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Ball J, Sinnott J, Fox DL, Burgess C. Incidental head and neck findings on 18 F-fluorodeoxyglucose positron emission tomography-computed tomography: Diagnostic outcomes and cost analysis. Clin Otolaryngol 2023; 48:709-714. [PMID: 37308456 DOI: 10.1111/coa.14055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 01/15/2023] [Accepted: 03/05/2023] [Indexed: 06/14/2023]
Affiliation(s)
- Jessica Ball
- Department of Otolaryngology, Head and Neck Surgery, Cambridge University Hospital, Cambridge, UK
| | - Joseph Sinnott
- Department of Otolaryngology, Head and Neck Surgery, Great Western Hospital, Swindon, UK
| | - Danial L Fox
- Department of Radiology, Musgrove Park Hospital, Taunton, Somerset, UK
| | - Christopher Burgess
- Department of Otolaryngology, Head and Neck Surgery, Musgrove Park Hospital, Taunton, Somerset, UK
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2
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PET imaging of animal models with depressive-like phenotypes. Eur J Nucl Med Mol Imaging 2023; 50:1564-1584. [PMID: 36642759 PMCID: PMC10119194 DOI: 10.1007/s00259-022-06073-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 12/03/2022] [Indexed: 01/17/2023]
Abstract
Major depressive disorder is a growing and poorly understood pathology. Due to technical and ethical limitations, a significant proportion of the research on depressive disorders cannot be performed on patients, but needs to be investigated in animal paradigms. Over the years, animal studies have provided new insight in the mechanisms underlying depression. Several of these studies have used PET imaging for the non-invasive and longitudinal investigation of the brain physiology. This review summarises the findings of preclinical PET imaging in different experimental paradigms of depression and compares these findings with observations from human studies. Preclinical PET studies in animal models of depression can be divided into three main different approaches: (a) investigation of glucose metabolism as a biomarker for regional and network involvement, (b) evaluation of the availability of different neuroreceptor populations associated with depressive phenotypes, and (c) monitoring of the inflammatory response in phenotypes of depression. This review also assesses the relevance of the use of PET imaging techniques in animal paradigms for the understanding of specific aspects of the depressive-like phenotypes, in particular whether it might contribute to achieve a more detailed characterisation of the clinical depressive phenotypes for the development of new therapies for depression.
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3
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Serrano ME, Kim E, Petrinovic MM, Turkheimer F, Cash D. Imaging Synaptic Density: The Next Holy Grail of Neuroscience? Front Neurosci 2022; 16:796129. [PMID: 35401097 PMCID: PMC8990757 DOI: 10.3389/fnins.2022.796129] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 02/15/2022] [Indexed: 12/19/2022] Open
Abstract
The brain is the central and most complex organ in the nervous system, comprising billions of neurons that constantly communicate through trillions of connections called synapses. Despite being formed mainly during prenatal and early postnatal development, synapses are continually refined and eliminated throughout life via complicated and hitherto incompletely understood mechanisms. Failure to correctly regulate the numbers and distribution of synapses has been associated with many neurological and psychiatric disorders, including autism, epilepsy, Alzheimer’s disease, and schizophrenia. Therefore, measurements of brain synaptic density, as well as early detection of synaptic dysfunction, are essential for understanding normal and abnormal brain development. To date, multiple synaptic density markers have been proposed and investigated in experimental models of brain disorders. The majority of the gold standard methodologies (e.g., electron microscopy or immunohistochemistry) visualize synapses or measure changes in pre- and postsynaptic proteins ex vivo. However, the invasive nature of these classic methodologies precludes their use in living organisms. The recent development of positron emission tomography (PET) tracers [such as (18F)UCB-H or (11C)UCB-J] that bind to a putative synaptic density marker, the synaptic vesicle 2A (SV2A) protein, is heralding a likely paradigm shift in detecting synaptic alterations in patients. Despite their limited specificity, novel, non-invasive magnetic resonance (MR)-based methods also show promise in inferring synaptic information by linking to glutamate neurotransmission. Although promising, all these methods entail various advantages and limitations that must be addressed before becoming part of routine clinical practice. In this review, we summarize and discuss current ex vivo and in vivo methods of quantifying synaptic density, including an evaluation of their reliability and experimental utility. We conclude with a critical assessment of challenges that need to be overcome before successfully employing synaptic density biomarkers as diagnostic and/or prognostic tools in the study of neurological and neuropsychiatric disorders.
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Affiliation(s)
- Maria Elisa Serrano
- Department of Neuroimaging, The BRAIN Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom
| | - Eugene Kim
- Department of Neuroimaging, The BRAIN Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom
| | - Marija M Petrinovic
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,MRC Centre for Neurodevelopmental Disorders, King's College London, London, United Kingdom
| | - Federico Turkheimer
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom
| | - Diana Cash
- Department of Neuroimaging, The BRAIN Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom
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4
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Zhang YD, Dong Z, Wang SH, Yu X, Yao X, Zhou Q, Hu H, Li M, Jiménez-Mesa C, Ramirez J, Martinez FJ, Gorriz JM. Advances in multimodal data fusion in neuroimaging: Overview, challenges, and novel orientation. AN INTERNATIONAL JOURNAL ON INFORMATION FUSION 2020; 64:149-187. [PMID: 32834795 PMCID: PMC7366126 DOI: 10.1016/j.inffus.2020.07.006] [Citation(s) in RCA: 115] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/06/2020] [Accepted: 07/14/2020] [Indexed: 05/13/2023]
Abstract
Multimodal fusion in neuroimaging combines data from multiple imaging modalities to overcome the fundamental limitations of individual modalities. Neuroimaging fusion can achieve higher temporal and spatial resolution, enhance contrast, correct imaging distortions, and bridge physiological and cognitive information. In this study, we analyzed over 450 references from PubMed, Google Scholar, IEEE, ScienceDirect, Web of Science, and various sources published from 1978 to 2020. We provide a review that encompasses (1) an overview of current challenges in multimodal fusion (2) the current medical applications of fusion for specific neurological diseases, (3) strengths and limitations of available imaging modalities, (4) fundamental fusion rules, (5) fusion quality assessment methods, and (6) the applications of fusion for atlas-based segmentation and quantification. Overall, multimodal fusion shows significant benefits in clinical diagnosis and neuroscience research. Widespread education and further research amongst engineers, researchers and clinicians will benefit the field of multimodal neuroimaging.
