1
|
Shegani A, Kealey S, Luzi F, Basagni F, Machado JDM, Ekici SD, Ferocino A, Gee AD, Bongarzone S. Radiosynthesis, Preclinical, and Clinical Positron Emission Tomography Studies of Carbon-11 Labeled Endogenous and Natural Exogenous Compounds. Chem Rev 2023; 123:105-229. [PMID: 36399832 PMCID: PMC9837829 DOI: 10.1021/acs.chemrev.2c00398] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Indexed: 11/19/2022]
Abstract
The presence of positron emission tomography (PET) centers at most major hospitals worldwide, along with the improvement of PET scanner sensitivity and the introduction of total body PET systems, has increased the interest in the PET tracer development using the short-lived radionuclides carbon-11. In the last few decades, methodological improvements and fully automated modules have allowed the development of carbon-11 tracers for clinical use. Radiolabeling natural compounds with carbon-11 by substituting one of the backbone carbons with the radionuclide has provided important information on the biochemistry of the authentic compounds and increased the understanding of their in vivo behavior in healthy and diseased states. The number of endogenous and natural compounds essential for human life is staggering, ranging from simple alcohols to vitamins and peptides. This review collates all the carbon-11 radiolabeled endogenous and natural exogenous compounds synthesised to date, including essential information on their radiochemistry methodologies and preclinical and clinical studies in healthy subjects.
Collapse
Affiliation(s)
- Antonio Shegani
- School
of Biomedical Engineering & Imaging Sciences, King’s College London, King’s Health Partners, St Thomas’ Hospital, London SE1 7EH, United Kingdom
| | - Steven Kealey
- School
of Biomedical Engineering & Imaging Sciences, King’s College London, King’s Health Partners, St Thomas’ Hospital, London SE1 7EH, United Kingdom
| | - Federico Luzi
- School
of Biomedical Engineering & Imaging Sciences, King’s College London, King’s Health Partners, St Thomas’ Hospital, London SE1 7EH, United Kingdom
| | - Filippo Basagni
- Department
of Pharmacy and Biotechnology, Alma Mater
Studiorum−University of Bologna, via Belmeloro 6, 40126 Bologna, Italy
| | - Joana do Mar Machado
- School
of Biomedical Engineering & Imaging Sciences, King’s College London, King’s Health Partners, St Thomas’ Hospital, London SE1 7EH, United Kingdom
| | - Sevban Doğan Ekici
- School
of Biomedical Engineering & Imaging Sciences, King’s College London, King’s Health Partners, St Thomas’ Hospital, London SE1 7EH, United Kingdom
| | - Alessandra Ferocino
- Institute
of Organic Synthesis and Photoreactivity, Italian National Research Council, via Piero Gobetti 101, 40129 Bologna, Italy
| | - Antony D. Gee
- School
of Biomedical Engineering & Imaging Sciences, King’s College London, King’s Health Partners, St Thomas’ Hospital, London SE1 7EH, United Kingdom
| | - Salvatore Bongarzone
- School
of Biomedical Engineering & Imaging Sciences, King’s College London, King’s Health Partners, St Thomas’ Hospital, London SE1 7EH, United Kingdom
| |
Collapse
|
2
|
Higgins MCSS, Soulen MC. Combining locoregional therapies in the treatment of hepatocellular carcinoma. Semin Intervent Radiol 2014; 30:74-81. [PMID: 24436520 DOI: 10.1055/s-0033-1333656] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In an effort to promote more durable local control of larger lesions, thermal ablation has been combined with chemical ablative techniques and with vaso-occlusive procedures such as chemoembolization and bland embolization in an effort to mitigate the limitations inherent in the use of any single treatment for hepatocellular carcinoma (HCC) >3 cm. The heat-sink effect is the underlying principle for combining vaso-occlusive therapies with ablative techniques. Combination therapies do present viable options for abrogating tumor progression and potentially downsizing tumors to facilitate transplant. We discuss the two most commonly used combination locoregional therapies by the interventionalist and the evidence defining the best techniques in practice.
