, United States
| | - Junghoon Lee
- Johns Hopkins University, Department of Radiation Oncology and Molecular Radiation Sciences, Baltimore, Maryland, United States
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Riola-Parada C, Carreras-Delgado J, Pérez-Dueñas V, Garcerant-Tafur M, García-Cañamaque L. 18F-choline PET/MR in suspected recurrence of prostate cancer. Rev Esp Med Nucl Imagen Mol 2018. [DOI: 10.1016/j.remnie.2018.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Riola-Parada C, Carreras-Delgado JL, Pérez-Dueñas V, Garcerant-Tafur M, García-Cañamaque L. 18F-choline PET/MRI in suspected recurrence of prostate carcinoma. Rev Esp Med Nucl Imagen Mol 2018; 37:296-301. [PMID: 29793842 DOI: 10.1016/j.remn.2018.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 04/12/2018] [Accepted: 04/13/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To evaluate the usefulness of simultaneous 18F-choline PET/MRI in the suspicion of prostate cancer recurrence and to relate 18F-choline PET/MRI detection rate with analytical and pathological variables. MATERIAL AND METHODS 27 patients with prostate cancer who received local therapy as primary treatment underwent a 18F-choline PET/MRI due to suspicion of recurrence (persistently rising serum PSA level). 18F-choline PET/MRI findings were validated by anatomopathological analysis, other imaging tests or by biochemical response to oncological treatment. RESULTS 18F-choline PET/MRI detected disease in 15 of 27 patients (detection rate 55.56%). 4 (15%) presented exclusively local recurrence, 5 (18%) lymph node metastases and 7 (26%) bone metastases. Mean PSA (PSAmed) at study time was 2.94ng/mL (range 0.18-10ng/mL). PSAmed in patients with positive PET/MRI was 3.70ng/mL (range 0.24-10ng/mL), higher than in patients with negative PET/MRI, PSAmed 1.97ng/mL (range 0.18-4.38ng/mL), although without statistically significant differences. Gleason score at diagnosis in patients with a positive study was 7.33 (range 6-9) and in patients with a negative study was 7 (range 6-9), without statistically significant differences. CONCLUSION 18F-choline PET/MRI detection rate was considerable despite the relatively low PSA values in our sample. The influence of Gleason score and PSA level on 18F-choline PET/MRI detection rate was not statistically significant.
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Affiliation(s)
- C Riola-Parada
- Servicio de Medicina Nuclear, Hospital Universitario HM Puerta del Sur, Móstoles, Madrid, España.
| | - J L Carreras-Delgado
- Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, España
| | - V Pérez-Dueñas
- Servicio de Radiología, Hospital Universitario HM Puerta del Sur, Móstoles, Madrid, España
| | - M Garcerant-Tafur
- Servicio de Medicina Nuclear, Hospital Universitario HM Puerta del Sur, Móstoles, Madrid, España
| | - L García-Cañamaque
- Servicio de Medicina Nuclear, Hospital Universitario HM Puerta del Sur, Móstoles, Madrid, España
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Righi S, Ugolini M, Bottoni G, Puntoni M, Iacozzi M, Paparo F, Cabria M, Ceriani L, Gambaro M, Giovanella L, Piccardo A. Biokinetic and dosimetric aspects of 64CuCl 2 in human prostate cancer: possible theranostic implications. EJNMMI Res 2018; 8:18. [PMID: 29492782 PMCID: PMC5833894 DOI: 10.1186/s13550-018-0373-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 02/20/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The aim of the present study is to evaluate the kinetics and dosimetry of 64CuCl2 in human prostate cancer (PCa) lesions. We prospectively evaluated 50 PCa patients with biochemical relapse after surgery or external beam radiation therapy. All patients underwent 64CuCl2-PET/CT to detect PCa recurrence/metastases. Volumes of interest were manually drawn for each 64CuCl2 avid PCa lesion with a diameter > 1 cm on mpMRI in each patient. Time-activity curves for all lesions were obtained. The effective and biological half-life and the standard uptake values (SUVs) were calculated. Tumour/background ratio (TBR) curves as a function of time were considered. Finally, the absorbed dose per lesion was estimated. RESULTS The mean effective half-life of 64CuCl2 calculated in the lymph nodes (10.2 ± 1.7 h) was significantly higher than in local relapses (8.8 ± 1.1 h) and similar to that seen in bone metastases (9.0 ± 0.4 h). The mean 64CuCl2 SUVmax calculated 1 h after tracer injection was significantly higher in the lymph nodes (6.8 ± 4.3) and bone metastases (6.8 ± 2.9) than in local relapses (4.7 ± 2.4). TBR mean curve of 64CuCl2 revealed that the calculated TBRmax value was 5.0, 7.0, and 6.2 in local relapse and lymph node and bone metastases, respectively, and it was achieved about 1 h after 64CuCl2 injection. The mean absorbed dose of the PCa lesions per administrated activity was 6.00E-2 ± 4.74E-2mGy/MBq. Indeed, for an administered activity of 3.7 GBq, the mean dose absorbed by the lesion would be 0.22 Gy. CONCLUSIONS Dosimetry showed that the dose absorbed by PCa recurrences/metastases per administrated activity was low. The dosimetric study performed does not take into account the possible therapeutic effect of the Auger electrons. Clinical trials are needed to evaluate 64Cu internalization in the cell nucleus that seems related to the therapeutic effectiveness reported in preclinical studies.