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Affiliation(s)
- Yu-Dong Zhang
- School of Informatics, University of Leicester, Leicester, LE1 7RH, Leicestershire, UK
- Department of Information Systems, Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Zhengchao Dong
- Department of Psychiatry, Columbia University, USA
- New York State Psychiatric Institute, New York, NY 10032, USA
| | - Shui-Hua Wang
- Department of Information Systems, Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- School of Architecture Building and Civil engineering, Loughborough University, Loughborough, LE11 3TU, UK
- School of Mathematics and Actuarial Science, University of Leicester, LE1 7RH, UK
| | - Xiang Yu
- School of Informatics, University of Leicester, Leicester, LE1 7RH, Leicestershire, UK
| | - Xujing Yao
- School of Informatics, University of Leicester, Leicester, LE1 7RH, Leicestershire, UK
| | - Qinghua Zhou
- School of Informatics, University of Leicester, Leicester, LE1 7RH, Leicestershire, UK
| | - Hua Hu
- Department of Psychiatry, Columbia University, USA
- Department of Neurology, The Second Affiliated Hospital of Soochow University, China
| | - Min Li
- Department of Psychiatry, Columbia University, USA
- School of Internet of Things, Hohai University, Changzhou, China
| | - Carmen Jiménez-Mesa
- Department of Signal Theory, Networking and Communications, University of Granada, Granada, Spain
| | - Javier Ramirez
- Department of Signal Theory, Networking and Communications, University of Granada, Granada, Spain
| | - Francisco J Martinez
- Department of Signal Theory, Networking and Communications, University of Granada, Granada, Spain
| | - Juan Manuel Gorriz
- Department of Signal Theory, Networking and Communications, University of Granada, Granada, Spain
- Department of Psychiatry, University of Cambridge, Cambridge CB21TN, UK
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5
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London ED, Okita K, Kinney KR, Dean AC, McClintick MN, Rizor EJ, Johnson MC, Mahmoudie T, Brody AL, Nurmi EL, Seaman LC, Farahi J, Ginder N, Mandelkern MA. No significant elevation of translocator protein binding in the brains of recently abstinent methamphetamine users. Drug Alcohol Depend 2020; 213:108104. [PMID: 32570138 PMCID: PMC9059651 DOI: 10.1016/j.drugalcdep.2020.108104] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/22/2020] [Accepted: 05/26/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Radioligands for the translocator protein (TSPO) 18 kDa have been used with positron emission tomography (PET) to assess neuroinflammation and microglial activation in psychiatric disorders. One study using this approach showed substantial TSPO elevation throughout the brain in chronic methamphetamine users following long-term abstinence (0.5-4 years), but clients typically present for treatment earlier in abstinence. METHODS We used PET with [11C]DAA1106 to compare standardized uptake values (SUVs) as an index of TSPO binding in the brains of methamphetamine-dependent participants who were abstinent for < 6 months (n = 11) and healthy controls (n = 12). We also assayed other typical correlates of Methamphetamine Dependence (e.g., striatal D2-type dopamine receptor deficits, depressed mood, anxiety and impaired emotion regulation). RESULTS Methamphetamine users exhibited depression (p < 0.0001), anxiety (p = 0.002), difficulties in emotional regulation (p = 0.01), and lower striatal dopamine D2-type receptor availability vs. controls (p = 0.02). SUVs for [11C]DAA1106 were larger in all brain regions of methamphetamine-dependent participants vs. controls, but the effect size was small to medium and not statistically significant. CONCLUSIONS The discrepancy between the lack of significant difference in TSPO binding in early-abstinent methamphetamine users vs. controls in this study and a previous report of elevated binding in longer-abstinent methamphetamine users may reflect methodological differences or limitations of TSPO binding as an index of neuroinflammation. It also seems possible that gliosis increases over time during the first 6 months of abstinence; longitudinal studies could clarify this possibility.
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Affiliation(s)
- Edythe D. London
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Molecular and Medical Pharmacology, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Brain Research Institute, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA,Corresponding author at: Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, PO Box 175919, Los Angeles, CA, 90095, USA. (E.D. London)
| | - Kyoji Okita
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA,Department of Clinical Neuroimaging, Integrative Brain Imaging Center, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8551, Japan,Department of Drug Dependence, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8551, Japan
| | - Kaitlin R. Kinney
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA
| | - Andrew C. Dean
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA
| | - Megan N. McClintick
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA
| | - Elizabeth J. Rizor
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA
| | - Maritza C. Johnson
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA
| | - Tarannom Mahmoudie
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA
| | - Arthur L. Brody
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA,Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA
| | - Erika L. Nurmi
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA
| | - Lauren C. Seaman
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA
| | - Judah Farahi
- Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA
| | - Nathaniel Ginder
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), Los Angeles, CA, 90024, USA
| | - Mark A. Mandelkern
- Department of Research, Veterans Administration Greater Los Angeles Healthcare System (VAGLAHS), Los Angeles, CA, 90073, USA,Department of Physics, University of California Irvine, Irvine, CA, 92697, USA
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6
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Serrano ME, Bahri MA, Becker G, Seret A, Mievis F, Giacomelli F, Lemaire C, Salmon E, Luxen A, Plenevaux A. Quantification of [ 18F]UCB-H Binding in the Rat Brain: From Kinetic Modelling to Standardised Uptake Value. Mol Imaging Biol 2020; 21:888-897. [PMID: 30460626 DOI: 10.1007/s11307-018-1301-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE [18F]UCB-H is a specific positron emission tomography (PET) biomarker for the Synaptic Vesicle protein 2A (SV2A), the binding site of the antiepileptic drug levetiracetam. With a view to optimising acquisition time and simplifying data analysis with this radiotracer, we compared two parameters: the distribution volume (Vt) obtained from Logan graphical analysis using a Population-Based Input Function, and the Standardised Uptake Value (SUV). PROCEDURES Twelve Sprague Dawley male rats, pre-treated with three different doses of levetiracetam were employed to develop the methodology. Three additional kainic acid (KA) treated rats (temporal lobe epilepsy model) were also used to test the procedure. Image analyses focused on: (i) length of the dynamic acquisition (90 versus 60 min); (ii) correlations between Vt and SUV over 20-min consecutive time-frames; (iii) and (iv) evaluation of differences between groups using the Vt and the SUV; and (v) preliminary evaluation of the methodology in the KA epilepsy model. RESULTS A large correlation between the Vt issued from 60 to 90-min acquisitions was observed. Further analyses highlighted a large correlation (r > 0.8) between the Vt and the SUV. Equivalent differences between groups were detected for both parameters, especially in the 20-40 and 40-60-min time-frames. The same results were also obtained with the epilepsy model. CONCLUSIONS Our results enable the acquisition setting to be changed from a 90-min dynamic to a 20-min static PET acquisition. According to a better image quality, the 20-40-min time-frame appears optimal. Due to its equivalence to the Vt, the SUV parameter can be considered in order to quantify [18F]UCB-H uptake in the rat brain. This work, therefore, establishes a starting point for the simplification of SV2A in vivo quantification with [18F]UCB-H, and represents a step forward to the clinical application of this PET radiotracer.