Collapse
Affiliation(s)
| | - Michael C Soulen
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|
3
|
Oxidation of ethanol in the rat brain and effects associated with chronic ethanol exposure. Proc Natl Acad Sci U S A 2013; 110:14444-9. [PMID: 23940368 DOI: 10.1073/pnas.1306011110] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
It has been reported that chronic and acute alcohol exposure decreases cerebral glucose metabolism and increases acetate oxidation. However, it remains unknown how much ethanol the living brain can oxidize directly and whether such a process would be affected by alcohol exposure. The questions have implications for reward, oxidative damage, and long-term adaptation to drinking. One group of adult male Sprague-Dawley rats was treated with ethanol vapor and the other given room air. After 3 wk the rats received i.v. [2-(13)C]ethanol and [1, 2-(13)C2]acetate for 2 h, and then the brain was fixed, removed, and divided into neocortex and subcortical tissues for measurement of (13)C isotopic labeling of glutamate and glutamine by magnetic resonance spectroscopy. Ethanol oxidation was seen to occur both in the cortex and the subcortex. In ethanol-naïve rats, cortical oxidation of ethanol occurred at rates of 0.017 ± 0.002 µmol/min/g in astroglia and 0.014 ± 0.003 µmol/min/g in neurons, and chronic alcohol exposure increased the astroglial ethanol oxidation to 0.028 ± 0.002 µmol/min/g (P = 0.001) with an insignificant effect on neuronal ethanol oxidation. Compared with published rates of overall oxidative metabolism in astroglia and neurons, ethanol provided 12.3 ± 1.4% of cortical astroglial oxidation in ethanol-naïve rats and 20.2 ± 1.5% in ethanol-treated rats. For cortical astroglia and neurons combined, the ethanol oxidation for naïve and treated rats was 3.2 ± 0.3% and 3.8 ± 0.2% of total oxidation, respectively. (13)C labeling from subcortical oxidation of ethanol was similar to that seen in cortex but was not affected by chronic ethanol exposure.
Collapse
|
4
|
Tomasi G, Turkheimer F, Aboagye E. Importance of quantification for the analysis of PET data in oncology: review of current methods and trends for the future. Mol Imaging Biol 2012; 14:131-46. [PMID: 21842339 DOI: 10.1007/s11307-011-0514-2] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
In oncology, positron emission tomography (PET) is an important tool for tumour diagnosis and staging, assessment of response to treatment and evaluation of the pharmacokinetic properties and efficacy of new drugs. Despite its quantitative potential, however, in daily clinical practice PET is used almost exclusively with 2-deoxy-2-[(18)F]fluoro-D-glucose ([(18)F]FDG) and, in addition, [(18)F]FDG data are normally assessed visually or using simple indices as the standardised uptake value (SUV). After explaining why more sophisticated quantification methods can be useful in oncology, the paper reviews the approaches that are commonly used and those available but not routinely employed. Particular emphasis is addressed to the SUV, for its importance in clinical practice. Issues specific to PET quantification in oncology and related examples are then discussed. Finally, some ideas for the development of new quantitative methods for analysing PET data in oncology and for the application of approaches already existing but not commonly employed are presented.
