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Zhang X, Nakajima K, Mizokami A, Horikoshi H, Nishimoto K, Hashine K, Matsuyama H, Takahashi S, Wakabayashi H, Kinuya S. Flare phenomenon visualized by 99mTc-bone scintigraphy has prognostic value for patients with metastatic castration-resistant prostate cancer. Ann Nucl Med 2024; 38:428-440. [PMID: 38478154 PMCID: PMC11108890 DOI: 10.1007/s12149-024-01914-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 02/12/2024] [Indexed: 05/22/2024]
Abstract
OBJECTIVE This study aimed to determine the prognostic value of the flare phenomenon in patients with metastatic castration-resistant prostate cancer (mCRPC) using the bone scan index (BSI) derived from 99mTc-methylenediphosphonate (MDP) bone scintigraphy images. METHODS We categorized 72 patients from the PROSTAT-BSI registry with mCRPC who were followed-up for 2 years after starting docetaxel chemotherapy to groups based on pre-chemotherapy BSI values of < 1, 1-4, and > 4. We assessed the effects of the flare phenomenon (defined as a > 10% increase in the BSI within 3 months of starting chemotherapy, followed by > 10% improvement within the next 3 months) on survival using Kaplan-Meier curves and Cox proportional hazard analyses. RESULTS The flare phenomenon was found in 26 (36%) of the 72 patients. Prostate-specific antigen (PSA), alkaline phosphatase (ALP), and hemoglobin (Hb) levels steadily increased, then deteriorated in patients with and without flare, respectively. Elevated BSI and PSA values at 3 months after starting therapy and the absence of abiraterone or/and enzalutamide therapy led to poor 2-year overall survival (OS) in the group without flare. In contrast, no influence was noticeable in the group with flare. The results of multivariable analyses that included only factors associated with PSA and BSI showed that increased baseline BSI (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.04-1.86; P = 0.023) and PSA (HR, 7.15; 95% CI 2.13-24.04; P = 0.0015) values could be independent risk factors for patients with mCRPC without flare. However, these factors lost significance during flare. The risk for all-cause death was significantly higher among patients with BSI > 4 without, than with flare. The results of univariable analyses indicated that flare positively impacted survival (HR, 0.24; 95% CI 0.06‒0.91; P = 0.035). Multivariable analysis did not identify any factors that could predict outcomes. CONCLUSION Favorable prognosis, with fewer disturbances from other factors such as the use of abiraterone or/and enzalutamide, PSA changes, and BSI, was attainable in cases when the mCRPC patient demonstrated flare phenomenon. Follow-up bone scintigraphy at least every 3 months could help to determine the prognosis of patients with bone metastasis of mCRPC.
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Affiliation(s)
- Xue Zhang
- Department of Nuclear Medicine, Kanazawa University, Kanazawa, Japan
| | - Kenichi Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8640, Japan.
| | | | - Hiroyuki Horikoshi
- Department of Diagnostic Radiology, Gunma Prefectural Cancer Center, Ota, Japan
| | - Koshiro Nishimoto
- Department of Uro-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
- Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | | | - Hideyasu Matsuyama
- Department of Urology, JA Yamaguchi Kouseiren Nagato General Hospital, Nagato, Japan
| | - Satoru Takahashi
- Department of Urology, Nihon University School of Medicine, Tokyo, Japan
| | | | - Seigo Kinuya
- Department of Nuclear Medicine, Kanazawa University, Kanazawa, Japan
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Fukai S, Daisaki H, Umeda T, Shimada N, Terauchi T, Koizumi M. Evaluation of two-dimensional total bone uptake (2D-TBU) and bone scan index (BSI) extracted from active bone metastatic burden on the bone scintigraphy in patients with radium-223 treatment. Ann Nucl Med 2024; 38:450-459. [PMID: 38517659 DOI: 10.1007/s12149-024-01918-4] [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: 11/21/2023] [Accepted: 02/25/2024] [Indexed: 03/24/2024]
Abstract
OBJECTIVE Radium-223 is a first alpha-emitting radionuclide treatment for metastatic castration-resistant prostate cancer (mCRPC) patients with bone metastases. Although the spread-based bone scan index (BSI) and novel index of the intensity-based two-dimensional total bone uptake (2D-TBU) from bone scintigraphy may provide useful input in radium-223 treatment, they have not been evaluated in detail yet. This study aimed to fill this gap by evaluating BSI and 2D-TBU in patients treated with radium-223. METHODS Twenty-seven Japanese patients with mCRPC treated with radium-223 were retrospectively analyzed. The patients were evaluated via blood tests and bone scans at baseline and 3 cycles intervals of treatment. BSI and 2D-TBU were analyzed via VSBONE BSI in terms of correlations, response to radium-223 treatment, association with treatment completion, and the Kaplan-Meier survival analysis was performed. RESULTS Nineteen patients (70.4%) completed six cycles of radium-223 treatment, whereas eight patients (29.6%) did not complete the treatment regimen. A significant difference in baseline BSI and 2D-TBU was observed between these groups of patients. Both BSI and 2D-TBU were highly correlated (r = 0.96, p < 0.001). Univariate analysis showed an association between radium-223 completion in median BSI and 2D-TBU values (p = 0.015) and completion percentage differences (91.7% vs. 45.5%; p = 0.027). The Kaplan-Meier product limit estimator showed that the median overall survival was 25.2 months (95% CI 14.0-33.6 months) in the completion group and 7.5 months (95% CI 3.3-14.2 months) in the without completion group (p < 0.001). The overall survival based on median cutoff levels showed a significant difference in 2D-TBU (p = 0.007), but not in BSI (p = 0.15). CONCLUSIONS The 2D-TBU may offer advantages over BSI in classifying patients towards radium-223 treatment based on the degree of progression of bone metastases. This study supports the importance of preliminary assessment of bone metastasis status using BSI and 2D-TBU extracted from VSBONE BSI for radium-223 treatment decisions.
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Affiliation(s)
- Shohei Fukai
- Department of Nuclear Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
- Graduate School of Radiological Technology, Gunma Prefectural College of Health Sciences, 323-1 Kamioki-machi, Maebashi, Gunma, 371-0052, Japan.
| | - Hiromitsu Daisaki
- Graduate School of Radiological Technology, Gunma Prefectural College of Health Sciences, 323-1 Kamioki-machi, Maebashi, Gunma, 371-0052, Japan
| | - Takuro Umeda
- Department of Nuclear Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Naoki Shimada
- Department of Nuclear Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Takashi Terauchi
- Department of Nuclear Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Mitsuru Koizumi
- Department of Nuclear Medicine, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
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Zamani-Siahkali N, Mirshahvalad SA, Farbod A, Divband G, Pirich C, Veit-Haibach P, Cook G, Beheshti M. SPECT/CT, PET/CT, and PET/MRI for Response Assessment of Bone Metastases. Semin Nucl Med 2024; 54:356-370. [PMID: 38172001 DOI: 10.1053/j.semnuclmed.2023.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 01/05/2024]
Abstract
Recent developments in hybrid SPECT/CT systems and the use of cadmium-zinc-telluride (CZT) detectors have improved the diagnostic accuracy of bone scintigraphy. These advancements have paved the way for novel quantitative approaches to accurate and reproducible treatment monitoring of bone metastases. PET/CT imaging using [18F]F-FDG and [18F]F-NaF have shown promising clinical utility in bone metastases assessment and monitoring response to therapy and prediction of treatment response in a broad range of malignancies. Additionally, specific tumor-targeting tracers like [99mTc]Tc-PSMA, [68Ga]Ga-PSMA, or [11C]C- or [18F]F-Choline revealed high diagnostic performance for early assessment and prognostication of bone metastases, particularly in prostate cancer. PET/MRI appears highly accurate imaging modality, but has associated limitations notably, limited availability, more complex logistics and high installation costs. Advances in artificial intelligence (Al) seem to improve the accuracy of imaging modalities and provide an assistant role in the evaluation of treatment response of bone metastases.
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Affiliation(s)
- Nazanin Zamani-Siahkali
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, Salzburg, Austria; Research Center for Nuclear Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Mirshahvalad
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, Salzburg, Austria; Joint Department of Medical Imaging, University Medical Imaging Toronto, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, Toronto, Canada
| | - Abolfazl Farbod
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, Salzburg, Austria; Research Center for Nuclear Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Christian Pirich
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Patrick Veit-Haibach
- Joint Department of Medical Imaging, University Medical Imaging Toronto, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, Toronto, Canada
| | - Gary Cook
- Cancer Imaging Department, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Mohsen Beheshti
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, Salzburg, Austria.
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Shibutani T, Konishi T, Ichikawa H, Onoguchi M, Yoneyama H, Ito T, Okuda K, Nakajima K. Detectability of cold tumors by xSPECT bone technology compared with hot tumors: a supine phantom study. Phys Eng Sci Med 2024; 47:287-294. [PMID: 38117462 DOI: 10.1007/s13246-023-01364-y] [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: 04/14/2023] [Accepted: 11/28/2023] [Indexed: 12/21/2023]
Abstract
Detecting cold as well as hot tumors is vital for interpreting bone tumors on single-photon emission computed tomography (SPECT) images. This study aimed to visually and quantitatively demonstrate the detectability of cold tumors using xSPECT technology compared with that of hot tumors in the phantom study. Five tumors of different sizes and normal bone contained a mixture of 99mTc and K2HPO4 in a spine phantom. We acquired SPECT data using an xSPECT protocol and transverse images were reconstructed using xSPECT Bone (xB) and xSPECT Quant (xQ). Mean standardized uptake values (SUVmean) in volumes of interest (VOI) were calculated. Recovery coefficients (RCs) for each tumor site were calculated with reference to radioactive concentrations. The SUVmeans of the whole vertebral body for hot tumor bone image in cortical bone phantom reconstructed by with xB and xQ were 5.77 and 4.86 respectively. The SUVmean of xB was similar to the true value. The SUVmeans for xB and xQ reconstructed images of cold tumors were both approximately 0.16. The RC of the cold tumor on xQ images increased as the tumor diameter decreased, whereas that of xB remained almost constant regardless of the tumor diameter. In conclusion, the quantitative accuracy of detecting hot and cold tumors was higher in the xB image than in the xQ image. Moreover, the visual detectability of cold tumors was also excellent in xB images.
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Affiliation(s)
- Takayuki Shibutani
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan.
| | - Takahiro Konishi
- Department of Radiological Technology, Kanazawa University Hospital, Kanazawa, Japan
| | - Hajime Ichikawa
- Department of Radiology, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Hiroto Yoneyama
- Department of Radiological Technology, Kanazawa University Hospital, Kanazawa, Japan
| | - Toshimune Ito
- Department of Radiological, Technology, Faculty of Medical Technology, Teikyo University, Tokyo, Japan
| | - Koichi Okuda
- Department of Radiation Science, Graduate School of Health Sciences, Hirosaki University, Hirosaki, Japan
| | - Kenichi Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa University, Kanazawa, Japan
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Volpe F, Nappi C, Piscopo L, Zampella E, Mainolfi CG, Ponsiglione A, Imbriaco M, Cuocolo A, Klain M. Emerging Role of Nuclear Medicine in Prostate Cancer: Current State and Future Perspectives. Cancers (Basel) 2023; 15:4746. [PMID: 37835440 PMCID: PMC10571937 DOI: 10.3390/cancers15194746] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
Prostate cancer is the most frequent epithelial neoplasia after skin cancer in men starting from 50 years and prostate-specific antigen (PSA) dosage can be used as an early screening tool. Prostate cancer imaging includes several radiological modalities, ranging from ultrasonography, computed tomography (CT), and magnetic resonance to nuclear medicine hybrid techniques such as single-photon emission computed tomography (SPECT)/CT and positron emission tomography (PET)/CT. Innovation in radiopharmaceutical compounds has introduced specific tracers with diagnostic and therapeutic indications, opening the horizons to targeted and very effective clinical care for patients with prostate cancer. The aim of the present review is to illustrate the current knowledge and future perspectives of nuclear medicine, including stand-alone diagnostic techniques and theragnostic approaches, in the clinical management of patients with prostate cancer from initial staging to advanced disease.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Michele Klain
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80138 Naples, Italy; (F.V.); (C.N.); (L.P.); (E.Z.); (C.G.M.); (A.P.); (M.I.); (A.C.)