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Affiliation(s)
- Maria Elisa Serrano
- GIGA - CRC In Vivo Imaging, University of Liège, Allée du 6 Août, Building B30, Sart Tilman, 4000, Liège, Belgium.
| | - Mohamed Ali Bahri
- GIGA - CRC In Vivo Imaging, University of Liège, Allée du 6 Août, Building B30, Sart Tilman, 4000, Liège, Belgium
| | - Guillaume Becker
- GIGA - CRC In Vivo Imaging, University of Liège, Allée du 6 Août, Building B30, Sart Tilman, 4000, Liège, Belgium
| | - Alain Seret
- GIGA - CRC In Vivo Imaging, University of Liège, Allée du 6 Août, Building B30, Sart Tilman, 4000, Liège, Belgium
| | - Frédéric Mievis
- Nucleis, University of Liège, Allée du 6 Août, Building B30, Sart Tilman, 4000, Liège, Belgium
| | - Fabrice Giacomelli
- Nucleis, University of Liège, Allée du 6 Août, Building B30, Sart Tilman, 4000, Liège, Belgium
| | - Christian Lemaire
- GIGA - CRC In Vivo Imaging, University of Liège, Allée du 6 Août, Building B30, Sart Tilman, 4000, Liège, Belgium
| | - Eric Salmon
- GIGA - CRC In Vivo Imaging, University of Liège, Allée du 6 Août, Building B30, Sart Tilman, 4000, Liège, Belgium
| | - André Luxen
- GIGA - CRC In Vivo Imaging, University of Liège, Allée du 6 Août, Building B30, Sart Tilman, 4000, Liège, Belgium
| | - Alain Plenevaux
- GIGA - CRC In Vivo Imaging, University of Liège, Allée du 6 Août, Building B30, Sart Tilman, 4000, Liège, Belgium
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7
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Lau J, Rousseau E, Kwon D, Lin KS, Bénard F, Chen X. Insight into the Development of PET Radiopharmaceuticals for Oncology. Cancers (Basel) 2020; 12:E1312. [PMID: 32455729 PMCID: PMC7281377 DOI: 10.3390/cancers12051312] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/17/2020] [Accepted: 05/18/2020] [Indexed: 12/20/2022] Open
Abstract
While the development of positron emission tomography (PET) radiopharmaceuticals closely follows that of traditional drug development, there are several key considerations in the chemical and radiochemical synthesis, preclinical assessment, and clinical translation of PET radiotracers. As such, we outline the fundamentals of radiotracer design, with respect to the selection of an appropriate pharmacophore. These concepts will be reinforced by exemplary cases of PET radiotracer development, both with respect to their preclinical and clinical evaluation. We also provide a guideline for the proper selection of a radionuclide and the appropriate labeling strategy to access a tracer with optimal imaging qualities. Finally, we summarize the methodology of their evaluation in in vitro and animal models and the road to clinical translation. This review is intended to be a primer for newcomers to the field and give insight into the workflow of developing radiopharmaceuticals.
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Affiliation(s)
- Joseph Lau
- Laboratory of Molecular Imaging and Nanomedicine (LOMIN), National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Etienne Rousseau
- Department of Nuclear Medicine and Radiobiology, University of Sherbrooke, Sherbrooke, QC J1H 5N4, Canada;
| | - Daniel Kwon
- Department of Molecular Oncology, BC Cancer, Vancouver, BC V5Z 1L3, Canada; (D.K.); (K.-S.L.); (F.B.)
| | - Kuo-Shyan Lin
- Department of Molecular Oncology, BC Cancer, Vancouver, BC V5Z 1L3, Canada; (D.K.); (K.-S.L.); (F.B.)
| | - François Bénard
- Department of Molecular Oncology, BC Cancer, Vancouver, BC V5Z 1L3, Canada; (D.K.); (K.-S.L.); (F.B.)
| | - Xiaoyuan Chen
- Laboratory of Molecular Imaging and Nanomedicine (LOMIN), National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD 20892, USA;
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18F-PBR06 Versus 11C-PBR28 PET for Assessing White Matter Translocator Protein Binding in Multiple Sclerosis. Clin Nucl Med 2018; 43:e289-e295. [PMID: 30004939 DOI: 10.1097/rlu.0000000000002179] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE F-PBR06 and C-PBR28 are second-generation PET radioligands targeting the 18-kd translocator protein to assess microglial activation. We directly compared F-PBR06 and C-PBR28 for detecting brain translocator protein binding in multiple sclerosis (MS). METHODS Six patients with MS (4 women; mean age ± SD, 32.1 ± 4.9 [range, 23.5-37.4 years]; Expanded Disability Status Scale score 2.3 ± 1.2 [range, 1.0-4.0]) underwent brain PET with both ligands, along with 3-T MRI. MRI was coregistered to the summed 60- to 90-minute PET images. SUV ratios (SUVRs), derived by normalization to global brain radioactivity, were obtained for whole-brain white matter (WM), supratentorial WM, normal-appearing WM (NAWM), and T2 (fluid-attenuated inversion recovery) hyperintense and T1 hypointense MS WM lesions. The highest mean SUVR for the fluid-attenuated inversion-recovery lesional slices was defined as SUVRmax. RESULTS F-PBR06 and C-PBR28 were moderately intercorrelated for whole-brain WM SUVR (r = 0.83, P = 0.04) and supratentorial WM SUVR (r = 0.81, P = 0.05) but not for SUVRs of NAWM, T1 lesions, T2 lesions, or SUVRmax. Both tracers demonstrated that SUVR was higher in NAWM than in T1 and T2 lesions (all P < 0.05). F-PBR06 (but not C-PBR28) demonstrated a higher SUVR in T1 versus T2 lesions (0.85 ± 0.07 vs 0.78 ± 0.03, P = 0.03). F-PBR06-derived (but not C-PBR28) SUVRmax correlated with both Expanded Disability Status Scale score (r = 0.82, P = 0.04) and timed 25-ft walking speed (r = 0.89, P = 0.01). CONCLUSIONS Our preliminary results suggest an association between microglial activation and physical disability in MS. Microglial detection in lesions was not interchangeable between the tracers, with a higher clinical relevance suggested for F-PBR06.
