JournalTOCs

Annals of Nuclear Medicine
Journal Prestige (SJR): 0.687

Citation Impact (citeScore): 2
Number of Followers: 6

Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1864-6433 - ISSN (Online) 0914-7187
Published by Springer-Verlag

[2469 journals]

68Ga-DOTA-FAPI-04 PET/CT imaging in radioiodine-refractory differentiated
thyroid cancer (RR-DTC) patients
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  Abstract: Objective This study aimed to assess the potential of 68Ga-DOTA-FAPI-04 PET/CT for the detection of the radioiodine-refractory differentiated thyroid cancer (RR-DTC) lesions. Methods We analyzed the 68Ga-DOTA-FAPI-04 PET/CT imaging data of 24 RR-DTC patients (7 men and 17 women; 49.6 ± 10.5 year). Clinical data were collected including history, last post-therapeutic radioiodine whole body scan, contemporary CT, thyroglobulin, and antithyroglobulin. Target lesions were selected and measured by the RECIST 1.1. The mean growth rates of the target lesions in the past 6 months were recorded. Tumor uptake of lesions were quantified by SUVmax and the tumor-to-background ratios. The correlation between SUVmax and target lesion growth rate and thyroglobulin was analyzed. Results On patient-based analysis, positive metastases were detected in 87.5% (21/24) patients. Except for the lymph node (LN) metastasis of 3 patients (patient 6, 12 and 17#) and the lung metastasis of another 3 patients (patient 9, 13 and 21#), most of the lesions were positive on 68Ga-DOTA-FAPI-04 PET/CT images, including LN metastasis and distant metastasis such as lung, bone and pleura. There were altogether 33 target lesions including 30 lung metastases and 3 LN metastases with the mean SUVmax and the growth rate were 4.25 and 6.51%, respectively. SUVmax was statistically associated with the growth rates of the target lesions (p = 0.047). No statistically significant correlation was found between the SUVmax and the serum thyroglobulin levels (p = 0.139). Conclusions 68Ga-DOTA-FAPI-04 PET/CT has a promising detection rate for RR-DTC metastasis. The FAPI uptake of the tumor may provide a potential therapeutic target for RR-DTC. Trial registry NIH Clinical Trials.gov (NCT04499365).
  PubDate: 2022-05-12
Impact of patient body habitus on image quality and quantitative value in
bone SPECT/CT
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  Abstract: Objective The first edition of guidelines for standardization of bone single photon emission computed tomography (SPECT) imaging was published in 2017, and the optimization and standardization are widely promoted. To the purpose, clarification of the factors related to image quality and quantitative values and their influence are required. The present study aimed to clarify and optimize the influence of patient body habitus on image quality and quantitative values in bone SPECT/CT. Methods National Electrical Manufacturers Association body phantom (S-size) and custom-made large body phantoms (M-size and L-size) that simulate the abdomens of Japanese patients weighing 60, 80, and 100 kg, were used. Each phantom was filled with 99mTc-solutions of 108 and 18 kBq/mL for the hot spheres and background, respectively. Dynamic SPECT acquisition was performed for 6000 s (150 s /rotation × 40 rotation). The data were divided into six projection data and reconstructed each acquisition time (150, 300, 450, 600, 750, 900 s, and single projection 6000 s). Image quality was evaluated for contrast (QH, 17 mm), background noise (NB, 17 mm), contrast-to-noise ratio (CNR), maximum standardized uptake value (SUVmax, 17 mm), and visual assessment for a 17 mm hot sphere. Results Image quality in the 300 s acquisition showed that values of QH, 17 mm, CNR, and SUVmax, 17 mm decreased (-16.7%, -11.8%, and -11.3%) for M-size and (-28.2%, -30.1%, and -21.7%) for L-size compared with S-size, respectively. No significant difference was observed in NB, 17 mm values. M-size and L-size required 1.2 and 2.3 times longer acquisition, to achieve same CNR as S-size. In visual assessment, 17 mm hot sphere could not be detected only in the L-size. When the Japanese bone SPECT guidelines criteria were applied in 600 s, the sphere could be detected between all phantoms. Conclusions Patient body habitus significantly affects image quality and decreases the quantitative value in bone SPECT/CT. For the optimization, extend acquisition time according to the patient body habitus is effective for image quality. And for the standardization, it is important to achieve imaging conditions that meet the Japanese bone SPECT guidelines criteria to ensure adequate detectability.