Collapse
Affiliation(s)
- Giampaolo Tomasi
- Comprehensive Cancer Imaging Center, Imperial College, Hammersmith Hospital London, London W120NN, UK
| | | | | |
Collapse
|
5
|
Xiang Y, Shen J. In vivo detection of intermediate metabolic products of [1-(13) C]ethanol in the brain using (13) C MRS. NMR IN BIOMEDICINE 2011; 24:1054-62. [PMID: 21312308 PMCID: PMC3400341 DOI: 10.1002/nbm.1653] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Revised: 09/29/2010] [Accepted: 11/07/2010] [Indexed: 05/30/2023]
Abstract
In this study, in vivo (13) C MRS was used to investigate the labeling of brain metabolites after intravenous administration of [1-(13) C]ethanol. After [1-(13) C]ethanol had been administered systemically to rats, (13) C labels were detected in glutamate, glutamine and aspartate in the carboxylic and amide carbon spectral region. (13) C-labeled bicarbonate HCO 3- (161.0 ppm) was also detected. Saturating acetaldehyde C1 at 207.0 ppm was found to have no effect on the ethanol C1 (57.7 ppm) signal intensity after extensive signal averaging, providing direct in vivo evidence that direct metabolism of alcohol by brain tissue is minimal. To compare the labeling of brain metabolites by ethanol with labeling by glucose, in vivo time course data were acquired during intravenous co-infusion of [1-(13) C]ethanol and [(13) C(6) ]-D-glucose. In contrast with labeling by [(13) C(6) ]-D-glucose, which produced doublets of carboxylic/amide carbons with a J coupling constant of 51 Hz, the simultaneously detected glutamate and glutamine singlets were labeled by [1-(13) C]ethanol. As (13) C labels originating from ethanol enter the brain after being converted into [1-(13) C]acetate in the liver, and the direct metabolism of ethanol by brain tissue is negligible, it is suggested that orally or intragastrically administered (13) C-labeled ethanol may be used to study brain metabolism and glutamatergic neurotransmission in investigations involving alcohol administration. In vivo (13) C MRS of rat brain following intragastric administration of (13) C-labeled ethanol is demonstrated.
Collapse
Affiliation(s)
- Yun Xiang
- Molecular Imaging Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, Bethesda, MD, United States
| | - Jun Shen
- Molecular Imaging Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, Bethesda, MD, United States
| |
Collapse
|
6
|
Gao F, Gu YK, Fan WJ, Zhang L, Huang JH. Evaluation of transarterial chemoembolization combined with percutaneous ethanol ablation for large hepatocellular carcinoma. World J Gastroenterol 2011; 17:3145-50. [PMID: 21912458 PMCID: PMC3158415 DOI: 10.3748/wjg.v17.i26.3145] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2011] [Revised: 03/24/2011] [Accepted: 03/31/2011] [Indexed: 02/06/2023] Open
Abstract
AIM: To assess the effects of combined transcatheter arterial chemoembolization (TACE) and percutaneous ethanol ablation (PEA) in patients with large hepatocellular carcinoma (HCC).
METHODS: A total of 63 patients with unresectable large HCC were treated with TACE followed by PEA. The largest dimension of the tumors ranged from 5.3 cm to 17.8 cm. The survival rates, acute effects, toxicity and prognostic factors were analyzed.
RESULTS: The cumulative survival rates at 1, 3 and 5 years were 59.4%, 28.4% and 15.8%, respectively (a median survival of 27.7 mo). Tumor area was reduced by more than 50% in 30 (47.6%) cases. In 56 cases with increased α-fetoprotein (AFP) values, AFP level was declined by more than 75%. The combined therapy was generally well tolerated. Only two patients died from variceal bleeding associated with the therapy. The Cox proportional hazards model showed that the number of tumors, the tumor margin and the ethanol dose were independent prognostic factors.
CONCLUSION: The combined TACE and PEA therapy is a promising approach for unresectable large HCC.