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9
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Zaidi H, Alavi A, Naqa IE. Novel Quantitative PET Techniques for Clinical Decision Support in Oncology. Semin Nucl Med 2018; 48:548-564. [PMID: 30322481 DOI: 10.1053/j.semnuclmed.2018.07.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Quantitative image analysis has deep roots in the usage of positron emission tomography (PET) in clinical and research settings to address a wide variety of diseases. It has been extensively employed to assess molecular and physiological biomarkers in vivo in healthy and disease states, in oncology, cardiology, neurology, and psychiatry. Quantitative PET allows relating the time-varying activity concentration in tissues/organs of interest and the basic functional parameters governing the biological processes being studied. Yet, quantitative PET is challenged by a number of degrading physical factors related to the physics of PET imaging, the limitations of the instrumentation used, and the physiological status of the patient. Moreover, there is no consensus on the most reliable and robust image-derived PET metric(s) that can be used with confidence in clinical oncology owing to the discrepancies between the conclusions reported in the literature. There is also increasing interest in the use of artificial intelligence based techniques, particularly machine learning and deep learning techniques in a variety of applications to extract quantitative features (radiomics) from PET including image segmentation and outcome prediction in clinical oncology. These novel techniques are revolutionizing clinical practice and are now offering unique capabilities to the clinical molecular imaging community and biomedical researchers at large. In this report, we summarize recent developments and future tendencies in quantitative PET imaging and present example applications in clinical decision support to illustrate its potential in the context of clinical oncology.
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Affiliation(s)
- Habib Zaidi
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva, Switzerland; Geneva Neuroscience Centre, University of Geneva, Geneva, Switzerland; Department of Nuclear Medicine and Molecular Imaging, University of Groningen, Groningen, the Netherlands; Department of Nuclear Medicine, University of Southern Denmark, Odense, Denmark.
| | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Issam El Naqa
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
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10
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Zaidi H, Karakatsanis N. Towards enhanced PET quantification in clinical oncology. Br J Radiol 2017; 91:20170508. [PMID: 29164924 DOI: 10.1259/bjr.20170508] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Positron emission tomography (PET) has, since its inception, established itself as the imaging modality of choice for the in vivo quantitative assessment of molecular targets in a wide range of biochemical processes underlying tumour physiology. PET image quantification enables to ascertain a direct link between the time-varying activity concentration in organs/tissues and the fundamental parameters portraying the biological processes at the cellular level being assessed. However, the quantitative potential of PET may be affected by a number of factors related to physical effects, hardware and software system specifications, tracer kinetics, motion, scan protocol design and limitations in current image-derived PET metrics. Given the relatively large number of PET metrics reported in the literature, the selection of the best metric for fulfilling a specific task in a particular application is still a matter of debate. Quantitative PET has advanced elegantly during the last two decades and is now reaching the maturity required for clinical exploitation, particularly in oncology where it has the capability to open many avenues for clinical diagnosis, assessment of response to treatment and therapy planning. Therefore, the preservation and further enhancement of the quantitative features of PET imaging is crucial to ensure that the full clinical value of PET imaging modality is utilized in clinical oncology. Recent advancements in PET technology and methodology have paved the way for faster PET acquisitions of enhanced sensitivity to support the clinical translation of highly quantitative four-dimensional (4D) parametric imaging methods in clinical oncology. In this report, we provide an overview of recent advances and future trends in quantitative PET imaging in the context of clinical oncology. The pros/cons of the various image-derived PET metrics will be discussed and the promise of novel methodologies will be highlighted.
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Affiliation(s)
- Habib Zaidi
- 1 Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital , Geneva , Switzerland.,2 Department of Nuclear Medicine and Molecular Imaging, University of Groningen , Groningen , Netherlands.,3 Geneva Neuroscience Centre, University of Geneva , Geneva , Switzerland.,4 Department of Nuclear Medicine, Universityof Southern Denmark , Odense , Denmark
| | - Nicolas Karakatsanis
- 5 Division of Radiopharmaceutical Sciences, Department of Radiology, Weill Cornell Medical College of Cornell Univercity , New york, NY , USA.,6 Department of Radiology, Translational and Molecular Imaging Institute, ICAHN School of Medicine at Mount Sinai , New york, NY , USA
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11
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Pelegrí Martínez L, Kohan AA, Vercher Conejero JL. Optimization of the protocols for the use of contrast agents in PET/CT studies. RADIOLOGIA 2016; 59:64-74. [PMID: 27726860 DOI: 10.1016/j.rx.2016.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 06/27/2016] [Accepted: 07/05/2016] [Indexed: 10/20/2022]
Abstract
The introduction of PET/CT scanners in clinical practice in 1998 has improved care for oncologic patients throughout the clinical pathway, from the initial diagnosis of disease through the evaluation of the response to treatment to screening for possible recurrence. The CT component of a PET/CT study is used to correct the attenuation of PET studies; CT also provides anatomic information about the distribution of the radiotracer. CT is especially useful in situations where PET alone can lead to false positives and false negatives, and CT thereby improves the diagnostic performance of PET. The use of intravenous or oral contrast agents and optimal CT protocols have improved the detection and characterization of lesions. However, there are circumstances in which the systematic use of contrast agents is not justified. The standard acquisition in PET/CT scanners is the whole body protocol, but this can lead to artifacts due to the position of patients and respiratory movements between the CT and PET acquisitions. This article discusses these aspects from a constructive perspective with the aim of maximizing the diagnostic potential of PET/CT and providing better care for patients.
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Affiliation(s)
- L Pelegrí Martínez
- Servei de Diagnòstic per la Imatge, Hospital Sant Joan Despí-Moisès Broggi, Sant Joan Despí (Barcelona), España.
