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Belotta AF, Beazley S, Hutcheson M, Mayer M, Beaufrère H, Sukut S. Comparison of sedation and general anesthesia protocols for 18F-FDG-PET/CT studies in dogs and cats: Musculoskeletal uptake and radiation dose to workers. Vet Radiol Ultrasound 2024. [PMID: 39388650 DOI: 10.1111/vru.13439] [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: 03/01/2024] [Revised: 08/02/2024] [Accepted: 09/09/2024] [Indexed: 10/12/2024] Open
Abstract
In veterinary medicine, PET/CT scans are generally performed with the patient under general anesthesia. The aim of this prospective crossover study was to compare the musculoskeletal uptake of 18F-FDG and radiation doses to workers during PET/CT studies of healthy dogs and cats between sedation and general anesthesia. Volume and maximal standard uptake values (SUVmax) values of abnormal 18F-FDG uptake in the skeletal musculature, presence of misregistration artifact, and radiation doses to workers for each PET/CT study were recorded. Sedation was associated with increased volume of 18F-FDG uptake in the musculature of the thoracic limbs (p = .01), cervical (p = .02), and thoracic (p = .03) spine. Increased volume and SUVmax of the musculature assessed altogether were associated with the lighter degree of sedation (p = .04 for both). A significant decrease in the odds of misregistration artifact was observed for anesthetized animals in comparison with sedated (OR: 0.0, 95% CI: 0.0-0.0, p = .01). Radiation doses to workers were significantly higher for sedation compared with general anesthesia (p = .01) and for the anesthesia technician compared with the nuclear medicine technologist (p = .01). Use of sedation for PET/CT studies in dogs and cats is feasible. However, it is associated with increased physiologic musculoskeletal uptake of 18F-FDG in the thoracic limbs, cervical, and thoracic spine, with increased frequency of misregistration artifact, and with increased radiation doses to workers. These limitations can be overcome by recognition of the uptake pattern and monitoring/rotation of the involved staff at institutions where a high caseload is expected.
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Affiliation(s)
- Alexandra F Belotta
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Shannon Beazley
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Matthew Hutcheson
- Safety Resources, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Monique Mayer
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Hugues Beaufrère
- Department of Veterinary Medicine and Epidemiology, UC Davis School of Veterinary Medicine, Davis, California, USA
| | - Sally Sukut
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Martin TW, Griffin L. Prospective pilot study utilizing changes in quantitative values obtained on serial fluorine-18 fluorodeoxyglucose ( 18F-FDG) positron emission tomography-computed tomography (PET/CT) in dogs with appendicular osteosarcoma before and after stereotactic body radiation therapy (SBRT) and carboplatin chemotherapy to assess for prediction of survival and therapeutic effectiveness. Vet Radiol Ultrasound 2024; 65:408-416. [PMID: 38655687 DOI: 10.1111/vru.13361] [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: 11/30/2023] [Revised: 01/24/2024] [Accepted: 03/10/2024] [Indexed: 04/26/2024] Open
Abstract
Serial fluorine 18 fluorodeoxyglucose (18F-FDG) positron emission tomography-CT (PET/CT) is commonly used in human oncology to prognosticate and evaluate for therapeutic effectiveness. In this pilot study, dogs with naturally occurring appendicular osteosarcoma were evaluated with serial 18F-FDG PET/CT in an attempt to assess for response to therapy, prognostic factors, and appropriateness of imaging intervals. Fourteen dogs were enrolled in the trial. All dogs had the initial 18F-FDG PET/CT (PET1), with nine dogs having their end-of-therapy 18F-FDG PET/CT (EoT PET) 3 months after stereotactic body radiation therapy (SBRT) to the primary tumor. The median percent change from the PET1 to the EoT PET for the standard uptake value maximum (SUVmax%) was -58% (range: -17 to -88%), metabolic tumor volume (MTV%) was -99.8% (range: -65 to -100%), and total lesion glycolysis (TLG%) was -99.8% (range: -75 to -100%), all of which were significant (P < .05, <.05, and <.05, respectively). On evaluation, it was found that volumes of GTV and CTV were significant for survival (P < .05 and <.05), MTV1, TLG1, and SUVmax on the EoT PET (SUVmaxEoT) were predictive of metastasis (P < .05), and the SUVmax% was significantly correlated to the time to first event (P < .05). Based on this data, serial 18F-FDG PET/CT performed 3 months after SBRT can show a significant reduction in avidity, and the quantitative data collected may help predict metastatic disease in canine appendicular osteosarcoma.