Collapse
|
7
|
Ho CS, Kachura JR, Gallinger S, Grant D, Greig P, McGilvray I, Knox J, Sherman M, Wong F, Wong D. Percutaneous Ethanol Injection of Unresectable Medium-to-Large-Sized Hepatomas Using a Multipronged Needle: Efficacy and Safety. Cardiovasc Intervent Radiol 2007; 30:241-7. [PMID: 17200905 DOI: 10.1007/s00270-005-0169-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Fine needles with an end hole or multiple side holes have traditionally been used for percutaneous ethanol injection (PEI) of hepatomas. This study retrospectively evaluates the safety and efficacy of PEI of unresectable medium-to-large (3.5-9 cm) hepatomas using a multipronged needle and with conscious sedation. Twelve patients, eight men and four women (age 51-77 years; mean: 69) received PEI for hepatomas, mostly subcapsular or exophytic in location with average tumor size of 5.6 cm (range: 3.5-9.0 cm). Patients were consciously sedated and an 18G retractable multipronged needle (Quadrafuse needle; Rex Medical, Philadelphia, PA) was used for injection under real-time ultrasound guidance. By varying the length of the prongs and rotating the needle, the alcohol was widely distributed within the tumor. The progress of ablation was monitored by contrast-enhanced ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) after each weekly injection and within a month after the final (third) injection and 3 months thereafter. An average total of 63 mL (range: 20-154 ml) of alcohol was injected per patient in an average of 2.3 sessions. Contrast-enhanced CT, ultrasound, or MRI was used to determine the degree of necrosis. Complete necrosis was noted in eight patients (67%), near-complete necrosis (90-99%) in two (16.7%), and partial success (50-89%) in two (16.7%). Follow-up in the first 9 months showed local recurrence in two patients and new lesions in another. There was no mortality. One patient developed renal failure, liver failure, and localized perforation of the stomach. He responded to medical treatment and surgery was not required for the perforation. One patient had severe postprocedural abdominal pain and fever, and another had transient hyperbilirubinemia; both recovered with conservative treatment. PEI with a multipronged needle is a new, safe, and efficacious method in treating medium-to-large-sized hepatocellular carcinoma under conscious sedation. Its survival benefits require further investigations.
Collapse
Affiliation(s)
- C S Ho
- Department of Medical Imaging, University of Toronto, University Health Network and Mt Sinai Hospital, Toronto, Canada.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Dettmer A, Kirchhoff TD, Gebel M, Zender L, Malek NP, Panning B, Chavan A, Rosenthal H, Kubicka S, Krusche S, Merkesdal S, Galanski M, Manns MP, Bleck JS. Combination of repeated single-session percutaneous ethanol injection and transarterial chemoembolisation compared to repeated single-session percutaneous ethanol injection in patients with non-resectable hepatocellular carcinoma. World J Gastroenterol 2006; 12:3707-15. [PMID: 16773687 PMCID: PMC4087463 DOI: 10.3748/wjg.v12.i23.3707] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the treatment effect of percutaneous ethanol injection (PEI) for patients with advanced, non-resectable HCC compared with combination of transarterial chemoembolisation (TACE) and repeated single-session PEI, repeated single-session PEI alone, repeated TACE alone, or best supportive care.
METHODS: All patients who received PEI treatment during the study period were included and stratified to one of the following treatment modalities according to physical status and tumor extent: combination of TACE and repeated single-session PEI, repeated single-session PEI alone, repeated TACE alone, or best supportive care. Prognostic value of clinical parameters including Okuda-classification, presence of portal vein thrombosis, presence of ascites, number of tumors, maximum tumor diameter, and serum cholinesterase (CHE), as well as Child-Pugh stage, α-fetoprotein (AFP), fever, incidence of complications were assessed and compared between the groups. Survival was determined using Kaplan-Meier and multivariate regression analyses.
RESULTS: The 1- and 3-year survival of all patients was 73% and 47%. In the subgroup analyses, the combination of TACE and PEI (1) was associated with a longer survival (1-, 3-, 5-year survival: 90%, 52%, and 43%) compared to PEI treatment alone (2) (1-, 3-, 5-year survival: 65%, 50%, and 37%). Secondary PEI after initial stratification to TACE (3) yielded comparable results (1-, 3-, 5-year survival: 91%, 40%, and 30%) while PEI after stratification to best supportive care (4) was associated with decreased survival (1-, 3-, 5-year survival: 50%, 23%, 12%). Apart from the chosen treatment modalities, predictors for better survival were tumor number (n < 5), tumor size (< 5 cm), no ascites before PEI, and stable serum cholinesterase after PEI (P < 0.05). The mortality within 2 wk after PEI was 2.8% (n = 3). There were 24 (8.9%) major complications after PEI including segmental liver infarction, focal liver necrosis, and liver abscess. All complications could be managed non-surgically.
CONCLUSION: Repeated single-session PEI is effective in patients with advanced HCC at an acceptable and manageable complication rate. Patients stratified to a combination of TACE and PEI can expect longer survival than those stratified to repeated PEI alone. Furthermore, patients with large or multiple tumors in good clinical status may also profit from a combination of TACE and reconsideration for secondary PEI.