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Yu PN, Lai YC, Chen YY, Cheng DC. Skeleton Segmentation on Bone Scintigraphy for BSI Computation. Diagnostics (Basel) 2023; 13:2302. [PMID: 37443695 DOI: 10.3390/diagnostics13132302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/02/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
Bone Scan Index (BSI) is an image biomarker for quantifying bone metastasis of cancers. To compute BSI, not only the hotspots (metastasis) but also the bones have to be segmented. Most related research focus on binary classification in bone scintigraphy: having metastasis or none. Rare studies focus on pixel-wise segmentation. This study compares three advanced convolutional neural network (CNN) based models to explore bone segmentation on a dataset in-house. The best model is Mask R-CNN, which reaches the precision, sensitivity, and F1-score: 0.93, 0.87, 0.90 for prostate cancer patients and 0.92, 0.86, and 0.88 for breast cancer patients, respectively. The results are the average of 10-fold cross-validation, which reveals the reliability of clinical use on bone segmentation.
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Affiliation(s)
- Po-Nien Yu
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung 404, Taiwan
| | - Yung-Chi Lai
- Department of Nuclear Medicine, Feng Yuan Hospital Ministry of Health and Welfare, Taichung 420, Taiwan
| | - Yi-You Chen
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung 404, Taiwan
| | - Da-Chuan Cheng
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung 404, Taiwan
- Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung 404, Taiwan
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Tually P, Currie G, Blache D, Meadows J, Gray C, Hemmings L, O'Callaghan P, Murphy D. Concurrent measurement of serum and radiomic biomarkers in the clinical investigation of equine musculoskeletal injuries: A prospective pilot study. Vet Radiol Ultrasound 2023. [PMID: 36853616 DOI: 10.1111/vru.13223] [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: 02/26/2022] [Revised: 12/20/2022] [Accepted: 01/02/2023] [Indexed: 03/01/2023] Open
Abstract
The prevention of musculoskeletal injuries and their related welfare and economic impacts represent an immediate priority for the horse racing industry. This prospective pilot study aimed to evaluate a method to quantitatively analyze scintigraphic features of specific anatomical regions of the horse's appendicular skeleton in combination with secondary measures of musculoskeletal metabolism in blood. Twelve horses referred for scintigraphic assessment of lameness were enrolled. Blood samples were collected immediately prior to the administration of radiotracer. Serum concentrations associated with bone turnover were determined for the following biomarkers: C-terminal telopeptides of type I collagen, proteoglycans and sulfated glycosaminoglycans, collagen type II, osteocalcin, and procollagen II C-terminal propeptide. Scintigraphic images underwent radiomic analysis of discrete regions of the distal limbs and these data were correlated to bone turnover markers. Three lame horses demonstrated asymmetrical radiomic abnormalities. The concentration of osteocalcin in the lame horses was significantly higher when compared to the control group, while no significant changes were observed for the other screened serum biomarkers. Findings from the current study provided evidence that radiomic analysis of equine scintigraphy is feasible. This method has the potential to interrogate which serum markers are associated with musculoskeletal injuries.
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Affiliation(s)
- Peter Tually
- Department of Nuclear Medicine, TeleMedVET, Charles Sturt University, Perth, Western Australia, Australia
| | - Geoff Currie
- School of Dentistry and Medical Sciences, Charles Sturt University, New South Wales, Australia
| | - Dominique Blache
- School of Agriculture and Environment, University of Western Australia, Perth, Western Australia, Australia
| | - Jack Meadows
- Department of Nuclear Medicine, TeleMedVET, Charles Sturt University, Perth, Western Australia, Australia
| | - Chloe Gray
- Department of Nuclear Medicine, TeleMedVET, Charles Sturt University, Perth, Western Australia, Australia.,Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Lisa Hemmings
- Department of Nuclear Medicine, TeleMedVET, Charles Sturt University, Perth, Western Australia, Australia
| | | | - David Murphy
- School of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia
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Development of a Prognostic Model of Overall Survival for Metastatic Hormone-Naïve Prostate Cancer in Japanese Men. Cancers (Basel) 2022; 14:cancers14194822. [PMID: 36230745 PMCID: PMC9563582 DOI: 10.3390/cancers14194822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/22/2022] [Accepted: 09/30/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Treatment strategies have changed dramatically in recent years with the development of a variety of agents for metastatic hormone-naïve prostate cancer. There is a need to identify prognostic factors for the appropriate choice of treatment for patients with hormone-naïve prostate cancer in Japanese men. Among the prostate cancer patients receiving treatment at our institution from 2000 to 2019, 198 patients with bone or visceral metastases at the initial diagnosis were included in the study. We retrospectively examined these factors of the overall survival, and identified Gleason pattern 5 content, bone scan index ≥ 1.5, and lactate dehydrogenase evels ≥ 300 IU/L as prognostic factors. Using these three factors, we developed a new prognostic model for overall survival that can more objectively predict the prognosis of patients simply and objectively. Abstract Background: Treatment strategies have changed dramatically in recent years with the development of a variety of agents for metastatic hormone-naïve prostate cancer (mHNPC). There is a need to identify prognostic factors for the appropriate choice of treatment for patients with mHNPC, and we retrospectively examined these factors. Methods: Patients with mHNPC treated at our institution from 2000 to 2019 were included in this study. Overall survival (OS) was estimated retrospectively using the Kaplan–Meier method, and factors associated with OS were identified using univariate and multivariate analyses. A prognostic model was then developed based on the factors identified. Follow-up was terminated on 24 October 2021. Results: The median follow-up duration was 44.2 months, whereas the median OS was 85.2 months, with 88 patients succumbing to their disease. Multivariate analysis identified Gleason pattern (GP) 5 content, bone scan index (BSI) ≥ 1.5, and lactate dehydrogenase (LDH) levels ≥ 300 IU/L as prognostic factors associated with OS. We also developed a prognostic model that classified patients with mHNPC as low risk with no factor, intermediate risk with one factor, and high risk with two or three factors. Conclusions: Three prognostic factors for OS were identified in patients with mHNPC, namely GP5 inclusion, BSI ≥ 1.5, and LDH ≥ 300. Using these three factors, we developed a new prognostic model for OS that can more objectively predict patient prognosis.
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Nakai Y, Iemura Y, Miyasaka T, Hori S, Miyake M, Marugami N, Fujimoto K, Tanaka N. Clinical Significance of the Highest Regional Bone Scan Index in Patients with Metastatic Castration-Resistant Prostate Cancer. Nucl Med Mol Imaging 2022; 56:221-227. [PMID: 36310836 PMCID: PMC9508292 DOI: 10.1007/s13139-022-00759-1] [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: 02/16/2022] [Revised: 06/07/2022] [Accepted: 06/22/2022] [Indexed: 10/16/2022] Open
Abstract
Purpose This study evaluated the clinical utility of the highest bone scan index (BSI), among other BSIs, for each bone metastatic site in patients with bone metastatic castration-resistant prostate cancer (bmCRPC). Methods Thirty patients, diagnosed with bmCRPC by bone scintigraphy, were included. Total BSI, the number of hot spots, and regional BSI on each hot spot from bone scintigraphy at diagnosis with bmCRPC were evaluated by VSBONE BSI®. Highest regional BSI was defined as the highest value among regional BSIs on each hot spot in each patient. Related factors to overall survival and skeletal-related events (SREs) were evaluated using the Cox proportional-hazards model. Results The median follow-up time from diagnosis with bmCRPC was 29.0 months. During this time, 24 patients died, of which 22 patients died from prostate cancer. On univariate analysis, alkaline phosphatase (ALP) [Hazard ratio (HR): 5.96, 95% confidence interval (CI): 2.05-17.3] and highest regional BSI (HR: 2.01, 95% CI: 1.17-7.05) had significant correlation with overall survival. On multivariate analysis, ALP (HR: 4.79, 95% CI: 1.61-14.2) had significant correlation with overall survival. SREs were found in eight patients. Only the highest regional BSI (HR: 9.99, 95% CI: 2.46-40.6) significantly correlated with SREs on univariate analysis. Conclusion Highest regional BSI may provide important information regarding prognosis and SREs in patients with bmCRPC.
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Affiliation(s)
- Yasushi Nakai
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522 Japan
| | - Yusuke Iemura
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522 Japan
| | - Toshiteru Miyasaka
- Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522 Japan
| | - Shunta Hori
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522 Japan
| | - Makito Miyake
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522 Japan
| | - Nagaaki Marugami
- Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522 Japan
| | - Kiyohide Fujimoto
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522 Japan
| | - Nobumichi Tanaka
- Department of Brachytherapy for Prostate, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522 Japan
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Ichikawa H, Shibutani T, Onoguchi M, Taniguchi Y. New index to assess the extent of bone disease in patients with prostate cancer using SPECT/CT. Ann Nucl Med 2022; 36:941-950. [PMID: 36048347 DOI: 10.1007/s12149-022-01783-z] [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: 06/20/2022] [Accepted: 08/11/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Assessing the extent of bone metastases in patients with prostate cancer is very important to predict patient prognosis. Therefore, the bone scan index (BSI), which is easy to use, has been used; however, the accuracy is not that high. In this study, we proposed a new index for the extent of bone disease using single-photon emission computed tomography with computed tomography (SPECT/CT) images and assessed the accuracy of calculation. METHODS In this study, a total of 46 bone scans from 12 patients with prostate cancer treated for bone metastases with Radium-223 were included. Whole-body planar images were obtained 150-180 min after an intravenous injection of 99mTc-methylene diphosphonate, and cervical-to-pelvic SPECT/CT was immediately obtained. The total bone volume (TBV) and regional metabolic bone volume (MBV) were defined as Hounsfield unit of > 120, standardized uptake value (SUV) of > 0.5, and SUV of > 5-8 in four levels, respectively. Bone metabolism volumetric index (BMVI) was calculated as the percentage of the total MBV divided by TBV. The variability of the TBV measurement was evaluated by the percentage coefficient of variance (%CV) of TBV within individual patients. We evaluated the correlation of TBV with age, height, weight, and body mass index and the correlation and agreement between BSI and BMVI. RESULTS The mean and %CV of TBV were 4661.7 cm3 and 2.8%, respectively, and TBV was strongly correlated with body weight. BMVI was significantly higher than BSI and correlated with alkaline phosphatase. For patients with progressive bone metastases, BSI was clearly underestimated, whereas BMVI was elevated. CONCLUSIONS Although assessed in a small number of cases, the new index for assessing the extent of bone disease using SPECT/CT imaging was highly value than BSI and was significantly correlated with alkaline phosphatase. Therefore, this study suggests that BMVI could improve the low sensitivity of BSI in patients with low extent of disease grade.
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Affiliation(s)
- Hajime Ichikawa
- Department of Radiology, Toyohashi Municipal Hospital, 50 Aza Hachiken Nishi, Aotake-Cho, Toyohashi, Aichi, 4418570, Japan
| | - Takayuki Shibutani
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 9200942, Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 9200942, Japan.
| | - Yuki Taniguchi
- Department of Radiology, Toyohashi Municipal Hospital, 50 Aza Hachiken Nishi, Aotake-Cho, Toyohashi, Aichi, 4418570, Japan
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Evaluation of prostate health index in predicting bone metastasis of prostate cancer before bone scanning. Int Urol Nephrol 2022; 54:3079-3086. [DOI: 10.1007/s11255-022-03340-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 08/08/2022] [Indexed: 12/01/2022]
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Nakajima K, Saito S, Chen Z, Komatsu J, Maruyama K, Shirasaki N, Watanabe S, Inaki A, Ono K, Kinuya S. Diagnosis of Parkinson syndrome and Lewy-body disease using 123I-ioflupane images and a model with image features based on machine learning. Ann Nucl Med 2022; 36:765-776. [PMID: 35798937 PMCID: PMC9304062 DOI: 10.1007/s12149-022-01759-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/25/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES 123I-ioflupane has been clinically applied to dopamine transporter imaging and visual interpretation assisted by region-of-interest (ROI)-based parameters. We aimed to build a multivariable model incorporating machine learning (ML) that could accurately differentiate abnormal profiles on 123I-ioflupane images and diagnose Parkinson syndrome or disease and dementia with Lewy bodies (PS/PD/DLB). METHODS We assessed 123I-ioflupane images from 239 patients with suspected neurodegenerative diseases or dementia and classified them as having PS/PD/DLB or non-PS/PD/DLB. The image features of high or low uptake (F1), symmetry or asymmetry (F2), and comma- or dot-like patterns of caudate and putamen uptake (F3) were analyzed on 137 images from one hospital for training. Direct judgement of normal or abnormal profiles (F4) was also examined. Machine learning methods included logistic regression (LR), k-nearest neighbors (kNNs), and gradient boosted trees (GBTs) that were assessed using fourfold cross-validation. We generated the following multivariable models for the test database (n = 102 from another hospital): Model 1, ROI-based measurements of specific binding ratios and asymmetry indices; Model 2, ML-based judgement of abnormalities (F4); and Model 3, features F1, F2 and F3, plus patient age. Diagnostic accuracy was compared using areas under receiver-operating characteristics curves (AUC). RESULTS The AUC was high with all ML methods (0.92-0.96) for high or low uptake. The AUC was the highest for symmetry or asymmetry with the kNN method (AUC 0.75) and the comma-dot feature with the GBT method (AUC 0.94). Based on the test data set, the diagnostic accuracy for a diagnosis of PS/PD/DLB was 0.86 ± 0.04 (SE), 0.87 ± 0.04, and 0.93 ± 0.02 for Models 1, 2 and 3, respectively. The AUC was optimal for Model 3, and significantly differed between Models 3 and 1 (p = 0.027), and 3 and 2 (p = 0.029). CONCLUSIONS Image features such as high or low uptake, symmetry or asymmetry, and comma- or dot-like profiles can be determined using ML. The diagnostic accuracy of differentiating PS/PD/DLB was the highest for the multivariate model with three features and age compared with the conventional ROI-based method.