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Affiliation(s)
- Sergio Righi
- Medical Physics Department, E.O. Galliera Hospital, Genoa, Italy
| | - Martina Ugolini
- Medical Physics Department, E.O. Galliera Hospital, Genoa, Italy
| | - Gianluca Bottoni
- Department of Nuclear Medicine, Galliera Hospital, Mura delle Cappuccine 14, 16128, Genoa, Italy
| | - Matteo Puntoni
- Clinical Trial Unit, Office of the Scientific Director, Galliera Hospital, Genoa, Italy
| | - Massimiliano Iacozzi
- Department of Nuclear Medicine, Galliera Hospital, Mura delle Cappuccine 14, 16128, Genoa, Italy
| | | | - Manlio Cabria
- Department of Nuclear Medicine, Galliera Hospital, Mura delle Cappuccine 14, 16128, Genoa, Italy
| | - Luca Ceriani
- Department of Nuclear Medicine, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Monica Gambaro
- Medical Physics Department, E.O. Galliera Hospital, Genoa, Italy
| | - Luca Giovanella
- Department of Nuclear Medicine, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Arnoldo Piccardo
- Department of Nuclear Medicine, Galliera Hospital, Mura delle Cappuccine 14, 16128, Genoa, Italy.
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Piccardo A, Paparo F, Puntoni M, Righi S, Bottoni G, Bacigalupo L, Zanardi S, DeCensi A, Ferrarazzo G, Gambaro M, Ruggieri FG, Campodonico F, Tomasello L, Timossi L, Sola S, Lopci E, Cabria M. 64CuCl2 PET/CT in Prostate Cancer Relapse. J Nucl Med 2017; 59:444-451. [DOI: 10.2967/jnumed.117.195628] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 07/25/2017] [Indexed: 01/19/2023] Open
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Local recurrence of prostate cancer after radical prostatectomy is at risk to be missed in 68Ga-PSMA-11-PET of PET/CT and PET/MRI: comparison with mpMRI integrated in simultaneous PET/MRI. Eur J Nucl Med Mol Imaging 2016; 44:776-787. [PMID: 27988802 DOI: 10.1007/s00259-016-3594-z] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 12/06/2016] [Indexed: 12/27/2022]
Abstract
PURPOSE The positron emission tomography (PET) tracer 68Ga-PSMA-11, targeting the prostate-specific membrane antigen (PSMA), is rapidly excreted into the urinary tract. This leads to significant radioactivity in the bladder, which may limit the PET-detection of local recurrence (LR) of prostate cancer (PC) after radical prostatectomy (RP), developing in close proximity to the bladder. Here, we analyze if there is additional value of multi-parametric magnetic resonance imaging (mpMRI) compared to the 68Ga-PSMA-11-PET-component of PET/CT or PET/MRI to detect LR. METHODS One hundred and nineteen patients with biochemical recurrence after prior RP underwent both hybrid 68Ga-PSMA-11-PET/CTlow-dose (1 h p.i.) and -PET/MRI (2-3 h p.i.) including a mpMRI protocol of the prostatic bed. The comparison of both methods was restricted to the abdomen with focus on LR (McNemar). Bladder-LR distance and recurrence size were measured in axial T2w-TSE. A logistic regression was performed to determine the influence of these variables on detectability in 68Ga-PSMA-11-PET. Standardized-uptake-value (SUVmean) quantification of LR was performed. RESULTS There were 93/119 patients that had at least one pathologic finding. In addition, 18/119 Patients (15.1%) were diagnosed with a LR in mpMRI of PET/MRI but only nine were PET-positive in PET/CT and PET/MRI. This mismatch was statistically significant (p = 0.004). Detection of LR using the PET-component was significantly influenced by proximity to the bladder (p = 0.028). The PET-pattern of LR-uptake was classified into three types (1): separated from bladder; (2): fuses with bladder, and (3): obliterated by bladder). The size of LRs did not affect PET-detectability (p = 0.84), mean size was 1.7 ± 0.69 cm long axis, 1.2 ± 0.46 cm short-axis. SUVmean in nine men was 8.7 ± 3.7 (PET/CT) and 7.0 ± 4.2 (PET/MRI) but could not be quantified in the remaining nine cases (obliterated by bladder). CONCLUSION The present study demonstrates additional value of hybrid 68Ga-PSMA-11-PET/MRI by gaining complementary diagnostic information compared to the 68Ga-PSMA-11-PET/CTlow-dose for patients with LR of PC.
