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Kaneko K, Nagao M, Ueda K, Yamamoto A, Sakai S. Simultaneous evaluation of brain metastasis and thoracic cancer using semiconductor 11C-methionine PET/CT imaging. Ann Nucl Med 2024; 38:278-287. [PMID: 38386272 DOI: 10.1007/s12149-024-01908-6] [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: 10/18/2023] [Accepted: 12/27/2023] [Indexed: 02/23/2024]
Abstract
OBJECTIVE To investigate the potential of whole-body digital 11C-methionine (MET) PET/CT imaging for simultaneous evaluation of thoracic cancer patients suspected of local recurrence (LR) after stereotactic radiosurgery (SRS) for brain metastasis. METHODS A total of 45 lung or breast cancer patients suspected of LR after SRS were investigated using brain and whole-body MET-PET/CT scans. We compared the tumor-to-normal ratio (TNR) and maximum standardized uptake values (SUVmax) between patients with LR and radiation necrosis (RN) and performed receiver operating characteristic (ROC) analyses. We also investigated associations among extracranial recurrence, intracranial recurrence, primary site, and initial treatment type. RESULTS A total of 44 LR and 14 RN lesions were analyzed. In the ROC analyses for differentiating LR from RN, TNR showed higher area under the curve (AUC) (0.82) than SUVmax (0.79), and the cutoff TNR value (2.12) was higher than current cutoff values of conventional PET systems. The whole-body scans detected extracranial recurrences in 31.1% of the patients. Recurrence rates were not significantly correlated with existence of intracranial recurrence or primary site, but patients who underwent non-surgical treatment (consisting of stage III/ IV patients according to the Union for International Cancer Control TNM classification or small-cell lung cancer patients) showed significantly higher recurrence than the surgically treated patients (68.8% vs. 10.3%, p = 0.0001). CONCLUSION In digital MET-PET/CT imaging, TNR was a more useful parameter to differentiate LR from RN than SUVmax, and the cutoff value was higher than those with conventional PET systems. Additional whole-body scans could detect extracranial recurrence and would be especially useful for advanced thoracic cancer patients who underwent non-surgical treatment.
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Affiliation(s)
- Koichiro Kaneko
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
| | - Michinobu Nagao
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Kaori Ueda
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Atsushi Yamamoto
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Shuji Sakai
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
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Hagedorn KN, Nelson AT, Towbin AJ, Frederickson N, Mallinger P, Lucas JT, Dehner LP, Messinger YH, Shulkin BL, Mize WA, Schultz KAP. Assessing the role of positron emission tomography and bone scintigraphy in imaging of pleuropulmonary blastoma (PPB): A report from the International PPB/DICER1 Registry. Pediatr Blood Cancer 2023; 70:e30628. [PMID: 37592371 PMCID: PMC10538369 DOI: 10.1002/pbc.30628] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/11/2023] [Accepted: 08/06/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Pleuropulmonary blastoma (PPB) is the most common primary lung neoplasm of infancy and early childhood. Given the rarity of PPB, the role of positron emission tomography (PET) and bone scintigraphy (bone scans) in diagnostic evaluation and surveillance has not been documented to date. Available PET and bone scan data are presented in this study. PROCEDURES Patients with PPB enrolled in the International PPB/DICER1 Registry and available PET imaging and/or bone scan reports were retrospectively abstracted. RESULTS On retrospective analysis, 133 patients with type II and III (advanced) PPB were identified with available report(s) (PET scan only = 34, bone scan only = 83, and both bone scan and PET = 16). All advanced primary PPB (n = 11) and recurrent (n = 8) tumors prior to treatment presented with 18 F-fluorodeoxyglucose (FDG)-avid lesions, with median maximum standardized uptake values of 7.4 and 6.7, respectively. False positive FDG uptake in the thorax was noted during surveillance (specificity: 59%). Bone metastases were FDG-avid prior to treatment. Central nervous system metastases were not discernable on PET imaging. Sensitivity and specificity of bone scans for metastatic bone disease were 89% and 92%, respectively. Bone scans had a negative predictive value of 99%, although positive predictive value was 53%. Four patients with distant bone metastases had concordant true positive bone scan and PET. CONCLUSION Primary, recurrent, and/or extracranial metastatic PPB presents with an FDG-avid lesion on PET imaging. Additional prospective studies are needed to fully assess the utility of nuclear medicine imaging in surveillance for patients with advanced PPB.