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Affiliation(s)
- Kenichi Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa University Graduate School of Advanced Preventive Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Japan.
| | - Shintaro Saito
- Department of Nuclear Medicine, Kanazawa University, Kanazawa, Japan
| | - Zhuoqing Chen
- Department of Nuclear Medicine, Kanazawa University, Kanazawa, Japan
| | - Junji Komatsu
- Department of Neurology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Koji Maruyama
- Wolfram Research Inc., Champaign, IL, USA
- Department of Chemistry and Materials Science, Osaka City University, Osaka, Japan
| | - Naoki Shirasaki
- Department of Neurosurgery, Kaga Medical Center, Kaga, Japan
| | - Satoru Watanabe
- Department of Functional Imaging and Artificial Intelligence, Kanazawa University Graduate School of Advanced Preventive Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Japan
| | - Anri Inaki
- Department of Nuclear Medicine, Kanazawa University, Kanazawa, Japan
| | - Kenjiro Ono
- Department of Neurology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Seigo Kinuya
- Department of Nuclear Medicine, Kanazawa University, Kanazawa, Japan
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Tasmeera E, Bawinile H, Colleen A, Tinarwo P, Nyakale N. Segmented linear correlations between bone scan index and prostate cancer biomarkers, alkaline phosphatase, and prostate specific antigen in patients with a Gleason score ≥7. Medicine (Baltimore) 2022; 101:e29515. [PMID: 35758394 PMCID: PMC9276229 DOI: 10.1097/md.0000000000029515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 05/06/2022] [Indexed: 11/27/2022] Open
Abstract
Technetium-99m methyl diphosphonate bone scintigraphy is relatively easily accessible for detecting bone metastases in prostate cancer patients. However, it is subjective and can be challenging to compare images taken at different time points. The bone scan index (BSI) is a more objective evaluation and allows for better comparison of images. Its correlation with other biomarkers of prostate cancer metastases such as prostate specific antigen (PSA) and alkaline phosphatase (ALP) is not clearly understood. This study thus aimed to compare the BSI correlation to PSA against that of BSI to ALP levels in patients with a Gleason score ≥7.A retrospective analysis of the medical records of 50 prostate cancer patients with a Gleason score of ≥7 referred for a bone scan between January 1, 2015 and December 31, 2018 was undertaken. Bone scans were interpreted visually, and using a semi-automated computer programme to quantify the BSI and its relation to PSA and ALP measurements.For the metastasis positive measurements, there was a statistically significant moderate positive overall linear correlation between BSI and PSA. For ALP and BSI, there were 2 segmented strong positive linear relationships between them. The first segment consisted of ALP < 375 IU/L and BSI >10%, where ALP and BSI were strongly and positively correlated. The other segment tended to have generally low BSI measurements (<10%) and also had a strong and positive correlation.The BSI was found to be better linearly correlated with ALP than PSA.
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Affiliation(s)
- Ebrahim Tasmeera
- Department of Nuclear Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- Department of Nuclear Medicine, Inkosi Albert Luthuli Central Hospital, Durban, South Africa
| | - Hadebe Bawinile
- Department of Nuclear Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- Department of Nuclear Medicine, Inkosi Albert Luthuli Central Hospital, Durban, South Africa
| | - Aldous Colleen
- College of Health Sciences, School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Partson Tinarwo
- Department of Biostatistics, Nelson Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Nozipho Nyakale
- Department of Nuclear Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- Department of Nuclear Medicine, Sefako Makgatho Health Sciences University and Dr George Mukhari Academic Hospital, Pretoria, South Africa
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14
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Heidegger I, Kesch C, Kretschmer A, Tsaur I, Ceci F, Valerio M, Tilki D, Marra G, Preisser F, Fankhauser CD, Zattoni F, Chiu P, Puche-Sanz I, Olivier J, van den Bergh RCN, Kasivisvanathan V, Pircher A, Virgolini I, Gandaglia G. Biomarkers to personalize treatment with 177Lu-PSMA-617 in men with metastatic castration-resistant prostate cancer - a state of the art review. Ther Adv Med Oncol 2022; 14:17588359221081922. [PMID: 35273651 PMCID: PMC8902011 DOI: 10.1177/17588359221081922] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 02/02/2022] [Indexed: 01/11/2023] Open
Abstract
Radioligand therapy with Lutetium-177 (177Lu)-Prostate-specific membrane antigen (PSMA) has shown to prolong survival in metastatic castration resistant prostate cancer (mCRPC). One of the major challenges for clinicians in the future is to select those patients who would benefit most from this therapy to position it in the treatment landscape of mCRPC. This, in turn, will lead to the delivery of personalized therapies. In this narrative review article we summarize recent studies investigating both predictive and prognostic clinical, imaging-based, and molecular biomarkers to predict treatment response to 177Lu-PSMA-617 radioligand therapy with the aim of identifying men who should be considered for this approach. Of note, the evidence on the role of biomarkers currently relies on small retrospective trials and their validation in larger prospective cohorts is necessary before these results can be translated in the clinical practice.
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Affiliation(s)
- Isabel Heidegger
- Professor of Urology, Department of Urology, Medical University Innsbruck, 6020 Innsbruck, Austria
| | - Claudia Kesch
- Department of Urology, Essen University Hospital, Essen, Germany
| | | | - Igor Tsaur
- Department of Urology and Pediatric Urology, Mainz University Medicine, Mainz, Germany
| | - Francesco Ceci
- Division of Nuclear Medicine, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Massimo Valerio
- Department of Urology, Lausanne University Hospital, Lausanne, Switzerland
| | - Derya Tilki
- Martini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Urology, Koç University Hospital, Istanbul, Turkey
| | - Giancarlo Marra
- Department of Urology, San Giovanni Battista Hospital, University of Torino, Turin, Italy
| | - Felix Preisser
- Department of Urology, University Hospital Frankfurt, Frankfurt, Germany
| | | | - Fabio Zattoni
- Urology Unit, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - Peter Chiu
- Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Ignacio Puche-Sanz
- Department of Urology, Bio-Health Research Institute, Hospital Universitario Virgende las Nieves, University of Granada, Granada, Spain
| | | | | | - Veeru Kasivisvanathan
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Andreas Pircher
- Hematology and Oncology, Department of Internal Medicine V, Medical University Innsbruck, Innsbruck, Austria
| | - Irene Virgolini
- Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Giorgio Gandaglia
- Division of Oncology and Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
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Regula N, Kostaras V, Johansson S, Trampal C, Lindström E, Lubberink M, Iyer V, Velikyan I, Sörensen J. Comparison of 68Ga-PSMA PET/CT with fluoride PET/CT for detection of bone metastatic disease in prostate cancer. Eur J Hybrid Imaging 2022; 6:5. [PMID: 35229224 PMCID: PMC8885936 DOI: 10.1186/s41824-022-00127-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/01/2022] [Indexed: 12/12/2022] Open
Abstract
Background 18F-NaF positron emission tomography/computed tomography (fluoride PET/CT) is considered the most sensitive technique to detect bone metastasis in prostate cancer (PCa). 68Ga-PSMA-11 (PSMA) PET/CT is increasingly used for staging of PCa. This study primarily aimed to compare the diagnostic performance of fluoride PET/CT and gallium-based PSMA PET/CT in identifying bone metastasis followed by a comparison of PSMA PET/CT with contrast-enhanced CT (CE-CT) in identifying soft tissue lesions as a secondary objective. Methods Twenty-eight PCa patients with high suspicion of disseminated disease following curative treatment were prospectively evaluated. PET/CT examinations using fluoride and PSMA were performed. All suspicious bone lesions were counted, and the tracer uptake was measured as standardized uptake values (SUV) for both tracers. In patients with multiple findings, ten bone lesions with highest SUVmax were selected from which identical lesions from both scans were considered for direct comparison of SUVmax. Soft tissue findings of local and lymph node lesions from CE-CT were compared with PSMA PET/CT. Results Both scans were negative for bone lesions in 7 patients (25%). Of 699 lesions consistent with skeletal metastasis in 21 patients on fluoride PET/CT, PSMA PET/CT identified 579 lesions (83%). In 69 identical bone lesions fluoride PET/CT showed significantly higher uptake (mean SUVmax: 73.1 ± 36.8) compared to PSMA PET/CT (34.5 ± 31.4; p < 0.001). Compared to CE-CT, PSMA PET/CT showed better diagnostic performance in locating local (96% vs 61%, p = 0.004) and lymph node (94% vs 46%, p < 0.001) metastasis. Conclusion In this prospective comparative study, PSMA PET/CT detected the majority of bone lesions that were positive on fluoride PET/CT. Further, this study indicates better diagnostic performance of PSMA PET/CT to locate soft tissue lesions compared to CE-CT. Supplementary Information The online version contains supplementary material available at 10.1186/s41824-022-00127-4.
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Hirata K, Sugimori H, Fujima N, Toyonaga T, Kudo K. Artificial intelligence for nuclear medicine in oncology. Ann Nucl Med 2022; 36:123-132. [PMID: 35028877 DOI: 10.1007/s12149-021-01693-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 11/07/2021] [Indexed: 12/12/2022]
Abstract
As in all other medical fields, artificial intelligence (AI) is increasingly being used in nuclear medicine for oncology. There are many articles that discuss AI from the viewpoint of nuclear medicine, but few focus on nuclear medicine from the viewpoint of AI. Nuclear medicine images are characterized by their low spatial resolution and high quantitativeness. It is noted that AI has been used since before the emergence of deep learning. AI can be divided into three categories by its purpose: (1) assisted interpretation, i.e., computer-aided detection (CADe) or computer-aided diagnosis (CADx). (2) Additional insight, i.e., AI provides information beyond the radiologist's eye, such as predicting genes and prognosis from images. It is also related to the field called radiomics/radiogenomics. (3) Augmented image, i.e., image generation tasks. To apply AI to practical use, harmonization between facilities and the possibility of black box explanations need to be resolved.
