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Sample records for 11c-l-methionine pet tumor

  1. Brain protein synthesis in normal and demented patients. A study by P.E.T. with 11C-L methionine

    A compartmental model representing protein synthesis in the brain was validated experimentally in 9 baboons. After sequential injections of 11C, 3H and 14C methionines on the same animal, followed by P.E.T. recording of the γ activity in a chosen brain section with time, the distribution of methionine injected into the different compartments of the model after a bolus was measured by crushing and precipitation with T.C.A. The agreement between direct in vitro findings and computed results is excellent. This method of studying brain protein synthesis in vivo was applied to 28 Alzheimer dementia cases and 20 normal subjects of the same age. The correlation between the results of clinical and psychometric tests and the brain protein synthesis activity confirms an anomaly in this biochemical synthesis process during the illness. A 65% fall in activity may be found in the frontal lobes of certain patients

  2. Local cerebral metabolic rate of 11C-L-Methionine in early stages of dementia, schizophrenia, Parkinson's disease

    A dynamic three-compartment model of methionine metabolism in brain was applied in human patients using 11C-L-Methionine and positron emission tomography (P.E.T). Psychometric evaluations of demented patients were correlated with a significant diminution of protein synthesis in the frontal area. This diminution was lower in ebephrenic patients (-17%) but was consistent with the results obtained with 18F glucose. No significant abnormality was detected in patients with Parkinson disease

  3. Positron emission tomography (PET) study of patients with pituitary adenoma using labeled amino acid

    Mineura, Katsuyoshi; Sasajima, Toshio; Sakamoto, Tetsuya; Kowada, Masayoshi (Akita Univ. (Japan). Hospital); Shishido, Fumio; Uemura, Kazuo

    1989-12-01

    Four cases with pituitary adenomas were studied using {sup 11}C-L-methionine (C-11 Met) positron-emission tomography (PET). The C-11 Met was intravenously administered at a dose of 0.6 mCi/kg. The uptake of the tracer for tumors was calculated on the PET images 45 min after the injection; the uptake index was represented as a percentage of the total count in the arterial blood over a period of 45 min. In all cases, the C-11 Met accumulated intensely in the tumor regions; the PET images clearly delineated the extent of the tumor. The C-11 Met uptake index for pituitary adenomas varied widely from 3.94 x 10{sup -2}% to 15.36 x 10{sup -2}%, with a mean of 7.87 x 10{sup -2}%. These indices for the tumors increased markedly in comparison with that of the contralateral left temporal gray matter as a nontumor region (1.89 x 10{sup -2}% to 2.43 x 10{sup -2}% with a mean of 2.06 x 10{sup -2}%). In a case of prolactinoma, repeated PET following bromocriptine treatment showed a decrease in the C-11 Met uptake index; this decrease reflected changes in the serum prolactin value. In another case with ACTH-producing adenoma, the T/NT (tumor/nontumor) ratio fell from 3.44 to 2.40; however, the C-11 Met index remained unchanged. C-11 Met PET images facilitate determining the extent of pituitary adenomas and the monitoring of tumor response to treatment. Further application may give useful knowledge on the amino-acid metabolism of the tumor. (author).

  4. Positron emission tomography (PET) study of patients with pituitary adenoma using labeled amino acid

    Four cases with pituitary adenomas were studied using 11C-L-methionine (C-11 Met) positron-emission tomography (PET). The C-11 Met was intravenously administered at a dose of 0.6 mCi/kg. The uptake of the tracer for tumors was calculated on the PET images 45 min after the injection; the uptake index was represented as a percentage of the total count in the arterial blood over a period of 45 min. In all cases, the C-11 Met accumulated intensely in the tumor regions; the PET images clearly delineated the extent of the tumor. The C-11 Met uptake index for pituitary adenomas varied widely from 3.94 x 10-2% to 15.36 x 10-2%, with a mean of 7.87 x 10-2%. These indices for the tumors increased markedly in comparison with that of the contralateral left temporal gray matter as a nontumor region (1.89 x 10-2% to 2.43 x 10-2% with a mean of 2.06 x 10-2%). In a case of prolactinoma, repeated PET following bromocriptine treatment showed a decrease in the C-11 Met uptake index; this decrease reflected changes in the serum prolactin value. In another case with ACTH-producing adenoma, the T/NT (tumor/nontumor) ratio fell from 3.44 to 2.40; however, the C-11 Met index remained unchanged. C-11 Met PET images facilitate determining the extent of pituitary adenomas and the monitoring of tumor response to treatment. Further application may give useful knowledge on the amino-acid metabolism of the tumor. (author)

  5. Pioneering and fundamental achievements on the development of positron emission tomography (PET) in oncology

    Positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG), a glucose analog, is widely used throughout the world as an indispensable imaging modality for the management of cancer treatment. This article reviews the pioneering achievements of PET in oncology with a focus on the development of PET that occurred from 1980 through the early-1990s. 18F-FDG was first applied for imaging of animal tumors in 1980 and for brain tumor imaging clinically in 1982. 18F-FDG enabled to visualize liver metastasis as clear positive image that could not be obtained by conventional nuclear imaging. Subsequently, 18F-FDG was used for imaging various cancers, such as lung, pancreas, colorectal and hepatoma. 11C-L-methionine (11C-MET) that reflects amino acid transport of cancers has an advantage that its uptake is lower in the brain and inflammatory tissue compared to 18F-FDG, and was first applied for imaging lung cancer and brain tumor. 18F-FDG and 11C-MET were proved to be sensitive tracers that can be used to objectively evaluate the effectiveness of cancer treatment. The diagnostic accuracy of PET, which is critical in clinical practice, was evaluated for the differential diagnosis of malignant and benign lung nodules using 18F-FDG or 11C-MET. In addition to 18F-FDG and 11C-MET, many radiopharmaceuticals were developed, such as 18F-labled thymidine analogs for evaluating proliferative activity, 18F-fluoromisonidazole for imaging of hypoxia, and 18F-fluorodeoxygalactose for evaluating liver-specific galactose metabolism and for imaging of hepatoma that retains galactose metabolic activity. These early efforts and achievements have greatly contributed to the development and clinical application of 18F-FDG PET in oncology. (author) 113 refs.

  6. PET imaging for evaluating tumor angiogenesis

    Angiogenesis, a main characteristic in tumors, plays an important role in tumor growth and metastasis, which provides a new strategy for tumor treatment. By marking angiogenesis-related receptors, polypeptides, kinases or extracellular matrix proteins as high affinity molecular probes, PET imaging can noninvasively display integrin, VEGF/VEGFR, matrix metalloproteinases (MMPs) and closely monitor tumor angiogenesis and vascular-targeted treatments on the molecular level. In this paper, research progress and future development of PET imaging for evaluating tumor angiogenesis are reviewed. (authors)

  7. Quantitative analysis of PET measurements in tumors

    The positron emission tomograhpy (PET) has been used for the evaluation of the characteristics of various tumors. The role of PET in oncology has been evolved from a pure research tool to a methodology of enormous clinical potential. The unique characteristics of PET imaging make sophisticated quantitation possible. Several quantitative methods, such as standardized uptake values (SUV), simplifield quantitation method, Patlak graphical analysis, and Sokoloff's glucose metabolism measurement, have been used in the field of oncology. However, each quantitative method has limitations of its own. For example, the SUV has been used as a quantitative index of glucose metabolism for tumor classification and monitoring response to treatment, even though it depends on blood glucose level, body configuration of patient, and scanning time. The quantitative methods of PET are reviewed and strategy for implementing these methods are presented

  8. Clinical Application of {sup 18}F-FDG PET and PET-CT in Adrenal Tumor

    Hwang, Kyung Hoon; Choi, Duck Joo; Lee, Min Kyung; Choe, Won Sick [Gachon University Gil Hospital, Incheon (Korea, Republic of)

    2008-12-15

    Adrenal tumors are increasingly detected by widespread use of anatomical imaging such as CT, MRI, etc. For these adrenal tumors, differentiation between malignancy and benignancy is very important. In diagnostic assessment of adrenal tumor, {sup 18}F-FDG PET and PET-CT have been reported to have high diagnostic performance, especially, very excellent performance in evaluation of adrenal metastasis in the oncologic patient. In cases of adrenal incidentalomas, {sup 18}F-FDG PET or PET-CT is helpful if CT or chemical-shift MRI is inconclusive. {sup 18}F-FDG PET and PET-CT may be applied to the patients with MIBG-negative pheochromocytomas. In summary, {sup 18}F-FDG PET and PET-CT are expected to be effective diagnostic tools in the management of adrenal tumor.

  9. The progression of PET/CT in pediatric malignant tumors

    PET/CT has become a major mean for discriminating benign and malignant tumors, finding the primary tumor, staging, restaging, evaluating the response of treatment,predicting the survivors and guiding the operation, radiotherapy, chemotherapy in adults since it was applied in clinic,but it has been rarely applied in children. There exists some difference between internal and overseas in the application of PET/CT in pediatric malignant tumors based on the relative literatures analysis. It is related to the low level of medical radionuclides knowledge and lack of the knowledge about the application of PET/CT in pediatric malignant tumors, and all of these induce less carry out of the pediatric PET/CT imaging, lack of the experience, eventually form a vicious circle. This article mainly described the above two aspects, in order to promote the application of PET/CT in pediatric malignant tumors. (authors)

  10. Non-FDG PET imaging of brain tumors

    HUANG Zemin; GUAN Yihui; ZUO Chuantao; ZHANG Zhengwei; XUE Fangping; LIN Xiangtong

    2007-01-01

    Due to relatively high uptake of glucose in the brain cortex, the use of FDG PET imaging is greatly limited in brain tumor imaging, especially for low-grade gliomas and some metastatic tumours. More and more tracers with higher specificity were developed lately for brain tumor imaging. There are 3 main types of non-FDG PET tracers:amino acid tracers, choline tracers and nucleic acid tracers. These tracers are now widely applied in many aspects of brain tumor imaging. This article summarized the general use of non-FDG PET in different aspects of brain tumor imaging.

  11. PET and endocrine tumors; TEP et tumeurs endocrines

    Rigo, P.; Belhocine, T.; Hustinx, R.; Foidart-Willems, J. [Centre Hospitalier Universitaire de Liege, Service de Medecine Nucleaire et d' Hematologie (Belgium)

    2000-08-01

    The authors review the main indications of PET examination, and specifically of {sup 18}FDG, in the assessment of endocrine tumors: of the thyroid, of the parathyroid, of the adrenal and of the pituitary glands. Neuroendocrine tumors, gastro-entero-pancreatic or carcinoid tumors are also under the scope. Usually, the most differentiated tumors show only poor uptake of the FDG as they have a weak metabolic and proliferative activity. In the assessment of endocrine tumors, FDG-PET should be used only after most specific nuclear examinations been performed. (author)

  12. Detection of Unknown Primary Tumors Using Whole Body FDG PET

    ZHAOJun; LINXiangtong; GUANYihui; ZUOChuantao; HUAFengchun; SHENGXiaofang; WANGYang

    2003-01-01

    Objective: To assess the usefulness of 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in locating occult primary lesions. Methods: 50 patients with varying hetero-geneous metastases of unknown primary origin were referred for FDG PET. The locations of the known metastatic tumor manifestations were distributed as follows: cervical lymph nodes metastases (n=18),skeletal metastases (n=15), cerebral metastases (n=12), others (n=5). All patients underwent whole body 18F-FDG PET imaging. The images were interpreted by visual inspection and semi-quantitative analysis(standardized uptake value, SUV). The patients had undergone conventional imaging within 2 weeks of FDG PET. Surgical, clinical and histopathologic findings were used to assess the performance of FDG PET.Results: FDG PET was able to detect the location of the primary tumor in 32/50 patients (64%). The primary tumors were proved by histopathologic results, and located in the lungs (n=17), the nasopharynx(n=9), the breast (n=2), the ovary (n=l), the colon(n=l), the prostate(n=l),the thyroid (n=l). FDG PET were proved false positive in 2 patients (4%), and the suspicious primary tumors were in uterus and colon respectively. During the clinical follow-up of 2 to 26 months, the primary tumor was found in only 2 patients ( prostate cancer, gastric cancer). Conclusion: PET imaging allows identification of the primary site and metastatic lesions(including bone and soft tissue metastases) at a single examination.Whole body lSF-FDG PET allows effective localization of the unknown primary site of origin and can contribute substantially to patient care.

  13. Lung tumor segmentation in PET images using graph cuts.

    Ballangan, Cherry; Wang, Xiuying; Fulham, Michael; Eberl, Stefan; Feng, David Dagan

    2013-03-01

    The aim of segmentation of tumor regions in positron emission tomography (PET) is to provide more accurate measurements of tumor size and extension into adjacent structures, than is possible with visual assessment alone and hence improve patient management decisions. We propose a segmentation energy function for the graph cuts technique to improve lung tumor segmentation with PET. Our segmentation energy is based on an analysis of the tumor voxels in PET images combined with a standardized uptake value (SUV) cost function and a monotonic downhill SUV feature. The monotonic downhill feature avoids segmentation leakage into surrounding tissues with similar or higher PET tracer uptake than the tumor and the SUV cost function improves the boundary definition and also addresses situations where the lung tumor is heterogeneous. We evaluated the method in 42 clinical PET volumes from patients with non-small cell lung cancer (NSCLC). Our method improves segmentation and performs better than region growing approaches, the watershed technique, fuzzy-c-means, region-based active contour and tumor customized downhill. PMID:23146420

  14. PET/FDG EB GastroIntestinal Stromal Tumors (GIST)

    Objectives: Review the results of PET / FDG in patients diagnosed with GIST, to establish whether there is active tumor requiring treatment with imatinib or to evaluate the response to it; Imatinib is a tyrosine kinase inhibitor which in turn, by a mutation of a proto-oncogene leads to uncontrolled cell proliferation. Methods: Practical PET / CT from the vertex to the middle third of the thighs, 90 minutes after IV administration of FDG (0.42 mCi / Kgrm) with Discovery LS PET / CT GE

  15. FDG PET/CT imaging of lung tumor

    PET/CT imaging combines PET for functional information and CT for morphological information in a single examination, and has shown how the initial staging with lung cancer. [18F]fluoro-deoxy-glucose (FDG) PET/CT imaging has a higher diagnostic accuracy for lung cancer except so-called bronchioloalveolar carcinoma and acute inflammatory lesion such as tuberculosis, pneumonia etc, compared with the conventional diagnostic modalities. FDG PET/CT imaging can demonstrate unexpected sites of mediastinal lymph node metastases (N factor), distant metastases (M factor) in initial staging and influence treatment plans for lung cancer. Furthermore, the grade of FDG uptake on PET/CT predicts prognosis of lung cancer and evaluates tumor response to treatment. Recurrences or metastases of lung cancer, and pleural disease can be detected correctly on FDG PET/CT. It is important that interpreting physicians understand the role of FDG PET/CT in staging, assessing of treatment and observing after therapy on the multidisciplinary managements of lung cancer. The clinical applications of PET/CT are still evolving, and future researches will determine the precise role that combined metabolic and morphological imaging has to play in the management of patients with lung cancer. (author)

  16. PET examination in intracranial tumor diagnosis of a cat

    This paper shows the significance of the Positron Emission Tomography (PET) in the veterinary medication through a case study of a cat brain tumor. A castrated male cat with bilateral mydriasis and blindness arrived at the veterinary clinic. After physical, laboratory and neurological investigations other sickness was ruled out and the inkling of the intracranial lesion had come to light. Brain tumor seemed the most likely to cause the illness because other symptoms appeared (for example: anorexia, depression) and they progrediated fast. PET examination, using 18F-FDG isotope, was performed to confirm the possible causes of the cat's symptoms

  17. PET examination in intracranial tumor diagnosis of a cat

    Angyal, G.; Csepura, G.; Balkay, L.; Galuska, L.; Molnár, J.; Valastyán, I.

    2008-12-01

    This paper shows the significance of the Positron Emission Tomography (PET) in the veterinary medication through a case study of a cat brain tumor. A castrated male cat with bilateral mydriasis and blindness arrived at the veterinary clinic. After physical, laboratory and neurological investigations other sickness was ruled out and the inkling of the intracranial lesion had come to light. Brain tumor seemed the most likely to cause the illness because other symptoms appeared (for example: anorexia, depression) and they progrediated fast. PET examination, using 18F-FDG isotope, was performed to confirm the possible causes of the cat's symptoms

  18. Utility of C-11 Choline PET for brain tumors

    The purpose of the present study was to assess the clinical potential of methyl-11C choline (C-11 choline) in brain tumors. The results of magnetic resonance (MR) imaging in 23 patients suspected of having brain tumors were then compared to the results of C-11 choline and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET). PET with C-11 choline and FDG, in addition to gadolinium-enhanced MR, were performed in these patients. A pathological diagnosis was made for each patient by open surgery. The standardized uptake values (SUVs) of brain tumors and the tumor-to-white matter count (T/W) ratios were determined. The degree of C-11 choline accumulation noted in PET images was compared to the gadolinium-enhanced areas of MR images. The mean T/W ratio of high-grade gliomas was found to be higher than that of low-grade gliomas. This difference was statistically significant (mean±SD: 8.7±6.2, n=9 versus 1.5±0.7 respectively, n=5, p<0.03) when data pertaining to the prominent uptake of C-11 choline by a patient with a pilocytic astrocytoma was excluded. C-11 choline PET failed to detect non-neoplastic lesions in two patients. Areas of C-11 choline accumulation in PET scans were longer than areas visualized by contrast enhancement on MR images in five cases involving high-grade gliomas. C-11 choline PET differentiated between low-grade gliomas and high-grade gliomas, but did not differentiate between low-grade gliomas and non-neoplasms. A combination of C-11 choline PET and MR imaging may provide investigators with accurate means to identify high-grade gliomas. (author)

  19. Utility of C-11 Choline PET for brain tumors

    Ohtani, Toshiyuki; Hashiba, Yasuhiro; Tosaka, Masahiko; Fujimaki, Hiroya; Sasaki, Tomio; Oriuchi, Noboru [Gunma Univ., Maebashi (Japan). School of Medicine; Inoue, Tomio [Yokohama City Univ. (Japan). School of Medicine

    2002-03-01

    The purpose of the present study was to assess the clinical potential of methyl-{sup 11}C choline (C-11 choline) in brain tumors. The results of magnetic resonance (MR) imaging in 23 patients suspected of having brain tumors were then compared to the results of C-11 choline and {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET). PET with C-11 choline and FDG, in addition to gadolinium-enhanced MR, were performed in these patients. A pathological diagnosis was made for each patient by open surgery. The standardized uptake values (SUVs) of brain tumors and the tumor-to-white matter count (T/W) ratios were determined. The degree of C-11 choline accumulation noted in PET images was compared to the gadolinium-enhanced areas of MR images. The mean T/W ratio of high-grade gliomas was found to be higher than that of low-grade gliomas. This difference was statistically significant (mean{+-}SD: 8.7{+-}6.2, n=9 versus 1.5{+-}0.7 respectively, n=5, p<0.03) when data pertaining to the prominent uptake of C-11 choline by a patient with a pilocytic astrocytoma was excluded. C-11 choline PET failed to detect non-neoplastic lesions in two patients. Areas of C-11 choline accumulation in PET scans were longer than areas visualized by contrast enhancement on MR images in five cases involving high-grade gliomas. C-11 choline PET differentiated between low-grade gliomas and high-grade gliomas, but did not differentiate between low-grade gliomas and non-neoplasms. A combination of C-11 choline PET and MR imaging may provide investigators with accurate means to identify high-grade gliomas. (author)

  20. A phantom study of tumor contouring on PET imaging

    Objective: To explore an algorithm to define the threshold value for tumor contouring on 18F-fluorodeoxyglucose (FDG) PET imaging. Methods: A National Electrical Manufacturing Association (NEMA)NU 2 1994 PET phantom with 5 spheres of different diameters were filled with 18F-FDG. Seven different sphere-to-background ratios were obtained and the phantom was scanned by Discovery LS 4. For each sphere-to-background ratio, the maximum standardized uptake value (SUVmax) of each sphere, the SUV of the border of each sphere (SUVborder), the mean SUV of a 1 cm region of background (SUVbg) and the diameter (D) of each sphere were measured. SPSS 13.0 software was used for curve fitting and regression analysis to obtain the threshold algorithm. The calculated thresholds were applied to delineate 29 pathologically confirmed lung cancer lesions on PET images and the obtained volumes were compared with the volumes contoured on CT images in lung window. Results: The algorithm for defining contour threshold is TH% = 33.1% + 46.8% SUVbg/SUVmax + 13.9%/D (r = 0.994) by phantom studies. For 29 lung cancer lesions, the average gross tumor volumes (GTV) delineated on PET and CT are (7.36±1.62) ml and (8.31±2.05) ml, respectively (t = -1.26, P>0.05). Conclusion: The proposed threshold algorithm for tumor contouring on PET image could provide comparable GTV with CT. (authors)

  1. Choline PET for Monitoring Early Tumor Response to Photodynamic Therapy

    Fei, Baowei; Wang, Hesheng; Wu, Chunying; Chiu, Song-mao

    2009-01-01

    Photodynamic therapy (PDT) is a relatively new therapy that has shown promise for treating various cancers in both preclinical and clinical studies. The present study evaluated the potential use of PET with radiolabeled choline to monitor early tumor response to PDT in animal models.

  2. 18F-FDG PET/MRI fusion in characterizing pancreatic tumors. Comparison to PET/CT

    The objective of this study was to demonstrate that positron emission tomography (PET)/magnetic resonance imaging (MRI) fusion was feasible in characterizing pancreatic tumors (PTs), comparing MRI and computed tomography (CT) as mapping images for fusion with PET as well as fused PET/MRI and PET/CT. We retrospectively reviewed 47 sets of 18F-fluorodeoxyglucose (18F-FDG) PET/CT and MRI examinations to evaluate suspected or known pancreatic cancer. To assess the ability of mapping images for fusion with PET, CT (of PET/CT), T1- and T2-weighted (w) MR images (all non-contrast) were graded regarding the visibility of PT (5-point confidence scale). Fused PET/CT, PET/T1-w or T2-w MR images of the upper abdomen were evaluated to determine whether mapping images provided additional diagnostic information to PET alone (3-point scale). The overall quality of PET/CT or PET/MRI sets in diagnosis was also assessed (3-point scale). These PET/MRI-related scores were compared to PET/CT-related scores and the accuracy in characterizing PTs was compared. Forty-three PTs were visualized on CT or MRI, including 30 with abnormal FDG uptake and 13 without. The confidence score for the visibility of PT was significantly higher on T1-w MRI than CT. The scores for additional diagnostic information to PET and overall quality of each image set in diagnosis were significantly higher on the PET/T1-w MRI set than the PET/CT set. The diagnostic accuracy was higher on PET/T1-w or PET/T2-w MRI (93.0 and 90.7%, respectively) than PET/CT (88.4%), but statistical significance was not obtained. PET/MRI fusion, especially PET with T1-w MRI, was demonstrated to be superior to PET/CT in characterizing PTs, offering better mapping and fusion image quality. (author)

  3. Early Tumor Response to Hsp90 Therapy Using HER2 PET: Comparison with 18F-FDG PET

    Smith-Jones, Peter M.; Solit, David; Afroze, Farzana; Rosen, Neal; Larson, Steven M.

    2006-01-01

    We compared 68Ga-DOTA-F(ab′)2-herceptin (DOTA is 1,4,7,10-tetraazacyclododecane-N,N′,N″,N‴-tetraacetic acid [HER2 PET]) and 18F-FDG PET for imaging of tumor response to the heat shock protein 90 (Hsp90) inhibitor 17-allylamino-17-demethoxygeldanamycin (17AAG).

  4. PET and PET/CT in tumour of undetermined origin; PET y PET/CT en tumor de origen indeterminado

    Garcia O, J.R. [Nuclear Medicine and Molecular Imaging, PET/CT, Centro Medico ABC, Mexico D.F. (Mexico)

    2007-07-01

    In this presentation the following conclusions were obtained regarding the use of PET and PET/CT in patient with cancer of unknown primary: 1. Detection of the primary one in 1/3 at 1/2 of patient. 2. It detects metastases in other places in 50%. 3. It changes the initial therapy planned in 1/3 at 1/2 of patient. 4. Useful in initial phases of protocol study to limit the other procedures. After standard evaluation. Before advanced protocol. 5. PET/CT study increases the % of primary detection, although in a non significant way vs. PET. 6. They are required more studies to value their utility to a more objective manner. (Author)

  5. A pretargeting system for tumor PET imaging and radioimmunotherapy

    Françoise eKraeber-Bodéré

    2015-03-01

    Full Text Available Labeled antibodies, as well as their fragments and antibody-derived recombinant constructs, have long been proposed as general vectors to target radionuclides to tumor lesions for imaging and therapy. They have indeed shown promise in both imaging and therapeutic applications, but they have not fulfilled the original expectations of achieving sufficient image contrast for tumor detection or sufficient radiation dose delivered to tumors for therapy. Pretargeting was originally developed for tumor immunoscintigraphy. It was assumed that directly-radiolabled antibodies could be replaced by an unlabeled immunoconjugate capable of binding both a tumor-specific antigen and a small molecular weight molecule. The small molecular weight molecule would carry the radioactive payload and would be injected after the bispecific immunoconjugate. It has been demonstrated that this approach does allow for both antibody-specific recognition and fast clearance of the radioactive molecule, thus resulting in improved tumor-to-normal tissue contrast ratios. It was subsequently shown that pretargeting also held promise for tumor therapy, translating improved tumor-to-normal tissue contrast ratios into more specific delivery of absorbed radiation doses. Many technical approaches have been proposed to implement pretargeting, and two have been extensively documented. One is based on the avidin-biotin system, and the other on bispecific antibodies binding a tumor-specific antigen and a hapten. Both have been studied in preclinical models, as well as in several clinical studies, and have shown improved targeting efficiency. This article reviews the historical and recent preclinical and clinical advances in the use of bispecific-antibody-based pretargeting for radioimmunodetection and radioimmunotherapy of cancer. The results of recent evaluation of pretargeting in PET imaging also are discussed.

  6. Assessment of Chemotherapy Response Using FDG-PET in Pediatric Bone Tumors: A Single Institution Experience

    Kim, Dong Hwan; Kim, Seung Yeon; Lee, Hyeon Jeong; Song, Bong Sup; Kim, Dong Ho; Cho, Joong Bum; Lim, Jung Sub; Lee, Jun Ah

    2011-01-01

    Purpose Response to neo-adjuvant chemotherapy is an important prognostic factor for osteosarcoma (OS) and the Ewing sarcoma family of tumors (ESFT). [F-18]-fluorodeoxy-D-glucose (FDG)-positron emission tomography (PET) is a non-invasive imaging modality that predicts histologic response to chemotherapy of various malignancies; however, limited data exist about the usefulness of FDG-PET in predicting the histologic response of pediatric bone tumors to chemotherapy. We analyzed the FDG-PET imag...

  7. PET-CT Fusion in Radiation Management of Patients with Anorectal Tumors

    Purpose: To compare computed tomography (CT) with positron emission tomography-CT (PET-CT) scans with respect to anorectal tumor volumes, correlation in overlap, and influence on radiation treatment fields and patient care. Patients and Methods: From March to November 2003, 20 patients with rectal cancer and 3 patients with anal cancer were treated with preoperative or definitive chemoradiation, respectively. Computed tomography simulation data generated a CT gross tumor volume (CT-GTV) and CT planning target volume (CT-PTV) and 18F-fluoro-2-deoxy-glucose PET (FDG-PET) created a PET-GTV and PET-PTV. The PET-CT and CT images were fused using manual coregistration. Patients were treated with three-dimensional conformal therapy to traditional doses. The PET, CT, and overlap volumes (OVs) were measured in cubic centimeters. Results: Mean PET-GTV was smaller than the mean CT-GTV (91.7 vs. 99.6 cm3). The mean OV was 46.7%. As tumor volume increased, PET and CT OV correlated significantly (p 10 and the posttreatment PET standardized uptake value was <6, 100% achieved pathologic downstaging (p = 0.047). Conclusions: Variation in volume was significant, with 17% and 26% of patients requiring a change in treatment fields and patient management, respectively. Positron emission tomography can change the management for anorectal tumors by early detection of metastatic disease or disease outside standard radiation fields

  8. Analysis of 18F-FDG PET mapping in malignant tumor patients with depression by SPM

    Objective: To investigate brain 18F-fluorodeoxyglucose (FDG) PET mapping in malignant tumor patients with depressive emotion. Methods: 18F-FDG PET imaging was performed in 21 malignant tumor patients (tumor group) and 21 healthy controls (control group). All were evaluated by self-rating depression scale (SDS)and 24 questions Hamilton rating scale for depression (HAMD). Results: (1) The standard total score of SDS and HAMD of the tumor group were higher than those of the control group (P18F-FDG PET imagings. The abnormalities of glucose metabolism might be related to their depressive emotion. (authors)

  9. Multimodal imaging utilising integrated MR-PET for human brain tumour assessment

    Neuner, Irene [Institute of Neuroscience and Medicine 4, INM 4, Juelich (Germany); RWTH Aachen University, Department of Psychiatry, Psychotherapy and Psychosomatics, Aachen (Germany); JARA-BRAIN-Translational Medicine, Aachen (Germany); Kaffanke, Joachim B. [Institute of Neuroscience and Medicine 4, INM 4, Juelich (Germany); MR-Transfer e.K., Wuppertal (Germany); Langen, Karl-Josef; Kops, Elena Rota; Tellmann, Lutz; Stoffels, Gabriele; Weirich, Christoph; Filss, Christian; Scheins, Juergen; Herzog, Hans [Institute of Neuroscience and Medicine 4, INM 4, Juelich (Germany); Shah, N. Jon [Institute of Neuroscience and Medicine 4, INM 4, Juelich (Germany); RWTH Aachen University, Department of Neurology, Aachen (Germany); JARA-BRAIN-Translational Medicine, Aachen (Germany)

    2012-12-15

    The development of integrated magnetic resonance (MR)-positron emission tomography (PET) hybrid imaging opens up new horizons for imaging in neuro-oncology. In cerebral gliomas the definition of tumour extent may be difficult to ascertain using standard MR imaging (MRI) only. The differentiation of post-therapeutic scar tissue, tumour rests and tumour recurrence is challenging. The relationship to structures such as the pyramidal tract to the tumour mass influences the therapeutic neurosurgical approach. The diagnostic information may be enriched by sophisticated MR techniques such as diffusion tensor imaging (DTI), multiple-volume proton MR spectroscopic imaging (MRSI) and functional MRI (fMRI). Metabolic imaging with PET, especially using amino acid tracers such as {sup 18}F-fluoroethyl-l-tyrosine (FET) or {sup 11}C-l-methionine (MET) will indicate tumour extent and response to treatment. The new technologies comprising MR-PET hybrid systems have the advantage of providing comprehensive answers by a one-stop-job of 40-50 min. The combined approach provides data of different modalities using the same iso-centre, resulting in optimal spatial and temporal realignment. All images are acquired exactly under the same physiological conditions. We describe the imaging protocol in detail and provide patient examples for the different imaging modalities such as FET-PET, standard structural imaging (T1-weighted, T2-weighted, T1-weighted contrast agent enhanced), DTI, MRSI and fMRI. (orig.)

  10. Multimodal imaging utilising integrated MR-PET for human brain tumour assessment

    The development of integrated magnetic resonance (MR)-positron emission tomography (PET) hybrid imaging opens up new horizons for imaging in neuro-oncology. In cerebral gliomas the definition of tumour extent may be difficult to ascertain using standard MR imaging (MRI) only. The differentiation of post-therapeutic scar tissue, tumour rests and tumour recurrence is challenging. The relationship to structures such as the pyramidal tract to the tumour mass influences the therapeutic neurosurgical approach. The diagnostic information may be enriched by sophisticated MR techniques such as diffusion tensor imaging (DTI), multiple-volume proton MR spectroscopic imaging (MRSI) and functional MRI (fMRI). Metabolic imaging with PET, especially using amino acid tracers such as 18F-fluoroethyl-l-tyrosine (FET) or 11C-l-methionine (MET) will indicate tumour extent and response to treatment. The new technologies comprising MR-PET hybrid systems have the advantage of providing comprehensive answers by a one-stop-job of 40-50 min. The combined approach provides data of different modalities using the same iso-centre, resulting in optimal spatial and temporal realignment. All images are acquired exactly under the same physiological conditions. We describe the imaging protocol in detail and provide patient examples for the different imaging modalities such as FET-PET, standard structural imaging (T1-weighted, T2-weighted, T1-weighted contrast agent enhanced), DTI, MRSI and fMRI. (orig.)

  11. Diagnostic value of PET/CT for the staging and restaging of pediatric tumors

    The objective of this retrospective study was to compare the diagnostic value of 2-[18F]fluoro-2-deoxy-d-glucose positron emission tomography (18F-FDG PET)/CT versus 18F-FDG PET and CT alone for staging and restaging of pediatric solid tumors. Forty-three children and adolescents (19 females and 24 males; mean age, 15.2 years; age range, 6-20 years) with osteosarcoma (n 1), squamous cell carcinoma (n = 1), synovial sarcoma (n = 2), germ cell tumor (n = 2), neuroblastoma (n = 2), desmoid tumor (n = 2), melanoma (n = 3), rhabdomyosarcoma (n = 5), Hodgkin's lymphoma (n = 7), non-Hodgkin-lymphoma (n 9), and Ewing's sarcoma (n = 9) who had undergone 18F-FDG PET/CT imaging for primary staging or follow-up of metastases were included in this study. The presence, location, and size of primary tumors was determined separately for PET/CT, PET, and CT by two experienced reviewers. The diagnosis of the primary tumor was confirmed by histopathology. The presence or absence of metastases was confirmed by histopathology (n = 62) or clinical and imaging follow-up (n 238). The sensitivities for the detection of solid primary tumors using integrated 18F-FDG PET/CT (95%), 18F-FDG PET alone (73%), and CT alone (93%) were not significantly different (p > 0.05). Seventeen patients showed a total of 153 distant metastases. Integrated PET/CT had a significantly higher sensitivity for the detection of these metastases (91%) than PET alone (37%; p 0.05). When lesions with a diameter of less than 0.5 cm were excluded, PET/CT (89%) showed a significantly higher specificity compared to PET (45%; p 18F-FDG PET/CT, 18F-FDG PET alone, and CT alone were diagnostically correct in 83%, 61%, and 42%. A sub-analysis focusing on the ability of PET/CT, PET, and CT to detect osseous metastases showed no statistically significant difference between the three imaging modalities (p > 0.05). Our study showed a significantly increased sensitivity of PET/CT over that of PET for the detection of distant

  12. Evaluation of thymic tumors with 18F-FDG PET-CT - A pictorial review

    Sharma, Punit; Singhal, Abhinav; Bal, Chandrasekhar; Malhotra, Arun; Kumar, Rakesh [Dept. of Nuclear Medicine, All India Inst. of Medical Sciences, New Delhi (India)], e-mail: rkphulia@yahoo.com; Kumar, Arvind [Dept. of Surgical Disciplines, All India Inst. of Medical Sciences, New Delhi (India)

    2013-02-15

    Thymic tumors represent a broad spectrum of neoplastic disorders and pose considerable diagnostic difficulties. A non-invasive imaging study to determine the nature of thymic lesions can have significant impact on management of such tumors. 18F-flurorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET-CT) has shown promising results in characterization of thymic tumors. The objective of this article is to provide an illustrative tutorial highlighting the clinical utility of 18F-FDG PET-CT imaging in patients with thymic tumors. We have pictorially depicted the 18F-FDG PET-CT salient imaging characteristics of various thymic tumors, both epithelial and non-epithelial. Also discussed is the dynamic physiology of thymus gland which is to be kept in mind when evaluating thymic pathology on 18F-FDG PET-CT, as it can lead to interpretative pitfalls.

  13. Recurrent giant cell tumor of foot detected by F18-FDG PET/CT

    Detection of recurrence of tumors with conventional imaging like computed tomography (CT) and magnetic resonance imaging (MRI) can be difficult because of distorted anatomy and implants in situ. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) has been shown to be very useful in detection of recurrent tumors with higher accuracy than conventional imaging method. Giant cell tumors of foot though rare have high recurrence potential after initial curative treatment. However, currently there is no literature addressing the role of F-18 FDG PET/CT in evaluation of these tumors. We report a case of post excisional recurrent giant cell tumor of foot diagnosed on F-18 FDG PET/CT. In addition, to detection of recurrence F-18 FDG PET/CT also aided in accurate management of the patient. (author)

  14. Evaluation of thymic tumors with 18F-FDG PET-CT - A pictorial review

    Thymic tumors represent a broad spectrum of neoplastic disorders and pose considerable diagnostic difficulties. A non-invasive imaging study to determine the nature of thymic lesions can have significant impact on management of such tumors. 18F-flurorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET-CT) has shown promising results in characterization of thymic tumors. The objective of this article is to provide an illustrative tutorial highlighting the clinical utility of 18F-FDG PET-CT imaging in patients with thymic tumors. We have pictorially depicted the 18F-FDG PET-CT salient imaging characteristics of various thymic tumors, both epithelial and non-epithelial. Also discussed is the dynamic physiology of thymus gland which is to be kept in mind when evaluating thymic pathology on 18F-FDG PET-CT, as it can lead to interpretative pitfalls

  15. Clinical value of PET/CT for the management of malignant tumors

    Objective: To investigate the clinical value of PET/CT for the management of malignant tumors. Methods: 96 patients (68 male, 28 female, mean age 61.7, ranged 26-89 years old). All are confirmed by pathology or clinic ally except brain tumor and all were not treated. PET/CT imaging was performed using GE Discovery LS PET/CT. Radiotherapy target definition: gross target volume (GTV) was defined using PET/CT fusion imaging. All data were analyzed with SPSS 10.0. Results: 1) Of 96 patients, PET/CT detection sensitivity was 97.92%. The overall tumor staging was changed in 44(45.83%) patients and the rates of metastasis to the lymph nodes and other organs were increased 37.50% and 23.96%, respectively. 2) The therapy regimen was changed in 35(36.46%) patients after PET/CT imaging. 3) The size, boundary and surrounding tissue of the tumor were clearly delineated in the fusion image. Hence it was possible for localization of biological target volume in radiotherapy and also for assessment of the resected extent for surgery. Conclusion: PET/CT plays an important role in early diagnosis, accurate staging and management of tumor patients, especially as a guide to localization of the target volume in radiotherapy and assessment of the resected tumor extent during operation. (authors)

  16. FDG-PET probe-guided surgery for recurrent retroperitoneal testicular tumor recurrences

    Jong, J.S. de; van Ginkel, R.J.; Slart, R.H.J.A.; Lemstra, C.L.; Paans, A.M.J.; Mulder, N. H.; Hoekstra, H.J.

    2010-01-01

    Abstract Aim Tumor marker based recurrences of previously treated testicular cancer are generally detected with CT-scan. They sometimes cannot be visualized with conventional morphologic imaging. FDG-PET has the ability to detect these recurrences. PET probe-guided surgery, may facilitate the extent of surgery and optimize the surgical resection. Methods Three patient with resectable 2nd or 3rd recurrent testicular cancer based on elevated tumor mar...

  17. Benign and malignant neurogenic tumors of nerve sheath origin on FDG PET

    The differentiation between benign and malignant nerve sheath tumors is difficult based on conventional radiological imaging. This study was undertaken to investigate the value of FDG PET in distinguishing benign from malignant neurogenic tumors of nerve sheath origin. We performed a retrospective review of the medical record to select patients with nerve sheath tumors who had underdone FDG PET imaging. Fifteen patients (7F: 8M) with benign or malignant nerve sheath tumors were included in this study. Of the 15 patients, 9 were diagnosed with the known neurofibromatosis type I. A total of 19 nerve sheath tumors were included from the 15 patients. All patients had undergone FDG PET to evaluate for malignant potential of the known lesions. Images of FDG PET were semi-quantitatively analyzed and a region of interest (ROI) was placed over the area of the maximum FDG uptake and an average standardized uptake value was taken for final analysis. There were 5 malignant peripheral nerve sheath tumors, 5 schwannomas, and 9 neurofibromas. The mean SUV was 2 (ranged from 1.6 to 3.3) for schwannomas, 1.3 (0.7 to 2.5) for neurofibromas, and 8.4 (4.6 to 12.2) for malignant peripheral nerve sheath tumors. Of 14 benign tumors, all except one schwannoma showed a SUV less than 3. When a cutoff SUV of 4 was used to differentiate the nerve sheath tumors, all tumors were correctly classified as benign or malignant, respectively. Among the 9 patients diagnosed with neurofibromatosis type I. 4 had malignant peripheral nerve sheath tumors and FDG PET accurately detected all the 4 lesions with malignant transformation. According to our results, FDG PET seems to have a great potential for accurately characterizing benign versus malignant nerve sheath tumors. It appears to be extremely useful for patients with neurofibromatosis to localize the lesion with malignant transformation

  18. Benign and malignant neurogenic tumors of nerve sheath origin on FDG PET

    Yun, M. J.; Go, D. H.; Yoo, Y. H.; Shin, K. H.; Lee, J. D [College of Medicine, Yonsei University, Seoul (Korea, Republic of)

    2004-07-01

    The differentiation between benign and malignant nerve sheath tumors is difficult based on conventional radiological imaging. This study was undertaken to investigate the value of FDG PET in distinguishing benign from malignant neurogenic tumors of nerve sheath origin. We performed a retrospective review of the medical record to select patients with nerve sheath tumors who had underdone FDG PET imaging. Fifteen patients (7F: 8M) with benign or malignant nerve sheath tumors were included in this study. Of the 15 patients, 9 were diagnosed with the known neurofibromatosis type I. A total of 19 nerve sheath tumors were included from the 15 patients. All patients had undergone FDG PET to evaluate for malignant potential of the known lesions. Images of FDG PET were semi-quantitatively analyzed and a region of interest (ROI) was placed over the area of the maximum FDG uptake and an average standardized uptake value was taken for final analysis. There were 5 malignant peripheral nerve sheath tumors, 5 schwannomas, and 9 neurofibromas. The mean SUV was 2 (ranged from 1.6 to 3.3) for schwannomas, 1.3 (0.7 to 2.5) for neurofibromas, and 8.4 (4.6 to 12.2) for malignant peripheral nerve sheath tumors. Of 14 benign tumors, all except one schwannoma showed a SUV less than 3. When a cutoff SUV of 4 was used to differentiate the nerve sheath tumors, all tumors were correctly classified as benign or malignant, respectively. Among the 9 patients diagnosed with neurofibromatosis type I. 4 had malignant peripheral nerve sheath tumors and FDG PET accurately detected all the 4 lesions with malignant transformation. According to our results, FDG PET seems to have a great potential for accurately characterizing benign versus malignant nerve sheath tumors. It appears to be extremely useful for patients with neurofibromatosis to localize the lesion with malignant transformation.

  19. Role of 18F - DOPA PET/CT in evaluation of patients with neuroendocrine tumors (NETs)

    Full text: NETs are heterogeneous group of tumors which take up amino acids, transform them into biogenic amines and store the amines in vesicles, this forms the basis of uptake of 18F-DOPA in these tumors. These tumors can be small and situated almost throughout the body and may also present as advanced disease with multiple metastatic sites. Like in management of any other tumor it is imperative to stage the status of disease in NETs for the effective management of these patients and 18F-DOPA PET/CT is one such imaging modality used in the evaluation of neuroendocrine tumors (NETs). Here is our initial experience using 18F-DOPA PET/CT imaging in these patients. Twenty-seven patients with NETs (carcinoids, medullary thyroid carcinomas, phaeochromocytomas Insulinoma) were prospectively enrolled and scheduled for 18F-DOPA PET/CT. Wherever possible, tissue diagnosis was attempted. Results obtained were compared with other conventional diagnostic procedures (mainly 18F-FDG PET/CT, and 68Ga-DOTANOC PET/CT, and with ultrasound, CT, etc) and with follow-up. 18F-DOPA PET/CT identified 17/24 positive cases in either the primary/metastatic/recurrent tumor. In case of Insulinoma 18F-DOPA was found to be most superior than other imaging modalities in localizing the disease and staging of disease

  20. Automatic delineation of tumor volumes by co-segmentation of combined PET/MR data

    Combined PET/MRI may be highly beneficial for radiotherapy treatment planning in terms of tumor delineation and characterization. To standardize tumor volume delineation, an automatic algorithm for the co-segmentation of head and neck (HN) tumors based on PET/MR data was developed. Ten HN patient datasets acquired in a combined PET/MR system were available for this study. The proposed algorithm uses both the anatomical T2-weighted MR and FDG-PET data. For both imaging modalities tumor probability maps were derived, assigning each voxel a probability of being cancerous based on its signal intensity. A combination of these maps was subsequently segmented using a threshold level set algorithm. To validate the method, tumor delineations from three radiation oncologists were available. Inter-observer variabilities and variabilities between the algorithm and each observer were quantified by means of the Dice similarity index and a distance measure. Inter-observer variabilities and variabilities between observers and algorithm were found to be comparable, suggesting that the proposed algorithm is adequate for PET/MR co-segmentation. Moreover, taking into account combined PET/MR data resulted in more consistent tumor delineations compared to MR information only. (paper)

  1. Desmoid Tumor Showing Intense Uptake on 68Ga PSMA-HBED-CC PET/CT.

    Kanthan, Gowri L; Hsiao, Edward; Kneebone, Andrew; Eade, Thomas; Schembri, Geoffrey Paul

    2016-06-01

    Ga-PSMA PET/CT is a new imaging technique that is highly sensitive to metastatic prostate cancer lesions compared with other conventional imaging modalities. We report a case of a 77-year-old man with newly diagnosed prostate carcinoma who had a PSMA PET/CT scan for staging of his disease. An intensely PSMA-avid right pelvic mass was identified abutting the cecum and terminal ileum. Surgical removal and histopathologic examination of this lesion revealed the diagnosis of a desmoid tumor. It is important to be aware that many tumors other than prostate carcinoma may also show avid uptake on PSMA PET/CT scan. PMID:26909712

  2. Automatic co-segmentation of lung tumor based on random forest in PET-CT images

    Jiang, Xueqing; Xiang, Dehui; Zhang, Bin; Zhu, Weifang; Shi, Fei; Chen, Xinjian

    2016-03-01

    In this paper, a fully automatic method is proposed to segment the lung tumor in clinical 3D PET-CT images. The proposed method effectively combines PET and CT information to make full use of the high contrast of PET images and superior spatial resolution of CT images. Our approach consists of three main parts: (1) initial segmentation, in which spines are removed in CT images and initial connected regions achieved by thresholding based segmentation in PET images; (2) coarse segmentation, in which monotonic downhill function is applied to rule out structures which have similar standardized uptake values (SUV) to the lung tumor but do not satisfy a monotonic property in PET images; (3) fine segmentation, random forests method is applied to accurately segment the lung tumor by extracting effective features from PET and CT images simultaneously. We validated our algorithm on a dataset which consists of 24 3D PET-CT images from different patients with non-small cell lung cancer (NSCLC). The average TPVF, FPVF and accuracy rate (ACC) were 83.65%, 0.05% and 99.93%, respectively. The correlation analysis shows our segmented lung tumor volumes has strong correlation ( average 0.985) with the ground truth 1 and ground truth 2 labeled by a clinical expert.

  3. The importance of PET/CT in the evaluation of patients with Ewing tumors

    Guimaraes, Julio Brandao; Rigo, Leticia; Lewin, Fabio; Emerick, Andre, E-mail: juliobrandaoguimaraes@hotmail.com [Hospital Sao Jose-Beneficincia Portuguesa de Sao Paulo, SP (Brazil)

    2015-05-15

    The effective evaluation for the treatment of patients with Ewing tumors depends on the accuracy in the determination of the primary tumor extent and the presence of metastatic disease. Currently, no universally accepted staging system is available to assess Ewing tumors. The present study aimed at discussing the use of PET/CT as a tool for staging, restaging and assessment of therapeutic response in patients with Ewing tumors. In spite of some limitations of PET/CT as compared with anatomical imaging methods, its relevance in the assessment of these patients is related to the capacity of the method to provide further physiological information, which often generates important clinical implications. Currently, the assessment of patients with Ewing tumor should comprise a study with PET/CT combined with other anatomical imaging modalities, such as radiography, computed tomography and magnetic resonance imaging. (author)

  4. Dynamic respiratory gated 18FDG-PET of lung tumors - a feasibility study

    Background. 18FDG-PET/CT imaging is well established for diagnosis and staging of lung tumors. However, more detailed information regarding the distribution of FDG within the tumor, also as a function of time after injection may be relevant. In this study we explore the feasibility of a combined dynamic and respiratory gated (DR) PET protocol. Material and methods. A DR FDG-PET protocol for a Siemens Biograph 16 PET/CT scanner was set up, allowing data acquisition from the time of FDG injection. Breath-hold (BH) respiratory gating was performed at four intervals over a total acquisition time of 50 minutes. Thus, the PET protocol provides both motion-free images and a spatiotemporal characterization of the glucose distribution in lung tumors. Software tools were developed in-house for tentative tumor segmentation and for extracting standard uptake values (SUVs) voxel by voxel, tumor volumes and SUV gradients in all directions. Results. Four pilot patients have been investigated with the DR PET protocol. The procedure was well tolerated by the patients. The BH images appeared sharper, and SUVmax/SUVmean was higher, compared to free breathing (FB) images. Also, SUV gradients in the periphery of the tumor in the BH images were in general greater than or equal to the gradients in the FB PET images. Conclusion. The DR FDG-PET protocol is feasible and the BH images have a superior quality compared to the FB images. The protocol may also provide information of relevance for radiotherapy planning and follow-up. A patient trial is needed for assessing the clinical value of the imaging protocol

  5. Assessment of Tumor Response to Therapy in Lymphoma Using 18F-FDG PET: Diagnostic Performance of 18F-FDG PET and Interval Likelihood Ratio

    In this paper, the authors intended to summarize briefly the features of lymphoma with regard to 18F-FDG PET for assessment of tumor response to therapy, to describe why assessment of treatment response should be performed, to review what method so far has been used in monitoring treatment response, to discuss what limitations of morphologic imaging criteria for assessing tumor response are, in compared with 18F-FDG PET, and to introduce recently proposed criteria for assessing tumor response in malignant lymphoma. And also the authors emphasize the need to understand the characteristics of diagnostic performance of 18F-FDG PET in several clinical settings in order to interpret 18F-FDG PET results appropriately, and to encourage the use of interval likelihood ratio to enhance clinical implications of test results which, in turns, allows referring physicians to understand the meaning of interpretation with easy. Until recently, treatment response has been assessed according to the morphologic criteria. Metabolic imaging with 18F-FDG PET was adopted to have important role for treatment assessment in IWC+PET criteria proposed recently by IHP. To accomplish this role, we should perform and interpret 18F-FDG PET according to IWC+PET criteria. It is important for referring physicians to understand the various limitations of 18F-FDG PET and pitfalls in PET interpretation, and to understand that clinical information are needed by nuclear medicine physicians to optimize the interpretation of 18F-FDG PET

  6. Diagnostic value of PET/CT for the staging and restaging of pediatric tumors

    Kleis, Margit [University of California (UCSF), Department of Radiology, San Francisco, CA (United States)]|[Technical University of Munich, Department of Radiology, Munich (Germany); Daldrup-Link, Heike; Lu, Ying; Schreck, Carole; Chu, Philip W.; Hawkins, Randall A.; Franc, Benjamin L. [University of California (UCSF), Department of Radiology, San Francisco, CA (United States); Matthay, Katherine [University of California, Department of Pediatrics, Division of Pediatric Hemato-Oncology, San Francisco, CA (United States); Goldsby, Robert [University of California, Department of Pediatric Oncology, San Francisco, CA (United States); Schuster, Tibor [Technical University of Munich, Department of Biostatistics and Epidemiology, Munich (Germany)

    2009-01-15

    The objective of this retrospective study was to compare the diagnostic value of 2-[{sup 18}F]fluoro-2-deoxy-d-glucose positron emission tomography ({sup 18}F-FDG PET)/CT versus {sup 18}F-FDG PET and CT alone for staging and restaging of pediatric solid tumors. Forty-three children and adolescents (19 females and 24 males; mean age, 15.2 years; age range, 6-20 years) with osteosarcoma (n = 1), squamous cell carcinoma (n = 1), synovial sarcoma (n = 2), germ cell tumor (n = 2), neuroblastoma (n = 2), desmoid tumor (n = 2), melanoma (n = 3), rhabdomyosarcoma (n = 5), Hodgkin's lymphoma (n = 7), non-Hodgkin-lymphoma (n = 9), and Ewing's sarcoma (n = 9) who had undergone {sup 18}F-FDG PET/CT imaging for primary staging or follow-up of metastases were included in this study. The presence, location, and size of primary tumors was determined separately for PET/CT, PET, and CT by two experienced reviewers. The diagnosis of the primary tumor was confirmed by histopathology. The presence or absence of metastases was confirmed by histopathology (n = 62) or clinical and imaging follow-up (n = 238). The sensitivities for the detection of solid primary tumors using integrated {sup 18}F-FDG PET/CT (95%), {sup 18}F-FDG PET alone (73%), and CT alone (93%) were not significantly different (p > 0.05). Seventeen patients showed a total of 153 distant metastases. Integrated PET/CT had a significantly higher sensitivity for the detection of these metastases (91%) than PET alone (37%; p < 0.05), but not CT alone (83%; p > 0.05). When lesions with a diameter of less than 0.5 cm were excluded, PET/CT (89%) showed a significantly higher specificity compared to PET (45%; p < 0.05) and CT (55%; p < 0.05). In a sub-analysis of pulmonary metastases, the values for sensitivity and specificity were 90%, 14%, 82% and 63%, 78%, 65%, respectively, for integrated PET/CT, stand-alone PET, and stand-alone CT. For the detection of regional lymph node metastases, {sup 18}F-FDG PET/CT, {sup 18}F

  7. Random walk and graph cut for co-segmentation of lung tumor on PET-CT images

    Ju, Wei; Xiang, Deihui; Zhang, Bin; Wang, Lirong; Kopriva, Ivica; Chen, Xinjian

    2015-01-01

    Accurate lung tumor delineation plays an important role in radiotherapy treatment planning. Since the lung tumor has poor boundary in positron emission tomography (PET) images and low contrast in computed tomography (CT) images, segmentation of tumor in the PET and CT images is a challenging task. In this paper, we effectively integrate the two modalities by making fully use of the superior contrast of PET images and superior spatial resolution of CT images. Random walk and graph cut method i...

  8. PET imaging in a longitudinal non-Hodgkin's lymphoma study: association with tumor volume

    Rossi, Maija; Jaervenpaeae, Ritva (Medical Imaging Centre, Dept. of Radiology, Tampere Univ. Hospital, Tampere (Finland)), email: maija.rossi@pshp.fi; Korkola, Pasi (Medical Imaging Centre, Dept. of Nuclear Medicine, Tampere Univ. Hospital, Tampere (Finland)); Pertovaara, Hannu (Dept. of Oncology, Tampere Univ. Hospital, Tampere (Finland)); Dastidar, Prasun; Soimakallio, Seppo (Medical Imaging Centre, Dept. of Radiology, Tampere Univ. Hospital, Tampere (Finland); Tampere Medical School, Tampere (Finland)); Wu, Xingchen (Medical Imaging Centre, Dept. of Radiology, Tampere Univ. Hospital, Tampere (Finland); Dept. of Oncology, Tampere Univ. Hospital, Tampere (Finland)); Eskola, Hannu (Medical Imaging Centre, Dept. of Radiology, Tampere Univ. Hospital, Tampere (Finland); Dept. of Biomedical Engineering, Tampere Univ. of Technology, Tampere (Finland)); Kellokumpu-Lehtinen, Pirkko-Liisa (Dept. of Oncology, Tampere Univ. Hospital, Tampere (Finland); Tampere Medical School, Tampere (Finland))

    2011-11-15

    Background. Computed tomography (CT) is generally used in the evaluation of the treatment response of non-Hodgkin's lymphoma (NHL) patients. Instead of morphological images, positron emission tomography (PET) shows metabolic information that is connected to tumor activity, cell proliferation rate, and, thus, prognosis. Purpose. To determine the prognostic value of PET for tumor volume reduction measured by CT and magnetic resonance imaging (MRI) along with clinical characteristics in NHL patients. Material and Methods. We imaged 21 B-cell type NHL patients using whole-body 18F-FDG-PET at the onset and the completion of treatment and at six-month follow-up. The maximum standardized uptake value (SUV{sub max}) was calculated. Morphological tumor volume calculations were assessed using both MRI and CT. Additionally, patients underwent thorough clinical examination including several laboratory tests. Results. A high SUV{sub max} was able to predict significant tumor volume reduction at the beginning of treatment, but the relation to pure tumor volume was poor. Conclusion. The SUV{sub max} values derived from FDG-PET seemed to correlate with volume changes but not with their absolute values or laboratory tests. Unlike MRI and CT, FDG-PET showed the disappearance of active tumors after treatment

  9. Discrimination of lung tumors on PET/CT images using registration method

    Positron Emission Tomography (PET) inspection have been performed to discover malignant tumor. However, it is difficult to discriminate benign tumors from malignant tumors, because the sugar metabolism is active on the inflammation of benign tumors as well as malignant tumors. In there cases, medical doctors take an image at regular intervals again to distinguish them. It is difficult to diagnosis lung tumor by observation, so the doctor does the comparable interpretation of radiogram. Then, we proposed a method to help doctor's comparison interpretation of radiogram using computers. We subtract between the early image and the delay image for the comparison interpretation of radiogram by computer, to make temporal subtraction image that emphasized the temporal change. Registration is important in the temporal difference image because correct difference processing cannot be done by the gap of the physique and the breath. However, the exact registration cannot be performed by the PET images because of their low resolution. The present study used the registration of the PET image is performed by doing the registration of the computed tomography image, and applying the deformation parameter to the PET image. After, we makes the temporal difference image of the PET image to distinguish it. (author)

  10. 6-L-(18)F-fluorodihydroxyphenylalanine PET in neuroendocrine tumors : Basic aspects and emerging clinical applications

    Jager, Pieter L.; Chirakal, Raman; Marriott, Christopher J.; Brouwers, Adrienne H.; Koopmans, Klaas Pieter; Gulenchyn, Karen Y.

    2008-01-01

    In recent years, 6-L-(18)F-fluorodihydroxyphenylalanine ((18)F-DOPA) PET has emerged as a new diagnostic tool for the imaging of neuroendocrine tumors. This application is based on the unique property of neuroendocrine tumors to produce and secrete various substances, a process that requires the upt

  11. (18)F-Fluorodeoxyglucose PET/Computed Tomography for Primary Brain Tumors

    Antonsen Segtnan, Eivind; Hess, Søren; Grupe, Peter;

    2015-01-01

    Structural imaging with computed tomography (CT) and MR imaging is the mainstay in primary diagnosis of primary brain tumors, but these modalities depend on morphologic appearance and an intact blood-brain barrier, and important aspects of tumor biology are not addressed. Such issues may be...... alleviated by (18)F-fluorodeoxyglucose (FDG)-PET and FDG-PET/CT imaging, which may provide clinically important information with regard to primary differentiation between tumor types, initial staging and risk stratification, therapy planning, response evaluation, and recurrence detection. This article...

  12. The effect of radiotherapy on rat pulmonary tumor model with PET/CT

    Objective: The aim of this study was to understand the role of PET/CT in monitoring the therapeutic effect of radiotherapy (RT) on lung cancer with Wistar rats. Methods: Thirty Wistar in-bred strain rats (6-8 weeks, weighed 180-280 g, female, ordinary) were made into Lewis pulmonary tumor model rats. 18F-fluorodeoxyglucose (FDG) PET/CT was performed when tumor reached 1.5-2.0 cm in greatest diameter (4-6 weeks) as a baseline. In order to get the optimal time point of PET/CT for monitoring RT effect in rat cancer model, PET/CT was performed at the 3rd day, 1st, 2n'd, 3rd, and 4th week after giving single dose of 5 Gy to each rat. Standardized uptake values (SUV) from FDG PET were measured and rats were sacrificed at different time point for validation. Besides, the expressions of glucose transport1 (Glut1) in tumor tissue were studied using immunohistochemistry. The level of tumor cell apoptosis, degradation, and necrosis were observed. SPSS 11.0 software was used for data analyses. Results: A negative correlation of SUV uptake and time after RT and negative correlation of Glut1 expression and time after RT were observed in rat tumors, respectively. Positive correlation of SUV uptake and Glut1 expression in rat tumors was observed (Spearman rank correlation test, rs = 0.97, P rd day and 0.18 ± 0.10 at the 4th week after RT (F=15.126, Prd day and 0. 1320 ± 0.04 at the 4th week after RT. The amounts of tumor cell apoptosis, degradation, and necrosis increased with time after RT. Conclusion: Though FDG PET could monitor the therapeutic effect at the 3rd day after giving single dose of RT to rat lung tumor model, the optimal time was the the 4th week after treatment. (authors)

  13. Evaluation of malignant solid tumor in childhood with FDG-PET

    Usefulness of FDG-PET (18F-deoxyglucose PET) was examined in evaluation of diagnosis and therapeutic efficacy of childhood malignant solid tumors. Subjects were 32 patients (16 males) of the median age of 7 y (1 - 27 y), involving those with neuroblastoma (9 cases), hepatoblastoma (4), chronic granulomatous disorder (4) and others (each ≤2). They underwent 75 FDG-PET examinations for diagnosis before and during treatment in authors' hospital in the period from May 2001 to December 2003. Standard uptake value (SUV), 1 x 1 cm region of interest (ROI) of abnormally high distribution area of radioactivity in the lesion/FDG dose/kg body wt., was used for evaluation: SUV>1.5 was defined positive. In neuroblastoma, FDG was found to be highly distributed and kinetics of SUV, to be useful for evaluation of therapeutic efficacy and early metastasis detection. In some cases of hepatoblastoma, the therapeutic effectiveness and recurrence were not satisfactorily evaluative. The distribution of FDG was not satisfactory in Wilms' tumor relative to other tumors. The PET was thought to be useful, despite their small case number examined, for those evaluations of Ewing's tumor, dysgerminoma and Langerhans cell histiocytosis. Thus FDG-PET was found useful for detection, evaluation of therapeutic efficacy and early metastasis detection of pediatric malignant solid tumors. (T.I.)

  14. Automatic Lung Tumor Segmentation on PET/CT Images Using Fuzzy Markov Random Field Model

    Yu Guo

    2014-01-01

    Full Text Available The combination of positron emission tomography (PET and CT images provides complementary functional and anatomical information of human tissues and it has been used for better tumor volume definition of lung cancer. This paper proposed a robust method for automatic lung tumor segmentation on PET/CT images. The new method is based on fuzzy Markov random field (MRF model. The combination of PET and CT image information is achieved by using a proper joint posterior probability distribution of observed features in the fuzzy MRF model which performs better than the commonly used Gaussian joint distribution. In this study, the PET and CT simulation images of 7 non-small cell lung cancer (NSCLC patients were used to evaluate the proposed method. Tumor segmentations with the proposed method and manual method by an experienced radiation oncologist on the fused images were performed, respectively. Segmentation results obtained with the two methods were similar and Dice’s similarity coefficient (DSC was 0.85 ± 0.013. It has been shown that effective and automatic segmentations can be achieved with this method for lung tumors which locate near other organs with similar intensities in PET and CT images, such as when the tumors extend into chest wall or mediastinum.

  15. 18F-FDG PET/CT is Useful for pretreatment Assessment of the Histopathologic Type of Thymic Epithelial Tumors

    This study was performed to assess the usefulness of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) of PET/computed tomography (CT) for distinguishing thymic epithelial tumors according to World Health Organization (WHO) classifications. We analyzed a total of 45 patients (range, 29-75 years of age; mean, 55 years) with pathologically confirmed thymic epithelial tumors who underwent pretreatment 18F-FDG PET or PET/CT between November 2003 and October 2009. The size, visual grading of uptake value, peak standardized uptake value (SUVpeak), uptake pattern, and contour of each tumor, and associated findings on PET or PET/CT, were analyzed relative to the three simplified WHO subgroups: lee-invasive thymomas (types A and AB), more-invasive thymomas (types B1, B2, and B3) and thymic carcinomas. We statistically assessed the relationship of 18F-FDG PET or PET/CT findings with these simplified subgroups. Of the 45 patients, ten had less-invasive thymomas, 23 had more-invasive thymomas, and 12 had thymic carcinomas. The SUVpeak of the less- and more-invasive thymomas were significantly lower than those of thymic carcinomas (p18F-FDG PET or PET/CT differed significantly by histologic subgroups. Pretreatment evaluation with 18F-FDG PET or PET/CT might be helpful in differentiating subgroups of thymic epithelial tumors.

  16. A new dimension of FDG-PET interpretation: assessment of tumor biology

    Kwee, Thomas C. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Basu, Sandip [Tata Memorial Center Annexe, Radiation Medicine Center (Bhabha Atomic Research Center), Bombay (India); Hospital of the University of Pennsylvania, Division of Nuclear Medicine, Philadelphia, PA (United States); Saboury, Babak; Torigian, Drew A.; Alavi, Abass [Hospital of the University of Pennsylvania, Division of Nuclear Medicine, Philadelphia, PA (United States); Ambrosini, Valentina [Sant' Orsola-Malpighi University Hospital, Department of Nuclear Medicine, Bologna (Italy)

    2011-06-15

    {sup 18}F-Fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) is increasingly being used for the evaluation of several malignancies. Key to the correct interpretation of oncological FDG-PET studies is awareness of the concept that the degree of FDG uptake reflects the biology of the tumor in many cancers. More specifically, cancers with high FDG uptake are often histologically and clinically more aggressive than those with low or no FDG uptake. Therefore, although a negative FDG-PET scan in a patient with a cancer that has a size above the spatial resolution of PET may be interpreted as false-negative in terms of tumor detectability, it should in fact be regarded as true-negative from the view-point of tumor biology. This nonsystematic review will give examples of several major cancers in which the relationship between FDG avidity and tumor biology is applicable, and emphasizes the need to reconsider the definition of a ''false-negative'' FDG-PET scan in clinical oncology. (orig.)

  17. A new dimension of FDG-PET interpretation: assessment of tumor biology

    18F-Fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) is increasingly being used for the evaluation of several malignancies. Key to the correct interpretation of oncological FDG-PET studies is awareness of the concept that the degree of FDG uptake reflects the biology of the tumor in many cancers. More specifically, cancers with high FDG uptake are often histologically and clinically more aggressive than those with low or no FDG uptake. Therefore, although a negative FDG-PET scan in a patient with a cancer that has a size above the spatial resolution of PET may be interpreted as false-negative in terms of tumor detectability, it should in fact be regarded as true-negative from the view-point of tumor biology. This nonsystematic review will give examples of several major cancers in which the relationship between FDG avidity and tumor biology is applicable, and emphasizes the need to reconsider the definition of a ''false-negative'' FDG-PET scan in clinical oncology. (orig.)