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Haroon A, Ahmed HU, Cathcart P, Almuhaideb A, Kayani I, Dickson J, Kirkham A, Freeman A, Emberton M, Bomanji J. 18F-FECH PET/CT to Assess Clinically Significant Disease in Prostate Cancer: Correlation With Maximum and Total Cancer Core Length Obtained via MRI-Guided Template Mapping Biopsies. AJR Am J Roentgenol 2016; 207:1297-1306. [PMID: 27611962 DOI: 10.2214/ajr.15.15679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The objective of this study was to detect clinically significant and insignificant prostate cancer on 18F-fluoroethylcholine (FECH) PET/CT and to correlate findings with transperineal template-guided prostate mapping (TPM) biopsy. SUBJECTS AND METHODS Fifty-six lobes of the prostate were analyzed in 28 men who underwent FECH PET/CT and TPM. Whole-body images and pelvic images were acquired at 60 and 90 minutes after tracer administration. FECH PET/CT findings were correlated with TPM. Sensitivity, specificity, positive predictive values, negative predictive values, and AUC of dual phase FECH PET/CT were calculated. RESULTS Mean age of the patients was 68.8 years (range, 53-79 years), and mean prostate-specific antigen level was 12.1 ng/mL (range, 0.6-45 ng/mL). Mean maximum cancer core length was 4.4 mm (median, 4 mm; range, 1-14 mm) and mean total cancer core length, 14.6 mm (median, 14.6 mm; range, 1-82 mm). Prostate cancer was identified in 38 lobes with a Gleason score of 6 in five lobes (13%), 7 in 27 lobes (71%), 8 in four lobes (11%), and 9 in two lobes (5%). FECH PET/CT showed findings of prostate cancer in 46/56 lobes (82%). The ranges for maximum standardized uptake value for 60- and 90-minute FECH PET/CT were 1.3-11.4 and 1.2-10.9, respectively. Clinically significant cancer was seen in 30 of 38 positive lobes; eight had clinically insignificant disease. For 60-minute imaging, the sensitivity, specificity, and ROC AUC were 75%, 75%, and 0.746 (95% CI, 0.612-0.853). For 90-minute imaging, the sensitivity, specificity, and ROC AUC were 73.7%, 58.3%, and 0.646 (95% CI, 0.498-0.776). Overall sensitivity, specificity, positive predictive value, and negative predictive value were 95%, 50%, 82.6%, and 80%, respectively. CONCLUSION FECH PET/CT can detect prostate cancer and localizes TPM biopsy-proven clinically significant prostate cancer with sensitivity of greater than 89.7%. Of the two imaging durations, 60-minute imaging is more sensitive and specific than 90-minute imaging.