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Affiliation(s)
- Kenji Hirata
- Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan. .,Department of Nuclear Medicine, Hokkaido University Hospital, Sapporo, Japan. .,Division of Medical AI Education and Research, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
| | | | - Noriyuki Fujima
- Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.,Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - Takuya Toyonaga
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
| | - Kohsuke Kudo
- Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.,Division of Medical AI Education and Research, Hokkaido University Graduate School of Medicine, Sapporo, Japan.,Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan.,Global Center for Biomedical Science and Engineering, Hokkaido University Faculty of Medicine, Sapporo, Japan
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17
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Jung JH, Hong CM, Jo I, Jeong SY, Lee SW, Lee J, Ahn BC. Reliability of Alkaline Phosphatase for Differentiating Flare Phenomenon from Disease Progression with Bone Scintigraphy. Cancers (Basel) 2022; 14:cancers14010254. [PMID: 35008418 PMCID: PMC8750286 DOI: 10.3390/cancers14010254] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/29/2021] [Accepted: 01/01/2022] [Indexed: 11/24/2022] Open
Abstract
Simple Summary Bone scintigraphy is the most widely used radionuclide technique to investigate bone metastasis, primarily due to its reasonable time and cost factor. However, it is important to recognize that bone scintigraphy to assess treatment response sometimes shows a “flare phenomenon”, which can be misinterpreted as disease progression. Distinction between flare phenomenon and disease progression could help in the decision to continue effective treatments in patients with flare phenomenon and to cease ineffective treatments and consider other salvage treatment plans in patients with disease progression. Despite many methods having been tried to answer this question, there was still no reliable way to differentiate between flare phenomenon and progression of bone metastases. Our results suggest that ALP is a useful serologic marker to differentiate flare phenomenon from disease progression on bone scintigraphy in breast or prostate cancer patients with bone metastasis. Abstract The flare phenomenon (FP) on bone scintigraphy after the initiation of systemic treatment seriously complicates evaluations of therapeutic response in patients with bone metastases. The aim of this study was to evaluate whether serum alkaline phosphatase (ALP) can differentiate FP from disease progression on bone scintigraphy in these patients. Breast or prostate cancer patients with bone metastases who newly underwent systemic therapy were reviewed. Pretreatment baseline and follow-up data, including age, pathologic factors, type of systemic therapy, radiologic and bone scintigraphy findings, and ALP levels, were obtained. Univariate and multivariate analyses of these factors were performed to predict FP. An increased extent and/or new lesions were found in 160 patients on follow-up bone scintigraphy after therapy. Among the 160 patients, 80 (50%) had an improvement on subsequent bone scintigraphy (BS), while subsequent scintigraphy also showed an increased uptake in 80 (50%, progression). Multiple regression analysis revealed that stable or decreased ALP was an independent predictor for FP (p < 0.0001). ALP was an independent predictor for FP on subgroup analysis for breast and prostate cancer (p = 0.001 and p = 0.0223, respectively). Results of the study suggest that ALP is a useful serologic marker to differentiate FP from disease progression on bone scintigraphy in patients with bone metastasis. Clinical interpretation for scintigraphic aggravation can be further improved by the ALP data and it may prevent fruitless changes of therapeutic modality by misdiagnosis of disease progression in cases of FP.
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Affiliation(s)
- Ji-hoon Jung
- Department of Radiology, College of Medicine, Hanyang University Guri Hospital, Guri 11923, Korea;
| | - Chae-Moon Hong
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea; (C.-M.H.); (I.J.); (S.-Y.J.); (S.-W.L.); (J.L.)
| | - Il Jo
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea; (C.-M.H.); (I.J.); (S.-Y.J.); (S.-W.L.); (J.L.)
| | - Shin-Young Jeong
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea; (C.-M.H.); (I.J.); (S.-Y.J.); (S.-W.L.); (J.L.)
| | - Sang-Woo Lee
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea; (C.-M.H.); (I.J.); (S.-Y.J.); (S.-W.L.); (J.L.)
| | - Jaetae Lee
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea; (C.-M.H.); (I.J.); (S.-Y.J.); (S.-W.L.); (J.L.)
| | - Byeong-Cheol Ahn
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea; (C.-M.H.); (I.J.); (S.-Y.J.); (S.-W.L.); (J.L.)
- Correspondence: ; Tel.: +82-53-420-5583
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Ishibashi N, Maebayashi T, Kimura Y, Okada M. Bone scan index on bone scintigraphy and radiation therapy for bone metastases from cancers other than prostate and breast cancers: A retrospective observational study. J Cancer Res Ther 2022; 18:1716-1721. [DOI: 10.4103/jcrt.jcrt_1558_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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19
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Gomes Marin JF, Duarte PS, Ordones MB, Sado HN, Sapienza MT, Buchpiguel CA. Whole Skeletal Mean SUV Measured on 18F-NaF PET/CT Studies as a Prognostic Indicator in Patients with Bone Metastatic Breast Cancer. J Nucl Med Technol 2021; 50:jnmt.121.262907. [PMID: 34750238 DOI: 10.2967/jnmt.121.262907] [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: 08/18/2021] [Accepted: 10/05/2021] [Indexed: 11/16/2022] Open
Abstract
In this work we assessed the association between the whole skeletal mean standardized uptake value (SUV) measured on 18F-NaF PET/CT studies and the overall survival (OS) of bone metastatic breast cancer patients. Methods: We retrospectively analyzed 176 patients with breast cancer and bone metastatic disease who performed 18F-NaF PET/CT studies. The outcomes of the patients (dead or alive) were established based on the last information available on their files. The mean and maximum SUVs were measured in a whole skeletal volume of interest (wsVOI). The wsVOI was defined based on the CT component of the PET/CT study using Hounsfield Units thresholds. The wsVOI was then applied on the 18F-NaF PET image. Univariate analyses were performed to assess the association of the SUVs with OS. We also analyzed the association of the age of the patients, the presence of visceral metastatic disease, histological subtypes, presence of hormone receptors, human epidermal growth factor receptor 2 expression and the creatinine, CA15-3 and alkaline phosphatase (ALP) levels with OS. The variables statistically significant in the univariate analyses were included in a multivariate cox regression survival analysis. Results: In the univariate analyses there were associations of the mean and maximum whole skeletal SUVs, estrogen receptor status and the CA15-3 and ALP levels with OS. In the multivariate analysis, all the variables that were statistically significant in the univariate analysis but the CA15-3 were associated with OS. Conclusion: In patients with bone metastatic breast cancer, the whole skeletal mean SUV is an independent predictor of overall survival.
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Ban J, Fock V, Aryee DNT, Kovar H. Mechanisms, Diagnosis and Treatment of Bone Metastases. Cells 2021; 10:2944. [PMID: 34831167 PMCID: PMC8616226 DOI: 10.3390/cells10112944] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/22/2021] [Accepted: 10/27/2021] [Indexed: 12/24/2022] Open
Abstract
Bone and bone marrow are among the most frequent metastatic sites of cancer. The occurrence of bone metastasis is frequently associated with a dismal disease outcome. The prevention and therapy of bone metastases is a priority in the treatment of cancer patients. However, current therapeutic options for patients with bone metastatic disease are limited in efficacy and associated with increased morbidity. Therefore, most current therapies are mainly palliative in nature. A better understanding of the underlying molecular pathways of the bone metastatic process is warranted to develop novel, well-tolerated and more successful treatments for a significant improvement of patients' quality of life and disease outcome. In this review, we provide comparative mechanistic insights into the bone metastatic process of various solid tumors, including pediatric cancers. We also highlight current and innovative approaches to biologically targeted therapy and immunotherapy. In particular, we discuss the role of the bone marrow microenvironment in the attraction, homing, dormancy and outgrowth of metastatic tumor cells and the ensuing therapeutic implications. Multiple signaling pathways have been described to contribute to metastatic spread to the bone of specific cancer entities, with most knowledge derived from the study of breast and prostate cancer. However, it is likely that similar mechanisms are involved in different types of cancer, including multiple myeloma, primary bone sarcomas and neuroblastoma. The metastatic rate-limiting interaction of tumor cells with the various cellular and noncellular components of the bone-marrow niche provides attractive therapeutic targets, which are already partially exploited by novel promising immunotherapies.
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Affiliation(s)
- Jozef Ban
- St. Anna Children’s Cancer Research Institute, 1090 Vienna, Austria; (J.B.); (V.F.); (D.N.T.A.)
| | - Valerie Fock
- St. Anna Children’s Cancer Research Institute, 1090 Vienna, Austria; (J.B.); (V.F.); (D.N.T.A.)
| | - Dave N. T. Aryee
- St. Anna Children’s Cancer Research Institute, 1090 Vienna, Austria; (J.B.); (V.F.); (D.N.T.A.)
- Department of Pediatrics, Medical University Vienna, 1090 Vienna, Austria
| | - Heinrich Kovar
- St. Anna Children’s Cancer Research Institute, 1090 Vienna, Austria; (J.B.); (V.F.); (D.N.T.A.)
- Department of Pediatrics, Medical University Vienna, 1090 Vienna, Austria
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21
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Nakajima K, Mizokami A, Matsuyama H, Ichikawa T, Kaneko G, Takahashi S, Shiina H, Horikoshi H, Hashine K, Sugiyama Y, Miyao T, Kamiyama M, Harada K, Ito A. Prognosis of patients with prostate cancer and bone metastasis from the Japanese Prostatic Cancer Registry of Standard Hormonal and Chemotherapy Using Bone Scan Index cohort study. Int J Urol 2021; 28:955-963. [PMID: 34148264 PMCID: PMC8453930 DOI: 10.1111/iju.14614] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/09/2021] [Indexed: 11/28/2022]
Abstract
Objective To determine prognostic factors including the Bone Scan Index in prostate cancer patients receiving standard hormonal therapy and chemotherapy. Methods This multicenter Prostatic Cancer Registry of Standard Hormonal and Chemotherapy Using Bone Scan Index study involved 30 hospitals and enrolled 247 patients (age 71 ± 8 years) with metastatic hormone‐sensitive prostate cancer (n = 148) under hormone therapy and metastatic castration‐resistant prostate cancer (n = 99) under chemotherapy. The Bone Scan Index (%) was determined by whole‐body bone scintigraphy using 99mTc‐methylenediphosphonate. Patients were classified into tertiles and binary groups, and predictors of all‐cause death including Bone Scan Index, prostate‐specific antigen, and bone metabolic markers were determined using survival and proportional hazard analyses. Results During a mean follow‐up period of 716 ± 404 days, 81 (33%) of the patients died, and 3‐year mortality rates were 20% and 52% in the metastatic hormone‐sensitive prostate cancer and metastatic castration‐resistant prostate cancer groups, respectively. Survival analysis showed that a Bone Scan Index >3.5% was a significant determinant of death in the metastatic hormone‐sensitive prostate cancer group, whereas prostate‐specific antigen >55 ng/mL before chemotherapy was a determinant of prognosis in the metastatic castration‐resistant prostate cancer group. A Bone Scan Index >3.5% was also associated with a high incidence of prostate‐specific antigen progression in the metastatic hormone‐sensitive prostate cancer group. Patients with metastatic hormone‐sensitive prostate cancer and a better Bone Scan Index response (>45%) to treatment had lower mortality rates than those without such response. Conclusion The Bone Scan Index and hot spot number are significant determinants of 3‐year mortality, and combining the Bone Scan Index with prostate‐specific antigen should contribute to the management of prostate cancer patients with bone metastasis.
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Affiliation(s)
- Kenichi Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa University, Kanazawa, Japan
| | - Atsushi Mizokami
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Hideyasu Matsuyama
- Department of Urology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Tomohiko Ichikawa
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Go Kaneko
- Department of Uro-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Satoru Takahashi
- Department of Urology, Nihon University School of Medicine, Tokyo, Japan
| | - Hiroaki Shiina
- Department of Urology, Shimane University Faculty of Medicine, Shimane, Japan
| | - Hiroyuki Horikoshi
- Department of Diagnostic Radiology, Gunma Prefectural Cancer Center, Ota, Japan
| | - Katsuyoshi Hashine
- Department of Urology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Yutaka Sugiyama
- Department of Urology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Takeshi Miyao
- Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Manabu Kamiyama
- Department of Urology, University of Yamanashi, Yamanashi, Japan
| | - Kenichi Harada
- Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akito Ito
- Department of Urology, Iwate Medical University, Yahaba, Japan
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Gillett D, Marsden D, Ballout S, Attili B, Bird N, Heard S, Gurnell M, Mendichovszky IA, Aloj L. 3D printing 18F radioactive phantoms for PET imaging. EJNMMI Phys 2021; 8:38. [PMID: 33909154 PMCID: PMC8081805 DOI: 10.1186/s40658-021-00383-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 04/13/2021] [Indexed: 11/12/2022] Open
Abstract
Purpose Phantoms are routinely used in molecular imaging to assess scanner performance. However, traditional phantoms with fillable shapes do not replicate human anatomy. 3D-printed phantoms have overcome this by creating phantoms which replicate human anatomy which can be filled with radioactive material. The problem with these is that small objects suffer to a greater extent than larger objects from the effects of inactive walls, and therefore, phantoms without these are desirable. The purpose of this study was to explore the feasibility of creating resin-based 3D-printed phantoms using 18F. Methods Radioactive resin was created using an emulsion of printer resin and 18F-FDG. A series of test objects were printed including twenty identical cylinders, ten spheres with increasing diameters (2 to 20 mm), and a double helix. Radioactive concentration uniformity, printing accuracy and the amount of leaching were assessed. Results Creating radioactive resin was simple and effective. The radioactive concentration was uniform among identical objects; the CoV of the signal was 0.7% using a gamma counter. The printed cylinders and spheres were found to be within 4% of the model dimensions. A double helix was successfully printed as a test for the printer and appeared as expected on the PET scanner. The amount of radioactivity leached into the water was measurable (0.72%) but not visible above background on the imaging. Conclusions Creating an 18F radioactive resin emulsion is a simple and effective way to create accurate and complex phantoms without inactive walls. This technique could be used to print clinically realistic phantoms. However, they are single use and cannot be made hollow without an exit hole. Also, there is a small amount of leaching of the radioactivity to take into consideration.