  PubDate: 2022-05-11
F18-FDG PET/CT imaging early predicts pathologic complete response to
induction chemoimmunotherapy of locally advanced head and neck cancer:
preliminary single-center analysis of the checkrad-cd8 trial
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  Abstract: Aim In the CheckRad-CD8 trial patients with locally advanced head and neck squamous cell cancer are treated with a single cycle of induction chemo-immunotherapy (ICIT). Patients with pathological complete response (pCR) in the re-biopsy enter radioimmunotherapy. Our goal was to study the value of F-18-FDG PET/CT in the prediction of pCR after induction therapy. Methods Patients treated within the CheckRad-CD8 trial that additionally received FDG- PET/CT imaging at the following two time points were included: 3–14 days before (pre-ICIT) and 21–28 days after (post-ICIT) receiving ICIT. Tracer uptake in primary tumors (PT) and suspicious cervical lymph nodes (LN +) was measured using different quantitative parameters on EANM Research Ltd (EARL) accredited PET reconstructions. In addition, mean FDG uptake levels in lymphatic and hematopoietic organs were examined. Percent decrease (Δ) in FDG uptake was calculated for all parameters. Biopsy of the PT post-ICIT acquired after FDG-PET/CT served as reference. The cohort was divided in patients with pCR and residual tumor (ReTu). Results Thirty-one patients were included. In ROC analysis, ΔSUVmax PT performed best (AUC = 0.89) in predicting pCR (n = 17), with a decline of at least 60% (sensitivity, 0.77; specificity, 0.93). Residual SUVmax PT post-ICIT performed best in predicting ReTu (n = 14), at a cutpoint of 6.0 (AUC = 0.91; sensitivity, 0.86; specificity, 0.88). Combining two quantitative parameters (ΔSUVmax ≥ 50% and SUVmax PT post-ICIT ≤ 6.0) conferred a sensitivity of 0.81 and a specificity of 0.93 for determining pCR. Background activity in lymphatic organs or uptake in suspected cervical lymph node metastases lacked significant predictive value. Conclusion FDG-PET/CT can identify patients with pCR after ICIT via residual FDG uptake levels in primary tumors and the related changes compared to baseline. FDG-uptake in LN + had no predictive value. Trial registry ClinicalTrials.gov identifier: NCT03426657.
  PubDate: 2022-05-10
Physiologically intense FDG uptake of distal spinal cord on total-body
PET/CT
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  Abstract: Objective Physiologically mild-to-moderate FDG uptake of the spinal cord was reported. However, we noticed intense FDG uptake of distal spinal cord in several patients without definite spinal cord lesions on total-body PET/CT. Thus, this study aimed to investigate the frequency, pattern, intensity, and associations of FDG uptake in such cases on total-body PET/CT. Methods The clinical characteristics of age, gender, body mass index (BMI), lower extremity symptom, diabetes, and fasting blood glucose level, and total-body FDG PET/CT metabolic parameters of maximum standard uptake value (SUVmax), SUVmax of lean body mass (SUVlbm), and SUVmax of body surface area (SUVbsa), were retrospectively analyzed in 527 patients without definite spinal cord lesions. Intense FDG uptake was defined as greater than liver glucometabolism on visual analysis, and T5 cord was selected as cord background. Results Intense FDG uptake of distal spinal cord was observed in 87 out of 527 patients (16.5%) and involved with 2–3 vertebral segments including T11–T12 in 33 cases (38.0%), T12–L1 in 29 (33.3%), and T11–L1 in 25 (28.7%). No lesions were demonstrated on follow-up physical examinations, MRI or contrast-enhanced CT in these 87 cases with intense FDG accumulation in the distal spinal cord. The median SUVmax, SUVlbm, and SUVbsa of distal spinal cord with intense FDG uptake were 3.8 (2.7–5.5), 2.9 (2.2–4.3), and 1.0 (0.7–1.6), respectively. Significant differences in SUVmax, SUVlbm, and SUVbsa of distal cord and cord background were found between the groups with and without intense FDG uptake (P < 0.05). Moreover, significant differences in ratios of distal spinal cord-to-cord background, to mediastinal blood pool, and to liver were observed between two groups (P < 0.05). Intense FDG uptake of distal cord was associated with age, diabetic status, and blood glucose level. Conclusions Intense FDG uptake of distal spinal cord on total-body PET/CT may be physiological, more common in younger age, patients without diabetes, or lower fasting blood glucose.
