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Moon H, Choi CH, Kim S, Kim C. Incidental 18 F-Florapronol Uptake in Pituitary Adenoma. Clin Nucl Med 2024; 49:890-891. [PMID: 38914071 DOI: 10.1097/rlu.0000000000005335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
ABSTRACT A 55-year-old man with cognitive impairment underwent 18 F-florapronol brain PET/CT, a diagnostic radiotracer for the visualization of β-amyloid plaques. Brain PET images revealed incidental 18 F-florapronol uptake in the sellar region. The following contrast-enhanced MRI confirmed pituitary adenoma.
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Burkett BJ, Johnson DR, Lowe VJ. Evaluation of Neurodegenerative Disorders with Amyloid-β, Tau, and Dopaminergic PET Imaging: Interpretation Pitfalls. J Nucl Med 2024; 65:829-837. [PMID: 38664015 DOI: 10.2967/jnumed.123.266463] [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: 11/08/2023] [Revised: 04/03/2024] [Indexed: 06/05/2024] Open
Abstract
Antiamyloid therapies for Alzheimer disease recently entered clinical practice, making imaging biomarkers for Alzheimer disease even more relevant to guiding patient management. Amyloid and tau PET are valuable tools that can provide objective evidence of Alzheimer pathophysiology in living patients and will increasingly be used to complement 18F-FDG PET in the diagnostic evaluation of cognitive impairment and dementia. Parkinsonian syndromes, also common causes of dementia, can likewise be evaluated with a PET imaging biomarker,18F-DOPA, allowing in vivo assessment of the presynaptic dopaminergic neurons. Understanding the role of these PET biomarkers will help the nuclear medicine physician contribute to the appropriate diagnosis and management of patients with cognitive impairment and dementia. To successfully evaluate brain PET examinations for neurodegenerative diseases, knowledge of the necessary protocol details for obtaining a reliable imaging study, inherent limitations for each PET radiopharmaceutical, and pitfalls in image interpretation is critical. This review will focus on underlying concepts for interpreting PET examinations, important procedural details, and guidance for avoiding potential interpretive pitfalls for amyloid, tau, and dopaminergic PET examinations.
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Affiliation(s)
| | | | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
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Morgan J, Manickavel S, Sorace A, Hartman Y, Eli A, Massicano A, Gonzalez ML, Warram JM, Walsh E. Utility of Targeted Positron Emission Tomography Imaging to Predict Schwannoma Growth in a Murine Tumor Model. Laryngoscope 2024; 134:1372-1380. [PMID: 37578272 DOI: 10.1002/lary.30943] [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: 01/24/2023] [Revised: 05/31/2023] [Accepted: 07/14/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVE To identify if targeted positron emission tomography (PET) imaging with radiolabeled antibodies can predict tumor growth rate and ultimate tumor size in a murine flank schwannoma model. STUDY DESIGN Animal research study. METHODS Rat schwannoma cells were cultured and implanted into 40 athymic nude mice. Once tumors reached 5 mm in diameter, 30 mice were injected with zirconium-89 labeled antibodies (HER2/Neu, vascular endothelial growth factor receptor 2 (VEGFR2), or IgG isotype). PET/CT was performed, and standardized uptake values (SUV) were recorded. Tumors were serially measured until mice were sacrificed per IACUC protocol. Statistical analysis was performed to measure correlations between SUV values, tumor size, and growth. RESULTS Mean tumor sizes in mm3 on Day 0 were 144 ± 162 for anti-HER2/Neu, 212 ± 247 for anti-VEGFR2, and 172 ± 204 for IgG isotype groups respectively. Mean growth rates in mm3 /day were 531 ± 250 for HER2, 584 ± 188 for VEGFR2, and 416 ± 163 for the IgG isotype group. For both initial tumor size and growth rates, there was no significant difference between groups. There were significant correlations between maximum tumor volume and both the SUV max in the HER2 group (p = 0.0218, R2 = 0.5020), and we observed significant correlations between growth rate, and SUV values (p = 0.0156, R2 = 0.5394). Respectively, in the anti-VEGFR2 group, there were no significant correlations. CONCLUSION In a murine schwannoma model, immunotargeted PET imaging with anti-HER2/Neu antibodies predicted tumor growth rate and final tumor size. Laryngoscope, 134:1372-1380, 2024.