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Affiliation(s)
- Daniel Gillett
- Department of Nuclear Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK. .,Cambridge Endocrine Molecular Imaging Group, University of Cambridge, Addenbrooke's Hospital, Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK.
| | - Daniel Marsden
- Clinical Engineering, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
| | - Safia Ballout
- Department of Nuclear Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
| | - Bala Attili
- Clinical Pharmacology & Safety Sciences, AstraZeneca, Darwin Building, Cambridge Science Park Milton Road, Cambridge, CB4 0WG, UK
| | - Nick Bird
- Department of Nuclear Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
| | - Sarah Heard
- Department of Nuclear Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
| | - Mark Gurnell
- Cambridge Endocrine Molecular Imaging Group, University of Cambridge, Addenbrooke's Hospital, Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK.,Metabolic Research Laboratories, Wellcome-MRC Institute of Metabolic Science, University of Cambridge, National Institute for Health Research, Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Hills Road, CB2 0QQ, Cambridge, UK.,NIHR Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK
| | - Iosif A Mendichovszky
- Department of Nuclear Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK.,Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
| | - Luigi Aloj
- Department of Nuclear Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK.,Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK
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23
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Lee JW, Jung KJ, Lee SM, Chang SH. Clinical Use of Quantitative Analysis of Bone Scintigraphy to Assess the Involvement of Arthritis Diseases in Patients with Joint Symptoms. Diagnostics (Basel) 2020; 10:diagnostics10121000. [PMID: 33255422 PMCID: PMC7761348 DOI: 10.3390/diagnostics10121000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/12/2020] [Accepted: 11/23/2020] [Indexed: 11/16/2022] Open
Abstract
We aimed to compare the diagnostic ability of quantitative analysis of bone scintigraphy with that of visual analysis for identifying arthritis disease involvement in patients with joint symptoms. We retrospectively included 93 patients with joint symptoms who underwent Tc-99m methylene diphosphonate bone scintigraphy for evaluating arthritis disease involvement. Bone scintigraphy images were visually and quantitatively analyzed using an in-house software by two reviewers. On quantitative analysis, joint uptake ratio was measured for 64 joints in 14 joints areas. The inter-rater agreement of visual and quantitative analyses was assessed, and diagnostic abilities were compared based on the area under the receiver operating characteristic (ROC) curve (AUC) values. Regarding visual analysis, there was a moderate degree of inter-rater agreement (kappa coefficient of 0.597), while there was a substantial inter-rater agreement (concordance correlation coefficient of 0.987) in the measurement of the joint uptake ratio. The comparisons of ROC curves for the total 5941 joints revealed that the joint uptake ratio had a significantly higher AUC value (0.789) to detect the affected joint than that of the visual analysis (p < 0.001). Quantitative analysis using joint uptake ratio showed substantial reproducibility and higher diagnostic ability to detect joints involving arthritis diseases than visual analysis on bone scintigraphy.
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Affiliation(s)
- Jeong Won Lee
- Department of Nuclear Medicine, Catholic Kwandong University College of Medicine, International St. Mary’s Hospital, 25, Simgok-ro 100-gil, Seo-gu 22711, Incheon, Korea;
| | - Ki Jin Jung
- Department of Orthopedic Surgery, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Chungcheongnam-do, Korea;
| | - Sang Mi Lee
- Department of Nuclear Medicine. Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Chungcheongnam-do, Korea
- Correspondence: (S.M.L.); (S.H.C.); Tel.: +82-415-703-540 (S.M.L.); +82-41-530-2971 (S.H.C.)
| | - Sung Hae Chang
- Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Chungcheongnam-do, Korea
- Correspondence: (S.M.L.); (S.H.C.); Tel.: +82-415-703-540 (S.M.L.); +82-41-530-2971 (S.H.C.)
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24
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Auto-ROIs of bone scan image using thin-plate spline with specific bone landmarks. HEALTH AND TECHNOLOGY 2020. [DOI: 10.1007/s12553-020-00483-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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25
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Aoki Y, Nakayama M, Nomura K, Tomita Y, Nakajima K, Yamashina M, Okizaki A. The utility of a deep learning-based algorithm for bone scintigraphy in patient with prostate cancer. Ann Nucl Med 2020; 34:926-931. [PMID: 32955663 DOI: 10.1007/s12149-020-01524-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/08/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Bone scintigraphy has often been used to evaluate bone metastases. Its functionality is evident in detecting bone metastasis in patients with malignant tumor including prostate cancer, as appropriate treatment and prognosis are dependent on the presence and degree of bone metastasis. The development of a deep learning-based algorithm in the field of information processing has been remarkable in recent years. We hypothesized that a deep learning-based algorithm is useful in diagnosing osseous metastases in patients with prostate cancer using bone scintigraphy. Thus, this study aims to examine the utility of deep learning-based algorithm in detecting bone metastases in patients with prostate cancer, as compared with nuclear medicine specialists. METHODS In total, 139 serial patients with prostate cancer, who underwent whole-body bone scintigraphy, were enrolled in this study. Each scintigraphy examination was evaluated visually and independently by nuclear medicine specialists; this was also analyzed using a deep learning-based algorithm. The number of abnormal uptakes was assessed by the nuclear medicine specialists and with a software which used the deep learning-based algorithm, and the per-patient detection rate and the per-region detection rate were then calculated. The software automatically analyzed bone scintigraphy for the presence or absence of osseous metastasis in individual patients, for the 12 body regions. The detection rates analyzed separately by the nuclear medicine specialists and using the software were then compared. The sensitivity, specificity, and accuracy by the specialist and with the software were calculated. RESULTS The sensitivity, specificity, and accuracy by the nuclear medicine specialists were 100%, 94.9% and 97.1%. On the other hand, they with the software were 91.7%, 87.3% and 89.2%. No statistically significant difference was determined between the per-patient detection rates assessed by the specialists versus the software. In regional assessment, there was also no statistically significant difference between most of the per-region detection rates (10 of 12 regions) by the specialists versus the results obtained by the software. CONCLUSIONS The software with the deep learning-based algorithm might be used as diagnostic aid in the evaluation of bone metastases for prostate cancer patients.
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Affiliation(s)
- Yuki Aoki
- Department of Radiology, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido, 078-8510, Japan
| | - Michihiro Nakayama
- Department of Radiology, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido, 078-8510, Japan
| | - Kenta Nomura
- Department of Radiology, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido, 078-8510, Japan
| | - Yui Tomita
- Department of Radiology, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido, 078-8510, Japan
| | - Kaori Nakajima
- Department of Radiology, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido, 078-8510, Japan
| | - Masaaki Yamashina
- Department of Radiology, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido, 078-8510, Japan
| | - Atsutaka Okizaki
- Department of Radiology, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido, 078-8510, Japan.
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26
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Miyoshi Y, Tsutsumi S, Kawahara T, Yasui M, Uemura K, Yoneyama S, Yokomizo Y, Hayashi N, Yao M, Uemura H. Prognostic value of automated bone scan index for predicting overall survival among bone metastatic castration resistant prostate cancer patients treated with radium‐223. BJUI COMPASS 2020; 2:24-30. [PMID: 35474664 PMCID: PMC8988825 DOI: 10.1002/bco2.43] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/19/2020] [Accepted: 08/19/2020] [Indexed: 11/10/2022] Open
Affiliation(s)
- Yasuhide Miyoshi
- Department of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan
| | - Sohgo Tsutsumi
- Department of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan
| | - Takashi Kawahara
- Department of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan
| | - Masato Yasui
- Department of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan
| | - Koichi Uemura
- Department of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan
| | - Shuko Yoneyama
- Department of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan
| | - Yumiko Yokomizo
- Department of Urology Yokohama City University School of Medicine Yokohama Japan
| | - Narihiko Hayashi
- Department of Urology Yokohama City University School of Medicine Yokohama Japan
| | - Masahiro Yao
- Department of Urology Yokohama City University School of Medicine Yokohama Japan
| | - Hiroji Uemura
- Department of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan
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27
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Evaluation of bone metastasis burden as an imaging biomarker by quantitative single-photon emission computed tomography/computed tomography for assessing prostate cancer with bone metastasis: a phantom and clinical study. Radiol Phys Technol 2020; 13:219-229. [PMID: 32535819 DOI: 10.1007/s12194-020-00571-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 06/06/2020] [Accepted: 06/08/2020] [Indexed: 12/21/2022]
Abstract
Metabolic bone volume (MBV), standardized uptake value (SUV), and total bone uptake (TBU) are new imaging biomarkers for quantitative bone single-photon emission computed tomography/computed tomography. The purpose of this study was to validate the quantitative accuracy and utility of MBV, SUVmean, and TBU for the assessment of bone metastases in prostate cancer. We used a bone-specific phantom with four hot spheres (φ = 13, 17, 22, 28 mm) filled with different Tc-99 m activities to simulate uptake ratios of 3 and 7, corresponding to normal and metastatic values. We calculated the error ratio (%Error) by comparing MBV, SUVmean, and TBU with true values for various parameters, including bone lesion size, uptake ratio, and SUV cut-off level. Differences for MBV, SUVmean, TBU, and bone scan index (BSI) were calculated to verify their utility in assessing bone metastases. Receiver-operating characteristic curve (ROC) analysis was performed to calculate the area under the curve (AUC) for each biomarker. MBV, SUVmean, and TBU were affected by lesion size, uptake ratio, and SUV cut-off level; however, TBU demonstrated the most stable %Error. The TBU %Error was within 15% in spheres 17 mm or larger when the SUV cut-off level was 7, regardless of the uptake ratio. The ROC analyses revealed the AUCs of BSI (0.977) and TBU (0.968). Additionally, TBU was able to assess bone metastasis when BSI provided false-negative results, but TBU also provided false-positive results by degenerative changes. The synergy between TBU and BSI could potentially improve diagnostic accuracy.
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28
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Seifert R, Herrmann K, Kleesiek J, Schäfers M, Shah V, Xu Z, Chabin G, Grbic S, Spottiswoode B, Rahbar K. Semiautomatically Quantified Tumor Volume Using 68Ga-PSMA-11 PET as a Biomarker for Survival in Patients with Advanced Prostate Cancer. J Nucl Med 2020; 61:1786-1792. [PMID: 32332147 DOI: 10.2967/jnumed.120.242057] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 03/25/2020] [Indexed: 12/15/2022] Open
Abstract
Prostate-specific membrane antigen (PSMA)-targeting PET imaging is becoming the reference standard for prostate cancer staging, especially in advanced disease. Yet, the implications of PSMA PET-derived whole-body tumor volume for overall survival are poorly elucidated to date. This might be because semiautomated quantification of whole-body tumor volume as a PSMA PET biomarker is an unmet clinical challenge. Therefore, in the present study we propose and evaluate a software that enables the semiautomated quantification of PSMA PET biomarkers such as whole-body tumor volume. Methods: The proposed quantification is implemented as a research prototype. PSMA-accumulating foci were automatically segmented by a percental threshold (50% of local SUVmax). Neural networks were trained to segment organs in PET/CT acquisitions (training CTs: 8,632, validation CTs: 53). Thereby, PSMA foci within organs of physiologic PSMA uptake were semiautomatically excluded from the analysis. Pretherapeutic PSMA PET/CTs of 40 consecutive patients treated with 177Lu-PSMA-617 were evaluated in this analysis. The whole-body tumor volume (PSMATV50), SUVmax, SUVmean, and other whole-body imaging biomarkers were calculated for each patient. Semiautomatically derived results were compared with manual readings in a subcohort (by 1 nuclear medicine physician). Additionally, an interobserver evaluation of the semiautomated approach was performed in a subcohort (by 2 nuclear medicine physicians). Results: Manually and semiautomatically derived PSMA metrics were highly correlated (PSMATV50: R 2 = 1.000, P < 0.001; SUVmax: R 2 = 0.988, P < 0.001). The interobserver agreement of the semiautomated workflow was also high (PSMATV50: R 2 = 1.000, P < 0.001, interclass correlation coefficient = 1.000; SUVmax: R 2 = 0.988, P < 0.001, interclass correlation coefficient = 0.997). PSMATV50 (ml) was a significant predictor of overall survival (hazard ratio: 1.004; 95% confidence interval: 1.001-1.006, P = 0.002) and remained so in a multivariate regression including other biomarkers (hazard ratio: 1.004; 95% confidence interval: 1.001-1.006 P = 0.004). Conclusion: PSMATV50 is a promising PSMA PET biomarker that is reproducible and easily quantified by the proposed semiautomated software. Moreover, PSMATV50 is a significant predictor of overall survival in patients with advanced prostate cancer who receive 177Lu-PSMA-617 therapy.