  PubDate: 2022-05-10
Thyroid function after diagnostic 123I-metaiodobenzylguanidine in children
with neuroblastic tumors
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  Abstract: Background Metaiodobenzylguanidine (MIBG) labeled with radioisotopes can be used for diagnostics 123I−) and treatment (131I−) in patients with neuroblastic tumors. Thyroid dysfunction has been reported in 52% of neuroblastoma (NBL) survivors after 131I-MIBG, despite thyroid protection. Diagnostic 123I-MIBG is not considered to be hazardous for thyroid function; however, this has never been investigated. Therefore, the aim of this study was to evaluate the prevalence of thyroid dysfunction in survivors of a neuroblastic tumor who received diagnostic 123I-MIBG only. Methods Thyroid function and uptake of 123I− in the thyroid gland after 123I-MIBG administrations were evaluated in 48 neuroblastic tumor survivors who had not been treated with 131I-MIBG. All patients had received thyroid prophylaxis consisting of potassium iodide or a combination of potassium iodide, thiamazole and thyroxine during exposure to 123I-MIBG. Results After a median follow-up of 6.6 years, thyroid function was normal in 46 of 48 survivors (95.8%). Two survivors [prevalence 4.2% (95% CI 1.2–14.0)] had mild thyroid dysfunction. In 29.2% of the patients and 11.1% of images 123I− uptake was visible in the thyroid. In 1 patient with thyroid dysfunction, weak uptake of 123I− was seen on 1 of 10 images. Conclusions The prevalence of thyroid dysfunction does not seem to be increased in patients with neuroblastic tumors who received 123I-MIBG combined with thyroid protection. Randomized controlled trials are required to investigate whether administration of 123I-MIBG without thyroid protection is harmful to the thyroid gland.
  PubDate: 2022-05-02
18F-FDG PET/CT as predictive and prognostic factor in esophageal cancer
treated with combined modality treatment
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  Abstract: Purpose [18F] fluorodeoxyglucose positron emission tomography/computed tomography ([18F] FDG-PET/CT) is used for diagnosis, staging, response assessment and prognosis prediction in different tumors, but its role in esophageal cancer is still debated. The aim of this study was to evaluate the role of semiquantitative baseline PET parameters as possible prognostic and predictive factors in a series of esophageal carcinomas treated with combined modalities. Methods 43 patients with esophageal carcinoma were treated with chemoradiotherapy (CRT) followed by surgery in 20 cases and underwent pre-treatment 18F-FDG-PET/CT. Semiquantitative PET parameters were evaluated including Standardized Uptake Value (SUVmax e SUVmean), Metabolic Tumor Volume (MTV) and Total Lesion Glycolysis (TLG) with isocontour of 41 and 50%. Further variables analyzed were gender, primary tumor site, histological type, use of surgery, achievement of a radical resection and the type of chemotherapy regimen. The correlation of all variables with treatment response, loco-regional control (LR), Overall survival (OS) and Disease-Free Survival (DFS) was evaluated. Results SUVmax, SUVmean50 and SUVmean41 were significantly higher in node-positive cases and in squamous cell carcinomas. With respect to prognostic factors, MTV was found to be correlated with OS: patients with MTV41 < 11.32 cm3 and MTV50 < 8.07 cm3 (both p values = 0.04) showed better 3-year OS rates (33 vs. 20%). Further factors predicting a better prognosis were the use of surgery and radical resection (R0) (both p values < 0.01). Conclusions Pre-treatment MTV values were significant prognostic factors for OS, together with the use of surgery and R0 resection in esophageal cancers treated with multimodal therapies.
  PubDate: 2022-05-01
Prediction of cardiac events following concurrent chemoradiation therapy
for non-small-cell lung cancer using FDG PET
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  Abstract: Objective No imaging biomarkers are available for the prediction of cardiac events following concurrent chemoradiation therapy (CCRT) for non-small-cell lung cancer (NSCLC). We evaluated whether F-18 fluorodeoxyglucose positron emission tomography (FDG PET) early after CCRT, in addition to cardiac dosimetry, could predict late cardiac events in NSCLC. Methods We retrospectively enrolled 133 consecutive patients with locally advanced, unresectable stage III NSCLC, who underwent FDG PET early after CCRT and survived at least 6 months. The primary endpoint was cardiac event ≥ grade 2 according to the Common Terminology Criteria for Adverse Events (version 5.0). Myocardial FDG uptake was measured and its association with the risk of cardiac events was evaluated. Results FDG PET was performed after a median interval of 11 days of completing CCRT. Overall, 42 (32%) patients experienced cardiac events during a median follow-up of 45 months. The mean heart dose, maximum left ventricular (LV) standardized uptake value (SUV), changes in maximum and mean LV SUV, right ventricular uptake, tumor stage, white blood cell count, and diabetes were associated with cardiac events in univariable analysis. In multivariable analysis, maximum LV SUV (cutoff > 12.84; hazard ratio [95% confidence interval] = 2.140 [1.140–4.016]; p = 0.018) was an independent predictor of cardiac events along with the mean heart dose (> 11.1 Gy; 3.646 [1.792–7.417]; p < 0.001) and tumor stage (IIIB; 1.986 [1.056–3.734]; p = 0.033). It remained predictive of cardiac events in those with higher mean heart dose but not in those with lower mean heart dose. Conclusions Early FDG PET after CCRT for NSCLC could aid in predicting late cardiac events, especially in patients with higher mean heart dose.