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Affiliation(s)
- Athar Haroon
- 1 Institute of Nuclear Medicine, 5th Fl, Tower Block, University College London NHS Foundation Trust, 235 Euston Rd, London NW1 2BU, UK
- 2 St. Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - Hashim U Ahmed
- 3 Department of Urology, University College Hospital, London, UK
| | - Paul Cathcart
- 3 Department of Urology, University College Hospital, London, UK
| | - Ahmad Almuhaideb
- 1 Institute of Nuclear Medicine, 5th Fl, Tower Block, University College London NHS Foundation Trust, 235 Euston Rd, London NW1 2BU, UK
| | - Irfan Kayani
- 1 Institute of Nuclear Medicine, 5th Fl, Tower Block, University College London NHS Foundation Trust, 235 Euston Rd, London NW1 2BU, UK
| | - John Dickson
- 1 Institute of Nuclear Medicine, 5th Fl, Tower Block, University College London NHS Foundation Trust, 235 Euston Rd, London NW1 2BU, UK
| | - Alex Kirkham
- 4 Department of Radiology, University College Hospital, London, UK
| | - Alex Freeman
- 5 Department of Pathology, University College Hospital, London, UK
| | - Mark Emberton
- 3 Department of Urology, University College Hospital, London, UK
| | - Jamshed Bomanji
- 1 Institute of Nuclear Medicine, 5th Fl, Tower Block, University College London NHS Foundation Trust, 235 Euston Rd, London NW1 2BU, UK
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Evangelista L, Cimitan M, Hodolič M, Baseric T, Fettich J, Borsatti E. The ability of 18F-choline PET/CT to identify local recurrence of prostate cancer. ACTA ACUST UNITED AC 2016; 40:3230-7. [PMID: 26428685 DOI: 10.1007/s00261-015-0547-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE To determine when 18F-choline PET/CT can truly identify local recurrence of prostate cancer. METHODS 1031 patients from 3 European centers underwent (18)F-choline PET/CT (FCH PET/CT) for recurrent disease; 131 subjects (12.7%) showed a positive FCH uptake in the prostatic gland or prostatic fossa. Median age was 72 years (range 48-87 years), and the median PSA level at the time of FCH PET/CT scan was 4.41 ng/mL (0.22-18.13 ng/mL). 45 patients (34.4%) had a Gleason score (GS) >7, and the residual subjects had a GS ≤ 7. The assessment of true or false-positive FCH PET/CT findings was made by magnetic resonance imaging (n = 34) and/or biopsy in 75/131 cases. A χ (2) test and a Z Kolmogorov-Smirnov test were used to assess the correlation between clinical variables (age, PSA, GS, type of therapy) and FCH PET/CT findings. RESULTS FCH PET/CT resulted truly positive (TP) for recurrent disease in the prostatic gland/fossa in 59/75 patients (79%) and falsely positive (FP) in 16 subjects (21%). The median value of PSA at the time of FCH PET/CT scan was higher in TP as compared to FP, although not statistically significant (4.76 vs. 3.04 ng/mL p > 0.05). Similarly, median age, GS categories, and the type of therapy were similar between the two groups (p > 0.05). However, when matching GS categories and PSA values, we found that the number of patients with TP findings were higher in the case of a PSA > 2 ng/mL, independently from the GS (ranging between 74% and 92%). Conversely, FP rate ranged between 50% and 65% in patients with a PSA ≤ 2 ng/mL, especially in the case of GS ≤ 7, whereas FP was around 25% in those with a GS >7 and PSA > 2 ng/mL. CONCLUSIONS FCH PET/CT has a limited role in evaluation of prostatic gland/fossa recurrence, due to the physiological biodistribution of the radiopharmaceutical agent. However, in 70-90% of patients with a PSA >2 ng/mL, independently from GS, a focal FCH uptake is compatible with a true local recurrence.
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Affiliation(s)
- Laura Evangelista
- Radiotherapy and Nuclear Medicine Unit, Veneto Institute of Oncology IOV - IRCCS, Via Gattamelata, 64, 35128, Padua, Italy.
| | - Marino Cimitan
- Nuclear Medicine Unit, IRCCS National Cancer Institute (CRO), Aviano, PN, Italy
| | - Marina Hodolič
- Nuclear Medicine Research Department, IASON, Graz, Austria
| | - Tanja Baseric
- Nuclear Medicine Unit, IRCCS National Cancer Institute (CRO), Aviano, PN, Italy
| | - Jure Fettich
- Nuclear Medicine Department, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Eugenio Borsatti
- Nuclear Medicine Unit, IRCCS National Cancer Institute (CRO), Aviano, PN, Italy
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Arteaga-Marrero N, Brekke Rygh C, Mainou-Gomez JF, Adamsen TCH, Lutay N, Reed RK, Olsen DR. Radiation treatment monitoring using multimodal functional imaging: PET/CT ((18)F-Fluoromisonidazole & (18)F-Fluorocholine) and DCE-US. J Transl Med 2015; 13:383. [PMID: 26682742 PMCID: PMC4683758 DOI: 10.1186/s12967-015-0708-5] [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] [Received: 08/19/2015] [Accepted: 10/22/2015] [Indexed: 12/02/2022] Open
Abstract
Background
This study aims to assess the effect of radiation treatment on the tumour vasculature and its downstream effects on hypoxia and choline metabolism using a multimodal approach in the murine prostate tumour model CWR22. Functional parameters derived from Positron Emission Tomography (PET)/Computer Tomography (CT) with 18F-Fluoromisonidazole (18F-FMISO) and 18F-Fluorocholine (18F-FCH) as well as Dynamic Contrast-Enhanced Ultrasound (DCE-US) were employed to determine the relationship between metabolic parameters and microvascular parameters that reflect the tumour microenvironment. Immunohistochemical analysis was employed for validation. Methods
PET/CT and DCE-US were acquired pre- and post-treatment, at day 0 and day 3, respectively. At day 1, radiation treatment was delivered as a single fraction of 10 Gy. Two experimental groups were tested for treatment response with 18F-FMISO and 18F-FCH. Results The maximum Standardized Uptake Values (SUVmax) and the mean SUV (SUVmean) for the 18F-FMISO group were decreased after treatment, and the SUVmean of the tumour-to-muscle ratio was correlated to microvessel density (MVD) at day 3. The kurtosis of the amplitude of the contrast uptake A was significantly decreased for the control tumours in the 18F-FCH group. Furthermore, the eliminating rate constant of the contrast agent from the plasma kel derived from DCE-US was negatively correlated to the SUVmean of tumour-to-muscle ratio, necrosis and MVD. Conclusions The present study suggests that the multimodal approach using 18F-FMISO PET/CT and DCE-US seems reliable in the assessment of both microvasculature and necrosis as validated by histology. Thus, it has valuable diagnostic and prognostic potential for early non-invasive evaluation of radiotherapy.