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Affiliation(s)
- Robert Seifert
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany.,Department of Nuclear Medicine, University Hospital Essen, Essen, Germany.,German Cancer Consortium (DKTK), Essen, Germany.,West German Cancer Center, Muenster and Essen, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen, Essen, Germany.,German Cancer Consortium (DKTK), Essen, Germany.,West German Cancer Center, Muenster and Essen, Germany
| | - Jens Kleesiek
- German Cancer Consortium (DKTK), Essen, Germany.,Division of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Michael Schäfers
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany.,West German Cancer Center, Muenster and Essen, Germany
| | - Vijay Shah
- Siemens Medical Solutions USA, Inc., Knoxville, Tennessee; and
| | - Zhoubing Xu
- Siemens Medical Solutions USA, Inc., Princeton, New Jersey
| | | | - Sasa Grbic
- Siemens Medical Solutions USA, Inc., Princeton, New Jersey
| | | | - Kambiz Rahbar
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany .,West German Cancer Center, Muenster and Essen, Germany
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Xie GS, Li G, Li Y, Pu JX, Huang YH, Li JH, Yin HM. Clinical association between pre-treatment levels of plasma fibrinogen and bone metastatic burden in newly diagnosed prostate cancer patients. Chin Med J (Engl) 2019; 132:2684-2689. [PMID: 31725446 PMCID: PMC6940101 DOI: 10.1097/cm9.0000000000000506] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Due to the different treatments for low-volume metastatic prostate cancer (PCa) as well as high-volume ones, evaluation of bone metastatic status is clinically significant. In this study, we evaluated the correlation between pre-treatment plasma fibrinogen and the burden of bone metastasis in newly diagnosed PCa patients. METHODS A single-center retrospective analysis, focusing on prostate biopsies of newly diagnosed PCa patients, was performed. A total of 261 patients were enrolled in this study in a 4-year period. All subjects were submitted to single-photon emission computerized tomography-computed tomography to confirm the status of bone metastasis and, if present, the number of metastatic lesions would then be calculated. Clinical information such as age, prostate-specific antigen (PSA), fibrinogen, clinical T stage, and Gleason score were collected. Patients were divided into three groups: (i) a non-metastatic group, (ii) a high volume disease (HVD) group (>3 metastases with at least one lesion outside the spine), and (iii) a low volume disease (LVD) group (metastatic patients excluding HVD ones). The main statistical methods included non-parametric Mann-Whitney test, Spearman correlation, receiver operating characteristic (ROC) curves, and logistic regression. RESULTS Fibrinogen positively correlated with Gleason score (r = 0.180, P = 0.003), PSA levels (r = 0.216, P < 0.001), and number of metastatic lesions (r = 0.296, P < 0.001). Compared with the non-metastatic and LVD groups, the HVD group showed the highest PSA (104.98 ng/mL, median) and fibrinogen levels (3.39 g/L, median), as well as the largest proportion of Gleason score >7 (86.8%). Both univariate (odds ratio [OR] = 2.16, 95% confidential interval [CI]: 1.536-3.038, P < 0.001) and multivariate (OR = 1.726, 95% CI: 1.206-2.472, P = 0.003) logistic regressions showed that fibrinogen was independently associated with HVD. The ROC curve suggested that fibrinogen acts as a predictor of HVD patients, yielding a cut-off of 3.08 g/L, with a sensitivity of 0.684 and a specificity of 0.760 (area under the curve = 0.739, 95% CI: 0.644-0.833, P < 0.001). CONCLUSIONS Pre-treatment plasma fibrinogen is positively associated with bone metastatic burden in PCa patients. Our results indicate that fibrinogen might be a potential predictor of HVD.
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Affiliation(s)
- Gan-Sheng Xie
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215031, China
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30
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Kodama H, Hatakeyama S, Narita S, Takahashi M, Sakurai T, Kawamura S, Hoshi S, Ishida M, Kawaguchi T, Ishidoya S, Shimoda J, Narita T, Sato H, Mitsuzuka K, Tochigi T, Tsuchiya N, Arai Y, Habuchi T, Ohyama C. Clinical Characterization of Low Prostate-specific Antigen on Prognosis in Patients With Metastatic Castration-naive Prostate Cancer. Clin Genitourin Cancer 2019; 17:e1091-e1098. [PMID: 31575477 DOI: 10.1016/j.clgc.2019.05.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 05/19/2019] [Accepted: 05/20/2019] [Indexed: 12/20/2022]
Abstract
INTRODUCTION This study aimed to investigate the effect of low prostate-specific antigen (PSA) on prognosis, as the association of initial PSA level with prognosis in patients with metastatic castration-naive prostate cancer (mCNPC) remains unclear. PATIENTS AND METHODS We evaluated 575 patients with mCNPC from 10 hospitals. Patients were stratified into 2 groups according to their initial PSA: PSA < 100 and PSA ≥ 100 groups. We compared castration-resistant prostate cancer (CRPC)-free survival, overall survival (OS), and OS from the CRPC diagnosis between the groups. Multivariate Cox regression analysis was performed to evaluate the effect of initial PSA level on prognosis. RESULTS Of the 575 patients, 196 (34%) patients belonged to the PSA < 100 group. No significant difference was found in patients' backgrounds except for PSA, the extent of disease, and high tumor burden between the groups. CRPC-free survival was significantly shorter in the PSA ≥ 100 group than in the PSA < 100 group. However, the OS after CRPC diagnosis was significantly shorter in the PSA < 100 group than that of the PSA ≥ 100 group. Multivariate analyses showed that PSA < 100 ng/mL was an independent factor for OS after CRPC, whereas no significant association was observed in the CRPC-free survival and OS. CONCLUSIONS A significant effect of initial PSA < 100 ng/mL on OS after CRPC was observed. PSA < 100 ng/mL might be a poor prognostic factor in patients with mCNPC after CRPC.
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Affiliation(s)
- Hirotake Kodama
- Department of Urology, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan.
| | - Shintaro Narita
- Department of Urology, Akita University School of Medicine, Akita, Japan
| | - Masahiro Takahashi
- Department of Urology, Tohoku University School of Medicine, Aoba-ku, Sendai, Miyagi, Japan
| | - Toshihiko Sakurai
- Department of Urology, Yamagata University School of Medicine, Yamagata, Yamagata, Japan
| | - Sadafumi Kawamura
- Department of Urology, Miyagi Cancer Center, Shiote, Aijima, Natori, Miyagi, Japan
| | - Senji Hoshi
- Department of Urology, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Masanori Ishida
- Department of Urology, Iwate Prefectural Isawa Hospital, Mizusawa-ku, Oshu, Iwate, Japan
| | - Toshiaki Kawaguchi
- Department of Urology, Aomori Prefectural Central Hospital, Aomori, Japan
| | - Shigeto Ishidoya
- Department of Urology, Sendai City Hospital, Asuto, Taihaku-ku, Sendai, Miyagi, Japan
| | - Jiro Shimoda
- Department of Urology, Iwate Prefectural Isawa Hospital, Mizusawa-ku, Oshu, Iwate, Japan
| | - Takuma Narita
- Department of Urology, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan
| | - Hiromi Sato
- Department of Urology, Akita University School of Medicine, Akita, Japan
| | - Koji Mitsuzuka
- Department of Urology, Tohoku University School of Medicine, Aoba-ku, Sendai, Miyagi, Japan
| | - Tatsuo Tochigi
- Department of Urology, Miyagi Cancer Center, Shiote, Aijima, Natori, Miyagi, Japan
| | - Norihiko Tsuchiya
- Department of Urology, Yamagata University School of Medicine, Yamagata, Yamagata, Japan
| | - Yoichi Arai
- Department of Urology, Miyagi Cancer Center, Shiote, Aijima, Natori, Miyagi, Japan
| | - Tomonori Habuchi
- Department of Urology, Akita University School of Medicine, Akita, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan
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31
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Perez-Lopez R, Tunariu N, Padhani AR, Oyen WJG, Fanti S, Vargas HA, Omlin A, Morris MJ, de Bono J, Koh DM. Imaging Diagnosis and Follow-up of Advanced Prostate Cancer: Clinical Perspectives and State of the Art. Radiology 2019; 292:273-286. [PMID: 31237493 DOI: 10.1148/radiol.2019181931] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The management of advanced prostate cancer has changed substantially with the availability of multiple effective novel treatments, which has led to improved disease survival. In the era of personalized cancer treatments, more precise imaging may help physicians deliver better care. More accurate local staging and earlier detection of metastatic disease, accurate identification of oligometastatic disease, and optimal assessment of treatment response are areas where modern imaging is rapidly evolving and expanding. Next-generation imaging modalities, including whole-body MRI and molecular imaging with combined PET and CT and combined PET and MRI using novel radiopharmaceuticals, create new opportunities for imaging to support and refine management pathways in patients with advanced prostate cancer. This article demonstrates the potential and challenges of applying next-generation imaging to deliver the clinical promise of treatment breakthroughs.
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Affiliation(s)
- Raquel Perez-Lopez
- From the Radiomics Group, Vall D'Hebron Institute of Oncology, Barcelona, Spain (R.P.L.); Departments of Radiology (N.T., D.M.K.) and Nuclear Medicine (W.J.G.O.), Royal Marsden NHS Foundation Trust, Downs Road, Sutton SM2 5PT, England; Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, England (A.R.P.); Divisions of Radiotherapy and Imaging (W.J.G.O., D.M.K.) and Clinical Studies & Prostate Cancer Targeted Therapy Group (J.d.B.), Institute of Cancer Research, Sutton, England; Departments of Radiology (S.F.) and Genitourinary Oncology Service and Medicine (M.J.M.), Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Oncology and Haematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (H.A.V., A.O.); Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland (H.A.V., A.O.); and Department of Medicine, Weill Cornell Medicine, New York, NY (M.J.M.)
| | - Nina Tunariu
- From the Radiomics Group, Vall D'Hebron Institute of Oncology, Barcelona, Spain (R.P.L.); Departments of Radiology (N.T., D.M.K.) and Nuclear Medicine (W.J.G.O.), Royal Marsden NHS Foundation Trust, Downs Road, Sutton SM2 5PT, England; Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, England (A.R.P.); Divisions of Radiotherapy and Imaging (W.J.G.O., D.M.K.) and Clinical Studies & Prostate Cancer Targeted Therapy Group (J.d.B.), Institute of Cancer Research, Sutton, England; Departments of Radiology (S.F.) and Genitourinary Oncology Service and Medicine (M.J.M.), Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Oncology and Haematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (H.A.V., A.O.); Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland (H.A.V., A.O.); and Department of Medicine, Weill Cornell Medicine, New York, NY (M.J.M.)
| | - Anwar R Padhani
- From the Radiomics Group, Vall D'Hebron Institute of Oncology, Barcelona, Spain (R.P.L.); Departments of Radiology (N.T., D.M.K.) and Nuclear Medicine (W.J.G.O.), Royal Marsden NHS Foundation Trust, Downs Road, Sutton SM2 5PT, England; Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, England (A.R.P.); Divisions of Radiotherapy and Imaging (W.J.G.O., D.M.K.) and Clinical Studies & Prostate Cancer Targeted Therapy Group (J.d.B.), Institute of Cancer Research, Sutton, England; Departments of Radiology (S.F.) and Genitourinary Oncology Service and Medicine (M.J.M.), Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Oncology and Haematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (H.A.V., A.O.); Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland (H.A.V., A.O.); and Department of Medicine, Weill Cornell Medicine, New York, NY (M.J.M.)
| | - Wim J G Oyen
- From the Radiomics Group, Vall D'Hebron Institute of Oncology, Barcelona, Spain (R.P.L.); Departments of Radiology (N.T., D.M.K.) and Nuclear Medicine (W.J.G.O.), Royal Marsden NHS Foundation Trust, Downs Road, Sutton SM2 5PT, England; Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, England (A.R.P.); Divisions of Radiotherapy and Imaging (W.J.G.O., D.M.K.) and Clinical Studies & Prostate Cancer Targeted Therapy Group (J.d.B.), Institute of Cancer Research, Sutton, England; Departments of Radiology (S.F.) and Genitourinary Oncology Service and Medicine (M.J.M.), Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Oncology and Haematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (H.A.V., A.O.); Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland (H.A.V., A.O.); and Department of Medicine, Weill Cornell Medicine, New York, NY (M.J.M.)