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Affiliation(s)
- Jake Morgan
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sudhir Manickavel
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Anna Sorace
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, Alabama, USA
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Yolanda Hartman
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Abbigael Eli
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Adriana Massicano
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Manuel Lora Gonzalez
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jason M Warram
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Erika Walsh
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Zhang J, Dong A, Wang Y. Solitary Isolated Dural Metastasis From Lung Adenocarcinoma Mimicking Meningioma. Clin Nucl Med 2022; 47:283-285. [PMID: 34619702 DOI: 10.1097/rlu.0000000000003923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Solitary isolated dural metastasis is extremely rare. Distinguishing solitary dural metastasis from meningioma based on radiological findings can be challenging. We describe MRI and FDG PET/CT findings in 2 cases of histologically proved solitary isolated dural metastasis from lung adenocarcinoma. Enhanced brain MRI of the 2 cases showed parafalcine extra-axial, dural-based tumors with hypervascularity mimicking meningioma. Preoperative FDG PET/CT was performed in one case with a known history of lung adenocarcinoma showing intense FDG uptake of the parafalcine tumor. Postoperative FDG PET/CT was performed in the other case showing solitary lung tumor, suggestive of the primary tumor.
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Affiliation(s)
- Jun Zhang
- From the Department of Cardiothoracic Surgery, The Second Affiliated Hospital, Jiaxing University, Jiaxing, Zhejiang Province
| | - Aisheng Dong
- Department of Nuclear Medicine, Changhai Hospital, Navy Medical University
| | - Yang Wang
- Department of Pathology, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
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Badawy M, Johnson G, Jain M, Kendi AT, Johnson DR, Porter A, Yang M, Sonbol MB. Intracranial neuroendocrine tumour simulating meningioma for several years: an overview of diagnosis and treatment. BJR Case Rep 2022; 8:20210222. [PMID: 36101727 PMCID: PMC9461727 DOI: 10.1259/bjrcr.20210222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/24/2021] [Accepted: 01/17/2022] [Indexed: 12/03/2022] Open
Abstract
Metastatic neuroendocrine tumour (NET) to brain has been reported in 1.5–5% of patients with NETs. Differentiation between intracranial NET metastasis and meningiomas can cause a diagnostic dilemma. We present a symptomatic case of a 66-year-old male with a history of left-sided skull base mass. The diagnosis of a meningioma was made based on the MRI findings and clinical presentation. The patient received radiation and the mass remained stable on serial MRI images at follow-up visits. Five years after his initial presentation, the patient’s mass showed further growth. He also complained of worsening of his recent diagnosis of irritable bowel syndrome and fluctuations in his blood pressure. Surgical resection was performed, and histopathological features were consistent with moderately differentiated neuroendocrine tumour. Further evaluation with 68 Gallium-DOTATATE positron emission-computed tomography (Ga-68 PET/CT) showed metastatic disease involving the bones, lymph nodes, and liver without convincing evidence of the location of primary malignancy within the bowel loops or the pancreas. The patient was started on combination of capecitabine and temozolomide with partial response and significant improvement of his symptoms. This case highlights the clinical and radiological behaviour of intracranial NET that can mimic the diagnosis of meningioma.
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Affiliation(s)
- Mohamed Badawy
- Division of Radiology and Nuclear Medicine, Mayo Clinic, Rochester, MN
| | - Geoffrey Johnson
- Division of Radiology and Nuclear Medicine, Mayo Clinic, Rochester, MN
- Department of Immunology, Mayo Clinic, Rochester, MN
| | - Manoj Jain
- Division of Radiology and Nuclear Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Ayse Tuba Kendi
- Division of Radiology and Nuclear Medicine, Mayo Clinic, Rochester, MN
| | - Derek R. Johnson
- Division of Radiology and Nuclear Medicine, Mayo Clinic, Rochester, MN
- Division of Neurology, Mayo Clinic, Rochester, MN
| | - Alyx Porter
- Division of Neurology, Mayo Clinic, Phoenix, Arizona
| | - Ming Yang
- Division of Diagnostic Radiology, Mayo Clinic, Phoenix, Arizona
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Abstract
ABSTRACT A 76-year-old woman underwent 18F-florapronol (18F-FC119S, an amyloid β imaging PET agent) PET, owing to cognitive impairment. 18F-florapronol PET images revealed an incidental 18F-florapronol uptake in the right frontal lobe. A well-enhancing extra-axial mass in the right frontal lobe was observed on MRI scans, suggesting a meningioma. After excision of the tumor, the biopsy results confirmed it as a meningothelial meningioma.