  PubDate: 2022-05-01
Role of nanoparticles in transarterial radioembolization with glass
microspheres
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  Abstract: Objective Transarterial Radioembolization (TARE) with 90Y-loaded glass microspheres is a locoregional treatment option for Hepatocellular Carcinoma (HCC). Post-treatment 90Y bremsstrahlung imaging using Single-Photon Emission Tomography (SPECT) is currently a gold-standard imaging modality for quantifying the delivered dose. However, the nature of bremsstrahlung photons causes difficulty for dose estimation using SPECT imaging. This work aimed to investigate the possibility of using glass microspheres loaded with 90Y and Nanoparticles (NPs) to improve the quantification of delivered doses. Methods The Monte Carlo codes were used to simulate the post-TARE 90Y planar imaging. Planar images from bremsstrahlung photons and characteristic X-rays are acquired when 0, 1.2 mol/L, 2.4 mol/L, and 4.8 mol/L of Gold (Au), Hafnium (Hf), and Gadolinium (Gd) NPs are incorporated into the glass microspheres. We evaluated the quality of acquired images by calculating sensitivity and Signal-to-Background Ratio (SBR). Therapeutic effects of NPs were evaluated by calculation of Dose Enhancement Ratio (DER) in tumoral and non-tumoral liver tissues. Results The in silico results showed that the sensitivity values of bremsstrahlung and characteristic X-ray planar images increased significantly as the NPs concentration increased in the glass microspheres. The SBR values decreased as the NPs concentration increased for the bremsstrahlung planar images. In contrast, the SBR values increased for the characteristic X-ray planar images when Hf and Gd were incorporated into the glass microspheres. The DER values decreased in the tumoral and non-tumoral liver tissues as the NPs concentration increased. The maximum dose reduction was observed at the NPs concentration of 4.8 mol/L (≈ 7%). Conclusions The incorporation of Au, Hf, and Gd NPs into the glass microspheres improved the quality and quantity of post-TARE planar images. Also, treatment efficiency was decreased significantly at NPs concentration > 4.8 mol/L.
  PubDate: 2022-05-01
Voxel-based analysis of age and gender effects on striatal [123I] FP-CIT
binding in healthy Japanese adults
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  Abstract: Objective Although previous studies have investigated age and gender effects on striatal subregional dopamine transporter (DaT) binding, these studies were mostly based on a conventional regions of interest-based analysis. Here, we investigated age and gender effects on striatal DaT binding at the voxel level, using a multicenter database of [(123)I] N-omega-fluoropropyl-2beta-carbomethoxy-3beta-{4-iodophenyl}nortropane ([(123)I] FP-CIT)-single photon emission computed tomography (SPECT) scans in 256 healthy Japanese adults. Methods We used the Southampton method to calculate the specific binding ratios (SBRs) of each subject’s striatum and then converted the [123I] FP-CIT SPECT images to quantitative SBRs images. To investigate the effects of age and gender effects on striatal DaT binding, we performed a voxel-based analysis using statistical parametric mapping. Gender differences were also compared between young to middle-aged subjects and elderly subjects (age threshold: 60 years). Results When all subjects were explored as a group, DaT binding throughout the striatum decreased with advancing age. Among all subjects, the females showed higher DaT binding in the bilateral caudate compared to the males. In the young to middle-aged subjects, the females showed higher DaT binding throughout the striatum (with a slight caudate predominance) versus the males. In the elderly, there were no gender differences in striatal DaT binding. Conclusion Our findings of striatal subregional age- and gender-related differences may provide useful information to construct a more detailed DaT database in healthy Japanese subjects.