  18. Comparative evaluation of 11C methionine (MET-PET) and 18F flurodeoxyglucose (FDG) PET/CT for detection of recurrent brain tumors

    Full text: Comparative evaluation of 11C Methionine (MET-PET) and 18F flurodeoxyglucose (FDG) PET/CT for detection of recurrent brain tumors. Patients and Methods: 23 post-operative, histologically proven cases of primary brain tumors were included; there were two cases of grade I (WHO), 9 cases of grade II, 5 cases of grade III, 3 cases of grade IV, 3 medulloblastomas and one gliosarcoma. Ratio of M:F=16:7, age 27.5+14.4 years (range 5-56 years). All patients underwent the MET-PET and FDG-PET scans on the same day. Images were evaluated for recurrence using visual analysis and final results were compared with MRI/MRS and follow up as gold standard. Results: Fourteen cases were positive for recurrence on the MET-PET study while FDG was unequivocally positive in eleven cases. MET-PET scans were true negative for recurrence in nine cases and concurrent with the MRI/MRS findings in all 23 cases. Tumor to background ratio for the MET-PET study were 2.2+.55. Conclusion: MET-PET is superior to FDG-PET for detection of recurrence in both low and high grade gliomas and has excellent correlation with MRI/MRS

  19. Diagnosis of maxillofacial tumor with L-3-[18F]-fluoro-alpha-methyltyrosine (FMT) PET. A comparative study with FDG-PET

    The objective of this study was to compare L-3-[18F]-fluoro-α-methyltyrosine (FMT)-positron emission tomography (PET) and 2-[18F]-fluoro-2-deoxy-D-glucose (FDG)-PET in the differential diagnosis of maxillofacial tumors. This study included 36 patients (16 males, 20 females; 31-90 years old) with untreated malignant tumors (34 squamous cell carcinoma, one mucoepidermoid carcinoma, one rhabdomyosarcoma) and seven patients (five males, two females; 32-81 years old) with benign lesions. In all patients, both FMT-PET and FDG-PET were performed within two weeks before biopsy or treatment of the lesions. To evaluate the diagnostic usefulness of FMT-PET and FDG-PET, visual interpretation and semiquantitative analysis were performed. PET images were rated according to the contrast of tumor uptake as compared with background, and were statistically analyzed. As a semiquantitative analysis, standardized uptake values (SUV) of the primary tumors were measured, and the SUV data were analyzed using receiver operating characteristic (ROC) curves. The mean SUV of the malignant lesions were significantly higher than those of the benign lesions in both FMT-PET (2.62±1.58 vs. 1.20±0.30, p<0.01) and FDG-PET (9.17±5.06 vs. 3.14±1.34, p<0.01). A positive correlation (r=0.567, p<0.0001, n=46) was noted between FMT and FDG. ROC analysis revealed that there was no statistically significant difference in SUVs between FMT and FDG for differentiating malignant tumors. In 27 of 36 patients, FMT-PET had better contrast of malignant tumor visualization to the surrounding normal structures by visual assessment (p<0.005, binomial proportion test). Differential diagnosis of FMT-PET based on the uptake in maxillofacial tumors is equivalent to FDG-PET. However, the contrast of FMT uptake between maxillofacial tumors and the surrounding normal structures is higher than that of FDG, indicating the possibility of accurate diagnosis of maxillofacial tumors by FMT-PET. (author)

  20. The usefulness of 18F-FDG PET in patients with head and neck tumors

    Objective: The purpose of this study is to assess the usefulness of 18F-fluorodeoxyglucose (FDG) PET in patients with head and neck tumors. Methods: Thirty-nine patients (56 studies) with pathologically confirmed head and neck tumors underwent whole body 18F-FDG PET imaging for staging (5 cases) or for post-therapeutic monitoring and restaging. The results of whole body 18F-FDG PET imaging were evaluated with both visual and semiquantitative analyses (standardized uptake value, SUV). Results: (1) 18F-FDG PET helped to define the extent of lesions in 3 patients and downstage another patient before treatment, and accurately detected residual or recurrent lesions in 6, local lymph node metastasis in 11, lung and bone metastases in 4 and 3 cases after treatment. (2) Of 22 positive 18F-FDG PET imaging, 20 were true positive confirmed by surgeries or follow-up studies. All of 17 patients with negative 18F-FDG PET findings remained disease-free during follow-up. The sensitivity, specificity and accuracy of 18F-FDG PET imaging in detecting residual, recurrent and metastatic lesions were 100%, 89.5%, and 94.9% respectively. (3) 18F-FDG PET imaging detected more lesions than CT or MRI in 3 of 21 cases, and corrected another 6 CT or MRI false-positive findings. (4) Consecutive PET studies were carried out in 9 patients. Remission was found in 5 patients and progression in 3. In one patient with nasopharyngeal carcinoma, PET imaging showed complete response of primary lesion and metastatic lymph nodes to treatment, but found another high uptake focus in the middle part of descending colon which was confirmed to be an adenoma by colonoscopy. Conclusion: Due to its high sensitivity and accuracy in the detection of residual, recurrent, metastatic lesions and of second primary tumor, FDG PET imaging is a useful modality for staging and post-therapeutic follow-up in patients with head and neck tumors. (authors)

  1. The clinical value of PET/CT in therapeutic management of the malignant tumor

    Objective: To evaluate the clinical value of hybrid PET/CT in therapeutic management of the malignant tumor. Methods: 69 patients with malignant tumor without accepting any treatment, who were diagnosed by either pathology (24 patients) or clinical data (45 patients), were analyzed in this study. The age of the 20 females and 49 males ranged between 26 and 99 years (mean 63 years). PET/CT scans were performed using Discovery LS-PET/CT system (GE Discovery LS, CT attenuation correction, OSEM reconstruction), after injection of 5.55 MBq/kg FDG 40 minutes. Results: l. PET/CT showed 18 patients with single lesion and 51 patients with multiple lesions. while in CT imaging showed 47 patients with single lesion before PET/CT scanning. 29 (61.7%) patients were changed the clinical stage and therapeutic scheme after PET/CT performing. 2. Offered biological target orientation to radiotherapy or operation extension to surgery: radiotherapy doctors used PET/CT fusion imaging to direct radiotherapy orientation to 29 patients who were fit for radiotherapy. Five of them, who had treated by MM50 for one period of treatment, reexamined PET/CT after one month later, the former tumor was disappeared or shirked and the metabolism of glucose returned to normal. 10 patients were operated after the doctor confirmed the operation extension and operation path according to the PET/CT fusion images. The pathological results showed no carcinoma cell implicated or soakage in surgery cutting margins. The metastasis lymph nodes were completely removed. One patient, her operation was failed, was diagnosed primary lung cancer with hilus and lymph nodes metastases by PET/CT which indicated that the operation was not suitable for this patient. Conclusion: Hybrid PFT/CT imaging may offer an important tool in therapeutic management of the malignant tumor. One, it can provide more accurate diagnosis for clinical stage of the malignant tumor and assistant doctor's to draw the therapeutic scheme. Two, it

  2. Lung PET scan

    Chest PET scan; Lung positron emission tomography; PET - chest; PET - lung; PET - tumor imaging ... A PET scan requires a small amount of tracer. The tracer is given through a vein (IV), usually on ...

  3. [A Case of Metastatic Seminomatous Testicular Tumor with Complicated Diagnosis by FDG-PET].

    Hashizume, Akihito; Mizuno, Nobuhiko; Kawai, Masaki; Kishida, Takeshi

    2016-07-01

    18F-fluorodeoxy glucose positron emission tomography (FDG-PET) for evaluation of the post chemotherapy residual tumor of the seminomatous testicular germ cell tumor is recommended by several guidelines. We report a case whose residual tumor was evaluated by FDG PET but the results were difficult to interpret. A 41-year-old male with left seminomatous germ cell tumor of the testis and 60 mm retroperitoneal lymph node (RPLN) metastasis was referred to our hospital. The International Germ Cell Consensus Classification (IGCCC) was good prognosis. After high orchiectomy, three cycles of bleomycin, etoposide, and cisplatin (BEP) chemotherapy normalized the tumor marker and the RPLN decreased to 15 mm. The standardized uptake value (SUV) max at the RPLN by FDG-PET was 2.93. Although residual viable cells were suspected, the SUV max was relatively low. Thus surveillance without additional therapy was selected. After observation for 25 weeks, the tumor grew to 25 mm. Then four cycles of paclitaxel, ifosfamide, and cisplatin (TIP) chemotherapy were indicated for the recurrence. The RPLN was decreased to 15 mm, but the SUV max was still as high as 2.67 at 6 weeks after the last chemotherapy. We dissected the residual tumor suspecting viable cancer, but the pathological examination revealed necrotic tissue without any viable cells. He has had no signs of recurrence for 1 year and 9 months after the operation. PMID:27569358

  4. PET in tumor imaging: research only or a cost effective clinical tool?

    PET imaging has for many years been a versatile tool for non-invasive imaging of neuro-physiology and, indeed, whole body physiology. Quantitative PET imaging of trace amounts of radioactivity is scientifically elegant and can be very complex. This lecture focuses on whether and where this test is clinically useful. Because of the research tradition, PET imaging has been perceived as an 'expensive' test, as it costs more per scan than CT and MRI scans at most institutions. Such a superficial analysis is incorrect, however, as it is increasingly recognized that imaging costs, which in some circumstances will be increased by the use of PET, are only a relatively small component of patient care costs. Thus, PET may raise imaging costs and the number of imaging procedures in some settings, though PET may reduce imaging test numbers in other settings. However, the analysis must focus on the total costs of patient management. Analyses focused on total patient care costs, including cost of hospitalization and cost surgery as well as imaging costs, have shown that PET can substantially reduce total patient care costs in several settings. This is achieved by providing a more accurate diagnosis, and thus having fewer instances of an incorrect diagnosis resulting in subsequent inappropriate surgery or investigations. Several institutions have shown scenarios in which PET for tumor imaging is cost effective. While the specific results of the analyses vary based on disease prevalence and cost input values for each procedure, as well as the projected performance of PET, the similar results showing total care cost savings in the management of several common cancers, strongly supports the rational for the use of PET in cancer management. In addition, promising clinical results are forthcoming in several other illnesses, suggesting PET will have broader utility than these uses, alone. Thus, while PET is an 'expensive' imaging procedure and has considerable utility as a research

  5. Carbon-11-labeled daunorubicin and verapamil for probing P-glycoprotein in tumors with PET

    Elsinga, PH; Franssen, EJF; Hendrikse, NH; Fluks, L; Weemaes, AMA; vanderGraaf, WTA; deVries, GE; Visser, GM; Vaalburg, W

    1996-01-01

    One of the mechanisms for multidrug resistance (MDR) of tumors is an overexpression of the P-glycoprotein (P-gp). The cytostatic agent daunorubicin and the modulator verapamil were labeled with C-11 to probe P-gp with PET. Methods: Carbon-11-daunorubicin was prepared from (CCH2N2)-C-11 with an aldeh

  6. Quantitative Assessment of Heterogeneity in Tumor Metabolism Using FDG-PET

    Purpose: [18F]-fluorodeoxyglucose-positron emission tomography (FDG-PET) images are usually quantitatively analyzed in “whole-tumor” volumes of interest. Also parameters determined with dynamic PET acquisitions, such as the Patlak glucose metabolic rate (MRglc) and pharmacokinetic rate constants of two-tissue compartment modeling, are most often derived per lesion. We propose segmentation of tumors to determine tumor heterogeneity, potentially useful for dose-painting in radiotherapy and elucidating mechanisms of FDG uptake. Methods and Materials: In 41 patients with 104 lesions, dynamic FDG-PET was performed. On MRglc images, tumors were segmented in quartiles of background subtracted maximum MRglc (0%–25%, 25%–50%, 50%–75%, and 75%–100%). Pharmacokinetic analysis was performed using an irreversible two-tissue compartment model in the three segments with highest MRglc to determine the rate constants of FDG metabolism. Results: From the highest to the lowest quartile, significant decreases of uptake (K1), washout (k2), and phosphorylation (k3) rate constants were seen with significant increases in tissue blood volume fraction (Vb). Conclusions: Tumor regions with highest MRglc are characterized by high cellular uptake and phosphorylation rate constants with relatively low blood volume fractions. In regions with less metabolic activity, the blood volume fraction increases and cellular uptake, washout, and phosphorylation rate constants decrease. These results support the hypothesis that regional tumor glucose phosphorylation rate is not dependent on the transport of nutrients (i.e., FDG) to the tumor.

  7. 18F-FDG PET-CT in diagnosis of tumor thrombus

    Full text: Venous thromboembolism is a relatively common phenomenon in cancer patients while tumor thrombosis is a rare complication of solid cancers. The correct diagnosis of tumor thrombosis and its differentiation from benign thrombus can change patient management and prevent unnecessary anticoagulation treatment. Materials and Methods: We conducted a retrospective review of FDG PET-CT scans of patients who underwent the study between July 2007 and July 2010. Any focal and/or linear area of increased FDG uptake (more than mediastinal blood pool) conforming to a blood vessel was taken as positive. SUVmax of the thrombus, SUVmax of tumor (if any) and SUVmax of mediastinal blood pool were calculated. PET-CT results were confirmed with clinical follow up, structural imaging and histopathology when available. Results: Total 24 patients (15 male and 9 female) with mean age of 43.8 years (range: 3-72; median-47.5) were evaluated. All patients underwent PET/CT for staging or restaging of a known malignancy and had a FDG avid thrombus. Based on structural imaging and clinical follow up, 9 patients had benign thromboembolism and 13 patients had tumor thrombosis. On FDG PET-CT, uptake in the thrombus was linear in 18 patients and focal in 6 patients. The most common site of thrombosis was IVC (n=14) followed by PV (n=7). One patient had catheter associated thrombosis. Four patients had only the thrombus as the FDG avid foci while remaining 18 patients had other FDG avid focus of disease. The mean SUVmax in the benign thrombosis group was 3.2 (range: 2.3-4.6; median-3.3). The mean SUVmax in the tumor thrombosis group was 6.0 (range: 2.3-13.8; median-3.3).There was significant difference in SUVmax between the two groups P = 0.013. On ROC analysis a cut off SUVmax of 3.63 was obtained to differentiate tumor thrombus from benign thromboembolism. In 6 patients FDG PET-CT detected occult vascular thrombosis, which was later confirmed with other imaging modality. Conclusion: FDG

  8. 18F-FDG PET/CT compared to conventional imaging modalities in pediatric primary bone tumors

    F-Fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) is useful in adults with primary bone tumors. Limited published data exist in children. To compare hybrid FDG positron emission tomography/computed tomography (PET/CT) with conventional imaging (CI) modalities in detecting malignant lesions, predicting response to chemotherapy and diagnosing physeal involvement in pediatric primary bone tumors. Retrospective analysis of PET/CT and CI reports with histopathology or follow-up > 6 months as reference standard. Response parameters and physeal involvement at diagnosis were compared to histopathology. A total of 314 lesions were detected in 86 scans. Excluding lung lesions, PET/CT had higher sensitivity and specificity than CI (83%, 98% and 78%, 97%, respectively). In lung lesions, PET/CT had higher specificity than CI (96% compared to 87%) but lower sensitivity (80% compared to 93%). Higher initial SUVmax and greater SUVmax reduction on PET/CT after chemotherapy predicted a good response. Change in tumor size on MRI did not predict response. Both PET/CT and MRI were very sensitive but of low specificity in predicting physeal tumor involvement. PET/CT appears more accurate than CI in detecting malignant lesions in childhood primary bone tumors, excluding lung lesions. It seems better than MRI at predicting tumor response to chemotherapy. (orig.)

  9. {sup 18}F-FDG PET/CT compared to conventional imaging modalities in pediatric primary bone tumors

    London, Kevin [The Children' s Hospital at Westmead, Department of Nuclear Medicine, Sydney, NSW (Australia); University of Sydney, Discipline of Paediatrics and Child Health, Sydney Medical School, Sydney, NSW (Australia); Stege, Claudia; Kaspers, Gertjan [VU Medical Centre, Divisions of Paediatric Oncology/Haematology, Amsterdam (Netherlands); Cross, Siobhan; Dalla-Pozza, Luciano [The Children' s Hospital at Westmead, Department of Oncology, Sydney (Australia); Onikul, Ella [The Children' s Hospital at Westmead, Department of Medical Imaging, Sydney (Australia); Graf, Nicole [The Children' s Hospital at Westmead, Department of Pathology, Sydney (Australia); Howman-Giles, Robert [The Children' s Hospital at Westmead, Department of Nuclear Medicine, Sydney, NSW (Australia); University of Sydney, Discipline of Imaging, Sydney Medical School, Sydney, NSW (Australia)

    2012-04-15

    F-Fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) is useful in adults with primary bone tumors. Limited published data exist in children. To compare hybrid FDG positron emission tomography/computed tomography (PET/CT) with conventional imaging (CI) modalities in detecting malignant lesions, predicting response to chemotherapy and diagnosing physeal involvement in pediatric primary bone tumors. Retrospective analysis of PET/CT and CI reports with histopathology or follow-up > 6 months as reference standard. Response parameters and physeal involvement at diagnosis were compared to histopathology. A total of 314 lesions were detected in 86 scans. Excluding lung lesions, PET/CT had higher sensitivity and specificity than CI (83%, 98% and 78%, 97%, respectively). In lung lesions, PET/CT had higher specificity than CI (96% compared to 87%) but lower sensitivity (80% compared to 93%). Higher initial SUV{sub max} and greater SUV{sub max} reduction on PET/CT after chemotherapy predicted a good response. Change in tumor size on MRI did not predict response. Both PET/CT and MRI were very sensitive but of low specificity in predicting physeal tumor involvement. PET/CT appears more accurate than CI in detecting malignant lesions in childhood primary bone tumors, excluding lung lesions. It seems better than MRI at predicting tumor response to chemotherapy. (orig.)

  10. CT-guided automated detection of lung tumors on PET images

    Cui, Yunfeng; Zhao, Binsheng; Akhurst, Timothy J.; Yan, Jiayong; Schwartz, Lawrence H.

    2008-03-01

    The calculation of standardized uptake values (SUVs) in tumors on serial [ 18F]2-fluoro-2-deoxy-D-glucose ( 18F-FDG) positron emission tomography (PET) images is often used for the assessment of therapy response. We present a computerized method that automatically detects lung tumors on 18F-FDG PET/Computed Tomography (CT) images using both anatomic and metabolic information. First, on CT images, relevant organs, including lung, bone, liver and spleen, are automatically identified and segmented based on their locations and intensity distributions. Hot spots (SUV >= 1.5) on 18F-FDG PET images are then labeled using the connected component analysis. The resultant "hot objects" (geometrically connected hot spots in three dimensions) that fall into, reside at the edges or are in the vicinity of the lungs are considered as tumor candidates. To determine true lesions, further analyses are conducted, including reduction of tumor candidates by the masking out of hot objects within CT-determined normal organs, and analysis of candidate tumors' locations, intensity distributions and shapes on both CT and PET. The method was applied to 18F-FDG-PET/CT scans from 9 patients, on which 31 target lesions had been identified by a nuclear medicine radiologist during a Phase II lung cancer clinical trial. Out of 31 target lesions, 30 (97%) were detected by the computer method. However, sensitivity and specificity were not estimated because not all lesions had been marked up in the clinical trial. The method effectively excluded the hot spots caused by mediastinum, liver, spleen, skeletal muscle and bone metastasis.

  11. Use of PET in neuroendocrine tumors. In vivo applications and in vitro studies

    Eriksson, B.; Oerlefors, H.; Oeberg, K. [Uppsala Univ. Hospital, Uppsala (Sweden). Dept. of Medical Sciences; Langstroem, B.; Bergstroem, M. [Uppsala Univ. Hospital, Uppsala (Sweden). Dept. of Radiology; Sundin, A. [Uppsala Univ. Hospital, Uppsala (Sweden). Dept. of Medical Sciences; Uppsala Univ. Hospital, Uppsala (Sweden). Dept. of Radiology

    2000-03-01

    Positron emission tomography (PET) performed with various radiolabelled compounds facilitates the study of tumor biochemistry. If the tumor uptake of an administered tracer is greater than that of surrounding normal tissue, it is also possible to localize the tumor. In initial studies, {sup 18}F-labeled deoxyglucose (FDG) was attempted to visualize the tumors, since this tracer had been successfully used in oncology, reflecting increased glucose metabolism in cancerous tissue. However, this tracer was no to any significant degree taken up by the neuroendocrine tumors. Instead the serotonin precursor 5-hydroxytryptophan (5-HTP) labeled with {sup 11}C was used and showed an increased uptake and irreversible trapping of this tracer in carcinoid tumors. The uptake was selective and the resolution so high that we could detect more liver and lymph node metastases with PET than with CT or octreotide scintigraphy. One problem was, however, the high renal excretion of the tracer producing streaky artifacts in the area of interest. Elevation of U-5-HIAA (Urinary 5-hydroxyindoleacetic acid) is considered to be uncommon in endocrine pancreatic tumors (EPTs). It is currently exploring a wide range of biochemical systems, including enzymes and receptors, both for neurotransmitters and for peptides and proteins in in vitro essays with the potential to use some of the developed tracers for in vivo visualization and tumor biological studies. In conclusion, PET is a valuable tool in the diagnosis of neuroendocrine tumors. It can detect small lesions in the thorax and abdomen not detected by other methods, which has been of great value preoperatively in several cases. It detects more lesions in the liver and lymph nodes than other methods and furthermore, it can be used to monitor treatment effects.

  12. The relationship between boron neutron capture therapy (BNCT) and positron emission tomography (PET) for malignant brain tumors

    Boron neutron capture therapy (BNCT) is a particle irradiation therapy that is theoretically available for selective radiation of tumor cells. Boronophenylalanine-positron emission tomography (18F-BPA-PET) was used in this study. Boron is used as a tracer compound for the neutron capture reaction and has been particularly useful for the recent noncraniotomy BNCT. In this report, we introduce this type of PET as a principal axis in BNCT and relationship with PET. We calculated the drug accumulation to the tumor before neutron irradiation to individualize the treatment. We decided the indication for BNCT on the basis of a PET study and are now expanding the indications to other systemic cancers, including head and neck, lung, and liver cancers. In addition, other irradiation modalities have developed a radiation plan on the basis of a PET study, and several studies attempted improving the results; however, the lesion is exposed to high radiation doses and appear as high accumulation on BPA-PET during BNCT. We determined the neutron exposure time from the dosage for normal tissue in the actual treatment, but the lesion/normal tissue ratio obtained from BPA-PET is for evaluating the tumor dose and following the treatment plan. We also found that a PET study was useful in the follow-up stage to aid in diagnosis of pathologic conditions such as increase in tumor volume, recurrence, or radiation necrosis and for patients who had already been treated for malignant brain tumor. (author)

  13. Role of 18F FDG PET scan to localize tumor in patients of oncogenic osteomalacia

    Full text: Oncogenic osteomalacia is a rare paraneoplastic syndrome of renal phosphate wasting which is usually caused by phosphaturic mesenchymal tumors. Conventional radiologic techniques usually fail to detect these small, slow growing neoplasms located at unusual sites. The objective of this study was to evaluate the role of 18F FDG PET imaging in patients of oncogenic osteomalacia. Materials and Methods: Fifteen patients (8 males and 7 females) (mean age: 38.5 ± 12.2 years) with clinical and biochemical evidence of oncogenic osteomalacia were subjected to 'total' whole body 18F FDG PET scan including both limbs and skull views. The images were reconstructed and the final output was displayed as per the standard institution protocol. Results: 18F FDG PET imaging localized suspicious hypermetabolic foci of SUVmax ranging from 1.4 to 3.8 (Mean ± S.D.: 2.39 ± 0.63) suggesting presence of occult tumor in 11 of 15 patients. The suspected foci were localized in lower limbs in ten patients and in the petrous temporal region of skull in 1 patient. FDG localized tumors were histopathologically correlated in 6 patients who underwent surgical biopsy/excision after correlative radiological investigations. Four of these patients were cured after surgical excision while partial surgical excision/biopsy was performed in two patients. Conclusions: 18F FDG PET imaging is a promising technique for detection of occult tumors in patients of oncogenic osteomalacia. It is mandatory to include limbs in the field as these tumors are common in limbs and may be easily missed. Preoperative localization increases odds for cure after surgical removal of tumor

  14. 18 FDG-PET/CT: 21st century approach to leukemic tumors in 124 cases.

    Cunningham, Isabel; Kohno, Brigett

    2016-06-01

    Extramedullary tumors remain an obstacle to curing more acute leukemia patients. Their incidence is unknown because the presence of occult tumors that contribute to relapse is not routinely sought as in other cancers. No standard approach exists for treating tumors at most sites, apparent clinical response is typically followed by further tumors, and achievement of lengthy remission is uncommon. Body scanning with (18) FDG PET/CT now provides a means to identify the extent of occult tumors that enables directed tumor eradication and a way to evaluate tumor response. To evaluate its potential benefits, analysis was undertaken of 124 published cases scanned after apparent tumors were diagnosed. Clinical and radiologic exams underestimated extent of disease in over half of 100 cases. Among 70 cases that reported scans after various treatments, 70% achieved negative scans. Half relapsed subsequently but disease-free survivals up to 6 years were documented. These reported cases add to our knowledge of extramedullary leukemia in showing that further tumors are more likely than marrow relapse, clinical and radiologic evaluation of response is inadequate, intensive chemotherapy alone generally does not prevent progression and is associated with significant mortality, and tumor-directed plus systemic therapies appears the most effective approach, particularly to AML tumors. This analysis suggests this technology could increase our ability to eradicate all foci of leukemia, and identify tumors responsible for refractory, residual, and relapsed disease. PMID:26718745

  15. 124I-Iodopyridopyrimidinone for PET of Abl Kinase–Expressing Tumors In Vivo

    Doubrovin, Mikhail; Kochetkova, Tatiana; Santos, Elmer; Veach, Darren R.; Smith-Jones, Peter; Pillarsetty, Nagavarakishore; Balatoni, Julius; Bornmann, William; Gelovani, Juri; Larson, Steven M.

    2015-01-01

    Because of the recent development of an iodopyridopyrimidinone Abl protein kinase inhibitor (PKI), 124I-SKI-212230 (124I-SKI230), we investigated the feasibility of a PET-based molecular imaging method for the direct visualization of Abl kinase expression and PKI treatment. Methods In vitro pharmacokinetic properties, including specific and nonspecific binding of 124I-SKI230 to its Abl kinase target and interaction with other PKIs, were assessed in cell-free medium and chronic myelogenous leukemia (CML) cells overexpressing BCR-Abl (K562), in comparison with BT-474 cells that are low in Abl expression. In a xenograft tumor model, we assessed the in vivo pharmacokinetics of 124I-SKI230 using PET and postmortem tissue sampling. We also tested a paradigm of 124I-SKI230 PET after treatment of the animal with a dose of Abl-specific PKI for the monitoring of the tumor response. Results In vitro studies confirmed that SKI230 binds to Abl kinase with nanomolar affinity, that selective uptake occurs in cell lines known to express Abl kinase, that RNAi knock-down supports specificity of cellular uptake due to Abl kinase, and that imatinib, an archetype Abl PKI, completely displaces SKI230. With SKI230, we obtained successful in vivo PET of Abl-expressing human tumors in a nude rat. We were also able to demonstrate evidence of substrate inhibition of in vivo radiotracer uptake in the xenograft tumor after treatment of the animal as a model of PKI treatment monitoring. Conclusion These results support the hypothesis that molecular imaging using PET will be useful for the study of in vivo pharmacodynamics of Abl PKI molecular therapy in humans. PMID:20048131

  16. Imaging of sigma receptors in tumors by PET with [C-11]SA4503

    Aim: Sigma receptors are implicated in some diseases in the central nervous system (CNS), such as schizophrenia, depression, dementia and ischemia, and are also expressed in a variety of human tumors, such as melanoma, carcinoma of the breast, lung and prostate, and the brain tumor. Therefore, several radioligands have been proposed for imaging of sigma receptors by positron emission tomography (PET) and by single photon emission computed tomography. Recently, we have applied [C-11]labeled 1-(3,4-dimethoxyphenethyl)-4-(3-phenylpropyl)piperazine ([C-11]SA4503) to mapping sigma1 receptors in the brain of monkeys and human. In the present study, we evaluated the potential of the [C-11]SA4503 PET for imaging of sigma receptors using the AH109A bearing rats, and the VX-2 carcinoma bearing rabbits. Materials and Methods: [C-11]SA4503 was injected i.v. into AH109A bearing rats, and the tissue distribution was measured by tissue dissection. To determine the receptor-specific uptake, cold SA4503 or haloperidol was co-injected into the other group of rats. The PET scanning were performed in the rats in the baseline condition and after pretreatment with haloperidol. In the VX-2 carcinoma bearing rabbits, PET scanning was also performed in the baseline and blockade conditions. The sigma receptors in the AH109A and VX-2 were measured in vitro by the standard membrane binding assays. Results: The sigma receptors were found in AH109A and VX-2. The density was much higher in VX-2 than in AH109A. In the tissue dissection study, the AH109A uptake of [C-11]SA4503 increased for 60 min after injection. By the co-injection of SA4503 or haloperidol, the AH109A uptake was enhanced. The PET study also confirmed that the radioactivity level in the AH109A was enhanced by the pretreatment with haloperidol. On the other hand, In the VX-2 carcinoma bearing rabbits, the radioactivity level of in VX-2 remained constant after initial uptake in the baseline PET measurement, but the VX-2 uptake was

  17. FDG-avid portal vein tumor thrombosis from hepatocellular carcinoma in contrast-enhanced FDG PET/CT

    Canh Nguyen; Huy Nguyen; Tan Ngo; Simone Maurea

    2015-01-01

    Objective(s): In this study, we aimed to describe the characteristics of portal vein tumor thrombosis (PVTT), complicating hepatocellular carcinoma (HCC) in contrast-enhanced FDG PET/CT scan. Methods: In this retrospective study, 9 HCC patients with FDG-avid PVTT were diagnosed by contrast-enhanced fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT), which is a combination of dynamic liver CT scan, multiphase imaging, and whole-body PET sca...

  18. Clinical relevance of F-18 FDG PET for imaging of neuroendocrine tumors

    Neuroendocrine tumors are characterized immunocytochemically by the expression of different peptides and biogenic amines. Hormones induce their biological action by binding to and stimulating specific membrane-associated receptors for e.g. somatostatin. The presence of somatostatin receptors (SR) has been described mainly in endocrine glands and the central nervous system. Interestingly, a large variety of human tumors, including gastroenteropancreatic (GEP) tumors and medullary thyroid carcinomas (MTC) also express a high density of SR and can be imaged with [111In-DTPA-D-Phe1]-pentetreotide. Cell proliferative activity is an important indicator of the growth of various malignant tumors associated with a poorer prognosis and Ki-67 expression. 18F-FDG is a marker of tumor viability, based upon the increased glycolysis that is associated with malignancy as compared with normal tissue. SR-containing neuroendocrine tumors are well-differentiated and tend to grow slowly. Furthermore, these tumors demonstrate inverse relationship between in vivo SR expression, cell proliferation (low Ki-67 expression) and FDG uptake (normal biodistribution). In comparison, less differentiated tumors, e.g. atypical carcinoids or MTC with increasing CEA levels show mitotic activity (high levels of Ki-67 immunoreactivity and increased FDG uptake) and often lack of SR. In conclusion, SR scintigraphy has been shown to localize well-differentiated neuroendocrine tumors. In contrast, PET imaging is valuable for predicting malignancy only in less differentiated tumors with increased glucose metabolism. Therefore, an additional F-18 FDG PET should be performed if SR scintigraphy (GEP tumors) or combined imaging using [111In-DTPA-D-Phe1]-pentetreotide and 99mTc(V)-DMSA (MTC) is negative. (orig.)

  19. Applications of PET imaging of neurological tumors with radiolabeled amino acids

    Routine diagnostics and treatment monitoring of brain tumors is usually based on contrast-enhanced magnetic resonance imaging (MRI). However, the capacity of structural MRI to differentiate neoplastic tissue from non-specific treatment changes may be limited especially after therapeutic interventions such as neurosurgical resection, radio- and chemotherapy. Metabolic imaging using PET may provide relevant additional information on tumor metabolism, which allows for more accurate diagnostics especially in clinically equivocal situations. In contrast to the widely used 18F-2-fluoro-2-deoxy-D-glucose, which exhibits a poor tumor-to-background contrast within the brain, amino acid tracers provide high sensitivity to detect primary tumors, recurrent or residual gliomas, including most low-grade gliomas. The method improves targeting of biopsy and provides additional information of tumor extent, which is helpful for planning neurosurgery and radiotherapy. In the further course of the disease, amino acid positron-emission tomography (PET) allows a sensitive monitoring of treatment response, the early detection of tumor recurrence, and an improved differentiation of tumor recurrence from treatment-related changes. In the past, the method had only limited availability due to the use of radiopharmaceuticals with a short half-life. In recent years, however, novel amino acid tracers labeled with positron emitters with a longer half-life have been developed and clinically validated which allow a more efficient and cost-effective application. These developments and the well-documented diagnostic performance of PET using radiolabeled amino acids suggest that its application continues to spread and that the method may be available as a routine diagnostic technique for certain indications in the near future.

  20. Dynamic 11C-methionine PET analysis has an additional value for differentiating malignant tumors from granulomas: an experimental study using small animal PET

    We evaluated whether the dynamic profile of L-11C-methionine (11C-MET) may have an additional value in differentiating malignant tumors from granulomas in experimental rat models by small animal positron emission tomography (PET). Rhodococcus aurantiacus and allogenic rat C6 glioma cells were inoculated, respectively, into the right and left calf muscles to generate a rat model bearing both granulomas and tumors (n = 6). Ten days after the inoculations, dynamic 11C-MET PET was performed by small animal PET up to 120 min after injection of 11C-MET. The next day, after overnight fasting, the rats were injected with 18F-2-deoxy-2-fluoro-D-glucose (18F-FDG), and dynamic 18F-FDG PET was performed up to 180 min. The time-activity curves, static images, and mean standardized uptake value (SUV) in the lesions were calculated. 11C-MET uptake in the granuloma showed a slow exponential clearance after an initial distribution, while the uptake in the tumor gradually increased with time. The dynamic pattern of 11C-MET uptake in the granuloma was significantly different from that in the tumor (p 11C-MET, visual assessment and SUV analysis could not differentiate the tumor from the granuloma in all cases, although the mean SUV in the granuloma (1.48 ± 0.09) was significantly lower than that in the tumor (1.72 ± 0.18, p 18F-FDG in the granuloma were similar to those in the tumor (p = NS). Dynamic 11C-MET PET has an additional value for differentiating malignant tumors from granulomatous lesions, which deserves further elucidation in clinical settings. (orig.)

  1. Dynamic {sup 11}C-methionine PET analysis has an additional value for differentiating malignant tumors from granulomas: an experimental study using small animal PET

    Zhao, Songji; Zhao, Yan [Hokkaido University, Department of Nuclear Medicine, Graduate School of Medicine, Sapporo (Japan); Hokkaido University, Department of Tracer Kinetics and Bioanalysis, Graduate School of Medicine, Sapporo (Japan); Kuge, Yuji; Hatano, Toshiyuki [Hokkaido University, Central Institute of Isotope Science, Sapporo (Japan); Yi, Min; Kohanawa, Masashi [Hokkaido University, Department of Advanced Medicine, Graduate School of Medicine, Sapporo (Japan); Magota, Keiichi; Tamaki, Nagara [Hokkaido University, Department of Nuclear Medicine, Graduate School of Medicine, Sapporo (Japan); Nishijima, Ken-ichi [Hokkaido University, Department of Molecular Imaging, Graduate School of Medicine, Sapporo (Japan)

    2011-10-15

    We evaluated whether the dynamic profile of L-{sup 11}C-methionine ({sup 11}C-MET) may have an additional value in differentiating malignant tumors from granulomas in experimental rat models by small animal positron emission tomography (PET). Rhodococcus aurantiacus and allogenic rat C6 glioma cells were inoculated, respectively, into the right and left calf muscles to generate a rat model bearing both granulomas and tumors (n = 6). Ten days after the inoculations, dynamic {sup 11}C-MET PET was performed by small animal PET up to 120 min after injection of {sup 11}C-MET. The next day, after overnight fasting, the rats were injected with {sup 18}F-2-deoxy-2-fluoro-D-glucose ({sup 18}F-FDG), and dynamic {sup 18}F-FDG PET was performed up to 180 min. The time-activity curves, static images, and mean standardized uptake value (SUV) in the lesions were calculated. {sup 11}C-MET uptake in the granuloma showed a slow exponential clearance after an initial distribution, while the uptake in the tumor gradually increased with time. The dynamic pattern of {sup 11}C-MET uptake in the granuloma was significantly different from that in the tumor (p < 0.001). In the static analysis of {sup 11}C-MET, visual assessment and SUV analysis could not differentiate the tumor from the granuloma in all cases, although the mean SUV in the granuloma (1.48 {+-} 0.09) was significantly lower than that in the tumor (1.72 {+-} 0.18, p < 0.01). The dynamic patterns, static images, and mean SUVs of {sup 18}F-FDG in the granuloma were similar to those in the tumor (p = NS). Dynamic {sup 11}C-MET PET has an additional value for differentiating malignant tumors from granulomatous lesions, which deserves further elucidation in clinical settings. (orig.)

  2. Evaluating image reconstruction methods for tumor detection performance in whole-body PET oncology imaging

    Lartizien, Carole; Kinahan, Paul E.; Comtat, Claude; Lin, Michael; Swensson, Richard G.; Trebossen, Regine; Bendriem, Bernard

    2000-04-01

    This work presents initial results from observer detection performance studies using the same volume visualization software tools that are used in clinical PET oncology imaging. Research into the FORE+OSEM and FORE+AWOSEM statistical image reconstruction methods tailored to whole- body 3D PET oncology imaging have indicated potential improvements in image SNR compared to currently used analytic reconstruction methods (FBP). To assess the resulting impact of these reconstruction methods on the performance of human observers in detecting and localizing tumors, we use a non- Monte Carlo technique to generate multiple statistically accurate realizations of 3D whole-body PET data, based on an extended MCAT phantom and with clinically realistic levels of statistical noise. For each realization, we add a fixed number of randomly located 1 cm diam. lesions whose contrast is varied among pre-calibrated values so that the range of true positive fractions is well sampled. The observer is told the number of tumors and, similar to the AFROC method, asked to localize all of them. The true positive fraction for the three algorithms (FBP, FORE+OSEM, FORE+AWOSEM) as a function of lesion contrast is calculated, although other protocols could be compared. A confidence level for each tumor is also recorded for incorporation into later AFROC analysis.

  3. Role of PET/CT functional imaging on constructing a tumor radiotherapeutic biological target volume

    In studies on intensity modulated radiotherapy with conventional fractionation, different radiosensitivity areas require different irradiation doses. In tumor radiotherapy areas CR, boosts in radiotherapy doses should be determined according to whether there are survived tumor cells or not. To those survived cells, CT imaging has become the key tool to delineate the radiotherapy target. Thus, the study on the construction of biological target volume with PET/CT functional imaging, which could reflect either radiosensitivity or cell proliferation-related cell metabolism, anoxia and DNA number of various cell cycle phases, is an important research area. (authors)

  4. Improvement of internal tumor volumes of non-small cell lung cancer patients for radiation treatment planning using interpolated average CT in PET/CT.

    Yao-Ching Wang

    Full Text Available Respiratory motion causes uncertainties in tumor edges on either computed tomography (CT or positron emission tomography (PET images and causes misalignment when registering PET and CT images. This phenomenon may cause radiation oncologists to delineate tumor volume inaccurately in radiotherapy treatment planning. The purpose of this study was to analyze radiology applications using interpolated average CT (IACT as attenuation correction (AC to diminish the occurrence of this scenario. Thirteen non-small cell lung cancer patients were recruited for the present comparison study. Each patient had full-inspiration, full-expiration CT images and free breathing PET images by an integrated PET/CT scan. IACT for AC in PET(IACT was used to reduce the PET/CT misalignment. The standardized uptake value (SUV correction with a low radiation dose was applied, and its tumor volume delineation was compared to those from HCT/PET(HCT. The misalignment between the PET(IACT and IACT was reduced when compared to the difference between PET(HCT and HCT. The range of tumor motion was from 4 to 17 mm in the patient cohort. For HCT and PET(HCT, correction was from 72% to 91%, while for IACT and PET(IACT, correction was from 73% to 93% (*p<0.0001. The maximum and minimum differences in SUVmax were 0.18% and 27.27% for PET(HCT and PET(IACT, respectively. The largest percentage differences in the tumor volumes between HCT/PET and IACT/PET were observed in tumors located in the lowest lobe of the lung. Internal tumor volume defined by functional information using IACT/PET(IACT fusion images for lung cancer would reduce the inaccuracy of tumor delineation in radiation therapy planning.

  5. 18F-EF5 PET Is Predictive of Response to Fractionated Radiotherapy in Preclinical Tumor Models.

    Ali, Rehan; Apte, Sandeep; Vilalta, Marta; Subbarayan, Murugesan; Miao, Zheng; Chin, Frederick T; Graves, Edward E

    2015-01-01

    We evaluated the relationship between pre-treatment positron emission tomography (PET) using the hypoxic tracer 18F-[2-(2-nitro-1-H-imidazol-1-yl)-N-(2,2,3,3,3- pentafluoropropyl) acetamide] (18F-EF5) and the response of preclinical tumor models to a range of fractionated radiotherapies. Subcutaneous HT29, A549 and RKO tumors grown in nude mice were imaged using 18F-EF5 positron emission tomography (PET) in order to characterize the extent and heterogeneity of hypoxia in these systems. Based on these results, 80 A549 tumors were subsequently grown and imaged using 18F-EF5 PET, and then treated with one, two, or four fraction radiation treatments to a total dose of 10-40 Gy. Response was monitored by serial caliper measurements of tumor volume. Longitudinal post-treatment 18F-EF5 PET imaging was performed on a subset of tumors. Terminal histologic analysis was performed to validate 18F-EF5 PET measures of hypoxia. EF5-positive tumors responded more poorly to low dose single fraction irradiation relative to EF5-negative tumors, however both groups responded similarly to larger single fraction doses. Irradiated tumors exhibited reduced 18F-EF5 uptake one month after treatment compared to control tumors. These findings indicate that pre- treatment 18F-EF5 PET can predict the response of tumors to single fraction radiation treatment. However, increasing the number of fractions delivered abrogates the difference in response between tumors with high and low EF5 uptake pre-treatment, in agreement with traditional radiobiology. PMID:26431331

  6. 18F-EF5 PET Is Predictive of Response to Fractionated Radiotherapy in Preclinical Tumor Models.

    Rehan Ali

    Full Text Available We evaluated the relationship between pre-treatment positron emission tomography (PET using the hypoxic tracer 18F-[2-(2-nitro-1-H-imidazol-1-yl-N-(2,2,3,3,3- pentafluoropropyl acetamide] (18F-EF5 and the response of preclinical tumor models to a range of fractionated radiotherapies. Subcutaneous HT29, A549 and RKO tumors grown in nude mice were imaged using 18F-EF5 positron emission tomography (PET in order to characterize the extent and heterogeneity of hypoxia in these systems. Based on these results, 80 A549 tumors were subsequently grown and imaged using 18F-EF5 PET, and then treated with one, two, or four fraction radiation treatments to a total dose of 10-40 Gy. Response was monitored by serial caliper measurements of tumor volume. Longitudinal post-treatment 18F-EF5 PET imaging was performed on a subset of tumors. Terminal histologic analysis was performed to validate 18F-EF5 PET measures of hypoxia. EF5-positive tumors responded more poorly to low dose single fraction irradiation relative to EF5-negative tumors, however both groups responded similarly to larger single fraction doses. Irradiated tumors exhibited reduced 18F-EF5 uptake one month after treatment compared to control tumors. These findings indicate that pre- treatment 18F-EF5 PET can predict the response of tumors to single fraction radiation treatment. However, increasing the number of fractions delivered abrogates the difference in response between tumors with high and low EF5 uptake pre-treatment, in agreement with traditional radiobiology.

  7. PET

    Mariager, Rasmus Mølgaard; Schmidt, Regin; Heiberg, Morten Rievers

    PET handler om den hemmelige tjenestes arbejde under den kolde krig 1945-1989. Her fortæller Regin Schmidt, Rasmus Mariager og Morten Heiberg om de mest dramatiske og interessante sager fra PET's arkiv. PET er på flere måder en udemokratisk institution, der er sat til at vogte over demokratiet....... Dens virksomhed er skjult for offentligheden, den overvåger borgernes aktiviteter, og den registrerer følsomme personoplysninger. Historien om PET rejser spørgsmålet om, hvad man skal gøre, når befolkningen i et demokrati er kritisk indstillet over for overvågningen af lovlige politiske aktiviteter......, mens myndighederne mener, at det er nødvendigt for at beskytte demokratiet. PET er på en gang en fortælling om konkrete aktioner og begivenheder i PET's arbejde og et stykke Danmarkshistorie. Det handler om overvågning, spioner, politisk ekstremisme og international terrorisme.  ...

  8. Thoracic tumor volume delineation in 4D-PET/CT by low dose interpolated CT for attenuation correction.

    Tzung-Chi Huang

    Full Text Available PURPOSE: 4D-PET/CT imaging is an excellent solution for reducing the breathing-induced effects in both CT and PET images. In 4D-PET/CT, 4D-CT images are selected to match those of 4D-PET phase by phase and the corresponding phases are used for attenuation correction in 4D-PET. However, the high radiation dose that patients acquire while undergoing 4D-CT imaging for diagnostic purposes remains a concern. This study aims to assess low-dose interpolated CT (ICT for PET attenuation correction (PETICT in thoracic tumor volume delineation. METHODS AND MATERIALS: Twelve thoracic cancer patients (10 esophageal and 2 lung cancer cases were recruited. All patients underwent 4D-PET/CT scans. The optical flow method based on image intensity gradient was applied to calculate the motion displacement in three dimensions for each voxel on two original extreme CT phases in the respiratory cycle, end-inspiration and end-expiration. The interpolated CTs were generated from two phases of the original 4D-CT using motion displacement. RESULTS: Tumor motion due to respiration was estimated in the anterior-posterior dimension, the lateral dimension and the superior-inferior dimension by the optical flow method. The PETICT and ICT (4D-PET ICT/ICT matched each other spatially in all the phases. The distortion of tumor shape and size resulting from respiratory motion artifacts were not observed in 4D-PETICT. The tumor volume measured by 4D-PET ICT/ICT correlated to the tumor volume measured by 4D-PET/CT (p = 0.98. CONCLUSIONS: 4D-PETICT consistently represented the interpretation of FDG uptake as effectively as 4D-PET. 4D-PET ICT/ICT is a low-dose alternative to 4D-CT and significantly improves the interpretation of PET and CT images, while solving the respiratory motion problem as effectively as 4D-PET/CT.

  9. PET tracers for somatostatin receptor imaging of neuroendocrine tumors

    Johnbeck, Camilla Bardram; Knigge, Ulrich; Kjær, Andreas

    2014-01-01

    the perfect neuroendocrine tumor imaging tracer. (68)Ga-labeled tracers coupled to synthetic somatostatin analogs with differences in affinity for the five somatostatin receptor subtypes are now widely applied in Europe. Comparison of sensitivity between the most used tracers - (68)Ga-DOTA-Tyr3......-octreotide, (68)Ga-DOTA-Tyr3-octreotate and (68)Ga-DOTA-l-Nal3-octreotide - shows little difference and expertise on the specific tracer used, and knowledge regarding physiological uptake might be more important than in vitro-proven differences in affinity. Using isotopes such as (18)F or (64)Cu might...

  10. Extensive tumor thrombus in a case of carcinoma lung detected by F18-FDG-PET/CT.

    Mudalsha, Ravina; Jacob, Mj; Pandit, Ag; Jora, Charu

    2011-04-01

    Tumor thrombus is a rare complication of solid cancers, mainly seen in cases of renal cell carcinoma, wilm's tumor, testicular carcinoma, adrenal cortical carcinoma and hepatocellular carcinoma.[1] Tumor thrombus in inferior vena cava is a rare complication of primary carcinoma lung. It should be identified so as to rule out venous thromboembolism and avoiding unnecessary anticoagulant therapy. We describe a case where F18-Fluorodeoxyglucose (FDG) positron emission tomography - computed tomography (PET/CT) helped to identify extensive tumor thrombus. PMID:22174524

  11. Extensive tumor thrombus in a case of carcinoma lung detected by 18F-FDG-PET/CT

    Tumor thrombus is a rare complication of solid cancers, mainly seen in cases of renal cell carcinoma, Wilm's tumor, testicular carcinoma, adrenal cortical carcinoma and hepatocellular carcinoma. Tumor thrombus in inferior vena cava is a rare complication of primary carcinoma lung. It should be identified so as to rule out venous thromboembolism and avoiding unnecessary anticoagulant therapy. We describe a case where 18F-Fluorodeoxyglucose (FDG) positron emission tomography - computed tomography (PET/CT) helped to identify extensive tumor thrombus. (author)

  12. SU-E-QI-20: A Review of Advanced PET and CT Image Features for the Evaluation of Tumor Response

    Lu, W [University of Maryland School of Medicine, Baltimore, MD (United States)

    2014-06-15

    Purpose: To review the literature in using quantitative PET and CT image features for the evaluation of tumor response. Methods: We reviewed and summarized more than fifty papers that use advanced, quantitative PET/CT image features for the evaluation of tumor response. We also discussed future works on extracting disease-specific features, combining multiple and complementary features in response modeling, delineating tumor in multimodality images, and exploring biological explanations of these advanced features. Results: Advanced PET image features considering spatial information, such as tumor volume, tumor shape, total glycolytic volume, histogram distance, and texture features (characterizing spatial distribution of FDG uptake) have been found more informative than the traditional SUVmax for the prediction of tumor response. Advanced CT features, including volumetric, attenuation, morphologic, structure, and texture descriptors, have also been found advantage over the traditional RECIST and WHO criteria in certain tumor types. Conclusions: Advanced, quantitative FDG PET/CT image features have been shown promising for the evaluation of tumor response. With the emerging multi-modality imaging performed at multiple time points for each patient, it becomes more important to analyze the serial images quantitatively, select and combine both complementary and contradictory information from various sources, for accurate and personalized evaluation of tumor response to therapy.

  13. FDG-PET during Therapy of Head and Neck Carcinomas. Prediction of tumor response and associations to tumor cell properties

    Introduction: Correlations between FDG uptake to single tumor properties, such as tumor grade, tumor cell proliferation or DNA ploidy have failed. Association between FDG metabolism during cytotoxic therapy, treatment outcome and tumor cell properties were evaluated in a prospective study of 47 patients with locally advanced head neck carcinomas (HNSCC) receiving radical treatment, radiotherapy with or without neoadjuvant cisplatinum-based chemotherapy. Methods: Repeated FDG PET scans with evaluation of metabolic rate of FDG (MR FDG) before and early during, either radiotherapy or initial chemotherapy. Fine needle aspiration of palpable node metastasis was performed in 31 patients immediately after each PET scan for analysis of S-phase (SPF), and DNA ploidy (analyzed by FCM and Image Cytometry; ICM). The associations between MR FDG and therapy outcome, and MR FDG and ploidy and s-phase were evaluated. We also studied changes in these properties during therapy. Results: Early changes in MR FDG were associated to treatment outcome, both survival and locoregional control. MR FDG below the median value during therapy was associated to a significantly better outcome, compared to MR FDG above the median value. This regards both 5 year-survival (72 % and 35% resp., p 0.0042) and locoregional control (96% and 55% resp., p 0.002). Analysis of DNA ploidy revealed differences depending on analyses used. ICM identified primarily more non-diploid tumors than FCM did, as well as more persisting non-diploid clones during treatment. No significant association to treatment outcome depending on DNA ploidy or SPF was seen.There was neither any significant association between DNA ploidy nor SPF to MR FDG. Conclusions: MR FDG during therapy was associated to therapy outcome, and thus enabling in vivo monitoring of metabolic response. Ploidy and SPF was not associated to FDG-metabolism

  14. FDG-PET provides the best correlation with the tumor specimen compared to MRI and CT in rectal cancer

    Purpose: To compare CT-, MR- and PET-CT based tumor length measurements in rectal cancer with pathology. Patients and Methods: Twenty-six rectal cancer patients underwent both MR and PET-CT imaging followed by short-course radiotherapy (RT 5 x 5 Gy) and surgery within 3 days after RT. Tumor length was measured manually and independently by 2 observers on CT, MR and PET. PET-based tumor length measurements were also generated automatically using the signal-to-background-ratio (SBR) method. All measurements were correlated with the tumor length on the pathological specimen. Results: CT-based measurements did not show a valuable correlation with pathology. MR-based measurements correlated only weakly, but still significantly (Pearson correlation = 0.55 resp. 0.57; p < 0.001). Manual PET measurements reached a good correlation with pathology, but less strong (Pearson correlation 0.72 and 0.76 for the two different observers) than automatic PET-CT based measurements, which provided the best correlation with pathology (Pearson correlation of 0.91 (p < 0.001)). Bland-Altman analysis demonstrated in general an overestimation of the tumor diameter using manual measurements, while the agreement of automatic contours and pathology was within acceptable ranges. A direct comparison of the different modalities revealed a significant better precision for PET-based auto-contours as compared to all other measurements. Conclusion: Automatically generated PET-CT based contours show the best correlation with the surgical specimen and thus provide a useful and powerful tool to accurately determine the largest tumor dimension in rectal cancer. This could be used as a quick and reliable tool for target delineation in radiotherapy. However, a 3D volume analysis is needed to confirm these results.

  15. Comparison of 18F-FET and 18F-FDG PET in brain tumors

    The purpose of this study was to compare the diagnostic value of positron emission tomography (PET) using [18F]-fluorodeoxyglucose (18F-FDG) and O-(2-[18F]fluoroethyl)-L-tyrosine (18F-FET) in patients with brain lesions suspicious of cerebral gliomas. Methods: Fifty-two patients with suspicion of cerebral glioma were included in this study. From 30 to 50 min after injection of 180 MBq 18F-FET, a first PET scan (18F-FET scan) was performed. Thereafter, 240 MBq 18F-FDG was injected and a second PET scan was acquired from 30 to 60 min after the second injection (18F-FET/18F-FDG scan). The cerebral accumulation of 18F-FDG was calculated by decay corrected subtraction of the 18F-FET scan from the 18F-FET/18F-FDG scan. Tracer uptake was evaluated by visual scoring and by lesion-to-background (L/B) ratios. The imaging results were compared with the histological results and prognosis. Results: Histology revealed 24 low-grade gliomas (LGG) of World Health Organization (WHO) Grade II and 19 high-grade gliomas (HGG) of WHO Grade III or IV, as well as nine others, mainly benign histologies. The gliomas showed increased 18F-FET uptake (>normal brain) in 86% and increased 18F-FDG uptake (>white matter) in 35%. 18F-FET PET provided diagnostically useful delineation of tumor extent while this was impractical with 18F-FDG due to high tracer uptake in the gray matter. A local maximum in the tumor area for biopsy guidance could be identified with 18F-FET in 76% and with 18F-FDG in 28%. The L/B ratios showed significant differences between LGG and HGG for both tracers but considerable overlap so that reliable preoperative grading was not possible. A significant correlation of tracer uptake with overall survival was found with 18F-FDG only. In some benign lesions like abscesses, increased uptake was observed for both tracers indicating a limited specificity of both techniques. Conclusions: 18F-FET PET is superior to 18F-FDG for biopsy guidance and treatment planning of cerebral gliomas

  16. Clinical evidence on PET-CT for radiation therapy planning in gastro-intestinal tumors

    A large number of histological and anatomically distinct malignancies originate from the gastro-intestinal (GI) tract. Radiotherapy (RT) plays an increasing role in the multimodal treatment of most of these malignancies. The proximity of different organs at risk such as the kidneys, the spinal cord and the small bowel and the potential toxicity associated with combined treatment modalities make accurate target volume delineation imperative. The ability of positron emission tomography (PET) imaging to visualize a so-called 'biological target volume' (BTV) may be helpful in this respect. Currently the most widely used tracer for diagnosis, staging, restaging and response assessment is [18F]Fluoro-deoxyglucose (FDG). Promising preliminary results in esophageal, pancreatic and anorectal cancers and colorectal liver metastasis suggest that FDG-PET might provide us with additional information useful in target volume delineation. Poor image resolution and a low sensitivity for lymph node detection currently obstructs its widespread implementation. Moreover, validation in large prospective trials and the pathological validation of the correct tumor volume is still lacking. In hepatocellular carcinoma (HCC) and gastric adenocarcinoma there is currently little evidence for the use of FDG-PET in target delineation. However more extensive research is warranted before the true value of FDG-PET in these sites can be assessed. Also other tracers are constantly being developed and investigated. Up to now however none of these tracers has found its way into the daily practice of target volume delineation.

  17. Delineation of FDG-PET tumors from heterogeneous background using spectral clustering

    This paper explored the feasibility of using spectral clustering to segment FDG-PET tumor in the presence of heterogeneous background. Spectral clustering refers to a class of clustering methods which employ the eigenstructure of a similarity matrix to partition image voxels into disjoint clusters. The similarity between two voxels was measured with the intensity distance scaled by voxel-varying factors capturing local statistics and the number of clusters was inferred based on rotating the eigenvector matrix for the maximally sparse representation. Metrics used to evaluate the segmentation accuracy included: Dice coefficient, Jaccard coefficient, false positive dice, false negative dice, symmetric mean absolute surface distance, and absolute volumetric difference. Comparison of segmentation results between the presented method and the adaptive thresholding method on the simulated PET data shows the former attains an overall better detection accuracy. Applying the presented method on patient data gave segmentation results in fairly good agreement with physician manual annotations. These results indicate that the presented method have the potential to accurately delineate complex shaped FDG-PET tumors containing inhomogeneous activities in the presence of heterogeneous background.

  18. WE-G-BRF-06: Positron Emission Tomography (PET)-Guided Dynamic Lung Tumor Tracking for Cancer Radiotherapy: First Patient Simulations

    Purpose: PET-guided dynamic tumor tracking is a novel concept of biologically targeted image guidance for radiotherapy. A dynamic tumor tracking algorithm based on list-mode PET data has been developed and previously tested on dynamic phantom data. In this study, we investigate if dynamic tumor tracking is clinically feasible by applying the method to lung cancer patient PET data. Methods: PET-guided tumor tracking estimates the target position of a segmented volume in PET images reconstructed continuously from accumulated coincidence events correlated with external respiratory motion, simulating real-time applications, i.e., only data up to the current time point is used to estimate the target position. A target volume is segmented with a 50% threshold, consistently, of the maximum intensity in the predetermined volume of interest. Through this algorithm, the PET-estimated trajectories are quantified from four lung cancer patients who have distinct tumor location and size. The accuracy of the PET-estimated trajectories is evaluated by comparing to external respiratory motion because the ground-truth of tumor motion is not known in patients; however, previous phantom studies demonstrated sub-2mm accuracy using clinically derived 3D tumor motion. Results: The overall similarity of motion patterns between the PET-estimated trajectories and the external respiratory traces implies that the PET-guided tracking algorithm can provide an acceptable level of targeting accuracy. However, there are variations in the tracking accuracy between tumors due to the quality of the segmentation which depends on target-to-background ratio, tumor location and size. Conclusion: For the first time, a dynamic tumor tracking algorithm has been applied to lung cancer patient PET data, demonstrating clinical feasibility of real-time tumor tracking for integrated PET-linacs. The target-to-background ratio is a significant factor determining accuracy: screening during treatment planning would

  19. Strategies of assessing and quantifying radiation treatment metabolic tumor response using F18 FDG Positron Emission Tomography (PET)

    The use of positron emission tomography (PET) using F-18 labeled fluorodeoxyglucose (FDG) for both oncology disease staging and radiation therapy target volume delineation has steadily increased over the last decade, and FDG-PET is today readily available in all major medical centers. The goal of anti tumor treatment, including chemotherapy and/or radiation therapy is to diminish a tumor cell population, ideally to the state of total eradication. Reducing the number of viable tumor cells can lead to a reduction in anatomical tumor size, and may also be correlated with decreased FDG uptake. Efforts to assess tumor response to therapy have attempted to describe and quantify changes in glucose utilization, also referred to as metabolic tumor response. In this review, an attempt is made to present and discuss methodologies to assess and quantify tumor metabolic response to radiation therapy or chemoradiation treatment courses.

  20. Diffusion-weighted and PET/MR Imaging after Radiation Therapy for Malignant Head and Neck Tumors.

    Varoquaux, Arthur; Rager, Olivier; Dulguerov, Pavel; Burkhardt, Karim; Ailianou, Angeliki; Becker, Minerva

    2015-01-01

    Interpreting imaging studies of the irradiated neck constitutes a challenge because of radiation therapy-induced tissue alterations, the variable appearances of recurrent tumors, and functional and metabolic phenomena that mimic disease. Therefore, morphologic magnetic resonance (MR) imaging, diffusion-weighted (DW) imaging, positron emission tomography with computed tomography (PET/CT), and software fusion of PET and MR imaging data sets are increasingly used to facilitate diagnosis in clinical practice. Because MR imaging and PET often yield complementary information, PET/MR imaging holds promise to facilitate differentiation of tumor recurrence from radiation therapy-induced changes and complications. This review focuses on clinical applications of DW and PET/MR imaging in the irradiated neck and discusses the added value of multiparametric imaging to solve diagnostic dilemmas. Radiologists should understand key features of radiation therapy-induced tissue alterations and potential complications seen at DW and PET/MR imaging, including edema, fibrosis, scar tissue, soft-tissue necrosis, bone and cartilage necrosis, cranial nerve palsy, and radiation therapy-induced arteriosclerosis, brain necrosis, and thyroid disorders. DW and PET/MR imaging also play a complementary role in detection of residual and recurrent disease. Interpretation pitfalls due to technical, functional, and metabolic phenomena should be recognized and avoided. Familiarity with DW and PET/MR imaging features of expected findings, potential complications, and treatment failure after radiation therapy increases diagnostic confidence when interpreting images of the irradiated neck. Online supplemental material is available for this article. PMID:26252192

  1. Non-Invasive imaging of small-animal tumors: high-frequency ultrasound vs. MicroPET.

    Liao, Ai-Ho; Li, Chen-Han; Cheng, Weng-Fang; Li, Pai-Chi

    2005-01-01

    Tumor volume measurement on small animals is important but currently invasive. We employ ultrasonic micro-imaging (UMI) in this study and demonstrate its feasibility. In addition, we use small animal positron emission tomography (microPET) as a preliminary effort to develop multi-modality small animal imaging techniques. The tumor growth curve from UMI is also compared to radioactivity from microPET. Both UMI and [18F] FDG microPET imaging were performed on C57BL/6J black mice bearing WF-3 ovary cancer cells at various stages from the second week till up to the eighth week. Segmentation and 3D reconstruction were also done. The growth curve was obtained in vivo noninvasively by UMI. The cell doubling time was 7.46 days according to UMI. This result was compared with vernier caliper measurement and radioactivity counting by microPET. In microPET, we obtained the time-activity curves from the tumor and the tumor-surrounding tissue. The tumor-to-normal-tissues ratios reached maximum at the fifth week after tumor cell implantation. PMID:17281549

  2. Comparison of tumor volumes derived from glucose metabolic rate maps and SUV maps in dynamic 18F-FDG PET.

    Visser, E.P.; Philippens, M.E.P.; Kienhorst, L.; Kaanders, J.H.A.M.; Corstens, F.H.M.; Geus-Oei, L.F. de; Oyen, W.J.G.

    2008-01-01

    Tumor delineation using noninvasive medical imaging modalities is important to determine the target volume in radiation treatment planning and to evaluate treatment response. It is expected that combined use of CT and functional information from 18F-FDG PET will improve tumor delineation. However, u

  3. Unusual Finding of a Tumor Thrombus Arising From Osteosarcoma Detected on 18F-NaF PET/CT.

    Verma, Priyanka; Purandare, Nilendu; Agrawal, Archi; Shah, Sneha; Rangarajan, Venkatesh

    2016-06-01

    Osteosarcoma is the most common bone sarcoma in adolescents and children. Tumor thrombus arising from osteosarcoma is rare. We describe the case of a 13-year-old girl with osteosarcoma of the right femur, in whom the F-NaF PET/CT was done for initial staging to look for skeletal metastases. The scan showed abnormal increased tracer uptake in the primary tumor and the right common femoral and external iliac vein representing a tumor thrombus. Our case emphasizes the importance of extraosseous findings on F-NaF PET/CT, which may result in important management changes. PMID:26909709

  4. Positive correlations between tumor uptake on FDG PET and energy expenditure of patients with esophageal cancer

    Cancer patients are prone to clinical malnutrition; moreover, the energy expenditure in patients with certain cancers is higher than that in healthy individuals, rendering their nutritional management a challenging issue. We hypothesized that 2-deoxy-2-[18F]fluoro-D-glucose (FDG) uptake on positron emission tomography (PET) may be related to the energy expenditure and analyzed the FDG uptake and energy expenditure in esophageal cancer patients to clarify this. Esophageal cancer patients [n=13, 10 males and 3 females, age 66.5±8.9 (51-82) years] were evaluated for FDG uptake using PET. The resting energy expenditure (REE) and basal energy expenditure (BEE) were calculated using indirect calorimetry and the Harris-Benedict formula, respectively. Regression analyses were performed to compare the parameters of imaging and energy expenditure. Positive correlations were found between tumor uptake on FDG PET and the parameters of energy expenditure. Among them, the correlations between SUVmax and the ratio of REE to BEE (REE/BEE, r=0.59; p=0.035) and between SUVmax and the difference between REE and BEE (REE-BEE, r=0.58; p=0.036) were moderate and statistically significant. Further, the correlation between tumor uptake expressed as a percentage (%TU) and REE/BEE was mild (r=0.51) but not significant (p=0.07), while that between %TU and REE-BEE was weak (r=0.42) and not significant (p=0.15). Significant positive correlations between SUVmax on FDG PET and energy expenditure were noted in our study; we consider that these results may aid in determining the nutritional management for esophageal cancer patients. (author)

  5. Single-scan dual-tracer FLT+FDG PET tumor characterization

    Kadrmas, Dan J.; Rust, Thomas C.; Hoffman, John M.

    2013-02-01

    Rapid multi-tracer PET aims to image two or more tracers in a single scan, simultaneously characterizing multiple aspects of physiology and function without the need for repeat imaging visits. Using dynamic imaging with staggered injections, constraints on the kinetic behavior of each tracer are applied to recover individual-tracer measures from the multi-tracer PET signal. The ability to rapidly and reliably image both 18F-fluorodeoxyglucose (FDG) and 18F-fluorothymidine (FLT) would provide complementary measures of tumor metabolism and proliferative activity, with important applications in guiding oncologic treatment decisions and assessing response. However, this tracer combination presents one of the most challenging dual-tracer signal-separation problems—both tracers have the same radioactive half-life, and the injection delay is short relative to the half-life and tracer kinetics. This work investigates techniques for single-scan dual-tracer FLT+FDG PET tumor imaging, characterizing the performance of recovering static and dynamic imaging measures for each tracer from dual-tracer datasets. Simulation studies were performed to characterize dual-tracer signal-separation performance for imaging protocols with both injection orders and injection delays of 10-60 min. Better performance was observed when FLT was administered first, and longer delays before administration of FDG provided more robust signal-separation and recovery of the single-tracer imaging measures. An injection delay of 30 min led to good recovery (R > 0.96) of static image values (e.g. SUV), Knet, and K1 as compared to values from separate, single-tracer time-activity curves. Recovery of higher order rate parameters (k2, k3) was less robust, indicating that information regarding these parameters was harder to recover in the presence of statistical noise and dual-tracer effects. Performance of the dual-tracer FLT(0 min)+FDG(32 min) technique was further evaluated using PET/CT imaging studies in

  6. Retroperitoneal bronchogenic cyst presenting paraadrenal tumor incidentally detected by 18F-FDG PET/CT

    A follow-up 18F-fluorodeoxyglucose (18F-FDG) PET/CT scan of a 57-year-old asymptomatic male who had undergone total thyroidectomy for thyroid cancer revealed a 5.0 x 4.0-cm, well-defined, ovoid-shaped mass around the left adrenal gland without definite FDG uptake. On the adrenal CT scan, the left paraadrenal tumor showed high attenuation on the precontrast scan without enhancement. The average Hounsfield unit (HU) was 58.1 on the precontrast scan and 58.4 on the postcontrast scan. The patient underwent laparoscopic adrenalectomy for resection of the left paraadrenal tumor. The final histopathologic examination revealed a bronchogenic cyst. Although retroperitoneal bronchogenic cysts are rare, they should be considered in the differential diagnosis of retroperitoneal cystic tumors. The preoperative diagnosis is difficult, but a contrast-enhanced CT scan or 18F-FDG PET/CT scan may be useful for differentiating hyperattenuated cysts from other soft tissue masses

  7. The value of 18F-FDG PET/CT in diagnosing brain metastases from unknown primary tumor

    Objective: To investigate the value of 18F-FDG PET/CT in diagnosis of brain metastases from unknown primary tumor. Method: The 18F-FDG PET/CT findings of 17 patients with brain metastases from unknown primary tumor were retrospectively analyzed. Results: Primary tumors of the seventeen cases were confirmed by biopsy, the accuracy rate was 100%. There were thirteen cases with primary lung cancer, accounted for 76%, including two cases of lung cancer which were found in the second PET/CT examination,two cases with liver cancer, accounted for 12%, one case with cardia cancer, accounted for 6%, one case with the ascending colon cancer,accounted for 6%. On the base of founding the primary tumor, 18F-FDG PET/CT also found 10 cases accompanied by lung metastasis (2 cases), lymph node metastases (3 cases), bone metastases (2 cases)and other sites of metastases (3 cases), a total of 61 lesions were detected. Two cases of liver cancer patients with single brain metastases had cerebral apoplexy. Conclusion: 18F-FDG PET/CT contributes important value in finding brain metastases from unknown primary tumor,and is very helpful for clinical staging and treatment. (authors)

  8. ImmunoPET imaging of phosphatidylserine in pro-apoptotic therapy treated tumor models

    An immunoPET imaging probe for the detection of phosphatidylserine was developed and tested in animal models of human cancer treated with pro-apoptotic therapy. We hypothesized that the relatively long plasma half-life of a probe based on a full-length antibody coupled with a residualizing radionuclide would be able to catch the wave of drug-induced apoptosis and lead to a specific accumulation in apoptotic tumor tissue. Methods: The imaging probe is based on a 89Zr-labeled monoclonal antibody PGN635 targeting phosphatidylserine. The probe was evaluated pre-clinically in four tumor xenograft models: one studied treatment with paclitaxel to trigger the intrinsic apoptotic pathway, and three others interrogated treatment with an agonistic death-receptor monoclonal antibody to engage the extrinsic apoptotic pathway. Results: High accumulation of 89Zr-PGN635 was observed in treated tumors undergoing apoptosis reaching 30 %ID/g and tumor-to-blood ratios up to 13. The tumor uptake in control groups treated with vehicle or imaged with a non-binding antibody probe was significantly lower. Conclusions: The results demonstrate the ability of 89Zr-PGN635 to image drug-induced apoptosis in animal models and corroborate our hypothesis that radiolabeled antibodies binding to intracellular targets transiently exposed on the cell surface during apoptosis can be employed for detection of tumor response to therapy.

  9. Splenosis Mimicking Relapse of a Neuroendocrine Tumor at Gallium-68-DOTATOC PET/CT

    Treglia, Giorgio; Luca, Giovanella [Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Barbara, Muoio; Carmelo, Caldarella [Catholic Univ., Rome (Italy)

    2014-06-15

    A 48-year-old female patient underwent splenopancreasectomy for a 4-cm pancreatic neuroendocrine tumor (pNET), grade G2, located in the pancreatic tail. One year after surgery, the patient presented an increased serum level of the tumor marker chromogranin A (value: 160 U/l). Therefore, she underwent somatostatin receptor PET/CT using gallium-68-DOTATOC for restaging. This imaging method showed a focal area of increased radiopharmaceutical uptake corresponding to a 2.5-cm nodule located in the left superior abdomen near a clip from the previous surgery, suggesting a possible relapse of pNET. Based on this PET/CT finding, the patient underwent ultrasonography-guided core biopsy of this nodule. Histology did not reveal findings suggestive of pNET but identified spleen tissue most likely caused by splenosis accidentally seeded at the previous operation. It is likely that the increased serum level of the tumor marker chromogranin A was due to the chronic proton-pump inhibitors use. Somatostatin receptor PET/CT is an accurate imaging method for staging and restaging pNET, presenting high sensitivity and specificity in this setting. Nevertheless, possible sources of false-negative and -positive findings with this method should be taken into account. Inflammatory lesions represent the most frequent causes of false-positive findings for pNET at somatostatin receptor imaging because inflammatory cellsmay overexpress somatostatin receptors on their cell surface. In our case, we showed that splenosis may represent a possible cause of false-positive findings for pNET relapse due to the physiological uptake of somatostatin analogs by the spleen tissue.