| | - A A Kohan
- Servicio de Radiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - J L Vercher Conejero
- Unitat PET-TC IDI, Hospital Universitari de Bellvitge, Institut d'Investigació Biomédica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat (Barcelona), España
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Micro Regional Heterogeneity of 64Cu-ATSM and 18F-FDG Uptake in Canine Soft Tissue Sarcomas: Relation to Cell Proliferation, Hypoxia and Glycolysis. PLoS One 2015; 10:e0141379. [PMID: 26501874 PMCID: PMC4621038 DOI: 10.1371/journal.pone.0141379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 10/06/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Tumour microenvironment heterogeneity is believed to play a key role in cancer progression and therapy resistance. However, little is known about micro regional distribution of hypoxia, glycolysis and proliferation in spontaneous solid tumours. The overall aim was simultaneous investigation of micro regional heterogeneity of 64Cu-ATSM (hypoxia) and 18F-FDG (glycolysis) uptake and correlation to endogenous markers of hypoxia, glycolysis, proliferation and angiogenesis to better therapeutically target aggressive tumour regions and prognosticate outcome. METHODS Exploiting the different half-lives of 64Cu-ATSM (13 h) and 18F-FDG (2 h) enabled simultaneous investigation of micro regional distribution of hypoxia and glycolysis in 145 tumour pieces from four spontaneous canine soft tissue sarcomas. Pairwise measurements of radioactivity and gene expression of endogenous markers of hypoxia (HIF-1α, CAIX), glycolysis (HK2, GLUT1 and GLUT3), proliferation (Ki-67) and angiogenesis (VEGFA and TF) were performed. Dual tracer autoradiography was compared with Ki-67 immunohistochemistry. RESULTS Micro regional heterogeneity in hypoxia and glycolysis within and between tumour sections of each tumour piece was observed. The spatial distribution of 64Cu-ATSM and 18F-FDG was rather similar within each tumour section as reflected in moderate positive significant correlations between the two tracers (ρ = 0.3920-0.7807; p = 0.0180 -<0.0001) based on pixel-to-pixel comparisons of autoradiographies and gamma counting of tumour pieces. 64Cu-ATSM and 18F-FDG correlated positively with gene expression of GLUT1 and GLUT3, but negatively with HIF-1α and CAIX. Significant positive correlations were seen between Ki-67 gene expression and 64Cu-ATSM (ρ = 0.5578, p = 0.0004) and 18F-FDG (ρ = 0.4629-0.7001, p = 0.0001-0.0151). Ki-67 gene expression more consistently correlated with 18F-FDG than with 64Cu-ATSM. CONCLUSIONS Micro regional heterogeneity of hypoxia and glycolysis was documented in spontaneous canine soft tissue sarcomas. 64Cu-ATSM and 18F-FDG uptakes and distributions showed significant moderate correlations at the micro regional level indicating overlapping, yet different information from the tracers.18F-FDG better reflected cell proliferation as measured by Ki-67 gene expression than 64Cu-ATSM.
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Zornhagen KW, Clausen MM, Hansen AE, Law I, McEvoy FJ, Engelholm SA, Kjær A, Kristensen AT. Use of Molecular Imaging Markers of Glycolysis, Hypoxia and Proliferation ((18)F-FDG, (64)Cu-ATSM and (18)F-FLT) in a Dog with Fibrosarcoma: The Importance of Individualized Treatment Planning and Monitoring. Diagnostics (Basel) 2015; 5:372-82. [PMID: 26854160 PMCID: PMC4665600 DOI: 10.3390/diagnostics5030372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 08/27/2015] [Accepted: 09/03/2015] [Indexed: 12/14/2022] Open
Abstract
Glycolysis, hypoxia, and proliferation are important factors in the tumor microenvironment contributing to treatment-resistant aggressiveness. Imaging these factors using combined functional positron emission tomography and computed tomography can potentially guide diagnosis and management of cancer patients. A dog with fibrosarcoma was imaged using 18F-FDG, 64Cu-ATSM, and 18F-FLT before, during, and after 10 fractions of 4.5 Gy radiotherapy. Uptake of all tracers decreased during treatment. Fluctuations in 18F-FDG and 18F-FLT PET uptakes and a heterogeneous spatial distribution of the three tracers were seen. Tracer distributions partially overlapped. It appears that each tracer provides distinct information about tumor heterogeneity and treatment response.
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Affiliation(s)
- Kamilla Westarp Zornhagen
- Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 16, DK-1870 Frederiksberg C, Denmark.
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Blegdamsvej 3B, DK-2200 Copenhagen N, Denmark.
- Department of Radiation Oncology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2200 Copenhagen N, Denmark.
| | - Malene M Clausen
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Blegdamsvej 3B, DK-2200 Copenhagen N, Denmark.
| | - Anders E Hansen
- Department of Micro- and Nanotechnology, Technical University of Denmark, Ørsteds Plads, Building 345E, DK-2800 Kgs. Lyngby, Denmark.
| | - Ian Law
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Blegdamsvej 3B, DK-2200 Copenhagen N, Denmark.
| | - Fintan J McEvoy
- Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 16, DK-1870 Frederiksberg C, Denmark.
| | - Svend A Engelholm
- Department of Radiation Oncology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2200 Copenhagen N, Denmark.
| | - Andreas Kjær
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Blegdamsvej 3B, DK-2200 Copenhagen N, Denmark.
| | - Annemarie T Kristensen
- Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlaegevej 16, DK-1870 Frederiksberg C, Denmark.
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de Barros ALB, Chacko AM, Mikitsh JL, Al Zaki A, Salavati A, Saboury B, Tsourkas A, Alavi A. Assessment of global cardiac uptake of radiolabeled iron oxide nanoparticles in apolipoprotein-E-deficient mice: implications for imaging cardiovascular inflammation. Mol Imaging Biol 2015; 16:330-9. [PMID: 24297372 DOI: 10.1007/s11307-013-0709-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE Atherosclerosis is a leading cause of death in industrialized countries and is characterized by the accumulation of lipids and inflammatory cells, including macrophages, in blood vessel walls. Therefore, the ability to image macrophages could help identify plaques that are precursors of acute thrombotic events. Previous research has shown that long-circulating nanoparticles could be used to detect macrophages within atherosclerotic plaques of the aorta. By conducting this study, we investigated whether global cardiac uptake of radiolabeled nanoparticles could allow assessment of total macrophage burden in the coronary arteries. PROCEDURES Dextran-coated iron oxide nanoparticles (IONPs) were labeled with iodine-125 via Bolton-Hunter (sulfosuccinimidyl-3-[4-hydroxyphenyl]propionate) method. IONPs were characterized by means of dynamic light scattering and transmission electronic microscopy. Biodistribution studies were performed in healthy and atherosclerotic mice. Additionally, digital autoradiography of hearts from both healthy and atherosclerotic mice was performed to assess regional and global atherosclerotic burden. RESULTS The [(125)I]IONPs exhibited high radiolabel stability and long blood circulation, which eventually led to high heart uptake in apoE -/- mice when compared with healthy controls. Furthermore, digital autoradiography showed substantially enhanced emission of signals from the hearts of atherosclerotic mice, while no or minimal cardiac signals were detected in healthy mice. CONCLUSIONS This preparation showed adequate physical-chemical properties for in vivo studies, such as small size (∼30 nm), good radiolabel stability, and long circulation time. There was also significant accumulation in the heart of apoE-/- mice compared with that of healthy control animals. These findings suggest that radiolabeled dextran-coated iron oxide nanoparticles may have potential to become a useful tool to detect macrophages in the atherosclerosis plaques of coronary arteries; however, these preliminary findings should be confirmed by further studies in a larger scale in various atherosclerosis models.