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Affiliation(s)
- Natalia Arteaga-Marrero
- Department of Physics and Technology, University of Bergen, P.O. Box 7803, Bergen, 5020, Norway.
| | - Cecilie Brekke Rygh
- Department of Biomedicine, University of Bergen, Bergen, Norway. .,Department of Health Sciences, Bergen University College, Bergen, Norway.
| | | | - Tom C H Adamsen
- Department of Radiology, Haukeland University Hospital, Bergen, Norway. .,Department of Chemistry, University of Bergen, Bergen, Norway.
| | - Nataliya Lutay
- Division of Dermatology and Venereology, Department of Clinical Sciences, Lund University, Lund, Sweden.
| | - Rolf K Reed
- Department of Biomedicine, University of Bergen, Bergen, Norway. .,Centre for Cancer Biomarkers (CCBIO), University of Bergen, Bergen, Norway.
| | - Dag R Olsen
- Department of Physics and Technology, University of Bergen, P.O. Box 7803, Bergen, 5020, Norway.
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Paparo F, Massollo M, Rollandi L, Piccardo A, Ruggieri FG, Rollandi GA. The clinical role of multimodality imaging in the detection of prostate cancer recurrence after radical prostatectomy and radiation therapy: past, present, and future. Ecancermedicalscience 2015; 9:570. [PMID: 26435743 PMCID: PMC4583244 DOI: 10.3332/ecancer.2015.570] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Indexed: 12/18/2022] Open
Abstract
Detection of the recurrence sites in prostate cancer (PCa) patients affected by biochemical recurrence after radical prostatectomy (RP) and radiation therapy (RT) is still a challenge for clinicians, nuclear medicine physicians, and radiologists. In the era of personalised and precision care, this task requires the integration, amalgamation, and combined analysis of clinical and imaging data from multiple sources. At present, multiparametric Magnetic Resonance Imaging (mpMRI) and choline–positron emission tomography (PET) are giving encouraging results; their combination allows the effective detection of local, lymph nodal, and skeletal recurrences at low PSA levels. Future diagnostic perspectives include the clinical implementation of PET/MRI scanners, multimodal fusion imaging platforms for retrospective co-registration of PET and MR images, real-time transrectal ultrasound/mpMRI fusion imaging, and novel organ-specific PET radiotracers.
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Affiliation(s)
- Francesco Paparo
- Radiology Unit, Department of Diagnostic Imaging, E O Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy
| | - Michela Massollo
- Nuclear Medicine Unit, Department of Diagnostic Imaging, E O Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy
| | - Ludovica Rollandi
- Klinikum Augsburg Radiologie, Stelingstrasse 2, 86156 Augsburg, Germany
| | - Arnoldo Piccardo
- Nuclear Medicine Unit, Department of Diagnostic Imaging, E O Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy
| | - Filippo Grillo Ruggieri
- Radiotherapy Unit, Department of Diagnostic Imaging, E O Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy
| | - Gian Andrea Rollandi
- Radiology Unit, Department of Diagnostic Imaging, E O Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy
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12
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Elective pelvic versus prostate bed-only salvage radiotherapy following radical prostatectomy. Strahlenther Onkol 2015; 191:801-9. [DOI: 10.1007/s00066-015-0872-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Accepted: 06/23/2015] [Indexed: 10/23/2022]
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