  10. Retroperitoneal Bronchogenic Cyst Presenting Paraadrenal Tumor Incidentally Detected by 18F-FDG PET/CT

    Yoon, Ye Ri; Choi, Jiyoun; Lee, Sang Mi; Kim, Yeo Joo; Cho, Hyun Deuk; Lee, Jeong Won; Jeon, Youn Soo

    2014-01-01

    A follow-up 18F-fluorodeoxyglucose (18F-FDG) PET/CT scan of a 57-year-old asymptomatic male who had undergone total thyroidectomy for thyroid cancer revealed a 5.0 × 4.0-cm, well-defined, ovoid-shaped mass around the left adrenal gland without definite FDG uptake. On the adrenal CT scan, the left paraadrenal tumor showed high attenuation on the precontrast scan without enhancement. The average Hounsfield unit (HU) was 58.1 on the precontrast scan and 58.4 on the postcontrast scan. The patient...

  11. Pharmacokinetic Analysis of (64)Cu-ATSM Dynamic PET in Human Xenograft Tumors in Mice

    Li, Fan; Jørgensen, Jesper Tranekjær; Madsen, Jacob; Kjaer, Andreas

    2015-01-01

    PET scans with (64)Cu-ATSM and CT scans with contrast. Irreversible and reversible two-tissue compartment models were fitted to time activity curves (TACs) obtained from whole tumor volumes and compared using the Akaike information criterion (AIC). Based on voxel-wise pharmacokinetic analysis...... early tracer uptake (mean spearman R = 0.88) 5 min post injection (pi). Moreover, positive relationships were found between late tracer uptake (90 min pi) and both k₃ and the net influx rate constant, Ki (mean spearman R = 0.56 and R = 0.86; respectively). CONCLUSION: This study shows the feasibility to...

  12. [18F]-fluoroestradiol quantitative PET imaging to differentiate ER+ and ERα-knockdown breast tumors in mice

    Introduction: The purpose of this study was to develop a noninvasive model in tumor-bearing mice to investigate the use of 16α-[18F]fluoro-17β-estradiol (FES) positron emission tomography (PET) imaging as a tool to discriminate between tumors having different estrogen receptor (ER) α status. Methods: MC7-L1 and MC4-L2 murine mammary adenocarcinoma cell lines (ER+) received a small hairpin RNA targeting the ERα gene by lentiviral infection. In vitro assessment of ERα levels of the new cell lines (MC7-L1 and MC4-L2 ERα-knockdown; ERαKD), compared to the parental cell lines, was performed by immunoblotting (−75% ERα protein) and binding assays (−50% estrogen binding). These cell lines were implanted subcutaneously in Balb/c mice and allowed to grow up to a volume of at least 20 mm3. FES and [18F]fluorodeoxyglucose (FDG) PET images were acquired to measure FES and FDG uptake in the various tumors. Results: FES uptake as assessed by PET imaging was 1.06±0.21 percent injected dose per gram of tissue (%ID/g) for MC7-L1 tumors and 0.47±0.08 %ID/g for MC7-L1 ERαKD tumors. MC4-L2 tumors had a FES uptake of 1.03±0.30 %ID/g, whereas its ERαKD equivalent was 0.51±0.19 %ID/g. Each ERαKD tumor had a significantly lower %ID/g value, by ∼50%, than its ER+ counterpart. Biodistribution studies confirmed these findings and gave %ID/g values that were not significantly different from PET imaging data. FDG PET showed no significant uptake difference between the ER+ and ERαKD tumors, indicating that the metabolic phenotype of the ERαKD cell lines was not altered. Conclusion: FES PET imaging was able to reliably differentiate between tumors having differences in their ERα expression in vivo, in a mouse model. Quantitative data obtained by FES PET were in concordance with biodistribution studies and in vitro assays. It is concluded that FES PET imaging can likely be used to monitor subtle ER status changes during the course of hormone therapy.

  13. 18F-FLT and 18F-FDOPA PET kinetics in recurrent brain tumors

    In this study, kinetic parameters of the cellular proliferation tracer 18F-3'-deoxy-3'-fluoro-l-thymidine (FLT) and the amino acid probe 3,4-dihydroxy-6-18F-fluoro-l-phenylalanine (FDOPA) were measured before and early after the start of therapy, and were used to predict the overall survival (OS) of patients with recurrent malignant glioma using multiple linear regression (MLR) analysis. High-grade recurrent brain tumors in 21 patients (11 men and 10 women, age range 26 - 76 years) were investigated. Each patient had three dynamic PET studies with each probe: at baseline and after 2 and 6 weeks from the start of treatment. Treatment consisted of biweekly cycles of bevacizumab (an angiogenesis inhibitor) and irinotecan (a chemotherapeutic agent). For each study, about 3.5 mCi of FLT (or FDOPA) was administered intravenously and dynamic PET images were acquired for 1 h (or 35 min for FDOPA). A total of 126 PET scans were analyzed. A three-compartment, two-tissue model was applied to estimate tumor FLT and FDOPA kinetic rate constants using a metabolite- and partial volume-corrected input function. MLR analysis was used to model OS as a function of FLT and FDOPA kinetic parameters for each of the three studies as well as their relative changes between studies. An exhaustive search of MLR models using three or fewer predictor variables was performed to find the best models. Kinetic parameters from FLT were more predictive of OS than those from FDOPA. The three-predictor MLR model derived using information from both probes (adjusted R2 = 0.83) fitted the OS data better than that derived using information from FDOPA alone (adjusted R2 = 0.41), but was only marginally different from that derived using information from FLT alone (adjusted R2 = 0.82). Standardized uptake values (either from FLT alone, FDOPA alone, or both together) gave inferior predictive results (best adjusted R2 = 0.25). For recurrent malignant glioma treated with bevacizumab and irinotecan, FLT kinetic

  14. 124I labeled Arg-Gly-Asp (RGD) peptide: PET/MR fusion imaging of tumor expressing integrin v3

    Tumor-induced angiogenesis and metastasis express high level of integrin v3 which has become a promising diagnostic biomarker and therapeutic target for various tumors. Radiolabeled RGD (Arg-Gly-Asp) peptides are well known to specifically bind to integrin and can be used not only for noninvasive imaging of integrin over-expression but also for integrin-targeted radionuclide therapy. We used three RGDyK derivatives, monomeric-, dimeric- and tetrameric-RGD for radio labeling. They were labeled with [124I]NaI using iodo-bead. Labeled RGD peptide was purified by FPLC. Xenografts were induced by subcutaneous injection of 1X107 U87MG cells into the right thigh of female Balb/c nude mice. After injection of 124I-labeled monomeric-RGD via the tail vein, the microPET imaging was obtained during 2 hours. Right after microPET imaging, T2-weighted MR imaging was performed with fast gradient spin echo sequence in 0.8 mm of a slice thickness. PET/MR fusion images were constructed by AMIDE program. For immobilization and reproducible positioning of animal, animal-specific positioning molds were fabricated. Monomeric-RGD peptide was labeled with 124I in labeling yield of 50%. After FPLC purification, the radiochemical purity was above 90%. U87MG tumor was clearly seen in both microPET and MR imaging of tumor-bearing nude mouse. The fusion imaging was well constructed by using AMIDE with little discrepancy thanks to animal-specific molds. Three RGD derivatives were also labeled with 131I in labeling yield of 20-55%. All three RGD peptides were successfully radioiodinated with 124I or 131I. U87MG glioblastoma tumor was clearly visualized in PET/MR fusion imaging. MicroPET/MR fusion imaging of dimeric- and tetrameric-RGD peptides in tumor bearing mice will also be presented during conference

  15. Using {sup 18F} FDG PET/CT to Detect an occult Mesenchymal Tumor Causing Oncogenic Osteomalacia

    Seo, Hyo Jung; Choi, Yun Jung; Kim, Hyun Jeong; Jeong, Yong Hyu; Cho, Arthur; Lee, Jae Hoon; Yun, Mijin; Lee, Jong Doo; Kang, Won Jun [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    2011-09-15

    Oncogenic osteomalacia is a rare paraneoplastic syndrome characterized by renal phosphate excretion, hypophosphatemia, and osteomalacia. This syndrome is often caused by tumors of mesenchymal origin. Patients with oncogenic osteomalacia have abnormal bone mineralization, resulting in a high frequency of fractures. Tumor resection is the treatment of choice, as it will often correct the metabolic imbalance. Although oncogenic osteomalacia is a potentially curable disease, diagnosis is difficult and often delayed because of the small size and sporadic location of the tumor. Bone scintigraphy and radiography best characterize osteoma lacia; magnetic resonance imaging findings are nonspecific. Here, we report a case of oncogenic osteomalacia secondary to a phosphaturic mesenchymal tumor that was successfully detected by {sup 18F} fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18F} FDG PET/CT). This case illustrates the advantages of {sup 18F} FDG PET/CT in detecting the occult mesenchymal tumor that causes oncogenic osteomalacia.

  16. 18F-EF5 PET Is Predictive of Response to Fractionated Radiotherapy in Preclinical Tumor Models

    Rehan Ali; Sandeep Apte; Marta Vilalta; Murugesan Subbarayan; Zheng Miao; Chin, Frederick T.; Graves, Edward E.

    2015-01-01

    We evaluated the relationship between pre-treatment positron emission tomography (PET) using the hypoxic tracer 18F-[2-(2-nitro-1-H-imidazol-1-yl)-N-(2,2,3,3,3- pentafluoropropyl) acetamide] (18F-EF5) and the response of preclinical tumor models to a range of fractionated radiotherapies. Subcutaneous HT29, A549 and RKO tumors grown in nude mice were imaged using 18F-EF5 positron emission tomography (PET) in order to characterize the extent and heterogeneity of hypoxia in these systems. Based ...

  17. Comparative study of 18F-DOPA, 13N-Ammonia and F18-FDG PET/CT in primary brain tumors

    Jacob, Mattakarottu J; Pandit, Aniruddha G; Jora, Charu; Mudalsha, Ravina; Sharma, Amit; Pathak, Harish C

    2011-01-01

    Aim: To determine the diagnostic reliability of 18F-FDOPA, 13N-Ammonia and F18-FDG PET/CT in primary brain tumors. We evaluated the amino acid and glucose metabolism of brain tumors by using PET with 18F-FDOPA, 13N-Ammonia and F18-FDG PET/CT. Materials and Methods: Nine patients undergoing evaluation for brain tumors were studied. Tracer uptake was quantified by the use of standardized uptake values and the ratio of tumor uptake to normal identical area of contra lateral hemisphere (T/N). In addition, PET uptake with 18F-FDOPA was quantified by use of ratio of tumor uptake to striatum uptake (T/S). The results were correlated with the patient's clinical profile. Results: Both high-grade and low-grade tumors were well visualized with 18F-FDOPA. The sensitivity for identifying tumors was substantially higher with 18F-FDOPA PET than with F18-FDG and 13N-Ammonia PET as determined by simple visual inspection. The sensitivity for identifying recurrence in low grade gliomas is higher with 13N-Ammonia than with F18-FDG. Conclusion: 18F-FDOPA PET is more reliable than F18-FDG and 13N-Ammonia PET for evaluating brain tumors. PMID:23326065

  18. Comparative study of 18F-DOPA, 13 N-ammonia and 18F-FDG PET/CT in primary brain tumors

    To determine the diagnostic reliability of 18F-FDOPA, 13N-ammonia and 18F-FDG PET/CT in primary brain tumors. We evaluated the amino acid and glucose metabolism of brain tumors by using PET with 18F-FDOPA, 13N-ammonia and 18F-FDG PET/CT. Nine patients undergoing evaluation for brain tumors were studied. Tracer uptake was quantified by the use of standardized uptake values and the ratio of tumor uptake to normal identical area of contra lateral hemisphere (T/N). In addition, PET uptake with 18F-FDOPA was quantified by use of ratio of tumor uptake to striatum uptake (T/S). The results were correlated with the patient's clinical profile. Both high-grade and low-grade tumors were well visualized with 18F-FDOPA. The sensitivity for identifying tumors was substantially higher with 18F-FDOPA PET than with 18F-FDG and 13N-Ammonia PET as determined by simple visual inspection. The sensitivity for identifying recurrence in low grade gliomas is higher with 13N-Ammonia than with 18F-FDG. 18F-FDOPA PET is more reliable than 18F-FDG and 13N-Ammonia PET for evaluating brain tumors. (author)

  19. Correlation of PET images of metabolism, proliferation and hypoxia to characterize tumor phenotype in patients with cancer of the oropharynx

    Spatial organization of tumor phenotype is of great interest to radiotherapy target definition and outcome prediction. We characterized tumor phenotype in patients with cancers of the oropharynx through voxel-based correlation of PET images of metabolism, proliferation, and hypoxia. Methods: Patients with oropharyngeal cancer received 18F-fluorodeoxyglucose (FDG) PET/CT, 18F-fluorothymidine (FLT) PET/CT, and 61Cu-diacetyl-bis(N4-methylthiosemicarbazone) (Cu-ATSM) PET/CT. Images were co-registered and standardized uptake values (SUV) were calculated for all modalities. Voxel-based correlation was evaluated with Pearson’s correlation coefficient in tumor regions. Additionally, sensitivity studies were performed to quantify the effects of image segmentation, registration, noise, and segmentation on R. Results: On average, FDG PET and FLT PET images were most highly correlated (RFDG:FLT = 0.76, range 0.53–0.85), while Cu-ATSM PET showed greater heterogeneity in correlation to other tracers (RFDG:Cu-ATSM = 0.64, range 0.51–0.79; RFLT:Cu-ATSM = 0.61, range 0.21–0.80). Of the tested parameters, correlation was most sensitive to image registration. Misregistration of one voxel lead to ΔRFDG = 0.25, ΔRFLT = 0.39, and ΔRCu-ATSM = 0.27. Image noise and reconstruction also had quantitative effects on correlation. No significant quantitative differences were found between GTV, expanded GTV, or CTV regions. Conclusions: Voxel-based correlation represents a first step into understanding spatial organization of tumor phenotype. These results have implications for radiotherapy target definition and provide a framework to test outcome prediction based on pretherapy distribution of phenotype.

  20. Impact of Anatomical Location on Value of CT-PET Co-Registration for Delineation of Lung Tumors

    Purpose: To derive guidelines for the need to use positron emission tomography (PET) for delineation of the primary tumor (PT) according to its anatomical location in the lung. Methods and Materials: In 22 patients with non-small-cell lung cancer, thoracic X-ray computed tomography (CT) and PET were performed. Eleven radiation oncologists delineated the PT on the CT and on the CT-PET registered scans. The PTs were classified into two groups. In Group I patients, the PT was surrounded by lung or visceral pleura, without venous invasion, without extension to chest wall or the mediastinum over more than one quarter of its surface. In Group II patients, the PT invaded the hilar region, heart, great vessels, pericardium, mediastinum over more than one quarter of its surface and/or associated with atelectasis. A comparison of interobserver variability for each group was performed and expressed as a local standard deviation. Results: The comparison of delineations showed a good reproducibility for Group I, with an average SD of 0.4 cm on CT and an average SD of 0.3 cm on CT-PET (p = 0.1628). There was also a significant improvement with CT-PET for Group II, with an average SD of 1.3 cm on CT and SD of 0.4 cm on CT-PET (p = 0.0003). The improvement was mainly located at the atelectasis/tumor interface. At the tumor/lung and tumor/hilum interfaces, the observer variation was similar with both modalities. Conclusions: Using PET for PT delineation is mandatory to decrease interobserver variability in the hilar region, heart, great vessels, pericardium, mediastinum, and/or the region associated with atelectasis; however it is not essential for delineation of PT surrounded by lung or visceral pleura, without venous invasion or extension to the chest wall

  1. Folic acid derivatives for PET imaging and therapy addressing folate receptor positive tumors

    Folic acid, also known as vitamin B9, is the oxidized form of 5,6,7,8-tetrahydrofolate, which serves as methyl- or methylene donor (C1-building blocks) during DNA synthesis. Under physiological conditions the required amount of 5,6,7,8-tetrahydrofolate for survival of the cell is accomplished through the reduced folate carrier (RFC). In contrast, the supply of 5,6,7,8-tetrahydrofolate is insufficient under pathophysiological conditions of tumors due to an increased proliferation rate. Consequently, many tumor cells exhibit an (over)expression of the folate receptor. This phenomenon has been applied to diagnostics (PET, SPECT, MR) to image FR-positive tumors and on the other hand to treat malignancies related to a FR (over)expression. Based on this concept, a new 18F-labeled folate for PET imaging has been developed and was evaluated in vivo using tumor-bearing mice. The incorporation of oligoethylene spacers into the molecular structure led to a significant enhancement of the pharmacokinetics in comparison to previously developed 18F-folates. The liver uptake could be reduced by one sixth by remaining a tumor uptake of 3%ID/g leading to better contrast ratios. Encouraged by these results, a clickable 18F-labeled serine-based prosthetic group has been synthesized, again with the idea to improve the metabolic and pharmacokinetic profile of hydrophilic radiotracers. Therefore, an alkyne-carrying azido-functionalized serine derivative for coupling to biomolecules was synthesized and a chlorine leaving group for 18F-labeling, which could be accomplished using a microwave-assisted synthesis, a [K is contained in 2.2.2]+/carbonate system in DMSO. Radiochemical yields of 77±6% could be achieved. The promising results obtained from the FR-targeting concept in the diagnostic field have been transferred to the boron neutron capture therapy. Therefore, a folate derivative was coupled to different boron clusters and cell uptake studies were conducted. The synthesis of the

  2. Folic acid derivatives for PET imaging and therapy addressing folate receptor positive tumors

    Schieferstein, Hanno

    2013-07-01

    Folic acid, also known as vitamin B9, is the oxidized form of 5,6,7,8-tetrahydrofolate, which serves as methyl- or methylene donor (C1-building blocks) during DNA synthesis. Under physiological conditions the required amount of 5,6,7,8-tetrahydrofolate for survival of the cell is accomplished through the reduced folate carrier (RFC). In contrast, the supply of 5,6,7,8-tetrahydrofolate is insufficient under pathophysiological conditions of tumors due to an increased proliferation rate. Consequently, many tumor cells exhibit an (over)expression of the folate receptor. This phenomenon has been applied to diagnostics (PET, SPECT, MR) to image FR-positive tumors and on the other hand to treat malignancies related to a FR (over)expression. Based on this concept, a new {sup 18}F-labeled folate for PET imaging has been developed and was evaluated in vivo using tumor-bearing mice. The incorporation of oligoethylene spacers into the molecular structure led to a significant enhancement of the pharmacokinetics in comparison to previously developed {sup 18}F-folates. The liver uptake could be reduced by one sixth by remaining a tumor uptake of 3%ID/g leading to better contrast ratios. Encouraged by these results, a clickable {sup 18}F-labeled serine-based prosthetic group has been synthesized, again with the idea to improve the metabolic and pharmacokinetic profile of hydrophilic radiotracers. Therefore, an alkyne-carrying azido-functionalized serine derivative for coupling to biomolecules was synthesized and a chlorine leaving group for {sup 18}F-labeling, which could be accomplished using a microwave-assisted synthesis, a [K is contained in 2.2.2]{sup +}/carbonate system in DMSO. Radiochemical yields of 77±6% could be achieved. The promising results obtained from the FR-targeting concept in the diagnostic field have been transferred to the boron neutron capture therapy. Therefore, a folate derivative was coupled to different boron clusters and cell uptake studies were

  3. Early Detection of Tumor Response by FLT/MicroPET Imaging in a C26 Murine Colon Carcinoma Solid Tumor Animal Model

    Wan-Chi Lee

    2011-01-01

    Full Text Available Fluorine-18 fluorodeoxyglucose (18F-FDG positron emission tomography (PET imaging demonstrated the change of glucose consumption of tumor cells, but problems with specificity and difficulties in early detection of tumor response to chemotherapy have led to the development of new PET tracers. Fluorine-18-fluorothymidine (18F-FLT images cellular proliferation by entering the salvage pathway of DNA synthesis. In this study, we evaluate the early response of colon carcinoma to the chemotherapeutic drug, lipo-Dox, in C26 murine colorectal carcinoma-bearing mice by 18F-FDG and 18F-FLT. The male BALB/c mice were bilaterally inoculated with 1×105 and 1×106 C26 tumor cells per flank. Mice were intravenously treated with 10 mg/kg lipo-Dox at day 8 after 18F-FDG and 18F-FLT imaging. The biodistribution of 18F-FDG and 18F-FLT were followed by the microPET imaging at day 9. For the quantitative measurement of microPET imaging at day 9, 18F-FLT was superior to 18F-FDG for early detection of tumor response to Lipo-DOX at various tumor sizes (<0.05. The data of biodistribution showed similar results with those from the quantification of SUV (standard uptake value by microPET imaging. The study indicates that 18F-FLT/microPET is a useful imaging modality for early detection of chemotherapy in the colorectal mouse model.

  4. Pathological validation of FLT PET-CT in delineating the biological target length of gross tumor in esophageal carcinoma

    Objective: To establish a optimal method and threshold of 3-deoxy-3-fluoro thymidine (FLT) PET-CT in delineating the biological target length of gross tumor in esophageal carcinoma, and to compare FLT PET-CT with other imaging modalities including esophagoscopy, esophagography, CT and fluorodeoxyglucose (FDG) PET-CT. Methods: Twenty-four patients with esophageal squamous cell carcinoma treated with radical surgery were enrolled. Before surgery, all the patients underwent FLT PET-CT, esephagoscopy and esophagography. Twenty-two patients also received FDG PET-CT scan. Gross tumor volumes (GTV) were delineated using seven different threshold of FLT PET-CT: visual interpretation, standardized uptake value (SUV) 1.3, SUV 1.4, SUV 1.5, 20% of maximum standard uptake value (SUVmax), 25% SUVmax, and 30% SUVmax. Three different thresholds of FDG PET-CT were used, including visual interpretation, SUV 2.5, and 40% SUVmax. The length of tumors on FLT PET-CT scan were measured and recorded as LFLTvis, LFLT1.3, LFLT1.4, LFLT1.5, LFLT20%, LFLT25%, and LFLT30%, respectively. The length of tumors on FDG PET-CT scan were recorded as LFDGvis, LFDG2.5, and LFDG40%, respectively. The length of tumors on CT, esophagography and esophagoscopy were recorded as LCT, LX-ray and LScopy. All of these results were com-pared with the length of gross tumor in the reseated specimen measured by pathological examination (LPath). Results: The LPath was (4.90±2.14) cm. The Length of tumors delineated by different methods, being from short to long, were LFDG40%, LScopy, LX-ray, LFLT1.5, LCT, LFLT30%, LFLTvis, LFLT1.4, LFLT25%, LFDG2.5, LFDGvis, LFLT1.3, LFLT20%. The mean values were (3.85±1.52), (4.46±2.23), (4.63±2.37), (4.64±2.38), (4.69±31.85), (4.75±2.19), (4.85±2.33), (4.87±2.35), (5.05±2.20), (5.08±2.19), (5.10±2.22), (5.21±2.40) and (5.53±2.17) cm,respectively. The correlation coefficients were 0.91, 0.93, 0.88, 0.95, 0.90, 0.81, 0.96, 0.96, 0.80, 0.99, 0.99, 0.95 and 0

  5. The value of 18F-FDG PET/CT in the management of malignant peripheral nerve sheath tumors

    Our objective was to determine how positron emission tomography (PET)/CT had been used in the clinical treatment of malignant peripheral nerve sheath tumor (MPNST) patients at The University of Texas MD Anderson Cancer Center. We reviewed a database of MPNST patients referred to MD Anderson Cancer Center during 1995-2011. We enrolled 47 patients who underwent PET/CT imaging. Disease stage was based on conventional imaging and PET/CT findings using National Comprehensive Cancer Network (NCCN) guidelines. Treatment strategies based on PET/CT and conventional imaging were determined by chart review. The maximum and mean standardized uptake values (SUVmax, SUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG), change in SUVmax, change in MTV, and change in TLG were calculated from the PET/CT studies before and after treatment. Response prediction was based on imaging studies performed before and after therapy and categorized as positive or negative for residual tumor. Clinical outcome was determined from chart review. PET/CT was performed for staging in 16 patients, for restaging in 29 patients, and for surveillance in 2 patients. Of the patients, 88 % were correctly staged with PET/CT, whereas 75 % were correctly staged with conventional imaging. The sensitivity to detect local recurrence and distant metastasis at restaging was 100 and 100 % for PET/CT compared to 86 and 83 % for conventional imaging, respectively. PET/CT findings resulted in treatment changes in 31 % (5/16) and 14 % (4/29) of patients at staging and restaging, respectively. Recurrence, MTV, and TLG were prognostic factors for survival, whereas SUVmax and SUVmean were not predictive. For 21 patients who had imaging studies performed both before and after treatment, PET/CT was better at predicting outcome (overall survival, progression-free survival) than conventional imaging. A decreasing SUVmax ≥ 30 % and decrease in TLG and MTV were significant predictors for overall and

  6. The value of {sup 18}F-FDG PET/CT in the management of malignant peripheral nerve sheath tumors

    Khiewvan, Benjapa [University of Texas MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States); Mahidol University, Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine Siriraj Hospital, Bangkok (Thailand); Macapinlac, Homer A.; Chuang, Hubert H. [University of Texas MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States); Lev, Dina; Al Sannaa, Ghadah [University of Texas MD Anderson Cancer Center, Department of Cancer Biology, Houston, TX (United States); McCutcheon, Ian E. [University of Texas MD Anderson Cancer Center, Department of Neurosurgery, Houston, TX (United States); Slopis, John M. [University of Texas MD Anderson Cancer Center, Department of Neuro-Oncology, Houston, TX (United States); Wei, Wei [University of Texas MD Anderson Cancer Center, Department of Biostatistics, Houston, TX (United States)

    2014-09-15

    Our objective was to determine how positron emission tomography (PET)/CT had been used in the clinical treatment of malignant peripheral nerve sheath tumor (MPNST) patients at The University of Texas MD Anderson Cancer Center. We reviewed a database of MPNST patients referred to MD Anderson Cancer Center during 1995-2011. We enrolled 47 patients who underwent PET/CT imaging. Disease stage was based on conventional imaging and PET/CT findings using National Comprehensive Cancer Network (NCCN) guidelines. Treatment strategies based on PET/CT and conventional imaging were determined by chart review. The maximum and mean standardized uptake values (SUV{sub max}, SUV{sub mean}), metabolic tumor volume (MTV), total lesion glycolysis (TLG), change in SUV{sub max}, change in MTV, and change in TLG were calculated from the PET/CT studies before and after treatment. Response prediction was based on imaging studies performed before and after therapy and categorized as positive or negative for residual tumor. Clinical outcome was determined from chart review. PET/CT was performed for staging in 16 patients, for restaging in 29 patients, and for surveillance in 2 patients. Of the patients, 88 % were correctly staged with PET/CT, whereas 75 % were correctly staged with conventional imaging. The sensitivity to detect local recurrence and distant metastasis at restaging was 100 and 100 % for PET/CT compared to 86 and 83 % for conventional imaging, respectively. PET/CT findings resulted in treatment changes in 31 % (5/16) and 14 % (4/29) of patients at staging and restaging, respectively. Recurrence, MTV, and TLG were prognostic factors for survival, whereas SUV{sub max} and SUV{sub mean} were not predictive. For 21 patients who had imaging studies performed both before and after treatment, PET/CT was better at predicting outcome (overall survival, progression-free survival) than conventional imaging. A decreasing SUV{sub max} ≥ 30 % and decrease in TLG and MTV were significant

  7. Predicting location of recurrence using FDG, FLT, and Cu-ATSM PET in canine sinonasal tumors treated with radiotherapy

    Dose painting relies on the ability of functional imaging to identify resistant tumor subvolumes to be targeted for additional boosting. This work assessed the ability of FDG, FLT, and Cu-ATSM PET imaging to predict the locations of residual FDG PET in canine tumors following radiotherapy. Nineteen canines with spontaneous sinonasal tumors underwent PET/CT imaging with radiotracers FDG, FLT, and Cu-ATSM prior to hypofractionated radiotherapy. Therapy consisted of 10 fractions of 4.2 Gy to the sinonasal cavity with or without an integrated boost of 0.8 Gy to the GTV. Patients had an additional FLT PET/CT scan after fraction 2, a Cu-ATSM PET/CT scan after fraction 3, and follow-up FDG PET/CT scans after radiotherapy. Following image registration, simple and multiple linear and logistic voxel regressions were performed to assess how well pre- and mid-treatment PET imaging predicted post-treatment FDG uptake. R2 and pseudo R2 were used to assess the goodness of fits. For simple linear regression models, regression coefficients for all pre- and mid-treatment PET images were significantly positive across the population (P < 0.05). However, there was large variability among patients in goodness of fits: R2 ranged from 0.00 to 0.85, with a median of 0.12. Results for logistic regression models were similar. Multiple linear regression models resulted in better fits (median R2 = 0.31), but there was still large variability between patients in R2. The R2 from regression models for different predictor variables were highly correlated across patients (R ≈ 0.8), indicating tumors that were poorly predicted with one tracer were also poorly predicted by other tracers. In conclusion, the high inter-patient variability in goodness of fits indicates that PET was able to predict locations of residual tumor in some patients, but not others. This suggests not all patients would be good candidates for dose painting based on a single biological target. (paper)

  8. Predicting location of recurrence using FDG, FLT, and Cu-ATSM PET in canine sinonasal tumors treated with radiotherapy

    Bradshaw, Tyler; Fu, Rau; Bowen, Stephen; Zhu, Jun; Forrest, Lisa; Jeraj, Robert

    2015-07-01

    Dose painting relies on the ability of functional imaging to identify resistant tumor subvolumes to be targeted for additional boosting. This work assessed the ability of FDG, FLT, and Cu-ATSM PET imaging to predict the locations of residual FDG PET in canine tumors following radiotherapy. Nineteen canines with spontaneous sinonasal tumors underwent PET/CT imaging with radiotracers FDG, FLT, and Cu-ATSM prior to hypofractionated radiotherapy. Therapy consisted of 10 fractions of 4.2 Gy to the sinonasal cavity with or without an integrated boost of 0.8 Gy to the GTV. Patients had an additional FLT PET/CT scan after fraction 2, a Cu-ATSM PET/CT scan after fraction 3, and follow-up FDG PET/CT scans after radiotherapy. Following image registration, simple and multiple linear and logistic voxel regressions were performed to assess how well pre- and mid-treatment PET imaging predicted post-treatment FDG uptake. R2 and pseudo R2 were used to assess the goodness of fits. For simple linear regression models, regression coefficients for all pre- and mid-treatment PET images were significantly positive across the population (P < 0.05). However, there was large variability among patients in goodness of fits: R2 ranged from 0.00 to 0.85, with a median of 0.12. Results for logistic regression models were similar. Multiple linear regression models resulted in better fits (median R2 = 0.31), but there was still large variability between patients in R2. The R2 from regression models for different predictor variables were highly correlated across patients (R ≈ 0.8), indicating tumors that were poorly predicted with one tracer were also poorly predicted by other tracers. In conclusion, the high inter-patient variability in goodness of fits indicates that PET was able to predict locations of residual tumor in some patients, but not others. This suggests not all patients would be good candidates for dose painting based on a single biological target.

  9. Analysis of pairwise correlations in multi-parametric PET/MR data for biological tumor characterization and treatment individualization strategies

    The aim of this pilot study was to explore simultaneous functional PET/MR for biological characterization of tumors and potential future treatment adaptations. To investigate the extent of complementarity between different PET/MR-based functional datasets, a pairwise correlation analysis was performed. Functional datasets of N=15 head and neck (HN) cancer patients were evaluated. For patients of group A (N=7), combined PET/MR datasets including FDG-PET and ADC maps were available. Patients of group B (N=8) had FMISO-PET, DCE-MRI and ADC maps from combined PET/MRI, an additional dynamic FMISO-PET/CT acquired directly after FMISO tracer injection as well as an FDG-PET/CT acquired a few days earlier. From DCE-MR, parameter maps Ktrans, ve and vp were obtained with the extended Tofts model. Moreover, parameter maps of mean DCE enhancement, ΔSDCE, and mean FMISO signal 0-4 min p.i., anti AFMISO, were derived. Pairwise correlations were quantified using the Spearman correlation coefficient (r) on both a voxel and a regional level within the gross tumor volume. Between some pairs of functional imaging modalities moderate correlations were observed with respect to the median over all patient datasets, whereas distinct correlations were only present on an individual basis. Highest inter-modality median correlations on the voxel level were obtained for FDG/FMISO (r = 0.56), FDG/ anti AFMISO (r = 0.55), anti AFMISO/ΔSDCE (r = 0.46), and FDG/ADC (r = -0.39). Correlations on the regional level showed comparable results. The results of this study suggest that the examined functional datasets provide complementary information. However, only pairwise correlations were examined, and correlations could still exist between combinations of three or more datasets. These results might contribute to the future design of individually adapted treatment approaches based on multiparametric functional imaging.

  10. Anesthesia condition for {sup 18}F-FDG imaging of lung metastasis tumors using small animal PET

    Woo, Sang-Keun; Lee, Tae Sup; Kim, Kyeong Min; Kim, June-Youp; Jung, Jae Ho; Kang, Joo Hyun [Division of Nuclear Medicine and RI Application, Korea Institute of Radiological and Medical Sciences (KIRAMS), Nowon-Gu, Seoul 139-706 (Korea, Republic of); Cheon, Gi Jeong [Division of Nuclear Medicine and RI Application, Korea Institute of Radiological and Medical Sciences (KIRAMS), Nowon-Gu, Seoul 139-706 (Korea, Republic of); Department of Nuclear Medicine, Korea Institute of Radiological and Medical Sciences (KIRAMS), Nowon-Gu, Seoul 139-706 (Korea, Republic of)], E-mail: larry@kcch.re.kr; Choi, Chang Woon; Lim, Sang Moo [Division of Nuclear Medicine and RI Application, Korea Institute of Radiological and Medical Sciences (KIRAMS), Nowon-Gu, Seoul 139-706 (Korea, Republic of); Department of Nuclear Medicine, Korea Institute of Radiological and Medical Sciences (KIRAMS), Nowon-Gu, Seoul 139-706 (Korea, Republic of)

    2008-01-15

    Small animal positron emission tomography (PET) with {sup 18}F-FDG has been increasingly used for tumor imaging in the murine model. The aim of this study was to establish the anesthesia condition for imaging of lung metastasis tumor using small animal {sup 18}F-FDG PET. Methods: To determine the impact of anesthesia on {sup 18}F-FDG distribution in normal mice, five groups were studied under the following conditions: no anesthesia, ketamine and xylazine (Ke/Xy), 0.5% isoflurane (Iso 0.5), 1% isoflurane (Iso 1) and 2% isoflurane (Iso 2). The ex vivo counting, standard uptake value (SUV) image and glucose SUV of {sup 18}F-FDG in various tissues were evaluated. The {sup 18}F-FDG images in the lung metastasis tumor model were obtained under no anesthesia, Ke/Xy and Iso 0.5, and registered with CT image to clarify the tumor region. Results: Blood glucose concentration and muscle uptake of {sup 18}F-FDG in the Ke/Xy group markedly increased more than in the other groups. The Iso 2 group increased {sup 18}F-FDG uptake in heart compared with the other groups. The Iso 0.5 anesthesized group showed the lowest {sup 18}F-FDG uptake in heart and chest wall. The small size of lung metastasis tumor (2 mm) was clearly visualized by {sup 18}F-FDG image with the Iso 0.5 anesthesia. Conclusion: Small animal {sup 18}F-FDG PET imaging with Iso 0.5 anesthesia was appropriate for the detection of lung metastasis tumor. To acquire {sup 18}F-FDG PET images with small animal PET, the type and level of anesthetic should be carefully considered to be suitable for the visualization of target tissue in the experimental model.

  11. Breast PET scan

    Breast positron emission tomography; PET - breast; PET - tumor imaging - breast ... A PET scan requires a small amount of radioactive material (tracer). This tracer is given through a vein (IV), usually ...

  12. Tumor necrosis at FDG-PET is an independent predictor of outcome in diffuse large B-cell lymphoma

    Adams, Hugo J A; De Klerk, John M H; Fijnheer, Rob; Heggelman, Ben G F; Dubois, Stefan V.; Nievelstein, Rutger A J; Kwee, Thomas C.

    2016-01-01

    Purpose To determine the prognostic performance of tumor necrosis at FDG-PET in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) who are treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) therapy. Materials and methods 108 patients with new

  13. Assessment of [18F]-fluoroacetate PET/CT as a tumor-imaging modality. Preclinical study in healthy volunteers and clinical evaluation in patients with liver tumor

    Although [18F]-FDG is a useful oncologic PET tracer, FDG uptake is known to be low in a certain type of hepatocellular carcinoma (HCC). [18F]-fluoroacetate (18F-FACE) is an [18F] fluorinated acetate, which is known to be converted into fatty acids, incorporated in membrane and is expected to be a promising oncologic PET tracer. The aim of this study was to evaluate the usefulness of 18F-FACE as an oncologic PET tracer in preclinical study in healthy volunteers and in patients with liver tumors. Twenty-four healthy volunteers (age 48.2 ± 12.9 years old; 15 male and 9 female) and ten patients with liver tumor (age 72.1 ± 7.0 years old; 6 male and 4 female) were included. We performed whole-body static PET/CT scan using 18F-FACE (n=34) and 18F-FDG (n=5 for volunteers, n=8 for patients) on each day, respectively. Qualitative analysis and quantitative analysis of tumors (5 HCCs, 1 cholangiocellular carcinoma, 4 metastatic tumors from colon cancer and P-NET) were performed using SUVmax and tumor-to-normal liver ratio (TNR). In healthy volunteers, 18F-FACE was metabolically stable in vivo and its biodistribution was almost similar to blood pool, basically uniformly independent of age and gender during PET scan time (up to 3 h). Normal physiological uptake of 18F-FACE at each organ including liver (SUVmean 1.8 ± 0.2) was lower than that of blood pool (SUVmean 2.3 ± 0.3) at 1 h after injection. Chronic inflammatory uptake around femur of post-operative state of femoral osteotomy and faint uptake of benign hemangioma were observed in a case of healthy volunteer. 18F-FACE (SUVmax 2.7 ± 0.6, TNR 1.5 ± 0.4) of liver tumors was significantly lower than those of 18F-FDG uptake (6.5 ± 4.2, 2.6 ± 1.7, respectively). In qualitative analysis, 18F-FDG was positive in 4 tumors (3 HCCs, 1 CCC) and negative in the other 6 tumors, while 18F-FACE was also positive in 4 tumors which were the same tumors with positive 18F-FDG uptake. Biodistribution of 18F-FACE was appropriate for

  14. Differentiation between low potential malignancy and ovarian cancer, benign ovarian tumor using FDG PET/CT in comparison with MRI

    We evaluated the usefulness of fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT for differentiation between ovarian tumors in comparison with MRI. Seventeen women who had ovarian tumors histologically proven were studied. There were 6 ovarian cancers, 6 low potential malignancys (LPMs), and 5 benign tumors. PET/CT was performed early scan at 1 hour and delayed scan at 2 hours after administration of FDG. FDG uptake was seen in the solid portion of tumors on MRI. Early and delayed standardized uptake value (SUV)max on solid portion of LPMs were significantly lower than those of cancers and were also lower than those of benign tumors. The delayed SUVmax of cancers was significantly higher than early SUVmax, while there was no significant difference between early and delayed SUVmax of LPMs. It is important differential diagnosis of ovarian tumors, because operation procedure for LPM is different from cancer. Our results suggest that FDG PET/CT is useful for differentiation LPMs from ovarian cancers, but further investigation is needed. (author)

  15. Radiolabelling and evaluation of a novel sulfoxide as a PET imaging agent for tumor hypoxia

    [18F]FMISO is the most widely validated PET radiotracer for imaging hypoxic tissue. However, as a result of the pharmacokinetics of [18F]FMISO a 2 h wait between tracer administration and patient scanning is required for optimal image acquisition. In order to develop hypoxia imaging agents with faster kinetics, we have synthesised and evaluated several F-18 labelled anilino sulfoxides. In this manuscript we report on the synthesis, in vitro and in vivo evaluation of a novel fluoroethyltriazolyl propargyl anilino sulfoxide. The radiolabelling of the novel tracer was achieved via 2-[18F]fluoroethyl azide click chemistry. Radiochemical yields were 23 ± 4% based on 2-[18F]fluoroethyl azide and 7 ± 2% based on K[18F]F. The radiotracer did not undergo metabolism or defluorination in an in vitro assay using S9 liver fractions. Imaging studies using SK-RC-52 tumors in BALB/c nude mice have indicated that the tracer may have a higher pO2 threshold than [18F]FMISO for uptake in hypoxic tumors. Although clearance from muscle was faster than [18F]FMISO, uptake in hypoxic tumors was slower. The average tumor to muscle ratio at 2 h post injection in large, hypoxic tumors with a volume greater than 686 mm3 was 1.7, which was similar to the observed ratio of 1.75 for [18F]FMISO. Although the new tracer showed improved pharmacokinetics when compared with the previously synthesised sulfoxides, further modifications to the chemical structure need to be made in order to offer significant in vivo imaging advantages over [18F]FMISO

  16. FDG-avid portal vein tumor thrombosis from hepatocellular carcinoma in contrast-enhanced FDG PET/CT

    Canh Nguyen

    2015-01-01

    Full Text Available Objective(s: In this study, we aimed to describe the characteristics of portal vein tumor thrombosis (PVTT, complicating hepatocellular carcinoma (HCC in contrast-enhanced FDG PET/CT scan. Methods: In this retrospective study, 9 HCC patients with FDG-avid PVTT were diagnosed by contrast-enhanced fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT, which is a combination of dynamic liver CT scan, multiphase imaging, and whole-body PET scan. PET and CT DICOM images of patients were imported into the PET/CT imaging system for the re-analysis of contrast enhancement and FDG uptake in thrombus, the diameter of the involved portal vein, and characteristics of liver tumors and metastasis. Results: Two patients with previously untreated HCC and 7 cases with previously treated HCC had FDG-avid PVTT in contrast-enhanced FDG PET/CT scan. During the arterial phase of CT scan, portal vein thrombus showed contrast enhancement in 8 out of 9 patients (88.9%. PET scan showed an increased linear FDG uptake along the thrombosed portal vein in all patients. The mean greatest diameter of thrombosed portal veins was 1.8 ± 0.2 cm, which was significantly greater than that observed in normal portal veins (P<0.001. FDG uptake level in portal vein thrombus was significantly higher than that of blood pool in the reference normal portal vein (P=0.001. PVTT was caused by the direct extension of liver tumors. All patients had visible FDG-avid liver tumors in contrast-enhanced images. Five out of 9 patients (55.6% had no extrahepatic metastasis, 3 cases (33.3% had metastasis of regional lymph nodes, and 1 case (11.1% presented with distant metastasis. The median estimated survival time of patients was 5 months. Conclusion: The intraluminal filling defect consistent with thrombous within the portal vein, expansion of the involved portal vein, contrast enhancement, and linear increased FDG uptake of the thrombus extended from liver tumor are

  17. Analysis of Pretreatment FDG-PET SUV Parameters in Head-and-Neck Cancer: Tumor SUVmean Has Superior Prognostic Value

    Purpose: To evaluate the prognostic significance of different descriptive parameters in head-and-neck cancer patients undergoing pretreatment [F-18] fluoro-D-glucose-positron emission tomography (FDG-PET) imaging. Patients and Methods: Head-and-neck cancer patients who underwent FDG-PET before a course of curative intent radiotherapy were retrospectively analyzed. FDG-PET imaging parameters included maximum (SUVmax), and mean (SUVmean) standard uptake values, and total lesion glycolysis (TLG). Tumors and lymph nodes were defined on co-registered axial computed tomography (CT) slices. SUVmax and SUVmean were measured within these anatomic regions. The relationships between pretreatment SUVmax, SUVmean, and TLG for the primary site and lymph nodes were assessed using a univariate analysis for disease-free survival (DFS), locoregional control (LRC), and distant metastasis-free survival (DMFS). Kaplan-Meier survival curves were generated and compared via the log‒rank method. SUV data were analyzed as continuous variables. Results: A total of 88 patients was assessed. Two-year OS, LRC, DMFS, and DFS for the entire cohort were 85%, 78%, 81%, and 70%, respectively. Median SUVmax for the primary tumor and lymph nodes was 15.4 and 12.2, respectively. Median SUVmean for the primary tumor and lymph nodes was 7 and 5.2, respectively. Median TLG was 770. Increasing pretreatment SUVmean of the primary tumor was associated with decreased disease-free survival (p = 0.01). Neither SUVmax in the primary tumor or lymph nodes nor TLG was prognostic for any of the clinical endpoints. Patients with pretreatment tumor SUVmean that exceeded the median value (7) of the cohort demonstrated inferior 2-year DFS relative to patients with SUVmean ≤ the median value of the cohort, 58% vs. 82%, respectively, p = 0.03. Conclusion: Increasing SUVmean in the primary tumor was associated with inferior DFS. Although not routinely reported, pretreatment SUVmean may be a useful prognostic FDG-PET

  18. SPEQTACLE: An automated generalized fuzzy C-means algorithm for tumor delineation in PET

    Lapuyade-Lahorgue, Jérôme; Visvikis, Dimitris; Hatt, Mathieu, E-mail: hatt@univ-brest.fr [LaTIM, INSERM, UMR 1101, Brest 29609 (France); Pradier, Olivier [LaTIM, INSERM, UMR 1101, Brest 29609, France and Radiotherapy Department, CHRU Morvan, Brest 29609 (France); Cheze Le Rest, Catherine [DACTIM University of Poitiers, Nuclear Medicine Department, CHU Milétrie, Poitiers 86021 (France)

    2015-10-15

    Purpose: Accurate tumor delineation in positron emission tomography (PET) images is crucial in oncology. Although recent methods achieved good results, there is still room for improvement regarding tumors with complex shapes, low signal-to-noise ratio, and high levels of uptake heterogeneity. Methods: The authors developed and evaluated an original clustering-based method called spatial positron emission quantification of tumor—Automatic Lp-norm estimation (SPEQTACLE), based on the fuzzy C-means (FCM) algorithm with a generalization exploiting a Hilbertian norm to more accurately account for the fuzzy and non-Gaussian distributions of PET images. An automatic and reproducible estimation scheme of the norm on an image-by-image basis was developed. Robustness was assessed by studying the consistency of results obtained on multiple acquisitions of the NEMA phantom on three different scanners with varying acquisition parameters. Accuracy was evaluated using classification errors (CEs) on simulated and clinical images. SPEQTACLE was compared to another FCM implementation, fuzzy local information C-means (FLICM) and fuzzy locally adaptive Bayesian (FLAB). Results: SPEQTACLE demonstrated a level of robustness similar to FLAB (variability of 14% ± 9% vs 14% ± 7%, p = 0.15) and higher than FLICM (45% ± 18%, p < 0.0001), and improved accuracy with lower CE (14% ± 11%) over both FLICM (29% ± 29%) and FLAB (22% ± 20%) on simulated images. Improvement was significant for the more challenging cases with CE of 17% ± 11% for SPEQTACLE vs 28% ± 22% for FLAB (p = 0.009) and 40% ± 35% for FLICM (p < 0.0001). For the clinical cases, SPEQTACLE outperformed FLAB and FLICM (15% ± 6% vs 37% ± 14% and 30% ± 17%, p < 0.004). Conclusions: SPEQTACLE benefitted from the fully automatic estimation of the norm on a case-by-case basis. This promising approach will be extended to multimodal images and multiclass estimation in future developments.

  19. A novel {sup 18}F-labeled two-helix scaffold protein for PET imaging of HER2-positive tumor

    Miao, Zheng; Ren, Gang; Jiang, Lei; Liu, Hongguang; Cheng, Zhen [Stanford University, Molecular Imaging Program at Stanford (MIPS), Department of Radiology, Stanford Cancer Center, Bio-X Program, Stanford, CA (United States); Webster, Jack M.; Zhang, Rong; Syud, Faisal [General Electric Company, Global Research, Niskayuna, NY (United States); Namavari, Mohammad; Gambhir, Sanjiv S. [Stanford University, MIPS, Departments of Radiology and Bioengineering, Stanford Cancer Center, Bio-X Program, Stanford, CA (United States)

    2011-11-15

    Two-helix scaffold proteins ({proportional_to} 5 kDa) against human epidermal growth factor receptor type 2 (HER2) have been discovered in our previous work. In this research we aimed to develop an {sup 18}F-labeled two-helix scaffold protein for positron emission tomography (PET) imaging of HER2-positive tumors. An aminooxy-functionalized two-helix peptide (AO-MUT-DS) with high HER2 binding affinity was synthesized through conventional solid phase peptide synthesis. The purified linear peptide was cyclized by I{sub 2} oxidation to form a disulfide bridge. The cyclic peptide was then conjugated with a radiofluorination synthon, 4-{sup 18}F-fluorobenzyl aldehyde ({sup 18}F-FBA), through the aminooxy functional group at the peptide N terminus (30% yield, non-decay corrected). The binding affinities of the peptides were analyzed by Biacore analysis. Cell uptake assay of the resulting PET probe, {sup 18}F-FBO-MUT-DS, was performed at 37 C. {sup 18}F-FBO-MUT-DS with high specific activity (20-32 MBq/nmol, 88-140 {mu}Ci/{mu}g, end of synthesis) was injected into mice xenograft model bearing SKOV3 tumor. MicroPET and biodistribution and metabolic stability studies were then conducted. Cell uptake assays showed high and specific cell uptake ({proportional_to}12% applied activity at 1 h) by incubation of {sup 18}F-FBO-MUT-DS with HER2 high-expressing SKOV3 ovarian cancer cells. The affinities (K{sub D}) of AO-MUT-DS and FBO-MUT-DS as tested by Biacore analysis were 2 and 1 nM, respectively. In vivo small animal PET demonstrated fast tumor targeting, high tumor accumulation, and good tumor to normal tissue contrast of {sup 18}F-FBO-MUT-DS. Biodistribution studies further revealed that the probe had excellent tumor uptake (6.9%ID/g at 1 h post-injection) and was cleared through both liver and kidneys. Co-injection of the probe with 500 {mu}g of HER2 Affibody protein reduced the tumor uptake (6.9 vs 1.8%ID/g, p < 0.05). F-FBO-MUT-DS displays excellent HER2 targeting ability

  20. [11C]Sorafenib: Radiosynthesis and preclinical evaluation in tumor-bearing mice of a new TKI-PET tracer

    Introduction: Tyrosine kinase inhibitors (TKIs) like sorafenib are important anticancer therapeutics with thus far limited treatment response rates in cancer patients. Positron emission tomography (PET) could provide the means for selection of patients who might benefit from TKI treatment, if suitable PET tracers would be available. The aim of this study was to radiolabel sorafenib (1) with carbon-11 and to evaluate its potential as TKI-PET tracer in vivo. Methods: Synthetic methods were developed in which sorafenib was labeled at two different positions, followed by a metabolite analysis in rats and a PET imaging study in tumor-bearing mice. Results: [methyl-11C]-1 and [urea-11C]-1 were synthesized in yields of 59% and 53%, respectively, with a purity of > 99%. The identity of the products was confirmed by coinjection on HPLC with reference sorafenib. In an in vivo metabolite analysis [11C]sorafenib proved to be stable. The percentage of intact product in blood–plasma after 45 min was 90% for [methyl-11C]-1 and 96% for [urea-11C]-1, respectively. Due to the more reliable synthesis, further research regarding PET imaging was performed with [methyl-11C]-1 in nude mice bearing FaDu (head and neck cancer), MDA-MB-231 (breast cancer) or RXF393 (renal cancer) xenografts. Highest tracer accumulation at a level of 2.52 ± 0.33 %ID/g was observed in RXF393, a xenograft line extensively expressing the sorafenib target antigen Raf-1 as assessed by immunohistochemistry. Conclusion: In conclusion, we have synthesized [11C]sorafenib as PET tracer, which is stable in vivo and has the capability to be used as PET tracer for imaging in tumor-bearing mice

  1. Correlation of F-18 FDG PET with morphometric tumor response after neoadjuvant chemoradiation in locally advanced (stage III) non-small cell lung cancer (NSCLC)

    Aim: To determine the role of 2-[(18)F] fluoro-2- deoxy-D-glucose (FDG) positron emission tomography (PET) in morphometric tumor response after neoadjuvant chemoradiation, findings in 32 patients were analyzed prospectively in an ongoing multicenter trial (LUCAS-MD, Germany). Material and Methods: Inclusion criteria was histologically confirmed NSCLC stage IIIA/IIIB. For staging all patients received a PET scan in addition to a spiral CT and/or MRI before therapy. Neoadjuvant treatment consisted of 2-3 cycles of chemotherapy with paclitaxel (225 mg/m2) and carboplatin (AUC 6), each d1 q22 and a block of chemoradiation (45Gy, 1.5Gy b.i.d., concomitant with paclitaxel (50 mg/m2) and carboplatin (AUC = 2), each d1, d8, d15) followed by surgery. All patients received a second PET after completion of neoadjuvant therapy prior to surgery. Whole-body PET (ECAT Exact 47) studies (attenuation corrected, iteratively reconstructed) were obtained 60 min. after injection of 6 MBq/kg body weight F-18 FDG. For semi-quantitative analysis, the tumor standardized uptake values (SUV), the tumor to background SUV ratio (T/B ratio), the metabolic tumor diameter (MTD) and the metabolic tumor index (MTI = SUV x MTD) were assessed in all primary tumors and in metastatic lymph nodes. Additionally, image fusion of PET with CT data was applied (using a HERMES Computer, Nuclear Diagnostics, Sweden). Results: So far, all patients (7/32) with complete metabolic response in lymph node metastases detected by PET, had no vital tumor cells (morphometric regression grade III). In primary tumors showing complete metabolic response, the regression grade was IIB (less than 10% vital tumor cells) or III. Conclusion: Morphometric tumor response after neoadjuvant therapy correlates strongly with metabolic remission by FDG-PET. PET precedes the tumor response as measured by CT after neoadjuvant treatment and may predict the long term therapeutic outcome in stage III NSCLC

  2. Synthesis and evaluation of two novel 2-nitroimidazole derivatives as potential PET radioligands for tumor imaging

    Zha Zhihao; Zhu Lin [Key Laboratory of Radiopharmaceuticals, Beijing Normal University, Ministry of Education, Beijing 100875 (China); Department of Radiology, University of Pennsylvania, Philadelphia, PA 19014 (United States); Liu Yajing; Du Fenghua; Gan Hongmei; Qiao Jinping [Key Laboratory of Radiopharmaceuticals, Beijing Normal University, Ministry of Education, Beijing 100875 (China); Kung, Hank F., E-mail: kunghf@gmail.co [Key Laboratory of Radiopharmaceuticals, Beijing Normal University, Ministry of Education, Beijing 100875 (China); Department of Radiology, University of Pennsylvania, Philadelphia, PA 19014 (United States)

    2011-05-15

    }F]7) and NEFT ([{sup 19}F]8). Conclusions: In this research, two new fluorine-18 labeled 2-nitroimidazole derivatives, [{sup 18}F]7 and [{sup 18}F]8, both of which containing in vivo hydrolyzable group, were successfully prepared. Further biological evaluations are warranted to investigate their potential as PET radioligands for imaging tumor.

  3. Synthesis and evaluation of two novel 2-nitroimidazole derivatives as potential PET radioligands for tumor imaging

    derivatives, [18F]7 and [18F]8, both of which containing in vivo hydrolyzable group, were successfully prepared. Further biological evaluations are warranted to investigate their potential as PET radioligands for imaging tumor.

  4. Molecular markers derived from bombesin for tumor diagnosis by SPECT and PET; Marcadores moleculares derivados da bombesina para diagnostico de tumores por SPECT e PET

    Pujatti, Priscilla Brunelli

    2012-07-01

    A high number of molecules have already been identified to have high affinity to some receptors overexpressed on tumour cells and the radiolabelling of those molecules offers the possibility of new compounds for tumour diagnosis and therapy by nuclear medicine. Among of those molecules, bombesin (BBN) has become focus of interest, as its BB{sub 2} receptors are known to be overexpressed in prostate, breast, colon, pancreatic and lung tumour, as long as glioblastomas and neuroblastomas. BBN agonists and antagonists have already been described for this purpose and promising results were obtained in preclinical studies. However, most of them exhibited high abdominal accumulation, especially in pancreas and intestines, which can compromise diagnosis accuracy and cause serious adverse effects in therapy. In this context, the goal of the present work to radiolabel new BBN derivatives with {sup 11}1In and {sup 68}Ga and to evaluate their potential for BB{sub 2} positive tumors diagnosis by single photon emission tomography (SPECT) and positron emission tomography (PET). The structure of studied peptides was Q-YG{sub n}-BBN(6-14), where Q is the chelator, n is the number of glycine aminoacids in the spacer YG{sub n} and BBN(6-14) is the original bombesin sequence from the aminoacid 6 to 14. The derivative in which the last aminoacid (methionine, Met) was replaced by norleucine (Nle) was also evaluated. The experimental evaluation of the bombesin derivatives was divided into four steps: computational studies, molecular markers for SPECT, molecular markers for PET and toxicological studies. The theoretical partition (log P) and distribution (log D) coefficients were calculated for all bombesin derivatives conjugated to DTPA (diethylenetriaminepentaacetic acid) and DOTA (1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid) chelators applying computational programmes. Bombesin derivatives for SPECT were developed by radiolabelling DTPA-conjugated bombesin derivatives with

  5. Does the pretreatment tumor sampling location correspond with metabolic activity on 18F-FDG PET/CT in breast cancer patients scheduled for neoadjuvant chemotherapy?

    Koolen, Bas B., E-mail: b.koolen@nki.nl [Department of Nuclear Medicine, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Department of Surgical Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Elshof, Lotte E. [Department of Nuclear Medicine, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Department of Surgical Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Loo, Claudette E. [Department of Radiology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Wesseling, Jelle [Department of Pathology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Vrancken Peeters, Marie-Jeanne T.F.D. [Department of Surgical Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Vogel, Wouter V. [Department of Nuclear Medicine, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Rutgers, Emiel J.Th. [Department of Surgical Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Valdés Olmos, Renato A. [Department of Nuclear Medicine, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands)

    2013-12-01

    Purpose: To define the correlation between the core biopsy location and the area with highest metabolic activity on 18F-FDG PET/CT in stage II–III breast cancer patients before neoadjuvant chemotherapy. Also, we would like to select a subgroup of patients in which PET/CT information may optimize tumor sampling. Methods: A PET/CT in prone position was acquired in 199 patients with 203 tumors. The distance and relative difference in standardized uptake value (SUV) between core biopsy localization (indicated by a marker) and area with highest degree of FDG uptake were evaluated. A distance ≥2 cm and a relative difference in SUV ≥25% were considered clinically relevant and a combination of both was defined as non-correspondence. Non-correspondence for different tumor characteristics (TNM stage, lesion morphology on MRI and PET/CT, histology, subtype, grade, and Ki-67) was assessed. Results: Non-correspondence was found in 28 (14%) of 203 tumors. Non-correspondence was significantly associated with T-stage, lesion morphology on MRI and PET/CT, tumor diameter, and histologic type. It was more often seen in tumors with a higher T-stage (p = 0.028), diffuse (non-mass) and multifocal tumors on MRI (p = 0.001), diffuse and multifocal tumors on PET/CT (p < 0.001), tumors >3 cm (p < 0.001), and lobular carcinomas (p < 0.001). No association was found with other features. Conclusion: Non-correspondence between the core biopsy location and area with highest FDG uptake is regularly seen in stage II–III breast cancer patients. PET/CT information and possibly FDG-guided biopsies are most likely to improve pretreatment tumor sampling in tumors >3 cm, lobular carcinomas, and diffuse and multifocal tumors.

  6. Does the pretreatment tumor sampling location correspond with metabolic activity on 18F-FDG PET/CT in breast cancer patients scheduled for neoadjuvant chemotherapy?

    Purpose: To define the correlation between the core biopsy location and the area with highest metabolic activity on 18F-FDG PET/CT in stage II–III breast cancer patients before neoadjuvant chemotherapy. Also, we would like to select a subgroup of patients in which PET/CT information may optimize tumor sampling. Methods: A PET/CT in prone position was acquired in 199 patients with 203 tumors. The distance and relative difference in standardized uptake value (SUV) between core biopsy localization (indicated by a marker) and area with highest degree of FDG uptake were evaluated. A distance ≥2 cm and a relative difference in SUV ≥25% were considered clinically relevant and a combination of both was defined as non-correspondence. Non-correspondence for different tumor characteristics (TNM stage, lesion morphology on MRI and PET/CT, histology, subtype, grade, and Ki-67) was assessed. Results: Non-correspondence was found in 28 (14%) of 203 tumors. Non-correspondence was significantly associated with T-stage, lesion morphology on MRI and PET/CT, tumor diameter, and histologic type. It was more often seen in tumors with a higher T-stage (p = 0.028), diffuse (non-mass) and multifocal tumors on MRI (p = 0.001), diffuse and multifocal tumors on PET/CT (p < 0.001), tumors >3 cm (p < 0.001), and lobular carcinomas (p < 0.001). No association was found with other features. Conclusion: Non-correspondence between the core biopsy location and area with highest FDG uptake is regularly seen in stage II–III breast cancer patients. PET/CT information and possibly FDG-guided biopsies are most likely to improve pretreatment tumor sampling in tumors >3 cm, lobular carcinomas, and diffuse and multifocal tumors

  7. The clinical application of 4D 18F-FDG PET/CT on gross tumor volume delineation for radiotherapy planning in esophageal squamous cell cancer

    Wang, Yao-Ching; Hsieh, Te-Chun; Yu, Chun-Yen; Yen, Kuo-Yang; Chen, Shang-Wen; Yang, Shih-Neng; Chien, Chun-Ru; Hsu, Shih-Ming; Pan, Tinsu; Kao, Chia-Hung; Liang, Ji-An

    2012-01-01

    A combination of four-dimensional computed tomography with 18F-fluorodeoxyglucose positron emission tomography (4D CT-FDG PET) was used to delineate gross tumor volume (GTV) in esophageal cancer (EC). Eighteen patients with EC were prospectively enrolled. Using 4D images taken during the respiratory cycle, the average CT image phase was fused with the average FDG PET phase in order to analyze the optimal standardized uptake values (SUV) or threshold. PET-based GTV (GTVPET) was determined with...

  8. The correlation between PET-CT imaging and microvessed density in rabbit lung VX2 tumor model

    Objective: To evaluate and compare the suitability of 11C-choline and 18F-FDG PET-CT for reflecting tumors angiogenesis. Methods: Fifty-four New Zealand white rabbits which weighted 2.5∼3.0 kg were used in the experiment. Under general anesthesia, a needle was transthoracically inserted into the right lung, 0.5 ml viable VX2 tumor cell suspension was slowly injected through the needle to establish the model. 11C-choline and 18F-FDG PET-CT were performed after 10∼11 d. The tumors SUVmax were calculated. The sections were stained with hematoxylin and eosin, and immunostained for CD34. Assessment of micro vessel density (MVD) was performed by computer-assisted image analysis. The relationship 11C-choline SUVmax and 18F-FDG SUVmax with tumor size and MVD were statistically analyzed. Results: Thirty-three rabbits successfully completed all imaging examinations. 11C-choline and 18F-FDG differently accumulated in all lung VX2 tumors. The mean of 11C-choline SUVmax was 4.02±3.07 (1.4∼12.2), and the mean of 18F-FDG SUVmax was 5.70±3.45 (1.0∼13.0). The mean size of tumor was (1.68±1.61)cm3 (0.13∼8.00 cm3). Under high power microscope field of vision (200 x 0.739 mm2), the mean of MVD was 35.8±13.6 (13∼64), 11C-choline SUVmax did not correlate with tumor size and MVD. 18F-FDG SUVmax significantly and positively related to MVD (r=0.525, P=0.002). There was a critical positive correlation between 18F-FDG SUVmax and tumor size (r=0.335, P=0.057). Conclusion: In the rabbit VX2 lung tumor model, 18F-FDG SUVmax correlated with MVD, so 18F-FDG PET-CT could reflect tumor angiogenesis. 11C-choline SUVmax did not statistically correlate with MVD, and 11C-choline PET-CT could not reflect tumor angiogenesis. (authors)

  9. SU-E-I-81: Targeting of HER2-Expressing Tumors with Dual PET-MR Imaging Probes

    Purpose: The detection of human epidermal growth factor receptor type 2 (HER2) expression in malignant tumors provides important information influencing patient management. Radionuclide in vivo imaging of HER2 may permit the detection of HER2 in both primary tumors and metastases by a single noninvasive procedure. Trastuzumab, effective in about 15 % of women with breast cancer, downregulates signalling through the Akt/PI3K and MAPK pathways.These pathways modulate metabolism which can be monitored by positron emission tomography (PET) and magnetic resonance imaging (MRI). Methods: The relationship between response of HER2 overexpressing tumours and changes in imaging PET or SPECT and MRI will be examined by a integrated bimodal imaging probe.Small (7 kDa) high-affinity anti-HER2 Affibody molecules and KCCYSL targeting peptide may be suitable tracers for visualization of HER2-expressing tumors. Peptide-conjugated iron oxide nanoparticles (Fe3O4 NPs) as MRI imaging and CB-TE2A as PET imaging are integrated into a single synthetic molecule in the HER2 positive cancer. Results: One of targeted contrast bimodal imaging probe agents was synthesized and evaluated to target HER2-expressing tumors in a HER2 positive rat model. We will report the newest results regarding the development of bimodal imaging probes. Conclusion: The preliminary results of the bimodal imaging probe presents high correlation of MRI signal and PET imaging intensity in vivo. This unique feature can hardly be obtained by single model contrast agents. It is envisioned that this bimodal agents can hold great potential for accurate detection of HER2-expressing tumors which are critical for clinical management of the disease

  10. SU-E-I-81: Targeting of HER2-Expressing Tumors with Dual PET-MR Imaging Probes

    Xu, P; Peng, Y; Sun, M; Yang, X [Suzhou Institute of Biomedical Engineering and Technology Chinese Academy o, Suzhou, Jiangsu (China)

    2015-06-15

    Purpose: The detection of human epidermal growth factor receptor type 2 (HER2) expression in malignant tumors provides important information influencing patient management. Radionuclide in vivo imaging of HER2 may permit the detection of HER2 in both primary tumors and metastases by a single noninvasive procedure. Trastuzumab, effective in about 15 % of women with breast cancer, downregulates signalling through the Akt/PI3K and MAPK pathways.These pathways modulate metabolism which can be monitored by positron emission tomography (PET) and magnetic resonance imaging (MRI). Methods: The relationship between response of HER2 overexpressing tumours and changes in imaging PET or SPECT and MRI will be examined by a integrated bimodal imaging probe.Small (7 kDa) high-affinity anti-HER2 Affibody molecules and KCCYSL targeting peptide may be suitable tracers for visualization of HER2-expressing tumors. Peptide-conjugated iron oxide nanoparticles (Fe3O4 NPs) as MRI imaging and CB-TE2A as PET imaging are integrated into a single synthetic molecule in the HER2 positive cancer. Results: One of targeted contrast bimodal imaging probe agents was synthesized and evaluated to target HER2-expressing tumors in a HER2 positive rat model. We will report the newest results regarding the development of bimodal imaging probes. Conclusion: The preliminary results of the bimodal imaging probe presents high correlation of MRI signal and PET imaging intensity in vivo. This unique feature can hardly be obtained by single model contrast agents. It is envisioned that this bimodal agents can hold great potential for accurate detection of HER2-expressing tumors which are critical for clinical management of the disease.

  11. The Feasibility of 18F Fluorothymidine PET for Prediction of Tumor Response after Induction Chemotherapy Followed by Chemoradiotherapy with S 1/Oxaliplatin in Patients with Resectable Esophageal Cancer

    The aim of this study was to determine whether 18F fluorothymidine (FLT) PET is feasible for the early prediction of tumor response to induction chemotherapy followed by concurrent chemoradiotherapy in patients with esophageal cancer. This study was prospectively performed as a collateral study of randomized phase II study of preoperative concurrent chemoradiotherapy with S 1/oxaliplatin in patients with resectable esophageal cancer. 18F FLT positron emission tomography (PET) images were obtained before and after two cycles of induction chemotherapy, and the percent change of maximum standardized uptake value (SUVmax) was calculated. All patients underwent esophagography, gastrofiberoscopy, endoscopic ultrasonography (EUS), computed tomography (CT) and 18F fluorodeoxyglucose (FDG) PET at baseline and 3-4 weeks after completion of concurrent chemoradiotherapy. Final tumor response was determined by both clinical and pathologic tumor responses after surgery. The 13 patients for induction chemotherapy group were enrolled until interim analysis. In a primary tumor visual analysis, the tumor detection rates of baseline 18F FLT and 18F FDG PET were 85% and 100%, respectively. The tumor uptakes on 18F FLT PET were lower than those of 18F FDG PET. Among nine patients who completed second 18F FLT PET, eight patients were responders and one patient was a non responder in the assessment of final tumor response. The percent change of SUVmax in responders ranged from 41.2% to 79.2% (median 57.1%), whereas it was 10.2% in one non responder. The percent change of tumor uptake in 18F FLT PET after induction chemotherapy might be feasible for early prediction of tumor response after induction chemotherapy and concurrent chemoradiotherapy in patients with esophageal cancer

  12. Metabolic characterisation by PET-T.D.M. with 18 F.D.G. of non secreting adrenal tumors and undetermined by conventional imaging

    The PET-T.D.M. with F.D.G. allows a precise characterization of adrenal tumors with an excellent sensitivity and predictive negative value among these patients. So, a negative examination can be a strong argument for a benign tumor, that could potentially avoid surgery for the adrenal tumors with non conclusive examinations of conventional imaging. (N.C.)