  PubDate: 2022-05-01
18F-FDG PET/CT characteristics of solitary fibrous tumour of the pleura:
single institution experience
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  Abstract: Background To date, published studies have shown that 18F-FDG PET/CT and CT have limited value in differentiating benign and malignant solitary fibrous tumours of the pleura (SFTP). This study aimed to determine whether the metabolic and morphological characteristics of 18F-FDG PET/CT can be a valuable addition to diagnostic tools for SFTPs. Methods From January 2016 to November 2021, we performed a retrospective review in 32 SFTPs patients who underwent 18F-FDG PET/CT scan. All the SFTP diagnoses were confirmed by surgical resection or biopsy samples. The metabolic parameters (including SUVmax, SUVmean, MTV, TLG, and SULmax) were obtained from 18F-FDG PET/CT images. Results Thirty-two patients with SFTP were consecutively identified. The malignant SFTPs have higher Ki-67 expression (P = 0.005). The study observed that tumour heterogeneity without contrast injection (P = 0.001) and intratumor blood vessels (P = 0.047) were morphological features associated with malignant SFTP. Malignant SFTP was more frequently observed with higher SUVmax values (P = 0.001), higher SUVmean values (P = 0.001), higher TLG values (P = 0.006), and higher SULmax values (P < 0.001). For predicting malignant SFTP, the AUC values of SUVmax, SUVmean, TLG, and SULmax obtained by the area under curve analysis were 0.970 (95% CI 0.907–1.000; P = 0.001), 0.874 (95% CI 0.675–1.000; P = 0.009), 0.807 (95% CI 0.654–0.961; P = 0.031), and 0.911 (95% CI 0.747–1.000; P = 0.004), respectively. Conclusion The study showed that metabolic and morphological features were useful for distinguishing malignant from benign SFTPs.
  PubDate: 2022-05-01
Influence of antidepressant use on 123I-MIBG heart and lung uptakes in the
diagnosis of Lewy body disease
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  Abstract: Objective The clinical significance of decreased physiological lung uptake of 123I-metaiodobenzylguanidine (MIBG) has not been well investigated. This study aimed to elucidate the association between a decrease in lung MIBG uptake with antidepressant intake and the myocardial MIBG uptake in patients who were clinically diagnosed with Lewy body disease (LBD) and patients who were diagnosed as not having LBD. Methods We retrospectively reviewed the heart and lung uptakes on 167 consecutive MIBG scans, antidepressant status, and clinical diagnosis of LBD. The images were visually classified into two groups: decreased lung uptake and preserved lung uptake. A semi-quantitative analysis was performed using the heart-to-mediastinum ratio (H/M), lung-to-mediastinum ratio (L/M), and myocardial washout rate (WR). Results All 17 patients with decreased lung uptake were on treated with antidepressants, while none of the 150 patients with preserved lung uptake were treated with any antidepressants. Of the 17 patients with decreased lung uptake, 6 patients were clinically diagnosed as LBD and other 11 were clinically diagnosed as non-LBD. There was not significant difference in early H/M, delayed H/M, and myocardial WR between the 11 non-LBD patients with decreased lung uptake and 83 non-LBD patients with preserved lung uptake (2.87 ± 0.69 vs. 2.89 ± 0.44, 3.09 ± 0.48 vs. 2.98 ± 0.59, and 21.8 ± 11.3% vs. 21.1 ± 12.5%, respectively). Moreover, in LBD patients, there were no significant differences in those values between six patients with decreased lung uptake and 67 patients with preserved lung uptake (1.68 ± 0.32 vs. 1.73 ± 0.42, 1.34 ± 0.21 vs. 1.54 ± 0.57, 46.2 ± 22.8% vs. 42.8 ± 21.3%, respectively). Conclusions Antidepressants probably blocked MIBG uptake in the lungs, and a decreased lung uptake was not significantly associated with heart uptake. A remarkable decrease in lung uptake can be a signal to check a patient’s medication status.
  PubDate: 2022-05-01
Deep learning-based detection of parathyroid adenoma by 99mTc-MIBI
scintigraphy in patients with primary hyperparathyroidism
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  Abstract: Objective It is important to detect parathyroid adenomas by parathyroid scintigraphy with 99m-technetium sestamibi (99mTc-MIBI) before surgery. This study aimed to develop and validate deep learning (DL)-based models to detect parathyroid adenoma in patients with primary hyperparathyroidism, from parathyroid scintigrams with 99mTc-MIBI. Methods DL-based models for detecting parathyroid adenoma in early- and late-phase parathyroid scintigrams were, respectively, developed and evaluated. The training dataset used to train the models was collected from 192 patients (165 adenoma cases, mean age: 64 years ± 13, 145 women) and the validation dataset used to tune the models was collected from 45 patients (30 adenoma cases, mean age: 67 years ± 12, 37 women). The images were collected from patients who were pathologically diagnosed with parathyroid adenomas or in whom no lesions could be detected by either parathyroid scintigraphy or ultrasonography at our institution from June 2010 to March 2019. The models were tested on a dataset collected from 44 patients (30 adenoma cases, mean age: 67 years ± 12, 38 women) who took scintigraphy from April 2019 to March 2020. The models’ lesion-based sensitivity and mean false positive indications per image (mFPI) were assessed with the test dataset. Results The sensitivity was 82% [95% confidence interval 72–92%] with mFPI of 0.44 for the scintigrams of the early-phase model and 83% [73–92%] with mFPI of 0.31 for the scintigrams of the delayed-phase model in the test dataset, respectively. Conclusions The DL-based models were able to detect parathyroid adenomas with a high sensitivity using parathyroid scintigraphy with 99m-technetium sestamibi.