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Affiliation(s)
| | - Alexander T. Nelson
- International Pleuropulmonary Blastoma/DICER1 Registry, Children’s Minnesota, Minneapolis, MN
- International Ovarian and Testicular Stromal Tumor Registry, Children’s Minnesota, Minneapolis, MN
- Cancer and Blood Disorders, Children’s Minnesota, Minneapolis, MN
- University of Minnesota Medical School, Minneapolis, MN
| | - Alexander J. Towbin
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Nicole Frederickson
- International Pleuropulmonary Blastoma/DICER1 Registry, Children’s Minnesota, Minneapolis, MN
- International Ovarian and Testicular Stromal Tumor Registry, Children’s Minnesota, Minneapolis, MN
- Cancer and Blood Disorders, Children’s Minnesota, Minneapolis, MN
| | - Paige Mallinger
- International Pleuropulmonary Blastoma/DICER1 Registry, Children’s Minnesota, Minneapolis, MN
- International Ovarian and Testicular Stromal Tumor Registry, Children’s Minnesota, Minneapolis, MN
- Cancer and Blood Disorders, Children’s Minnesota, Minneapolis, MN
| | - John T. Lucas
- Department of Radiation Oncology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Louis P. Dehner
- Lauren V. Ackerman Laboratory of Surgical Pathology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO
| | - Yoav H. Messinger
- International Pleuropulmonary Blastoma/DICER1 Registry, Children’s Minnesota, Minneapolis, MN
- International Ovarian and Testicular Stromal Tumor Registry, Children’s Minnesota, Minneapolis, MN
- Cancer and Blood Disorders, Children’s Minnesota, Minneapolis, MN
| | - Barry L. Shulkin
- Department of Diagnostic Imaging, St. Jude Children’s Research Hospital, Memphis, TN
| | - William A. Mize
- Department of Radiology, Children’s Minnesota, Minneapolis, MN
| | - Kris Ann P. Schultz
- International Pleuropulmonary Blastoma/DICER1 Registry, Children’s Minnesota, Minneapolis, MN
- International Ovarian and Testicular Stromal Tumor Registry, Children’s Minnesota, Minneapolis, MN
- Cancer and Blood Disorders, Children’s Minnesota, Minneapolis, MN
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Urso L, Bonatto E, Nieri A, Castello A, Maffione AM, Marzola MC, Cittanti C, Bartolomei M, Panareo S, Mansi L, Lopci E, Florimonte L, Castellani M. The Role of Molecular Imaging in Patients with Brain Metastases: A Literature Review. Cancers (Basel) 2023; 15:cancers15072184. [PMID: 37046845 PMCID: PMC10093739 DOI: 10.3390/cancers15072184] [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: 02/28/2023] [Revised: 03/28/2023] [Accepted: 04/03/2023] [Indexed: 04/14/2023] Open
Abstract
Over the last several years, molecular imaging has gained a primary role in the evaluation of patients with brain metastases (BM). Therefore, the "Response Assessment in Neuro-Oncology" (RANO) group recommends amino acid radiotracers for the assessment of BM. Our review summarizes the current use of positron emission tomography (PET) radiotracers in patients with BM, ranging from present to future perspectives with new PET radiotracers, including the role of radiomics and potential theranostics approaches. A comprehensive search of PubMed results was conducted. All studies published in English up to and including December 2022 were reviewed. Current evidence confirms the important role of amino acid PET radiotracers for the delineation of BM extension, for the assessment of response to therapy, and particularly for the differentiation between tumor progression and radionecrosis. The newer radiotracers explore non-invasively different biological tumor processes, although more consistent findings in larger clinical trials are necessary to confirm preliminary results. Our review illustrates the role of molecular imaging in patients with BM. Along with magnetic resonance imaging (MRI), the gold standard for diagnosis of BM, PET is a useful complementary technique for processes that otherwise cannot be obtained from anatomical MRI alone.
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Affiliation(s)
- Luca Urso
- Department of Nuclear Medicine PET/CT Centre, S. Maria della Misericordia Hospital, 45100 Rovigo, Italy
| | - Elena Bonatto
- Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Alberto Nieri
- Nuclear Medicine Unit, Oncological Medical and Specialist Department, University Hospital of Ferrara, 44124 Cona, Italy
| | - Angelo Castello
- Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Anna Margherita Maffione
- Department of Nuclear Medicine PET/CT Centre, S. Maria della Misericordia Hospital, 45100 Rovigo, Italy
| | - Maria Cristina Marzola
- Department of Nuclear Medicine PET/CT Centre, S. Maria della Misericordia Hospital, 45100 Rovigo, Italy
| | - Corrado Cittanti
- Nuclear Medicine Unit, Oncological Medical and Specialist Department, University Hospital of Ferrara, 44124 Cona, Italy
- Department of Translational Medicine, University of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
| | - Mirco Bartolomei
- Nuclear Medicine Unit, Oncological Medical and Specialist Department, University Hospital of Ferrara, 44124 Cona, Italy
| | - Stefano Panareo
- Nuclear Medicine Unit, Oncology and Haematology Department, University Hospital of Modena, 41125 Modena, Italy
| | - Luigi Mansi
- Interuniversity Research Center for the Sustainable Development (CIRPS), 00152 Rome, Italy
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS-Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
| | - Luigia Florimonte
- Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Massimo Castellani
- Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
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Galldiks N, Wollring M, Werner JM, Friedrich M, Fink GR, Langen KJ, Lohmann P. An updated review on the diagnosis and assessment of post-treatment relapse in brain metastases using PET. Expert Rev Neurother 2022; 22:915-921. [PMID: 36563186 DOI: 10.1080/14737175.2022.2162880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Brain metastases in patients with extracranial cancer are typically associated with increased morbidity and mortality. Stereotactic radiotherapy and immunotherapy using checkpoint inhibitors currently are essential in brain metastases treatment. Since conventional contrast-enhanced MRI alone cannot reliably differentiate between treatment-induced changes and brain metastasis relapse, several studies investigated the role of PET imaging and, more recently, radiomics, based on routinely acquired PET images, to overcome this clinically relevant challenge. AREAS COVERED The current literature on PET imaging, including radiomics, in patients with brain metastases, focusing on the diagnosis and assessment of post-treatment relapse, is summarized. EXPERT OPINION Available data suggest that imaging parameters, including radiomics features, mainly derived from amino acid PET, are helpful for diagnosis and assessment of post-treatment relapse in patients with brain metastases.