  13. Malignant phyllodes tumor of the breast metastasizing to the vulva: {sup 18}F FDG PET CT Demonstrating rare metastasis from a rare tumor

    Khangembam, Bang Kim Chand Ra; Sharma, Punit; Singla, Su Has; Singhal, Abinav; Dhull, Varun Singh; Bal, Chand Rasek Har; Kumar, Rakesh [All India Institute of Medical Sciences, New Delhi (India)

    2012-09-15

    Phyllodes tumors are extremely rare fibroepithelial neoplasms accounting for 0.3 to 0.5% of all female breast tumors with an incidence of 2.1 per 1 million women. They are classified histologically into benign, borderline and malignant varieties. The majority of them are benign, with only 25% being malignant. Surgery remains the mainstay of treatment. One characteristic is that although the malignant variety tends to metastasize and recur, the benign form has also been found to behave in a similar manner. Benign phyllodes tumor has a 21% risk of local recurrence, while that of the malignant variety ranges from 20 to 32%. In patients with malignant phyllodes tumor, the rate of distant metastases ranges from 25 to 40%. The most frequent sites of distant metastasis is uncommon as this tumor spreads by hematogeneous route. Other sites for distant metastasis have been reported sporadically, including the duodenum, pancreas, brain, nasal cavity, forearm, parotid, skin, oral cavity, skeletal muscle, mandible and maxilla. We present a rare case of recurrent malignant phyllodes tumor with metastasis to the vulva, which has not been reported in the literature to the best of our knowledge. A 49 year old female who had undergone lumpectomy and locoregional radiotherapy 1 year previously for malignant phyllodes tumor of the right breast presented with difficulty in breathing and cervical lymphadenopathy. Chest X ray showed multiple pulmonary nodules suggestive of metastasis. She was referred for restaging with 18F fluorodeoxyglucose (FDG)positron emission tomography computed tomography (PET CT)FDG PET CT. Maximum intensity projection (MIP)PET images revealed multiple FDG avid enlarged cervical lymph nodes, bilateral pulmonary nodules along with left pleural effusion and extensive bone marrow metastases. The interesting finding was an intensely FDG avid (SUV{sup max}-21.4)subcutaneous soft tissue density lesion (measuring 2.0x2.2x2.0cm)in the vulva, which was later proved to be

  14. Malignant phyllodes tumor of the breast metastasizing to the vulva: 18F FDG PET CT Demonstrating rare metastasis from a rare tumor

    Phyllodes tumors are extremely rare fibroepithelial neoplasms accounting for 0.3 to 0.5% of all female breast tumors with an incidence of 2.1 per 1 million women. They are classified histologically into benign, borderline and malignant varieties. The majority of them are benign, with only 25% being malignant. Surgery remains the mainstay of treatment. One characteristic is that although the malignant variety tends to metastasize and recur, the benign form has also been found to behave in a similar manner. Benign phyllodes tumor has a 21% risk of local recurrence, while that of the malignant variety ranges from 20 to 32%. In patients with malignant phyllodes tumor, the rate of distant metastases ranges from 25 to 40%. The most frequent sites of distant metastasis is uncommon as this tumor spreads by hematogeneous route. Other sites for distant metastasis have been reported sporadically, including the duodenum, pancreas, brain, nasal cavity, forearm, parotid, skin, oral cavity, skeletal muscle, mandible and maxilla. We present a rare case of recurrent malignant phyllodes tumor with metastasis to the vulva, which has not been reported in the literature to the best of our knowledge. A 49 year old female who had undergone lumpectomy and locoregional radiotherapy 1 year previously for malignant phyllodes tumor of the right breast presented with difficulty in breathing and cervical lymphadenopathy. Chest X ray showed multiple pulmonary nodules suggestive of metastasis. She was referred for restaging with 18F fluorodeoxyglucose (FDG)positron emission tomography computed tomography (PET CT)FDG PET CT. Maximum intensity projection (MIP)PET images revealed multiple FDG avid enlarged cervical lymph nodes, bilateral pulmonary nodules along with left pleural effusion and extensive bone marrow metastases. The interesting finding was an intensely FDG avid (SUVmax-21.4)subcutaneous soft tissue density lesion (measuring 2.0x2.2x2.0cm)in the vulva, which was later proved to be

  15. Imaging of lung metastasis tumor mouse model using [{sup 18}F]FDG small animal PET and CT

    Kim, June Youp; Woo, Sang Keun; Lee, Tae Sup [Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul (Korea, Republic of)] (and others)

    2007-02-15

    The purpose of this study is to image metastaic lung melanoma model with optimal pre-conditions for animal handling by using [{sup 18}F]FDG small animal PET and clinical CT. The pre-conditions for lung region tumor imaging were 16-22 h fasting and warming temperature at 30 .deg. C. Small animal PET image was obtained at 60 min postinjection of 7.4 MBq [{sup 18}F]FDG and compared pattern of [{sup 18}F]FDG uptake and glucose standard uptake value (SUVG) of lung region between Ketamine/Xylazine (Ke/Xy) and Isoflurane (Iso) anesthetized group in normal mice. Metastasis tumor mouse model to lung was established by intravenous injection of B16-F10 cells in C57BL/6 mice. In lung metastasis tumor model, [{sup 18}F]FDG image was obtained and fused with anatomical clinical CT image. Average blood glucose concentration in normal mice were 128.0 {+-} 22.87 and 86.0 {+-} 21.65 mg/dL in Ke/Xy group and Iso group, respectively. Ke/Xy group showed 1.5 fold higher blood glucose concentration than Iso group. Lung to Background ratio (L/B) in SUVG image was 8.6 {+-} 0.48 and 12.1 {+-}0.63 in Ke/Xy group and Iso group, respectively. In tumor detection in lung region, [{sup 18}F]FDG image of Iso group was better than that of Ke/Xy group, because of high L/B ratio. Metastatic tumor location in [{sup 18}F]FDG small animal PET image was confirmed by fusion image using clinical CT. Tumor imaging in small animal lung region with [{sup 18}F]FDG small animal PET should be considered pre-conditions which fasting, warming and an anesthesia during [{sup 18}F]FDG uptake. Fused imaging with small animal PET and CT image could be useful for the detection of metastatic tumor in lung region.

  16. A novel 18F-labeled two-helix scaffold protein for PET imaging of HER2-positive tumor

    Two-helix scaffold proteins (∝ 5 kDa) against human epidermal growth factor receptor type 2 (HER2) have been discovered in our previous work. In this research we aimed to develop an 18F-labeled two-helix scaffold protein for positron emission tomography (PET) imaging of HER2-positive tumors. An aminooxy-functionalized two-helix peptide (AO-MUT-DS) with high HER2 binding affinity was synthesized through conventional solid phase peptide synthesis. The purified linear peptide was cyclized by I2 oxidation to form a disulfide bridge. The cyclic peptide was then conjugated with a radiofluorination synthon, 4-18F-fluorobenzyl aldehyde (18F-FBA), through the aminooxy functional group at the peptide N terminus (30% yield, non-decay corrected). The binding affinities of the peptides were analyzed by Biacore analysis. Cell uptake assay of the resulting PET probe, 18F-FBO-MUT-DS, was performed at 37 C. 18F-FBO-MUT-DS with high specific activity (20-32 MBq/nmol, 88-140 μCi/μg, end of synthesis) was injected into mice xenograft model bearing SKOV3 tumor. MicroPET and biodistribution and metabolic stability studies were then conducted. Cell uptake assays showed high and specific cell uptake (∝12% applied activity at 1 h) by incubation of 18F-FBO-MUT-DS with HER2 high-expressing SKOV3 ovarian cancer cells. The affinities (KD) of AO-MUT-DS and FBO-MUT-DS as tested by Biacore analysis were 2 and 1 nM, respectively. In vivo small animal PET demonstrated fast tumor targeting, high tumor accumulation, and good tumor to normal tissue contrast of 18F-FBO-MUT-DS. Biodistribution studies further revealed that the probe had excellent tumor uptake (6.9%ID/g at 1 h post-injection) and was cleared through both liver and kidneys. Co-injection of the probe with 500 μg of HER2 Affibody protein reduced the tumor uptake (6.9 vs 1.8%ID/g, p 18F-based PET probes. (orig.)

  17. Improved automated production of 18F-FMISO and its tumor hypoxia imaging by Micro-PET/CT

    Background: 1-H-1-(3-[18F]fluoro-2-hydroxypropyl)-2-nitroimidazole (18F-FMISO) is a specific molecular imaging probe for tumor hypoxia imaging, and its PET/CT imaging has an important clinical value for planning cancer radiotherapy target volume. Purpose: This study aimed to develop an improved, automated production of 18F-FMISO and to perform Micro-PET/CT imaging of tumor hypoxia. Methods: Based on the labeling precursor NITTP and a simple 'one-pot' method, an upgraded Explora GN module together with Explora LC was adopted to run radiofluorination (NITTP (10 mg), MeCN (1.0 mL), 120℃, 5.0 min), hydrolysis (HCI (1.0 mol/L, 1.0 mL), 130℃, 8.0 min) and high performance liquid chromatography (HPLC) purification to produce 18F-FMISO automatically. Moreover, Radio-HPLC and Radio-TLC were applied for the quality control, and Micro-PET/CT scanner for hypoxia imaging of SW1990 pancreatic tumor-bearing mice. Results: As results, 18F-FMISO was obtained with the synthesis time for about 65 min, the radiochemical yield of (30±5.0)% (no decay corrected, n=20), the radiochemical purity of above 99%, the specific activity of (2.04±0.17)x1011 Bq·μmol-1, plus with the enhanced chemical purity. Moreover, MicroPET/CT imaging showed that 18F-FMISO presented whole-body distribution in SW1990 tumor-bearing mice, and the optimized time point for tumor hypoxia imaging was 3 h post injection with the uptake ratios of tumor-to-muscle of 3.00±0.08. Conclusion: In sum, we developed an improved, automated production of 18F-FMISO with high performance liquid chromatography purification, high radiochemical yield, high specific activity and high reliability , and also verified its MicroPET/CT imaging of tumor hypoxia for providing experimental reference data. (authors)

  18. Quantification of immunohistochemical expression of somatostatin receptors in neuroendocrine tumors using 68Ga-DOTATATE PET/CT

    The immunohistochemical expression of somatostatin receptor (SSTR) subtype 2 was compared to quantitative 68Ga-DOTATATE PET in neuroendocrine tumors (NET). In 27 patients suffering from metastatic NET the expression of somatostatin receptors (SSTR, score 0-3) and the Ki-67 index were assessed. The immunohistochemical findings were compared with the 68Ga-DOTATATE PET uptake in these tumors using the SUVmax (standardized uptake value). Both values were compared with the Ki-67 proliferation index. The SUVmax in NET without SSTR expression was significantly lower compared to those with SSTR expression (p 68Ga-DOTATATE. The SUVmax correlated significantly (r=0.40, p max (r=-0.33, p=0.11). 68Ga-DOTATATE uptake was moderately correlated with the results of immunohistochemical SSTR analyses. However, SSTR negative NET may show high uptake of 68Ga-DOTATATE. (orig.)

  19. Clinical Usefulness of 18F-FDG PET/CT in the Detection of Early Recurrence in Treated Cervical Cancer Patients with Unexplained Elevation of Serum Tumor Markers

    Chong, Ari; Ha, Jung-Min; Jeong, Shin Young; Song, Ho-Chun; Min, Jung Joon; Bom, Hee-Seung; Choi, Ho-Sun

    2013-01-01

    We investigated the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) for restaging of treated uterine cervix squamous cell cancer with tumor maker elevation that was not explained by other conventional evaluation. We enrolled 32 cases who underwent PET/CT for the restaging of treated cervical cancer with tumor marker elevation that was not explained by recent conventional evaluation. All enrolled cases had squamous cell carcinoma. Increased ...

  20. Clinical relevance of F-18 FDG PET for imaging of neuroendocrine tumors; Wertigkeit der F-18-FDG-PET bei neuroendokrinen Tumoren

    Adams, S. [Klinikum der Ruhr-Univ. Bochum - Marienhospital, Herne (Germany). Klinik fuer Radiologie und Nuklearmedizin; Baum, R.P. [Zentralklinik Bad Berka (Germany). Klinik fuer Nuklearmedizin/PET-Zentrum; Hoer, G. [Frankfurt Univ., Frankfurt am Main (Germany). Klinik fuer Nuklearmedizin

    2001-04-01

    Neuroendocrine tumors are characterized immunocytochemically by the expression of different peptides and biogenic amines. Hormones induce their biological action by binding to and stimulating specific membrane-associated receptors for e.g. somatostatin. The presence of somatostatin receptors (SR) has been described mainly in endocrine glands and the central nervous system. Interestingly, a large variety of human tumors, including gastroenteropancreatic (GEP) tumors and medullary thyroid carcinomas (MTC) also express a high density of SR and can be imaged with [{sup 111}In-DTPA-D-Phe{sup 1}]-pentetreotide. Cell proliferative activity is an important indicator of the growth of various malignant tumors associated with a poorer prognosis and Ki-67 expression. {sup 18}F-FDG is a marker of tumor viability, based upon the increased glycolysis that is associated with malignancy as compared with normal tissue. SR-containing neuroendocrine tumors are well-differentiated and tend to grow slowly. Furthermore, these tumors demonstrate inverse relationship between in vivo SR expression, cell proliferation (low Ki-67 expression) and FDG uptake (normal biodistribution). In comparison, less differentiated tumors, e.g. atypical carcinoids or MTC with increasing CEA levels show mitotic activity (high levels of Ki-67 immunoreactivity and increased FDG uptake) and often lack of SR. In conclusion, SR scintigraphy has been shown to localize well-differentiated neuroendocrine tumors. In contrast, PET imaging is valuable for predicting malignancy only in less differentiated tumors with incresed glucose metabolism. Therefore, an additional F-18 FDG PET should be performed if SR scintigraphy (GEP tumors) or combined imaging using [{sup 111}In-DTPA-D-Phe{sup 1}]-pentetreotide and {sup 99m}Tc(V)-DMSA (MTC) is negative. (orig.) [German] Neuroendokrine Tumoren werden durch die spezifische Produktion von Polypeptidhormonen und biogenen Aminen klassifiziert. Die Informationsuebertragung der

  1. Analysis of pairwise correlations in multi-parametric PET/MR data for biological tumor characterization and treatment individualization strategies

    Leibfarth, Sara; Moennich, David; Thorwarth, Daniela [University Hospital Tuebingen, Section for Biomedical Physics, Department of Radiation Oncology, Tuebingen (Germany); Simoncic, Urban [University Hospital Tuebingen, Section for Biomedical Physics, Department of Radiation Oncology, Tuebingen (Germany); University of Ljubljana, Faculty of Mathematics and Physics, Ljubljana (Slovenia); Jozef Stefan Institute, Ljubljana (Slovenia); Welz, Stefan; Zips, Daniel [University Hospital Tuebingen, Department of Radiation Oncology, Tuebingen (Germany); Schmidt, Holger; Schwenzer, Nina [University Hospital Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany)

    2016-07-15

    The aim of this pilot study was to explore simultaneous functional PET/MR for biological characterization of tumors and potential future treatment adaptations. To investigate the extent of complementarity between different PET/MR-based functional datasets, a pairwise correlation analysis was performed. Functional datasets of N=15 head and neck (HN) cancer patients were evaluated. For patients of group A (N=7), combined PET/MR datasets including FDG-PET and ADC maps were available. Patients of group B (N=8) had FMISO-PET, DCE-MRI and ADC maps from combined PET/MRI, an additional dynamic FMISO-PET/CT acquired directly after FMISO tracer injection as well as an FDG-PET/CT acquired a few days earlier. From DCE-MR, parameter maps K{sup trans}, v{sub e} and v{sub p} were obtained with the extended Tofts model. Moreover, parameter maps of mean DCE enhancement, ΔS{sub DCE}, and mean FMISO signal 0-4 min p.i., anti A{sub FMISO}, were derived. Pairwise correlations were quantified using the Spearman correlation coefficient (r) on both a voxel and a regional level within the gross tumor volume. Between some pairs of functional imaging modalities moderate correlations were observed with respect to the median over all patient datasets, whereas distinct correlations were only present on an individual basis. Highest inter-modality median correlations on the voxel level were obtained for FDG/FMISO (r = 0.56), FDG/ anti A{sub FMISO} (r = 0.55), anti A{sub FMISO}/ΔS{sub DCE} (r = 0.46), and FDG/ADC (r = -0.39). Correlations on the regional level showed comparable results. The results of this study suggest that the examined functional datasets provide complementary information. However, only pairwise correlations were examined, and correlations could still exist between combinations of three or more datasets. These results might contribute to the future design of individually adapted treatment approaches based on multiparametric functional imaging.

  2. Assessment of the Tumor Redox Status in Head and Neck Cancer by 62Cu-ATSM PET

    Tsujikawa, Tetsuya; Asahi, Satoko; Oh, Myungmi; Sato, Yoshitaka; Narita, Norihiko; Makino, Akira; Mori, Tetsuya; Kiyono, Yasushi; Tsuchida, Tatsuro; Kimura, Hirohiko; Fujieda, Shigeharu; Okazawa, Hidehiko

    2016-01-01

    Purpose Tumor redox is an important factor for cancer progression, resistance to treatments, and a poor prognosis. The aim of the present study was to define tumor redox (over-reduction) using 62Cu-diacetyl-bis(N4-methylthiosemicarbazone) (62Cu-ATSM) PET and compare its prognostic potential in head and neck cancer (HNC) with that of 2-deoxy-2-[18F]fluoro-D-glucose (18F-FDG). Methods Thirty HNC patients (stage II–IV) underwent pretreatment 62Cu-ATSM and 18F-FDG PET scans. Maximum standardized uptake values (SUVATSM and SUVFDG) and tumor-to-muscle activity concentration ratios (TMRATSM and TMRFDG) were measured. Reductive-tumor-volume (RTV) was then determined at four thresholds (40%, 50%, 60%, and 70% SUVATSM), and total-lesion-reduction (TLR) was calculated as the product of the mean SUV and RTV for 62Cu-ATSM. In 18F-FDG, metabolic-tumor-volume (MTV) and total-lesion-glycolysis (TLG) were obtained at a threshold of 40%. A ROC analysis was performed to determine % thresholds for RTV and TLR showing the best predictive performance, and these were then used to determine the optimal cut-off values to stratify patients for each parameter. Progression-free-survival (PFS) and cause-specific-survival (CSS) were evaluated by the Kaplan-Meier method. Results The means ± standard deviations of PFS and CSS periods were 16.4±13.4 and 19.2±12.4 months, respectively. A ROC analysis determined that the 70% SUVATSM threshold for RTV and TLR was the best for predicting disease progression and cancer death. Optimal cut-offs for each index were SUVATSM = 3.6, SUVFDG = 7.9, TMRATSM = 3.2, TMRFDG = 5.6, RTV = 2.9, MTV = 8.1, TLR = 14.0, and TLG = 36.5. When the cut-offs for TMRATSM and TLR were set as described above in 62Cu-ATSM PET, patients with higher TMRATSM (p = 0.03) and greater TLR (p = 0.02) showed significantly worse PFS, while patients with greater TLR had significantly worse CSS (p = 0.02). Only MTV in 18F-FDG PET predicted differences in PSF and CSS (p = 0.03 and p = 0

  3. Evolving role of 18F-FDG-PET/CT for the body tumor and metastases in pediatrics

    18F-FDG-positron emission tomography-computerized tomography (18F-FDG-PET/CT) scan is an important imaging tool which may provide both functional and anatomical information in a single diagnostic test. It has the potential to be a valuable tool in the noninvasive evaluation and monitoring of pediatric tumors including the metastases because 18fluorodeoxyglucose (18F-FDG) is a glucose analogue that concentrates in areas of active metabolic activity. This review provides an update on functional and metabolic imaging approaches for assessment and management of the body tumor and metastases in pediatrics using a combined whole body 18F-FDG-PET/CT scanners. We discuss the benefits include improved pediatric patients' outcome facilitated by staging and monitoring of disease and better treatment planning. It is worth to concern the preparation of children undergoing PET studies and radiation dosimetry and its implications for family and caregivers. It is important to consider the normal distribution of 18FDG in children, common variations of the normal distribution. We show some of our cases that most tumors in children accumulate and retain FDG, allowing high-quality images of their distribution and pathophysiology either at the primary site as well as in the areas of metastatic disease.

  4. Evolving role of {sup 18}F-FDG-PET/CT for the body tumor and metastases in pediatrics

    Chen Zhengguang, E-mail: guangchen1@gmail.co [Department of Radiology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, No. 5 Hai Yun Cang Beijing 100700 (China); Li Xiaozhen, E-mail: lixiaozhen79@gmail.co [Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shui Fu Yuan, Wang Fu Jing Da Jie, Beijing 100730 (China); Li Fang, E-mail: lifang@gmail.co [Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shui Fu Yuan, Wang Fu Jing Da Jie, Beijing 100730 (China); Ouyang Qiaohong [Department of Nuclear Medicine, First Affiliated Hospital, PLA General Hospital, Beijing 100853 (China); Yu Tong [Imaging Center, Beijing Children' s Hospital Affiliated to Capital Medical University. 56, Nanlishi Road, Xicheng District, Beijing 100045 (China)

    2010-09-15

    {sup 18}F-FDG-positron emission tomography-computerized tomography ({sup 18}F-FDG-PET/CT) scan is an important imaging tool which may provide both functional and anatomical information in a single diagnostic test. It has the potential to be a valuable tool in the noninvasive evaluation and monitoring of pediatric tumors including the metastases because {sup 18}fluorodeoxyglucose ({sup 18}F-FDG) is a glucose analogue that concentrates in areas of active metabolic activity. This review provides an update on functional and metabolic imaging approaches for assessment and management of the body tumor and metastases in pediatrics using a combined whole body {sup 18}F-FDG-PET/CT scanners. We discuss the benefits include improved pediatric patients' outcome facilitated by staging and monitoring of disease and better treatment planning. It is worth to concern the preparation of children undergoing PET studies and radiation dosimetry and its implications for family and caregivers. It is important to consider the normal distribution of {sup 18}FDG in children, common variations of the normal distribution. We show some of our cases that most tumors in children accumulate and retain FDG, allowing high-quality images of their distribution and pathophysiology either at the primary site as well as in the areas of metastatic disease.

  5. PET in Lung Cancer

    Hans C. Steinert,

    2005-01-01

    Accurate tumor staging is essential for choosing the appropriate treatment strategy inpatients with lung cancer. It has already been shown that FDG-PET is highly accurate inclassifying lung nodules as benign or malignant. Integrated PET-CT enables the exactmatching of focal abnormalities on PET to anatomic structures on CT. PET-CT is superior indiagnostic accuracy for T staging and differentiation between tumor and peritumoral atelectasis.PET has also proved to be a very effective staging mod...

  6. Incidental tenosynovial huge cell tumors of the flexor hallucis longus muscle: seldom differential diagnosis of metabolic lesions using F18-FDG PET/CT; Inzidenteller tenosynovialer Riesenzelltumor des Musculus flexor hallucis longus. Seltene Differenzialdiagnose stoffwechselaktiver Laesionen in der F-18-FDG PET/CT

    Koestner, W.; Daemmrich, M.; Derlin, T.

    2016-03-15

    Tenosynovial huge cell tumors are seldom benign tumors in extremities originating from bone joint synovia and tendon sheats. In F18-FDG PET/CT imaging the tenosynovial huge cell tumors show increased metabolic activity and can trigger false diagnoses.

  7. 18F-fluorodeoxyglucose-PET/CT to evaluate tumor, nodal disease, and gross tumor volume of oropharyngeal and oral cavity cancer: comparison with MR imaging and validation with surgical specimen

    The purpose of this paper is to evaluate the impact of adding combined 18F-PET/CT to MRI for T and N staging of the oral and oropharyngeal cancer and calculation of the gross tumor volume (GTV) having histopathology as reference standard. PET/CT and MRI were performed in 66 patients with suspected oral and oropharyngeal cancer (41 primary tumors/25 recurrent tumors) and nodal disease (114 nodes). Statistical analysis included the McNemar test, sensitivity, specificity for the diagnostic modalities as well as regression analysis, and Bland-Altman graphs for calculated tumor volumes. There was no statistically significant difference between the two modalities compared to pathological findings regarding detection of disease (P≥0.72). The sensitivity/specificity for tumor detection were 100/80% and 96.72/60% for MRI and PET/CT, respectively. The sensitivity/specificity for nodal metastases were 88.46/75% and 83.81/73.91% for MRI and PET/CT, respectively. In 18% of cases, the MRI-based T staging resulted in an overestimation of the pathologic tumor stage. The corresponding rate for PET/CT was 22%. Regarding the treated necks, both modalities showed 100% sensitivity for detection of the recurrent lesions. In necks with histologically N0 staging, MRI and PET/CT gave 22% and 26% false positive findings, respectively. The mean tumor volume in the pathologic specimen was 16.6±18.6 ml, the mean volume derived by the MR imaging was 17.6±19.1 ml while the estimated by PET/CT volume was 18.8±18.1 ml (P≤0.007 between the three methods). The Bland-Altman analysis showed a better agreement between PET/CT and MRI. The diagnostic performance of FDG-PET/CT in the local staging of oral cancer is not superior to MRI. (orig.)

  8. Textural analysis of pre-therapeutic [18F]-FET-PET and its correlation with tumor grade and patient survival in high-grade gliomas

    Pyka, Thomas; Hiob, Daniela; Wester, Hans-Juergen [Klinikum Rechts der Isar der TU Muenchen, Department of Nuclear Medicine, Munich (Germany); Gempt, Jens; Ringel, Florian; Meyer, Bernhard [Klinikum Rechts der Isar der TU Muenchen, Neurosurgic Department, Munich (Germany); Schlegel, Juergen [Klinikum Rechts der Isar der TU Muenchen, Institute of Pathology and Neuropathology, Munich (Germany); Bette, Stefanie [Klinikum Rechts der Isar der TU Muenchen, Neuroradiologic department, Munich (Germany); Foerster, Stefan [Klinikum Rechts der Isar der TU Muenchen, Department of Nuclear Medicine, Munich (Germany); Klinikum Rechts der Isar der TU Muenchen, TUM Neuroimaging Center (TUM-NIC), Munich (Germany)

    2016-01-15

    Amino acid positron emission tomography (PET) with [18F]-fluoroethyl-L-tyrosine (FET) is well established in the diagnostic work-up of malignant brain tumors. Analysis of FET-PET data using tumor-to-background ratios (TBR) has been shown to be highly valuable for the detection of viable hypermetabolic brain tumor tissue; however, it has not proven equally useful for tumor grading. Recently, textural features in 18-fluorodeoxyglucose-PET have been proposed as a method to quantify the heterogeneity of glucose metabolism in a variety of tumor entities. Herein we evaluate whether textural FET-PET features are of utility for grading and prognostication in patients with high-grade gliomas. One hundred thirteen patients (70 men, 43 women) with histologically proven high-grade gliomas were included in this retrospective study. All patients received static FET-PET scans prior to first-line therapy. TBR (max and mean), volumetric parameters and textural parameters based on gray-level neighborhood difference matrices were derived from static FET-PET images. Receiver operating characteristic (ROC) and discriminant function analyses were used to assess the value for tumor grading. Kaplan-Meier curves and univariate and multivariate Cox regression were employed for analysis of progression-free and overall survival. All FET-PET textural parameters showed the ability to differentiate between World Health Organization (WHO) grade III and IV tumors (p < 0.001; AUC 0.775). Further improvement in discriminatory power was possible through a combination of texture and metabolic tumor volume, classifying 85 % of tumors correctly (AUC 0.830). TBR and volumetric parameters alone were correlated with tumor grade, but showed lower AUC values (0.644 and 0.710, respectively). Furthermore, a correlation of FET-PET texture but not TBR was shown with patient PFS and OS, proving significant in multivariate analysis as well. Volumetric parameters were predictive for OS, but this correlation did not

  9. Textural analysis of pre-therapeutic [18F]-FET-PET and its correlation with tumor grade and patient survival in high-grade gliomas

    Amino acid positron emission tomography (PET) with [18F]-fluoroethyl-L-tyrosine (FET) is well established in the diagnostic work-up of malignant brain tumors. Analysis of FET-PET data using tumor-to-background ratios (TBR) has been shown to be highly valuable for the detection of viable hypermetabolic brain tumor tissue; however, it has not proven equally useful for tumor grading. Recently, textural features in 18-fluorodeoxyglucose-PET have been proposed as a method to quantify the heterogeneity of glucose metabolism in a variety of tumor entities. Herein we evaluate whether textural FET-PET features are of utility for grading and prognostication in patients with high-grade gliomas. One hundred thirteen patients (70 men, 43 women) with histologically proven high-grade gliomas were included in this retrospective study. All patients received static FET-PET scans prior to first-line therapy. TBR (max and mean), volumetric parameters and textural parameters based on gray-level neighborhood difference matrices were derived from static FET-PET images. Receiver operating characteristic (ROC) and discriminant function analyses were used to assess the value for tumor grading. Kaplan-Meier curves and univariate and multivariate Cox regression were employed for analysis of progression-free and overall survival. All FET-PET textural parameters showed the ability to differentiate between World Health Organization (WHO) grade III and IV tumors (p < 0.001; AUC 0.775). Further improvement in discriminatory power was possible through a combination of texture and metabolic tumor volume, classifying 85 % of tumors correctly (AUC 0.830). TBR and volumetric parameters alone were correlated with tumor grade, but showed lower AUC values (0.644 and 0.710, respectively). Furthermore, a correlation of FET-PET texture but not TBR was shown with patient PFS and OS, proving significant in multivariate analysis as well. Volumetric parameters were predictive for OS, but this correlation did not

  10. Response evaluation of gastrointestinal stromal tumors treated with imatinib using 18F-FDG PET/CT

    Full text: Several studies have demonstrated the effective use of adjuvant treatment with Imatinib mesylate for unresectable, metastatic or recurrent Gastrointestinal Stromal Tumors (GIST). We retrospectively evaluated the role of 18F-FDG PET/CT scanning in assessing the response of GIST patients to imatinib mesylate therapy. Materials and Methods: Thirteen consecutive patients with GIST confirmed by surgery (5 stomach, 6 small bowel, 1 small bowel and peritoneum, and 1 rectum) underwent 60 18F-FDG PET/CT imaging before and after beginning imatinib mesylate therapy (400 mg/day or greater if disease progression). PET/CT scan was acquired 60 minutes after the intravenous injection of 333-707 MBq of 18F-FDG. Visual and semiquantitative (standardized uptake value (SUV)) analysis of images was performed. A decrease in SUV of more than 50% was considered as significant response, decrease in SUV of more than 25% was considered as partial response. Increase in SUV of more than 25% or appearance of new lesion (s) was considered as progression of disease. Response to therapy was assessed according to EORTC recommendations for PET. Results were confirmed by clinical follow-up, CECT findings or histological analysis (when available). Results: Complete response to imatinib mesylate was observed in 5 patients. Partial response and stable disease was noted in two each. Four patient demonstrated progression of disease, two developed liver metastasis, one developed abdominal lymphnode pathology and one had increase in size and uptake of tumor. Conclusion: 18F-FDG PET/CT scan identified the degree of GIST response to imatinib therapy. Patients who responded to therapy showed normalisation of FDG uptake or a decrease in the SUV of lesions. Patients with progression of disease demonstrated increase in uptake value or development of new lesion

  11. The role of whole-body FDG-PET in preoperative assessment of tumor staging in oral cancers

    The aim of this study is to clarify the clinical utility of 2-deoxy-2-[18F]fluoro-D-glucose (FDG) positron emission tomography (PET) in determining the TNM classification in patients with oral cancer. Twenty-five consecutive patients (14 male and 11 female; age range, 40 yr to 86 yr) with oral cancer were included in this study. The diagnostic accuracy for detecting cervical lymph nodes was investigated by comparing the results of CT and/or MRI and physical findings. For the semi-quantitative analysis, the tumor standardized uptake value (SUV) and tumor to background SUV ratio (T/B ratio) were assessed in primary tumors and cervical lymph nodes. All primary lesions were visualized on FDG-PET images. Even though artifacts from dental materials near the lesion hampered the delineation of primary tumors on CT/MRI, the extent of primary tumors was accurately assessed by FDG-PET. The SUV and T/B ratio in the primary tumor classified in higher T grade (T3 and T4) was significantly higher than that in lower T grade (T1 and T2) (mean±SD of SUV; 8.32±2.99 vs. 5.15±3.77, p<0.01, mean ±SD of T/B ratio; 6.96±3.23 vs. 3.61±2.76, p<0.01). The SUV and T/B ratio of metastatic lymph nodes were also significantly higher than those of normal lymph nodes (mean ±SD of SUV; 3.39±1.69 vs. 1.55±0.57, p<0.001, mean ±SD of T/B ratio; 2.46±1.08 vs. 1.03±0.22, p<0.001). Among these three methods, FDG-PET in conjunction with CT/MRI showed the highest accuracy of 92%, but there were no significant differences in diagnostic accuracy among the three methods. For the semi-quantitative analysis, a threshold SUV of 2.0 provided 100% sensitivity, 82% specificity, and 88% accuracy. Furthermore, a threshold T/B ratio of 1.5 provided 100% sensitivity, 100% specificity, and 100% accuracy. Regarding the detection of distant metastasis, there was one positive result in FDG-PET showing distant pulmonary metastasis. Whole-body FDG-PET is an effective and convenient diagnostic tool for the

  12. A prospective, multicentre trial on the Value of {sup 18}F-FET PET in the post-therapeutic evaluation of childhood brain tumors; Prospektive, multizentrische Studie zur Bedeutung der O-(2-[{sup 18}F]Fluoroethyl)-L-Tyrosin-Positronen-Emissions-Tomografie (FET-PET) in der Verlaufsbeurteilung von Hirntumoren im Kindes- und Jugendalter (FET PET 2010). Vorstellung des Studiendesigns

    Plotkin, M.; Steffen, I.G. [Charite, Universitaetsmedizin Berlin (Germany). Klinik fuer Nuklearmedizin; Guggemos, A. [Kliniken der Stadt Koeln (Germany). Klinik fuer Kinder- und Jugendmedizin; Hernaiz Driever, P. [Charite, Universitaetsmedizin Berlin (Germany). Klinik fuer Paediatrie m.S. Onkologie/Haematologie

    2011-07-15

    We present a study concept of a prospective, multicentre trial on the value of {sup 18}F-FET PET in the post-therapeutic evaluation of childhood brain tumors (FET PET 2010). The main objective of this study is to evaluate the performance of {sup 18}F-FET PET in comparison to the MRI in differentiating residual tumor/recurrence from therapy-related changes in pediatric brain tumors after first line therapy. 160 patients will be recruited in this German multicenter study. Duration of study will be 3 years for all patients. (orig.)

  13. PET pharmacokinetic analysis to estimate boron concentration in tumor and brain as a guide to plan BNCT for malignant cerebral glioma

    Introduction: To plan the optimal BNCT for patients with malignant cerebral glioma, estimation of the ratio of boron concentration in tumor tissue against that in the surrounding normal brain (T/N ratio of boron) is important. We report a positron emission tomography (PET) imaging method to estimate T/N ratio of tissue boron concentration based on pharmacokinetic analysis of amino acid probes. Methods: Twelve patients with cerebral malignant glioma underwent 60 min dynamic PET scanning of brain after bolus injection of 18F-borono-phenyl-alanine (FBPA) with timed arterial blood sampling. Using kinetic parameter obtained by this scan, T/N ratio of boron concentration elicited by one-hour constant infusion of BPA, as performed in BNCT, was simulated on Runge-Kutta algorithm. 11C-methionine (MET) PET scan, which is commonly used in worldwide PET center as brain tumor imaging tool, was also performed on the same day to compare the image characteristics of FBPA and that of MET. Result: PET glioma images obtained with FBPA and MET are almost identical in all patients by visual inspection. Estimated T/N ratio of tissue boron concentration after one-hour constant infusion of BPA, T/N ratio of FBPA on static condition, and T/N ratio of MET on static condition showed significant linear correlation between each other. Conclusion: T/N ratio of boron concentration that is obtained by constant infusion of BPA during BNCT can be estimated by FBPA PET scan. This ratio can also be estimated by MET-PET imaging. As MET-PET study is available in many clinical PET center, selection of candidates for BNCT may be possible by MET-PET images. Accurate planning of BNCT may be performed by static images of FBPA PET. Use of PET imaging with amino acid probes may contribute very much to establish an appropriate application of BNCT for patients with malignant glioma.

  14. PET pharmacokinetic analysis to estimate boron concentration in tumor and brain as a guide to plan BNCT for malignant cerebral glioma

    Nariai, Tadashi [Department of Neurosurgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo (Japan)], E-mail: nariai.nsrg@tmd.ac.jp; Ishiwata, Kiichi [Positron Medical Center, Tokyo Metropolitan Institute of Gerontology, 1-1, Nakacho, Itabashi-ku, Tokyo (Japan); Kimura, Yuichi [Molecular Imaging Center, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba (Japan); Inaji, Motoki; Momose, Toshiya [Department of Neurosurgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo (Japan); Yamamoto, Tetsuya; Matsumura, Akira [Department of Neurosurgery, University of Tsukuba, Tennodai, Tsukuba, Igaraki (Japan); Ishii, Kenji [Positron Medical Center, Tokyo Metropolitan Institute of Gerontology, 1-1, Nakacho, Itabashi-ku, Tokyo (Japan); Ohno, Kikuo [Department of Neurosurgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo (Japan)

    2009-07-15

    Introduction: To plan the optimal BNCT for patients with malignant cerebral glioma, estimation of the ratio of boron concentration in tumor tissue against that in the surrounding normal brain (T/N ratio of boron) is important. We report a positron emission tomography (PET) imaging method to estimate T/N ratio of tissue boron concentration based on pharmacokinetic analysis of amino acid probes. Methods: Twelve patients with cerebral malignant glioma underwent 60 min dynamic PET scanning of brain after bolus injection of {sup 18}F-borono-phenyl-alanine (FBPA) with timed arterial blood sampling. Using kinetic parameter obtained by this scan, T/N ratio of boron concentration elicited by one-hour constant infusion of BPA, as performed in BNCT, was simulated on Runge-Kutta algorithm. {sup 11}C-methionine (MET) PET scan, which is commonly used in worldwide PET center as brain tumor imaging tool, was also performed on the same day to compare the image characteristics of FBPA and that of MET. Result: PET glioma images obtained with FBPA and MET are almost identical in all patients by visual inspection. Estimated T/N ratio of tissue boron concentration after one-hour constant infusion of BPA, T/N ratio of FBPA on static condition, and T/N ratio of MET on static condition showed significant linear correlation between each other. Conclusion: T/N ratio of boron concentration that is obtained by constant infusion of BPA during BNCT can be estimated by FBPA PET scan. This ratio can also be estimated by MET-PET imaging. As MET-PET study is available in many clinical PET center, selection of candidates for BNCT may be possible by MET-PET images. Accurate planning of BNCT may be performed by static images of FBPA PET. Use of PET imaging with amino acid probes may contribute very much to establish an appropriate application of BNCT for patients with malignant glioma.

  15. Stereotactic Comparison Study of 18F-Alfatide and 18F-FDG PET Imaging in an LLC Tumor-Bearing C57BL/6 Mouse Model

    Wei, Yu-Chun; Gao, Yongsheng; Zhang, Jianbo; Fu, Zheng; Zheng, Jinsong; Liu, Ning; Hu, Xudong; Hou, Wenhong; Yu, Jinming; Yuan, Shuanghu

    2016-01-01

    This study aimed to stereotactically compare the PET imaging performance of 18F-Alfatide (18F-ALF-NOTA-PRGD2, denoted as 18F-Alfatide) and 18F-fluorodeoxyglucose (FDG) and immunohistochemistry (IHC) staining in Lewis lung carcinoma (LLC) tumor-bearing C57BL/6 mouse model. 18F-FDG standard uptake values (SUVs) were higher than 18F-Alfatide SUVs in tumors, most of the normal tissues and organs except for the bladder. Tumor-to-brain, tumor-to-lung, and tumor-to-heart ratios of 18F-Alfatide PET were significantly higher than those of 18F-FDG PET (P SUV and GLUT-1 (R = 0.895, P SUV and αvβ3 (R = 0.595, P = 0.019), 18F-FDG SUV and 18F-Alfatide SUV (R = 0.917, P < 0.001), and GLUT-1 and αvβ3 (R = 0.637, P = 0.011). Therefore, 18F-Alfatide PET may be an effective tracer for tumor detection, spatial heterogeneity imaging and an alternative supplement to 18F-FDG PET, particularly for patients with enhanced characteristics in the brain, chest tumors or diabetes, meriting further study. PMID:27350554

  16. Stereotactic Comparison Study of (18)F-Alfatide and (18)F-FDG PET Imaging in an LLC Tumor-Bearing C57BL/6 Mouse Model.

    Wei, Yu-Chun; Gao, Yongsheng; Zhang, Jianbo; Fu, Zheng; Zheng, Jinsong; Liu, Ning; Hu, Xudong; Hou, Wenhong; Yu, Jinming; Yuan, Shuanghu

    2016-01-01

    This study aimed to stereotactically compare the PET imaging performance of (18)F-Alfatide ((18)F-ALF-NOTA-PRGD2, denoted as (18)F-Alfatide) and (18)F-fluorodeoxyglucose (FDG) and immunohistochemistry (IHC) staining in Lewis lung carcinoma (LLC) tumor-bearing C57BL/6 mouse model. (18)F-FDG standard uptake values (SUVs) were higher than (18)F-Alfatide SUVs in tumors, most of the normal tissues and organs except for the bladder. Tumor-to-brain, tumor-to-lung, and tumor-to-heart ratios of (18)F-Alfatide PET were significantly higher than those of (18)F-FDG PET (P SUV and GLUT-1 (R = 0.895, P SUV and αvβ3 (R = 0.595, P = 0.019), (18)F-FDG SUV and (18)F-Alfatide SUV (R = 0.917, P < 0.001), and GLUT-1 and αvβ3 (R = 0.637, P = 0.011). Therefore, (18)F-Alfatide PET may be an effective tracer for tumor detection, spatial heterogeneity imaging and an alternative supplement to (18)F-FDG PET, particularly for patients with enhanced characteristics in the brain, chest tumors or diabetes, meriting further study. PMID:27350554

  17. A novel metric for quantification of homogeneous and heterogeneous tumors in PET for enhanced clinical outcome prediction

    Rahmim, Arman; Schmidtlein, C. Ross; Jackson, Andrew; Sheikhbahaei, Sara; Marcus, Charles; Ashrafinia, Saeed; Soltani, Madjid; Subramaniam, Rathan M.

    2016-01-01

    Oncologic PET images provide valuable information that can enable enhanced prognosis of disease. Nonetheless, such information is simplified significantly in routine clinical assessment to meet workflow constraints. Examples of typical FDG PET metrics include: (i) SUVmax, (2) total lesion glycolysis (TLG), and (3) metabolic tumor volume (MTV). We have derived and implemented a novel metric for tumor quantification, inspired in essence by a model of generalized equivalent uniform dose as used in radiation therapy. The proposed metric, denoted generalized effective total uptake (gETU), is attractive as it encompasses the abovementioned commonly invoked metrics, and generalizes them, for both homogeneous and heterogeneous tumors, using a single parameter a. We evaluated this new metric for improved overall survival (OS) prediction on two different baseline FDG PET/CT datasets: (a) 113 patients with squamous cell cancer of the oropharynx, and (b) 72 patients with locally advanced pancreatic adenocarcinoma. Kaplan-Meier survival analysis was performed, where the subjects were subdivided into two groups using the median threshold, from which the hazard ratios (HR) were computed in Cox proportional hazards regression. For the oropharyngeal cancer dataset, MTV, TLG, SUVmax, SUVmean and SUVpeak produced HR values of 1.86, 3.02, 1.34, 1.36 and 1.62, while the proposed gETU metric for a  = 0.25 (greater emphasis on volume information) enabled significantly enhanced OS prediction with HR  =  3.94. For the pancreatic cancer dataset, MTV, TLG, SUVmax, SUVmean and SUVpeak resulted in HR values of 1.05, 1.25, 1.42, 1.45 and 1.52, while gETU at a  = 3.2 (greater emphasis on SUV information) arrived at an improved HR value of 1.61. Overall, the proposed methodology allows placement of differing degrees of emphasis on tumor volume versus uptake for different types of tumors to enable enhanced clinical outcome prediction.

  18. FDG-PET/CT for detection of the unknown primary head and neck tumor

    Johansen, J; Petersen, H; Godballe, Christian; Loft, Annika; Grau, Cai

    2011-01-01

    The benefit of FDG-PET in addition to standard work-up for carcinoma of unknown primary (CUP) and metastatic neck lesions has been widely described. However, most studies have been of retrospective nature with large heterogeneities in terms of workup standards and patient selection leaving several...... questions to be answered regarding the real value of PET in CUP. We here present an overview of the literature with focus on the current evidence of FDG-PET in detecting a primary in CUP and discuss the rationale of PET/CT in the diagnostic armamentarium of CUP....

  19. Prognostic value of defining the systemic tumor volume with FDG-PET in diffuse large b cell lymphoma

    We measured the systemic tumor volume using FDG-PET in patients with diffuse large B cell lymphoma (DLBL). We also investigated its prognostic role, and compared it with that of other prognostic factors. FDG PET was performed in 38 newly diagnosed DLBL patients (20 men, 18 women, age 55.715.1 years) at pre-treatment of chemotherapy. Clinical staging of lymphoma was evaluated by Ann Arbor system. On each FDG PET scan, we acquired volume of interest (VOl) at the cut-off value of SUV=2.5 in every measurable tumor by the automatic edge detection software. According to the VOI, we measured the metabolic volume and mean SUV, and estimated volume-activity indexes (SUV Vol) as mean SUV times metabolic volume. And then, we calculated the summed metabolic volume (VOLsum) and summed SUV Vol (SUV Volsum) in every FDG PET scan. Maximum SUV of involved lesion (SUVmax) was also acquired on each FDG PET scan. Time to treatment failure (TTF) was compared among VOLsum (median), SUV Volsum (median), SUVmax (median), clinical stage, gender, age, LDH, and performance status-assigned response designations by Kaplan-Meier survival analysis. Initial stages of DLBL patients were stage I in 4, II in 14, III in 15, and IV in 4 by Ann Arbor system. Median follow up period was 15.5months, and estimated mean TTF was 22.3 months. Univariate analysis demonstrated that TTF is statistically significantly reduced in those with high VOLsum (>215.1cm2, p=0.004), high SUV Volsum (>1577.5, p=0.003), and increased LDH (p=0.036). TTF did not correlate with SUVmax (p=0.571), clinical stage (p=0.194), gender (p=0.549), and age (p=0.128), and performance status =2 (p=0.074). Multivariate analysis using VOLsum, SUV Volsum, LDH, and performance status demonstrated no statistically significant predictor of TTF (p>0.05). Systemic tumor volume measurement using FDG-PET is suggestive to be the significant prognostic factor in patients with DLBL

  20. Molecular markers derived from bombesin for tumor diagnosis by SPECT and PET

    A high number of molecules have already been identified to have high affinity to some receptors overexpressed on tumour cells and the radiolabelling of those molecules offers the possibility of new compounds for tumour diagnosis and therapy by nuclear medicine. Among of those molecules, bombesin (BBN) has become focus of interest, as its BB2 receptors are known to be overexpressed in prostate, breast, colon, pancreatic and lung tumour, as long as glioblastomas and neuroblastomas. BBN agonists and antagonists have already been described for this purpose and promising results were obtained in preclinical studies. However, most of them exhibited high abdominal accumulation, especially in pancreas and intestines, which can compromise diagnosis accuracy and cause serious adverse effects in therapy. In this context, the goal of the present work to radiolabel new BBN derivatives with 111In and 68Ga and to evaluate their potential for BB2 positive tumors diagnosis by single photon emission tomography (SPECT) and positron emission tomography (PET). The structure of studied peptides was Q-YGn-BBN(6-14), where Q is the chelator, n is the number of glycine aminoacids in the spacer YGn and BBN(6-14) is the original bombesin sequence from the aminoacid 6 to 14. The derivative in which the last aminoacid (methionine, Met) was replaced by norleucine (Nle) was also evaluated. The experimental evaluation of the bombesin derivatives was divided into four steps: computational studies, molecular markers for SPECT, molecular markers for PET and toxicological studies. The theoretical partition (log P) and distribution (log D) coefficients were calculated for all bombesin derivatives conjugated to DTPA (diethylenetriaminepentaacetic acid) and DOTA (1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid) chelators applying computational programmes. Bombesin derivatives for SPECT were developed by radiolabelling DTPA-conjugated bombesin derivatives with 111In to determine the best spacer

  1. FDG-PET Response Prediction in Pediatric Hodgkin’s Lymphoma: Impact of Metabolically Defined Tumor Volumes and Individualized SUV Measurements on the Positive Predictive Value

    Background: In pediatric Hodgkin’s lymphoma (pHL) early response-to-therapy prediction is metabolically assessed by (18)F-FDG PET carrying an excellent negative predictive value (NPV) but an impaired positive predictive value (PPV). Aim of this study was to improve the PPV while keeping the optimal NPV. A comparison of different PET data analyses was performed applying individualized standardized uptake values (SUV), PET-derived metabolic tumor volume (MTV) and the product of both parameters, termed total lesion glycolysis (TLG); Methods: One-hundred-eight PET datasets (PET1, n = 54; PET2, n = 54) of 54 children were analysed by visual and semi-quantitative means. SUVmax, SUVmean, MTV and TLG were obtained the results of both PETs and the relative change from PET1 to PET2 (Δ in %) were compared for their capability of identifying responders and non-responders using receiver operating characteristics (ROC)-curves. In consideration of individual variations in noise and contrasts levels all parameters were additionally obtained after threshold correction to lean body mass and background; Results: All semi-quantitative SUV estimates obtained at PET2 were significantly superior to the visual PET2 analysis. However, ΔSUVmax revealed the best results (area under the curve, 0.92; p < 0.001; sensitivity 100%; specificity 85.4%; PPV 46.2%; NPV 100%; accuracy, 87.0%) but was not significantly superior to SUVmax-estimation at PET2 and ΔTLGmax. Likewise, the lean body mass and background individualization of the datasets did not impove the results of the ROC analyses; Conclusions: Sophisticated semi-quantitative PET measures in early response assessment of pHL patients do not perform significantly better than the previously proposed ΔSUVmax. All analytical strategies failed to improve the impaired PPV to a clinically acceptable level while preserving the excellent NPV

  2. FDG-PET Response Prediction in Pediatric Hodgkin’s Lymphoma: Impact of Metabolically Defined Tumor Volumes and Individualized SUV Measurements on the Positive Predictive Value

    Amr Elsayed M. Hussien

    2015-01-01

    Full Text Available Background: In pediatric Hodgkin’s lymphoma (pHL early response-to-therapy prediction is metabolically assessed by (18F-FDG PET carrying an excellent negative predictive value (NPV but an impaired positive predictive value (PPV. Aim of this study was to improve the PPV while keeping the optimal NPV. A comparison of different PET data analyses was performed applying individualized standardized uptake values (SUV, PET-derived metabolic tumor volume (MTV and the product of both parameters, termed total lesion glycolysis (TLG; Methods: One-hundred-eight PET datasets (PET1, n = 54; PET2, n = 54 of 54 children were analysed by visual and semi-quantitative means. SUVmax, SUVmean, MTV and TLG were obtained the results of both PETs and the relative change from PET1 to PET2 (Δ in % were compared for their capability of identifying responders and non-responders using receiver operating characteristics (ROC-curves. In consideration of individual variations in noise and contrasts levels all parameters were additionally obtained after threshold correction to lean body mass and background; Results: All semi-quantitative SUV estimates obtained at PET2 were significantly superior to the visual PET2 analysis. However, ΔSUVmax revealed the best results (area under the curve, 0.92; p < 0.001; sensitivity 100%; specificity 85.4%; PPV 46.2%; NPV 100%; accuracy, 87.0% but was not significantly superior to SUVmax-estimation at PET2 and ΔTLGmax. Likewise, the lean body mass and background individualization of the datasets did not impove the results of the ROC analyses; Conclusions: Sophisticated semi-quantitative PET measures in early response assessment of pHL patients do not perform significantly better than the previously proposed ΔSUVmax. All analytical strategies failed to improve the impaired PPV to a clinically acceptable level while preserving the excellent NPV.

  3. FDG-PET Response Prediction in Pediatric Hodgkin’s Lymphoma: Impact of Metabolically Defined Tumor Volumes and Individualized SUV Measurements on the Positive Predictive Value

    Hussien, Amr Elsayed M. [Department of Nuclear Medicine (KME), Forschungszentrum Jülich, Medical Faculty, Heinrich-Heine-University Düsseldorf, Jülich, 52426 (Germany); Department of Nuclear Medicine, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, 40225 (Germany); Furth, Christian [Department of Radiology and Nuclear Medicine, Medical School, Otto-von-Guericke University Magdeburg, Magdeburg, 39120 (Germany); Schönberger, Stefan [Department of Pediatric Oncology, Hematology and Clinical Immunology, University Children’s Hospital, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, 40225 (Germany); Hundsdoerfer, Patrick [Department of Pediatric Oncology and Hematology, Charité Campus Virchow, Humboldt-University Berlin, Berlin, 13353 (Germany); Steffen, Ingo G.; Amthauer, Holger [Department of Radiology and Nuclear Medicine, Medical School, Otto-von-Guericke University Magdeburg, Magdeburg, 39120 (Germany); Müller, Hans-Wilhelm; Hautzel, Hubertus, E-mail: h.hautzel@fz-juelich.de [Department of Nuclear Medicine (KME), Forschungszentrum Jülich, Medical Faculty, Heinrich-Heine-University Düsseldorf, Jülich, 52426 (Germany); Department of Nuclear Medicine, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, 40225 (Germany)

    2015-01-28

    Background: In pediatric Hodgkin’s lymphoma (pHL) early response-to-therapy prediction is metabolically assessed by (18)F-FDG PET carrying an excellent negative predictive value (NPV) but an impaired positive predictive value (PPV). Aim of this study was to improve the PPV while keeping the optimal NPV. A comparison of different PET data analyses was performed applying individualized standardized uptake values (SUV), PET-derived metabolic tumor volume (MTV) and the product of both parameters, termed total lesion glycolysis (TLG); Methods: One-hundred-eight PET datasets (PET1, n = 54; PET2, n = 54) of 54 children were analysed by visual and semi-quantitative means. SUVmax, SUVmean, MTV and TLG were obtained the results of both PETs and the relative change from PET1 to PET2 (Δ in %) were compared for their capability of identifying responders and non-responders using receiver operating characteristics (ROC)-curves. In consideration of individual variations in noise and contrasts levels all parameters were additionally obtained after threshold correction to lean body mass and background; Results: All semi-quantitative SUV estimates obtained at PET2 were significantly superior to the visual PET2 analysis. However, ΔSUVmax revealed the best results (area under the curve, 0.92; p < 0.001; sensitivity 100%; specificity 85.4%; PPV 46.2%; NPV 100%; accuracy, 87.0%) but was not significantly superior to SUVmax-estimation at PET2 and ΔTLGmax. Likewise, the lean body mass and background individualization of the datasets did not impove the results of the ROC analyses; Conclusions: Sophisticated semi-quantitative PET measures in early response assessment of pHL patients do not perform significantly better than the previously proposed ΔSUVmax. All analytical strategies failed to improve the impaired PPV to a clinically acceptable level while preserving the excellent NPV.

  4. Unusual association of alveolar rhabdomyosarcoma with pancreatic metastasis: emerging role of PET-CT in tumor staging

    Pancreatic metastases in childhood cancer have been rarely reported in the radiology literature although ample evidence exists in pathology reports for its occurrence in patients with alveolar rhabdomyosarcomas (RMS). Assess the occurrence of pancreatic metastases in alveolar rhabdomyosarcomas, increase awareness of this association and reassess current staging protocols. Three major oncology centers reviewed their records and imaging examinations. Patients' history and demographics, primary tumor site and histology, presence of tumor recurrence, and presence and location of other metastases were reviewed. Pancreatic metastases occurred in eight patients with alveolar RMS. Four of these presented at diagnosis and four with disease recurrence. In recurrent disease, the duration between the diagnosis of the primary tumor and pancreatic metastases varied from 8 months to 6 years (mean ± SD: 2.38 ± 2.49 years). In all patients who received PET scans, pancreatic metastases showed a marked FDG-uptake, but had variable detectability with CT. Pancreatic metastases were not associated with certain primary tumor locations or presence of other metastases, mandating an evaluation of the pancreas in all cases of alveolar rhabdomyosarcomas. Radiologists should be sensitized and actively evaluate the pancreas in patients with alveolar RMS. Optimizing CT and PET-CT protocols may increase the diagnostic yield. (orig.)

  5. Comparative evaluation of 18F-FDOPA, 13N-AMMONIA, 18F-FDG PET/CT and MRI in primary brain tumors - a pilot study

    To determine the diagnostic reliability of 18F-FDOPA, 13N-Ammonia and 18F-FDG PET/CT in primary brain tumors and comparison with magnetic resonance imaging (MRI). A total of 23 patients, 8 preoperative and 15 postoperative, undergoing evaluation for primary brain tumors were included in this study. Of them, 9/15 were operated for high grade gliomas (7/9 astrocytomas and 2/9 oligodendrogliomas) and 6/15 for low grade gliomas (5/6 astrocytomas and 1/6 oligodendroglioma). After PET study, 2 of 8 preoperative cases were histopathologically proven to be of benign etiology. 3 low grade and 2 high grade postoperative cases were disease free on 6 months follow-up. Tracer uptake was quantified by standardized uptake values (SUVmax) and the SUVmax ratio of tumor to normal symmetrical area of contra lateral hemisphere (T/N). 18F-FDOPA uptake was also quantified by SUVmax ratio of tumor to striatum (T/S). Conventional MR studies were done in all patients. Both high-grade and low-grade tumors were well visualized with 18F-FDOPA PET. Sensitivity of 18F-FDOPA PET was substantially higher (6/6 preoperative, 3/3 low grade postoperative, 7/7 high grade postoperative) than with 18F-FDG (3/6 preoperative, 1/3 low grade postoperative, 3/7 high grade postoperative) and 13N-Ammonia PET (2/6 preoperative, 1/3 low grade postoperative, 1/7 high grade postoperative). FDOPA was equally specific as FDG and Ammonia PET in operated cases but was falsely positive in two preoperative cases. Sensitivity of FDOPA (16/16) was more than MRI (13/16). 18F-FDG uptake correlates with tumor grade. Though 18F-FDOPA PET cannot distinguish between tumor grade, it is more reliable than 18F-FDG and 13N-Ammonia PET for evaluating brain tumors. 18F-FDOPA PET may prove to be superior to MRI in evaluating recurrence and residual tumor tissue. 13N-Ammonia PET did not show any encouraging results. (author)

  6. MicroPET imaging of brain tumor angiogenesis with {sup 18}F-labeled PEGylated RGD peptide

    Chen, Xiaoyuan; Park, Ryan; Hou, Yingping; Tohme, Michel; Bading, James R.; Conti, Peter S. [PET Imaging Science Center, Department of Radiology, University of Southern California Keck School of Medicine, 1510 San Pablo St., Suite 350, CA 90033, Los Angeles (United States); Khankaldyyan, Vazgen; Gonzales-Gomez, Ignacio; Laug, Walter E. [Department of Pediatrics, Childrens Hospital Los Angeles, CA 90027, Los Angeles (United States)

    2004-08-01

    We have previously labeled cyclic RGD peptide c(RGDyK) with fluorine-18 through conjugation labeling via a prosthetic 4-[{sup 18}F]fluorobenzoyl moiety and applied this [{sup 18}F]FB-RGD radiotracer for {alpha}{sub v}-integrin expression imaging in different preclinical tumor models with good tumor-to-background contrast. However, the unfavorable hepatobiliary excretion and rapid tumor washout rate of this tracer limit its potential clinical applications. The aims of this study were to modify the [{sup 18}F]FB-RGD tracer by inserting a heterobifunctional poly(ethylene glycol) (PEG, M.W. =3,400) between the {sup 18}F radiolabel and the RGD moiety and to test this [{sup 18}F]FB-PEG-RGD tracer for brain tumor targeting and in vivo kinetics. [{sup 18}F]FB-PEG-RGD was prepared by coupling the RGD-PEG conjugate with N-succinimidyl 4-[{sup 18}F]fluorobenzoate ([{sup 18}F]SFB) under slightly basic conditions (pH=8.5). The radiochemical yield was about 20-30% based on the active ester [{sup 18}F]SFB, and specific activity was over 100 GBq/{mu}mol. This tracer had fast blood clearance, rapid and high tumor uptake in the subcutaneous U87MG glioblastoma model (5.2{+-}0.5%ID/g at 30 min p.i.). Moderately rapid tumor washout was observed, with the activity accumulation decreased to 2.2{+-}0.4%ID/g at 4 h p.i. MicroPET and autoradiography imaging showed a very high tumor-to-background ratio and limited activity accumulation in the liver, kidneys and intestinal tracts. U87MG tumor implanted into the mouse forebrain was well visualized with [{sup 18}F]FB-PEG-RGD. Although uptake in the orthotopic tumor was significantly lower (P<0.01) than in the subcutaneous tumor, the maximum tumor-to-brain ratio still reached 5.0{+-}0.6 due to low normal brain background. The results of H and E staining post mortem agreed with the anatomical information obtained from non-invasive microPET imaging. In conclusion, PEGylation suitably modifies the physiological behavior of the RGD peptide. [{sup 18

  7. Reproducibility of 18F-FDG microPET Studies in Mouse Tumor Xenografts

    Dandekar, Mangal; Tseng, Jeffrey R.; Gambhir, Sanjiv S.

    2007-01-01

    18F-FDG has been used to image mouse xenograft models with small-animal PET for therapy response. However, the reproducibility of serial scans has not been determined. The purpose of this study was to determine the reproducibility of 18F-FDG small-animal PET studies.

  8. Comparison of the prognostic values of {sup 68}Ga-DOTANOC PET/CT and {sup 18}F-FDG PET/CT in patients with well-differentiated neuroendocrine tumor

    Sharma, Punit; Naswa, Niraj; Kc, Sudhir Suman; Yadav, Yashwant; Kumar, Rakesh; Bal, Chandrasekhar [All India Institute of Medical Sciences, Department of Nuclear Medicine, Ansari Nagar, New Delhi (India); Alvarado, Luis Andres; Dwivedi, Alok Kumar [Texas Tech University Health Sciences Center, Division of Biostatistics and Epidemiology, El Paso, TX (United States); Ammini, Ariachery C. [All India Institute of Medical Sciences, Department of Endocrinology and Metabolism, New Delhi (India)

    2014-12-15

    To determine the prognostic value of {sup 68}Ga-DOTANOC PET/CT in patients with well-differentiated neuroendocrine tumor (NET), and to compare the prognostic value with that of {sup 18}F-FDG PET/CT and other conventional clinicopathological prognostic factors. Data from 37 consecutive patients (age 46.6 ± 13.5 years, 51 % men) with well-differentiated NET who underwent {sup 68}Ga-DOTANOC PET/CT and {sup 18}F-FDG PET/CT were analyzed. All patients underwent a baseline visit with laboratory and radiological examinations. Clinical and imaging follow-up was performed in all patients. Progression-free survival (PFS) was measured from the date of the first PET/CT scan to the first documentation of progression of disease. {sup 68}Ga-DOTANOC PET/CT was positive in 37 of the 37 patients and {sup 18}F-FDG PET/CT was positive in 21. During follow-up 10 patients (27 %) showed progression of disease and 27 (73 %) showed no progression (24 stable disease, 3 partial response). The median follow-up was 25 months (range 2 - 52 months). Among the variables evaluated none was significantly different between the progressive disease and nonprogressive disease groups, with only SUVmax on {sup 68}Ga-DOTANOC PET/CT being borderline significant (P = 0.073). In the univariate analysis for PFS outcome, SUVmax on {sup 68}Ga-DOTANOC PET/CT (HR 0.122, 95 % CI 0.019 - 0.779; P = 0.026) and histopathological tumor grade (HR 4.238, 95 % CI 1.058 - 16.976; P = 0.041) were found to be associated with PFS. Other factors including age, sex, primary site, Ki-67 index, TNM stage, {sup 18}F-FDG PET/CT status (positive/negative), SUVmax on {sup 18}F-FDG PET/CT and type of treatment were not significant. In multivariable analysis, only SUVmax on {sup 68}Ga-DOTANOC PET/CT was found to be an independent positive predictor of PFS (HR 0.122, 95 % CI 0.019 - 0.779; P = 0.026). SUVmax measured on {sup 68}Ga-DOTANOC PET/CT is an independent, positive prognostic factor in patients with well-differentiated NET and

  9. Investigation of realistic PET simulations incorporating tumor patient's specificity using anthropomorphic models: Creation of an oncology database

    Purpose: The GATE Monte Carlo simulation toolkit is used for the implementation of realistic PET simulations incorporating tumor heterogeneous activity distributions. The reconstructed patient images include noise from the acquisition process, imaging system's performance restrictions and have limited spatial resolution. For those reasons, the measured intensity cannot be simply introduced in GATE simulations, to reproduce clinical data. Investigation of the heterogeneity distribution within tumors applying partial volume correction (PVC) algorithms was assessed. The purpose of the present study was to create a simulated oncology database based on clinical data with realistic intratumor uptake heterogeneity properties.Methods: PET/CT data of seven oncology patients were used in order to create a realistic tumor database investigating the heterogeneity activity distribution of the simulated tumors. The anthropomorphic models (NURBS based cardiac torso and Zubal phantoms) were adapted to the CT data of each patient, and the activity distribution was extracted from the respective PET data. The patient-specific models were simulated with the Monte Carlo Geant4 application for tomography emission (GATE) in three different levels for each case: (a) using homogeneous activity within the tumor, (b) using heterogeneous activity distribution in every voxel within the tumor as it was extracted from the PET image, and (c) using heterogeneous activity distribution corresponding to the clinical image following PVC. The three different types of simulated data in each case were reconstructed with two iterations and filtered with a 3D Gaussian postfilter, in order to simulate the intratumor heterogeneous uptake. Heterogeneity in all generated images was quantified using textural feature derived parameters in 3D according to the ground truth of the simulation, and compared to clinical measurements. Finally, profiles were plotted in central slices of the tumors, across lines with

  10. Pre-operative FDG PET/CT findings related to early tumor recurrence in breast cancer patients

    The purpose of this study was to identify any pre-operative FDG PET/CT findings related to early recurrence in the breast cancer patients. One hundred eighteen breast cancer patients who underwent 18F-FDG PET/CT scan for preoperative staging from September 2004 to September 2005 were included. All patients received operation and follow-up examination. From the FDG PET/CT images, (1) the peak standard uptake values (pSUV) of the primary tumor, (2) pSUV of axillary lymph node (LN) were recorded. 7 out of 118 patients had tumor recurrence within 26 months after the surgery. The mean pSUV of primary tumors with early recurrence (6.113.22) was significantly higher than the mean pSUV of the early recurrence negative follow-up group (3.432.43). The mean pSUVs of the axillary LN showed no significant difference between the early recurrence group and recurrence negative (2.122.17 vs 2.411.13). Of 111 patients with no evidence of recurrence, 71 patients showed no perceptible FDG uptake in the axillary LNs. On the other hand, all of the 7 recurrent breast cancer cases show increased FDG uptakes of axillary LN. In the recurrence negative group, no axillary LN demonstrated perceptibly increased FDG uptakes in 64% (71/111 cases); increased FDG uptake was noted in 36% (40/111 cases). In breast cancer patients who had early recurrence, the pSUV of the primary tumor was significantly higher than that of early recurrence negative patients. Though the pSUV of the axillary LN was not a predictor of recurrent breast cancer, all recurrent breast cancer patients had FDG uptake in axillary LN

  11. Can an FDG-PET/CT predict tumor clearance of the mesorectal fascia after preoperative chemoradiation of locally advanced rectal cancer?

    Vliegen, R.F.A.; Beets-Tan, R.G. [Dept. of Radiology, Univ. Hospital Maastricht (Netherlands); Vanhauten, B.; Oellers, M.; Buijsen, J.; Baardwijk, A. van; Ruysscher, D. de; Lammering, G. [Maastricht Radiation Oncology (Maastro), GROW, Univ. Hospital Maastricht (Netherlands); Driessen, A. [Dept. of Pathology, Univ. Hospital Maastricht (Netherlands); Kessels, A.G. [Dept. of Statistics, Univ. Hospital Maastricht (Netherlands); Arens, A. [Dept. of Nuclear Medicine, Univ. Hospital Maastricht (Netherlands); Beets, G.L. [Dept. of Surgery, Univ. Hospital Maastricht (Netherlands)

    2008-09-15

    Background and purpose: more effective preoperative treatment in locally advanced rectal cancer gives rise to a more individualized, conservative surgical treatment strategy. This, however, requires accurate information on tumor response after chemoradiation (CRT). So far, MRI and CT have failed to provide such information. Therefore, the value of a combined FDG-PET/CT in predicting tumor clearance of the mesorectal fascia (MRF) was determined. Patients and methods: 20 rectal cancer patients with MRF tumor invasion underwent preoperative PET/CT before and on average 6.3 weeks after CRT. The SUV{sub max} (maximal standard uptake value) on sequential PET/CT and the shortest distance between the outlined tumor volume and the MRF measured by using autocontouring software on post-CRT PET/CT were registered. The surgical specimen was evaluated for tumor clearance of the MRF and the tumor regression grade (TRG). Results: the TRG significantly corresponded with the SUV{sub max} changes induced by CRT (p = 0.025), and showed a trend with the post-CRT SUV{sub max} (TRG 1-2 vs. TRG 3-5: SUV{sub max} = 3.0 vs. 5.0; p = 0.06). However, the pathologically verified tumor clearance of the MRF was not correlated with any of the tested SUV parameters nor with the shortest distance between the residual tumor and the MRF. Conclusion: post-CRT PET/CT is not a useful tool for evaluating anatomic tumor changes and, therefore, not accurate in predicting tumor clearance of the MRF. However, it might be a useful tool in predicting pathologic tumor response after CRT. (orig.)