Collapse
Affiliation(s)
- Arne Dettmer
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Shah SS, Jacobs DL, Krasinkas AM, Furth EE, Itkin M, Clark TWI. Percutaneous Ablation of VX2 Carcinoma–induced Liver Tumors with Use of Ethanol versus Acetic Acid: Pilot Study in a Rabbit Model. J Vasc Interv Radiol 2004; 15:63-7. [PMID: 14709691 DOI: 10.1097/01.rvi.0000106388.63463.9a] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Acetic acid has been employed as a chemical ablation agent for liver tumors because of its superior diffusion characteristics compared with ethanol and the resulting requirement for smaller volumes and fewer injection sessions. Early tissue changes were compared after injection of acetic acid and ethanol in a rabbit model of hepatocellular carcinoma. MATERIALS AND METHODS VX2 tumors were created in the left lobe of the liver in 11 male New Zealand White rabbits. Each animal underwent a midline minilaparotomy to expose the tumor-laden left lobe, followed by injection of 1.0 mL of 100% ethanol (n = 5) or 50% acetic acid (n = 6) with use of a 20-gauge infusion needle. Animals were killed 30 minutes after surgery; explanted livers were sectioned and examined for gross and microscopic changes. RESULTS Injection of each agent produced rapid diffusion through tumor and surrounding hepatic parenchyma, with immediate protein precipitation manifested by blanching as a result of coagulation effect. The sizes of coagulation zones, expressed as mean products of the maximum perpendicular diameters of tumoral diffusion, were 13.0 cm(2) +/- 9.4 and 1.3 cm(2) +/- 1.8 for acetic acid and ethanol, respectively (P =.049). No differences in histologic changes were seen between agents. CONCLUSIONS In this animal model, acetic acid produced significantly larger zones of tumor coagulation compared with ethanol when injected into VX2 carcinoma in equal volumes. Further evaluation is necessary before these findings can be extrapolated to a clinical setting.
Collapse
Affiliation(s)
- Samir S Shah
- Section of Vascular and Interventional Radiology, Hospital of the University of Pennsylvania, 1 Silverstein, 3400 Spruce Street, Philadelphia, Pennsylvania 19104, USA
| | | | | | | | | | | |
Collapse
|
10
|
Abstract
Hepatocellular carcinoma (HCC) is one of the most common malignancies in the world, responsible for an estimated one million deaths annually. It has a poor prognosis due to its rapid infiltrating growth and complicating liver cirrhosis. Surgical resection, liver transplantation and cryosurgery are considered the best curative options, achieving a high rate of complete response, especially in patients with small HCC and good residual liver function. In nonsurgery, regional interventional therapies have led to a major breakthrough in the management of unresectable HCC, which include transarterial chemoembolization (TACE), percutaneous ethanol injection (PEI), radiofrequency ablation (RFA), microwave coagulation therapy (MCT), laser-induced thermotherapy (LITT), etc. As a result of the technical development of locoregional approaches for HCC during the recent decades, the range of combined interventional therapies has been continuously extended. Most combined multimodal interventional therapies reveal their enormous advantages as compared with any single therapeutic regimen alone, and play more important roles in treating unresectable HCC.
Collapse
Affiliation(s)
- Jun Qian
- Department of Radiology, Xiehe Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China.
| | | | | |
Collapse
|
11
|
Thireou T, Strauss LG, Dimitrakopoulou-Strauss A, Kontaxakis G, Pavlopoulos S, Santos A. Performance evaluation of principal component analysis in dynamic FDG-PET studies of recurrent colorectal cancer. Comput Med Imaging Graph 2003; 27:43-51. [PMID: 12573889 DOI: 10.1016/s0895-6111(02)00050-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Performance evaluation of principal component analysis (PCA) of dynamic F-18-FDG-PET studies of patients with recurrent colorectal cancer. Principal component images (PCI) of 17 iteratively reconstructed data sets were visually and quantitatively evaluated. The F-18-FDG compartment model parameters were estimated using polynomial regression. All structures were present in PCI1. PCI2 was correlated with the vascular component and PCI3 with the tumor. The vessel density in the tumor was estimated with a correlation coefficient equal to 0.834. PCA supports the visual interpretation of dynamic F-18-FDG-PET studies, facilitates the application of compartment modeling and is a promising quantification technique.