| | - Stefano Fanti
- From the Radiomics Group, Vall D'Hebron Institute of Oncology, Barcelona, Spain (R.P.L.); Departments of Radiology (N.T., D.M.K.) and Nuclear Medicine (W.J.G.O.), Royal Marsden NHS Foundation Trust, Downs Road, Sutton SM2 5PT, England; Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, England (A.R.P.); Divisions of Radiotherapy and Imaging (W.J.G.O., D.M.K.) and Clinical Studies & Prostate Cancer Targeted Therapy Group (J.d.B.), Institute of Cancer Research, Sutton, England; Departments of Radiology (S.F.) and Genitourinary Oncology Service and Medicine (M.J.M.), Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Oncology and Haematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (H.A.V., A.O.); Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland (H.A.V., A.O.); and Department of Medicine, Weill Cornell Medicine, New York, NY (M.J.M.)
| | - Hebert Alberto Vargas
- From the Radiomics Group, Vall D'Hebron Institute of Oncology, Barcelona, Spain (R.P.L.); Departments of Radiology (N.T., D.M.K.) and Nuclear Medicine (W.J.G.O.), Royal Marsden NHS Foundation Trust, Downs Road, Sutton SM2 5PT, England; Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, England (A.R.P.); Divisions of Radiotherapy and Imaging (W.J.G.O., D.M.K.) and Clinical Studies & Prostate Cancer Targeted Therapy Group (J.d.B.), Institute of Cancer Research, Sutton, England; Departments of Radiology (S.F.) and Genitourinary Oncology Service and Medicine (M.J.M.), Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Oncology and Haematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (H.A.V., A.O.); Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland (H.A.V., A.O.); and Department of Medicine, Weill Cornell Medicine, New York, NY (M.J.M.)
| | - Aurelius Omlin
- From the Radiomics Group, Vall D'Hebron Institute of Oncology, Barcelona, Spain (R.P.L.); Departments of Radiology (N.T., D.M.K.) and Nuclear Medicine (W.J.G.O.), Royal Marsden NHS Foundation Trust, Downs Road, Sutton SM2 5PT, England; Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, England (A.R.P.); Divisions of Radiotherapy and Imaging (W.J.G.O., D.M.K.) and Clinical Studies & Prostate Cancer Targeted Therapy Group (J.d.B.), Institute of Cancer Research, Sutton, England; Departments of Radiology (S.F.) and Genitourinary Oncology Service and Medicine (M.J.M.), Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Oncology and Haematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (H.A.V., A.O.); Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland (H.A.V., A.O.); and Department of Medicine, Weill Cornell Medicine, New York, NY (M.J.M.)
| | - Michael J Morris
- From the Radiomics Group, Vall D'Hebron Institute of Oncology, Barcelona, Spain (R.P.L.); Departments of Radiology (N.T., D.M.K.) and Nuclear Medicine (W.J.G.O.), Royal Marsden NHS Foundation Trust, Downs Road, Sutton SM2 5PT, England; Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, England (A.R.P.); Divisions of Radiotherapy and Imaging (W.J.G.O., D.M.K.) and Clinical Studies & Prostate Cancer Targeted Therapy Group (J.d.B.), Institute of Cancer Research, Sutton, England; Departments of Radiology (S.F.) and Genitourinary Oncology Service and Medicine (M.J.M.), Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Oncology and Haematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (H.A.V., A.O.); Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland (H.A.V., A.O.); and Department of Medicine, Weill Cornell Medicine, New York, NY (M.J.M.)
| | - Johann de Bono
- From the Radiomics Group, Vall D'Hebron Institute of Oncology, Barcelona, Spain (R.P.L.); Departments of Radiology (N.T., D.M.K.) and Nuclear Medicine (W.J.G.O.), Royal Marsden NHS Foundation Trust, Downs Road, Sutton SM2 5PT, England; Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, England (A.R.P.); Divisions of Radiotherapy and Imaging (W.J.G.O., D.M.K.) and Clinical Studies & Prostate Cancer Targeted Therapy Group (J.d.B.), Institute of Cancer Research, Sutton, England; Departments of Radiology (S.F.) and Genitourinary Oncology Service and Medicine (M.J.M.), Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Oncology and Haematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (H.A.V., A.O.); Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland (H.A.V., A.O.); and Department of Medicine, Weill Cornell Medicine, New York, NY (M.J.M.)
| | - Dow-Mu Koh
- From the Radiomics Group, Vall D'Hebron Institute of Oncology, Barcelona, Spain (R.P.L.); Departments of Radiology (N.T., D.M.K.) and Nuclear Medicine (W.J.G.O.), Royal Marsden NHS Foundation Trust, Downs Road, Sutton SM2 5PT, England; Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, England (A.R.P.); Divisions of Radiotherapy and Imaging (W.J.G.O., D.M.K.) and Clinical Studies & Prostate Cancer Targeted Therapy Group (J.d.B.), Institute of Cancer Research, Sutton, England; Departments of Radiology (S.F.) and Genitourinary Oncology Service and Medicine (M.J.M.), Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Oncology and Haematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (H.A.V., A.O.); Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland (H.A.V., A.O.); and Department of Medicine, Weill Cornell Medicine, New York, NY (M.J.M.)
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Automated Definition of Skeletal Disease Burden in Metastatic Prostate Carcinoma: A 3D Analysis of SPECT/CT Images. Cancers (Basel) 2019; 11:cancers11060869. [PMID: 31234424 PMCID: PMC6627119 DOI: 10.3390/cancers11060869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 06/16/2019] [Accepted: 06/19/2019] [Indexed: 01/02/2023] Open
Abstract
To meet the current need for skeletal tumor-load estimation in castration-resistant prostate cancer (CRPC), we developed a novel approach based on adaptive bone segmentation. In this study, we compared the program output with existing estimates and with the radiological outcome. Seventy-six whole-body single-photon emission computed tomographies/x-ray computed tomography with 3,3-diphosphono-1,2-propanedicarboxylic acid from mCRPC patients were analyzed. The software identified the whole skeletal volume (SVol) and classified the voxels metastases (MVol) or normal bone (BVol). SVol was compared with the estimation of a commercial software. MVol was compared with manual assessment and with prostate specific antigen (PSA) levels. Counts/voxel were extracted from MVol and BVol. After six cycles of 223RaCl2-therapy every patient was re-evaluated as having progressive disease (PD), stable disease (SD), or a partial response (PR). SVol correlated with that of the commercial software (R = 0.99, p < 0.001). MVol correlated with the manually-counted lesions (R = 0.61, p < 0.001) and PSA (R = 0.46, p < 0.01). PD had a lower counts/voxel in MVol than PR/SD (715 ± 190 vs. 975 ± 215 and 1058 ± 255, p < 0.05 and p < 0.01) and BVol (PD 275 ± 60, PR 515 ± 188 and SD 528 ± 162 counts/voxel, p < 0.001). Segmentation-based tumor load correlated with radiological/laboratory indices. Uptake was linked with the clinical outcome, suggesting that metastases in PD patients have a lower affinity for bone-seeking radionuclides and might benefit less from bone-targeted radioisotope therapies.
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Bone scan index as metastatic bone disease quantifier and predictor of radium-223-dichloride biochemical response. Nucl Med Commun 2019; 40:588-596. [PMID: 30908340 DOI: 10.1097/mnm.0000000000001005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This work aims to assess whether the biochemical response of radium-223-dichloride treatment can be predicted based on the pretherapy bone scan, and consequently if bone scan index (BSI) and maximum lesion intensity have a place as alternatives or as complements to extent of bone disease (EOBD) scoring in predicting biochemical response to treatment. Many cases of advanced prostate cancer have evidence of bone metastasis. Accurate EOBD quantification could help predict the response to radium-223-dichloride therapy. Current EOBD score is simple to use but does not consider size, intensity or localisation of lesion BSI might be more suitable for stratification of bone metastases. PATIENTS AND METHODS Bone scans (n=20) preceding radium-223-dichloride treatment for prostate cancer were assessed retrospectively using automated BSI software (EXINI) and by assessing maximum counts per lesion. Results were then compared to total alkaline phosphatase (ALP) as a measure of biochemical response to therapy using linear regressions and to their EOBD scores using box plot analysis. RESULTS Moderate correlation was found between ALP response and maximum lesion intensity (R=0.41) and BSI (R=0.46). Strong correlation (R=0.71) was found between baseline ALP and BSI and between lesion number and BSI (R=0.60). Visual assessment of EOBD score was found to correlate well with baseline ALP and maximum ALP response. CONCLUSION BSI is a useful asset in stratification of patients with metastatic bone disease. It may also have a place in prediction of biochemical response.
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☆Symposium: Imaging modalities for drug-related osteonecrosis of the jaw (5), utility of bone scintigraphy and 18F-FDG PET/CT in early detection and risk assessment of medication-related osteonecrosis of the jaw (secondary publication). JAPANESE DENTAL SCIENCE REVIEW 2019; 55:76-79. [PMID: 30956739 PMCID: PMC6431786 DOI: 10.1016/j.jdsr.2018.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 12/07/2018] [Indexed: 01/12/2023] Open
Abstract
Medication-related osteonecrosis of the jaw (MRONJ) is a significant side effect of antiresorptive and antiangiogenic drugs. Since MRONJ is intractable, early detection is the best way to limit progression. Bone scintigraphy and 18F- fluorodeoxyglucose positron-emission tomography can detect minimal and subclinical changes in bones earlier than conventional radiological modalities. A differential diagnosis including MRONJ is recommended when abnormally high uptakes are incidentally detected in the jaws of patients who have bone metastases. Quantitative analysis of uptakes, such as bone scan index of the jaw using neural network analysis and maximum standardized uptake value, could differentiate MRONJ from common dental diseases and be useful for the early detection and risk assessment of MRONJ.
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Schiavina R, Chessa F, Borghesi M, Gaudiano C, Bianchi L, Corcioni B, Castellucci P, Ceci F, Ceravolo I, Barchetti G, Del Monte M, Campa R, Catalano C, Panebianco V, Nanni C, Fanti S, Minervini A, Porreca A, Brunocilla E. State-of-the-art imaging techniques in the management of preoperative staging and re-staging of prostate cancer. Int J Urol 2018; 26:18-30. [DOI: 10.1111/iju.13797] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 07/18/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Riccardo Schiavina
- Department of Urology; University of Bologna; St. Orsola-Malpighi Hospital; Bologna Italy
| | - Francesco Chessa
- Department of Urology; University of Bologna; St. Orsola-Malpighi Hospital; Bologna Italy
| | - Marco Borghesi
- Department of Urology; University of Bologna; St. Orsola-Malpighi Hospital; Bologna Italy
| | - Caterina Gaudiano
- Radiology Unit; Department of Diagnostic Medicine and Prevention; St. Orsola-Malpighi Hospital; Bologna Italy
| | - Lorenzo Bianchi
- Department of Urology; University of Bologna; St. Orsola-Malpighi Hospital; Bologna Italy
| | - Beniamino Corcioni
- Radiology Unit; Department of Diagnostic Medicine and Prevention; St. Orsola-Malpighi Hospital; Bologna Italy
| | - Paolo Castellucci
- Metropolitan Nuclear Medicine; St. Orsola-Malpighi Hospital; University of Bologna; Bologna Italy
| | - Francesco Ceci
- Metropolitan Nuclear Medicine; St. Orsola-Malpighi Hospital; University of Bologna; Bologna Italy
- Ahmanson Translational Imaging Division; Department of Molecular and Medical Pharmacology; University of California at Los Angeles; Los Angeles California USA
| | - Isabella Ceravolo
- Prostate Unit-Department of Radiological Sciences, Oncology and Pathology; Sapienza University of Rome; Rome Italy
| | - Giovanni Barchetti
- Prostate Unit-Department of Radiological Sciences, Oncology and Pathology; Sapienza University of Rome; Rome Italy
| | - Maurizio Del Monte
- Prostate Unit-Department of Radiological Sciences, Oncology and Pathology; Sapienza University of Rome; Rome Italy
| | - Riccardo Campa
- Prostate Unit-Department of Radiological Sciences, Oncology and Pathology; Sapienza University of Rome; Rome Italy
| | - Carlo Catalano
- Prostate Unit-Department of Radiological Sciences, Oncology and Pathology; Sapienza University of Rome; Rome Italy
| | - Valeria Panebianco
- Prostate Unit-Department of Radiological Sciences, Oncology and Pathology; Sapienza University of Rome; Rome Italy
| | - Cristina Nanni
- Metropolitan Nuclear Medicine; St. Orsola-Malpighi Hospital; University of Bologna; Bologna Italy
| | - Stefano Fanti
- Metropolitan Nuclear Medicine; St. Orsola-Malpighi Hospital; University of Bologna; Bologna Italy
| | - Andrea Minervini
- Department of Urology; Careggi Hospital; University of Florence; Florence Italy
| | - Angelo Porreca
- Department of Robotic Urological Surgery; Abano Terme Hospital; Abano Terme Italy
| | - Eugenio Brunocilla
- Department of Urology; University of Bologna; St. Orsola-Malpighi Hospital; Bologna Italy
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Fiz F, Dittman H, Campi C, Morbelli S, Marini C, Brignone M, Bauckneht M, Piva R, Massone AM, Piana M, Sambuceti G, la Fougère C. Assessment of Skeletal Tumor Load in Metastasized Castration-Resistant Prostate Cancer Patients: A Review of Available Methods and an Overview on Future Perspectives. Bioengineering (Basel) 2018; 5:bioengineering5030058. [PMID: 30060546 PMCID: PMC6163573 DOI: 10.3390/bioengineering5030058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 07/23/2018] [Accepted: 07/26/2018] [Indexed: 11/16/2022] Open
Abstract
Metastasized castration-resistant prostate cancer (mCRPC), is the most advanced form of prostate neoplasia, where massive spread to the skeletal tissue is frequent. Patients with this condition are benefiting from an increasing number of treatment options. However, assessing tumor response in patients with multiple localizations might be challenging. For this reason, many computational approaches have been developed in the last decades to quantify the skeletal tumor burden and treatment response. In this review, we analyzed the progressive development and diffusion of such approaches. A computerized literature search of the PubMed/Medline was conducted, including articles between January 2008 and March 2018. The search was expanded by manually reviewing the reference list of the chosen articles. Thirty-five studies were identified. The number of eligible studies greatly increased over time. Studies could be categorized in the following categories: automated analysis of 2D scans, SUV-based thresholding, hybrid CT- and SUV-based thresholding, and MRI-based thresholding. All methods are discussed in detail. Automated analysis of bone tumor burden in mCRPC is a growing field of research; when choosing the appropriate method of analysis, it is important to consider the possible advantages as well as the limitations thoroughly.