  12. Systematic analysis of 18F-FDG PET and metabolism, proliferation and hypoxia markers for classification of head and neck tumors

    Quantification of molecular cell processes is important for prognostication and treatment individualization of head and neck cancer (HNC). However, individual tumor comparison can show discord in upregulation similarities when analyzing multiple biological mechanisms. Elaborate tumor characterization, integrating multiple pathways reflecting intrinsic and microenvironmental properties, may be beneficial to group most uniform tumors for treatment modification schemes. The goal of this study was to systematically analyze if immunohistochemical (IHC) assessment of molecular markers, involved in treatment resistance, and 18F-FDG PET parameters could accurately distinguish separate HNC tumors. Several imaging parameters and texture features for 18F-FDG small-animal PET and immunohistochemical markers related to metabolism, hypoxia, proliferation and tumor blood perfusion were assessed within groups of BALB/c nu/nu mice xenografted with 14 human HNC models. Classification methods were used to predict tumor line based on sets of parameters. We found that 18F-FDG PET could not differentiate between the tumor lines. On the contrary, combined IHC parameters could accurately allocate individual tumors to the correct model. From 9 analyzed IHC parameters, a cluster of 6 random parameters already classified 70.3% correctly. Combining all PET/IHC characteristics resulted in the highest tumor line classification accuracy (81.0%; cross validation 82.0%), which was just 2.2% higher (p = 5.2×10-32) than the performance of the IHC parameter/feature based model. With a select set of IHC markers representing cellular processes of metabolism, proliferation, hypoxia and perfusion, one can reliably distinguish between HNC tumor lines. Addition of 18F-FDG PET improves classification accuracy of IHC to a significant yet minor degree. These results may form a basis for development of tumor characterization models for treatment allocation purposes

  13. Tumor uptake of 68Ga-DOTA-Tyr3-octreotate: animal PET studies of tumor flow and acute somatostatin receptor modulation in the CA20948 rat model

    Introduction: Factors determining the in vivo uptake of radiolabeled somatostatin analogs by neuroendocrine tumors are poorly known. The aim is to evaluate in vivo tumor perfusion and regulation of somatostatin receptors (sstr) following acute exposure to octreotide, in an animal model of neuroendocrine tumor. Methods: H215O flow studies were performed in 8 CA20948 tumor-bearing rats and another 36 rats underwent three [68Ga]-DOTA-Tyr3-octreotate imaging sessions at 24-h intervals. After baseline (Day 0) imaging, scanning was repeated on Day 1 after octreotide injection (175 μg/kg), with a variable delay: no injection (controls, n=7), coinjection (n=6), and octreotide injection 20 min (n=7), 2 h (n=8) and 4 h (n=8) before imaging. Repeat images without octreotide was performed at Day 2 followed by sacrifice and tumor counting. Results: H215O studies failed to measure quantitative tumor perfusion in this model. On Day 1, ratio of tumor uptake to Day 0 was 1.2±0.3 in controls; 0.6±0.2 in the coinjection group; 0.9±0.2, 1.1±0.1 and 1.2±0.2 in the other groups, respectively. Uptake in the coinjection group showed a statistically significant reduction of tumor uptake (P2=0.946). Conclusion: Acute exposure to unlabeled octreotide in this neuroendocrine tumor model results in a rapid recycling or resynthesis of sstr. Positron emission tomography (PET) allowed to reliably assess quantitative uptake of [68Ga]-DOTA-Tyr3-octreotate over time in the same animal, but failed in this model to measure tumor perfusion.

  14. Leptomeningeal carcinomatosis as only pathological finding at FDG-PET/CT in case of tumor marker elevation in breast cancer

    Leptomeningeal carcinomatosis is an infrequent disease and although its treatment is palliative, earlier diagnosis will lead to prolonged survival and improve functional outcome. Whole-body FDG-PET allows the entire spinal cord to be examined noninvasively, so close attention should be paid to the spinal canal, since these lesions can easily be mistaken for physiologic uptake, sometimes there is no clinical suspicion and may occur without concurrent active cancer. We present a female patient with a history of carcinoma of the breast, who presented an elevation of serum tumor marker CA 15-3. An FDG-PET/CT study only revealed multiple abnormal uptake at the vertebral foramen at thoracic and lumbosacral regions suggesting leptomeningeal metastases that were confirmed by MRI and cerebrospinal fluid cytology

  15. Giant Cell Tumor Pulmonary Metastases Mimic Primary malignant Pulmonary Nodules on 18F FDG PET/CT

    A 59-year-old man with a 30-year history of multiple recurrences of a giant cell tumor (GCT) of the left knee was referred for an 18F-FDG PET/CT to evaluate a solitary pulmonary nodule. The nodule was mildly FDG-avid, raising suspicion of malignancy. It was excised and histologically proven to be a GCT pulmonary metastasis. A follow-up PET/CT done 2 years later revealed a new, larger lung mass that was more intensely FDG-avid, but of the same histology. This rare report highlights a pitfall in the evaluation of solitary pulmonary lesions by 18F-FDG PCT/CT in patients with GCT of the bone

  16. SU-E-J-249: Characterization of Gynecological Tumor Heterogeneity Using Texture Analysis in the Context of An 18F-FDG PET Adaptive Protocol

    Purpose: We propose a method to examine gynecological tumor heterogeneity using texture analysis in the context of an adaptive PET protocol in order to establish if texture metrics from baseline PET-CT predict tumor response better than SUV metrics alone as well as determine texture features correlating with tumor response during radiation therapy. Methods: This IRB approved protocol included 29 women with node positive gynecological cancers visible on FDG-PET treated with EBRT to the PET positive nodes. A baseline and intra-treatment PET-CT was obtained. Tumor outcome was determined based on RECIST on posttreatment PET-CT. Primary GTVs were segmented using 40% threshold and a semi-automatic gradient-based contouring tool, PET Edge (MIM Software Inc., Cleveland, OH). SUV histogram features, Metabolic Volume (MV), and Total Lesion Glycolysis (TLG) were calculated. Four 3D texture matrices describing local and regional relationships between voxel intensities in the GTV were generated: co-occurrence, run length, size zone, and neighborhood difference. From these, 39 texture features were calculated. Prognostic power of baseline features derived from gradientbased and threshold GTVs were determined using the Wilcoxon rank-sum test. Receiver Operating Characteristics and logistic regression was performed using JMP (SAS Institute Inc., Cary, NC) to find probabilities of predicting response. Changes in features during treatment were determined using the Wilcoxon signed-rank test. Results: Of the 29 patients, there were 16 complete responders, 7 partial responders, and 6 non-responders. Comparing CR/PR vs. NR for gradient-based GTVs, 7 texture values, TLG, and SUV kurtosis had a p < 0.05. Threshold GTVs yielded 4 texture features and TLG with p < 0.05. From baseline to intra-treatment, 14 texture features, SUVmean, SUVmax, MV, and TLG changed with p < 0.05. Conclusion: Texture analysis of PET imaged gynecological tumors is an effective method for early prognosis and should

  17. SU-E-J-249: Characterization of Gynecological Tumor Heterogeneity Using Texture Analysis in the Context of An 18F-FDG PET Adaptive Protocol

    Nawrocki, J [Duke University Medical Physics Graduate Program, Durham, NC (United States); Chino, J; Craciunescu, O [Duke University Medical Center Department of Radiation Oncology, Durham, NC (United States); Das, S [University of North Carolina School of Medicine, Chapel Hill, NC (United States)

    2015-06-15

    Purpose: We propose a method to examine gynecological tumor heterogeneity using texture analysis in the context of an adaptive PET protocol in order to establish if texture metrics from baseline PET-CT predict tumor response better than SUV metrics alone as well as determine texture features correlating with tumor response during radiation therapy. Methods: This IRB approved protocol included 29 women with node positive gynecological cancers visible on FDG-PET treated with EBRT to the PET positive nodes. A baseline and intra-treatment PET-CT was obtained. Tumor outcome was determined based on RECIST on posttreatment PET-CT. Primary GTVs were segmented using 40% threshold and a semi-automatic gradient-based contouring tool, PET Edge (MIM Software Inc., Cleveland, OH). SUV histogram features, Metabolic Volume (MV), and Total Lesion Glycolysis (TLG) were calculated. Four 3D texture matrices describing local and regional relationships between voxel intensities in the GTV were generated: co-occurrence, run length, size zone, and neighborhood difference. From these, 39 texture features were calculated. Prognostic power of baseline features derived from gradientbased and threshold GTVs were determined using the Wilcoxon rank-sum test. Receiver Operating Characteristics and logistic regression was performed using JMP (SAS Institute Inc., Cary, NC) to find probabilities of predicting response. Changes in features during treatment were determined using the Wilcoxon signed-rank test. Results: Of the 29 patients, there were 16 complete responders, 7 partial responders, and 6 non-responders. Comparing CR/PR vs. NR for gradient-based GTVs, 7 texture values, TLG, and SUV kurtosis had a p < 0.05. Threshold GTVs yielded 4 texture features and TLG with p < 0.05. From baseline to intra-treatment, 14 texture features, SUVmean, SUVmax, MV, and TLG changed with p < 0.05. Conclusion: Texture analysis of PET imaged gynecological tumors is an effective method for early prognosis and should

  18. Clinical impact of [18F]FDG-PET in patients with suspected recurrent breast cancer based on asymptomatically elevated tumor marker serum levels. A preliminary report

    The purpose of this study was to evaluate retrospectively the impact of [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) on the detection of recurrent breast cancer based on asymptomatically elevated tumor markers levels. Whole-body FDG-PET was performed in 30 patients with suspected recurrent breast cancer and asymptomatic tumor marker increase but negative or equivocal other imaging modality results. A blood sample was drawn in each case for marker assay (CA 15-3 and CEA) on the same day as the FDG-PET. All of these 30 asymptomatic patients had either CA 15-3>32 U/ml or CEA>5 ng/ml. The final diagnosis of recurrent breast cancer was established by operation/biopsy histopathological findings or clinical follow-up for >1 year by additional morphological imaging techniques. Among the 30 patients, the final diagnosis of recurrent breast cancer was established in 38 sites in 28 patients. FDG-PET accurately detected 35/38 sites in 25/28 patients with recurrence. The diagnostic sensitivity and accuracy of FDG-PET in patients with suspected recurrent breast cancer and asymptomatically elevated tumor markers were 96 and 90%, respectively. FDG-PET is a useful technique for detecting recurrent breast cancer suspected from asymptomatically elevated tumor markers levels and has an important clinical impact on the management of these patients. (author)

  19. 18F-FAMT uptake correlates with tumor proliferative activity in oral squamous cell carcinoma. Comparative study with 18F-FDG PET and immunohistochemistry

    L-3-[18F]-fluoro-α-methyl tyrosine (FAMT) is transported into cancer cells by L-type amino acid transporter 1 (LAT1). The purpose of the present study is to correlate the uptake of FAMT and fluorodeoxyglucose (FDG) with the cellular proliferative activity measured by the Ki-67 labeling index (Ki-67 LI) in oral squamous cell carcinoma (OSCC). Twenty-five patients with OSCC were enrolled in this study. Both FAMT-positron emission tomography (PET) and FDG-PET were performed within 4 weeks before surgery in all cases. The uptake of FAMT and FDG was compared by semiquantitative analysis with maximal standardized uptake values (SUVmax) of the primary tumors. Ki-67 LI of the tumors was analyzed by immunohistochemical staining and correlated with the clinicopathologic variables and the uptake of PET tracers. For primary tumor detection, FAMT-PET exhibited a sensitivity of 84%, whereas that of FDG-PET was 88%. In all visible lesions, mean FDG uptake determined by average SUVmax was 9.7 (range 4.2-15.9) and mean FAMT uptake was 3.5 (range 1.3-8.5). The SUVmax of FAMT tended to show a better correlation with Ki-67 LI (r=0.878) than that of FDG (r=0.643). Uptake of FAMT correlated with cellular proliferation of OSCC. FAMT-PET may be a useful procedure to evaluate tumor proliferation of OSCC. (author)

  20. SU-C-9A-03: Simultaneous Deconvolution and Segmentation for PET Tumor Delineation Using a Variational Method

    Li, L; Tan, S [Huazhong University of Science and Technology, Wuhan, Hubei (China); Lu, W; D' Souza, W [University of Maryland School of Medicine, Baltimore, MD (United States)

    2014-06-01

    Purpose: To implement a new method that integrates deconvolution with segmentation under the variational framework for PET tumor delineation. Methods: Deconvolution and segmentation are both challenging problems in image processing. The partial volume effect (PVE) makes tumor boundaries in PET image blurred which affects the accuracy of tumor segmentation. Deconvolution aims to obtain a PVE-free image, which can help to improve the segmentation accuracy. Conversely, a correct localization of the object boundaries is helpful to estimate the blur kernel, and thus assist in the deconvolution. In this study, we proposed to solve the two problems simultaneously using a variational method so that they can benefit each other. The energy functional consists of a fidelity term and a regularization term, and the blur kernel was limited to be the isotropic Gaussian kernel. We minimized the energy functional by solving the associated Euler-Lagrange equations and taking the derivative with respect to the parameters of the kernel function. An alternate minimization method was used to iterate between segmentation, deconvolution and blur-kernel recovery. The performance of the proposed method was tested on clinic PET images of patients with non-Hodgkin's lymphoma, and compared with seven other segmentation methods using the dice similarity index (DSI) and volume error (VE). Results: Among all segmentation methods, the proposed one (DSI=0.81, VE=0.05) has the highest accuracy, followed by the active contours without edges (DSI=0.81, VE=0.25), while other methods including the Graph Cut and the Mumford-Shah (MS) method have lower accuracy. A visual inspection shows that the proposed method localizes the real tumor contour very well. Conclusion: The result showed that deconvolution and segmentation can contribute to each other. The proposed variational method solve the two problems simultaneously, and leads to a high performance for tumor segmentation in PET. This work was

  1. Quantitation and visualization of tumor-specific T cells in the secondary lymphoid organs during and after tumor elimination by PET

    Matsui, Ken; Wang Zheng; McCarthy, Timothy J.; Allen, Paul M.; Reichert, David E. E-mail: ReichertD@wustl.edu

    2004-11-01

    Increased understanding in the area of trafficking behavior of adoptively transferred tumor-specific T cells could help develop better therapeutic protocols. We utilized the DUC18/CMS5 tumor model system in conjunction with a microPET scanner to study the DUC18 T cell distribution pattern in spleens and lymph nodes in live mice. Anti-Thy1.2 antibodies conjugated to 1,4,7,10-tetraazacyclododecane-N,N',N'',N''-tetraacetic acid (DOTA) and radiolabeled with {sup 64}Cu were administered to three groups of BALB-Thy1.1 mice on days 4, 7, or 14 post-DUC18 T cell transfer. We were able to detect the transferred cells in all the major lymph nodes, spleens, and in tumors. Our findings suggest that tumor-specific T cells do not all preferentially localize to the tumors but they also home to all the major lymphoid organs; additionally the number of DUC18 T cells remains relatively constant during and after tumor elimination within each lymphoid organ.

  2. FDG PET/CT imaging of desmoplastic small round cell tumor: findings at staging, during treatment and at follow-up

    Desmoplastic small round cell tumor (DSRCT) is a very uncommon soft-tissue tumor of children and young adults. It has an aggressive course with generally poor survival. In general the assessment of tumor burden and response has relied upon CT or MRI. However these tumors are often metabolically active and can be evaluated using FDG PET/CT imaging. The purpose of this study was to determine the metabolic activity of desmoplastic small round cell tumors using FDG PET/CT imaging and the potential utility of FDG PET/CT in this disease. Eight patients (seven male, one female; ages 2-20 years, median 11 years) with confirmed DSRCT underwent 82 positron emission tomography/computed tomography (PET/CT) scans. PET/CT was used for initial staging (seven patients, eight scans), monitoring response to therapy (eight patients, 37 scans) and for surveillance of DSRCT recurrence (six patients, 37 scans). Each scan performed at diagnosis showed abnormally elevated uptake in the primary tumor. Five patients had abdominal pelvic involvement, and two of those also had thoracic disease. Six patients whose scans showed no abnormal sites of uptake at the end of therapy have had progression-free survivals of 2-10 years. One patient whose scan continued to show uptake during treatment died of disease 1.3 years from diagnosis. Another patient with persistent uptake remained in treatment 3 years after initial diagnosis. One surveillance scan identified recurrent disease. FDG PET/CT identified elevated metabolic activity in each patient studied. Despite our small sample size, FDG PET/CT scans appear useful for the management of patients with DSCRT. Patients whose studies become negative during or following treatment may have a prolonged remission. (orig.)

  3. FDG PET/CT imaging of desmoplastic small round cell tumor: findings at staging, during treatment and at follow-up

    Ostermeier, Austin; Snyder, Scott E.; Shulkin, Barry L. [St. Jude Children' s Research Hospital, Department of Radiological Sciences, MS 220, Memphis, TN (United States); McCarville, M.B. [St. Jude Children' s Research Hospital, Department of Radiological Sciences, MS 220, Memphis, TN (United States); College of Medicine, University of Tennessee Health Science Center, Department of Radiology, Memphis, TN (United States); Navid, Fariba [St. Jude Children' s Research Hospital, Department of Oncology, Memphis, TN (United States); University of Tennessee Health Science Center, Department of Pediatrics, College of Medicine, Memphis, TN (United States)

    2015-08-15

    Desmoplastic small round cell tumor (DSRCT) is a very uncommon soft-tissue tumor of children and young adults. It has an aggressive course with generally poor survival. In general the assessment of tumor burden and response has relied upon CT or MRI. However these tumors are often metabolically active and can be evaluated using FDG PET/CT imaging. The purpose of this study was to determine the metabolic activity of desmoplastic small round cell tumors using FDG PET/CT imaging and the potential utility of FDG PET/CT in this disease. Eight patients (seven male, one female; ages 2-20 years, median 11 years) with confirmed DSRCT underwent 82 positron emission tomography/computed tomography (PET/CT) scans. PET/CT was used for initial staging (seven patients, eight scans), monitoring response to therapy (eight patients, 37 scans) and for surveillance of DSRCT recurrence (six patients, 37 scans). Each scan performed at diagnosis showed abnormally elevated uptake in the primary tumor. Five patients had abdominal pelvic involvement, and two of those also had thoracic disease. Six patients whose scans showed no abnormal sites of uptake at the end of therapy have had progression-free survivals of 2-10 years. One patient whose scan continued to show uptake during treatment died of disease 1.3 years from diagnosis. Another patient with persistent uptake remained in treatment 3 years after initial diagnosis. One surveillance scan identified recurrent disease. FDG PET/CT identified elevated metabolic activity in each patient studied. Despite our small sample size, FDG PET/CT scans appear useful for the management of patients with DSCRT. Patients whose studies become negative during or following treatment may have a prolonged remission. (orig.)

  4. 68Ga-DOTA-NGR as a novel molecular probe for APN-positive tumor imaging using MicroPET

    Aminopeptidase N (APN) is selectively expressed on many tumors and the endothelium of tumor neovasculature, and may serve as a promising target for cancer diagnosis and therapy. Asparagine–glycine–arginine (NGR) peptides have been shown to bind specifically to the APN receptor and have served as vehicles for the delivery of various therapeutic drugs in previous studies. The purpose of this study was to synthesize and evaluate the efficacy of a 68Ga-labeled NGR peptide as a new molecular probe that binds to APN. Methods: NGR peptide was conjugated with 1,4,7,10-tetraazacyclododecane-N,N’,N”,N”’-tetraacetic acid (DOTA) and labeled with 68Ga at 95 °C for 10 min. In vitro uptake and binding analysis was performed with A549 and MDA-MB231 cells. Biodistribution of 68Ga-DOTA-NGR was determined in normal mice by dissection method. 68Ga-DOTA-NGR PET was performed in A549 and MDA-MB231 xenografts, and included dynamic and static imaging. APN expression in tumors and new vasculatures was analyzed by immunohistochemistry. Results: The radiochemical purity of 68Ga-DOTA-NGR was 98.0% ± 1.4% with a specific activity of about 17.49 MBq/nmol. The uptake of 68Ga-DOTA-NGR in A549 cells increased with longer incubation times, and could be blocked by cold DOTA-NGR, while no specific uptake was found in MDA-MB231 cells. In vivo biodistribution studies showed that 68Ga-DOTA-NGR was mainly excreted from the kidney, and rapidly cleared from blood and nonspecific organs. MicroPET imaging showed that high focal accumulation had occurred in the tumor site at 1 h post-injection (pi) in A549 tumor xenografts. A significant reduction of tumor uptake was observed following coinjection with a blocking dose of DOTA-NGR, whereas only mild uptake was found in MDA-MB231 tumor xenografts. Tumor uptake, measured as the tumor/lung ratio, increased with time peaking at 12.58 ± 1.26 at 1.5 h pi. Immunohistochemical staining confirmed that APN was overexpressed on A549 cells and

  5. PET imaging of tumor neovascularization in a transgenic mouse model with a novel 64Cu-DOTA-knottin peptide

    Nielsen, Carsten Haagen; Kimura, Richard H; Withofs, Nadia;

    2010-01-01

    the knottin peptide are compared with standard 18F-fluorodeoxyglucose (FDG) PET small animal imaging. Lung nodules as small as 3 mm in diameter were successfully identified in the transgenic mice by small animal CT, and both 64Cu-DOTA-knottin 2.5F and FDG were able to differentiate lung nodules from...... the surrounding tissues. Uptake and retention of the 64Cu-DOTA-knottin 2.5F tracer in the lung tumors combined with a low background in the thorax resulted in a statistically higher tumor to background (normal lung) ratio compared with FDG (6.01±0.61 versus 4.36±0.68; P...... animal CT followed by characterization with the use of small animal PET with a novel 64Cu-1,4,7,10-tetra-azacylododecane-N,N',N'',N'''-tetraacetic acid (DOTA)-knottin peptide that targets integrins upregulated during angiogenesis on the tumor associated neovasculature. The imaging results obtained with...

  6. Retroperitoneal bronchogenic cyst presenting paraadrenal tumor incidentally detected by {sup 18}F-FDG PET/CT

    Yoon, Ye Ri; Choi, Ji Youn; Lee, Sang Mi; Kim, Yeo Joo; Cho, Hyun Deuk; Lee, Jeong Won; Jeon, Youn Soo [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of)

    2015-03-15

    A follow-up 18F-fluorodeoxyglucose ({sup 18}F-FDG) PET/CT scan of a 57-year-old asymptomatic male who had undergone total thyroidectomy for thyroid cancer revealed a 5.0 x 4.0-cm, well-defined, ovoid-shaped mass around the left adrenal gland without definite FDG uptake. On the adrenal CT scan, the left paraadrenal tumor showed high attenuation on the precontrast scan without enhancement. The average Hounsfield unit (HU) was 58.1 on the precontrast scan and 58.4 on the postcontrast scan. The patient underwent laparoscopic adrenalectomy for resection of the left paraadrenal tumor. The final histopathologic examination revealed a bronchogenic cyst. Although retroperitoneal bronchogenic cysts are rare, they should be considered in the differential diagnosis of retroperitoneal cystic tumors. The preoperative diagnosis is difficult, but a contrast-enhanced CT scan or {sup 18}F-FDG PET/CT scan may be useful for differentiating hyperattenuated cysts from other soft tissue masses.

  7. Comparison of 18F PET and 99mTc SPECT imaging in phantoms and in tumored mice.

    Cheng, Dengfeng; Wang, Yi; Liu, Xinrong; Pretorius, P Hendrik; Liang, Minmin; Rusckowski, Mary; Hnatowich, Donald J

    2010-08-18

    Our objective was to compare the performance of a micro-single photon emission computed tomography (micro-SPECT) with that of a micro-positron emission tomography (microPET) in a Her2+ tumored mice using an anti-Her2 nanoparticle radiolabeled with (99m)Tc and (18)F. Camera performance was first compared using phantoms; then a tumored mouse administered the (99m)Tc-nanoparticle was imaged on a Bioscan NanoSPECT/CT, while another tumored mouse received the identical nanoparticle, labeled now with (18)F, and was imaged on a Philips Mosaic HP PET camera. The nanoparticle was radiolabeled with (99m)Tc via MAG(3) chelation and with (18)F via SFB as an intermediate. Phantom imaging showed that the resolution of the SPECT camera was clearly superior, but even with 4 heads and multipinhole collimators, detection sensitivity was 15-fold lower. Radiolabeling of the nanoparticle by chelation with (99m)Tc was considerably easier and safer than manual covalent attachment of (18)F. Both cameras provided accurate quantitation of radioactivity over a broad range. In conclusion, when deciding between (99m)Tc vs (18)F, an advantage rests with the chelation of (99m)Tc over covalent attachment of (18)F, achieved manually or otherwise, but with these small animal cameras, this choice also results in trading lower sensitivity for higher resolution. PMID:20681508

  8. Inter-modality variation in gross tumor volume delineation in 18FDG-PET guided IMRT treatment planning for lung cancer.

    Song, Yulin; Chan, Maria; Burman, Chandra; Cann, Donald

    2006-01-01

    Rapid advances in 18FDG-PET/CT technology and novel co-registration algorithms have created a strong interest in 18FDG-PET/CT's application in intensity modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT). Accurate target volume delineation, particularly identification of pathologically positive lymph nodes, could translate into favorable treatment outcome. However, gross tumor volume (GTV) delineation on both CT and 18FDG-PET is very sensitive to observer variation. The objectives of the study were to investigate the inter-modality variation in gross tumor volume delineation defined by two imaging modalities for lung cancer: CT and 18FDG-PET/CT and its dosimetric implications in intensity modulated radiation therapy (IMRT). PMID:17946204

  9. Early prediction of therapy response and disease free survival after induction chemotherapy in stage III non-small cell lung cancer by FDG-PET: Correlation between tumor FDG-metabolism and morphometric tumor response

    Aim: Chemotherapy with Docetaxel and Carboplatin (DC) has shown high response rates in advanced non-small cell lung cancer (NSCLC). Histologic tumor response after chemotherapy or combined chemoradiotherapy is strongly associated with systemic tumor control and potentially cure. Metabolic tumor response assessed by FDG-PET after induction VIP-chemotherapy has been shown to be predictive of outcome in NSCLC. The aim of the present study was to correlate the tumor FDG metabolism as measured by F-18 FDG-PET with morphometric findings after DC induction chemotherapy plus Erythropoietin (10,000 IU Epo s.c. three times a week). Material and Methods: In this prospective multicenter study, 54 patients with NSCLC stage IIIA (9 patients) or IIIB (45 patients) were enrolled and received neoadjuvant treatment with D 100 mg/m2 d1 and C AUC 7.5 d2 q21 days for 4 cycles prior to surgery. Postoperatively, all patients received adjuvant radiotherapy. WB-PET-studies (ECAT Exact 47) were obtained p.i. of 400 MBq F-18 FDG. Standardized uptake values (SUV), metabolic tumor diameter (MTD) and metabolic tumor index (MTI SUV x MTD) were assessed. Image fusion of PET and CT data was applied on a HERMES computer. Results: Of 54 enrolled patients, 46 were evaluable for response by CT. 30/46 patients (65%) achieved complete remission (CR, 1 patient) or partial remission (PR 29 patients.). Of the 46 patients, 37 patients completed neoadjuvant chemotherapy (Chx) and were studied before and after Chx by FDG-PET. 14 (30% of the 46 evaluable patients) had SUV < 2.5, corresponding to metabolic complete remission (mCR), 23 had PR or stable disease (non-mCR); in 9 patients, PET was not performed because of progressive disease demonstrated by CT. The R0-resection rate was 56% (27/48 evaluable patients). Of the 14 patients with metabolic CR, 9 were evaluated by morphometry. All had regression grades III (no vital tumor cells) or grade IIB (< 10% vital tumor cells and induced apoptosis). With a median

  10. Ga-68 DOTATOC PET/CT-Guided Biopsy and Cryoablation with Autoradiography of Biopsy Specimen for Treatment of Tumor-Induced Osteomalacia.

    Maybody, Majid; Grewal, Ravinder K; Healey, John H; Antonescu, Cristina R; Fanchon, Louise; Hwang, Sinchun; Carrasquillo, Jorge A; Kirov, Assen; Farooki, Azeez

    2016-09-01

    Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome caused by small benign tumors of mesenchymal origin also known as phosphaturic mesenchymal tumors mixed connective tissue variant. Excellent prognosis is expected with eradication of the culprit tumor. These small tumors are notoriously difficult to localize with conventional imaging studies; this often leads to an extensive work up and prolonged morbidity. We report a patient with clinical diagnosis of TIO whose culprit tumor was localized with Ga-68 DOTATOC PET/CT and MRI. Biopsy and cryoablation were performed under Ga-68 DOTATOC PET/CT guidance. Autoradiography of the biopsy specimen was performed and showed in situ correlation between Ga-68 DOTATOC uptake and histopathology with millimeter resolution. PMID:27150801

  11. Impact of patient weight on tumor visibility based on human-shaped phantom simulation study in PET imaging system

    Energy window technique has been implemented in all positron emission tomography (PET) imaging protocol, with the aim to remove the unwanted low energy photons. Current practices in our institution however are performed by using default energy threshold level regardless of the weight of the patient. Phantom size, which represents the size of the patient's body, is the factor that determined the level of scatter fraction during PET imaging. Thus, the motivation of this study is to determine the optimum energy threshold level for different sizes of human-shaped phantom, to represent underweight, normal, overweight and obese patients. In this study, the scanner was modeled by using Monte Carlo code, version MCNP5. Five different sizes of elliptical-cylinder shaped of human-sized phantoms with diameter ranged from 15 to 30 cm were modeled. The tumor was modeled by a cylindrical line source filled with 1.02 MeV positron emitters at the center of the phantom. Various energy window widths, in the ranged of 10–50% were implemented to the data. In conclusion, the phantom mass volume did influence the scatter fraction within the volume. Bigger phantom caused more scattering events and thus led to coincidence counts lost. We evaluated the impact of phantom sizes on the sensitivity and visibility of the simulated models. Implementation of wider energy window improved the sensitivity of the system and retained the coincidence photons lost. Visibility of the tumor improved as an appropriate energy window implemented for the different sizes of phantom. - Highlights: • Optimizing the energy window improved the sensitivity of the PET system. • Improving the visibility of the tumors using the optimized energy window. • Recommendations on the optimized energy windows for different body sizes. • Using simulated phantom using MCNP to determine various body sizes

  12. FDG-PET for Evaluating the Antitumor Effect of Intraarterial 3-Bromopyruvate Administration in a Rabbit VX2 Liver Tumor Model

    Park, Hee Sun; Chung, Jin Wook; Jae, Hwan Jun; Kim, Young Il; Son, Kyu Ri; Lee, Min Jong; Park, Jae Hyung; Kang, Won Jun; Yoon, Jung Hwan; Chung, Hesson; Lee, Kichang

    2007-01-01

    Objective We wanted to investigate the feasibility of using FDG-PET for evaluating the antitumor effect of intraarterial administration of a hexokinase II inhibitor, 3-bromopyruvate (3-BrPA), in a rabbit VX2 liver tumor model. Materials and Methods VX2 carcinoma was grown in the livers of ten rabbits. Two weeks later, liver CT was performed to confirm appropriate tumor growth for the experiment. After tumor volume-matched grouping of the rabbits, transcatheter intraarterial administration of ...

  13. One-step radiosynthesis of 18F-AlF-NOTA-RGD2 for tumor angiogenesis PET imaging

    One of the major obstacles of the clinical translation of 18F-labeled arginine-glycine-aspartic acid (RGD) peptides has been the laborious multistep radiosynthesis. In order to facilitate the application of RGD-based positron emission tomography (PET) probes in the clinical setting we investigated in this study the feasibility of using the chelation reaction between Al18F and a macrocyclic chelator-conjugated dimeric RGD peptide as a simple one-step 18F labeling strategy for development of a PET probe for tumor angiogenesis imaging. Dimeric cyclic peptide E[c(RGDyK)]2 (RGD2) was first conjugated with a macrocyclic chelator, 1,4,7-triazacyclononane-1,4,7-triacetic acid (NOTA), and the resulting bioconjugate NOTA-RGD2 was then radiofluorinated via Al18F intermediate to synthesize 18F-AlF-NOTA-RGD2. Integrin binding affinities of the peptides were assessed by a U87MG cell-based receptor binding assay using 125I-echistatin as the radioligand. The tumor targeting efficacy and in vivo profile of 18F-AlF-NOTA-RGD2 were further evaluated in a subcutaneous U87MG glioblastoma xenograft model by microPET and biodistribution. NOTA-RGD2 was successfully 18F-fluorinated with good yield within 40 min using the Al18F intermediate. The IC50 of 19F-AlF-NOTA-RGD2 was determined to be 46 ± 4.4 nM. Quantitative microPET studies demonstrated that 18F-AlF-NOTA-RGD2 showed high tumor uptake, fast clearance from the body, and good tumor to normal organ ratios. NOTA-RGD2 bioconjugate has been successfully prepared and labeled with Al18F in one single step of radiosynthesis. The favorable in vivo performance and the short radiosynthetic route of 18F-AlF-NOTA-RGD2 warrant further optimization of the probe and the radiofluorination strategy to accelerate the clinical translation of 18F-labeled RGD peptides. (orig.)

  14. Staging of cervical cancer based on tumor heterogeneity characterized by texture features on 18F-FDG PET images

    Mu, Wei; Chen, Zhe; Liang, Ying; Shen, Wei; Yang, Feng; Dai, Ruwei; Wu, Ning; Tian, Jie

    2015-07-01

    The aim of the study is to assess the staging value of the tumor heterogeneity characterized by texture features and other commonly used semi-quantitative indices extracted from 18F-FDG PET images of cervical cancer (CC) patients. Forty-two patients suffering CC at different stages were enrolled in this study. Firstly, we proposed a new tumor segmentation method by combining the intensity and gradient field information in a level set framework. Secondly, fifty-four 3D texture features were studied besides of SUVs (SUVmax, SUVmean, SUVpeak) and metabolic tumor volume (MTV). Through correlation analysis, receiver-operating-characteristic (ROC) curves analysis, some independent indices showed statistically significant differences between the early stage (ES, stages I and II) and the advanced stage (AS, stages III and IV). Then the tumors represented by those independent indices could be automatically classified into ES and AS, and the most discriminative feature could be chosen. Finally, the robustness of the optimal index with respect to sampling schemes and the quality of the PET images were validated. Using the proposed segmentation method, the dice similarity coefficient and Hausdorff distance were 91.78   ±   1.66% and 7.94   ±   1.99 mm, respectively. According to the correlation analysis, all the fifty-eight indices could be divided into 20 groups. Six independent indices were selected for their highest areas under the ROC curves (AUROC), and showed significant differences between ES and AS (P  Pearson correlation of RP under different sampling schemes is 0.9991   ±   0.0011. RP is a highly stable feature and well correlated with tumor stage in CC, which suggests it could differentiate ES and AS with high accuracy.

  15. Desmoplastic small round cell tumor: impact of 18F-FDG PET induced treatment strategy in a patient with long-term outcome

    Alessio Imperiale

    2009-07-01

    Full Text Available The desmoplastic small round cell tumor (DSRCT is an uncommon and highly aggressive cancer. The role of 18F-FDG PET in management of DSRCT is little reported. We report a case of metastasized abdominal DSRCT detected in a 43-year old patient whose diagnostic and therapeutic approaches were influenced by 18F-FDG PET-CT. The patient is still alive ten years after diagnosis. 18F-FDG PET-CT seems to be a useful method for assessing therapeutic efficiency and detecting early recurrences even in rare malignancies such as DSRCT.

  16. In Vivo Phenotyping of Tumor Metabolism in a Canine Cancer Patient with Simultaneous 18F-FDG-PET and Hyperpolarized 13C-Pyruvate Magnetic Resonance Spectroscopic Imaging (hyperPET: Mismatch Demonstrates that FDG may not Always Reflect the Warburg Effect

    Henrik Gutte

    2015-06-01

    Full Text Available In this communication the mismatch between simultaneous 18F-FDG-PET and a 13C-lactate imaging (hyperPET in a biopsy verified squamous cell carcinoma in the right tonsil of a canine cancer patient is shown. The results demonstrate that 18F-FDG-PET may not always reflect the Warburg effect in all tumors.

  17. Which FDG/PET parameters of the primary tumors in colon or sigmoid cancer provide the best correlation with the pathological findings?

    Chen, Shang-Wen, E-mail: vincent1680616@yahoo.com.tw [Department of Radiation Oncology, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung 404, Taiwan (China); Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan (China); School of Medicine, Taipei Medical University, Taipei, Taiwan (China); Chen, William Tzu-Liang, E-mail: wtchen@mail.cmuh.org.tw [Department of Surgery, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung 404, Taiwan (China); Wu, Yi-Chen, E-mail: ed101302@edah.org.tw [Department of Nuclear Medicine, E-DA Hospital, I-Shou University, No. 1, Yida Road, Jiaosu, Yanchao, Kaohsiung 82445, Taiwan (China); Yen, Kuo-Yang, E-mail: cruise_ann@yahoo.com.tw [Department of Nuclear Medicine and PET Center, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung 404, Taiwan (China); Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan (China); Hsieh, Te-Chun, E-mail: d10119@mail.cmuh.org.tw [Department of Nuclear Medicine and PET Center, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung 404, Taiwan (China); Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan (China); Lin, Tze-Yi, E-mail: tylin.tw@msa.hinet.net [Department of Pathology, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung 404, Taiwan (China); Kao, Chia-Hung, E-mail: d10040@mail.cmuh.org.tw [Department of Nuclear Medicine and PET Center, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung 404, Taiwan (China); Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan (China)

    2013-09-15

    Background To compare {sup 18}F-fluoro-2-deoxdeoxyglucose (FDG) positron emission tomography (PET) related parameters of primary colon or sigmoid cancer (CSC) with pathological findings. Methods Seventy-seven CSC patients who have undergone preoperative PET computed tomograms (PET/CT) are included in this study. Maximum PET-based tumor length (TL) and tumor width (TW) are determined using several auto-segmentation methods, and various thresholds of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) are measured. The PET-based TL and TW are compared with maximum pathological length and width on the pathological specimen. Results Using a 30% threshold level for maximum uptake of TL (TL30%) and TW (TW30%) yield results that provide an optimal match with maximum pathological length (R = 0.81, p < 0.001) and width (R = 0.70, p < 0.001). TW30% was an independent factor for predicting pathological T3 or T4 stages (OR = 1.26, 95% CI = 1.07–1.47, p = 0.01). The receiver-operating characteristic curves show MTV at a fixed threshold of 40% maximum uptake (MTV40%), and TW30% achieved better correlation with the advanced pathological T stage. No associations with positive N stage were observed. Conclusion Pretreatment PET/CT is a useful tool for predicting the final pathological findings for CSC patients requiring surgical procedures.

  18. Which FDG/PET parameters of the primary tumors in colon or sigmoid cancer provide the best correlation with the pathological findings?

    Background To compare 18F-fluoro-2-deoxdeoxyglucose (FDG) positron emission tomography (PET) related parameters of primary colon or sigmoid cancer (CSC) with pathological findings. Methods Seventy-seven CSC patients who have undergone preoperative PET computed tomograms (PET/CT) are included in this study. Maximum PET-based tumor length (TL) and tumor width (TW) are determined using several auto-segmentation methods, and various thresholds of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) are measured. The PET-based TL and TW are compared with maximum pathological length and width on the pathological specimen. Results Using a 30% threshold level for maximum uptake of TL (TL30%) and TW (TW30%) yield results that provide an optimal match with maximum pathological length (R = 0.81, p < 0.001) and width (R = 0.70, p < 0.001). TW30% was an independent factor for predicting pathological T3 or T4 stages (OR = 1.26, 95% CI = 1.07–1.47, p = 0.01). The receiver-operating characteristic curves show MTV at a fixed threshold of 40% maximum uptake (MTV40%), and TW30% achieved better correlation with the advanced pathological T stage. No associations with positive N stage were observed. Conclusion Pretreatment PET/CT is a useful tool for predicting the final pathological findings for CSC patients requiring surgical procedures

  19. Metabolic impact of partial volume correction of [18F]FDG PET-CT oncological studies on the assessment of tumor response to treatment

    The aim of this work is to evaluate the metabolic impact of Partial Volume Correction (PVC) on the measurement of the Standard Uptake Value (SUV) from [18F]FDG PET-CT oncological studies for treatment monitoring purpose. Twenty-nine breast cancer patients with bone lesions (42 lesions in total) underwent [18F]FDG PET-CT studies after surgical resection of breast cancer primitives, and before (PET-I) and after (PET-II) chemotherapy and hormone treatment. PVC of bone lesion uptake was performed on the two [18F]FDG PET-CT studies, using a method based on Recovery Coefficients (RC) and on an automatic measurement of lesion metabolic volume. Body-weight average SUV was calculated for each lesion, with and without PVC. The accuracy, reproducibility, clinical feasibility and the metabolic impact on treatment response of the considered PVC method was evaluated. The PVC method was found clinically feasible in bone lesions, with an accuracy of 93% for lesion sphere-equivalent diameter >1 cm. Applying PVC, average SUV values increased, from 7% up to 154% considering both PET-I and PET-II studies, proving the need of the correction. As main finding, PVC modified the therapy response classification in 6 cases according to EORTC 1999 classification and in 5 cases according to PERCIST 1.0 classification. In conclusion, PVC has an important metabolic impact on the assessment of tumor response to treatment by [18F]FDG PET-CT oncological studies

  20. Malignant extrarenal rhabdoid tumor of the spine: staging and evaluation of response to therapy with F-18 FDG PET/CT.

    Makis, William; Ciarallo, Anthony; Hickeson, Marc

    2011-07-01

    Malignant extrarenal rhabdoid tumor (ERRT) is a very rare type of soft-tissue sarcoma with a reported incidence of 0.3% of all soft-tissue sarcomas. Only 7 cases of spinal malignant ERRT have been reported in the literature, and to our knowledge, F-18 FDG PET/CT imaging for staging and evaluation of response to therapy for these tumors has not been previously described. This is a case of an 8-month-old boy with malignant ERRT of the spine, who was staged with F-18 FDG PET/CT, and had his tumor burden assessed with PET/CT after chemotherapy, which altered the subsequent chemotherapy regimen. PMID:21637073

  1. {sup 18}F-FLT and {sup 18}F-FDOPA PET kinetics in recurrent brain tumors

    Wardak, Mirwais; Schiepers, Christiaan; Dahlbom, Magnus; Phelps, Michael E.; Huang, Sung-Cheng [David Geffen School of Medicine at UCLA, Department of Molecular and Medical Pharmacology, Los Angeles, CA (United States); Cloughesy, Timothy F. [David Geffen School of Medicine at UCLA, Department of Neurology, Los Angeles, CA (United States)

    2014-06-15

    In this study, kinetic parameters of the cellular proliferation tracer {sup 18}F-3'-deoxy-3'-fluoro-l-thymidine (FLT) and the amino acid probe 3,4-dihydroxy-6-{sup 18}F-fluoro-l-phenylalanine (FDOPA) were measured before and early after the start of therapy, and were used to predict the overall survival (OS) of patients with recurrent malignant glioma using multiple linear regression (MLR) analysis. High-grade recurrent brain tumors in 21 patients (11 men and 10 women, age range 26 - 76 years) were investigated. Each patient had three dynamic PET studies with each probe: at baseline and after 2 and 6 weeks from the start of treatment. Treatment consisted of biweekly cycles of bevacizumab (an angiogenesis inhibitor) and irinotecan (a chemotherapeutic agent). For each study, about 3.5 mCi of FLT (or FDOPA) was administered intravenously and dynamic PET images were acquired for 1 h (or 35 min for FDOPA). A total of 126 PET scans were analyzed. A three-compartment, two-tissue model was applied to estimate tumor FLT and FDOPA kinetic rate constants using a metabolite- and partial volume-corrected input function. MLR analysis was used to model OS as a function of FLT and FDOPA kinetic parameters for each of the three studies as well as their relative changes between studies. An exhaustive search of MLR models using three or fewer predictor variables was performed to find the best models. Kinetic parameters from FLT were more predictive of OS than those from FDOPA. The three-predictor MLR model derived using information from both probes (adjusted R{sup 2} = 0.83) fitted the OS data better than that derived using information from FDOPA alone (adjusted R{sup 2} = 0.41), but was only marginally different from that derived using information from FLT alone (adjusted R{sup 2} = 0.82). Standardized uptake values (either from FLT alone, FDOPA alone, or both together) gave inferior predictive results (best adjusted R{sup 2} = 0.25). For recurrent malignant glioma treated

  2. Tumor hypoxia and microscopic diffusion capacity in brain tumors: A comparison of 62Cu-Diacetyl-Bis (N4-Methylthiosemicarbazone) PET/CT and diffusion-weighted MR imaging

    The aim of this study was to clarify the relationship between tumor hypoxia and microscopic diffusion capacity in primary brain tumors using 62Cu-Diacetyl-Bis (N4-Methylthiosemicarbazone) (62Cu-ATSM) PET/CT and diffusion-weighted MR imaging (DWI). This study was approved by the institutional human research committee and was HIPAA compliant, and informed consent was obtained from all patients. 62Cu-ATSM PET/CT and DWI were performed in a total of 40 primary brain tumors of 34 patients with low grade glioma (LGG, n = 13), glioblastoma (GBM, n = 20), and primary central nervous system lymphoma (PCNSL, n = 7). 62Cu-ATSM PET/CT parameters and apparent diffusion coefficient (ADC) obtained by DWI were compared. High intensity signals by 62Cu-ATSM PET/CT and DWI in patients with GBM and PCNSL, and low intensity signals in LGG patients were observed. An inverse correlation was found between maximum SUV (SUVmax) and minimum ADC (ADCmin) (r = -0.583, p ratio) and ADCmin for all tumors (r = -0.532, p max and T/Bratio in GBM were higher than LGG (p min was lower in GBM (p = 0.011) and PCNSL (p = 0.01) than in LGG, while no significant difference was found between GBM and PCNSL (p = 0.90). Tumor hypoxia assessed by 62Cu-ATSM PET/CT correlated with microscopic diffusion capacity obtained by DWI in brain tumors. Both 62Cu-ATSM PET/CT and DWI were considered feasible imaging methods for grading glioma. However, 62Cu-ATSM PET/CT provided additional diagnostic information to differentiate between GBM and PCNSL. (orig.)

  3. Usefulness of [18F]FDG-PET in diagnosis of bone and soft tissue tumors. Study with multi-center survey by questionnaire

    In the aspect of future additional approval of [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) diagnosis of the title tumors in the health insurance, its usefulness was studied by questionnaire to 18 facilities, where PET had been conducted for those tumors in the period July, 2005-February, 2006. Major questions concerned the purpose and finding of PET, findings by other imaging and by tumor markers, and judgment of PET effectiveness compared with other imaging (more useful, equally or less, and its reason). Subjects were 75 cases (42 males, 33 females; 3-82 years old) in 20 diseases, which involved 21 cases of osteosarcoma, 7 of leiomyosarcoma, 8 of Ewing sarcoma, 6 of liposarcoma, 5 of hemangiosarcoma, 4 of synovial sarcoma, each 3 of rhabdomyosarcoma, giant cell tumor, Schwannoma, malignant fibrous histiocytoma, each 2 of chondrosarcoma, alveolar soft part sarcoma, each one of epithelioid sarcoma, endometrial storomal sarcoma, hibernoma, fibrosarcoma, multiple osteochondroma, sacral chondroma, Langerhans cell histiocytosis and neurofibromatosis. Obtained were the judgments of highly useful in 5 diseases, fairly useful in 4, useful in 3, and useful/inconclusive due to the only one case in 8. FDG-PET was thus found useful in all diseases examined. (R.T.)

  4. Multiparametric Monitoring of Early Response to Antiangiogenic Therapy: A Sequential Perfusion CT and PET/CT Study in a Rabbit VX2 Tumor Model

    Jung Im Kim

    2014-01-01

    Full Text Available Objectives. To perform dual analysis of tumor perfusion and glucose metabolism using perfusion CT and FDG-PET/CT for the purpose of monitoring the early response to bevacizumab therapy in rabbit VX2 tumor models and to assess added value of FDG-PET to perfusion CT. Methods. Twenty-four VX2 carcinoma tumors implanted in bilateral back muscles of 12 rabbits were evaluated. Serial concurrent perfusion CT and FDG-PET/CT were performed before and 3, 7, and 14 days after bevacizumab therapy (treatment group or saline infusion (control group. Perfusion CT was analyzed to calculate blood flow (BF, blood volume (BV, and permeability surface area product (PS; FDG-PET was analyzed to calculate SUVmax, SUVmean, total lesion glycolysis (TLG, entropy, and homogeneity. The flow-metabolic ratio (FMR was also calculated and immunohistochemical analysis of microvessel density (MVD was performed. Results. On day 14, BF and BV in the treatment group were significantly lower than in the control group. There were no significant differences in all FDG-PET-derived parameters between both groups. In the treatment group, FMR prominently decreased after therapy and was positively correlated with MVD. Conclusions. In VX2 tumors, FMR could provide further insight into the early antiangiogenic effect reflecting a mismatch in intratumor blood flow and metabolism.

  5. SU-C-9A-01: Parameter Optimization in Adaptive Region-Growing for Tumor Segmentation in PET

    Purpose: To design a reliable method to determine the optimal parameter in the adaptive region-growing (ARG) algorithm for tumor segmentation in PET. Methods: The ARG uses an adaptive similarity criterion m - fσ ≤ I-PET ≤ m + fσ, so that a neighboring voxel is appended to the region based on its similarity to the current region. When increasing the relaxing factor f (f ≥ 0), the resulting volumes monotonically increased with a sharp increase when the region just grew into the background. The optimal f that separates the tumor from the background is defined as the first point with the local maximum curvature on an Error function fitted to the f-volume curve. The ARG was tested on a tumor segmentation Benchmark that includes ten lung cancer patients with 3D pathologic tumor volume as ground truth. For comparison, the widely used 42% and 50% SUVmax thresholding, Otsu optimal thresholding, Active Contours (AC), Geodesic Active Contours (GAC), and Graph Cuts (GC) methods were tested. The dice similarity index (DSI), volume error (VE), and maximum axis length error (MALE) were calculated to evaluate the segmentation accuracy. Results: The ARG provided the highest accuracy among all tested methods. Specifically, the ARG has an average DSI, VE, and MALE of 0.71, 0.29, and 0.16, respectively, better than the absolute 42% thresholding (DSI=0.67, VE= 0.57, and MALE=0.23), the relative 42% thresholding (DSI=0.62, VE= 0.41, and MALE=0.23), the absolute 50% thresholding (DSI=0.62, VE=0.48, and MALE=0.21), the relative 50% thresholding (DSI=0.48, VE=0.54, and MALE=0.26), OTSU (DSI=0.44, VE=0.63, and MALE=0.30), AC (DSI=0.46, VE= 0.85, and MALE=0.47), GAC (DSI=0.40, VE= 0.85, and MALE=0.46) and GC (DSI=0.66, VE= 0.54, and MALE=0.21) methods. Conclusions: The results suggest that the proposed method reliably identified the optimal relaxing factor in ARG for tumor segmentation in PET. This work was supported in part by National Cancer Institute Grant R01 CA172638; The

  6. SU-C-9A-01: Parameter Optimization in Adaptive Region-Growing for Tumor Segmentation in PET

    Tan, S [University of Maryland School of Medicine, Baltimore, MD (United States); Huazhong University of Science and Technology, Wuhan, Hubei (China); Xue, M; Chen, W; D' Souza, W; Lu, W [University of Maryland School of Medicine, Baltimore, MD (United States); Li, H [Washington University School of Medicine, Saint Louis, MO. (United States)

    2014-06-01

    Purpose: To design a reliable method to determine the optimal parameter in the adaptive region-growing (ARG) algorithm for tumor segmentation in PET. Methods: The ARG uses an adaptive similarity criterion m - fσ ≤ I-PET ≤ m + fσ, so that a neighboring voxel is appended to the region based on its similarity to the current region. When increasing the relaxing factor f (f ≥ 0), the resulting volumes monotonically increased with a sharp increase when the region just grew into the background. The optimal f that separates the tumor from the background is defined as the first point with the local maximum curvature on an Error function fitted to the f-volume curve. The ARG was tested on a tumor segmentation Benchmark that includes ten lung cancer patients with 3D pathologic tumor volume as ground truth. For comparison, the widely used 42% and 50% SUVmax thresholding, Otsu optimal thresholding, Active Contours (AC), Geodesic Active Contours (GAC), and Graph Cuts (GC) methods were tested. The dice similarity index (DSI), volume error (VE), and maximum axis length error (MALE) were calculated to evaluate the segmentation accuracy. Results: The ARG provided the highest accuracy among all tested methods. Specifically, the ARG has an average DSI, VE, and MALE of 0.71, 0.29, and 0.16, respectively, better than the absolute 42% thresholding (DSI=0.67, VE= 0.57, and MALE=0.23), the relative 42% thresholding (DSI=0.62, VE= 0.41, and MALE=0.23), the absolute 50% thresholding (DSI=0.62, VE=0.48, and MALE=0.21), the relative 50% thresholding (DSI=0.48, VE=0.54, and MALE=0.26), OTSU (DSI=0.44, VE=0.63, and MALE=0.30), AC (DSI=0.46, VE= 0.85, and MALE=0.47), GAC (DSI=0.40, VE= 0.85, and MALE=0.46) and GC (DSI=0.66, VE= 0.54, and MALE=0.21) methods. Conclusions: The results suggest that the proposed method reliably identified the optimal relaxing factor in ARG for tumor segmentation in PET. This work was supported in part by National Cancer Institute Grant R01 CA172638; The

  7. Can hypoxia-PET map hypoxic cell density heterogeneity accurately in an animal tumor model at a clinically obtainable image contrast?

    Background: PET allows non-invasive mapping of tumor hypoxia, but the combination of low resolution, slow tracer adduct-formation and slow clearance of unbound tracer remains problematic. Using a murine tumor with a hypoxic fraction within the clinical range and a tracer post-injection sampling time that results in clinically obtainable tumor-to-reference tissue activity ratios, we have analyzed to what extent inherent limitations actually compromise the validity of PET-generated hypoxia maps. Materials and methods: Mice bearing SCCVII tumors were injected with the PET hypoxia-marker fluoroazomycin arabinoside (FAZA), and the immunologically detectable hypoxia marker, pimonidazole. Tumors and reference tissue (muscle, blood) were harvested 0.5, 2 and 4 h after FAZA administration. Tumors were analyzed for global (well counter) and regional (autoradiography) tracer distribution and compared to pimonidazole as visualized using immunofluorescence microscopy. Results: Hypoxic fraction as measured by pimonidazole staining ranged from 0.09 to 0.32. FAZA tumor to reference tissue ratios were close to unity 0.5 h post-injection but reached values of 2 and 6 when tracer distribution time was prolonged to 2 and 4 h, respectively. A fine-scale pixel-by-pixel comparison of autoradiograms and immunofluorescence images revealed a clear spatial link between FAZA and pimonidazole-adduct signal intensities at 2 h and later. Furthermore, when using a pixel size that mimics the resolution in PET, an excellent correlation between pixel FAZA mean intensity and density of hypoxic cells was observed already at 2 h post-injection. Conclusions: Despite inherent weaknesses, PET-hypoxia imaging is able to generate quantitative tumor maps that accurately reflect the underlying microscopic reality (i.e., hypoxic cell density) in an animal model with a clinical realistic image contrast.

  8. Impact of patient weight on tumor visibility based on human-shaped phantom simulation study in PET imaging system

    Musarudin, M.; Saripan, M. I.; Mashohor, S.; Saad, W. H. M.; Nordin, A. J.; Hashim, S.

    2015-10-01

    Energy window technique has been implemented in all positron emission tomography (PET) imaging protocol, with the aim to remove the unwanted low energy photons. Current practices in our institution however are performed by using default energy threshold level regardless of the weight of the patient. Phantom size, which represents the size of the patient's body, is the factor that determined the level of scatter fraction during PET imaging. Thus, the motivation of this study is to determine the optimum energy threshold level for different sizes of human-shaped phantom, to represent underweight, normal, overweight and obese patients. In this study, the scanner was modeled by using Monte Carlo code, version MCNP5. Five different sizes of elliptical-cylinder shaped of human-sized phantoms with diameter ranged from 15 to 30 cm were modeled. The tumor was modeled by a cylindrical line source filled with 1.02 MeV positron emitters at the center of the phantom. Various energy window widths, in the ranged of 10-50% were implemented to the data. In conclusion, the phantom mass volume did influence the scatter fraction within the volume. Bigger phantom caused more scattering events and thus led to coincidence counts lost. We evaluated the impact of phantom sizes on the sensitivity and visibility of the simulated models. Implementation of wider energy window improved the sensitivity of the system and retained the coincidence photons lost. Visibility of the tumor improved as an appropriate energy window implemented for the different sizes of phantom.

  9. Preoperative Prediction of Cervical Lymph Node Metastasis Using Primary Tumor SUVmax on 18F-FDG PET/CT in Patients with Papillary Thyroid Carcinoma

    Jung, Ji-hoon; Kim, Choon-Young; Son, Seung Hyun; Kim, Do-Hoon; Jeong, Shin Young; Lee, Sang-Woo; Lee, Jaetae; Ahn, Byeong-Cheol

    2015-01-01

    Objectives The aim of the current study was to evaluate the value of preoperative 18F-FDG (FDG) PET/CT in predicting cervical lymph node (LN) metastasis in patients with papillary thyroid carcinoma (PTC). Methods One hundred and ninety-three newly diagnosed PTC patients (M: F = 25:168, age = 46.8 ± 12.2) who had undergone pretreatment FDG PET/CT and had neck node dissection were included in this study. The FDG avidity of the primary tumor and the SUVmax of the primary tumor (pSUVmax) were ana...

  10. Correlation of FDG-PET measurements with morphometric tumor response after induction chemotherapy and adjuvant radiotherapy in stage III non-small cell lung cancer (NSCLC)

    Full text: Docetaxel (D) and carboplatin (C) combination chemotherapy (DC) has shown high response rates in advanced NSCLC. Histologic tumor response after chemotherapy or combined modality induction is strongly associated with systemic tumor control and potentially cure. Metabolic tumor response assessed by FDG-PET after induction chemotherapy with etoposide, ifosfamide and cisplatin (VIP) has been shown to be predictive of outcome in NSCLC. Finally, erythropoietin (EPO) may prevent the decrease in hemoglobin levels that was seen in a previous study of DC (median drop 2.7 g/dl) and thus may enhance treatment efficacy. The aim of the present study was to correlate FDG-PET studies with histomorphometric findings after DC induction chemotherapy plus Epo. 33 patients (pts) with NSCLC stage IIIA (7 pts) or IIIB (24 pts) were enrolled and received treatment with D 100 mg/m2 dl and C AUC 7.5 d2 q21 days for 4 cycles. Epo was given at 10,000 IU s.c. three times a week. All pts received adjuvant radiotherapy. Of 33 enrolled patients, 22 were evaluable for response by CT imaging. 14/22 pts (64 %) achieved PR. Of the 22 responders, 20 were evaluable for repeated FDG-PET studies. 13/20 pts had a decrease of standardized uptake values (SUV) and of the metabolic tumor index (MTI) by >50 %, 9/20 had SUV <2.5 (CR). Seven of these 9 pts underwent tumor resection, and specimens were subjected to morphometric analysis. In 7/7 cases, no vital tumor cells were detected in the specimens. In contrast to our previous study, hemoglobin levels increased by a median of 0.3 g/dl. Morphometric tumor response after induction chemotherapy correlates strongly with metabolic remission by FDG-PET. FDG-PET appears to be a useful non-invasive diagnostic tool to predict pathologic response and potentially long-term outcome in stage III NSCLC. (author)

  11. Usefulness of [18F]FDG-PET in diagnosis of gastric cancer, duodenal ampullary cancer and gastrointestinal storomal tumor (GIST). Study with multi-center survey by questionnaire

    [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) diagnosis of the three cancers in the title (gastric cancer (GC), duodenal ampullary cancer (DAC) and gastrointestinal storomal tumor (GIST), respectively) is not approved in the health insurance despite their high morbidity in Japan. Clinical usefulness and economical effectiveness in PET diagnosis of these cancers were studied by questionnaire to facilities, where PET had been conducted for the cancers in the period July, 2005-February, 2006. Major questions concerned the purpose and finding of PET, findings by other imaging and by tumor markers, and judgment of PET effectiveness compared with other imaging (more useful, equally or less, and its reason). Patients with GC were 173 cases (120 males, 53 females; mean age 65.3 y), with DAC, 10 (8, 2; 67.6 y), and with GIST, 15 (10, 5; 59.9 y). Obtained were the judgments in GC diagnosis of more useful in 47.4%, equally in 45.1% and less in 7.5%; in DAC, 20, 70 and 10%; and in GIST, 40, 46.7 and 13.3%, respectively. More useful was found in the primary lesion and useful, in the metastatic and recurrent lesions. FDG-PET could detect the latter lesions which had not been found by other imaging techniques, and such findings were thought to be also meaningful from the aspect of medical economics because of possible avoidance of inappropriate surgery and time reduction of hospitalization. (R.T.)

  12. Noninvasive Evaluation of Metabolic Tumor Volume in Lewis Lung Carcinoma Tumor-Bearing C57BL/6 Mice with Micro-PET and the Radiotracers 18F-Alfatide and 18F-FDG: A Comparative Analysis.

    Yu-Chun Wei

    Full Text Available To explore the value of a new simple lyophilized kit for labeling PRGD2 peptide (18F-ALF-NOTA-PRGD2, denoted as 18F-alfatide in the determination of metabolic tumor volume (MTV with micro-PET in lewis lung carcinoma (LLC tumor-bearing C57BL/6 mice verified by pathologic examination and compared with those using 18F-fluorodeoxyglucose (FDG PET.All LLC tumor-bearing C57BL/6 mice underwent two attenuation-corrected whole-body micro-PET scans with the radiotracers 18F-alfatide and 18F-FDG within two days. 18F-alfatide metabolic tumor volume (VRGD and 18F-FDG metabolic tumor volume (VFDG were manually delineated slice by slice on PET images. Pathologic tumor volume (VPath was measured in vitro after the xenografts were removed.A total of 37 mice with NSCLC xenografts were enrolled and 33 of them underwent 18F-alfatide PET, and 35 of them underwent 18F-FDG PET and all underwent pathological examination. The mean ± standard deviation of VPath, VRGD, and VFDG were 0.59±0.32 cm3 (range,0.13~1.64 cm3, 0.61±0.37 cm3 (range,0.15~1.86 cm3, and 1.24±0.53 cm3 (range,0.17~2.20 cm3, respectively. VPath vs. VRGD, VPath vs. VFDG, and VRGD vs. VFDG comparisons were t = -0.145, P = 0.885, t = -6.239, P<0.001, and t = -5.661, P<0.001, respectively. No significant difference was found between VPath and VRGD. VFDG was much larger than VRGD and VPath. VRGD seemed more approximate to the pathologic gross tumor volume. Furthermore, VPath was more strongly correlated with VRGD (R = 0.964,P<0.001 than with VFDG (R = 0.584,P<0.001.18F-alfatide PET provided a better estimation of gross tumor volume than 18F-FDG PET in LLC tumor-bearing C57BL/6 mice.

  13. Decision tree sensitivity analysis for cost-effectiveness of chest FDG-PET in patients with a pulmonary tumor (non-small cell carcinoma)

    Decision tree analysis was used to assess cost-effectiveness of chest FDG-PET in patients with a pulmonary tumor (non-small cell carcinoma, ≤Stage IIIB), based on the data of the current decision tree. Decision tree models were constructed with two competing strategies (CT alone and CT plus chest FDG-PET) in 1,000 patient population with 71.4% prevalence. Baselines of FDG-PET sensitivity and specificity on detection of lung cancer and lymph node metastasis, and mortality and life expectancy were available from references. Chest CT plus chest FDG-PET strategy increased a total cost by 10.5% when a chest FDG-PET study costs 0.1 million yen, since it increased the number of mediastinoscopy and curative thoracotomy despite reducing the number of bronchofiberscopy to half. However, the strategy resulted in a remarkable increase by 115 patients with curable thoracotomy and decrease by 51 patients with non-curable thoracotomy. In addition, an average life expectancy increased by 0.607 year/patient, which means increase in medical cost is approximately 218,080 yen/year/patient when a chest FDG-PET study costs 0.1 million yen. In conclusion, chest CT plus chest FDG-PET strategy might not be cost-effective in Japan, but we are convinced that the strategy is useful in cost-benefit analysis. (author)

  14. Role of 18F- FDG PET-CT in detection of primary tumors in carcinoma of unknown primary site: an Indian experience

    Full text: The management of the patients with carcinoma of an unknown primary represents a difficult challenge in oncology. Metastatic cancers of unknown primary origin are characterised by a poor prognosis. Conventional radiological imaging allows only detection of 20%-27% of primary cancers. To evaluate the role of 18F-FDG PET/CT in detection of primary tumors in carcinoma of unknown primary site. Methods: In the present study, a total of 31 patients (22 males, 9 females; mean age 53.1 years) with biopsy or cytopathology proven metastatic carcinoma and negative conventional diagnostic procedures (CT, MRI or Panendoscopy) were included. All patients underwent whole body 18F-FDG PET/CT study. Patient data was retrospectively analysed. Histopathological diagnosis is kept as the gold standard. Hypermetabolic areas at the site of CT changes were considered as positive and rate of detection of primary site is evaluated. Among 31 patients, 18F-FDG PET/CT detected primary site in 14 patients. 18F-FDG PET/CT was negative in remaining 17 patients and could not localise primary. Among the 14 positive PET-CT patients, the results of 2 patients became false positive. The detection rate of 18F-FDG PET/CT in localising primary site was 38%. It is concluded that 18F-FDG PET/CT was found to be useful diagnostic procedure for the evaluation of patients with metastatic carcinoma and primary of unknown origin

  15. Decision tree sensitivity analysis for cost-effectiveness of chest FDG-PET in patients with a pulmonary tumor (non-small cell carcinoma)

    Kosuda, Shigeru; Watanabe, Masumi; Kobayashi, Hideo; Kusano, Shoichi [National Defence Medical College, Tokorozawa, Saitama (Japan); Ichihara, Kiyoshi

    1998-07-01

    Decision tree analysis was used to assess cost-effectiveness of chest FDG-PET in patients with a pulmonary tumor (non-small cell carcinoma, {<=}Stage IIIB), based on the data of the current decision tree. Decision tree models were constructed with two competing strategies (CT alone and CT plus chest FDG-PET) in 1,000 patient population with 71.4% prevalence. Baselines of FDG-PET sensitivity and specificity on detection of lung cancer and lymph node metastasis, and mortality and life expectancy were available from references. Chest CT plus chest FDG-PET strategy increased a total cost by 10.5% when a chest FDG-PET study costs 0.1 million yen, since it increased the number of mediastinoscopy and curative thoracotomy despite reducing the number of bronchofiberscopy to half. However, the strategy resulted in a remarkable increase by 115 patients with curable thoracotomy and decrease by 51 patients with non-curable thoracotomy. In addition, an average life expectancy increased by 0.607 year/patient, which means increase in medical cost is approximately 218,080 yen/year/patient when a chest FDG-PET study costs 0.1 million yen. In conclusion, chest CT plus chest FDG-PET strategy might not be cost-effective in Japan, but we are convinced that the strategy is useful in cost-benefit analysis. (author)

  16. Preliminary assessment of dynamic contrast-enhanced CT implementation in pretreatment FDG-PET/CT for outcome prediction in head and neck tumors

    Abramyuk, Andrij; Wolf, Gunter; Tokalov, Sergey; Koch, Arne; Abolmaali, Nasreddin (OncoRay - Molecular and Biological Imaging, Medical Faculty Carl Gustav Carus, Dresden Univ. of Technology, Dresden (Germany)), e-mail: Andrij.Abramyuk@OncoRay.de; Shakirin, Georgy (Forschungszentrum Dresden Rossendorf, Inst. of Radiation Physics, Dresden (Germany)); Haberland, Ulrike (Siemens Healthcare Sector Computed Tomography, Forchheim (Germany)); Appold, Steffen (Clinic and Policlinic for Radiotherapy and Radiation Oncology, Univ. Clinics Carl Gustav Carus, Dresden Univ. of Technology, Dresden (Germany)); Zoephel, Klaus (Clinic and Policlinic for Nuclear Medicine, Univ. Clinics Carl Gustav Carus, Dresden Univ. of Technology, Dresden (Germany))

    2010-09-15

    Background: Recently published data show some controversy concerning the impact of [18F]-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in predicting head and neck tumors (HNT) outcome. Assessment of tumor blood supply parameters using dynamic contrast-enhanced CT (DCE-CT) may deliver additional information concerning this important question. Purpose: To evaluate the contribution of DCE-CT implemented in pretherapeutic FDG-PET/CT protocol for prognosis prediction in patients with HNT. Material and Methods: Ten consecutive patients (median age 50 years, range 47-74 years) with histologically proven HNT underwent FDG-PET/CT with DCE-CT before treatment. FDG uptake was measured by maximum standardized uptake value (SUVmax). Relative tumor blood volume (rTBV) was determined from DCE-CT using Patlak analysis. Intratumoral heterogeneity was assessed by means of lacunarity analysis. Obtained values were compared with time-to-progression and overall survival. PET and DCE-CT images were compared on a pixel-by-pixel basis using Pearson coefficient of correlation. Results: Three patients with lower FDG uptake (SUVmax: 8+-1) and five patients with higher FDG uptake (SUVmax: 15+-4, P=0.004) were free of local recurrence for 24 months. Two groups of patients with significantly differing lower (group A: 0.37+-0.02, n=6) and higher (group B: 0.52+-0.01, n=4; P<0.01), tumor heterogeneity (lacunarity) were identified. Corresponding mean rTBV was higher in group A (9.6+-1.8 ml/100 ml) than in group B (6.2+-0.6 ml/100 ml). All six patients with homogeneous tumor blood supply (lower lacunarity) and higher rTBV were free of local recurrence during 24 months, while two of four patients with heterogeneous tumor blood supply (higher lacunarity) and lower rTBV died during follow-up due to tumor relapse. A weak correlation between FDG-PET and DCE-CT rTBV was observed (R2=0.1). Conclusion: FDG-PET/CT and DCT-CT are complementary methods for surveillance

  17. Synthesis and In Vitro and In Vivo Evaluation of a New 68Ga-Semicarbazone Complex: Potential PET Radiopharmaceutical for Tumor Imaging

    N. S. Al-Hokbany

    2014-01-01

    Full Text Available In an attempt to develop new tumor imaging radiotracers with favorable biochemical properties, we have synthesized new 68Ga-2-acetylpyridine semicarbazone (68Ga-[APSC]2 as a potential positron emission tomography (PET tumor imaging agent using a straightforward and a one-step simple reaction. Radiochemical yield and purity were quantitative without HPLC purification. Biodistribution studies in nude mice model bearing human MDA-MB-231 cell line xenografts displayed significant tumor uptake of 68Ga-[APSC]2 radiotracer after 2 h postinjection (p.i.. The initial results demonstrate that 68Ga-[APSC]2 radiotracer may be useful probe for detecting and staging of hypoxic tumor using PET imaging modality.