  PubDate: 2022-05-01
Diagnosis of prosthetic joint infection at the hip using the standard
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  Abstract: Purpose To retrospectively investigate whether the standard uptake value (SUV) of 99mTc-bone single-photon emission computed tomography (SPECT)/CT could be useful for predicting prosthetic joint infection (PJI) at the hip. Patients and methods We analyzed the cases of 37 patients with a suspected PJI at the hip who underwent 99mTc-bone SPECT/CT and surgical intervention with pathological and bacterial examinations. We divided the cases into those with and those without a causative bacterium detected in a surgical specimen, i.e., the positive bacterial culture (PBC) group (n = 17) and negative bacterial culture (NBC) group (n = 20). Cases with neutrophilic infiltration of surgical specimen comprised the positive neutrophilic infiltration (PINF) group (n = 18) and those without INF comprised the non-neutrophilic infiltration (NINF) group (n = 19). Quantitative analyses were performed using maximum SUVs and peak SUVs of blood-pool (BP) phase images (SUVmaxBP and SUVpeakBP) and late (LT)-phase images (SUVmaxLT and SUVpeakLT). Results Regarding the bacterial cultures, there were significant differences between the PBC and NBC groups in SUVmaxBP (5.26 ± 1.49 vs. 4.21 ± 1.15, respectively; p = 0.019), SUVpeakBP (4.89 ± 1.32 vs. 3.87 ± 1.06, p = 0.012), SUVmaxLT (16.10 ± 6.36 vs. 11.67 ± 4.95, p = 0.026), and SUVpeakLT (14.58 ± 5.83 vs. 10.49 ± 4.31 p = 0.036). Regarding neutrophilic infiltration, there were significant differences between the PINF and NINF groups in SUVmaxBP (5.18 ± 1.48 vs. 4.24 ± 1.19, p = 0.047) and SUVpeakBP (4.78 ± 1.32 vs. 3.92 ± 1.10, p = 0.043). Conclusion An SUV analysis of 99mTc-bone SPECT/CT is a useful method to differentiate a PJI at the hip from non-infection.
  PubDate: 2022-04-28
99mTc-PSMA targeted robot-assisted radioguided surgery during radical
prostatectomy and extended lymph node dissection of prostate cancer
patients
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  Abstract: Objective The feasibility of tracer production of 99mtechnetium (Tc)-prostate-specific membrane antigen (PSMA)—I&S sterile cold kit, imaging with single photon emission tomography/computed tomography (SPECT/CT), and 99mTc-PSMA-radioguided robot-assisted laparoscopic radical prostatectomy (99mTc-PSMA-RG-RALRP) technique for lymph node (LN) dissection of primary prostate cancer (PCa) patients were evaluated prospectively. Methods Fifteen primary PCa patients with intermediate- or high-risk score according to D’Amico risk stratification who had PSMA receptor affinity with Ga-68 PSMA-11 PET/CT were enrolled. After 99mTc-PSMA-I&S injection and SPECT/CT imaging, 99mTc-PSMA-RG-RALRP with DaVinci XI robotic platform and laparoscopic gamma probe were performed. Radioactive rating of resected tissue was compared with post-operative histopathology. Physiological and pathological uptakes of organs and tissues for both imaging modalities were compared. Results Physiological radiotracer distribution was similar for both imaging modalities. PCa lesions were much more visible on PET/CT. Metastatic LNs could not be visualized with SPECT/CT. Eighteen of 297 totally dissected LNs were metastatic, which were exactly the same with per-operative probe counts with sensitivity, specificity, accuracy, and negative and positive predictive value of all 100%. The median follow-up was 23.5 ± 4.6 months. tPSA reduction was > 98%. The 2.5 years biochemical recurrence-free survival, PCa-specific treatment-free survival and overall survival rates were 86,7%, 66,7% and 100%, respectively. Conclusion Tc-99 m-PSMA-RG-RALRP is a promising technique for extended pelvic lymph node dissection (ePLND) during robotic surgery, which may shorten the operation time and reduce complication risks. If LN metastases is detected during surgery with PSMA-targeted probe, it may be an early indicator of PCa-spesific treatment planning. Tc-99 m-PSMA-I&S SPECT/CT is not as successful as Ga-68 PSMA-11 PET/CT for diagnosis of primary PCA lesions or LN metastases.