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Affiliation(s)
- Tiffany W Martin
- Department of Clinical Sciences, Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado, USA
| | - Lynn Griffin
- VCA Canada Central Victoria Veterinary Hospital, Victoria, British Columbia, Canada
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Bryan JN. Updates in Osteosarcoma. Vet Clin North Am Small Anim Pract 2024; 54:523-539. [PMID: 38158305 DOI: 10.1016/j.cvsm.2023.12.007] [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] [Indexed: 01/03/2024]
Abstract
Clinical care of osteosarcoma (OSA) in dogs has seen little change during the past 2 decades, relying on amputation and platinum-based chemotherapy for pain control and survival. Recent advancements offer hope for improved outcomes. Genomic research reveals shared genetic abnormalities between canine and human OSA. Multidimensional imaging provides valuable staging and prognostic information. Limb-sparing approaches including stereotactic body radiation therapy are routine. Ablative therapies such as microwave ablation and histotripsy show promise. Immunotherapy including cell therapy and immune checkpoint inhibition are available. Radiopharmaceuticals are tuned to target OSA cells directly. These innovations may enhance treatment and prognosis for dogs with OSA.
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Affiliation(s)
- Jeffrey N Bryan
- Comparative Oncology Radiobiology and Epigenetics Laboratory, University of Missouri Columbia, Ellis Fischel Cancer Center, 900 East Campus Drive, Columbia, MO 65211, USA.
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Brody A, Crooks JC, French JM, Lang LG, Randall EK, Griffin LR. Staging canine patients with appendicular osteosarcoma utilizing fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography compared to whole body computed tomography. Vet Comp Oncol 2022; 20:541-550. [PMID: 35166445 DOI: 10.1111/vco.12805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 01/21/2022] [Accepted: 02/10/2022] [Indexed: 11/30/2022]
Abstract
Few studies have investigated the diagnostic performance of fluorine-18-fluorodeoxyglucose (18 F-FDG) positron emission tomography/computed tomography (PET/CT) for staging veterinary patients with appendicular osteosarcoma. The purpose of this study was to evaluate the efficacy of 18 F-FDG-PET/CT compared to whole-body CT (WBCT) for staging canine patients with appendicular osteosarcoma. The 18 F-FDG-PET/CT imaging studies of 66 dogs with appendicular osteosarcoma were anonymized and separated into two detached studies (one with whole body pre- and post-contrast CT images and the other with the whole body pre- and post-contrast CT images with the associated 18 F-FDG-PET overlay). Image assessment was performed retrospectively by five board-certified veterinary radiologists. The radiologists were instructed to assign a predefined categorical score to each pre-designated anatomic region based on a devised lesional scoring system. A score of 1 was normal, 2 abnormal but not neoplastic, 3 abnormal and concerning for neoplasia, and 4 abnormal, most likely neoplastic. Overall, the likelihood of detection of '3 or 4' was found to be significantly higher with 18 F-FDG PET/CT when compared to WBCT after adjusting for the effect of evaluator and the subject. Most significantly, 13 osseous lesions concerning for metastasis (scored 3-4) were identified in 10/66 dogs by at least one reviewer on 18 F-FDG PET/CT, which were not identified by any reviewer on WBCT. Additionally, four comorbid neoplastic lesions were identified with 18 F-FDG PET/CT and not with WBCT. The results of this study suggest that 18 F-FDG PET/CT is more efficacious in detecting metastatic and comorbid neoplastic lesions compared to WBCT in dogs with appendicular osteosarcoma. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Ariel Brody
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Veterinary Teaching Hospital, 300 West Drake Road, Fort Collins, CO, 80523 (Brody, Crooks, Lang, Randall, Griffin). Antech Imaging Services, 17620 Mt Herrmann St. Fountain Valley, California 92708, (French) United States
| | - J Clifton Crooks
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Veterinary Teaching Hospital, 300 West Drake Road, Fort Collins, CO, 80523 (Brody, Crooks, Lang, Randall, Griffin). Antech Imaging Services, 17620 Mt Herrmann St. Fountain Valley, California 92708, (French) United States
| | - John M French
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Veterinary Teaching Hospital, 300 West Drake Road, Fort Collins, CO, 80523 (Brody, Crooks, Lang, Randall, Griffin). Antech Imaging Services, 17620 Mt Herrmann St. Fountain Valley, California 92708, (French) United States
| | - Linda G Lang
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Veterinary Teaching Hospital, 300 West Drake Road, Fort Collins, CO, 80523 (Brody, Crooks, Lang, Randall, Griffin). Antech Imaging Services, 17620 Mt Herrmann St. Fountain Valley, California 92708, (French) United States
| | - Elissa K Randall
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Veterinary Teaching Hospital, 300 West Drake Road, Fort Collins, CO, 80523 (Brody, Crooks, Lang, Randall, Griffin). Antech Imaging Services, 17620 Mt Herrmann St. Fountain Valley, California 92708, (French) United States
| | - Lynn R Griffin
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Veterinary Teaching Hospital, 300 West Drake Road, Fort Collins, CO, 80523 (Brody, Crooks, Lang, Randall, Griffin). Antech Imaging Services, 17620 Mt Herrmann St. Fountain Valley, California 92708, (French) United States
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