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Affiliation(s)
- André Luís Branco de Barros
- Division of Nuclear Medicine and Clinical Molecular Imaging, Department of Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, 19104, USA,
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Hildebrandt MG, Kodahl AR, Teilmann-Jørgensen D, Mogensen O, Jensen PT. [18F]Fluorodeoxyglucose PET/Computed Tomography in Breast Cancer and Gynecologic Cancers. PET Clin 2015; 10:89-104. [DOI: 10.1016/j.cpet.2014.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Gobel Y, Valette G, Abgral R, Clodic C, Mornet E, Potard G, Salaun PY, Marianowski R. Interpretation of suspect head and neck fixations seen on PET/CT in lung cancer. Eur Ann Otorhinolaryngol Head Neck Dis 2014; 131:217-21. [DOI: 10.1016/j.anorl.2013.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Revised: 05/01/2013] [Accepted: 06/24/2013] [Indexed: 10/25/2022]
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Zhao X, Xiao J, Xing B, Wang R, Zhu Z, Li F. Comparison of (68)Ga DOTATATE to 18F-FDG uptake is useful in the differentiation of residual or recurrent pituitary adenoma from the remaining pituitary tissue after transsphenoidal adenomectomy. Clin Nucl Med 2014; 39:605-608. [PMID: 24873787 DOI: 10.1097/rlu.0000000000000457] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM The evaluation of the remaining pituitary tissue and recurrent or residual tumor after the pituitary adenoma resection is difficult. However, it is essential to assess the size of the recurrent tumor and remaining pituitary reserve before resurgery. This study aimed to distinguish the remaining pituitary tissue from pituitary adenoma with Ga 1,4,7,10-tetraazacyclododecane-N,N',N″,N″'-tetraacetic acid-D-Phe,Tyr3-octreotate (DOTATATE) and F-FDG PET imaging in patients status post transsphenoidal adenomectomy. METHODS Thirty-five patients with suspected recurrent/residual pituitary tumors were retrospectively evaluated. All of these patients underwent DOTATATE and FDG PET/CT within 1 week before additional surgery. The DOTATATE and FDG uptake levels were compared. The image findings were then compared with pathology results after the additional surgery. RESULTS Residual or recurrent pituitary adenoma were confirmed pathologically in all 35 patients. One recurrent pituitary adenoma did not have either DOTATATE or FDG uptake. In the remaining 34 adenomas, 33 had higher FDG uptake than DOTATATE uptake. In comparison, DOTATATE had significant higher uptake than FDG in the remaining pituitary tissues in all cases. CONCLUSIONS Different degree of uptake of Ga DOTATATE and F-FDG PET/CT in the remaining pituitary tissue and recurrent/residual pituitary tumor indicated that combined analysis of Ga DOTATATE and F-FDG PET/CT might be of clinical value in differentiating recurrent/residual pituitary adenoma from the remaining pituitary tissue.
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Affiliation(s)
- Xiaobin Zhao
- From the Departments of *Nuclear Medicine, and †Neurosurgery, Peking Union Medical College Hospital, Beijing, People's Republic of China
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Uludağ K, Roebroeck A. General overview on the merits of multimodal neuroimaging data fusion. Neuroimage 2014; 102 Pt 1:3-10. [PMID: 24845622 DOI: 10.1016/j.neuroimage.2014.05.018] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 04/28/2014] [Accepted: 05/08/2014] [Indexed: 10/25/2022] Open
Abstract
Multimodal neuroimaging has become a mainstay of basic and cognitive neuroscience in humans and animals, despite challenges to consider when acquiring and combining non-redundant imaging data. Multimodal data integration can yield important insights into brain processes and structures in addition to spatiotemporal resolution complementarity, including: a comprehensive physiological view on brain processes and structures, quantification, generalization and normalization, and availability of biomarkers. In this review, we discuss data acquisition and fusion in multimodal neuroimaging in the context of each of these potential merits. However, limitations - due to differences in the neuronal and structural underpinnings of each method - have to be taken into account when modeling and interpreting multimodal data using generative models. We conclude that when these challenges are adequately met, multimodal data fusion can create substantial added value for neuroscience applications making it an indispensable approach for studying the brain.
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Affiliation(s)
- Kâmil Uludağ
- Department of Cognitive Neuroscience, Maastricht Brain Imaging Centre (MBIC), Faculty of Psychology & Neuroscience, Maastricht University, PO Box 616, 6200MD, Maastricht, The Netherlands.
| | - Alard Roebroeck
- Department of Cognitive Neuroscience, Maastricht Brain Imaging Centre (MBIC), Faculty of Psychology & Neuroscience, Maastricht University, PO Box 616, 6200MD, Maastricht, The Netherlands.
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Invalidity of SUV Measurements of Lesions in Close Proximity to Hot Sources due to "Shine-Through" Effect on FDG PET-CT Interpretation. Radiol Res Pract 2012; 2012:867218. [PMID: 23097700 PMCID: PMC3477567 DOI: 10.1155/2012/867218] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Accepted: 09/19/2012] [Indexed: 11/17/2022] Open
Abstract
It is well known that many technical and physiologic factors can affect the reliability of the standardized uptake value (SUV) on FDG PET-CT. Another potential problem of which we may be aware but has not been previously discussed is significant SUV overestimation of lesions in the direct neighborhood of large hot sources, namely, areas with high FDG uptake or activity such as a tumor, myocardium, urinary bladder, kidney, or gastrointestinal tract. The magnitude of SUV overestimation of the lesions directly neighboring the large hot sources is varied among the different cases, and it is possibly secondary to "shine-through" effect of the hot sources, which would warrant further systematic investigation such as phantom simulation experiment. If the lesion is in the close territory of the hot source, measured SUV is often overestimated and invalid. Visual interpretation should be used for evaluation of FDG avidity of the lesion.