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Affiliation(s)
- Inki Lee
- From the Departments of Nuclear Medicine
| | | | | | - Ilhan Lim
- From the Departments of Nuclear Medicine
| | - Jeong Ho Ha
- Neurology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea
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Morrison DR, Sorace AG, Hamilton E, Moore LS, Houson HA, Udayakumar N, Ovaitt A, Warram JM, Walsh EM. Predicting Schwannoma Growth in a Tumor Model Using Targeted Imaging. Otol Neurotol 2021; 42:e615-e623. [PMID: 33661237 PMCID: PMC9762121 DOI: 10.1097/mao.0000000000003063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Vestibular schwannoma (VS) is a common pathology encountered in neurotology clinics. Many patients are observed with a "wait and scan" approach. Previous efforts to determine radiographic indicators of future growth have been unsuccessful. Using a mouse subcutaneous tumor model, we seek to determine if fluorescent imaging with directed immunotargets could be used to predict schwannoma growth rate. METHODS Anti-VEGFR2 and anti-Her2/Neu monoclonal antibodies were covalently linked to a near-infrared probe (IRDye800). Immunodeficient mice underwent subcutaneous injections with a rat-derived schwann (R3) cell line. When tumor growth was evident, either Anti-VEGFR2-IRDye800, anti-Her2/Neu-IRDye800, or Immunoglobulin G (IgG) Isotype-IRDye800 (control) were injected via tail vein. The mice were serially imaged in a closed field near-IR device. Fluorescent data were analyzed for tumor signal and correlated with tumor sie and growth rate. Heterogeneity of fluorescent tumor signal was also assessed. RESULTS In both anti-VEGFR2 and anti-Her2/Neu groups, there were strong correlations between day 1 mean tumor fluorescence and eventual maximum tumor volume (p = 0.002, 0.001; r2 = 0.92, 0.86). There was also strong correlation with maximum tumor signal on day 1 and maximum tumor volume (p = 0.003, 0.008; r2 = 0.90, 0.91). There was no such correlation in the control group (p = 0.99, 0.75; r2 = 0.0002, 0.028). CONCLUSION Given the potential morbidity in VS intervention, observation is an appropriate approach for patients with slow-growing or stagnant tumors. We seek to identify immunotargets in a murine model that show promise in predicting schwannoma growth with advanced imaging techniques. Both Her2/Neu and VEGFR2 correlated strongly wth tumor size and growth rates and are promising targets that merit further investigation.
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Affiliation(s)
- Daniel R. Morrison
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Anna G. Sorace
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, Alabama
- O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Ellis Hamilton
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Lindsay S. Moore
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Hailey A. Houson
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Neha Udayakumar
- School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Alyssa Ovaitt
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jason M. Warram
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, Alabama
- O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Erika M. Walsh
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, Alabama
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Detección de meningioma en un paciente con deterioro cognitivo leve evaluado mediante 11C-PIB y 18F-FDG PET/TC. Rev Esp Med Nucl Imagen Mol 2020; 39:106-107. [DOI: 10.1016/j.remn.2019.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 06/20/2019] [Indexed: 11/21/2022]
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Jiménez-Bonilla JF, Quirce R, De Arcocha-Torres M, Martínez-Rodríguez I, Martínez-Amador N, Banzo I. Detection of meningioma in a patient with mild cognitive impairment assessed by 11C-PIB and 18F-FDG PET/CT. Rev Esp Med Nucl Imagen Mol 2020. [DOI: 10.1016/j.remnie.2019.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Doi S, Kashiwagi N, Satou T, Kaida H, Ishi K. Pittsburgh Compound-B Uptake in Meningioma With Histopathologic Correlation. Clin Nucl Med 2019; 44:587-588. [PMID: 31135517 DOI: 10.1097/rlu.0000000000002590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Previous studies have reported increased Pittsburgh compound-B (PiB) uptake in meningiomas; however, histological correlation to elucidate the underlying mechanism has not yet been done. We report a case of an 82-year-old woman with an incidental intracranial tumor that showed focal increased PiB uptake. Because of tumor growth, surgical resection was performed, yielding a histological diagnosis of meningioma. Any special and immunochemical staining for amyloid did not reveal amyloid deposition in the tumor. Our findings suggest that increased PiB uptake was not associated with amyloid in this instance.
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Affiliation(s)
| | | | - Takao Satou
- Pathology, Kindai University Faculty of Medicine, Osakasayama, Osaka, Japan
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