Collapse
Affiliation(s)
- Trias Thireou
- Biomedical Engineering Laboratory, National Technical University of Athens, Iroon Polytechniou 9, GR-15773 Athens, Greece.
| | | | | | | | | | | |
Collapse
|
12
|
Arrivé L, Rosmorduc O, Dahan H, Fartoux L, Monnier-Cholley L, Lewin M, Poupon R, Tubiana JM. Percutaneous acetic acid injection for hepatocellular carcinoma: using CT fluoroscopy to evaluate distribution of acetic acid mixed with an iodinated contrast agent. AJR Am J Roentgenol 2003; 180:159-62. [PMID: 12490495 DOI: 10.2214/ajr.180.1.1800159] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of our study is to evaluate the distribution of acetic acid mixed with iodinated contrast agent during percutaneous acetic acid injection on CT fluoroscopy for hepatocellular carcinoma. CONCLUSION Monitoring acetic acid distribution on CT fluoroscopy can detect extratumoral diffusion and may optimize the distribution of acetic acid in hepatocellular carcinoma.
Collapse
Affiliation(s)
- Lionel Arrivé
- Service de Radiologie, Hôpital Saint-Antoine, 184 Rue du Faubourg Saint Antoine, 75012 Paris Cedex, France
| | | | | | | | | | | | | | | |
Collapse
|
13
|
Abstract
Chemical ablation with absolute ethanol is the most established technique of imaging-guided regional therapy for small hepatocellular carcinomas (HCCs), with long-term survival rates that rival those of surgical resection. In this article, the authors review patient selection criteria, techniques (including the one-shot approach of ethanol ablation for HCCs larger than 3 cm), complications, follow-up, and outcomes. The use of agents other than ethanol and the combination of chemical ablation with chemoembolization is also discussed.
Collapse
Affiliation(s)
- Timothy W I Clark
- Section of Vascular and Interventional Radiology, Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
| | | |
Collapse
|
14
|
Pham KH, Ramaswamy MR, Hawkins RA. Advances in positron emission tomography imaging for the GI tract. Gastrointest Endosc 2002; 55:S53-63. [PMID: 12024124 DOI: 10.1067/mge.2002.124741] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Kelly H Pham
- University of California-San Francisco Medical Center, San Francisco, California 94122, USA
| | | | | |
Collapse
|
15
|
Abstract
Positron emission tomography (PET) scanning with F18-fluorodeoxyglucose or FDG is a becoming a standard method for tumor staging. The prediction and evaluation of therapy response are newer applications of FDG-PET. PET often offers an early readout of treatment efficacy and is an attractive alternative to conventional anatomic assessments of treatment response. This article reviews the methods available with PET to monitor therapy response. Disease specific applications of PET imaging are then reviewed. While FDG is the most commonly used radiotracer for PET, many other radioligands could be applied in the future.