  PubDate: 2022-04-15
The role of Ga68 PSMA PET/CT imaging in Lu177 PSMA treatment planning in
metastatic castration-resistant prostate cancer
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  Abstract: Objective Lutetium-177 (Lu177) prostate-specific membrane antigen (Lu177 PSMA) is a novel targeted treatment for patients with metastatic castration-resistant prostate cancer (CRPC). The purpose of the study was to determine the molecular volumetric Gallium-68 (Ga68) PSMA PET/CT parameters that can predict patients who will respond to treatment. Methods These single-center retrospective data were obtained from metastatic CRPC patients receiving intravenous 6.0–8.5 GBq Lu177 PSMA treatment every 6–8 weeks for a maximum of 3–8 cycles, with baseline Ga68 PSMA PET/CT scan, clinical data, and information on treatment responses. All lesions were divided into two groups according to the increase and decrease in PSMA expression levels of 600 bone lesions and 85 lymph nodes that were compatible with metastasis of 23 patients after the treatment. The primary endpoint of our study was the evaluation of the relation between the baseline SUVmax, PSMA TV, TL PSMA values, and the treatment response of the two groups. The threshold values were determined for the parameters that had significant relations. In the present study, the prostate-specific antigen (PSA) response and treatment-induced toxicities were also evaluated as the secondary endpoint. Results It was found that SUVmax, PSMA TV, and TL PSMA values in bone metastases showed significant differences between the groups with decreased and increased PSMA expression levels after the treatment. The AUC value for SUVmax was significant (AUC = 0.677; p < 0.001). The cutoff value was > 10.50 (sensitivity = 91.8%, Specificity = 41.5%) for SUVmax, > 1.50 cm3 (sensitivity = 49.1%, specificity = 70%) for PSMA TV and > 8.50 g (sensitivity = %60.9, specificity = %72.2) for TL PSMA. The median SUVmax value before the treatment in all metastatic lymph nodes was found to be 7.1 (5.4–12.4), and the median SUVmax after the treatment was 2.5 (1.6–12.1) (p < 0.001). Conclusion It was shown in the present study that Lu177 PSMA treatment response may be higher in CRPC patients with metastatic bone lesion with high baseline PSMA expression level, and better treatment response may be achieved in patients with lymph node metastases than in bone metastases.
  PubDate: 2022-04-09
An evaluation of the response to neoadjuvant chemotherapy for osteosarcoma
of extremities: PERCIST versus RECIST 1.1 criteria after long-term
follow-up
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  Abstract: Objective The aim of this study was to compare the recent Positron emission tomography (PET) Response Criteria in Solid Tumors (PERCIST) and Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria for evaluating the response of osteosarcoma to neoadjuvant chemotherapy of the extremities. Methods We retrospectively reviewed patients with osteosarcoma of the extremities who received neoadjuvant chemotherapy and then surgical resection at Peking University People’s Hospital. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and magnetic resonance imaging (MRI) were performed prior to chemotherapy and before surgical resection. Therapeutic response was assessed separately by the PERCIST and RECIST 1.1 criteria. The association between the data acquired by the PERCIST and RECIST 1.1 criteria was then analyzed by Wilcoxon’s signed-rank test. The association between the PERCIST criteria and the pathological necrosis rate was analyzed by Fisher’s exact test. Finally, the impact of a range of clinicopathological factors on overall survival (OS) and event-free survival (EFS) was analyzed by Cox proportional hazards regression. Results We recruited 68 patients with a median follow-up of 74 months (range 45–102 months). The evaluations resulting from the RECIST 1.1 and PERCIST criteria were significantly different (p = 0.000). Only two responders were identified according to the RECIST 1.1 criteria. However, 34 responders were identified by the PERCIST criteria. Data arising from the PERCIST criteria were in accordance with the pathological necrosis rate. Survival analysis showed that metastasis at diagnosis, poor pathological response, and disease progression (according to the RECIST 1.1 or PERCIST criteria) were all associated with a poor prognosis (p < 0.05). Conclusion Our data indicate that the PERCIST criteria are significantly more sensitive than RECIST 1.1 criteria to identify more responders when evaluating the response of osteosarcoma to neoadjuvant chemotherapy.