  18. 18F-FDG and 18F-FLT-PET imaging for monitoring everolimus effect on tumor-growth in neuroendocrine tumors: studies in human tumor xenografts in mice.

    Camilla Bardram Johnbeck

    Full Text Available The mTOR inhibitor everolimus has shown promising results in some but not all neuroendocrine tumors. Therefore, early assessment of treatment response would be beneficial. In this study, we investigated the in vivo and in vitro treatment effect of everolimus in neuroendocrine tumors and evaluated the performance of 18F-FDG and the proliferation tracer 18F-FLT for treatment response assessment by PET imaging.The effect of everolimus on the human carcinoid cell line H727 was examined in vitro with the MTT assay and in vivo on H727 xenograft tumors. The mice were scanned at baseline with 18F-FDG or 18F-FLT and then treated with either placebo or everolimus (5 mg/kg daily for 10 days. PET/CT scans were repeated at day 1,3 and 10.Everolimus showed significant inhibition of H727 cell proliferation in vitro at concentrations above 1 nM. In vivo tumor volumes measured relative to baseline were significantly lower in the everolimus group compared to the control group at day 3 (126±6% vs. 152±6%; p = 0.016, day 7 (164±7% vs. 226±13%; p<0.001 and at day 10 (194±10% vs. 281±18%; p<0.001. Uptake of 18F-FDG and 18F-FLT showed little differences between control and treatment groups, but individual mean uptake of 18F-FDG at day 3 correlated with tumor growth day 10 (r2 = 0.45; P = 0.034, 18F-FLT mean uptake at day 1 correlated with tumor growth day 7 (r2 = 0.63; P = 0.019 and at day 3 18F-FLT correlated with tumor growth day 7 (r2 = 0.87; P<0.001 and day 10 (r2 = 0.58; P = 0.027.Everolimus was effective in vitro and in vivo in human xenografts lung carcinoid NETs and especially early 18F-FLT uptake predicted subsequent tumor growth. We suggest that 18F-FLT PET can be used for tailoring therapy for neuroendocrine tumor patients through early identification of responders and non-responders.

  19. The differentiation of malignant and benign musculoskeletal tumors by F-18 FDG PET/CT studies-determination of maxSUV by analysis of ROC curve

    Kong, Eun Jung; Cho, Ihn Ho; Chun, Kyung Ah; Won, Kyu Chang; Lee, Hyung Woo; Choi, Jun Heok; Shin, Duk Seop [Yeungnam University College of Medicine, Daegu (Korea, Republic of)

    2007-12-15

    We evaluated the standard uptake value (SUV) of F-18 FDG at PET/CT for differentiation of benign from malignant tumor in primary musculoskeletal tumors. Forty-six tumors (11 benign and 12 malignant soft tissue tumors, 9 benign and 14 malignant bone tumors) were examined with F-18 FDG PET/CT (Discovery ST, GE) prior to tissue diagnosis. The maxSUV(maximum value of SUV) were calculated and compared between benign and malignant lesions. The lesion analysis was based on the transverse whole body image. The maxSUV with cutoff of 4.1 was used in distinguishing benign from malignant soft tissue tumor and 3.05 was used in bone tumor by ROC curve. There was a statistically significant difference in maxSUV between benign (n = 11; maxSUV 3.4 {+-} 3.2) and malignant (n = 12; maxSUV 14.8 {+-} 12.2) lesion in soft tissue tumor ({rho} = 0.001). Between benign bone tumor (n = 9; maxSUV 5.4 {+-} 4.0) and malignant bone tumor (n = 14; maxSUV 7.3 {+-} 3.2), there was not a significant difference in maxSUV. The sensitivity and specificity for differentiating malignant from benign soft tissue tumor was 83% and 91%, respectively. There were four false positive malignant bone tumor cases to include fibrous dysplasia, Langerhans-cell histiocytosis (n = 2) and osteoid osteoma. Also, one false positive case of malignant soft tissue tumor was nodular fasciitis. The maxSUV was useful for differentiation of benign from malignant lesion in primary soft tissue tumors. In bone tumor, the low maxSUV correlated well with benign lesions but high maxSUV did not always mean malignancy.

  20. Combining [(11)C]-AnxA5 PET Imaging with Serum Biomarkers for Improved Detection in Live Mice of Modest Cell Death in Human Solid Tumor Xenografts

    Q. Cheng; Lu, L; Grafström, J; Olofsson, MH; Thorell, JO; Samén, E; K. Johansson; Ahlzén, HS; Stone-Elander, S; Linder, S; Arnér, Elias S.J.

    2012-01-01

    BACKGROUND: In vivo imaging using Annexin A5-based radioligands is a powerful technique for visualizing massive cell death, but has been less successful in monitoring the modest cell death typically seen in solid tumors after chemotherapy. Here we combined dynamic positron emission tomography (PET) imaging using Annexin A5 with a serum-based apoptosis marker, for improved sensitivity and specificity in assessment of chemotherapy-induced cell death in a solid tumor model. METHODOLOGY/...

  1. Bilateral pheochromocytomas and neuroendocrine tumor of pancreas demonstrated with FDG-PET/CT in a patient with von Hippel-Lindau syndrome: A case report

    Aim/Background: Von Hippel Lindau disease (VHL) is a hereditary cancer syndrome in which affected individuals are at risk for developing tumors in a number of organs, including the kidneys, brain, spine, adrenal glands, eyes and pancreas. Here we reported a case of a VHL syndrome with CNS hemangioblastoma, bilateral pheochromocytomas and pancreatic tumors and F-18 FDG PET/CT scan findings. Methods and Materials: A 21 year old female with no significant past medical or family history except iodine hypersensitivity (not suitable for CT contrast agents), presented initially with a CNS hemangioblastoma, which was completely resected. Her laboratory analysis showed increased 24-hour urine vanillylmandelic acid (VMA) and plasma metanephrine, and Ca19.9 levels. Other laboratory parameters were normal. She subsequently underwent a staging FDG PET/CT to exclude the possibility of other cancers of VHL syndrome. Whole-body image was obtained 60 minutes after the intravenous administration of 15 mCi of F-18 FDG on a Siemens Biograph 16 PET/CT scanner. Results: Whole body F-18 FDG PET/CT scan revealed an nonmetabolic area in the right cerebellar hemisphere secondary to tumor resection. Additionally, PET/CT study also showed abnormally increased FDG metabolism in the adrenal glands bilaterally and pancreas consistent with bilateral pheochromocytomas and pancreatic tumor. Bilateral pheochromocytomas and neuroendocrine tumor of pancreas were verified after surgical exploration. Discussions: VHL is a rare autosomal dominant familial cancer syndrome caused by germline deletions or mutations in the VHL tumor suppressor gene located on chromosome 3p25. Symptoms often begin in the second to third decades of life. Symptoms caused by VHL depend on the organ involved. Criteria for the diagnosis of VHL include: more than one hemangioblastoma in the CNS, one CNS hemangioblastoma and visceral manifestations of VHL, or one manifestation and a known family history of VHL. Important

  2. Evaluation of Clinical Contributions Provided by Addition of the Brain, Calvarium, and Scalp to the Limited Whole Body Imaging Area in FDG-PET/CT Tumor Imaging

    Bekir Tasdemir

    2014-01-01

    Full Text Available Purpose. The aim of this study was to detect additional findings in whole body FDG-PET/CT scan including the brain, calvarium, and scalp (compared to starting from the base of the skull in cancer patients and to determine contributions of these results to tumor staging and treatment protocols. Materials and Methods. We noted whether the findings related to the brain, calvarium, and scalp in 1359 patients had a potential to modify staging of the disease, chemotherapy protocol, radiotherapy protocol, and surgical management. We identified rates of metastatic findings on the brain, calvarium, and scalp according to the tumor types on FDG-PET/CT scanning. Results. We found FDG-PET/CT findings for malignancy above the base of the skull in 42 patients (3.1%, one of whom was a patient with an unknown primary tumor. Twenty-two of the metastatic findings were in the brain, 16 were in the calvarium, and two were in the scalp. Conclusion. This study has demonstrated that addition of the brain to the limited whole body FDG-PET/CT scanning may provide important contributions to the patient’s clinical management especially in patients with lung cancer, bladder cancer, malignant melanoma, breast cancer, stomach cancer, and unknown primary tumor.

  3. Staging of cervical cancer based on tumor heterogeneity characterized by texture features on 18F-FDG PET images

    The aim of the study is to assess the staging value of the tumor heterogeneity characterized by texture features and other commonly used semi-quantitative indices extracted from 18F-FDG PET images of cervical cancer (CC) patients. Forty-two patients suffering CC at different stages were enrolled in this study. Firstly, we proposed a new tumor segmentation method by combining the intensity and gradient field information in a level set framework. Secondly, fifty-four 3D texture features were studied besides of SUVs (SUVmax, SUVmean, SUVpeak) and metabolic tumor volume (MTV). Through correlation analysis, receiver-operating-characteristic (ROC) curves analysis, some independent indices showed statistically significant differences between the early stage (ES, stages I and II) and the advanced stage (AS, stages III and IV). Then the tumors represented by those independent indices could be automatically classified into ES and AS, and the most discriminative feature could be chosen. Finally, the robustness of the optimal index with respect to sampling schemes and the quality of the PET images were validated. Using the proposed segmentation method, the dice similarity coefficient and Hausdorff distance were 91.78   ±   1.66% and 7.94   ±   1.99 mm, respectively. According to the correlation analysis, all the fifty-eight indices could be divided into 20 groups. Six independent indices were selected for their highest areas under the ROC curves (AUROC), and showed significant differences between ES and AS (P  <  0.05). Through automatic classification with the support vector machine (SVM) Classifier, run percentage (RP) was the most discriminative index with the higher accuracy (88.10%) and larger AUROC (0.88). The Pearson correlation of RP under different sampling schemes is 0.9991   ±   0.0011. RP is a highly stable feature and well correlated with tumor stage in CC, which suggests it could differentiate ES and AS with high

  4. Automated contouring of tumor regions in treatment planning CT images using PET/CT images based on a localized level set method

    The aim of this study was to develop an automated method for contouring lung tumor regions in treatment planning computed tomography (CT) images using positron emission tomography (PET)/CT images. The initial regions of lung tumors were identified by thresholding the PET images at a certain percentage of maximum standardized uptake value (SUV). A localized level set method (LLSM), which we proposed in this study, was applied for the initial tumor region, and the proposed method determines an optimum contour of the gross tumor volume (GTV) region by searching a minimum point of average speed function on the contours of the LSM function with changing evolution time. For performance evaluation were employed the Dice similarity coefficient (DSC), which denotes the degree of a region similarity between the gold standard of the GTV determined by radiation oncologists and the GTV region obtained by our proposed method. We applied our proposed method to data sets of planning CT and PET/CT image sets for six lung cancer patients. The average DSC was 0.77, which seems to be feasible for segmentation of lung tumors. Preliminary results show that the proposed method may be useful for assisting treatment planners in delineation of the tumor region. (author)

  5. A prospective trial comparing FDG-PET/CT and CT to assess tumor response to cetuximab in patients with incurable squamous cell carcinoma of the head and neck

    Computed tomography (CT), the standard method to assess tumor response to cetuximab in incurable squamous cell carcinoma of the head and neck (SCCHN), performs poorly as judged by the disparity between high disease control rate (46%) and short time to progression (TTP) (70 days). F-18 fluorodeoxyglucose positron emission tomography (FDG-PET)/CT is an alternative method to assess tumor response. The primary objective of this prospective trial was to evaluate the metabolic response of target lesions, assessed as the change in maximum standardized uptake value (SUVmax) on FDG-PET/CT before and after 8 weeks (cycle 1) of cetuximab. Secondary objectives were to compare tumor response by CT (RECIST 1.0) and FDG-PET/CT (EORTC criteria) following cycle 1, and determine TTP with continued cetuximab administration in patients with disease control by CT after cycle 1 but stratified for disease control or progression by FDG-PET/CT. Among 27 patients, the mean percent change of SUVmax of target lesions after cycle 1 was −21% (range: +72% to −81%); by FDG-PET/CT, partial response (PR)/stable disease (SD) occurred in 15 patients (56%) and progression in 12 (44%), whereas by CT, PR/SD occurred in 20 (74%) and progression in 7 (26%). FDG-PET/CT and CT assessments were discordant in 14 patients (P = 0.0029) and had low agreement (κ = 0.30; 95% confidence interval [CI]: 0.12, 0.48). With disease control by CT after cycle 1, median TTP was 166 days (CI: 86, 217) if the FDG-PET/CT showed disease control and 105 days (CI: 66, 159) if the FDG-PET/CT showed progression (P < 0.0001). Median TTP of the seven patients whose post cycle 1 CT showed progression compared to the 12 whose FDG-PET/CT showed progression were similar (53 [CI: 49, 56] vs. 61 [CI: 50, 105] days, respectively). FDG-PET/CT may be better than CT in assessing benefit of cetuximab in incurable SCCHN

  6. Net-based data transfer and automatic image fusion of metabolic (PET) and morphologic (CT/MRI) images for radiosurgical planning of brain tumors

    Aim: The main purpose of radiosurgery in comparison to conventional radiotherapy of brain tumors is to reach a higher radiation dose in the tumor and sparing normal brain tissue as much as possible. To reach this aim it is crucial to define the target volume extremely accurately. For this purpose, MRI and CT examinations are used for radiotherapy planning. In certain cases, however, metabolic information obtained by positron emission tomography (PET) may be useful to achieve a higher therapeutic accuracy by sparing important brain structures. This can be the case, i.e. in low grade astrocytomas for exact delineation of vital tumor as well as in differentiating scaring tissue from tumor recurrence and edema after operation. For this purpose, radiolabeled aminoacid analogues (e.g. C-11 methionine) and recently O-2-[18F] Fluorethyl-L-Tyrosin (F-18 FET) have been introduced as PET tracers to detect the area of highest tumor metabolism which allows to obtain additional information as compared to FDG-PET that reflects the local glucose metabolism. In these cases, anatomical and metabolic data have to be combined with the technique of digital image fusion to exactly determine the target volume, the isodoses and the area where the highest dose has to be applied. Materials: We have set up a data transfer from the PET Center of the Zentralklinik Bad Berka with the Department of Stereotactic Radiation at the Helios Klinik Erfurt (distance approx. 25 km) to enable this kind of image fusion. PET data (ECAT EXACT 47, Siemens/CTI) are transferred to a workstation (NOVALIS) in the Dept. of Stereotactic Radiation to be co-registered with the CT or MRI data of the patient. All PET images are in DICOM format (obtained by using a HERMES computer, Nuclear Diagnostics, Sweden) and can easily be introduced into the NOVALIS workstation. The software uses the optimation of mutual information to achieve a good fusion quality. Sometimes manual corrections have to be performed to get an

  7. Evaluation of {sup 68}Ga-DOTA-TOC PET/CT for the detection of duodenopancreatic neuroendocrine tumors in patients with MEN1

    Morgat, Clement; Mazere, Joachim; Hindie, Elif; Fernandez, Philippe [CNRS, INCIA, Bordeaux (France); University of Bordeaux, INCIA, Bordeaux (France); University Hospital of Bordeaux, Department of Nuclear Medicine, Bordeaux (France); Velayoudom-Cephise, Fritz-Line; Nunes, Marie-Laure; Tabarin, Antoine [USN Haut-Leveque, Department of Endocrinology, Pessac (France); Schwartz, Paul; Guyot, Martine [University Hospital of Bordeaux, Department of Nuclear Medicine, Bordeaux (France); Gaye, Delphine [University Hospital of Bordeaux, Department of Radiology, Pessac (France); Vimont, Delphine; Schulz, Juergen [CNRS, INCIA, Bordeaux (France); University of Bordeaux, INCIA, Bordeaux (France); Smith, Denis [University Hospital of Bordeaux, Department of Oncology, Bordeaux (France)

    2016-07-15

    Somatostatin receptor scintigraphy with {sup 111}In-pentetreotide (SRS) is used to detect duodenopancreatic neuroendocrine tumors (dpNETs) in multiple endocrine neoplasia type 1 (MEN1). However, SRS has limited sensitivity for this purpose. Positron emission tomography/computed tomography (PET/CT) with {sup 68}Ga-DOTA-TOC has a higher rate of sporadic dpNETs detection than SRS but there is little data for dpNETs detection in MEN1. To compare the performances of {sup 68}Ga-DOTA-TOC PET/CT, SRS and contrast-enhanced computed tomography (CE-CT) to diagnose dpNETs in MEN1. Single-institution prospective comparative study Nineteen consecutive MEN1 patients (aged 47 ± 13 years) underwent {sup 68}Ga-DOTA-TOC PET/CT, SRS, and CE-CT within 2 months in random order. Blinded readings of images were performed separately by experienced physicians. Unblinded analysis of CE-CT, combined with additional magnetic resonance imaging, endoscopic-ultrasound, {sup 18}F-2-fluoro-deoxy-d-glucose ({sup 18}F-FDG) PET/CT or histopathology results served as reference standard for dpNETs diagnosis. The sensitivity of {sup 68}Ga-DOTA-TOC PET/CT, SRS, and CE-CT was 76, 20, and 60 %, respectively (p < 0.0001). All the true-positive lesions detected by SRS were also depicted on {sup 68}Ga-DOTA-TOC PET/CT. {sup 68}Ga-DOTA-TOC PET/CT detected lesions of smaller size than SRS (10.7 ± 7.6 and 15.2 ± 5.9 mm, respectively, p < 0.03). False negatives of {sup 68}Ga-DOTA-TOC PET/CT included small dpNETs (<10 mm) and {sup 18}F-FDG PET/CT positive aggressive dpNETs. No false positives were recorded. In addition, whole-body mapping with {sup 68}Ga-DOTA-TOC PET/CT identified extra-abdominal MEN1-related tumors including one neuroendocrine thymic carcinoma identified by the three imaging procedures, one bronchial carcinoid undetected by CE-CT and three meningiomas undetected by SRS. Owing to higher diagnostic performance, {sup 68}Ga-DOTA-TOC PET/CT (or alternative {sup 68}Ga-labeled somatostatin analogues

  8. Scintigraphy and PET scan in the exploration of the adrenal incidental tumor (incidentaloma)

    To eliminate a pheochromocytoma, the Mibg-scintigraphy has an excellent specificity and a sensitivity of 90%. The injuries do not fix this tracer and can get a PET scan with 18F-DOPA. Sometimes, a PET scan with 18F-F.D.G. can be useful even in absence of malignancy. To recognize an injury with a cortico-adrenal origin, the iodo-cholesterol is a specific tracer: in case of fixation of the tracer near the radiological injury, we can conclude generally to a benign cortico-adrenal injury. In case of lack of fixation of the tracer near the radiological injury, we will evoke a destructive injury of the adrenal gland, a priori malignant one. The PET scan with 18F-F.D.G. is also useful to help at the malignancy or not malignancy diagnosis of an adrenal mass whom radiological characteristics are not in favour of a typical adenoma. It is a whole body examination that allows to make an extension situation of a malignant adrenal mass in the same examination. (N.C.)

  9. Automatic FDG-PET-based tumor and metastatic lymph node segmentation in cervical cancer

    Arbonès, Dídac R.; Jensen, Henrik G.; Loft, Annika; Munck af Rosenschöld, Per; Hansen, Anders Elias; Igel, Christian; Darkner, Sune

    2014-03-01

    Treatment of cervical cancer, one of the three most commonly diagnosed cancers worldwide, often relies on delineations of the tumour and metastases based on PET imaging using the contrast agent 18F-Fluorodeoxyglucose (FDG). We present a robust automatic algorithm for segmenting the gross tumour volume (GTV) and metastatic lymph nodes in such images. As the cervix is located next to the bladder and FDG is washed out through the urine, the PET-positive GTV and the bladder cannot be easily separated. Our processing pipeline starts with a histogram-based region of interest detection followed by level set segmentation. After that, morphological image operations combined with clustering, region growing, and nearest neighbour labelling allow to remove the bladder and to identify the tumour and metastatic lymph nodes. The proposed method was applied to 125 patients and no failure could be detected by visual inspection. We compared our segmentations with results from manual delineations of corresponding MR and CT images, showing that the detected GTV lays at least 97.5% within the MR/CT delineations. We conclude that the algorithm has a very high potential for substituting the tedious manual delineation of PET positive areas.

  10. Role of {sup 18}F-FDG PET/CT in the evaluation of primary tumours of unknown origin; experience of the Hospital Angeles del Pedregal; Papel del 18F-FDG PET/CT en la evaluacion de tumores primarios de origen desconocido; experiencia del Hospital Angeles del Pedregal

    Sanchez, N.; Serna, J.A.; Quiroz, O.; Valenzuela, J.; Romo, C.; Ramirez, J.L. [Hospital Angeles del Pedregal, Mexico D.F. (Mexico)

    2007-07-01

    It was in 1994 when published studies appear that evaluate the utility of the {sup 18}F-FDG PET in the patients with primary tumors of unknown origin (TOD); starting from then diverse studies that support the clinical utility of the study arise with {sup 18}F-FDG PET in the detection of the primary tumor. It is as well as it has been calculated that the study with {sup 18}F-FDG PET is able to detect the primary tumor in around 40% of the patients with negative results in the conventional diagnostic procedures. Until the moment, most of the studies published in relation to the primary tumors of unknown origin only evaluate the paper of the study with {sup 18}F-FDG PET, without including the image fusion technique PET/CT, which has demonstrated in diverse studies; in oncological scenarios different from the TOD, a superior diagnosis certainty. (Author)

  11. Can initial diagnostic PET-CT aid to localize tumor bed in breast cancer radiotherapy: feasibility study using deformable image registration

    Localization of the tumor bed of breast cancer is crucial for accurate planning of boost irradiation. Lumpectomy cavity and surgical clips provide localizing information about tumor bed. However, defining the tumor bed is often difficult because of presence of unclear lumpectomy cavity and lack of certain information such as absence of surgical clips. In the present study, we evaluated the feasibility of initial diagnostic PET-CT in localization of the tumor bed using deformable image registration (DIR). We selected twenty-five patients who had an initial diagnostic PET-CT performed and underwent breast-conserving surgery with surgical clips in tumor bed. In every individual patient, two target volumes were separately delineated on planning CT; 1) target volume based on surgical clips with a margin of 1 cm (TVclip) and 2) tumor volume based on 90% of maximum SUV on PET-CT registered by DIR (TVPET). The percent of TVPET in TVclip (Vin) was calculated and distance between center points of two volumes (Dcenter) was also measured. Mean Dcenter between two volumes was 1.4 cm (range, 0.33 – 2.53). Mean Vin was 94.8% (range, 60.9-100) and 100% in 18 out of 25 patients. When compared to the center of TVclip, the center of TVPET tended to be located posteriorly (mean 0.3 cm, standard deviation 0.6), laterally (mean 0.3 cm, standard deviation 0.8) and inferiorly (mean 0.4 cm, standard deviation 0.9). Initial diagnostic PET-CT can be one of the possible references to localize the tumor bed in breast cancer radiotherapy

  12. Impact of 4D-18FDG-PET/CT imaging on target volume delineation in SBRT patients with central versus peripheral lung tumors. Multi-reader comparative study

    Purpose: Evaluation of the effect of co-registered 4D-18FDG-PET/CT for SBRT target delineation in patients with central versus peripheral lung tumors. Methods: Analysis of internal target volume (ITV) delineation of central and peripheral lung lesions in 21 SBRT-patients. Manual delineation was performed by 4 observers in 2 contouring phases: on respiratory gated 4DCT with diagnostic 3DPET available aside (CT-ITV) and on co-registered 4DPET/CT (PET/CT-ITV). Comparative analysis of volumes and inter-reader agreement. Results: 11 cases of peripheral and 10 central lesions were evaluated. In peripheral lesions, average CT-ITV was 6.2 cm3 and PET/CT-ITV 8.6 cm3, resembling a mean change in hypothetical radius of 2 mm. For both CT-ITVs and PET/CT-ITVs inter reader agreement was good and unchanged (0.733 and 0.716; p = 0.58). All PET/CT-ITVs stayed within the PTVs derived from CT-ITVs. In central lesions, average CT-ITVs were 42.1 cm3, PET/CT-ITVs 44.2 cm3, without significant overall volume changes. Inter-reader agreement improved significantly (0.665 and 0.750; p < 0.05). 2/10 PET/CT-ITVs exceeded the PTVs derived from CT-ITVs by >1 ml in average for all observers. Conclusion: The addition of co-registered 4DPET data to 4DCT based target volume delineation for SBRT of centrally located lung tumors increases the inter-observer agreement and may help to avoid geographic misses

  13. Clinical value of 18F-FDG PET/CT in detecting viable tumor, recurrence and metastases of hepato-cellular carcinoma after transcatheter arterial chemoembolization

    Objective: Accurate evaluation of treatment result of transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC) by conventional imaging is difficult. The objective of this study was to investigate the clinical value of 18F-fluorodeoxyglucose (FDG) PET/CT for detecting residual viable tumor, recurrence and metastases in patients with HCC after TACE. Methods: Twenty-two patients with HCC after TACE were investigated with 18F-FDG PET/CT. The accuracy of FDG PET/CT was determined by the histopathological results or evidences of clinical follow-up. Results: Of all 22 HCC patients after TACE, 18 had intra- and (or) extrahepatic lesions, detected by FDG PET/CT. Six-teen patients had intrahepatic FDG-avid lesion(s). Of the 16 patients, five had intrahepatic FDG-avid lesions located at both lipiodol-rich and -deprive regions, 13 had associated extrahepatic metastases. Of the two HCC patients who had no intrahepatic FDG-avid lesion, there were extrahepatic FDG-avid lesions at the retroperitoneal lymph nodes. In all, 15 HCC had extrahepatic lesions identified by FDG PET/CT. There were lung and lymph nodes (n = 9), bone (n = 2), tumor thrombus at portal vein (n - 1) and diaphragm crus (n = 1). Two patients were false negative. The sensitivity, specificity, accuracy of FDG PET/CT in detecting intra- and (or) extrahepatic lesions after TACE were 88.9% (16/18) vs 94.7 % (18/19), 4/4 vs 3/3, and 90.9% (20/22) vs 95.5% (21/22), respectively. Conclusion: 18F-FDG PET/CT is potential useful for detection both intra- and (or) extrahepatic lesions in HCC patients after TACE. (authors)

  14. PET Imaging of Multidrug Resistance in Tumors Using F-18-Fluoropaclitaxel

    Kurdziel, Karen A.; Kiesewetter, Dale O.

    2010-01-01

    The failure of solid tumors to respond to chemotherapy is a complicated and clinically frustrating issue. The ability to predict which tumors will respond to treatment could reduce the human and monetary costs of cancer therapy by allowing pro-active selection of a chemotherapeutic to which the tumo

  15. Imaging Tumor Perfusion and Oxidative Metabolism in Patients With Head-and-Neck Cancer Using 1- [11C]-Acetate PET During Radiotherapy: Preliminary Results

    Background: A growing body of in vitro evidence links alterations of the intermediary metabolism in cancer to treatment outcome. This study aimed to characterize tumor oxidative metabolism and perfusion in vivo using dynamic positron emission tomography (PET) with 1- [11C]-acetate (ACE) during radiotherapy. Methods and Materials: Nine patients with head-and-neck cancer were studied. Oxidative metabolic rate (kmono) and perfusion (rF) of the primary tumors were assessed by dynamic ACE-PET at baseline and after 15, 30, and 55 Gy was delivered. Tumor glucose uptake (Tglu) was evaluated with [18F]-fluorodeoxyglucose PET at baseline. Patients were grouped into complete (CR, n = 6) and partial responders (PR, n = 3) to radiotherapy. Results: The 3 PR patients died within a median follow-up period of 33 months. Baseline kmono was almost twice as high in CR as in PR (p = 0.02) and Tglu was lower in CR than in PR (p = 0.04). kmono increased during radiotherapy in PR (p = 0.004) but remained unchanged in CR. There were no differences in rF between CR and PR at any dosage. kmono and rF were coupled in CR (p = 0.001), but not in PR. Conclusions: This study shows that radiosensitive tumors might rely predominantly on oxidative metabolism for their bioenergetic needs. The impairment of oxidative metabolism in radioresistant tumors is potentially reversible, suggesting that therapies targeting the intermediary metabolism might improve treatment outcome.

  16. The usefulness of dynamic O-(2-18F-fluoroethyl)-L-tyrosine PET in the clinical evaluation of brain tumors in children and adolescents

    Dunkl, Veronika; Cleff, Corvin; Stoffels, Gabriele; Judov, Natalie; Sarikaya-Seiwert, Sevgi; Law, Ian; Bøgeskov, Lars; Nysom, Karsten; Andersen, Sofie B; Steiger, Hans-Jakob; Fink, Gereon R; Reifenberger, Guido; Shah, Nadim J; Coenen, Heinz H; Langen, Karl-Josef; Galldiks, Norbert

    2015-01-01

    UNLABELLED: Experience regarding O-(2-(18)F-fluoroethyl)-L-tyrosine ((18)F-FET) PET in children and adolescents with brain tumors is limited. METHODS: Sixty-nine (18)F-FET PET scans of 48 children and adolescents (median age, 13 y; range, 1-18 y) were analyzed retrospectively. Twenty-six scans to...... by receiver-operating-characteristic curve analyses using histology or clinical course as a reference. RESULTS: In patients with newly diagnosed cerebral lesions, the highest accuracy (77%) to detect neoplastic tissue (19/26 patients) was obtained when the maximum TBR was 1.7 or greater (area under...

  17. PET/CT imaging of neuroendocrine tumors with 68Gallium-labeled somatostatin analogues: An overview and single institutional experience from India

    Neuroendocrine tumors (NETs) are rare neoplasms characterized by overexpression of somatostatin receptors (SSTRs). Functional imaging plays a crucial role in management of NETs. Recently, positron emission tomography/computed tomography (PET/CT) with 68Gallium (68Ga)-labeled somatostatin analogues has shown excellent results for imaging of NETs and better results than conventional SSTR scintigraphy. In this review we have discussed the utility of 68Ga-labeled somatostatin analogue PET/CT in NETs for various established and potential indications. In addition we have also shared our own experience from a tertiary care center in India

  18. NI-37INCREASED CEREBRAL AMINO ACID UPTAKE DURING AND AFTER EPILEPTIC DISORDERS MIMICS BRAIN TUMOR IN 18F-FET PET

    Hutterer, Markus; Krenn, Yvonne; Kunz, Alexander; McCoy, Marc; Egger, Barbara; Schröder, Michael; Wendl, Christina; Marienhagen, Jörg; Fritsch, Brita; Urbach, Horst; Meyer, Philipp T; Galldiks, Norbert; Langen, Karl-Josef; Hau, Peter; Trinka, Eugen

    2014-01-01

    BACKGROUND: O-(2-[F-18]fluoroethyl)-L-tyrosine (18F-FET) PET has become an important diagnostic tool in addition to standard MRI to delineate cerebral gliomas. However, 18F-FET uptake has also been observed in non-tumoral lesions. METHODS AND RESULTS: We report on abnormal non-tumoral 18F-FET uptake in 6 patients with epileptic disorders: Patients A-C with clinically stable anaplastic astrocytoma over years, Patient D with anaplastic oligodendroglioma with stable residual tumor, Patient E wit...

  19. Tumor hypoxia and microscopic diffusion capacity in brain tumors: A comparison of {sup 62}Cu-Diacetyl-Bis (N4-Methylthiosemicarbazone) PET/CT and diffusion-weighted MR imaging

    Hino-Shishikura, Ayako; Tateishi, Ukihide; Shibata, Hirofumi; Yoneyama, Tomohiro; Nishii, Toshiaki; Torii, Ikuo; Inoue, Tomio [Graduate School of Medicine, Yokohama City University, Department of Radiology, Yokohama (Japan); Tateishi, Kensuke; Ohtake, Makoto; Kawahara, Nobutaka [Graduate School of Medicine, Yokohama City University, Department of Neurosurgery, Yokohama (Japan)

    2014-07-15

    The aim of this study was to clarify the relationship between tumor hypoxia and microscopic diffusion capacity in primary brain tumors using {sup 62}Cu-Diacetyl-Bis (N4-Methylthiosemicarbazone) ({sup 62}Cu-ATSM) PET/CT and diffusion-weighted MR imaging (DWI). This study was approved by the institutional human research committee and was HIPAA compliant, and informed consent was obtained from all patients. {sup 62}Cu-ATSM PET/CT and DWI were performed in a total of 40 primary brain tumors of 34 patients with low grade glioma (LGG, n = 13), glioblastoma (GBM, n = 20), and primary central nervous system lymphoma (PCNSL, n = 7). {sup 62}Cu-ATSM PET/CT parameters and apparent diffusion coefficient (ADC) obtained by DWI were compared. High intensity signals by {sup 62}Cu-ATSM PET/CT and DWI in patients with GBM and PCNSL, and low intensity signals in LGG patients were observed. An inverse correlation was found between maximum SUV (SUV{sub max}) and minimum ADC (ADC{sub min}) (r = -0.583, p < 0.0001), and between tumor/brain ratio (T/B{sub ratio}) and ADC{sub min} for all tumors (r = -0.532, p < 0.0001). Both SUV{sub max} and T/B{sub ratio} in GBM were higher than LGG (p < 0.0001 and p < 0.0001), and those in PCNSL were also higher than GBM (p = 0.033 and p = 0.044). The ADC{sub min} was lower in GBM (p = 0.011) and PCNSL (p = 0.01) than in LGG, while no significant difference was found between GBM and PCNSL (p = 0.90). Tumor hypoxia assessed by {sup 62}Cu-ATSM PET/CT correlated with microscopic diffusion capacity obtained by DWI in brain tumors. Both {sup 62}Cu-ATSM PET/CT and DWI were considered feasible imaging methods for grading glioma. However, {sup 62}Cu-ATSM PET/CT provided additional diagnostic information to differentiate between GBM and PCNSL. (orig.)

  20. Comparison of dynamic FDG-microPET study in a rabbit turpentine-induced inflammatory model and in a rabbit VX2 tumor model

    We investigated the optimum time for the differentiation tumor from inflammation using dynamic fluorodeoxyglucose (FDG)-microPET scans obtained by a MicroPET P4 scanner in animal models. Forty-six rabbits with 92 inflammatory lesions that were induced 2, 5, 7, 14, 30 and 60 days after 0.2 ml (Group 1) or 1.0 ml (Group 2) of turpentine oil injection were used as inflammatory models. Five rabbits with 10 VX2 tumors were used as the tumor model. Helical CT scans were performed before the PET studies. In the PET study, after 4 hours fasting, and following transmission scans and dynamic emission data acquisitions were performed until 2 hours after intravenous FDG injection. Images were reconstructed every 10 minutes using a filtered-back projection method. PET images were analyzed visually referring to CT images. For quantitative analysis, the inflammation-to-muscle (I/M) ratio and tumor-to-muscle (T/M) ratio were calculated after regions of interest were set in tumors and muscles referring to CT images and the time-I/M ratio and time-T/M ratio curves (TRCs) were prepared to show the change over time in these ratios. The histological appearance of both inflammatory lesions and tumor lesions were examined and compared with the CT and FDG-microPET images. In visual and quantitative analysis, All the I/M ratios and the T/M ratios increased over time except that Day 60 of Group 1 showed an almost flat curve. The TRC of the T/M ratio showed a linear increasing curve over time, while that of the I/M ratios showed a parabolic increasing over time at the most. FDG uptake in the inflammatory lesions reflected the histological findings. For differentiating tumors from inflammatory lesions with the early image acquired at 40 min for dual-time imaging, the delayed image must be acquired 30 min after the early image, while imaging at 90 min or later after intravenous FDG injection was necessary in single-time-point imaging. Our results suggest the possibility of shortening the

  1. 18F-FDG PET/CT for the evaluation of pathological changes of the VX2 rabbit tumors after treatment of Ar-He knife

    Objective: To study the correlation of 18F-fluorodeoxyglucose (FDG) PET/CT with pathological changes of the VX2 rabbit tumors after treatment of Ar-He knife, and to explore the evolution of the Ar-He knife curative effect for VX2 rabbit tumors. Methods: Thirty-six Japanese white rabbits had successfully been implanted with VX2 tumors in thighs. Four weeks later, the rabbits with VX2 tumors were imaged with FDG PET/CT before they were treated with Ar-He cryoablation. The rabbits were evenly and randomly divided into 6 groups (6 rabbits in each group) and imaged with FDG PET/CT respectively on the first day, third day, seventh day, fourteenth day, thirtieth day and sixtieth day after cryoablation. The rabbits in each group were sacriftced after post-treatment FDG PET/CT imaging for pathology and immunohistochemistry studies. The standardized uptake value (SUV) of tumor regions were calculated and compared with pathology and immunohistochemistry findings in the cryoablative area in each group. Paired-samples t-test and bivariate correlation analysis were evaluated by statistical software SPSS 16.0. Results: After ArHe cryoablation, pathological changes of 'necrosis-inflammatory response → organization' were found. On CT imaging, the tumors enlarged during 3-14 d after treatment and then shrank gradually. On FDG PET imaging,the maximum SUV (SUVmax) dropped dramatically on the first day after the operation (from 2.54 ± 1.12 to 0.67 ± 0.12), and increased slightly on the third day (1.71 ± 0.82), and then continually dropped to 0.51 ± 0.32 (60 d afterthe operation). The differences of SUVmax between pre-and after cryoablationin each stage were significant, respectively (t=5.471, 8.716, 11.388, 5.713, 7.144 and 7.213, all Pmax of the targeting area did not correlate with each other (r=0.259, P=0.675). The change of the MVD closely correlated with SUVmax (r=0.865, P=0.032). Conclusion: FDG PET/CT can reveal the pathological change of tumor tissue after Ar

  2. Tumor diagnosis by PET: potential of seven tracers examined in five experimental tumors including an artificial metastasis model

    The potential of seven tracers for the metabolic imaging of tumors by positron emission tomography was studied using five experimental tumor models. The tracers examined were 2-deoxy-2-[18F]fluoro-D-glucose([18F]FDG), 2-deoxy-2-[18F]fluoro-D-galactose (2-[18F]FdGal) and 2-deoxy-2-[18F]fluoro-L-fucose (2-[18F]FdFuc) for investigating energy metabolism. L-[methyl-11C]Methionine ([11C]Met) and 6-[18F]fluoro-L-fucose (6-[18F]FFuc) were used for assessing protein and glycoprotein synthesis, while [3H]thymidine ([3H]Thd) and 2-deoxy-5'-[18F]fluorouridine ([18F]FdUrd) were used to investigate nucleic acid metabolism. (Author)

  3. Thoracic Tumor Volume Delineation in 4D-PET/CT by Low Dose Interpolated CT for Attenuation Correction

    Huang, Tzung-Chi; Wang, Yao-Ching; Kao, Chia-Hung

    2013-01-01

    Purpose 4D-PET/CT imaging is an excellent solution for reducing the breathing-induced effects in both CT and PET images. In 4D-PET/CT, 4D-CT images are selected to match those of 4D-PET phase by phase and the corresponding phases are used for attenuation correction in 4D-PET. However, the high radiation dose that patients acquire while undergoing 4D-CT imaging for diagnostic purposes remains a concern. This study aims to assess low-dose interpolated CT (ICT) for PET attenuation correction (PE...

  4. FDG-PET for Evaluating the Antitumor Effect of Intraarterial 3-Bromopyruvate Administration in a Rabbit VX2 Liver Tumor Model

    Park, Hee Sun; Chung, Jin Wook; Jae, Hwan Jun [Seoul National University College of Medicine, Seoul (Korea, Republic of)] (and others)

    2007-06-15

    We wanted to investigate the feasibility of using FDG-PET for evaluating the antitumor effect of intraarterial administration of a hexokinase II inhibitor, 3-bromopyruvate (3-BrPA), in a rabbit VX2 liver tumor model. VX2 carcinoma was grown in the livers of ten rabbits. Two weeks later, liver CT was performed to confirm appropriate tumor growth for the experiment. After tumor volume-matched grouping of the rabbits, transcatheter intraarterial administration of 3-BrPA was performed (1 mM and 5 mM in five animals each, respectively). FDG-PET scan was performed the day before, immediately after and a week after 3-BrPA administration. FDG uptake was semiquantified by measuring the standardized uptake value (SUV). A week after treatment, the experimental animals were sacrificed and the necrosis rates of the tumors were calculated based on the histopathology. The SUV of the VX2 tumors before treatment (3.87{+-}1.51 [mean SD]) was significantly higher than that of nontumorous liver parenchyma (1.72{+-}0.34) (p < 0.0001, Mann-Whitney U test). The SUV was significantly decreased immediately after 3-BrPA administration (2.05{+-}1.21) (p = 0.002, Wilcoxon signed rank test). On the one-week follow up PET scan, the FDG uptake remained significantly lower (SUV 1.41{+-}0.73) than that before treatment (p 0.002), although three out of ten animals showed a slightly increasing tendency for the FDG uptake. The tumor necrosis rate ranged from 50.00% to 99.90% (85.48%{+-}15.87). There was no significant correlation between the SUV or the SUV decrease rate and the tumor necrosis rate in that range. Even though FDG-PET cannot exactly reflect the tumor necrosis rate, FDG-PET is a useful modality for the early assessment of the antitumor effect of intraarterial administration of 3-BrPA in VX2 liver tumor.

  5. Measurement of tumor volume by PET to evaluate prognosis in patients with advanced non-small cell lung cancer treated by non-surgical therapy

    Background: Patients with advanced non-small cell lung cancer (NSCLC) seem to have disparity in prognosis. Accurate prediction of prognosis could be useful in the future to predict individual risk and to develop more aggressive or alternative treatment strategies. Purpose: To evaluate the prognostic value of metabolic tumor volume (MTV) measured by 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) in patients with NSCLC. Material and Methods: We retrospectively reviewed 120 patients with pathologically proven NSCLC (61 squamous cell carcinomas and 59 adenocarcinomas) who underwent pretreatment 18F-FDG PET. MTV and maximum standardized uptake value (SUVmax) for the primary tumors were measured by 18F-FDG PET. Pretreatment variables (age, sex, American Joint Committee on Cancer [AJCC] stage, histological type, SUVmax, and MTV) were analyzed to identify their correlation with two-year survival. To further evaluate and compare the predictive value of PET parameters, MTV, and SUVmax, time-dependent receiver-operating characteristic curve (ROC) analysis was used. Results: In the univariate analysis, AJCC stage, histological type, MTV, and SUVmax of primary tumor were significant predictors of survival. On multivariate analysis, independent prognostic factors associated with decreased two-year survival were AJCC stage (hazard ratio [HR] 2.236, P 0.003), histological type (HR 2.038, P = 0. 004), and MTV (HR 1.016, P 0.001). SUVmax was not a significant factor (HR 0.96, P = 0.490). On time-dependent ROC analysis, MTV showed good predictive performance for two-year survival consistently better than SUVmax. Conclusion: MTV, a volumetric parameter of 18F-FDG PET, is an important independent prognostic factor for survival and a better predictor of survival than SUVmax for the primary tumor in patients with advanced NSCLC

  6. Evaluation of two novel {sup 64}Cu-labeled RGD peptide radiotracers for enhanced PET imaging of tumor integrin α{sub v}β{sub 3}

    Hernandez, Reinier; Graves, Stephen A.; Nickles, Robert J. [University of Wisconsin, Department of Medical Physics, Madison, WI (United States); Czerwinski, Andrzej; Valenzuela, Francisco [Peptides International, Inc., Louisville, KY (United States); Chakravarty, Rubel; Yang, Yunan; England, Christopher G. [University of Wisconsin, Department of Radiology, Madison, WI (United States); Cai, Weibo [University of Wisconsin, Department of Medical Physics, Madison, WI (United States); University of Wisconsin, Department of Radiology, Madison, WI (United States); University of Wisconsin Carbone Cancer Center, Madison, WI (United States)

    2015-11-15

    Our goal was to demonstrate that suitably derivatized monomeric RGD peptide-based PET tracers, targeting integrin α{sub v}β{sub 3}, may offer advantages in image contrast, time for imaging, and low uptake in nontarget tissues. Two cyclic RGDfK derivatives, (PEG){sub 2}-c(RGDfK) and PEG{sub 4}-SAA{sub 4}-c(RGDfK), were constructed and conjugated to NOTA for {sup 64}Cu labeling. Their integrin α{sub v}β{sub 3}-binding properties were determined via a competitive cell binding assay. Mice bearing U87MG tumors were intravenously injected with each of the {sup 64}Cu-labeled peptides, and PET scans were acquired during the first 30 min, and 2 and 4 h after injection. Blocking and ex vivo biodistribution studies were carried out to validate the PET data and confirm the specificity of the tracers. The IC{sub 50} values of NOTA-(PEG){sub 2}-c(RGDfK) and NOTA-PEG{sub 4}-SAA{sub 4}-c(RGDfK) were 444 ± 41 nM and 288 ± 66 nM, respectively. Dynamic PET data of {sup 64}Cu-NOTA-(PEG){sub 2}-c(RGDfK) and {sup 64}Cu-NOTA-PEG{sub 4}-SAA{sub 4}-c(RGDfK) showed similar circulation t{sub 1/2} and peak tumor uptake of about 4 %ID/g for both tracers. Due to its marked hydrophilicity, {sup 64}Cu-NOTA-PEG{sub 4}-SAA{sub 4}-c(RGDfK) provided faster clearance from tumor and normal tissues yet maintained excellent tumor-to-background ratios. Static PET scans at later time-points corroborated the enhanced excretion of the tracer, especially from abdominal organs. Ex vivo biodistribution and receptor blocking studies confirmed the accuracy of the PET data and the integrin α{sub v}β{sub 3}-specificity of the peptides. Our two novel RGD-based radiotracers with optimized pharmacokinetic properties allowed fast, high-contrast PET imaging of tumor-associated integrin α{sub v}β{sub 3}. These tracers may facilitate the imaging of abdominal malignancies, normally precluded by high background uptake. (orig.)

  7. Attenuation correction of PET images with interpolated average CT for thoracic tumors

    Huang, Tzung-Chi; Wang, Shyh-Jen; Wu, Tung-Hsin [Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, Taiwan (China); Mok, Greta S P [Department of Electrical and Electronics Engineering, Faculty of Science and Technology, University of Macau, Macau (China); Zhang, Geoffrey, E-mail: tung@ym.edu.tw [Department of Radiation Oncology, Moffitt Cancer Center, Florida (United States)

    2011-04-21

    To reduce positron emission tomography (PET) and computed tomography (CT) misalignments and standardized uptake value (SUV) errors, cine average CT (CACT) has been proposed to replace helical CT (HCT) for attenuation correction (AC). A new method using interpolated average CT (IACT) for AC is introduced to further reduce radiation dose with similar image quality. Six patients were recruited in this study. The end-inspiration and -expiration phases from cine CT were used as the two original phases. Deformable image registration was used to generate the interpolated phases. The IACT was calculated by averaging the original and interpolated phases. The PET images were then reconstructed with AC using CACT, HCT and IACT, respectively. Their misalignments were compared by visual assessment, mutual information, correlation coefficient and SUV. The doses from different CT maps were analyzed. The misalignments were reduced for CACT and IACT as compared to HCT. The maximum SUV difference between the use of IACT and CACT was {approx}3%, and it was {approx}20% between the use of HCT and CACT. The estimated dose for IACT was 0.38 mSv. The radiation dose using IACT could be reduced by 85% compared to the use of CACT. IACT is a good low-dose approximation of CACT for AC.

  8. Attenuation correction of PET images with interpolated average CT for thoracic tumors

    To reduce positron emission tomography (PET) and computed tomography (CT) misalignments and standardized uptake value (SUV) errors, cine average CT (CACT) has been proposed to replace helical CT (HCT) for attenuation correction (AC). A new method using interpolated average CT (IACT) for AC is introduced to further reduce radiation dose with similar image quality. Six patients were recruited in this study. The end-inspiration and -expiration phases from cine CT were used as the two original phases. Deformable image registration was used to generate the interpolated phases. The IACT was calculated by averaging the original and interpolated phases. The PET images were then reconstructed with AC using CACT, HCT and IACT, respectively. Their misalignments were compared by visual assessment, mutual information, correlation coefficient and SUV. The doses from different CT maps were analyzed. The misalignments were reduced for CACT and IACT as compared to HCT. The maximum SUV difference between the use of IACT and CACT was ∼3%, and it was ∼20% between the use of HCT and CACT. The estimated dose for IACT was 0.38 mSv. The radiation dose using IACT could be reduced by 85% compared to the use of CACT. IACT is a good low-dose approximation of CACT for AC.

  9. Exploratory evaluation of two-dimensional and three-dimensional methods of FDG PET quantification in pediatric anaplastic astrocytoma: a report from the Pediatric Brain Tumor Consortium (PBTC)

    Williams, Gethin; Treves, S. Ted [Harvard Medical School, Joint Program in Nuclear Medicine, Children' s Hospital Boston, Boston, MA (United States); Fahey, Frederic H. [Harvard Medical School, Joint Program in Nuclear Medicine, Children' s Hospital Boston, Boston, MA (United States); Harvard Medical School, Division of Nuclear Medicine, Department of Radiology, Children' s Hospital Boston, Boston, MA (United States); Kocak, Mehmet; Boyett, James M.; Kun, Larry E. [St Jude Children' s Research Hospital, Memphis, TN (United States); Pollack, Ian F. [Children' s Hospital Pittsburgh, Pittsburgh, PA (United States); Young Poussaint, Tina [Harvard Medical School, Division of Neuroradiology, Department of Radiology, Children' s Hospital Boston, Boston, MA (United States)

    2008-09-15

    The rationale of this study was to investigate the feasibility of three-dimensional (3D) methods to analyze {sup 18}F-fluoro-deoxy-glucose (FDG) uptake in children with anaplastic astrocytoma (AA) in a multi-institutional trial, to compare 3D and two-dimensional (2D) methods and explore data associations with progression-free survival (PFS). 3D tumor volumes from pretreatment MR images (fluid attenuation inversion recovery and postgadolinium) of children with recurrent AA on a phase I trial of imatinib mesylate were coregistered to FDG positron emission tomography (PET) images. PET data were normalized. Four metrics were defined: the maximum ratio (maximum pixel value within the 3D tumor volume, normalized), the total ratio (cumulative pixel values within the tumor volume, normalized) and tumor mean ratio (total pixel value divided by volume, normalized). 2D analysis methods were compared. Cox proportional hazards models were used to estimate the association between these methods and PFS. Strongest correlations between 2D and 3D methods were with analyses using postcontrast T1 images for volume of interest (VOI). The analyses suggest 3D maximum tumor and mean tumor ratios, whether normalized by gray matter or white matter, were associated with PFS. This study of a series of pretreatment AA patients suggests that 3D PET methods using VOIs based on postcontrast T1 correlate with 2D methods and are related to PFS. These methods yield an estimate of metabolically active tumor burden and may add prognostic information after tumor grade is determined. Future rigorous multi-institutional protocols with larger numbers of patients will be required for validation. (orig.)

  10. The effect of SUV discretization in quantitative FDG-PET Radiomics: the need for standardized methodology in tumor texture analysis

    Leijenaar, Ralph T. H.; Nalbantov, Georgi; Carvalho, Sara; van Elmpt, Wouter J. C.; Troost, Esther G. C.; Boellaard, Ronald; Aerts, Hugo J. W. L.; Gillies, Robert J.; Lambin, Philippe

    2015-08-01

    FDG-PET-derived textural features describing intra-tumor heterogeneity are increasingly investigated as imaging biomarkers. As part of the process of quantifying heterogeneity, image intensities (SUVs) are typically resampled into a reduced number of discrete bins. We focused on the implications of the manner in which this discretization is implemented. Two methods were evaluated: (1) RD, dividing the SUV range into D equally spaced bins, where the intensity resolution (i.e. bin size) varies per image; and (2) RB, maintaining a constant intensity resolution B. Clinical feasibility was assessed on 35 lung cancer patients, imaged before and in the second week of radiotherapy. Forty-four textural features were determined for different D and B for both imaging time points. Feature values depended on the intensity resolution and out of both assessed methods, RB was shown to allow for a meaningful inter- and intra-patient comparison of feature values. Overall, patients ranked differently according to feature values-which was used as a surrogate for textural feature interpretation-between both discretization methods. Our study shows that the manner of SUV discretization has a crucial effect on the resulting textural features and the interpretation thereof, emphasizing the importance of standardized methodology in tumor texture analysis.

  11. Cytotoxicity, tumor targeting and PET imaging of sub-5 nm KGdF4 multifunctional rare earth nanoparticles

    Cao, Xinmin; Cao, Fengwen; Xiong, Liqin; Yang, Yang; Cao, Tianye; Cai, Xi; Hai, Wangxi; Li, Biao; Guo, Yixiao; Zhang, Yimin; Li, Fuyou

    2015-08-01

    Ultrasmall sub-5 nm KGdF4 rare earth nanoparticles were synthesized as multifunctional probes for fluorescent, magnetic, and radionuclide imaging. The cytotoxicity of these nanoparticles in human glioblastoma U87MG and human non-small cell lung carcinoma H1299 cells was evaluated, and their application for in vitro and in vivo tumor targeted imaging has also been demonstrated.Ultrasmall sub-5 nm KGdF4 rare earth nanoparticles were synthesized as multifunctional probes for fluorescent, magnetic, and radionuclide imaging. The cytotoxicity of these nanoparticles in human glioblastoma U87MG and human non-small cell lung carcinoma H1299 cells was evaluated, and their application for in vitro and in vivo tumor targeted imaging has also been demonstrated. Electronic supplementary information (ESI) available: Details of the experimental section as well as EDXA, XRD, zeta potential, FTIR, TGA, stability, TEM, Z scanning, ICP-MS, and MicroPET/CT images. See DOI: 10.1039/c5nr03374h

  12. {sup 124}I labeled Arg-Gly-Asp (RGD) peptide: PET/MR fusion imaging of tumor expressing integrin v3

    Yun, Seon Young; Park, Jeong Chan [Kyungpook National University School of Medicine, Daegu (Korea, Republic of); Chen, Xiaoyuan [Standford Univ. School of Medicine, Palo Alto (United States)] (and others)

    2007-07-01

    Tumor-induced angiogenesis and metastasis express high level of integrin {sup v3} which has become a promising diagnostic biomarker and therapeutic target for various tumors. Radiolabeled RGD (Arg-Gly-Asp) peptides are well known to specifically bind to integrin and can be used not only for noninvasive imaging of integrin over-expression but also for integrin-targeted radionuclide therapy. We used three RGDyK derivatives, monomeric-, dimeric- and tetrameric-RGD for radio labeling. They were labeled with [{sup 124}I]NaI using iodo-bead. Labeled RGD peptide was purified by FPLC. Xenografts were induced by subcutaneous injection of 1X10{sup 7} U87MG cells into the right thigh of female Balb/c nude mice. After injection of {sup 124}I-labeled monomeric-RGD via the tail vein, the microPET imaging was obtained during 2 hours. Right after microPET imaging, T{sub 2}-weighted MR imaging was performed with fast gradient spin echo sequence in 0.8 mm of a slice thickness. PET/MR fusion images were constructed by AMIDE program. For immobilization and reproducible positioning of animal, animal-specific positioning molds were fabricated. Monomeric-RGD peptide was labeled with {sup 124}I in labeling yield of 50%. After FPLC purification, the radiochemical purity was above 90%. U87MG tumor was clearly seen in both microPET and MR imaging of tumor-bearing nude mouse. The fusion imaging was well constructed by using AMIDE with little discrepancy thanks to animal-specific molds. Three RGD derivatives were also labeled with {sup 131}I in labeling yield of 20-55%. All three RGD peptides were successfully radioiodinated with {sup 124}I or {sup 131}I. U87MG glioblastoma tumor was clearly visualized in PET/MR fusion imaging. MicroPET/MR fusion imaging of dimeric- and tetrameric-RGD peptides in tumor bearing mice will also be presented during conference.

  13. Computer-assisted delineation of lung tumor regions in treatment planning CT images with PET/CT image sets based on an optimum contour selection method

    To assist radiation oncologists in the delineation of tumor regions during treatment planning for lung cancer, we have proposed an automated contouring algorithm based on an optimum contour selection (OCS) method for treatment planning computed tomography (CT) images with positron emission tomography (PET)/CT images. The basic concept of the OCS is to select a global optimum object contour based on multiple active delineations with a level set method around tumors. First, the PET images were registered to the planning CT images by using affine transformation matrices. The initial gross tumor volume (GTV) of each lung tumor was identified by thresholding the PET image at a certain standardized uptake value, and then each initial GTV location was corrected in the region of interest of the planning CT image. Finally, the contours of final GTV regions were determined in the planning CT images by using the OCS. The proposed method was evaluated by testing six cases with a Dice similarity coefficient (DSC), which denoted the degree of region similarity between the GTVs contoured by radiation oncologists and the proposed method. The average three-dimensional DSC for the six cases was 0.78 by the proposed method, but only 0.34 by a conventional method based on a simple level set method. The proposed method may be helpful for treatment planners in contouring the GTV regions. (author)

  14. Multimodality functional imaging of spontaneous canine tumors using 64CU-ATSM and 18FDG PET/CT and dynamic contrast enhanced perfusion CT

    Hansen, Anders E; Kristensen, Annemarie T; Law, Ian;

    2012-01-01

    To compare the distribution and uptake of the hypoxia tracer (64)Cu-diacetyl-bis(N(4)-methylthiosemicarbazone) ((64)Cu-ATSM) PET/CT, FDG PET/CT and dynamic contrast enhanced perfusion CT (DCE-pCT) in spontaneous canine tumors. In addition (64)Cu-ATSM distribution over time was evaluated....

  15. Evaluation of sequential FDG-PET/CT for monitoring bone metastasis of breast cancer during therapy. Correlation between morphological and metabolic changes with tumor markers

    The purpose of this study was to clarify the significance of positron emission tomography (PET) and computed tomography (CT) findings for evaluating the bone metastasis of breast cancer during therapy. Forty-seven patients with bone metastases from breast cancer who underwent sequential 18F-flourodeoxyglucose (FDG)-PET/CT studies during therapy were enrolled. A total of 771 lesions were identified. The changes in the PET and CT findings were compared with the tumor marker levels in each patient by calculating the weighted kappa value. The correlation between the PET and CT findings was examined for each lesion by an adjusted Chi-square test. The change in the tumor marker levels was substantially correlated with the PET findings and moderately correlated with the CT findings (weighted kappa=0.780 and 0.585 for quadratic weighting, respectively). An increase in FDG uptake was correlated with lytic changes on the CT images (62/65, 95.4%, p<0.05). Sclerotic changes suggested improvement, but sclerosis and progression occurred at the same time in some lesions. Changes of FDG uptake are useful for evaluating individual bone metastases in cases of breast cancer during therapy. Lytic change on CT images suggests progression of bone metastasis. The lysis-progression/sclerosis-improvement pattern was observed in the majority of subjects, but a sclerosis-progression pattern was also observed. The hybrid pattern of increase of FDG uptake on PET/lytic change on CT is most accurate to show progression of bone metastases. Assessments of these processes during therapy are necessary for the precise evaluation of bone metastases. (author)

  16. A semi-automated technique determining the liver standardized uptake value reference for tumor delineation in FDG PET-CT.

    Kenji Hirata

    Full Text Available BACKGROUND: 18F-fluorodeoxyglucose (FDG positron emission tomography (PET-computed tomography (CT has been an essential modality in oncology. We propose a semi-automated algorithm to objectively determine liver standardized uptake value (SUV, which is used as a threshold for tumor delineation. METHODS: A large spherical volume of interest (VOI was placed manually to roughly enclose the right lobe (RL of the liver. For each voxel in this VOI, a coefficient of variation of voxel values (CVv was calculated for neighboring voxels within a radius of d/2. The voxel with the minimum CVv was then selected, where a 30-mm spherical VOI was placed at that voxel in accordance with PERCIST criteria. Two nuclear medicine physicians independently defined 30-mm VOIs manually on 124 studies in 62 patients to generate the standard values, against which the results from the new method were compared. RESULTS: The semi-automated method was successful in determining the liver SUV that was consistent between the two physicians in all the studies (d = 80 mm. The liver SUV threshold (mean +3 SD within 30-mm VOI determined by the new semi-automated method (3.12±0.61 was not statistically different from those determined by the manual method (Physician-1: 3.14±0.58, Physician-2: 3.15±0.58. The semi-automated method produced tumor volumes that were not statistically different from those by experts' manual operation. Furthermore, the volume change in the two sequential studies had no statistical difference between semi-automated and manual methods. CONCLUSIONS: Our semi-automated method could define the liver SUV robustly as the threshold value used for tumor volume measurements according to PERCIST. The method could avoid possible subjective bias of manual liver VOI placement and is thus expected to improve clinical performance of volume-based parameters for prediction of cancer treatment response.

  17. The role of metabolic tumor volume and total lesion glycolysis on {sup 18}F-FDG PET/CT in the prognosis of epithelial ovarian cancer

    Lee, Jeong Won; Cho, Arthur; Lee, Jae-Hoon; Yun, Mijin; Lee, Jong Doo; Kang, Won Jun [Yonsei University College of Medicine, Department of Nuclear Medicine, 134 Shinchon-dong, Seodaemoon-gu, Seoul (Korea, Republic of); Kim, Young Tae [Yonsei University College of Medicine, Department of Obstetrics and Gynecology, 134 Shinchon-dong, Seodaemoon-gu, Seoul (Korea, Republic of)

    2014-10-15

    This study assessed the prognostic value of pre-operative 2-[{sup 18}F] fluoro-2-deoxy-D-glucose ({sup 18}F-FDG) positron emission tomography/computed tomography (PET/CT) volumetric parameters, including metabolic tumor volume (MTV) and total lesion glycolysis (TLG), in patients with epithelial ovarian cancer. A total of 175 patients with epithelial ovarian cancer who underwent {sup 18} F-FDG PET/CT and subsequent cytoreductive surgery were retrospectively enrolled. Maximum standardized uptake value (SUVmax) on {sup 18}F-FDG PET/CT was measured for all patients. Because nine patients showed low tumor-to-background uptake ratios, MTV and TLG were measured in 166 patients. Univariate and multivariate analyses were performed to evaluate the prognostic significance of SUVmax, MTV, TLG, and clinicopathological factors for disease progression-free survival. Disease progressed in 78 (44.6 %) of the 175 patients, and the 2-year disease progression-free survival rate was 57.5 %. Univariate analysis showed that tumor stage, histopathological type, presence of regional lymph node metastasis, residual tumor after cytoreductive surgery, pre-operative serum carbohydrate antigen 125 (CA125) level, SUVmax, MTV, and TLG were significant prognostic factors (p < 0.05). Among these variables, tumor stage (p = 0.0006) and TLG (p = 0.008) independently correlated with disease progression-free survival on multivariate analysis. The disease progression rate was only 2.3 % in stage I-II patients with low TLG (≤100.0), compared to 80.0 % in stage III-IV patients with high TLG (>100.0). Along with tumor stage, TLG is an independent prognostic factor for disease progression after cytoreductive surgery in patients with epithelial ovarian cancer. By combining tumor stage and TLG, one can further stratify the risk of disease progression for patients undergoing cytoreductive surgery. (orig.)

  18. Impact on medical economics of [18F]FDG-PET application in health insurance of diagnosis of tumors unapproved in the present insurance

    Medical costs were estimated for the assumed case of approval of [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) and/or PET-CT diagnoses (D) of all tumors which are now unapproved in the national health insurance system. The number of D was predicted to be 275,785 examinations in 2008, based on results of 3 questionnaires to PET facilities in 2004-2006. The average D examination fee was found to be 78,350 Japanese yen when calculated from the proportion of examinations with the fee of 20% reduction and ratio of PET/PET-CT examinations. Frequency of surgical operation was assumed to be reduced by 27% because of precised D for the stage decision of malignant neoplasm. These assumptions resulted in the impact of 3,164,258,753 Japanese yen decrease by D approval in the insurance. Integration of precise D image reading by experts, patients' anamnesis, physical and biochemical findings, and other imaging diagnosis enables the decision of the stage of malignancy more accurate; based on which establishment of rational therapeutic planning is possible; which is important both for saving the cost of medicare and for improving its quality. (R.T.)

  19. Recurrent differentiated thyroid cancer: towards personalized treatment based on evaluation of tumor characteristics with PET (THYROPET Study): study protocol of a multicenter observational cohort study

    After initial treatment of differentiated thyroid carcinoma (DTC) patients are followed with thyroglobulin (Tg) measurements to detect recurrences. In case of elevated levels of Tg and negative neck ultrasonography, patients are treated 'blindly' with Iodine-131 (131I). However, in up to 50% of patients, the post-therapy scan reveals no 131I-targeting of tumor lesions. Such patients derive no benefit from the blind therapy but are exposed to its toxicity. Alternatively, iodine-124 (124I) Positron Emission Tomography/Computed Tomography (PET/CT) has become available to visualize DTC lesions and without toxicity. In addition to this, 18F-fluorodeoxyglucose (18F-FDG) PET/CT detects the recurrent DTC phenotype, which lost the capacity to accumulate iodine. Taken together, the combination of 124I and 18F-FDG PET/CT has potential to stratify patients for treatment with 131I. In a multicenter prospective observational cohort study the hypothesis that the combination of 124I and 18F-FDG PET/CT can avoid futile 131I treatments in patients planned for ‘blind’ therapy with 131I, is tested. One hundred patients planned for 131I undergo both 124I and 18F-FDG PET/CT after rhTSH stimulation. Independent of the outcome of the scans, all patients will subsequently receive, after thyroid hormone withdrawal, the 131I therapy. The post 131I therapeutic scintigraphy is compared with the outcome of the 124I and 18F-FDG PET/CT in order to evaluate the diagnostic value of the combined PET modalities. This study primary aims to reduce the number of futile 131I therapies. Secondary aims are the nationwide introduction of 124I PET/CT by a quality assurance and quality control (QA/QC) program, to correlate imaging outcome with histopathological features, to compare 124I PET/CT after rhTSH and after withdrawal of thyroid hormone, and to compare 124I and 131I dosimetry. This study aims to evaluate the potential value of the combination of 124I and 18F-FDG PET/CT in the prevention

  20. Evaluation of the angiogenesis inhibitor KR-31831 in SKOV-3 tumor-bearing mice using 64Cu-DOTA-VEGF121 and microPET

    KR-31831 ((2R,3R,4S)-6-amino-4-[N-(4-chloropheyl)-N-(1H-imidazol-2ylmethyl)amino] -3-hydroxyl-2-methyl-2-dimethoxymethyl-3,4-dihydro-2H-1-benzopyran), an angiogenesis inhibitor, was evaluated in tumor-bearing mice using molecular imaging technology. Pre-treatment microPET images were acquired on SKOV-3 cell-implanted nude mice after injection with 64Cu-DOTA-VEGF121. KR-31831 (50 mg/kg) was then injected intraperitoneally into the treatment group (n=3), while injection vehicle was injected into the control (n=4) and blocking (n=3) groups. After injections occurred daily for 28 days, all groups of mice underwent post-treatment microPET imaging after injection with 64Cu-DOTA-VEGF121. The post-treatment images showed high tumor uptake in the control group and reduced tumor uptake in both the blocking and treatment groups. ROI analysis of the tumor images revealed 6.25%±1.18% ID/g at 1 h, 6.55%±0.69% ID/g at 2 h, and 4.68%±0.63% ID/g at 16 h in the control group; 3.87%±0.45% ID/g at 1 h, 4.50%±0.44% ID/g at 2 h, and 3.63%±0.25% ID/g at 16 h in the blocking group; and 4.03%±0.74% ID/g at 1 h, 4.37%±0.67% ID/g at 2 h, and 3.83%±0.90% ID/g at 16 h in the treatment group. Biodistribution obtained after the post-treatment microPET imaging also demonstrated high tumor uptake (3.74%±0.27% ID/g) in the control group and reduced uptakes in both the blocking group (2.69%±0.73% ID/g, P<.05) and the treatment group (3.11%±0.25% ID/g, P<.05), which correlated well with microPET imaging data. Immunofluorescence analysis showed higher levels of VEGFR2 and CD31 expressions in tumor tissues of the control and blocking groups than in tumor tissues of the treatment group. These results suggest that the antiangiogenic activity of KR-31831 is mediated through VEGFR2 and microPET serves as a useful molecular imaging tool for evaluation of a newly developed angiogenesis inhibitor, KR-31831.