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Chiu CF, Lin YY, Hsu WH, Chen CY, Yeh JJ, Kao CH. Shorter-time dual-phase FDG PET/CT in characterizing solid or ground-glass nodules based on surgical results. Clin Imaging 2012; 36:509-14. [PMID: 22920354 DOI: 10.1016/j.clinimag.2011.11.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2011] [Revised: 10/19/2011] [Accepted: 11/30/2011] [Indexed: 10/28/2022]
Abstract
OBJECTIVES We compared the accuracy of shorter-time dual-phase (18)F-FDG PET/CT in evaluating 94 different lung nodules classified as solid or ground-glass nodules (GGNs). MATERIALS AND METHODS Early and delayed maximum standardized uptake values (SUV(max)) as well as the retention index (RI) of each nodule were determined in 75 solid nodules and 19 GGNs. RESULTS In solid nodules, early SUV(max), delayed SUV(max), and RI were higher in malignant than in benign lesions. In GGNs, these values were not significantly lower in the malignant than in the benign lesions. CONCLUSION In the patient group with solid nodules, shorter-time dual-phase (18)F-FDG PET/CT could significantly differentiate the malignant from the benign ones.
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Affiliation(s)
- Chen-Feng Chiu
- Institute of Clinical Medicine Science, China Medical University, Taichung, Taiwan
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Abstract
OBJECTIVE There is growing interest in using PET/CT for evaluating early response to therapy in cancer treatment. Although widely available and convenient to use, standardized uptake value (SUV) measurements can be influenced by a variety of biologic and technologic factors. Many of these factors can be addressed with close attention to detail and appropriate quality control. This article will review factors potentially affecting SUV measurements and provide recommendations on ways to minimize when using serial PET to assess early response to therapy. CONCLUSION Scanner and reconstruction parameters can significantly affect SUV measurements. When using serial SUV measurements to assess early response to therapy, imaging should be performed on the same scanner using the same image acquisition and reconstruction protocols. In addition, attention to detail is required for accurate determination of the administered radiopharmaceutical dose.
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Positron emission tomography with glucose hypermetabolism of a hypothalamic hamartoma in infantile spasms associated with Pallister-Hall syndrome. Brain Dev 2010; 32:677-80. [PMID: 19793630 DOI: 10.1016/j.braindev.2009.09.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2009] [Revised: 08/29/2009] [Accepted: 09/04/2009] [Indexed: 11/23/2022]
Abstract
Although hypothalamic hamartomas (HHs) have been shown to be intrinsically epileptogenic and to participate in the generation of gelastic seizures, no evidence has been reported regarding its contribution to the pathogenesis of infantile spasms. We describe a male infant with Pallister-Hall syndrome who had a large HH presenting with infantile spasms without hypsarrhythmia. [(18)F]fluoro-deoxyglucose positron emission tomography scan performed during the period of epileptic spasms demonstrated glucose hypermetabolism of the HH, which resolved after cessation of the spasms with adrenocorticotropin hormone treatment. No concurrent increased metabolic activity in the lenticular nuclei or brainstem was observed in the ictal or interictal states. The present case suggests that HHs may be involved in the pathogenesis of infantile spasms, possibly with propagation of epileptic discharges from the hamartoma to the descending spinal pathway.
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The effect of furosemide dose timing on bladder activity in oncology imaging with 18F-fluorodeoxyglucose PET/CT. Nucl Med Commun 2010; 31:167-72. [DOI: 10.1097/mnm.0b013e32833492eb] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fang YHD, Asthana P, Salinas C, Huang HM, Muzic RF. Integrated software environment based on COMKAT for analyzing tracer pharmacokinetics with molecular imaging. J Nucl Med 2009; 51:77-84. [PMID: 20008992 DOI: 10.2967/jnumed.109.064824] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED An integrated software package, Compartment Model Kinetic Analysis Tool (COMKAT), is presented in this report. METHODS COMKAT is an open-source software package with many functions for incorporating pharmacokinetic analysis in molecular imaging research and has both command-line and graphical user interfaces. RESULTS With COMKAT, users may load and display images, draw regions of interest, load input functions, select kinetic models from a predefined list, or create a novel model and perform parameter estimation, all without having to write any computer code. For image analysis, COMKAT image tool supports multiple image file formats, including the Digital Imaging and Communications in Medicine (DICOM) standard. Image contrast, zoom, reslicing, display color table, and frame summation can be adjusted in COMKAT image tool. It also displays and automatically registers images from 2 modalities. Parametric imaging capability is provided and can be combined with the distributed computing support to enhance computation speeds. For users without MATLAB licenses, a compiled, executable version of COMKAT is available, although it currently has only a subset of the full COMKAT capability. Both the compiled and the noncompiled versions of COMKAT are free for academic research use. Extensive documentation, examples, and COMKAT itself are available on its wiki-based Web site, http://comkat.case.edu. Users are encouraged to contribute, sharing their experience, examples, and extensions of COMKAT. CONCLUSION With integrated functionality specifically designed for imaging and kinetic modeling analysis, COMKAT can be used as a software environment for molecular imaging and pharmacokinetic analysis.
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Affiliation(s)
- Yu-Hua Dean Fang
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Su Y, Shoghi KI. Single-input-dual-output modeling of image-based input function estimation. Mol Imaging Biol 2009; 12:286-94. [PMID: 19949986 DOI: 10.1007/s11307-009-0273-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2009] [Revised: 07/08/2009] [Accepted: 07/29/2009] [Indexed: 11/30/2022]
Abstract
PURPOSE Quantification of small-animal positron emission tomography (PET) images necessitates knowledge of the plasma input function (PIF). We propose and validate a simplified hybrid single-input-dual-output (HSIDO) algorithm to estimate the PIF. PROCEDURES The HSIDO algorithm integrates the peak of the input function from two region-of-interest time-activity curves with a tail segment expressed by a sum of two exponentials. Partial volume parameters are optimized simultaneously. The algorithm is validated using both simulated and real small-animal PET images. In addition, the algorithm is compared to existing techniques in terms of area under curve (AUC) error, bias, and precision of compartmental model micro-parameters. RESULTS In general, the HSIDO method generated PIF with significantly (P < 0.05) less AUC error, lower bias, and improved precision of kinetic estimates in comparison to the reference method. CONCLUSIONS HSIDO is an improved modeling-based PIF estimation method. This method can be applied for quantitative analysis of small-animal dynamic PET studies.