  PubDate: 2022-04-05
Application of 18F-FDG brain PET for survival prediction in a rat model of
hanging-induced hypoxic brain injury
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  Abstract: Background Accurate prediction of survival outcomes after hanging is a crucial and challenging issue in comatose survivors. In this preclinical study, we evaluated the potential utility of using brain glucose metabolism as measured by fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) for survival prediction in a rat model of hanging-induced hypoxic brain injury (HBI). Methods HBI was induced by mechanical hanging using Sprague Dawley rats. 18F-FDG brain PET images were acquired in 26 HBI rats three hours post-injury (3 h post-injury) and 4 controls. During the 1 month follow-up period, HBI rats were further classified as survivors (n = 15) and nonsurvivors (n = 11). Between-group regional (standardized uptake values normalized to the reference whole brain = SUVRWB, cerebellum = SUVRCB, and pons = SUVRpons) and voxel-based analyses were performed. The prognostic value of the SUVR was tested for overall survival (OS). In addition, diffusion-weighted imaging (DWI) was performed in 2 controls and 5 HBI rats (3 survivors, 2 nonsurvivors, 3 h post), and an apparent diffusion coefficient (ADC) map was generated. Results The nonsurvivor group showed a significantly lower SUVRWB, SUVRCB, and SUVRpons of the cerebral cortices than the survivor group (all p < 0.001). Voxel-based comparison also demonstrated significant reduction in the nonsurvivor group compared with the survivor group (family-wise error-corrected p < 0.05). However, there was no significant difference between controls and survivors. Of 3 reference regions, the SUVRpons demonstrated the largest difference between the survivor and nonsurvivor groups. With an optimal cutoff value of 1.12 (AUC 0.952, p < 0.001), the SUVRpons predicted survival outcomes with a sensitivity of 81.8% and specificity of 100%. The OS of the low SUVRpons group was significantly shorter than that the high SUVRpons group (p < 0.001). The mean ADC values of each brain region showed no significant difference according to survival outcomes. Conclusions These results suggest the potential utility of 18F-FDG brain PET for predicting survival in hanging-induced HBI.
  PubDate: 2022-04-05
Beads phantom for evaluating heterogeneity of SUV on 18F-FDG PET images
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  Abstract: Purpose This study aimed to develop a dedicated phantom using acrylic beads for texture analysis and to represent heterogeneous 18F-fluorodeoxyglucose (FDG) distributions in various acquisition periods. Methods Images of acrylic spherical beads with or without diameters of 5- and 10-mm representing heterogeneous and homogeneous 18F-FDG distribution in phantoms, respectively, were collected for 20 min in list mode. Phantom data were reconstructed using three-dimensional ordered subset expectation maximization with attenuation and scatter corrections, and the time-of-flight algorithm. The beads phantom images were acquired twice to evaluate the robustness of texture features. Thirty-one texture features were extracted, and the robustness of texture feature values was evaluated by calculating the percentage of coefficient of variation (%COV) and intraclass coefficient of correlation (ICC). Cross-correlation coefficients among texture feature values were clustered to classify the characteristics of these features. Results Heterogeneous 18F-FDG distribution was represented by the beads phantom images. The agreements of %COV between two measurements were acceptable (ICC ≥ 0.71). All texture features were classified into four groups. Among 31 texture features, 24 exhibited significant different values between phantoms with and without beads in 1-, 2-, 3-, 4-, 5-, 20-min image acquisitions. Whereas, the homogeneous and heterogeneous 18F-FDG distribution could not be discriminated by seven texture features: low gray-level run emphasis, high gray-level run emphasis, short-run low gray-level emphasis, low gray-level zone emphasis, high gray-level zone emphasis, short-zone low gray-level emphasis, and coarseness. Conclusions We have developed the acrylic beads phantom for texture analysis that could represent heterogeneous 18F-FDG distributions in various acquisition periods. Most texture features could discriminate homogeneous and heterogeneous 18F-FDG distributions in the beads phantom images.
  PubDate: 2022-04-04
Correction to: Generative image transformer (GIT): unsupervised continuous
image generative and transformable model for [123I]FP-CIT SPECT images
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  PubDate: 2022-04-01
Correction to: Detection efficacy of PET/CT with 18F-FSU-880 in patients
with suspected recurrent prostate cancer: a prospective single-center
study
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  PubDate: 2022-03-17