  1. Comparison of neuroendocrine tumor detection and characterization using DOTATOC-PET in correlation with contrast enhanced CT and delayed contrast enhanced MRI

    Giesel, F.L., E-mail: f.giesel@dkfz.de [Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120 Heidelberg (Germany); Kratochwil, C., E-mail: Clemens.kratochwil@t-online.de [Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120 Heidelberg (Germany); Mehndiratta, A., E-mail: dramit.mehndiratta@gmail.com [Keble College, Institute of Biomedical Engineering, University of Oxford, Parks Road, Oxford OX13PG (United Kingdom); Wulfert, S., E-mail: sarah.wulfert@googlemail.com [Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120 Heidelberg (Germany); Moltz, J.H., E-mail: Jan.Moltz@mevis.fraunhofer.de [Fraunhofer MEVIS, Bremen (Germany); Zechmann, C.M., E-mail: christian.zechmann@med.uni-heidelberg.de [Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120 Heidelberg (Germany); Kauczor, H.U., E-mail: Hans-ulrich.kauczor@med.uni-heidelberg.de [Department of Diagnostic and Interventional Radiology, University of Heidelberg, INF 110, 69120 Heidelberg (Germany); Haberkorn, U., E-mail: uwe.haberkorn@med.uni-heidelberg.de [Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120 Heidelberg (Germany); Ley, S., E-mail: ley@gmx.de [Department of Diagnostic and Interventional Radiology, University of Heidelberg, INF 110, 69120 Heidelberg (Germany); Department of Medical Imaging, Toronto General Hospital (Canada)

    2012-10-15

    Purpose: We evaluated the rate of successful characterization of gastroenteropancreatic neuroendocrine tumors (NETs) present with an increased somatostatin receptor, comparing CE-CT with CE-MRI, each in correlation with DOTATOC-PET. Methods and materials: 8 patients with GEP-NET were imaged using CE-MRI (Gd-EOB-DTPA), CE-CT (Imeron 400) and DOTATOC-PET. Contrast-enhancement of normal liver-tissue and metastasis was quantified with ROI-technique. Tumor delineation was assessed with visual-score in blind-read-analysis by two experienced radiologists. Results: Out of 40 liver metastases in patients with NETs, all were detected by CE-MRI and the lesion extent could be adequately assessed, whereas CT failed to detect 20% of all metastases. The blind-read-score of CT in arterial and portal phase was median −0.65 and −1.4, respectively, and 2.7 for delayed-MRI. The quantitative ROI-analysis presented an improved contrast-enhancement-ratio with a median of 1.2, 1.6 and 3.3 for CE-CT arterial, portal-phase and delayed-MRI respectively. Conclusion: Late CE-MRI was superior to CE-CT in providing additionally morphologic characterization and exact lesion extension of hepatic metastases from neuroendocrine tumor detected with DOTATOC-PET. Therefore, late enhanced Gd-EOB-DTPA-MRI seems to be the adequate imaging modality for combination with DOTATOC-PET to provide complementary (macroscopic and molecular) tumor characterization in hepatic metastasized NETs.

  2. Impact of blood glucose, diabetes, insulin, and obesity on standardized uptake values in tumors and healthy organs on 18F-FDG PET/CT

    Introduction: Chronically altered glucose metabolism interferes with 18F-FDG uptake in malignant tissue and healthy organs and may therefore lower tumor detection in 18F-FDG PET/CT. The present study assesses the impact of elevated blood glucose levels (BGL), diabetes, insulin treatment, and obesity on 18F-FDG uptake in tumors and biodistribution in normal organ tissues. Methods: 18F-FDG PET/CT was analyzed in 90 patients with BGL ranging from 50 to 372 mg/dl. Of those, 29 patients were diabetic and 21 patients had received insulin prior to PET/CT; 28 patients were obese with a body mass index > 25. The maximum standardized uptake value (SUVmax) of normal organs and the main tumor site was measured. Differences in SUVmax in patients with and without elevated BGLs, diabetes, insulin treatment, and obesity were compared and analyzed for statistical significance. Results: Increased BGLs were associated with decreased cerebral FDG uptake and increased uptake in skeletal muscle. Diabetes and insulin diminished this effect, whereas obesity slightly enhanced the outcome. Diabetes and insulin also increased the average SUVmax in muscle cells and fat, whereas the mean cerebral SUVmax was reduced. Obesity decreased tracer uptake in several healthy organs by up to 30%. Tumoral uptake was not significantly influenced by BGL, diabetes, insulin, or obesity. Conclusions: Changes in BGLs, diabetes, insulin, and obesity affect the FDG biodistribution in muscular tissue and the brain. Although tumoral uptake is not significantly impaired, these findings may influence the tumor detection rate and are therefore essential for diagnosis and follow-up of malignant diseases

  3. 64Cu-ATSM and 18FDG PET uptake and 64Cu-ATSM autoradiography in spontaneous canine tumors: comparison with pimonidazole hypoxia immunohistochemistry

    The aim of this study was to compare 64Cu-diacetyl-bis(N4-methylsemicarbazone) (64Cu-ATSM) and 18FDG PET uptake characteristics and 64Cu-ATSM autoradiography to pimonidazole immunohistochemistry in spontaneous canine sarcomas and carcinomas. Biopsies were collected from individual tumors between approximately 3 and 25 hours after the intravenous injection of 64Cu-ATSM and pimonidazole. 64Cu-ATSM autoradiography and pimonidazole immunostaining was performed on sectioned biopsies. Acquired 64Cu-ATSM autoradiography and pimonidazole images were rescaled, aligned and their distribution patterns compared. 64Cu-ATSM and 18FDG PET/CT scans were performed in a concurrent study and uptake characteristics were obtained for tumors where available. Maximum pimonidazole pixel value and mean pimonidazole labeled fraction was found to be strongly correlated to 18FDG PET uptake levels, whereas more varying results were obtained for the comparison to 64Cu-ATSM. In the case of the latter, uptake at scans performed 3 h post injection (pi) generally showed strong positive correlated to pimonidazole uptake. Comparison of distribution patterns of pimonidazole immunohistochemistry and 64Cu-ATSM autoradiography yielded varying results. Significant positive correlations were mainly found in sections displaying a heterogeneous distribution of tracers. Tumors with high levels of pimonidazole staining generally displayed high uptake of 18FDG and 64Cu-ATSM (3 h pi.). Similar regional distribution of 64Cu-ATSM and pimonidazole was observed in most heterogeneous tumor regions. However, tumor and hypoxia level dependent differences may exist with regard to the hypoxia specificity of 64Cu-ATSM in canine tumors

  4. The influence of tumor oxygenation on 18F-FDG (Fluorine-18 Deoxyglucose) uptake: A mouse study using positron emission tomography (PET)

    This study investigated whether changing a tumor's oxygenation would alter tumor metabolism, and thus uptake of 18F-FDG (fluorine-18 deoxyglucose), a marker for glucose metabolism using positron emission tomography (PET). Tumor-bearing mice (squamous cell carcinoma) maintained at 37°C were studied while breathing either normal air or carbogen (95% O2, 5% CO2), known to significantly oxygenate tumors. Tumor activity was measured within an automatically determined volume of interest (VOI). Activity was corrected for the arterial input function as estimated from image and blood-derived data. Tumor FDG uptake was initially evaluated for tumor-bearing animals breathing only air (2 animals) or only carbogen (2 animals). Subsequently, 5 animals were studied using two sequential 18F-FDG injections administered to the same tumor-bearing mouse, 60 min apart; the first injection on one gas (air or carbogen) and the second on the other gas. When examining the entire tumor VOI, there was no significant difference of 18F-FDG uptake between mice breathing either air or carbogen (i.e. air/carbogen ratio near unity). However, when only the highest 18F-FDG uptake regions of the tumor were considered (small VOIs), there was a modest (21%), but significant increase in the air/carbogen ratio suggesting that in these potentially most hypoxic regions of the tumor, 18F-FDG uptake and hence glucose metabolism, may be reduced by increasing tumor oxygenation. Tumor 18F-FDG uptake may be reduced by increases in tumor oxygenation and thus may provide a means to further enhance 18F-FDG functional imaging

  5. Feasibility of a semi-automated contrast-oriented algorithm for tumor segmentation in retrospectively gated PET images: phantom and clinical validation

    Carles, Montserrat; Fechter, Tobias; Nemer, Ursula; Nanko, Norbert; Mix, Michael; Nestle, Ursula; Schaefer, Andrea

    2015-12-01

    PET/CT plays an important role in radiotherapy planning for lung tumors. Several segmentation algorithms have been proposed for PET tumor segmentation. However, most of them do not take into account respiratory motion and are not well validated. The aim of this work was to evaluate a semi-automated contrast-oriented algorithm (COA) for PET tumor segmentation adapted to retrospectively gated (4D) images. The evaluation involved a wide set of 4D-PET/CT acquisitions of dynamic experimental phantoms and lung cancer patients. In addition, segmentation accuracy of 4D-COA was compared with four other state-of-the-art algorithms. In phantom evaluation, the physical properties of the objects defined the gold standard. In clinical evaluation, the ground truth was estimated by the STAPLE (Simultaneous Truth and Performance Level Estimation) consensus of three manual PET contours by experts. Algorithm evaluation with phantoms resulted in: (i) no statistically significant diameter differences for different targets and movements (Δ φ =0.3+/- 1.6 mm); (ii) reproducibility for heterogeneous and irregular targets independent of user initial interaction and (iii) good segmentation agreement for irregular targets compared to manual CT delineation in terms of Dice Similarity Coefficient (DSC  =  0.66+/- 0.04 ), Positive Predictive Value (PPV  =  0.81+/- 0.06 ) and Sensitivity (Sen.  =  0.49+/- 0.05 ). In clinical evaluation, the segmented volume was in reasonable agreement with the consensus volume (difference in volume (%Vol)  =  40+/- 30 , DSC  =  0.71+/- 0.07 and PPV  =  0.90+/- 0.13 ). High accuracy in target tracking position (Δ ME) was obtained for experimental and clinical data (Δ ME{{}\\text{exp}}=0+/- 3 mm; Δ ME{{}\\text{clin}}=0.3+/- 1.4 mm). In the comparison with other lung segmentation methods, 4D-COA has shown the highest volume accuracy in both experimental and clinical data. In conclusion, the accuracy in volume

  6. Monitoring of Tumor Growth with [(18)F]-FET PET in a Mouse Model of Glioblastoma: SUV Measurements and Volumetric Approaches.

    Holzgreve, Adrien; Brendel, Matthias; Gu, Song; Carlsen, Janette; Mille, Erik; Böning, Guido; Mastrella, Giorgia; Unterrainer, Marcus; Gildehaus, Franz J; Rominger, Axel; Bartenstein, Peter; Kälin, Roland E; Glass, Rainer; Albert, Nathalie L

    2016-01-01

    Noninvasive tumor growth monitoring is of particular interest for the evaluation of experimental glioma therapies. This study investigates the potential of positron emission tomography (PET) using O-(2-(18)F-fluoroethyl)-L-tyrosine ([(18)F]-FET) to determine tumor growth in a murine glioblastoma (GBM) model-including estimation of the biological tumor volume (BTV), which has hitherto not been investigated in the pre-clinical context. Fifteen GBM-bearing mice (GL261) and six control mice (shams) were investigated during 5 weeks by PET followed by autoradiographic and histological assessments. [(18)F]-FET PET was quantitated by calculation of maximum and mean standardized uptake values within a universal volume-of-interest (VOI) corrected for healthy background (SUVmax/BG, SUVmean/BG). A partial volume effect correction (PVEC) was applied in comparison to ex vivo autoradiography. BTVs obtained by predefined thresholds for VOI definition (SUV/BG: ≥1.4; ≥1.6; ≥1.8; ≥2.0) were compared to the histologically assessed tumor volume (n = 8). Finally, individual "optimal" thresholds for BTV definition best reflecting the histology were determined. In GBM mice SUVmax/BG and SUVmean/BG clearly increased with time, however at high inter-animal variability. No relevant [(18)F]-FET uptake was observed in shams. PVEC recovered signal loss of SUVmean/BG assessment in relation to autoradiography. BTV as estimated by predefined thresholds strongly differed from the histology volume. Strikingly, the individual "optimal" thresholds for BTV assessment correlated highly with SUVmax/BG (ρ = 0.97, p SUV measurements is feasible for glioma imaging in the GBM mouse model. PVEC is beneficial to improve accuracy of [(18)F]-FET PET SUV quantification. Although SUVmax/BG and SUVmean/BG increase during the disease course, these parameters do not correlate with the respective tumor size. For the first time, we propose a histology-verified method allowing appropriate individual BTV

  7. Changes in skeletal tumor activity on {sup 18}F-choline PET/CT in patients receiving {sup 223}radium radionuclide therapy for metastatic prostate cancer

    Miyazaki, Kyle S. [Oncology Research Dept. and Hamamatsu/Queen' s PET Imaging Center, The Queen' s Medical Center, Honolulu (United States); Kang, Yu; Kwee, Sandi A. [Dept. of Medical Physics, School of Allied Health Sciences, University of Nevada Las Vegas, Las Vegas (United States)

    2015-06-15

    Radium-223 dichloride is an alpha-emitting radiopharmaceutical shown to prolong survival in patients with castrate-resistant prostate cancer (CRPC) and symptomatic skeletal metastases. This report describes in two patients the acute changes in bone metastatic activity detected by F-18 choline PET/CT imaging midway during treatment with radium-223 dichloride. In addition to visual and standardized uptake value analysis, changes in the whole-body tumor burden were quantified by measuring the difference in net metabolically active tumor volume (MATV) and total lesion activity (TLA) between pre- and mid-treatment PET scans. After the third dose of radium-223 dichloride, near-total disappearance of abnormal skeletal activity was observed in one case (net MATV change from 260.7 to 0.8 cc; net TLA change from 510.7 to 2.1), while a heterogeneous tumor response was observed in the other (net MATV change from 272.2 to 241.3 cc; net TLA change from 987.1 to 779.4). Corresponding normalization and persistent elevation in serum alkaline phosphatase levels were observed in these cases, respectively. Further research is needed to determine the predictive value of serial F-18 choline PET/CT imaging in patients receiving radium-223 dichloride for CRPC.

  8. Estado actual del PET en los tumores de cabeza y cuello: impacto en la planificación del tratamiento radioterápico Current state of PET in head and neck tumours: impact on the planning of radiotherapy treatment

    F. Arias de la Vega; M.J. García-Velloso; G. Asín; Rico, M.; M.T. Vila; V. Chicata

    2009-01-01

    El uso de la tomografía de emisión de positrones (PET) en los tumores de cabeza y cuello está cada vez más extendido. A sus indicaciones clínicas -especialmente en el estadiaje de los pacientes pero también en la valoración de la respuesta al tratamiento y en la detección o confirmación de recidivas-, se une ahora el posible impacto terapéutico a través de su aportación en la planificación del tratamiento radioterápico. La integración de las imágenes del PET en el proceso radioterápico parece...

  9. MicroPET assessment of androgenic control of glucose and acetate uptake in the rat prostate and a prostate cancer tumor model

    PET has been used to monitor changes in tumor metabolism in breast cancer following hormonal therapy. This study was undertaken to determine whether PET imaging could evaluate early metabolic changes in prostate tumor following androgen ablation therapy. Studies were performed comparing two positron-emitting tracers, 18F-FDG and 11C-acetate, in Sprague-Dawley male rats to monitor metabolic changes in normal prostate tissue. Additional studies were performed in nude mice bearing the CWR22 androgen-dependent human prostate tumor to evaluate metabolic changes in prostate tumor. In rats, for the androgen ablation pretreatment, 1 mg diethylstilbestrol (DES) was injected subcutaneously 3 and 24 hours before tracer injection. For androgen pretreatment, 500 μg dihydrotestosterone (DHT) was injected intraperitoneally 2 and 6 hours before tracer injection. The rats were divided into three groups, Group A (no-DES, no-DHT, n = 18), Group B (DES, no-DHT, n = 18) and Group C (DES, DHT, n = 18). In each group, 10 animals received 18F-FDG, whereas the remaining eight animals were administered 11C-acetate. Rats were sacrificed at 120 min post-injection of 18F-FDG or 30 min post-injection of 11C-acetate. Pretreatment of the mouse model using DHT (200 μg of DHT in 0.1 mL of sunflower seed oil) or DES (200 μg of DES in 0.1 mL of sunflower seed oil) was conducted every 2 days for one week. Mice were imaged with both tracers in the microPET scanner (Concorde Microsystems Inc.). DES treatment caused a decrease in acetate and glucose metabolism in the rat prostate. Co-treatment with DHT maintained the glucose metabolism levels at baseline values. In the tumor bearing mice, similar effects were seen in 18F-FDG study, while there was no significant difference in 11C-acetate uptake. These results indicate that changes in serum testosterone levels influence 18F-FDG uptake in the prostate gland, which is closely tied to glucose metabolism, within 24 hours of treatment and in the prostate

  10. Probable IgG4-related sclerosing disease presenting as a gastric submucosal tumor with an intense tracer uptake on PET/CT: a case report.

    Otsuka, Ryota; Kano, Masayuki; Hayashi, Hideki; Hanari, Naoyuki; Gunji, Hisashi; Hayano, Koichi; Matsubara, Hisahiro

    2016-12-01

    A 44-year-old man consulted an internist because of abnormalities in an upper gastrointestinal series. It showed an elevated lesion with central depression in the greater curvature of the middle part of the stomach. Upper gastrointestinal endoscopy showed an elevated lesion with central depression, bridging hold, and no abnormalities of the gastric mucosa in the greater curvature of the middle part of the stomach. Endoscopic ultrasonography showed a submucosal tumor derived from the muscle layer of the stomach. Computed tomography showed a 22-mm tumor in the upper part of the stomach. Integrated position emission tomography/computed tomography (PET/CT) showed an intense tracer uptake by the tumor. Based on these findings, a gastrointestinal stromal tumor was suspected and laparoscopic endoscopic cooperative surgery was performed. A histopathological examination showed lymphoplasmacytic infiltration and fibrosis, and an immunohistochemical analysis showed the infiltration of IgG4-positive lymphoplasmacytic cells. The probable diagnosis was IgG4-related sclerosing disease of the stomach. We herein describe a rare case of probable IgG4-related sclerosing disease which presented as a gastric submucosal tumor. PET/CT is a useful imaging technique for the diagnosis and follow-up of this disease. PMID:27059471

  11. Increasing the Accuracy of Volume and ADC Delineation for Heterogeneous Tumor on Diffusion-Weighted MRI: Correlation with PET/CT

    Purpose: To improve the accuracy of volume and apparent diffusion coefficient (ADC) measurements in diffusion-weighted magnetic resonance imaging (MRI), we proposed a method based on thresholding both the b0 images and the ADC maps. Methods and Materials: In 21 heterogeneous lesions from patients with metastatic gastrointestinal stromal tumors (GIST), gross lesion were manually contoured, and corresponding volumes and ADCs were denoted as gross tumor volume (GTV) and gross ADC (ADCg), respectively. Using a k-means clustering algorithm, the probable high-cellularity tumor tissues were selected based on b0 images and ADC maps. ADC and volume of the tissues selected using the proposed method were denoted as thresholded ADC (ADCthr) and high-cellularity tumor volume (HCTV), respectively. The metabolic tumor volume (MTV) in positron emission tomography (PET)/computed tomography (CT) was measured using 40% maximum standard uptake value (SUVmax) as the lower threshold, and corresponding mean SUV (SUVmean) was also measured. Results: HCTV had excellent concordance with MTV according to Pearson's correlation (r=0.984, Pthr correlated significantly and strongly with SUVmean (r=−0.807, Pmax (r=−0.843, Pg. Conclusions: The proposed lesion-adaptive semiautomatic method can help segment high-cellularity tissues that match hypermetabolic tissues in PET/CT and enables more accurate volume and ADC delineation on diffusion-weighted MR images of GIST

  12. Small animal PET imaging of TAG-72 expressing tumor using 68Ga-NOTA-3E8 Fab radioimmunoconjugate

    The tumor-associated glycoprotein TAG-72 is express ed in the majority of human adenocarcinomas but is rarely expressed in most normal tissues, which makes it a potential target for the diagnosis and therapy of a variety of human cancer. 3E8 is anti-TAG-72 humanized antibody. Antibody fragments have some advantages such as improved pharmacokinetics and reduced immunogenicity compared to whole IgG. 68Ga is a short-lived positron emitter (t1/268 min; β+, 88%) that is produced, independent from a cyclotron, by a 68Ge/68Ga generator. The parent nuclide 68Ge has a long half-life (270.8 day), allowing its use as a generator for more than 1 year. A 68Ga is labeled with antibodies through bifunctional chelators, which allows possible kit formulation and which wide availability of the nuclear imaging agents. In this study, Fab fragment of anti-TAG-72 humanized Ab (3E8) was conjugated with 2-(p-isothiocyanatobenzyl)-1,4,7-triazacyclononane-1,4, 7-triacetic acid (p-SCN-Bn-NOTA) and radiolabeled with 68Ga and acquire small animal PET image

  13. In vivo tumor vasculature targeted PET/NIRF imaging with TRC105(Fab)-conjugated, dual-labeled mesoporous silica nanoparticles.

    Chen, Feng; Nayak, Tapas R; Goel, Shreya; Valdovinos, Hector F; Hong, Hao; Theuer, Charles P; Barnhart, Todd E; Cai, Weibo

    2014-11-01

    Multifunctional mesoporous silica nanoparticles (MSN) with well-integrated multimodality imaging properties have generated increasing research interest in the past decade. However, limited progress has been made in developing MSN-based multimodality imaging agents to image tumors. We describe the successful conjugation of, copper-64 ((64)Cu, t1/2 = 12.7 h), 800CW (a near-infrared fluorescence [NIRF] dye), and TRC105 (a human/murine chimeric IgG1 monoclonal antibody) to the surface of MSN via well-developed surface engineering procedures, resulting in a dual-labeled MSN for in vivo targeted positron emission tomography (PET) imaging/NIRF imaging of the tumor vasculature. Pharmacokinetics and tumor targeting efficacy/specificity in 4T1 murine breast tumor-bearing mice were thoroughly investigated through various in vitro, in vivo, and ex vivo experiments. Dual-labeled MSN is an attractive candidate for future cancer theranostics. PMID:24937108

  14. Preparation of [6lCu]Bleomycin Complexes as a Potential PET radiopharmaceutical and it's biological evaluation in normal and tumor-bearing rodents

    [61Cu]Bleomycin ([61Cu]Bleomycin) was prepared using [61Cu]CuCl2, produced via natZn(p,x)61Cu (180μA proton irradiation, 22 MeV, 3.2 h), purified by ion chromatography method. [61Cu]Bleomycin was prepared at optimized conditions (room temperature, 45 min, 0.1 mg bleomycin for 2-10 mCi 61CuCl2) with radiochemical purity over 98% determined by HPLC and radio-thin layer chromatography. [61Cu]Bleomycin was administered into the normal and tumor bearing rodents up to 210 minutes followed by biodistribution and co incidence imaging studies. A significant tumor/non tumor accumulation was observed either by animal scarification or imaging method. [61Cu] Bleomycin can be a potential PET radiotracer for tumor imaging.

  15. Observer variation in contouring gross tumor volume in patients with poorly defined non-small-cell lung tumors on CT: the impact of 18FDG-hybrid PET fusion

    Purpose: To quantify interobserver variation in gross tumor volume (GTV) localization using CT images for patients with non-small-cell lung carcinoma and poorly defined tumors on CT and to determine whether variability would be reduced if coregistered 2-[18F]fluoro-2-deoxy-d-glucose (FDG)-hybrid positron emission tomography (PET) with CT images were used. Methods and Materials: Prospectively, 30 patients with non-small-cell lung carcinoma had CT and FDG-hybrid PET examinations in radiation treatment position on the same day. Images were coregistered using eight fiducial markers. Guidelines were established for contouring GTVs. Three radiation oncologists performed localization independently. The coefficient of variation was used to assess interobserver variability. Results: The size of the GTV defined showed great variation among observers. The mean ratios of largest to smallest GTV were 2.31 and 1.56 for CT only and for CT/FDG coregistered data, respectively. The addition of PET reduced this ratio in 23 of 30 cases and increased it in 7. The mean coefficient of variation for GTV based on the combined modalities was significantly smaller (p<0.01) than that for CT data only. Conclusions: High observer variability in CT-based definition of the GTV can occur. A more consistent definition of the GTV can often be obtained if coregistered FDG-hybrid PET images are used

  16. PET/CT Based In Vivo Evaluation of 64Cu Labelled Nanodiscs in Tumor Bearing Mice

    Huda, Pie; Binderup, Tina; Pedersen, Martin Cramer;

    2015-01-01

    64Cu radiolabelled nanodiscs based on the 11 α-helix MSP1E3D1 protein and 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphatidylcholine lipids were, for the first time, followed in vivo by positron emission tomography for evaluating the biodistribution of nanodiscs. A cancer tumor bearing mouse model was...... radiolabelling of proteins via a chelating agent, DOTA, was developed. The reaction was performed at sufficiently mild conditions to be compatible with labelling of the protein part of a lipid-protein particle while fully conserving the particle structure including the amphipathic protein fold....

  17. 64Cu-Labeled Lissamine Rhodamine B: A Promising PET Radiotracer Targeting Tumor Mitochondria

    Zhou, Yang; Kim, Young-Seung; Yan, Xin; Jacobson, Orit; Chen, Xiaoyuan; Liu, Shuang

    2011-01-01

    The enhanced mitochondrial potential in carcinoma cells is an important characteristic of cancer. It is of great current interest to develop a radiotracer that is sensitive to the mitochondrial potential changes at the early stage of tumor growth. In this report, we present the synthesis and evaluation of 64Cu-labeled Lissamine Rhodamine B (LRB), 64Cu(DOTA-LRB) (DOTA-LRB = 2-(6-(diethylamino)-3-(diethyliminio)-3H-xanthen-9-yl)-5-(N-(2-(2-(4,7,10-tris(carboxymethyl)-1,4,7,10-tetraazacyclo-dode...

  18. Variability of Gross Tumor Volume in Nasopharyngeal Carcinoma Using 11C-Choline and 18F-FDG PET/CT.

    Jun Jiang

    Full Text Available This study was conducted to evaluate the variability of gross tumor volume (GTV using 11C-Choline and 18F-FDG PET/CT images for nasopharyngeal carcinomas boundary definition. Assessment consisted of inter-observer and inter-modality variation analysis. Four radiation oncologists were invited to manually contour GTV by using PET/CT fusion obtained from a cohort of 12 patients with nasopharyngeal carcinoma (NPC and who underwent both 11C-Choline and 18F-FDG scans. Student's paired-sample t-test was performed for analyzing inter-observer and inter-modality variability. Semi-automatic segmentation methods, including thresholding and region growing, were also validated against the manual contouring of the two types of PET images. We observed no significant variation in the results obtained by different oncologists in terms of the same type of PET/CT volumes. Choline fusion volumes were significantly larger than the FDG volumes (p < 0.0001, mean ± SD = 18.21 ± 8.19. While significantly consistent results were obtained between the oncologists and the standard references in Choline volumes compared with those in FDG volumes (p = 0.0025. Simple semi-automatic delineation methods indicated that 11C-Choline PET images could provide better results than FDG volumes (p = 0.076, CI = [-0.29, 0.025]. 11C-Choline PET/CT may be more advantageous in GTV delineation for the radiotherapy of NPC than 18F-FDG. Phantom simulations and clinical trials should be conducted to prove the possible improvement of the treatment outcome.

  19. Cancer cells metabolically "fertilize" the tumor microenvironment with hydrogen peroxide, driving the Warburg effect: implications for PET imaging of human tumors.

    Martinez-Outschoorn, Ubaldo E; Lin, Zhao; Trimmer, Casey; Flomenberg, Neal; Wang, Chenguang; Pavlides, Stephanos; Pestell, Richard G; Howell, Anthony; Sotgia, Federica; Lisanti, Michael P

    2011-08-01

    .  Given that cancer-associated fibroblasts show the largest increases in glucose uptake, we suggest that PET imaging of human tumors, with Fluoro-2-deoxy-D-glucose (F-2-DG), may be specifically detecting the tumor stroma, rather than epithelial cancer cells. PMID:21778829

  20. A method for partial volume correction of PET-imaged tumor heterogeneity using expectation maximization with a spatially varying point spread function

    Barbee, David L; Holden, James E; Nickles, Robert J; Jeraj, Robert [Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Ave, Madison, WI 53705 (United States); Flynn, Ryan T [Department of Radiation Oncology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52245 (United States)], E-mail: barbee.david@gmail.com

    2010-01-07

    Tumor heterogeneities observed in positron emission tomography (PET) imaging are frequently compromised by partial volume effects which may affect treatment prognosis, assessment or future implementations such as biologically optimized treatment planning (dose painting). This paper presents a method for partial volume correction of PET-imaged heterogeneous tumors. A point source was scanned on a GE Discovery LS at positions of increasing radii from the scanner's center to obtain the spatially varying point spread function (PSF). PSF images were fit in three dimensions to Gaussian distributions using least squares optimization. Continuous expressions were devised for each Gaussian width as a function of radial distance, allowing for generation of the system PSF at any position in space. A spatially varying partial volume correction (SV-PVC) technique was developed using expectation maximization (EM) and a stopping criterion based on the method's correction matrix generated for each iteration. The SV-PVC was validated using a standard tumor phantom and a tumor heterogeneity phantom and was applied to a heterogeneous patient tumor. SV-PVC results were compared to results obtained from spatially invariant partial volume correction (SINV-PVC), which used directionally uniform three-dimensional kernels. SV-PVC of the standard tumor phantom increased the maximum observed sphere activity by 55 and 40% for 10 and 13 mm diameter spheres, respectively. Tumor heterogeneity phantom results demonstrated that as net changes in the EM correction matrix decreased below 35%, further iterations improved overall quantitative accuracy by less than 1%. SV-PVC of clinically observed tumors frequently exhibited changes of {+-}30% in regions of heterogeneity. The SV-PVC method implemented spatially varying kernel widths and automatically determined the number of iterations for optimal restoration, parameters which are arbitrarily chosen in SINV-PVC. Comparing SV-PVC to SINV

  1. A method for partial volume correction of PET-imaged tumor heterogeneity using expectation maximization with a spatially varying point spread function

    Tumor heterogeneities observed in positron emission tomography (PET) imaging are frequently compromised by partial volume effects which may affect treatment prognosis, assessment or future implementations such as biologically optimized treatment planning (dose painting). This paper presents a method for partial volume correction of PET-imaged heterogeneous tumors. A point source was scanned on a GE Discovery LS at positions of increasing radii from the scanner's center to obtain the spatially varying point spread function (PSF). PSF images were fit in three dimensions to Gaussian distributions using least squares optimization. Continuous expressions were devised for each Gaussian width as a function of radial distance, allowing for generation of the system PSF at any position in space. A spatially varying partial volume correction (SV-PVC) technique was developed using expectation maximization (EM) and a stopping criterion based on the method's correction matrix generated for each iteration. The SV-PVC was validated using a standard tumor phantom and a tumor heterogeneity phantom and was applied to a heterogeneous patient tumor. SV-PVC results were compared to results obtained from spatially invariant partial volume correction (SINV-PVC), which used directionally uniform three-dimensional kernels. SV-PVC of the standard tumor phantom increased the maximum observed sphere activity by 55 and 40% for 10 and 13 mm diameter spheres, respectively. Tumor heterogeneity phantom results demonstrated that as net changes in the EM correction matrix decreased below 35%, further iterations improved overall quantitative accuracy by less than 1%. SV-PVC of clinically observed tumors frequently exhibited changes of ±30% in regions of heterogeneity. The SV-PVC method implemented spatially varying kernel widths and automatically determined the number of iterations for optimal restoration, parameters which are arbitrarily chosen in SINV-PVC. Comparing SV-PVC to SINV-PVC demonstrated

  2. Preclinical Evaluation of a Potential GSH Ester Based PET/SPECT Imaging Probe DT(GSHMe₂ to Detect Gamma Glutamyl Transferase Over Expressing Tumors.

    Harleen Khurana

    Full Text Available Gamma Glutamyl Transferase (GGT is an important biomarker in malignant cancers. The redox processes ensuing from GGT-mediated metabolism of extracellular GSH are implicated in critical aspects of tumor cell biology. Reportedly, Glutathione monoethyl ester (GSHMe is a substrate of GGT, which has been used for its rapid transport over glutathione. Exploring GGT to be an important target, a homobivalent peptide system, DT(GSHMe2 was designed to target GGT-over expressing tumors for diagnostic purposes. DT(GSHMe2 was synthesized, characterized and preclinically evaluated in vitro using toxicity, cell binding assays and time dependent experiments. Stable and defined radiochemistry with 99mTc and 68Ga was optimized for high radiochemical yield. In vivo biodistribution studies were conducted for different time points along with scintigraphic studies of radiolabeled DT(GSHMe2 on xenografted tumor models. For further validation, in silico docking studies were performed on GGT (hGGT1, P19440. Preclinical in vitro evaluations on cell lines suggested minimal toxicity of DT(GSHMe2 at 100 μM concentration. Kinetic analysis revealed transport of 99mTc-DT(GSHMe2 occurs via a saturable high-affinity carrier with Michaelis constant (Km of 2.25 μM and maximal transport rate velocity (Vmax of 0.478 μM/min. Quantitative estimation of GGT expression from western blot experiments showed substantial expression with 41.6 ± 7.07 % IDV for tumor. Small animal micro PET (Positron Emission Tomography/CT(Computed Tomography coregistered images depicted significantly high uptake of DT(GSHMe2 at the BMG-1 tumor site. ROI analysis showed high tumor to contra lateral muscle ratio of 9.33 in PET imaging studies. Avid accumulation of radiotracer was observed at tumor versus inflammation site at 2 h post i.v. injection in an Ehrlich Ascites tumor (EAT mice model, showing evident specificity for tumor. We propose DT(GSHMe2 to be an excellent candidate for prognostication and

  3. HER1-targeted 86Y-panitumumab possesses superior targeting characteristics than 86Y-cetuximab for PET imaging of human malignant mesothelioma tumors xenografts.

    Tapan K Nayak

    Full Text Available Malignant mesothelioma (MM, a rare form of cancer is often associated with previous exposure to fibrous minerals, such as asbestos. Asbestos exposure increases HER1-activity and expression in pre-clinical models. Additionally, HER1 over-expression is observed in the majority of MM cases. In this study, the utility of HER1-targeted chimeric IgG(1, cetuximab, and a human IgG(2, panitumumab, radiolabeled with (86Y, were evaluated for PET imaging to detect MM non-invasively in vivo, and to select an antibody candidate for radioimmunotherapy (RIT.Radioimmunoconjugates (RICs of cetuximab and panitumumab were prepared by conjugation with CHX-A''-DTPA followed by radiolabeling with (86Y. The HER1 expression of NCI-H226, NCI-H2052, NCI-H2452 and MSTO-211H human mesothelioma cells was characterized by flow cytometry. In vivo biodistribution, pharmacokinetic analysis, and PET imaging were performed in tumor bearing athymic mice.In vivo studies demonstrated high HER1 tumor uptake of both RICs. Significant reduction in tumor uptake was observed in mice co-injected with excess mAb (0.1 mg, demonstrating that uptake in the tumor was receptor specific. Significant differences were observed in the in vivo characteristics of the RICs. The blood clearance T(½α of (86Y-cetuximab (0.9-1.1 h was faster than (86Y-panitumumab (2.6-3.1 h. Also, the tumor area under the curve (AUC to liver AUC ratios of (86Y-panitumumab were 1.5 to 2.5 times greater than (86Y-cetuximab as observed by the differences in PET tumor to background ratios, which could be critical when imaging orthotopic tumors and concerns regarding radiation doses to normal organs such as the liver.This study demonstrates the more favorable HER1-targeting characteristics of (86Y-panitumumab than (86Y-cetuximab for non-invasive assessment of the HER1 status of MM by PET imaging. Due to lower liver uptake, panitumumab based immunoconjugates may fare better in therapy than corresponding cetuximab based

  4. PET-based compartmental modeling of 124I-A33 antibody: quantitative characterization of patient-specific tumor targeting in colorectal cancer

    The molecular specificity of monoclonal antibodies (mAbs) directed against tumor antigens has proven effective for targeted therapy of human cancers, as shown by a growing list of successful antibody-based drug products. We describe a novel, nonlinear compartmental model using PET-derived data to determine the ''best-fit'' parameters and model-derived quantities for optimizing biodistribution of intravenously injected 124I-labeled antitumor antibodies. As an example of this paradigm, quantitative image and kinetic analyses of anti-A33 humanized mAb (also known as ''A33'') were performed in 11 colorectal cancer patients. Serial whole-body PET scans of 124I-labeled A33 and blood samples were acquired and the resulting tissue time-activity data for each patient were fit to a nonlinear compartmental model using the SAAM II computer code. Excellent agreement was observed between fitted and measured parameters of tumor uptake, ''off-target'' uptake in bowel mucosa, blood clearance, tumor antigen levels, and percent antigen occupancy. This approach should be generally applicable to antibody-antigen systems in human tumors for which the masses of antigen-expressing tumor and of normal tissues can be estimated and for which antibody kinetics can be measured with PET. Ultimately, based on each patient's resulting ''best-fit'' nonlinear model, a patient-specific optimum mAb dose (in micromoles, for example) may be derived. (orig.)

  5. PET-based compartmental modeling of {sup 124}I-A33 antibody: quantitative characterization of patient-specific tumor targeting in colorectal cancer

    Zanzonico, Pat; O' Donoghue, Joseph A.; Humm, John L. [Memorial Sloan Kettering Cancer Center, Department of Medical Physics, New York, NY (United States); Carrasquillo, Jorge A.; Pandit-Taskar, Neeta; Ruan, Shutian; Larson, Steven M. [Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY (United States); Smith-Jones, Peter [Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY (United States); Stony Brook School of Medicine, Departments of Psychiatry and Radiology, Stony Brook, NY (United States); Divgi, Chaitanya [Columbia University Medical Center, New York, NY (United States); Scott, Andrew M. [La Trobe University, Olivia Newton-John Cancer Research Institute, Melbourne (Australia); Kemeny, Nancy E.; Wong, Douglas; Scheinberg, David [Memorial Sloan Kettering Cancer Center, Department of Medicine, New York, NY (United States); Fong, Yuman [Memorial Sloan Kettering Cancer Center, Department of Surgery, New York, NY (United States); City of Hope, Department of Surgery, Duarte, CA (United States); Ritter, Gerd; Jungbluth, Achem; Old, Lloyd J. [Memorial Sloan Kettering Cancer Center, Ludwig Institute for Cancer Research, New York, NY (United States)

    2015-10-15

    The molecular specificity of monoclonal antibodies (mAbs) directed against tumor antigens has proven effective for targeted therapy of human cancers, as shown by a growing list of successful antibody-based drug products. We describe a novel, nonlinear compartmental model using PET-derived data to determine the ''best-fit'' parameters and model-derived quantities for optimizing biodistribution of intravenously injected {sup 124}I-labeled antitumor antibodies. As an example of this paradigm, quantitative image and kinetic analyses of anti-A33 humanized mAb (also known as ''A33'') were performed in 11 colorectal cancer patients. Serial whole-body PET scans of {sup 124}I-labeled A33 and blood samples were acquired and the resulting tissue time-activity data for each patient were fit to a nonlinear compartmental model using the SAAM II computer code. Excellent agreement was observed between fitted and measured parameters of tumor uptake, ''off-target'' uptake in bowel mucosa, blood clearance, tumor antigen levels, and percent antigen occupancy. This approach should be generally applicable to antibody-antigen systems in human tumors for which the masses of antigen-expressing tumor and of normal tissues can be estimated and for which antibody kinetics can be measured with PET. Ultimately, based on each patient's resulting ''best-fit'' nonlinear model, a patient-specific optimum mAb dose (in micromoles, for example) may be derived. (orig.)

  6. Histopathologic validation of 3′-deoxy-3′-18F-fluorothymidine PET for detecting tumor repopulation during fractionated radiotherapy of human FaDu squamous cell carcinoma in nude mice18F-FLT PET repopulation -->

    Background and purpose: FaDu human squamous cell carcinoma (FaDu-hSCC) demonstrates accelerated tumor repopulation during fractionated irradiation with pathological validation (Ki-67 and BrdUrd makers) in a xenograft model system. However, these and other functional assays must be performed ex vivo and post hoc. We propose a novel, in vivo, real-time assay utilizing 18F-FLT PET. Material and methods: Nude mice with FaDu-hSCC were irradiated with 12 or 18 fractions of 1.8 Gy ([Dm] = 3.0 Gy), either daily or every second day. 18F-FLT micro-PET scans were performed at different time points, FLT parameters (SUVmax, SUVmean, and T/NT) were measured. Tumor sections were stained for Ki-67 and BrdUrd, a labeling index (LI) was calculated. Imaging-pathology correlation was determined by comparing FLT parameters and immunohistochemical results. Results: Measured SUVmax, SUVmean and T/NT decreased significantly after daily irradiation with 12 fractions in 12 days (P < 0.05) and 18 fractions in 18 days (P < 0.05). In contrast, these parameters increased in mice treated with 12 fractions in 24 days (P > 0.05) and 18 fractions in 36 days (P > 0.05), suggesting accelerated repopulation. Similarly, Ki-67 and BrdUrd LIs demonstrated significant decreases with daily irradiation (P < 0.05), and increases with every-second-day irradiation (P > 0.05). 18F-FLT parameters correlated strongly with proliferation markers (r2: 0.679–0.879, P < 0.001). Conclusions: 18F-FLT parameters were in good agreement with Ki-67 and BrdUrd Li. These results may support a potential role for 18F-FLT PET in real-time detection of tumor repopulation during fractionated radiotherapy

  7. PET/CT Based In Vivo Evaluation of 64Cu Labelled Nanodiscs in Tumor Bearing Mice.

    Pie Huda

    Full Text Available 64Cu radiolabelled nanodiscs based on the 11 α-helix MSP1E3D1 protein and 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphatidylcholine lipids were, for the first time, followed in vivo by positron emission tomography for evaluating the biodistribution of nanodiscs. A cancer tumor bearing mouse model was used for the investigations, and it was found that the approximately 13 nm nanodiscs, due to their size, permeate deeply into cancer tissue. This makes them promising candidates for both drug delivery purposes and as advanced imaging agents. For the radiolabelling, a simple approach for 64Cu radiolabelling of proteins via a chelating agent, DOTA, was developed. The reaction was performed at sufficiently mild conditions to be compatible with labelling of the protein part of a lipid-protein particle while fully conserving the particle structure including the amphipathic protein fold.

  8. PET/CT Based In Vivo Evaluation of 64Cu Labelled Nanodiscs in Tumor Bearing Mice

    Huda, Pie; Binderup, Tina; Pedersen, Martin Cramer; Midtgaard, Søren Roi; Elema, Dennis Ringkjøbing; Kjær, Andreas; Jensen, Mikael; Arleth, Lise

    2015-01-01

    64Cu radiolabelled nanodiscs based on the 11 α-helix MSP1E3D1 protein and 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphatidylcholine lipids were, for the first time, followed in vivo by positron emission tomography for evaluating the biodistribution of nanodiscs. A cancer tumor bearing mouse model was used for the investigations, and it was found that the approximately 13 nm nanodiscs, due to their size, permeate deeply into cancer tissue. This makes them promising candidates for both drug delivery purposes and as advanced imaging agents. For the radiolabelling, a simple approach for 64Cu radiolabelling of proteins via a chelating agent, DOTA, was developed. The reaction was performed at sufficiently mild conditions to be compatible with labelling of the protein part of a lipid-protein particle while fully conserving the particle structure including the amphipathic protein fold. PMID:26132074

  9. SU-E-I-100: Heterogeneity Studying for Primary and Lymphoma Tumors by Using Multi-Scale Image Texture Analysis with PET-CT Images

    Li, Dengwang [Shandong Normal University, Jinan, Shandong Province (China); Wang, Qinfen [Shandong Normal University, Jinan, Shandong (China); Li, H; Chen, J [Shandong Cancer Hospital and Institute, Jinan, Shandong (China)

    2014-06-01

    Purpose: The purpose of this research is studying tumor heterogeneity of the primary and lymphoma by using multi-scale texture analysis with PET-CT images, where the tumor heterogeneity is expressed by texture features. Methods: Datasets were collected from 12 lung cancer patients, and both of primary and lymphoma tumors were detected with all these patients. All patients underwent whole-body 18F-FDG PET/CT scan before treatment.The regions of interest (ROI) of primary and lymphoma tumor were contoured by experienced clinical doctors. Then the ROI of primary and lymphoma tumor is extracted automatically by using Matlab software. According to the geometry size of contour structure, the images of tumor are decomposed by multi-scale method.Wavelet transform was performed on ROI structures within images by L layers sampling, and then wavelet sub-bands which have the same size of the original image are obtained. The number of sub-bands is 3L+1.The gray level co-occurrence matrix (GLCM) is calculated within different sub-bands, thenenergy, inertia, correlation and gray in-homogeneity were extracted from GLCM.Finally, heterogeneity statistical analysis was studied for primary and lymphoma tumor using the texture features. Results: Energy, inertia, correlation and gray in-homogeneity are calculated with our experiments for heterogeneity statistical analysis.Energy for primary and lymphomatumor is equal with the same patient, while gray in-homogeneity and inertia of primaryare 2.59595±0.00855, 0.6439±0.0007 respectively. Gray in-homogeneity and inertia of lymphoma are 2.60115±0.00635, 0.64435±0.00055 respectively. The experiments showed that the volume of lymphoma is smaller than primary tumor, but thegray in-homogeneity and inertia were higher than primary tumor with the same patient, and the correlation with lymphoma tumors is zero, while the correlation with primary tumor isslightly strong. Conclusion: This studying showed that there were effective heterogeneity

  10. PET with 18-FDG and esophagus cancer: impact on the macroscopic tumor volume definition in radiotherapy and clinical consequences

    The impact of PET appears major during the balance of extension and the definition of radiotherapy treatment plans, that confirms the data of anterior series. The impact of PET on the local control rates and survival, as well as the toxicity is still to demonstrate in a randomized study. (N.C.)

  11. Value of delayed [{sup 18}F]-FDG-PET for brain tumors detection; Interet de la TEP au [{sup 18}F]-FDG double phase avec acquisition tardive dans la detection des tumeurs cerebrales

    Vermeere, V.; Burg, S. [Centre Eugene-Marquis, Service de Medecine Nucleaire, 35 - Rennes (France); Wager, M. [Centre Hospitalier Universitaire de Poitiers, Service de Medecine Nucleaire et Biophysique, 86 - Poitiers (France); Perdrisot, R. [Centre Hospitalier Universitaire de Poitiers, Service de Neurochirurgie, 86 - Poitiers (France)

    2007-05-15

    The value of FDG-PET remains controversial in the study of brain tumors because of the high FDG uptake in gray matter. The aim of this study was to evaluate the utility of {sup 18}FDG-PET delayed acquisitions in the distinction of brain tumors from the cortex. Thirty patients with cerebral tumors were included, 25 high-grade tumors and five low grade. Two FDG-PET acquisitions, early (1 h), and delayed (5 h). were performed. On the delayed images. two types of three-dimensional regions of interest (ROI) were drawn using a Bayesian segmentation based on a Poisson law, the lesion ROI, specific (LS) and total (LT), and the ROI of references, on the healthy hemi-cortex (SG) and on the healthy white matter (SB). These ROI were reported on the early images. The evolution of the visualization of the lesions was appreciated using a qualitative visual analysis and a ROI ratios analysis. On the delayed images, the visual and the ROI ratios analysis showed an improvement of the visualization of the hyper-metabolic specific lesions compared to the SG and the SB. There was also a contrast improvement between the hypo-metabolic specific lesions and the SG with the ROI ratios analysis. Conclusion: delayed acquisitions in FDG-PET improve the visualization of brain tumors from the cortex. Dual phase FDG-PET with delayed acquisition could constitute an additional tool in the management of brain tumors. (authors)

  12. Positron emission tomography (PET) for cholangiocarcinoma

    Breitenstein, S; Apestegui, C.; Clavien, P.-A.

    2008-01-01

    The combination of positron emission tomography (PET) with computed tomography (PET-CT) provides simultaneous metabolic and anatomic information on tumors in the same imaging session. Sensitivity of PET/PET-CT is higher for intrahepatic (>90%) than for extrahepatic cholangiocarcinoma (CCA) (about 60%). The detection rate of distant metastasis is 100%. PET, and particularly PET-CT, improves the results and impacts on the oncological management in CCA compared with other imaging modalities. The...

  13. Comparison of two new angiogenesis PET tracers 68Ga-NODAGA-E[c(RGDyK)]2 and 64Cu-NODAGA-E[c(RGDyK)]2; in vivo imaging studies in human xenograft tumors

    Oxbøl, Jytte; Brandt-Larsen, Malene; Schjøth-Eskesen, Christina;

    2014-01-01

    INTRODUCTION: The aim of this study was to synthesize and perform a side-by-side comparison of two new tumor-angiogenesis PET tracers (68)Ga-NODAGA-E[c(RGDyK)](2) and (64)Cu-NODAGA-E[c(RGDyK)](2) in vivo using human xenograft tumors in mice. Human radiation burden was estimated to evaluate...

  14. Patterns of tumor response in canine and feline cancer patients treated with electrochemotherapy: preclinical data for the standardization of this treatment in pets and humans

    Bonetto Francesco

    2007-10-01

    Full Text Available Abstract Electrochemotherapy (ECT is a novel anticancer therapy that is currently being evaluated in human and pet cancer patients. ECT associates the administration of an anti-tumor agent to the delivery of trains of appropriate waveforms. The increased uptake of chemotherapy leads to apoptotic death of the neoplasm thus resulting in prolonged local control and extended survival. In this paper we describe the histological features of a broad array of spontaneous tumors of companion animals receiving pulse-mediated chemotherapy. Multivariate statistical analysis of the percentage of necrosis and apoptosis in the tumors before and after ECT treatment, shows that only a high percentage of necrosis and apoptosis after the ECT treatment were significantly correlated with longer survivals of the patients (p

  15. Comparison of the PET with fluoro-ethyl-tyrosine to perfusion MRI and T1 injected in the exploration of glial tumors: a pilot study

    Molecular imaging could be used in complement of MRI injected in the initial result of cerebral tumors. This study has for aim to compare the performances of the positron computed tomography with fluoro-ethyl-tyrosine (F.E.T.) with the T1 sequences with gadolinium injection and perfusion MRI in the staging of glial tumors. In spite of the low strength of the series, the cerebral PET shows a good performance in the staging of glial tumors, without being superior to MRI. however, the results seem interesting in view of possible merging to allow targeting at the best, the biopsies, especially for the injuries classified high grade for MRI without contrast after gadolinium injection. (N.C.)

  16. Ga68-DOTA peptide PET/CT to detect occult mesenchymal tumor-inducing osteomalacia: A case series of three patients

    Ho, Chi Long [Dept. of Diagnostic Radiology, Singapore General Hospital, Singapore (Singapore)

    2015-09-15

    Tumor-induced osteomalacia (TIO) is a rare disease that manifests with paraneoplasic syndrome and overproduction of fibroblast growth factor 23 (FGF23), leading to renal phosphate wasting and hyperphosphaturia, eventually leading to acquired hypophosphatemic osteomalacia. Diagnosis of this disease is often challenging because of the small size of the lesion, which can be localized in bone or soft tissue anywhere in the body. Detecting these occult mesenchymal tumors (OMT) is of great importance as they are potentially curable after tumor resection. The purpose of this case series is to provide some insight into the diagnosis and localization of OMT associated with osteomalacia, particularly using functional imaging with Ga68-DOTA peptide PET/CT scans.

  17. A fully automatic, threshold-based segmentation method for the estimation of the Metabolic Tumor Volume from PET images: validation on 3D printed anthropomorphic oncological lesions

    Gallivanone, F.; Interlenghi, M.; Canervari, C.; Castiglioni, I.

    2016-01-01

    18F-Fluorodeoxyglucose (18F-FDG) Positron Emission Tomography (PET) is a standard functional diagnostic technique to in vivo image cancer. Different quantitative paramters can be extracted from PET images and used as in vivo cancer biomarkers. Between PET biomarkers Metabolic Tumor Volume (MTV) has gained an important role in particular considering the development of patient-personalized radiotherapy treatment for non-homogeneous dose delivery. Different imaging processing methods have been developed to define MTV. The different proposed PET segmentation strategies were validated in ideal condition (e.g. in spherical objects with uniform radioactivity concentration), while the majority of cancer lesions doesn't fulfill these requirements. In this context, this work has a twofold objective: 1) to implement and optimize a fully automatic, threshold-based segmentation method for the estimation of MTV, feasible in clinical practice 2) to develop a strategy to obtain anthropomorphic phantoms, including non-spherical and non-uniform objects, miming realistic oncological patient conditions. The developed PET segmentation algorithm combines an automatic threshold-based algorithm for the definition of MTV and a k-means clustering algorithm for the estimation of the background. The method is based on parameters always available in clinical studies and was calibrated using NEMA IQ Phantom. Validation of the method was performed both in ideal (e.g. in spherical objects with uniform radioactivity concentration) and non-ideal (e.g. in non-spherical objects with a non-uniform radioactivity concentration) conditions. The strategy to obtain a phantom with synthetic realistic lesions (e.g. with irregular shape and a non-homogeneous uptake) consisted into the combined use of standard anthropomorphic phantoms commercially and irregular molds generated using 3D printer technology and filled with a radioactive chromatic alginate. The proposed segmentation algorithm was feasible in a

  18. Comparison of 18F-Fluorothymidine and 18F-Fluorodeoxyglucose PET/CT in Delineating Gross Tumor Volume by Optimal Threshold in Patients With Squamous Cell Carcinoma of Thoracic Esophagus

    Purpose: To determine the optimal method of using 18F-fluorothymidine (FLT) positron emission tomography (PET)/computed tomography (CT) simulation to delineate the gross tumor volume (GTV) in esophageal squamous cell carcinoma verified by pathologic examination and compare the results with those using 18F-fluorodeoxyglucose (FDG) PET/CT. Methods and Materials: A total of 22 patients were enrolled and underwent both FLT and FDG PET/CT. The GTVs with biologic information were delineated using seven different methods in FLT PET/CT and three different methods in FDG PET/CT. The results were compared with the pathologic gross tumor length, and the optimal threshold was obtained. Next, we compared the simulation plans using the optimal threshold of FLT and FDG PET/CT. The radiation dose was prescribed as 60 Gy in 30 fractions with a precise radiotherapy technique. Results: The mean ± standard deviation pathologic gross tumor length was 4.94 ± 2.21 cm. On FLT PET/CT, the length of the standardized uptake value 1.4 was 4.91 ± 2.43 cm. On FDG PET/CT, the length of the standardized uptake value 2.5 was 5.10 ± 2.18 cm, both of which seemed more approximate to the pathologic gross tumor length. The differences in the bilateral lung volume receiving ≥20 Gy, heart volume receiving ≥40 Gy, and the maximal dose received by spinal cord between FLT and FDG were not significant. However, the values for mean lung dose, bilateral lung volume receiving ≥5, ≥10, ≥30, ≥40, and ≥50 Gy, mean heart dose, and heart volume receiving ≥30 Gy using FLT PET/CT-based planning were significant lower than those using FDG PET/CT. Conclusion: A standardized uptake value cutoff of 1.4 on FLT PET/CT and one of 2.5 on FDG PET/CT provided the closest estimation of GTV length. Finally, FLT PET/CT-based treatment planning provided potential benefits to the lungs and heart.

  19. Dosimetric comparison of simulation treatment planning for thoracic esophageal carcinoma patients in contouring biological tumor volume with FLT and FDG PET-CT

    Objective: To investigate a feasibility of treatment planning in thoracic esophageal carcinoma with 3-deoxy-3-fluorothymidine (FLT) PET-CT and to compare with fluorodeoxyglucose (FDG) PET-CT based on dosimetric analysis. Methods: Twenty-two patients with esophageal squamous cell carcinoma detected by FLT and FDG PET-CT were enrolled. The gross tumor volumes (GTV), clinical target volume (CTV) and planning target volume (PTV) were delineated using treatment planning system of Philips Pinnacle3 based on the optimal threshold of FLT and FDG PET-CT respectively,and to make two groups simulation treatment planning. The parameters of dose-volume histograms in two groups planning were compared in the similar direction and ensuring prescribed dose line surround 95% target volume. Results: The values of GTV, CTV and PTV in FLT PET-CT planning were less than those of FDG, that was 29.03 cm3 : 33.05 cm3 (t=-2.62, P<0.05), 244.22 cm3 : 257.01 cm3 (t=-3.53, P<0.05) and 351.29 cm3 : 379.85 cm3 (t=-4.01, P<0.05), respectively. There were no significantly difference in conformity index and homogeneity index in two planning, that was 0.74 : 0.72 (t=0.89, P>0.05) and 1.09 : 1.11 (t=1.41, P>0.05), respectively. The values of V20 of bilateral lung, V40 of heat and maximal dose received by spinal cord in two planning were not significantly yet (t=-1.60, -1.55, all P>0.05). While, the values in mean lung dose, V5, V10, V30, V40 and V50 of bilateral lung, mean heart dose, and V30 of heart in FLT PET-CT planning were significant lower than those of FDG (t=-5.442 - -2.637, all P<0.05). Conclusions: Compared with FDG, FLT PET-CT based treatment planning brings potential benefits for lungs and heart. (authors)

  20. 68Ga-AMBA and 18 F-FDG for preclinical PET imaging of breast cancer: effect of tamoxifen treatment on tracer uptake by tumor

    Introduction: AMBA is a bombesin analogue that binds to GRPr. In a mouse model of estrogen-dependent human breast cancer, we tested whether 68Ga-AMBA can be used for PET detection of GRPr-expressing tumors and could be more accurate than 18F-FDG to monitor tumor response to hormone therapy. Methods: The radiolabeling of 68Ga-AMBA was automated using a R and D Synchrom module. ZR75-1, a breast cancer cell line, was xenografted in nude mice. 68Ga-AMBA tumor uptake was compared with that of 18F-FDG before and after treatment with tamoxifen. Results: AMBA was 68Ga-radiolabelled in 30 min with 95.3% yield and purity ≥ 98%. Prior to treatment, 68Ga-AMBA was highly concentrated into tumors (tumor to non-tumor ratio = 2.4 vs. 1.3 with 18F-FDG). With tamoxifen treatment (n = 6) 68Ga-AMBA uptake plateaued after 1 week and decreased after 2 weeks, with a significant reduction compared to controls (n = 4). In contrast the effect of tamoxifen treatment could not be appreciated using 18F-FDG. Conclusions: 68Ga-AMBA appeared better than 18F-FDG to visualize and monitor the response to hormone treatment in this breast cancer model

  1. Reproducibility of 'Intelligent' Contouring of Gross Tumor Volume in Non-Small-Cell Lung Cancer on PET/CT Images Using a Standardized Visual Method

    Purpose: Positron emission tomography/computed tomography (PET/CT) is increasingly used for delineating gross tumor volume (GTV) in non-small-cell lung cancer (NSCLC). The methodology for contouring tumor margins remains controversial. We developed a rigorous visual protocol for contouring GTV that uses all available clinical information and studied its reproducibility in patients from a prospective PET/CT planning trial. Methods and Materials: Planning PET/CT scans from 6 consecutive patients were selected. Six 'observers' (two radiation oncologists, two nuclear medicine physicians, and two radiologists) contoured GTVs for each patient using a predefined protocol and subsequently recontoured 2 patients. For the estimated GTVs and axial distances, least-squares means for each observer and for each case were calculated and compared, using the F test and pairwise t-tests. In five cases, tumor margins were also autocontoured using standardized uptake value (SUV) cutoffs of 2.5 and 3.5 and 40% SUVmax. Results: The magnitude of variation between observers was small relative to the mean (coefficient of variation [CV] = 3%), and the total variation (intraclass correlation coefficient [ICC] = 3%). For estimation of superior/inferior (SI), left/right (LR), and anterior/posterior (AP) borders of the GTV, differences between observers were also small (AP, CV = 2%, ICC = 0.4%; LR, CV = 6%, ICC = 2%; SI, CV 4%, ICC = 2%). GTVs autocontoured generated using SUV 2.5, 3.5, and 40% SUVmax differed widely in each case. An SUV contour of 2.5 was most closely correlated with the mean GTV defined by the human observers. Conclusions: Observer variation contributed little to total variation in the GTV and axial distances. A visual contouring protocol gave reproducible results for contouring GTV in NSCLC.

  2. Investigation on tumor hypoxia in resectable primary prostate cancer as demonstrated by 18F-FAZA PET/CT utilizing multimodality fusion techniques

    As hypoxia is believed to play an important role in the development and progression of prostate cancer, we evaluated whether 18F-labeled fluoroazomycin arabinoside (18F-FAZA) would be useful to identify tumor hypoxia in resectable prostate cancer. Positron emission tomography (PET)/CT was performed on 14 patients with untreated localized primary prostate cancer 3 h post-injection of approximately 390 MBq of 18F-FAZA using forced diuresis to decrease radioactivity in the urinary bladder. Anatomical trans-pelvic coil and pre- and post-contrast 1.5 T MRI with endorectal coil were performed on the same day. Patients underwent radical prostatectomy and ex vivo 3 T MRI of the prostatectomy specimen within 14 days following in vivo imaging. Imaging results were verified by whole mount histopathology plus tissue microarray (TMA) immunohistochemical (IHC) analysis for carbonic anhydrase IX (CAIX) and hypoxia-inducible factor 1α (HIF-1α). Registration of in vivo imaging with histology was achieved using mutual information software and performing ex vivo MRI of the prostatectomy specimen and whole mount sectioning with block face photography as intermediate steps. Whole mount histology identified 43 tumor nodules, 19 of them larger than 1 ml as determined on coregistered volumes featuring 18F-FAZA, MRI, and histological 3-D image information. None of these lesions was found to be positive for CAIX or visualized by 18F-FAZA PET/CT while IHC for HIF-1α showed variable staining of tumor tissues. Accordingly, no correlation was found between 18F-FAZA uptake and Gleason scores. Our data based on 18F-FAZA PET/CT and CAIX IHC do not support the presence of clinically relevant hypoxia in localized primary prostate cancer including high-grade disease. Activation of HIF-1α may be independent of tissue hypoxia in primary prostate cancer. (orig.)

  3. Differentiation of cardiac thrombus from cardiac tumor combining cardiac MRI and 18F-FDG-PET/CT Imaging.

    Rinuncini, Massimo; Zuin, Marco; Scaranello, Fiorenzo; Fejzo, Majlinda; Rampin, Lucia; Rubello, Domenico; Faggian, Giuseppe; Roncon, Loris

    2016-06-01

    Radiological differentiation of an unknown cardiac masse is often a challenging issue. 18F-FDG-PET/CT imaging was performed to evaluate a left ventricle mass visualized on transthoracic echocardiogram (TTE) and cardiac magnetic resonance (CMR) in a patient with an history of ischemic heart disease. The metabolically inert area on the PET/CT, corresponding to the relatively homogenous hypodensity in the LV, was thought to represent an old organized LV thrombus. Histopathological examination confirmed the imaging diagnosis. PMID:27038712

  4. Increasing the Accuracy of Volume and ADC Delineation for Heterogeneous Tumor on Diffusion-Weighted MRI: Correlation with PET/CT

    Gong, Nan-Jie [Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong (China); Wong, Chun-Sing, E-mail: drcswong@gmail.com [Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong (China); Chu, Yiu-Ching [Department of Radiology, Kwong Wah Hospital, Hong Kong (China); Guo, Hua [Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing (China); Huang, Bingsheng [Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong (China); Chan, Queenie [Philips Healthcare, Hong Kong (China)

    2013-10-01

    Purpose: To improve the accuracy of volume and apparent diffusion coefficient (ADC) measurements in diffusion-weighted magnetic resonance imaging (MRI), we proposed a method based on thresholding both the b0 images and the ADC maps. Methods and Materials: In 21 heterogeneous lesions from patients with metastatic gastrointestinal stromal tumors (GIST), gross lesion were manually contoured, and corresponding volumes and ADCs were denoted as gross tumor volume (GTV) and gross ADC (ADC{sub g}), respectively. Using a k-means clustering algorithm, the probable high-cellularity tumor tissues were selected based on b0 images and ADC maps. ADC and volume of the tissues selected using the proposed method were denoted as thresholded ADC (ADC{sub thr}) and high-cellularity tumor volume (HCTV), respectively. The metabolic tumor volume (MTV) in positron emission tomography (PET)/computed tomography (CT) was measured using 40% maximum standard uptake value (SUV{sub max}) as the lower threshold, and corresponding mean SUV (SUV{sub mean}) was also measured. Results: HCTV had excellent concordance with MTV according to Pearson's correlation (r=0.984, P<.001) and linear regression (slope = 1.085, intercept = −4.731). In contrast, GTV overestimated the volume and differed significantly from MTV (P=.005). ADC{sub thr} correlated significantly and strongly with SUV{sub mean} (r=−0.807, P<.001) and SUV{sub max} (r=−0.843, P<.001); both were stronger than those of ADC{sub g}. Conclusions: The proposed lesion-adaptive semiautomatic method can help segment high-cellularity tissues that match hypermetabolic tissues in PET/CT and enables more accurate volume and ADC delineation on diffusion-weighted MR images of GIST.

  5. Differentiation of tumor recurrence from radiation-induced pulmonary fibrosis after stereotactic ablative radiotherapy for lung cancer. Characterization of 18F-FDG PET/CT findings

    Stereotactic ablative radiotherapy (SABR), also known as stereotactic body radiotherapy (SBRT), is now a standard treatment option for patients with stage I non-small cell lung cancer or oligometastatic lung tumor who are medically inoperable or medically operable but refuse surgery. When mass-like consolidation is observed on follow-up CT after SABR, it is sometimes difficult to differentiate tumor recurrence from SABR-induced pulmonary fibrosis. In this study, we evaluated the role of 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) in differentiating tumor recurrence from radiation fibrosis after SABR. Between June 2006 and June 2009, 130 patients received SABR for stage I non-small cell lung cancer or metastatic lung cancer at our institution. Fifty-nine patients of them were imaged with FDG-PET/CT after SABR. There were a total of 137 FDG-PET/CT scans for retrospective analysis. The FDG uptake in the pulmonary region was assessed qualitatively using a 3-point scale (0, none or faint; 1, mild; or 2, moderate to intense), and the shape (mass-like or non mass-like) was evaluated. For semi-quantitative analysis, the maximum standardized uptake value (SUVmax) was calculated. Sixteen of 59 patients had local failure. In recurrent tumor, the combination of intensity grade 2 and mass-like shape was most common (21/23; 91%). By contrast, in cases of radiation fibrosis, the combination of intensity grade 0 or 1 and non mass-like shape was most common (48/59; 81%). The SUVmax of tumor recurrence after 12 months was significantly higher than that of radiation fibrosis (8.0±3.2 vs. 2.1±0.9, pmax >4.5 at diagnosis of local failure. At ≥12 months after SABR, these two variables, the combination of intensity 2 and mass-like FDG uptake or SUVmax >4.5 acquired a significant high predictive value of local recurrence, finding sensitivity 100% and specificity 100% for both of them. The combination of FDG uptake patterns and

  6. 18F-FDG PET/CT-based gross tumor volume definition for radiotherapy in head and neck Cancer: a correlation study between suitable uptake value threshold and tumor parameters

    To define a suitable threshold setting for gross tumor volume (GTV) when using 18Fluoro-deoxyglucose positron emission tomography and computed tomogram (PET/CT) for radiotherapy planning in head and neck cancer (HNC). Fifteen HNC patients prospectively received PET/CT simulation for their radiation treatment planning. Biological target volume (BTV) was derived from PET/CT-based GTV of the primary tumor. The BTVs were defined as the isodensity volumes when adjusting different percentage of the maximal standardized uptake value (SUVmax), excluding any artifact from surrounding normal tissues. CT-based primary GTV (C-pGTV) that had been previously defined by radiation oncologists was compared with the BTV. Suitable threshold level (sTL) could be determined when BTV value and its morphology using a certain threshold level was observed to be the best fitness of the C-pGTV. Suitable standardized uptake value (sSUV) was calculated as the sTL multiplied by the SUVmax. Our result demonstrated no single sTL or sSUV method could achieve an optimized volumetric match with the C-pGTV. The sTL was 13% to 27% (mean, 19%), whereas the sSUV was 1.64 to 3.98 (mean, 2.46). The sTL was inversely correlated with the SUVmax [sTL = -0.1004 Ln (SUVmax) + 0.4464; R2 = 0.81]. The sSUV showed a linear correlation with the SUVmax (sSUV = 0.0842 SUVmax + 1.248; R2 = 0.89). The sTL was not associated with the value of C-pGTVs. In PET/CT-based BTV for HNC, a suitable threshold or SUV level can be established by correlating with SUVmax rather than using a fixed threshold

  7. Synthesis of O-(2-[18F]fluoroethyl)-L-tyrosine and its biological evaluation in B16 melanoma-bearing mice as PET tracer for tumor imaging

    2007-01-01

    O-(2-[18F]fluoroethyl) -L-tyrosine([18F]FET) ,a fluorine-18 labeled analogue of tyrosine,has been syn-thesized and biologically evaluated in tumor-bearing mice. The whole synthesis procedure is com-pleted within 50 min. The radiochemical yield is about 40%(no decay corrected) and radiochemical purity more than 97% after simplified solid phase extraction. [18F]FET shows rapid,high uptake and long retention in the tumor as well as low uptake in the brain. The ratios of tumor-to-muscle(T/M) and tumor-to-blood(T/B) of [18F]FET are similar to those of [18F]FDG,but the ratios of tumor-to-brain(T/Br) are 2-3 times higher than that of [18F]FDG. Autoradiography of [18F]FET demonstrates a remarkable accumulation in melanoma with high contrast. It appears to be a probable competitive candidate for melanoma imaging with PET.

  8. Synthesis of O-(2-[18F]fluoroethyl)-L-tyrosine and its biological evaluation in B16 melanoma-bearing mice as PET tracer for tumor imaging

    WANG MingWei; YIN DuanZhi; LI ShiQiang; WANG YongXian

    2007-01-01

    O-(2-[18F]fluoroethyl)-L-tyrosine ([18F]FET), a fluorine-18 labeled analogue of tyrosine, has been synthesized and biologically evaluated in tumor-bearing mice. The whole synthesis procedure is completed within 50 min. The radiochemical yield is about 40% (no decay corrected) and radiochemical purity more than 97% after simplified solid phase extraction. [18F]FET shows rapid, high uptake and long retention in the tumor as well as low uptake in the brain. The ratios of tumor-to-muscle (T/M) and tumor-to-blood (T/B) of [18F]FET are similar to those of [18F]FDG, but the ratios of tumor-to-brain (T/Br)are 2-3 times higher than that of [18F]FDG. Autoradiography of [18F]FET demonstrates a remarkable accumulation in melanoma with high contrast. It appears to be a probable competitive candidate for melanoma imaging with PET.