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Affiliation(s)
- Yi Su
- Department of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Campus Box 8225, St. Louis, MO 63110, USA
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Preoperative evaluation of pancreatic adenocarcinoma. ACTA ACUST UNITED AC 2008; 15:429-35. [PMID: 18670846 DOI: 10.1007/s00534-007-1240-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2007] [Accepted: 04/11/2007] [Indexed: 12/22/2022]
Abstract
The preoperative evaluation of resectability for pancreatic cancer fails to identify up to 25% of patients who are unfortunately found to be unresectable at surgical exploration. Inoperative findings in this circumstance is usually due to either small volume metastatic disease or regional tumor invasion. While advances in computed tomography (CT) technology has increased accuracy of local tumor extent, occult metastatic disease remains a common problem. Although 2-[(18)F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) has been demonstrated to be useful in the staging of many malignancies (e.g. esophageal cancer, recurrent colorectal cancer, lung cancer), it has not been found to significantly increase the accuracy of determining resectability preoperatively in pancreatic cancer, especially with regard to detection of small volume metastatic disease. There are a variety of pancreatic cancer-specific antigens which are being developed as a method for targeted molecular imaging; we provide preliminary data targeting the integrin alpha(v)beta(6) to demonstrate the potential feasibility of this approach. Further developments may allow the accurate determination of patients with resectable pancreatic cancer, and more importantly, those with unresectable disease that may forego unnecessary surgery, the associated morbidity, and the subsequent delay of appropriate therapy.
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Whitson BA, Groth SS, Maddaus MA. Recommendations for optimal use of imaging studies to clinically stage mediastinal lymph nodes in non-small-cell lung cancer patients. Lung Cancer 2008; 61:177-85. [DOI: 10.1016/j.lungcan.2007.12.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2007] [Revised: 11/27/2007] [Accepted: 12/16/2007] [Indexed: 12/25/2022]
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Zytoon AA, Murakami K, El-Kholy MR, El-Shorbagy E, Ebied O. Breast cancer with low FDG uptake: characterization by means of dual-time point FDG-PET/CT. Eur J Radiol 2008; 70:530-8. [PMID: 18395387 DOI: 10.1016/j.ejrad.2008.01.045] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2007] [Revised: 01/29/2008] [Accepted: 01/30/2008] [Indexed: 01/02/2023]
Abstract
BACKGROUND Malignant breast lesions usually are differentiated by FDG-PET with a semiquantitative FDG standardized uptake value (SUV) of 2.5. However, the frequency of breast cancer with an SUV of less than or equal to 2.5 is noteworthy, and often present diagnostic challenges. This study was undertaken to evaluate the accuracy of dual-time point FDG-PET/CT with FDG standardized uptake value (SUV) calculation in the characterization of such breast tumors. METHODS Forty-nine female patients with newly diagnosed breast cancer were found to have primary breast cancer with minimally increased FDG uptake and met the criteria for inclusion in this study by having borderline levels of increased FDG uptake (SUV max less than or equal to 2.5) in the initial FDG-PET/CT images. Consequently, they underwent further delayed phase FDG-PET/CT scan for better evaluation of the disease. RESULTS Of the 49 cancer lesions; the majority were found to have rising or unvarying dual-time changes in SUV max (75.5%). The median value of SUV max increases by 25% between the early and delayed scan. The means+/-S.D. of the SUV max1, the SUV max2, and the Delta SUV max% were 1.2+/-0.6%, 1.3+/-0.9%, and 5.1+/-22.4%, respectively. The receiver-operating-characteristic (ROC) analysis proved that the highest accuracy for characterization of malignant breast lesions was obtained when a Delta SUV max% cut-off value 0.0% was used as criteria for malignant FDG uptake-change over time with sensitivity 75.5%, and false-positive rate 20.4%. CONCLUSION These results suggested that dual-time FDG-PET/CT imaging with standardized uptake value (SUV) estimation can improve the accuracy of the test in the evaluation of breast cancer with low FDG uptake.
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Affiliation(s)
- Ashraf Anas Zytoon
- Radiology Department, Menoufiya University School of Medicine, Menoufiya, Egypt.
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Xiu Y, Bhutani C, Dhurairaj T, Yu JQ, Dadparvar S, Reddy S, Kumar R, Yang H, Alavi A, Zhuang H. Dual-time point FDG PET imaging in the evaluation of pulmonary nodules with minimally increased metabolic activity. Clin Nucl Med 2007; 32:101-5. [PMID: 17242561 DOI: 10.1097/01.rlu.0000252457.54929.b7] [Citation(s) in RCA: 105] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE FDG PET has high accuracy in the evaluation of lung nodules. A standardized uptake value (SUV) > or =2.5 is frequently used as a criterion for malignancy in this setting. However, some malignant nodules have only mild FDG activity with a SUV less than 2.5. Assessment of the etiology of lung nodules with only mild metabolic activity remains difficult. This study was undertaken to compare the accuracy of dual-time point and standard single-time FDG PET imaging in the evaluation of such lung nodules. METHODS Four hundred fifty-seven dual-time FDG PET scans for lung nodules were retrospectively analyzed. Among them, 46 met the selection criteria and were included for the final analysis. Five methods of interpreting FDG PET results were compared. These methods included visual analysis for both initial and delayed images; SUV analysis for both initial and delayed images in which a SUV of 2.5 is regarded as criteria for malignancy; and finally, the retention index analysis in which a 10% increase in SUV on the delayed images was regarded as an indication of malignancy. RESULTS The lowest accuracies came from the visual and single SUV analysis on the initial images. The visual and single SUV analyses on the delayed images produced increased accuracy. The highest accuracy (84.8%) was obtained when a retention index of more than 10% was used as criteria for malignancy. CONCLUSION Dual-time FDG PET imaging has the potential for improving accuracy of a test in the evaluation of lung nodules with only borderline levels of increased metabolic activity.
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Affiliation(s)
- Yan Xiu
- Department of Radiology, University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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Joaquín C, Pellitero S, Soldevila B, Sanmartí A. Detección de cáncer de tiroides mediante tomografía por emisión de positrones. Med Clin (Barc) 2006; 127:78. [PMID: 16801013 DOI: 10.1157/13089996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
The discovery of the Law of Conservation of Energy in the 1840s had consequences for psychological theory. Does the process of thinking involve a novel form of energy that is not recognized by physical science? E. L. Youmans (1821-1887) argued that "mental operations are dependent upon material changes in the nervous system." Kurd Lasswitz (1848-1910) introduced the term "psychophysical energy," based upon the electrical activity of the brain. At the beginning of the twentieth century Alfred Lehmann (1858-1921) claimed that intense mental effort leads to a net increase in oxygen utilization and regarded this as evidence of a specific psychic energy. His views were adopted and extended by Hans Berger (1873-1941). F. G. Benedict (1870-1957), drawing upon extensive experience with balance experiments conducted on humans in large-scale respiration calorimeters, concluded that mental effort probably had no effect upon the brain's metabolism. Modern approaches to the problem make use of PET imaging, which detects local changes in glucose utilization by the brain during cognitive activity.
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