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Affiliation(s)
- Norbert Galldiks
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany.,Inst. of Neuroscience and Medicine (INM-3, -4), Research Center Juelich, Germany.,Center for Integrated Oncology (CIO), Universities of Aachen, Bonn, Germany
| | - Michael Wollring
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany.,Inst. of Neuroscience and Medicine (INM-3, -4), Research Center Juelich, Germany
| | - Jan-Michael Werner
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Michel Friedrich
- Inst. of Neuroscience and Medicine (INM-3, -4), Research Center Juelich, Germany
| | - Gereon R Fink
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany.,Inst. of Neuroscience and Medicine (INM-3, -4), Research Center Juelich, Germany
| | - Karl-Josef Langen
- Inst. of Neuroscience and Medicine (INM-3, -4), Research Center Juelich, Germany.,Center for Integrated Oncology (CIO), Universities of Aachen, Bonn, Germany.,Department of Nuclear Medicine, University Hospital RWTH Aachen, Germany
| | - Philipp Lohmann
- Inst. of Neuroscience and Medicine (INM-3, -4), Research Center Juelich, Germany.,Department of Stereotaxy and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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[ 68Ga]FAPI-PET/CT for radiation therapy planning in biliary tract, pancreatic ductal adeno-, and adenoidcystic carcinomas. Sci Rep 2022; 12:16261. [PMID: 36171444 PMCID: PMC9519639 DOI: 10.1038/s41598-022-20447-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 09/13/2022] [Indexed: 11/08/2022] Open
Abstract
Biliary-tract-carcinomas (BTC), pancreatic-ductal-adenocarcinomas (PDAC) and adenoidcystic-carcinomas (AC) have in common that they are traditionally treated with large clinical-target-volumes (CTV). The aim of this study is to examine the impact of pretreatment-[68Ga]FAPI-PET/CT on target-volume-definition and posttreatment-[68Ga]FAPI-PET/CT-response-assessment for BTC-, PDAC- and AC-patients referred to radiation-therapy. All consecutive BTC-, PDAC-, and AC-patients who received pretreatment-[68Ga]FAPI-PET/CT±[18F]FDG-PET/CT were included from 01.01.2020 to 01.03.2022. MTV and SUVmax were separately generated based on [68Ga]FAPI- and [18F]FDG-PET/CT-images. A [68Ga]FAPI- and [18F]FDG-based-CTV was defined. Treatment-plans were compared. Treatment-response was reassessed by a second [68Ga]FAPI-PET/CT and [18F]FDG-PET/CT after treatment-completion. Intermodality comparison of lesion-to-background-ratios [SUVmax_lesion/SUVmean_background] for individual timepoints t1 and t2 revealed significant higher values for [68Ga]FAPI compared to [18F]FDG (t1, p = 0.008; t2, p = 0.005). Intermodality comparison of radiation-therapy-plans showed that [68Ga]FAPI-based planning resulted in D100% = 97.2% and V95% = 98.8% for the [18F]FDG-MTV. [18F]FDG-based-planning resulted in D100% = 35.9% and V95% = 78.1% for [68Ga]FAPI-MTV. [18F]FDG-based-planning resulted only in 2 patients in V95% > 95% for [68Ga]FAPI-MTV, and in 1 patient in D100% > 97% for [68Ga]FAPI-MTV. GTV-coverage in terms of V95% was 76.4% by [18F]FDG-based-planning and 99.5% by [68Ga]FAPI-based-planning. Pretreatment [68Ga]FAPI-PET/CT enhances radiation-treatment-planning in this particular group of patients. While perilesional and tumoral follow-up [18F]FDG-uptake behaved uniformly, perilesional and tumoral reaction may differ in follow-up [68Ga]FAPI-imaging. Complementary [68Ga]FAPI- and [18F]FDG-imaging enhance treatment-response-assessment.
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