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Affiliation(s)
- Francesco Fiz
- Nuclear Medicine Unit, Department of Radiology, Uni-Klinikum Tübingen, 72076 Tübingen, Germany.
- Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy.
| | - Helmut Dittman
- Nuclear Medicine Unit, Department of Radiology, Uni-Klinikum Tübingen, 72076 Tübingen, Germany.
| | - Cristina Campi
- Nuclear Medicine Unit, Department of Medicine-DIMED, University Hospital of Padua, 35128 Padua, Italy.
| | - Silvia Morbelli
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, 16132 Genoa, Italy.
| | | | - Massimo Brignone
- Department of Engineering, University of Genoa, Pole of Savona, 17100 Savona, Italy.
| | - Matteo Bauckneht
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, 16132 Genoa, Italy.
| | - Roberta Piva
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, 16132 Genoa, Italy.
| | - Anna Maria Massone
- National Council of Research-SPIN, 16152 Genoa, Italy.
- Department of Mathematics, University of Genoa, 16146 Genoa, Italy.
| | - Michele Piana
- National Council of Research-SPIN, 16152 Genoa, Italy.
- Department of Mathematics, University of Genoa, 16146 Genoa, Italy.
| | - Gianmario Sambuceti
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa, 16132 Genoa, Italy.
| | - Christian la Fougère
- Nuclear Medicine Unit, Department of Radiology, Uni-Klinikum Tübingen, 72076 Tübingen, Germany.
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Mitsui Y. Editorial Comment to Role of bone scan index in the prognosis and effects of therapy on prostate cancer with bone metastasis: Study design and rationale for the multicenter Prostatic Cancer Registry of Standard Hormonal and Chemotherapy Using Bone Scan In. Int J Urol 2018; 25:500. [DOI: 10.1111/iju.13582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Yozo Mitsui
- Department of Urology; Faculty of Medicine; Toho University; Tokyo Japan
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Nakajima K, Kaneko G, Takahashi S, Matsuyama H, Shiina H, Ichikawa T, Horikoshi H, Hashine K, Sugiyama Y, Miyao T, Kamiyama M, Harada K, Ito A, Mizokami A. Role of bone scan index in the prognosis and effects of therapy on prostate cancer with bone metastasis: Study design and rationale for the multicenter Prostatic Cancer Registry of Standard Hormonal and Chemotherapy Using Bone Scan Index (PROSTAT-BSI) stu. Int J Urol 2018; 25:492-499. [DOI: 10.1111/iju.13556] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 02/09/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Kenichi Nakajima
- Department of Nuclear Medicine; Kanazawa University Hospital; Kanazawa Japan
| | - Go Kaneko
- Department of Uro-Oncology; Saitama Medical University International Medical Center; Saitama Japan
| | - Satoru Takahashi
- Department of Urology; Nihon University School of Medicine; Tokyo Japan
| | - Hideyasu Matsuyama
- Department of Urology; Graduate School of Medicine; Yamaguchi University; Ube Japan
| | - Hiroaki Shiina
- Department of Urology; Shimane University; Faculty of Medicine; Shimane Japan
| | - Tomohiko Ichikawa
- Department of Urology; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Hiroyuki Horikoshi
- Department of Diagnostic Radiology; Gunma Prefectural Cancer Center; Ota Japan
| | - Katsuyoshi Hashine
- Department of Urology; National Hospital Organization Shikoku Cancer Center; Matsuyama Japan
| | - Yutaka Sugiyama
- Department of Urology; Graduate School of Medical Sciences; Kumamoto University; Kumamoto , Japan
| | - Takeshi Miyao
- Department of Urology; Gunma University; Graduate School of Medicine; Maebashi Japan
| | - Manabu Kamiyama
- Department of Urology; Yamanashi University School of Medicine; Yamanashi Japan
| | - Kenichi Harada
- Division of Urology; Department of Surgery Related; Kobe University Graduate School of Medicine; Kobe , Japan
| | - Akito Ito
- Department of Urology; Iwate Medical University; Morioka Japan
| | - Atsushi Mizokami
- Department of Integrative Cancer Therapy and Urology; Kanazawa University Graduate School of Medical Science; Kanazawa Japan
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Montaner A, da Silva Santana TT, Schroeder T, Einicker-Lamas M, Girardini J, Costa MR, Banchio C. Specific Phospholipids Regulate the Acquisition of Neuronal and Astroglial Identities in Post-Mitotic Cells. Sci Rep 2018; 8:460. [PMID: 29323239 PMCID: PMC5765016 DOI: 10.1038/s41598-017-18700-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 12/15/2017] [Indexed: 11/09/2022] Open
Abstract
Hitherto, the known mechanisms underpinning cell-fate specification act on neural progenitors, affecting their commitment to generate neuron or glial cells. Here, we show that particular phospholipids supplemented in the culture media modify the commitment of post-mitotic neural cells in vitro. Phosphatidylcholine (PtdCho)-enriched media enhances neuronal differentiation at the expense of astroglial and unspecified cells. Conversely, phosphatidylethanolamine (PtdEtn) enhances astroglial differentiation and accelerates astrocyte maturation. The ability of phospholipids to modify the fate of post-mitotic cells depends on its presence during a narrow time-window during cell differentiation and it is mediated by the selective activation of particular signaling pathways. While PtdCho-mediated effect on neuronal differentiation depends on cAMP-dependent kinase (PKA)/calcium responsive element binding protein (CREB), PtdEtn stimulates astrogliogenesis through the activation of the MEK/ERK signaling pathway. Collectively, our results provide an additional degree of plasticity in neural cell specification and further support the notion that cell differentiation is a reversible phenomenon. They also contribute to our understanding of neuronal and glial lineage specification in the central nervous system, opening up new avenues to retrieve neurogenic capacity in the brain.
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Affiliation(s)
- Aneley Montaner
- Instituto de Biología Molecular y Celular de Rosario (IBR, CONICET) Ocampo y Esmeralda, Predio CONICET and Departamento de Ciencias Biológicas, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, 2000, Rosario, Argentina
| | | | - Timm Schroeder
- Department of Biosystems Science and Engineering, Cell Systems Dynamics, ETH Zurich, Basel, Switzerland
| | - Marcelo Einicker-Lamas
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, 21949-902, Ilha do Fundão, Rio de Janeiro, Brazil
| | - Javier Girardini
- Instituto de Biología Molecular y Celular de Rosario (IBR, CONICET) Ocampo y Esmeralda, Predio CONICET and Departamento de Ciencias Biológicas, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, 2000, Rosario, Argentina
| | - Marcos Romualdo Costa
- Brain Institute, Federal University of Rio Grande do Norte, Av. Nascimento de Castro 2155, 59056-450, Natal, Brazil.
| | - Claudia Banchio
- Instituto de Biología Molecular y Celular de Rosario (IBR, CONICET) Ocampo y Esmeralda, Predio CONICET and Departamento de Ciencias Biológicas, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, 2000, Rosario, Argentina.
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Kuji I, Yamane T, Seto A, Yasumizu Y, Shirotake S, Oyama M. Skeletal standardized uptake values obtained by quantitative SPECT/CT as an osteoblastic biomarker for the discrimination of active bone metastasis in prostate cancer. Eur J Hybrid Imaging 2017; 1:2. [PMID: 29782587 PMCID: PMC5954671 DOI: 10.1186/s41824-017-0006-y] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 09/01/2017] [Indexed: 11/18/2022] Open
Abstract
Purpose To investigate the improvement of prognostication of active bone metastatic burden by discriminating bone metastases from degenerative changes in hot foci, using skeletal standardized uptake values (SUVs) by quantitative bone single photon emission tomography/computed tomography (SPECT/CT) in patients with prostate cancer. Methods We investigated 170 patients with prostate cancer who underwent skeletal quantitative SPECT/CT using 99mTc-methylene-diphosphonate (MDP), through conjugate gradient reconstruction with tissue zoning, attenuation, and scatter corrections applied, called as CGZAS reconstruction, in a retrospective cohort study. The maximum, peak, and average SUVs (SUVmax, SUVpeak, and SUVave, respectively) were obtained for visually normal thoracic (T; n = 100) and lumbar (L; n = 140) vertebral bodies as controls, as well as for bone metastases (n = 126) and degenerative changes (n = 114) as hot foci. They were also correlated with age, body-weight, height, biochemistry data, and extent of disease (EOD). Discrimination accuracy of the SUVs for bone metastases in hot foci was evaluated by a patient-based and lesion-based receiver-operator characteristic curve (ROC) analysis. Results The skeletal SUVmax was 7.58 ± 2.42 for T, 8.12 ± 12.24 for L, 16.73 ± 6.74 for degenerative changes, and 40.90 ± 33.46 for bone metastases. The SUVs of the bone metastasis group were significantly (p < 0.001) greater than of the other three groups. With disease extent, serum alkaline phosphatase and prostate specific antigen were increased, while SUVs for bone metastases were decreased in EOD grade 4. In ROC analyses for bone metastases by skeletal SUVs demonstrating the diagnostic accuracy of skeletal SUVs for discriminating bone metastasis from degenerative changes in hot foci, area under curves were 0.840, 0.817, and 0.845 in patient-based mode, and 0.932, 0.920, and 0.930 in lesion-based mode. Conclusions The skeletal SUVs by 99mTc-MDP SPECT/CT for active bone metastases were greater than those for degenerative changes in patients with prostate cancer, with a feasible discrimination accuracy in the hot foci. Therefore, skeletal SUVs, especially SUVmax, in quantitative bone SPECT/CT may be helpful indices for the prognostication of bone metastatic burden, improving discrimination of active bone osteoblastic metastases in patients with prostate cancer from frequently coexisting degenerative changes.
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Affiliation(s)
- Ichiei Kuji
- 1Department of Nuclear Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298 Japan
| | - Tomohiko Yamane
- 1Department of Nuclear Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298 Japan
| | - Akira Seto
- 1Department of Nuclear Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298 Japan
| | - Yota Yasumizu
- 2Department of Uro-Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298 Japan
| | - Suguru Shirotake
- 2Department of Uro-Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298 Japan
| | - Masafumi Oyama
- 2Department of Uro-Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298 Japan
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