Collapse
Affiliation(s)
- Christian Cohade
- Division of Nuclear Medicine, The Johns Hopkins Hospital, Baltimore, Maryland 21287-0817, USA
| | | |
Collapse
|
16
|
Chen CH, Chen JC, Chou KL, Wu LC, Liu RS. Optimized protocols in terms of equalizing the true and accidental coincidences of each bed position in static multiple bed position carbon-11 PET studies and a target single bed position study. Nucl Med Commun 2001; 22:1061-8. [PMID: 11567177 DOI: 10.1097/00006231-200110000-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Quantitative carbon-11 (11C) positron emission tomography (PET) is gaining more attention in oncological applications. In addition, it was discovered that accidental coincidences (randoms) can play an important role in studies such as partial volume effects correction without needing to use anatomical information. However, because of the short half-life of 11C, a homogeneous multiple bed position 11C image is hard to obtain. This study aimed to determine whether innovative pseudogating, optimized pseudogating and optimized double-up methods could match the true counts and randoms to each bed position and to a target single bed position study. A long cylindrical phantom filled with [11C]acetate was scanned by a dedicated PET scanner using six protocols: whole body, frame-duration-compensated whole body, double-up, optimized double-up, pseudogating, and optimized pseudogating. The differences between the protocols are in the initial activity, frame duration and frame number for each bed position. The parameters for pseudogating were determined according to the theory that true counts and randoms are proportional to the radioactivity and its square, respectively. The results show that the stated goals could only be achieved by pseudogating and optimized pseudogating. We conclude that pseudogating or optimized pseudogating must be applied for a critical quantitative study. However, optimized double-up and double-up methods are good alternatives for semi-quantitative and qualitative studies, respectively.
Collapse
Affiliation(s)
- C H Chen
- National PET/Cyclotron Center, Department of Medical Radiation Technology and Institute of Radiological Sciences, School of Medical Technology and Engineering, National Yang-Ming University, Taiwan
| | | | | | | | | |
Collapse
|
17
|
Koda M, Murawaki Y, Mitsuda A, Oyama K, Okamoto K, Idobe Y, Suou T, Kawasaki H. Combination therapy with transcatheter arterial chemoembolization and percutaneous ethanol injection compared with percutaneous ethanol injection alone for patients with small hepatocellular carcinoma: a randomized control study. Cancer 2001; 92:1516-24. [PMID: 11745230 DOI: 10.1002/1097-0142(20010915)92:6<1516::aid-cncr1477>3.0.co;2-i] [Citation(s) in RCA: 101] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND To assess whether the effectiveness of a combination of transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) is superior to PEI alone in the treatment of patients with small hepatocellular carcinoma (HCC), a randomized controlled study was performed. METHODS Fifty-two patients with one to three HCC tumors measuring < than 3 cm in greatest dimension were enrolled and underwent the combination TACE-PEI therapy (26 patients with 31 nodules) or PEI alone (26 patients with 34 nodules). There were no significant differences in background between the two groups. The mean follow-up was 30.1 months +/- 17.5 months. RESULTS The cumulative detection rates of local residual disease in the TACE-PEI group (3.7% at 1 year and 19.3% at 3 years) were significantly lower compared with the detection rates in the PEI alone group (34.2% and 39.3%, respectively; P = 0.013). The cumulative new nodular recurrence rates in the TACE-PEI group (8.7% at 1 year and 19.3% at 3 years) tended to be lower compared with the recurrence rates in the PEI alone group (26.9% and 80.1%, respectively; P = 0.057). The cumulative survival rates were not significantly different between the two groups (TACE-PEI group: 100%, 80.8%, and 40.4% at 1 year, 3 years, and 5 years, respectively; PEI alone group: 91.3%, 65.9%, and 37.7%, respectively; P = 0.458). However, among the patients from each group with HCC tumors measuring < 2 cm, the survival rates in the TACE-PEI group were improved compared with the survival rates in the PEI alone group (P < 0.01) in addition to the detection rates of local residual disease and the new nodular recurrence rates (P < 0.01 and P = 0.047, respectively). The frequency of short-term and long-term adverse effects was not significantly different between the groups. However, only two major complications (biloma and ascites with pleural effusion) were observed, both of which occurred in patients in the TACE-PEI group. CONCLUSIONS Combination therapy with TACE-PEI was superior to PEI alone in the treatment of patients with small HCC tumors, especially for patients with HCC tumors measuring < 2 cm in greatest dimension.
Collapse
Affiliation(s)
- M Koda
- Second Department of Internal Medicine, Faculty of Medicine, Tottori University, Tottori, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
18
|
Alavi A, Sam JW, Zhuang H. PET Imaging in Oncologic Patients. J Vasc Interv Radiol 2001. [DOI: 10.1016/s1051-0443(01)70116-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|