  9. New octreotide derivatives for in vivo targeting of somatostatin receptor-positive tumors for Single Photon Emission Computed Tomography (SPECT) and Positron Emission Tomography (PET)

    Two new modifications of the somatostatin analog octreotide, designed to hold the gallium isotopes 67Ga and 68Ga (DFO-SMS) and 99mTc (PnAO-SMS) have been synthesized and evaluated in vitro and in vivo in tumor bearing rats. DFO-SMS can be labeled with 67Ga3+ and 68Ga3+ with high specific activity within less than 30 minutes in a ''cold kit'' type formulation. The labeled conjugate is stable under physiologgical conditions. Moreover the binding affinity to somatostatin receptors on rat brain cortex membranes was shown to be retained. In vivo fast tumor localization was demonstrated and the pharmacokinetics proved to be favourable as the main excretion route was via the kidneys. First PET studies with [68Ga]-DFO-SMS showed a rapid accumulation in the tumor and a residence half-life at the tumor site of about 6 hours. PnAO-SMS can be labeled with 99mTc with high radiochemical purity. In vivo the radiotracer accumulates well in the tumor but due to its high lipohilicity, its main excretion route is via the hepatobiliary system. (orig.)

  10. Comparison of abdominal MRI with diffusion-weighted imaging to 68Ga-DOTATATE PET/CT in detection of neuroendocrine tumors of the pancreas

    The aim of the study was to evaluate contrast-enhanced MRI, diffusion-weighted MRI (DW MRI), and 68Ga-DOTATATE positron emission tomography (PET)/CT in the detection of intermediate to well-differentiated neuroendocrine tumors (NET) of the pancreas. Eighteen patients with pathologically proven pancreatic NET who underwent MRI including DW MRI and PET/CT within 6 weeks of each other were included in this retrospective study. Two radiologists evaluated T2-weighted (T2w), T2w + DW MRI, T2w + contrast-enhanced T1-weighted (CE T1w) MR images, and PET/CT for NET detection. The sensitivity and level of diagnostic confidence were compared among modalities using McNemar's test and a Wilcoxon signed rank test. Apparent diffusion coefficients (ADC) of pancreatic NETs and normal pancreatic tissue were compared with Student's t test. Of the NETs, 8/23 (34.8 %) and 9/23 (39.1 %) were detected on T2w images by observers 1 and 2, respectively. Detection rates improved significantly by combining T2w images with DW MRI (observer 1: 14/23 = 61 %; observer 2: 15/23 = 65.2 %; p -3 mm2/s) was statistically significantly lower than that of normal pancreatic tissue (1.48 ± 0.39 x 10-3 mm2/s). DW MRI is a valuable adjunct to T2w imaging and comparable to CE T1w imaging in pancreatic NET detection, quantitatively differentiating between NET and normal pancreatic tissue with ADC measurements. 68Ga-DOTATATE PET/CT is more sensitive than MRI in the detection of pancreatic NET. (orig.)

  11. Metabolic tumor volume measured by F 18 FDG PET/CT can further stratify the prognosis of patients with stage IV Non Small Cell Lung Cancer

    This study aimed to further stratify prognostic factors in patients with stage IV non small cell lung cancer (NSCLC) by measuring their metabolic tumor volume (MTV) using F 18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). The subjects of this retrospective study were 57 patients with stage IV NSCLC. MTV, total lesion glycolysis (TLG), and maximum standardized uptake value (SUVmax) were measured on F 18 FDG PET/CT in both the primary lung lesion as well as metastatic lesions in torso. Optimal cutoff values of PET parameters were mea measured by receiver operating characteristic (ROC) curve anal analysis. Kaplan Meier survival (PET). The univariate and multivariate cox proportional hazards models were used to select the significant prognostic factors. Univariate analysis showed that both MTV and TLG of primary lung lesion (MTV lung and TLG lung) were significant factors for prediction of PFS ( <0.001 =0.038, respectively). Patients showing lower values of MTV lung and TLG lung than the cutoff values had significantly longer mean PFS than those with higher values. hazard ratios (95% confidence interval) of MTV lung and TLG lung measured by univariate analysis were 6.4 (2.5 16.3) and 2.4 (1.0 5.5), respectively. multivariate analysis revealed that MTV lung was the only significant factor for prediction of prognosis. Hazard ratio was 13,5 (1.6 111.1, =0,016). patients with stage IV NSCLC could be further stratified into subgroups of significantly better and worse prognosis by MTV of primary lung lesion

  12. A Phase II Comparative Study of Gross Tumor Volume Definition With or Without PET/CT Fusion in Dosimetric Planning for Non–Small-Cell Lung Cancer (NSCLC): Primary Analysis of Radiation Therapy Oncology Group (RTOG) 0515

    Background: Radiation Therapy Oncology Group (RTOG) 0515 is a Phase II prospective trial designed to quantify the impact of positron emission tomography (PET)/computed tomography (CT) compared with CT alone on radiation treatment plans (RTPs) and to determine the rate of elective nodal failure for PET/CT-derived volumes. Methods: Each enrolled patient underwent definitive radiation therapy for non–small-cell lung cancer (≥60 Gy) and had two RTP datasets generated: gross tumor volume (GTV) derived with CT alone and with PET/CT. Patients received treatment using the PET/CT-derived plan. The primary end point, the impact of PET/CT fusion on treatment plans was measured by differences of the following variables for each patient: GTV, number of involved nodes, nodal station, mean lung dose (MLD), volume of lung exceeding 20 Gy (V20), and mean esophageal dose (MED). Regional failure rate was a secondary end point. The nonparametric Wilcoxon matched-pairs signed-ranks test was used with Bonferroni adjustment for an overall significance level of 0.05. Results: RTOG 0515 accrued 52 patients, 47 of whom are evaluable. The follow-up time for all patients is 12.9 months (2.7–22.2). Tumor staging was as follows: II = 6%; IIIA = 40%; and IIIB = 54%. The GTV was statistically significantly smaller for PET/CT-derived volumes (98.7 vs. 86.2 mL; p < 0.0001). MLDs for PET/CT plans were slightly lower (19 vs. 17.8 Gy; p = 0.06). There was no significant difference in the number of involved nodes (2.1 vs. 2.4), V20 (32% vs. 30.8%), or MED (28.7 vs. 27.1 Gy). Nodal contours were altered by PET/CT for 51% of patients. One patient (2%) has developed an elective nodal failure. Conclusions: PET/CT-derived tumor volumes were smaller than those derived by CT alone. PET/CT changed nodal GTV contours in 51% of patients. The elective nodal failure rate for GTVs derived by PET/CT is quite low, supporting the RTOG standard of limiting the target volume to the primary tumor and involved nodes.

  13. A Phase II Comparative Study of Gross Tumor Volume Definition With or Without PET/CT Fusion in Dosimetric Planning for Non-Small-Cell Lung Cancer (NSCLC): Primary Analysis of Radiation Therapy Oncology Group (RTOG) 0515

    Bradley, Jeffrey, E-mail: jbradley@wustl.edu [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Bae, Kyounghwa [Department of Statistics, RTOG, Philadelphia, PA (United States); Choi, Noah [Massachusetts General Hospital, Boston, MA (United States); Forster, Ken [H. Lee Moffitt Cancer Center, Tampa, FL (United States); Siegel, Barry A. [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Brunetti, Jacqueline [Holy Name Medical Center, Teaneck, NJ (United States); Purdy, James [University of California at Davis, Davis, CA (United States); Faria, Sergio [McGill University, Montreal (Canada); Vu, Toni [Centre Hospitalier Universitaire de Montreal, Hospital Notre Dame, Montreal (Canada); Thorstad, Wade [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Choy, Hak [University of Texas Southwestern, Dallas, TX (United States)

    2012-01-01

    Background: Radiation Therapy Oncology Group (RTOG) 0515 is a Phase II prospective trial designed to quantify the impact of positron emission tomography (PET)/computed tomography (CT) compared with CT alone on radiation treatment plans (RTPs) and to determine the rate of elective nodal failure for PET/CT-derived volumes. Methods: Each enrolled patient underwent definitive radiation therapy for non-small-cell lung cancer ({>=}60 Gy) and had two RTP datasets generated: gross tumor volume (GTV) derived with CT alone and with PET/CT. Patients received treatment using the PET/CT-derived plan. The primary end point, the impact of PET/CT fusion on treatment plans was measured by differences of the following variables for each patient: GTV, number of involved nodes, nodal station, mean lung dose (MLD), volume of lung exceeding 20 Gy (V20), and mean esophageal dose (MED). Regional failure rate was a secondary end point. The nonparametric Wilcoxon matched-pairs signed-ranks test was used with Bonferroni adjustment for an overall significance level of 0.05. Results: RTOG 0515 accrued 52 patients, 47 of whom are evaluable. The follow-up time for all patients is 12.9 months (2.7-22.2). Tumor staging was as follows: II = 6%; IIIA = 40%; and IIIB = 54%. The GTV was statistically significantly smaller for PET/CT-derived volumes (98.7 vs. 86.2 mL; p < 0.0001). MLDs for PET/CT plans were slightly lower (19 vs. 17.8 Gy; p = 0.06). There was no significant difference in the number of involved nodes (2.1 vs. 2.4), V20 (32% vs. 30.8%), or MED (28.7 vs. 27.1 Gy). Nodal contours were altered by PET/CT for 51% of patients. One patient (2%) has developed an elective nodal failure. Conclusions: PET/CT-derived tumor volumes were smaller than those derived by CT alone. PET/CT changed nodal GTV contours in 51% of patients. The elective nodal failure rate for GTVs derived by PET/CT is quite low, supporting the RTOG standard of limiting the target volume to the primary tumor and involved nodes.

  14. {sup 18}F-FDG PET analysis of schwannoma: increase of SUVmax in the delayed scan is correlated with elevated VEGF/VPF expression in the tumors

    Hamada, Kenichiro [Osaka Medical Center for Cancer and Cardiovascular Diseases, Department of Orthopedic Surgery, Osaka (Japan)]|[Osaka University Graduate School of Medicine, Department of Nuclear Medicine and Tracer Kinetics, Osaka (Japan); Tomita, Yasuhiko; Tomoeda, Miki [Osaka Medical Center for Cancer and Cardiovascular Diseases, Department of Pathology, Osaka, Osaka (Japan); Qiu, Ying; Aozasa, Katsuyuki [Osaka University Graduate School of Medicine, Department of Pathology, Osaka (Japan); Ueda, Takafumi [Osaka National Hospital, Department of Orthopedic Surgery, Osaka (Japan); Tamai, Noriyuki; Hashimoto, Nobuyuki; Yoshikawa, Hideki [Osaka University Graduate School of Medicine, Department of Orthopedic Surgery, Osaka (Japan); Hatazawa, Jun [Osaka University Graduate School of Medicine, Department of Nuclear Medicine and Tracer Kinetics, Osaka (Japan)

    2009-03-15

    In order to clarify the increased 2-deoxy-2-fluoro-{sup 18}F-d-glucopyranose ({sup 18}F-FDG) accumulation in schwannoma by positron emission tomography (PET) analysis, immunohistochemical analysis for the factors involved in glucose transportation and vascular formation was performed. Twenty-six patients with schwannoma (13 men and 13 women) with ages ranging from 27 to 75 years, who received whole body {sup 18}F-FDG PET scan, were enrolled for the present study. The retention index (RI) was calculated by dividing the increase in the standardized uptake value (SUVmax) at the delayed scan by the SUVmax in the early scan. SUVmax and RI were compared with the histologic variables, including the expression of glucose transporters 1 and 3, hexokinase II, vascular endothelial growth factor/vascular permeability factor (VEGF/VPF), and microvascular density shown by CD31 immunohistochemistry. Mean SUVmax values in the early and delayed scans were 2.64{+-}1.47 and 2.71{+-}1.57 (mean {+-} SD), respectively. RI was -2.5{+-}21 (percentage). SUVmax showed a positive correlation with the tumor size (tumor size <5 cm, 2.06 {+-} 0.72; >5 cm, 3.95{+-}1.89; p<0.05) and the microvascular density (negative density, 2.16{+-}1.12; positive density, 3.56{+-}1.67; p<0.05). RI correlated with VEGF/VPF expression in the tumors (negative expression, -11{+-}6.1; positive expression, 13{+-}8.1; p<0.05). Other factors showed no correlation with SUVmax or RI. Microvascular density and vascular permeability of the tumor are suggested to affect the enhanced {sup 18}F-FDG accumulation in schwannoma. (orig.)

  15. Evaluation of [11C]SA5845 and [11C]SA4503 for imaging of sigma receptors in tumors by animal PET

    Sigma receptors are expressed in a wide variety of tumor cell lines, and are expressed in proliferating cells. A radioligand for the visualization of sigma receptors could be useful for selective detection of primary tumors and their metastases, and for non-invasive assessment of tumor proliferative status. To this end we evaluated two sigma receptor ligands, [11C]SA5845 and [11C]SA4503. In an in vitro study, AH109A hepatoma showed moderate densities of sigma1 and sigma2 receptors, and VX-2 carcinoma showed a high density of sigma2 receptors: Bmax (fmol/mg protein) for sigma1 vs. sigma2, 1,700 vs. 1,200 for AH109A hepatoma and 800 vs. 10,000 for VX-2 carcinoma. In a cell growth assay in vitro, neither SA5845 nor SA4503 (11C]SA5845 and [11C]SA4503 in AH109A tissues was accumulated over the first 60 minutes; however, the uptake of both tracers increased by co-injection with haloperidol as a sigma receptor ligand. On the other hand, in the PET studies of rabbits, the uptake of [11C]SA5845 in the VX-2 carcinoma was relatively higher than that of [11C]SA4503, because of a much higher density of sigma2 receptors compared to sigma1 receptors in the VX-2 tissue, and the uptake of both tracers in the VX-2 tissue was decreased by carrier-loading and pre-treatment with haloperidol ([11C]SA5845, 53% and 26%, respectively; [11C]SA4503, 41% and 22%, respectively at 30 minutes after injection). Therefore, [11C]SA5845 and [11C]SA4503 may be potential ligands for PET imaging of sigma receptor-rich tumors. (author)

  16. 18F-FDG PET analysis of schwannoma: increase of SUVmax in the delayed scan is correlated with elevated VEGF/VPF expression in the tumors

    In order to clarify the increased 2-deoxy-2-fluoro-18F-d-glucopyranose (18F-FDG) accumulation in schwannoma by positron emission tomography (PET) analysis, immunohistochemical analysis for the factors involved in glucose transportation and vascular formation was performed. Twenty-six patients with schwannoma (13 men and 13 women) with ages ranging from 27 to 75 years, who received whole body 18F-FDG PET scan, were enrolled for the present study. The retention index (RI) was calculated by dividing the increase in the standardized uptake value (SUVmax) at the delayed scan by the SUVmax in the early scan. SUVmax and RI were compared with the histologic variables, including the expression of glucose transporters 1 and 3, hexokinase II, vascular endothelial growth factor/vascular permeability factor (VEGF/VPF), and microvascular density shown by CD31 immunohistochemistry. Mean SUVmax values in the early and delayed scans were 2.64±1.47 and 2.71±1.57 (mean ± SD), respectively. RI was -2.5±21 (percentage). SUVmax showed a positive correlation with the tumor size (tumor size 5 cm, 3.95±1.89; p18F-FDG accumulation in schwannoma. (orig.)

  17. Intratumoral Heterogeneous F 18 Fluorodeoxyglucose Uptake Corresponds with Glucose Transporter 1 and Ki-67 Expression in a Case of Krukenberg Tumor: Localization of Intratumoral Hypermetabolic Focus by Fused PET/MR

    The expression of glucose transporters (Glut 1, Glut 3), Hexokinase II, and Ki-67 has been proposed to explain intratumoral heterogeneous F-18 fluorodeoxyglucose (FDG) uptake. We report a case of Krukenberg tumor with intratumoral heterogeneous FDG uptake which corresponded well with the expression tomography (PET)/magnetic resonance (MR) imaging was helpful for localizing the metabolically active area in the tumor specimen. This report elucidates the relationship between the intratumoral heterogeneous FDG uptake and biologic heterogeneity, and shows the usefulness of PET/MR in research on intratumoral heterogeneity.

  18. WE-E-17A-05: Complementary Prognostic Value of CT and 18F-FDG PET Non-Small Cell Lung Cancer Tumor Heterogeneity Features Quantified Through Texture Analysis

    Desseroit, M; Cheze Le Rest, C; Tixier, F [CHU Poitiers Poitiers (France); INSERM LaTIM UMR 1101, Brest (France); Majdoub, M; Visvikis, D; Hatt, M [INSERM LaTIM UMR 1101, Brest (France); Guillevin, R; Perdrisot, R [CHU Poitiers Poitiers (France)

    2014-06-15

    Purpose: Previous studies have shown that CT or 18F-FDG PET intratumor heterogeneity features computed using texture analysis may have prognostic value in Non-Small Cell Lung Cancer (NSCLC), but have been mostly investigated separately. The purpose of this study was to evaluate the potential added value with respect to prognosis regarding the combination of non-enhanced CT and 18F-FDG PET heterogeneity textural features on primary NSCLC tumors. Methods: One hundred patients with non-metastatic NSCLC (stage I–III), treated with surgery and/or (chemo)radiotherapy, that underwent staging 18F-FDG PET/CT images, were retrospectively included. Morphological tumor volumes were semi-automatically delineated on non-enhanced CT using 3D SlicerTM. Metabolically active tumor volumes (MATV) were automatically delineated on PET using the Fuzzy Locally Adaptive Bayesian (FLAB) method. Intratumoral tissue density and FDG uptake heterogeneities were quantified using texture parameters calculated from co-occurrence, difference, and run-length matrices. In addition to these textural features, first order histogram-derived metrics were computed on the whole morphological CT tumor volume, as well as on sub-volumes corresponding to fine, medium or coarse textures determined through various levels of LoG-filtering. Association with survival regarding all extracted features was assessed using Cox regression for both univariate and multivariate analysis. Results: Several PET and CT heterogeneity features were prognostic factors of overall survival in the univariate analysis. CT histogram-derived kurtosis and uniformity, as well as Low Grey-level High Run Emphasis (LGHRE), and PET local entropy were independent prognostic factors. Combined with stage and MATV, they led to a powerful prognostic model (p<0.0001), with median survival of 49 vs. 12.6 months and a hazard ratio of 3.5. Conclusion: Intratumoral heterogeneity quantified through textural features extracted from both CT and FDG PET

  19. WE-E-17A-05: Complementary Prognostic Value of CT and 18F-FDG PET Non-Small Cell Lung Cancer Tumor Heterogeneity Features Quantified Through Texture Analysis

    Purpose: Previous studies have shown that CT or 18F-FDG PET intratumor heterogeneity features computed using texture analysis may have prognostic value in Non-Small Cell Lung Cancer (NSCLC), but have been mostly investigated separately. The purpose of this study was to evaluate the potential added value with respect to prognosis regarding the combination of non-enhanced CT and 18F-FDG PET heterogeneity textural features on primary NSCLC tumors. Methods: One hundred patients with non-metastatic NSCLC (stage I–III), treated with surgery and/or (chemo)radiotherapy, that underwent staging 18F-FDG PET/CT images, were retrospectively included. Morphological tumor volumes were semi-automatically delineated on non-enhanced CT using 3D SlicerTM. Metabolically active tumor volumes (MATV) were automatically delineated on PET using the Fuzzy Locally Adaptive Bayesian (FLAB) method. Intratumoral tissue density and FDG uptake heterogeneities were quantified using texture parameters calculated from co-occurrence, difference, and run-length matrices. In addition to these textural features, first order histogram-derived metrics were computed on the whole morphological CT tumor volume, as well as on sub-volumes corresponding to fine, medium or coarse textures determined through various levels of LoG-filtering. Association with survival regarding all extracted features was assessed using Cox regression for both univariate and multivariate analysis. Results: Several PET and CT heterogeneity features were prognostic factors of overall survival in the univariate analysis. CT histogram-derived kurtosis and uniformity, as well as Low Grey-level High Run Emphasis (LGHRE), and PET local entropy were independent prognostic factors. Combined with stage and MATV, they led to a powerful prognostic model (p<0.0001), with median survival of 49 vs. 12.6 months and a hazard ratio of 3.5. Conclusion: Intratumoral heterogeneity quantified through textural features extracted from both CT and FDG PET

  20. Relationship of tumor absorbed doses of 177Lu-DOTA-TATE treatment and uptake in pre-therapeutic Ga68 DOTA-TATE PET/CT imaging

    Full text of publication follows. Introduction/Background: Peptide Receptor Radionuclide Therapy (PRRT) with labeled Lu177 labeled peptide in patients with neuroendocrine tumors (NETs) aroused great interest. An estimation of actual radiation doses to tumors is very important for therapy planning. It is well known that uptake of Ga-68 DOTATATE very well correlated with sst2 expression. The uptake of radio-labelled peptides calculated from SUV max values may predict the radiation-absorbed dosimetry of lesions treated with PRRT. Aim: the aim of the study was to evaluate the relationship between the tumor absorbed doses and pre-therapeutic Ga68 DOTA-TATE PET/CT uptake calculated from SUV values. Materials and methods: PRRT results of patients (M/F: 8/5, mean age: 55.5 ± 12.5 years) with histologically proven inoperable NETs were retrospectively analyzed. Dosimetric calculations were performed using MIRD scheme and lesion doses were calculated using post therapy whole body images obtained at 4, 20, 44, and 68 hours after injection. Calculated tumor absorbed doses were compared with SUVmax of 68Ga-DOTA-TATE PET/CT, which were performed before the therapy. Tumor volumes were determined from CT images. Thirteen blood samples beginning from time zero to 4 days after injection were obtained for bone marrow and whole body dosimetry. Results: there were 38 lesions in 13 patients. Lesions were selected according to lesion delineation and superimposed lesions were excluded. Mean lesion volume was 19.58 ± 25 cm3. Median tumor dose for all lesions, bone lesions, lesions on other sites (lung, liver, lymph nodes) were 15.08 Gy, 19.34 Gy, 14.05 Gy per 370 MBq respectively. Median SUVmax values of those were 25.8, 13.7, 23.05, respectively. Correlation between calculated tumor dose and uptake of 68Ga-DOTA-TATE was moderate (R=0.42). Also a moderate correlation was found for radiation absorbed doses of bone metastases. A very low correlation was found for radiation absorbed doses of

  1. Human Dosimetry and Preliminary Tumor Distribution of (superscript)18F-Fluoropaclitaxel in Healthy Volunteers and Newly Diagnosed Breast Cancer Patients Using PET/CT

    Kurdziel, K.A.; Logan, J.; Kurdziel, K.A.; Kalen, J.D.; Hirsch, J.I.; Wilson, J.D.; Bear, H.D.; Logan, J.; McCumisky, J.; Moorman-Sykes, K.; Adler, S.; Choyke, P.L.

    2011-08-17

    {sup 18}F-fluoropaclitaxel is a radiolabeled form of paclitaxel, a widely used chemotherapy agent. Preclinical data suggest that {sup 18}F-fluoropaclitaxel may be a reasonable surrogate for measuring the uptake of paclitaxel. As a substrate of P-glycoprotein, a drug efflux pump associated with multidrug resistance, {sup 18}F-fluoropaclitaxel may also be useful in identifying multidrug resistance and predicting tumor response for drugs other than paclitaxel. After informed consent was obtained, 3 healthy volunteers and 3 patients with untreated breast cancer (neoadjuvant chemotherapy candidates, tumor size > 2 cm) received an intravenous infusion of {sup 18}F-fluoropaclitaxel and then underwent PET/CT. Healthy volunteers underwent serial whole-body imaging over an approximately 3-h interval, and organ {sup 18}F residence times were determined from the time-activity curves uncorrected for decay to determine dosimetry. Radiation dose estimates were calculated using OLINDA/EXM software. For breast cancer patients, dynamic imaging of the primary tumor was performed for 60 min, followed by static whole-body scans at 1 and 2 h after injection. Dosimetry calculations showed that the gallbladder received the highest dose (229.50 {mu}Gy/MBq [0.849 rad/mCi]), followed by the small and large intestines (161.26 {mu}Gy/MBq [0.597 rad/mCi] and 184.59 {mu}Gy/MBq [0.683 rad/mCi]). The resultant effective dose was 28.79 {mu}Gy/MBq (0.107 rem/mCi). At approximately 1 h after injection, an average of 42% of the decay-corrected activity was in the gastrointestinal system, with a mean of 0.01% in the tumor. All 3 breast cancer patients showed retention of {sup 18}F-fluoropaclitaxel and ultimately demonstrated a complete pathologic response (no invasive cancer in the breast or axillary nodes) to chemotherapy that included a taxane (either paclitaxel or docetaxel) at surgical resection. The tumor-to-background ratio increased with time to a maximum of 7.7 at 20 min. This study

  2. Value of coincidence gamma camera PET in tumors of the thorax and abdomen and assessment of myocardial viability

    In this paper we report our experience of the usefulness of FDG scanning using a gamma camera equipped with coincidence detection for staging lung cancer and in the follow-up of patients with colorectal cancer. We also tested the diagnostic accuracy of cardiac FDG imaging. Our results demonstrate that, although a coincidence camera is technically inferior to a dedicated PET scanner, it may provide clinically useful results in situations were a lesion of sufficient size and FDG-uptake is to be expected. In patients with chronic ischemic cardiomyopathy coincidence PET can be introduced into clinical practice for the assessment of myocardial viability. (orig.)

  3. Multiple primary malignant tumors of upper gastrointestinal tract:A novel role of ~(18)F-FDG PET/CT

    2010-01-01

    AIM: To evaluate the capacity of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for detecting multiple primary cancer of upper gastrointestinal (UGI) tract. METHODS: Fifteen patients (12 without cancer histories and 3 with histories of upper GI tract cancer) were investigated due to the suspicion of primary cancer of UGI tract on X-ray barium meal and CT scan. Subsequent whole body 18F-FDG PET/CT scan was carried out for initial staging or restaging. All the patient...

  4. TU-C-12A-11: Comparisons Between Cu-ATSM PET and DCE-CT Kinetic Parameters in Canine Sinonasal Tumors

    Purpose: Regions of poor perfusion within tumors may be associated with higher hypoxic levels. This study aimed to test this hypothesis by comparing measurements of hypoxia from Cu-ATSM PET to vasculature kinetic parameters from DCE-CT kinetic analysis. Methods: Ten canine patients with sinonasal tumors received one Cu-ATSM PET/CT scan and three DCE-CT scans prior to treatment. Cu-ATSM PET/CT and DCE-CT scans were registered and resampled to matching voxel dimensions. Kinetic analysis was performed on DCE-CT scans and for each patient, the resulting kinetic parameter values from the three DCE-CT scans were averaged together. Cu-ATSM SUVs were spatially correlated (rspatial) on a voxel-to-voxel basis against the following DCE-CT kinetic parameters: transit time (t1), blood flow (F), vasculature fraction (v1), and permeability (PS). In addition, whole-tumor comparisons were performed by correlating (rROI) the mean Cu-ATSM SUV (SUVmean) with median kinetic parameter values. Results: The spatial correlations (rspatial) were poor and ranged from -0.04 to 0.21 for all kinetic parameters. These low spatial correlations may be due to high variability in the DCE-CT kinetic parameter voxel values between scans. In our hypothesis, t1 was expected to have a positive correlation, while F was expected to have a negative correlation to hypoxia. However, in wholetumor analysis the opposite was found for both t1 (rROI = -0.25) and F (rROI = 0.56). PS and v1 may depict angiogenic responses to hypoxia and found positive correlations to Cu-ATSM SUV for PS (rROI = 0.41), and v1 (rROI = 0.57). Conclusion: Low spatial correlations were found between Cu-ATSM uptake and DCE-CT vasculature parameters, implying that poor perfusion is not associated with higher hypoxic regions. Across patients, the most hypoxic tumors tended to have higher blood flow values, which is contrary to our initial hypothesis. Funding: R01 CA136927

  5. In vitro and in vivo evaluation of a (18F-labeled high affinity NOTA conjugated bombesin antagonist as a PET ligand for GRPR-targeted tumor imaging.

    Zohreh Varasteh

    Full Text Available Expression of the gastrin-releasing peptide receptor (GRPR in prostate cancer suggests that this receptor can be used as a potential molecular target to visualize and treat these tumors. We have previously investigated an antagonist analog of bombesin (D-Phe-Gln-Trp-Ala-Val-Gly-His-Sta-Leu-NH2, RM26 conjugated to 1,4,7-triazacyclononane-N,N',N''-triacetic acid (NOTA via a diethylene glycol (PEG2 spacer (NOTA-P2-RM26 labeled with (68Ga and (111In. We found that this conjugate has favorable properties for in vivo imaging of GRPR-expression. The focus of this study was to develop a (18F-labelled PET agent to visualize GRPR. NOTA-P2-RM26 was labeled with (18F using aluminum-fluoride chelation. Stability, in vitro binding specificity and cellular processing tests were performed. The inhibition efficiency (IC50 of the [(natF]AlF-NOTA-P2-RM26 was compared to that of the (natGa-loaded peptide using (125I-Tyr(4-BBN as the displacement radioligand. The pharmacokinetics and in vivo binding specificity of the compound were studied. NOTA-P2-RM26 was labeled with (18F within 1 h (60-65% decay corrected radiochemical yield, 55 GBq/µmol. The radiopeptide was stable in murine serum and showed high specific binding to PC-3 cells. [(natF]AlF-NOTA-P2-RM26 showed a low nanomolar inhibition efficiency (IC50=4.4±0.8 nM. The internalization rate of the tracer was low. Less than 14% of the cell-bound radioactivity was internalized after 4 h. The biodistribution of [(18F]AlF-NOTA-P2-RM26 demonstrated rapid blood clearance, low liver uptake and low kidney retention. The tumor uptake at 3 h p.i. was 5.5±0.7 %ID/g, and the tumor-to-blood, -muscle and -bone ratios were 87±42, 159±47, 38±16, respectively. The uptake in tumors, pancreas and other GRPR-expressing organs was significantly reduced when excess amount of non-labeled peptide was co-injected. The low uptake in bone suggests a high in vivo stability of the Al-F bond. High contrast PET image was obtained 3 h p

  6. TU-C-12A-11: Comparisons Between Cu-ATSM PET and DCE-CT Kinetic Parameters in Canine Sinonasal Tumors

    La Fontaine, M; Bradshaw, T [University of Wisconsin, Madison, Wisconsin (United States); Kubicek, L [University of Florida, Gainesville, Florida (United States); Forrest, L [University of Wisconsin-Madison, Madison, Wisconsin (United States); Jeraj, R [University of Wisconsin, Madison, WI (United States)

    2014-06-15

    Purpose: Regions of poor perfusion within tumors may be associated with higher hypoxic levels. This study aimed to test this hypothesis by comparing measurements of hypoxia from Cu-ATSM PET to vasculature kinetic parameters from DCE-CT kinetic analysis. Methods: Ten canine patients with sinonasal tumors received one Cu-ATSM PET/CT scan and three DCE-CT scans prior to treatment. Cu-ATSM PET/CT and DCE-CT scans were registered and resampled to matching voxel dimensions. Kinetic analysis was performed on DCE-CT scans and for each patient, the resulting kinetic parameter values from the three DCE-CT scans were averaged together. Cu-ATSM SUVs were spatially correlated (r{sub spatial}) on a voxel-to-voxel basis against the following DCE-CT kinetic parameters: transit time (t{sub 1}), blood flow (F), vasculature fraction (v{sub 1}), and permeability (PS). In addition, whole-tumor comparisons were performed by correlating (r{sub ROI}) the mean Cu-ATSM SUV (SUV{sub mean}) with median kinetic parameter values. Results: The spatial correlations (r{sub spatial}) were poor and ranged from -0.04 to 0.21 for all kinetic parameters. These low spatial correlations may be due to high variability in the DCE-CT kinetic parameter voxel values between scans. In our hypothesis, t{sub 1} was expected to have a positive correlation, while F was expected to have a negative correlation to hypoxia. However, in wholetumor analysis the opposite was found for both t{sub 1} (r{sub ROI} = -0.25) and F (r{sub ROI} = 0.56). PS and v{sub 1} may depict angiogenic responses to hypoxia and found positive correlations to Cu-ATSM SUV for PS (r{sub ROI} = 0.41), and v{sub 1} (r{sub ROI} = 0.57). Conclusion: Low spatial correlations were found between Cu-ATSM uptake and DCE-CT vasculature parameters, implying that poor perfusion is not associated with higher hypoxic regions. Across patients, the most hypoxic tumors tended to have higher blood flow values, which is contrary to our initial hypothesis. Funding

  7. Comparative Oncology: Evaluation of 2-Deoxy-2-[18F]fluoro-D-glucose (FDG Positron Emission Tomography/Computed Tomography (PET/CT for the Staging of Dogs with Malignant Tumors.

    Stefanie M F Seiler

    Full Text Available 2-Deoxy-2-[18F]fluoro-D-glucose PET/CT is a well-established imaging method for staging, restaging and therapy-control in human medicine. In veterinary medicine, this imaging method could prove to be an attractive and innovative alternative to conventional imaging in order to improve staging and restaging. The aim of this study was both to evaluate the effectiveness of this image-guided method in canine patients with spontaneously occurring cancer as well as to illustrate the dog as a well-suited animal model for comparative oncology.Ten dogs with various malignant tumors were included in the study and underwent a whole body FDG PET/CT. One patient has a second PET-CT 5 months after the first study. Patients were diagnosed with histiocytic sarcoma (n = 1, malignant lymphoma (n = 2, mammary carcinoma (n = 4, sertoli cell tumor (n = 1, gastrointestinal stromal tumor (GIST (n = 1 and lung tumor (n = 1. PET/CT data were analyzed with the help of a 5-point scale in consideration of the patients' medical histories.In seven of the ten dogs, the treatment protocol and prognosis were significantly changed due to the results of FDG PET/CT. In the patients with lymphoma (n = 2 tumor extent could be defined on PET/CT because of increased FDG uptake in multiple lymph nodes. This led to the recommendation for a therapeutic polychemotherapy as a treatment. In one of the dogs with mammary carcinoma (n = 4 and in the patient with the lung tumor (n = 1, surgery was cancelled due to the discovery of multiple metastasis. Consequently no treatment was recommended.FDG PET/CT offers additional information in canine patients with malignant disease with a potential improvement of staging and restaging. The encouraging data of this clinical study highlights the possibility to further improve innovative diagnostic and staging methods with regard to comparative oncology. In the future, performing PET/CT not only for staging but also in therapy control could offer a

  8. The Usefulness of Pre-Radiofrequency Ablation SUVmax in 18F-FDG PET/CT to Predict the Risk of a Local Recurrence of Malignant Lung Tumors after Lung Radiofrequency Ablation

    Harada,Sosuke

    2011-12-01

    Full Text Available The aim of the present study was to assess the diagnostic usefulness of Fluorine-18 fluorodeoxyglucose (18F-FDG positron emission tomography/computed tomography (PET/CT in the prediction of local recurrence of malignant lung tumors by analyzing the pre-radiofrequency ablation (RFA maximal standardized uptake value (SUVmax. We performed a historical cohort study of consecutive malignant lung tumors treated by RFA from January 2007 to May 2008 at Okayama University Hospital. We selected only lung tumors examined by PET/CT within 90 days before RFA and divided them (10 primary and 29 metastatic into 3 groups according to their tertiles of SUVmax. We calculated recurrence odds ratios in the medium group and the high group compared to the low group using multivariate logistic analysis. After we examined the relationship between SUVmax and recurrence in a crude model, we adjusted for some factors. Tumors with higher SUVmax showed higher recurrence odds ratios (medium group;1.84, high group;4.14, respectively. The tumor size also increased the recurrence odds ratio (2.67;we thought this was mainly due to selection bias because we excluded tumors less than 10mm in diameter. This study demonstrated the pre-RFA SUVmax in PET/CT may be a prognostic factor for local recurrence of malignant lung tumors.

  9. [Role of 18FDG-PET/CT in the management and gross tumor volume definition for radiotherapy of head and neck cancer; single institution experiences based on long-term follow-up].

    Hideghéty, Katalin; Cserháti, Adrienne; Besenyi, Zsuzsanna; Zag, Levente; Gaál, Szilvia; Együd, Zsófia; Mózes, Petra; Szántó, Erika; Csenki, Melinda; Rusz, Orsolya; Varga, Zoltán; Dobi, Ágnes; Maráz, Anikó; Pávics, László; Lengyel, Zsolt

    2015-06-01

    The purpose of our work is evaluation of the impact of 18FDG-PET/CT on the complex management of locoregionally advanced (T3-4N1-3) head and neck squamous cell cancer (LAHNSC), and on the target definition for 3D conformal (3DCRT) and intensity-modulated radiotherapy (IMRT). 18FDG-PET/CT were performed on 185 patients with LAHNSC prior to radiotherapy/chemoradiation in the treatment position between 2006 and 2011. Prior to it 91 patients received induction chemotherapy (in 20 cases of these, baseline PET/CT was also available). The independently delineated CT-based gross tumor volume (GTVct) and PET/CT based ones (GTVpet) were compared. Impact of PET/CT on the treatment strategy, on tumor response evaluation to ICT, on GTV definition furthermore on overall and disease-specific survival (OS, DSS) was analysed. PET/CT revealed 10 head and neck, 2 lung cancers for 15 patients with carcinoma of unknown primary (CUP) while 3 remained unknown. Second tumors were detected in 8 (4.4%), distant metastasis in 15 (8.2%) cases. The difference between GTVct and GTVpet was significant (p=0.001). In 16 patients (14%) the GTVpet were larger than GTVct due to multifocal manifestations in the laryngo-pharyngeal regions (4 cases) or lymph node metastases (12 cases). In the majority of the cases (82 pts, 72%) PET/CT-based conturing resulted in remarkable decrease in the volume (15-20%: 4 cases, 20-50%: 46 cases, >50%: 32 cases). On the basis of the initial and post-ICT PET/CT comparison in 15/20 patients more than 50% volume reduction and in 6/20 cases complete response were achieved. After an average of 6.4 years of follow-up the OS (median: 18.3±2.6 months) and DSS (median: 25.0±4.0 months) exhibited close correlation (p=0.0001) to the GTVpet. In cases with GTVpet 40 cm3 the median DSS was 8.4±0.96 months (HR= 11.48; 95% CI: 5.3-24.9). Our results suggest that 18FDG-PET/CT plays an important role for patient with LAHNSC, by modifying the treatment concept and improving the target

  10. (64)Cu-ATSM and (18)FDG PET uptake and (64)Cu-ATSM autoradiography in spontaneous canine tumors

    Hansen, Anders E; Kristensen, Annemarie T; Jørgensen, Jesper T;

    2012-01-01

    The aim of this study was to compare (64)Cu-diacetyl-bis(N(4)-methylsemicarbazone) ((64)Cu-ATSM) and (18)FDG PET uptake characteristics and (64)Cu-ATSM autoradiography to pimonidazole immunohistochemistry in spontaneous canine sarcomas and carcinomas....

  11. Combined measurement of tumor perfusion and glucose metabolism for improved tumor characterization in advanced cervical carcinoma. A PET/CT pilot study using [15O]water and [18F]fluorodeoxyglucose

    The aim of this pilot study was (1) to evaluate the combination of [18F]fluorodeoxyglucose (FDG) and [15O]water for detection of flow-metabolism mismatch in advanced cervical carcinomas, i.e., increased glycolysis at low blood flow, as a possible parameter for prediction of response to treatment, and (2) to propose a method for automated quantification of its spatial extent. The study retrospectively included 10 women with advanced cervical carcinoma in whom PET with both FDG and [15O]water had been performed prior to therapy. The metabolically active tumor volume was delineated automatically in the FDG images. For computation of the regional blood flow in the tumor, a recovery corrected image-derived arterial input function was used. A tumor voxel was classified as mismatched when the voxel SUV of FDG was larger than the median tumor SUV and the voxel perfusion (K1) was smaller than the median perfusion. The absolute mismatch volume (aMMV) was defined as the volume of all mismatched voxels in ml, and the relative mismatch volume (rMMV) as the ratio of the aMMV to the metabolic tumor volume in percent. The tumors were quite heterogeneous with respect to both FDG uptake and perfusion. The aMMV clustered into 2 groups: ''large aMMV'' ≥ 10 ml in 40 % of patients and ''small aMMV'' ≤ 5 ml in 60 % of patients. The rMMV ranged from 12.7-24.9 %. There was no correlation between rMMV and metabolic tumor volume. There was a tendency (p = 0.126) for an association between rMMV and histological grading, rMMV being about 20 % higher in G3 than in G2 tumors. rMMV did not correlate with SUV or perfusion. These results suggest that combined PET with FDG and [15O]water allows detection and quantitative characterization of flow-metabolism mismatch in advanced cervical carcinomas. (orig.)

  12. 18F-FDG-PET/CT imaging in an IL-6- and MYC-driven mouse model of human multiple myeloma affords objective evaluation of plasma cell tumor progression and therapeutic response to the proteasome inhibitor ixazomib

    18F-fluorodeoxyglucose positron emission tomography (FDG-PET) and computed tomography (CT) are useful imaging modalities for evaluating tumor progression and treatment responses in genetically engineered mouse models of solid human cancers, but the potential of integrated FDG-PET/CT for assessing tumor development and new interventions in transgenic mouse models of human blood cancers such as multiple myeloma (MM) has not been demonstrated. Here we use BALB/c mice that contain the newly developed iMycΔEμ gene insertion and the widely expressed H2-Ld-IL6 transgene to demonstrate that FDG-PET/CT affords an excellent research tool for assessing interleukin-6- and MYC-driven plasma cell tumor (PCT) development in a serial, reproducible and stage- and lesion-specific manner. We also show that FDG-PET/CT permits determination of objective drug responses in PCT-bearing mice treated with the investigational proteasome inhibitor ixazomib (MLN2238), the biologically active form of ixazomib citrate (MLN9708), that is currently in phase 3 clinical trials in MM. Overall survival of 5 of 6 ixazomib-treated mice doubled compared with mice left untreated. One outlier mouse presented with primary refractory disease. Our findings demonstrate the utility of FDG-PET/CT for preclinical MM research and suggest that this method will play an important role in the design and testing of new approaches to treat myeloma

  13. Comparison of abdominal MRI with diffusion-weighted imaging to {sup 68}Ga-DOTATATE PET/CT in detection of neuroendocrine tumors of the pancreas

    Schmid-Tannwald, Christine; Schmid-Tannwald, Christoph M.; Neumann, Ralph; Nikolaou, Konstantin; Schramm, Nicolai; Reiser, Maximilian F.; Rist, Carsten [Ludwig Maximilians University Hospital Munich, Institute for Clinical Radiology, Munich (Germany); Morelli, John N. [Scott and White Hospital Temple, Department of Radiology, Temple, TX (United States); Haug, Alexander R.; Jansen, Nathalie [Ludwig Maximilians University Hospital Munich, Department of Nuclear Medicine, Munich (Germany)

    2013-06-15

    The aim of the study was to evaluate contrast-enhanced MRI, diffusion-weighted MRI (DW MRI), and {sup 68}Ga-DOTATATE positron emission tomography (PET)/CT in the detection of intermediate to well-differentiated neuroendocrine tumors (NET) of the pancreas. Eighteen patients with pathologically proven pancreatic NET who underwent MRI including DW MRI and PET/CT within 6 weeks of each other were included in this retrospective study. Two radiologists evaluated T2-weighted (T2w), T2w + DW MRI, T2w + contrast-enhanced T1-weighted (CE T1w) MR images, and PET/CT for NET detection. The sensitivity and level of diagnostic confidence were compared among modalities using McNemar's test and a Wilcoxon signed rank test. Apparent diffusion coefficients (ADC) of pancreatic NETs and normal pancreatic tissue were compared with Student's t test. Of the NETs, 8/23 (34.8 %) and 9/23 (39.1 %) were detected on T2w images by observers 1 and 2, respectively. Detection rates improved significantly by combining T2w images with DW MRI (observer 1: 14/23 = 61 %; observer 2: 15/23 = 65.2 %; p < 0.05) or CE T1w images (observer 1: 14/23 = 61 %; observer 2: 15/23 = 65.2 %; p < 0.05). Detection rates of pancreatic NET with PET/CT (both observers: 23/23 = 100 %) were statistically significantly higher than with MRI (p < 0.05). The mean ADC value of NET (1.02 {+-} 0.26 x 10{sup -3} mm{sup 2}/s) was statistically significantly lower than that of normal pancreatic tissue (1.48 {+-} 0.39 x 10{sup -3} mm{sup 2}/s). DW MRI is a valuable adjunct to T2w imaging and comparable to CE T1w imaging in pancreatic NET detection, quantitatively differentiating between NET and normal pancreatic tissue with ADC measurements. {sup 68}Ga-DOTATATE PET/CT is more sensitive than MRI in the detection of pancreatic NET. (orig.)

  14. Gene transcript analysis blood values correlate with {sup 68}Ga-DOTA-somatostatin analog (SSA) PET/CT imaging in neuroendocrine tumors and can define disease status

    Bodei, L. [European Institute of Oncology, Division of Nuclear Medicine, Milan (Italy); Kidd, M.; Modlin, I.M.; Drozdov, I. [Wren Laboratories, Branford, CT (United States); Prasad, V. [Charite University Hospital, Department of Nuclear Medicine, Berlin (Germany); Severi, S.; Paganelli, G. [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Nuclear Medicine and Radiometabolic Units, Meldola (Italy); Ambrosini, V. [S. Orsola-Malpighi University Hospital, Nuclear Medicine, Bologna (Italy); Kwekkeboom, D.J.; Krenning, E.P. [Erasmus Medical Center Rotterdam, Nuclear Medicine Department, Rotterdam (Netherlands); Baum, R.P. [Zentralklinik Bad Berka, THERANOSTICS Center for Molecular Radiotherapy and Imaging, Bad Berka (Germany)

    2015-08-15

    Precise determination of neuroendocrine tumor (NET) disease status and response to therapy remains a rate-limiting concern for disease management. This reflects limitations in biomarker specificity and resolution capacity of imaging. In order to evaluate biomarker precision and identify if combinatorial blood molecular markers and imaging could provide added diagnostic value, we assessed the concordance between {sup 68}Ga-somatostatin analog (SSA) positron emission tomography (PET), circulating NET gene transcripts (NETest), chromogranin A (CgA), and Ki-67 in NETs. We utilized two independent patient groups with positive {sup 68}Ga-SSA PET: data set 1 ({sup 68}Ga-SSA PETs undertaken for peptide receptor radionuclide therapy (PRRT), as primary or salvage treatment, n = 27) and data set 2 ({sup 68}Ga-SSA PETs performed in patients referred for initial disease staging or restaging after various therapies, n = 22). We examined the maximum standardized uptake value (SUV{sub max}), circulating gene transcripts, CgA levels, and baseline Ki-67. Regression analyses, generalized linear modeling, and receiver-operating characteristic (ROC) analyses were undertaken to determine the strength of the relationships. SUV{sub max} measured in two centers were mathematically evaluated (regression modeling) and determined to be comparable. Of 49 patients, 47 (96 %) exhibited a positive NETest. Twenty-six (54 %) had elevated CgA (χ{sup 2} = 20.1, p < 2.5 x 10{sup -6}). The majority (78 %) had Ki-67 < 20 %. Gene transcript scores were predictive of imaging with >95 % concordance and significantly correlated with SUV{sub max} (R {sup 2} = 0.31, root-mean-square error = 9.4). The genes MORF4L2 and somatostatin receptors SSTR1, 3, and 5 exhibited the highest correlation with SUV{sub max}. Progressive disease was identified by elevated levels of a quotient of MORF4L2 expression and SUV{sub max} [ROC-derived AUC (R {sup 2} = 0.7, p < 0.05)]. No statistical relationship was identified

  15. Gene transcript analysis blood values correlate with 68Ga-DOTA-somatostatin analog (SSA) PET/CT imaging in neuroendocrine tumors and can define disease status

    Precise determination of neuroendocrine tumor (NET) disease status and response to therapy remains a rate-limiting concern for disease management. This reflects limitations in biomarker specificity and resolution capacity of imaging. In order to evaluate biomarker precision and identify if combinatorial blood molecular markers and imaging could provide added diagnostic value, we assessed the concordance between 68Ga-somatostatin analog (SSA) positron emission tomography (PET), circulating NET gene transcripts (NETest), chromogranin A (CgA), and Ki-67 in NETs. We utilized two independent patient groups with positive 68Ga-SSA PET: data set 1 (68Ga-SSA PETs undertaken for peptide receptor radionuclide therapy (PRRT), as primary or salvage treatment, n = 27) and data set 2 (68Ga-SSA PETs performed in patients referred for initial disease staging or restaging after various therapies, n = 22). We examined the maximum standardized uptake value (SUVmax), circulating gene transcripts, CgA levels, and baseline Ki-67. Regression analyses, generalized linear modeling, and receiver-operating characteristic (ROC) analyses were undertaken to determine the strength of the relationships. SUVmax measured in two centers were mathematically evaluated (regression modeling) and determined to be comparable. Of 49 patients, 47 (96 %) exhibited a positive NETest. Twenty-six (54 %) had elevated CgA (χ2 = 20.1, p < 2.5 x 10-6). The majority (78 %) had Ki-67 < 20 %. Gene transcript scores were predictive of imaging with >95 % concordance and significantly correlated with SUVmax (R 2 = 0.31, root-mean-square error = 9.4). The genes MORF4L2 and somatostatin receptors SSTR1, 3, and 5 exhibited the highest correlation with SUVmax. Progressive disease was identified by elevated levels of a quotient of MORF4L2 expression and SUVmax [ROC-derived AUC (R 2 = 0.7, p < 0.05)]. No statistical relationship was identified between CgA and Ki-67 and no relationship with imaging parameters was evident. 68Ga

  16. Medical application of PET technology

    Lim, Sang Moo; Choi, C. W.; An, S. H.; Woo, K. S.; Chung, W. S.; Yang, S. D.; Jun, G. S. and others

    1999-04-01

    We performed following studies using PET technology: 1. Clinical usefulness of [{sup 18}F]FDG whole body PET in malignant disease 2. Clinical usefulness of quantitative evaluation of F-18-FDG 3. Pilot study of C-11 methionine PET in brain tumor 4. PET study in patients with Parkinson's disease 5. A study on the clinical myocardial PET image. PET gives various metabolic information for the living human body, and is very important, new diagnostic modality. The PET study will give us the information of cancer patients such as early detection of cancer, staging, recurrence detection and characterization of cancer. The quantitative analysis using PET could be applied to evaluate the pathophysiology of various diseases and develop new drugs and develop new radiopharmaceuticals.

  17. Medical application of PET technology

    We performed following studies using PET technology: 1. Clinical usefulness of [18F]FDG whole body PET in malignant disease 2. Clinical usefulness of quantitative evaluation of F-18-FDG 3. Pilot study of C-11 methionine PET in brain tumor 4. PET study in patients with Parkinson's disease 5. A study on the clinical myocardial PET image. PET gives various metabolic information for the living human body, and is very important, new diagnostic modality. The PET study will give us the information of cancer patients such as early detection of cancer, staging, recurrence detection and characterization of cancer. The quantitative analysis using PET could be applied to evaluate the pathophysiology of various diseases and develop new drugs and develop new radiopharmaceuticals

  18. Role of combined DWIBS/3D-CE-T1w whole-body MRI in tumor staging: Comparison with PET-CT

    Objectives: To assess the diagnostic performance of whole-body magnetic resonance imaging (WB-MRI) by diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) in malignant tumor detection and the potential diagnostic advantages in generating fused DWIBS/3D-contrast enhanced T1w (3D-CE-T1w) images. Methods: 45 cancer patients underwent 18F-FDG PET-CT and WB-MRI for staging purpose. Fused DWIBS/3D-CE T1w images were generated off-line. 3D-CE-T1w, DWIBS images alone and fused with 3D-CE T1w were compared by two readers groups for detection of primary diseases and local/distant metastases. Diagnostic performance between the three WB-MRI data sets was assessed using receiver operating characteristic (ROC) curve analysis. Imaging exams and histopathological results were used as standard of references. Results: Areas under the ROC curves of DWIBS vs. 3D-CE-T1w vs. both sequences in fused fashion were 0.97, 0.978, and 1.00, respectively. The diagnostic performance in tumor detection of fused DWIBS/3D-CE-T1w images were statistically superior to DWIBS (p < 0.001) and 3D-CE-T1w (p ≤ 0.002); while the difference between DWIBS and 3D-CE-T1w did not show statistical significance difference. Detection rates of malignancy did not differ between WB-MRI with DWIBS and 18F-FDG PET-CT. Conclusion: WB-MRI with DWIBS is to be considered as alternative tool to conventional whole-body methods for tumor staging and during follow-up in cancer patients.

  19. Role of combined DWIBS/3D-CE-T1w whole-body MRI in tumor staging: Comparison with PET-CT

    Manenti, Guglielmo, E-mail: guggi@tiscali.it [Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, University ' Tor Vergata' , PTV Foundation - Policlinic ' Tor Vergata' , Viale Oxford 81, 00133 Rome (Italy); Ciccio, Carmelo, E-mail: carmeciccio@libero.it [Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, University ' Tor Vergata' , PTV Foundation - Policlinic ' Tor Vergata' , Viale Oxford 81, 00133 Rome (Italy); Squillaci, Ettore, E-mail: ettoresquillaci@tiscali.it [Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, University ' Tor Vergata' , PTV Foundation - Policlinic ' Tor Vergata' , Viale Oxford 81, 00133 Rome (Italy); Strigari, Lidia, E-mail: strigari@ifo.it [Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome (Italy); Calabria, Ferdinando, E-mail: ferdinandocalabria@hotmail.it [Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, University ' Tor Vergata' , PTV Foundation - Policlinic ' Tor Vergata' , Viale Oxford 81, 00133 Rome (Italy); Danieli, Roberta, E-mail: roberta.danieli@ptvonline.it [Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, University ' Tor Vergata' , PTV Foundation - Policlinic ' Tor Vergata' , Viale Oxford 81, 00133 Rome (Italy); and others

    2012-08-15

    Objectives: To assess the diagnostic performance of whole-body magnetic resonance imaging (WB-MRI) by diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) in malignant tumor detection and the potential diagnostic advantages in generating fused DWIBS/3D-contrast enhanced T1w (3D-CE-T1w) images. Methods: 45 cancer patients underwent 18F-FDG PET-CT and WB-MRI for staging purpose. Fused DWIBS/3D-CE T1w images were generated off-line. 3D-CE-T1w, DWIBS images alone and fused with 3D-CE T1w were compared by two readers groups for detection of primary diseases and local/distant metastases. Diagnostic performance between the three WB-MRI data sets was assessed using receiver operating characteristic (ROC) curve analysis. Imaging exams and histopathological results were used as standard of references. Results: Areas under the ROC curves of DWIBS vs. 3D-CE-T1w vs. both sequences in fused fashion were 0.97, 0.978, and 1.00, respectively. The diagnostic performance in tumor detection of fused DWIBS/3D-CE-T1w images were statistically superior to DWIBS (p < 0.001) and 3D-CE-T1w (p {<=} 0.002); while the difference between DWIBS and 3D-CE-T1w did not show statistical significance difference. Detection rates of malignancy did not differ between WB-MRI with DWIBS and 18F-FDG PET-CT. Conclusion: WB-MRI with DWIBS is to be considered as alternative tool to conventional whole-body methods for tumor staging and during follow-up in cancer patients.

  20. Comparison of diagnostic sensitivity and quantitative indices between {sup 68}Ga-DOTATOC PET and {sup 111}In-pentetreotide SPECT/CT in neuroendocrine tumors: A preliminary report

    Lee, In Ki; Paeng, Jin Chul; Shin, Chan Soo; Lee, Soo Jin; Jang, Jin Young; Cheon, Gi Jeong; Lee, Dong Soo; Chung, June Key; Kang, Keon Wook [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2015-12-15

    In-pentetreotide has been used for neuroendocrine tumors expressing somatostatin receptors. Recently, {sup 68}Ga-DOTATOC PET has been used with the advantage of high image quality. In this study, we compared quantitative indices between {sup 111}In-pentetreotide SPECT/CT and {sup 68}Ga-DOTATOC PET/CT. Thirteen patients diagnosed with neuroendocrine tumors were prospectively recruited. Patients underwent {sup 111}In-pentetreotide scans with SPECT/CT and {sup 68}Ga-DOTATOC PET/CT before treatment. The number and location of lesions were analyzed on both imaging techniques to compare lesion detectability. Additionally, the maximal uptake count of each lesion and mean uptake count of the lungs were measured on both imagings, and target-to-normal lung ratios (TNR) were calculated as quantitative indices. Among 13 patients, 10 exhibited lesions with increased uptake on {sup 111}In-pentetreotide SPECT/CT and/or {sup 68}Ga-DOTATOC PET/CT. Scans with SPECT/CT detected 19 lesions, all of which were also detected on PET/CT. Moreover, 16 additional lesions were detected on PET/CT (6 in the liver, 9 in the pancreas and 1 in the spleen). PET/CT exhibited a significantly higher sensitivity than SPECT/CT (100 % vs. 54 %, P < 0.001). TNR was significantly higher on PET/CT than on SPECT/CT (99.9 ± 84.3 vs. 71.1 ± 114.9, P < 0.001) in spite of a significant correlation (r = 0.692, P = 0.01). Ga-DOTATOC PET/CT has a higher diagnostic sensitivity than {sup 111}In-pentetreotide scans with SPECT/CT. The TNR on PET/CT is higher than that of SPECT/CT, which also suggests the higher sensitivity of PET/CT. {sup 111}In-pentetreotide SPECT/CT should be used carefully if it is stead of {sup 68}Ga-DOTATOC PET/CT.

  1. Interobserver variability among measurements of the maximum and mean standardized uptake values on 18F-FDG PET/CT and measurements of tumor size on diagnostic CT in patients with pulmonary tumors

    Background: 18F-fluoro-2-deoxyglucose positron emission tomography (18F-FDG PET) imaging has been shown to be an accurate method for diagnosing pulmonary lesions, and the standardized uptake value (SUV) has been shown to be useful in differentiating benign from malignant lesions. Purpose: To survey the interobserver variability of SUVmax and SUVmean measurements on 18F-FDG PET/CT scans and compare them with tumor size measurements on diagnostic CT scans in the same group of patients with focal pulmonary lesions. Material and Methods: Forty-three pulmonary nodules were measured on both 18F-FDG PET/CT and diagnostic chest CT examinations. Four independent readers measured the SUVmax and SUVmean of the 18F-FDG PET images, and the unidimensional nodule size of the diagnostic CT scans (UDCT) in all nodules. The region of interest (ROI) for the SUV measurements was drawn manually around each tumor on all consecutive slices that contained the nodule. The interobserver reliability and variability, represented by the intraclass correlation coefficient (ICC) and coefficient of variation (COV), respectively, were compared among the three parameters. The correlation between the SUVmax and SUVmean was also analyzed. Results: There was 100% agreement in the SUVmax measurements among the 4 readers in the 43 pulmonary tumors. The ICCs for the SUVmax, SUVmean, and UDCT by the four readers were 1.00, 0.97, and 0.97, respectively. The root-mean-square values of the COVs for the SUVmax, SUVmean, and UDCT by the four readers were 0%, 13.56%, and 11.03%, respectively. There was a high correlation observed between the SUVmax and SUVmean (Pearson's r=0.958; P <0.01). Conclusion: This study has shown that the SUVmax of lung nodules can be calculated without any interobserver variation. These findings indicate that SUVmax is a more valuable parameter than the SUVmean or UDCT for the evaluation of therapeutic effects of chemotherapy or radiation therapy on serial studies

  2. Combined imaging approach to neuroendocrine tumors using somatostatin receptor scintigraphy with 99mTc-HYNIC TOC SPECT/CT and 18F FDG PET/CT-implications for targeted peptide therapy

    Full text: A combined imaging approach using FDG PET (GLUT expression) and SRS (somatostatin Receptor expression) is necessary in order to stratify patients of NET's, for appropriate treatment planning. Aim: 1) To study the variable expression of somatostatin and GLUT receptors in pathologically proven neuroendocrine tumors at primary and metastatic sites. 2) To identify the subgroups and suitability for peptide therapy. Materials and Methods: 72 patients (age - 18-72 years) with a known diagnosis of neuroendocrine tumor were prospectively studied. SRS using 99mTc- HYNIC TOC SPECT/CT and GLUT imaging with FDG PET/CT study were performed in all the patients. The SPECT and PET results were interpreted independently by 2 nuclear medicine physicians and the corresponding studies were compared lesion by lesion for the final analysis. The findings were validated using available histological, imaging and follow up findings. Results: 49 patients had positive findings on both SRS and FDG PET/CT studies.12 patients showed a positive SRS study and negative FDG PET study. 11 patients had a positive FDG PET study and a negative SRS study. A total of 120 lesions were detected on SRS and 131 lesions detected on FDG PET.14 patients had solitary lesions on both the modalities. Neither FDG PET nor SRS added any incremental value in identifying additional sites in patients with solitary lesions. Conclusion: 1) 68% of the patients showed variable expression of somatostatin and GLUT receptors and thus were unsuitable for standalone radio peptide therapy and thus necessitated a combination therapy. The aim would be to control progression or palliation. 2) Only 29% of the patients showed lone somatostatin expression who could benefit from standalone somatostatin or radio peptide therapy with a curative intent

  3. The retention index calculated with dual-phase F-18 FDG PET by the primary tumor as a predictor for lymph node involvement in patients with non small cell lung cancer

    Kim, S. E.; Chung, H. C.; Lee, S. Y. [Korea University College of Medicine, Seoul (Korea, Republic of)] (and others)

    2005-07-01

    F-18 FDG uptake within primary tumor has been shown to correlate with aggressiveness and survival on PET studies of patients with NSCLC (Vesselle H, 2003). We investigated whether F-18 FDG uptake by primary tumor is a predictor of lymph node (LN) involvement in patients with non small cell lung cancer (NSCLC). A total of 51 consecutive patients with pathologically proven NSCLC were underwent dual-phase FDG PET. All of patients was underwent a thoracotomy within 1 month of F-18 FDG PET study. Maximum standard uptake values at 1 hour (SUV1) and 2 hour (SUV 2) following the injection of F-18 FDG were determined, and the retention index (RI) was calculated by dividing the difference between SUV2 and SUV1 by SUV1 (RI=(SUV2-SUV1)/SUV X 100%). The predictive values of SUV1, SUV2 and RI were analyzed, along with the clinical parameters. (age(=60 vs 60<), Sex(M vs F), tumor size(>3cm vs 3cm<), histology (adenocarcinoma vs nondenocaricnoma), and tumor differentiation (well/moderately vs poorly). The LN involvements were founded in 49%. In univariate analysis the tumor size, RI and histology were factors significantly associated with LN involvement (p<0.05). The best cut-off value for RI was 17. In multivariate analysis the tumor size and RI (>17) were factors significantly associated with LN involvement (P<0.001). SUV2 and RI from dual-phase FDG-PET by the primary tumor was significant predictors for LN involvement. High RI in the primary tumor at presentation should prompt high suspicion and an aggressive search for lymph node metastasis.

  4. 18FDG PET for grading malignancy in thymic epithelial tumors: Significant differences in 18FDG uptake and expression of glucose transporter-1 and hexokinase II between low and high-risk tumors: Preliminary study

    Purpose: To evaluate 18F-fluorodeoxyglucose (FDG) uptake to predict the malignant nature and analyze the correlation between FDG uptake and expression of glucose transporter 1 (Glut-1) and hexokinase II (HK-II) in thymic epithelial tumors. Materials and methods: Eleven patients with a thymic epithelial tumor who underwent FDG PET/CT before therapy were reviewed. The thymic tumors were classified by the WHO histological classification and Masaoka clinical staging. Comparison of maximum standardized uptake value (SUVmax) of the lesion was made between the low-risk (Type A, AB and B1) and high-risk {Type B2, B3 and C (thymic cancer)} groups and among clinical stages. Expression of Glut-1 and HK-II was analyzed immunohistochemically. Results: All 11 tumors showed FDG uptake visually. SUVmax was significantly higher in the high-risk group (n = 5, 5.24 ± 2.44) than the low-risk group (n = 6, 3.05 ± 0.55) (P = 0.008). Staining scores of both Glut-1 and HK-II were significantly higher in the high-risk group than in the low-risk group (Glut1: P = 0.034 and HK-II: P = 0.036). There were no significant differences in SUVmax (P = 0.11), Glut-1 (P = 0.35) and HK-II scores (P = 0.29) among clinical stages. SUVmax was significantly correlated to each of the staining scores of Glut-1 (ρ = 0.68, P = 0.031) and HK-II (ρ = 0.72, P = 0.024). Conclusion: These preliminary results support the previously published view that SUVmax may be useful to predict the malignant nature of thymic epitherial tumors and suggest that the degree of FDG uptake in the thymic epitherial tumors is closely related to the amount of Glut-1 and HK-II in the tumor.

  5. Assessment of Tumoricidal Efficacy and Response to Treatment with 18F-FDG PET/CT After Intraarterial Infusion with the Antiglycolytic Agent 3-Bromopyruvate in the VX2 Model of Liver Tumor

    Liapi, Eleni; Geschwind, Jean-Francois H; Vali, Mustafa; Khwaja, Afsheen A.; Prieto-Ventura, Veronica; Buijs, Manon; Vossen, Josephina A.; Ganapathy, Shanmugasudaram; Wahl, Richard L.

    2011-01-01

    The purpose of this study was to determine the effects of 3-bromopyruvate (3-BrPA) on tumor glucose metabolism as imaged with 18F-FDG PET/CT at multiple time points after treatment and compare them with those after intraarterial control injections of saline.

  6. PET/CT with 18F-fluorodeoxyglucose as metabolic alternative to biopsy for gastrointestinal stromal tumor?

    The usefulness of 18F-fluorodeoxyglucose (FDG) PET/CT in different clinical settings of many malignancies is well documented. Early evaluation of therapeutic response by means of functional imaging providing important predictive and prognostic information is particularly interesting. Furthermore, certain anticancer agents show significant therapeutic specificity for certain types of malignancies and therapeutic test evaluated by functional imaging my serve as metabolic surrogate for histology (metabolic biopsy). Gastrointestinal stromal tumours are FDG avid mesenchymal tumours, in most cases well responding to treatment by tyrosine-kinase inhibitors (imatinib mesylate, sunitinib maleate). Therapeutic test by imatinib mesylate evaluated by FDG PET/CT may potentially serve as metabolic biopsy in patients presenting tumour evocative of GIST. This article illustrates the potential role of metabolic biopsy in routine management of patients with abdominal tumour evocative of GIST. (author)

  7. 18F-FDG and 18F-FLT-PET Imaging for Monitoring Everolimus Effect on Tumor-Growth in Neuroendocrine Tumors

    Johnbeck, Camilla Bardram; Munk Jensen, Mette; Nielsen, Carsten Haagen;

    2014-01-01

    INTRODUCTION: The mTOR inhibitor everolimus has shown promising results in some but not all neuroendocrine tumors. Therefore, early assessment of treatment response would be beneficial. In this study, we investigated the in vivo and in vitro treatment effect of everolimus in neuroendocrine tumors...

  8. Evaluation of FDG uptake in pulmonary hila with FDG PET/CT and contrast-enhanced CT in patients with thoracic and non-thoracic tumors

    Fluorine-18 fluorodeoxyglucose (FDG) uptake is frequently observed in lung hilus. This finding causes difficulties during the interpretation. Our objective was to evaluate the features of FDG uptake in lung hilus associated with benign or malignant etiology in patients with thoracic and non-thoracic tumors. We retrospectively evaluated the files of 1172 patients who had undergone FDG positron emission tomography (PET)/computed tomography (CT) examination between January 2008 and June 2009. Forty-eight patients (21 males, 27 females, age range 12-80 years, mean 60.9±15.82 years) with either unilateral or bilateral hilar FDG uptake and who had thorax contrast-enhanced computed tomography (CECT) performed within 1 month of the FDG PET/CT scan were enrolled in the study. Characteristics of FDG uptake were classified according to the pathology and CECT or PET/CT follow-up over 12 months. The characteristics of 71 hilar regions with FDG uptake could be classified. In 30 of 71 (42.3%) hilar regions, FDG uptake was considered to be physiological because no lymph node was observed on CECT. In 19 of 71 (26.8%), FDG uptake was secondary to benign lymph nodes and in 22 (30.9%) to malignant lymph nodes. Significant differences were observed between benign and malignant lymph nodes for standardized uptake value of hilus (SUVhilus) and SUVhilus to the mean SUV of liver (SUVhilus/SUVliver) ratio. Using 4.49 as the cut-off value for SUVhilus, a sensitivity of 85.7% and a specificity of 86.4% were achieved (area under curve, AUC: 0.956). For SUVhilus/SUVliver ratio, sensitivity and specificity to detect malignant lymph nodes were 77.6 and 77.3% (AUC: 0.885), respectively, at a cut-off value of 1.75. SUVhilus and SUVhilus/SUVliver ratio were found to be significant parameters for determining malignancy in lung hilus. Combined interpretation with CECT is warranted during the evaluation of lung hilus with FDG PET/CT. (author)

  9. Differentiation of Brain Tumor Recurrence from Post-Radiotherapy Necrosis with 11C-Methionine PET: Visual Assessment versus Quantitative Assessment.

    Ryogo Minamimoto

    Full Text Available The aim of this multi-center study was to assess the diagnostic capability of visual assessment in L-methyl-11C-methionine positron emission tomography (MET-PET for differentiating a recurrent brain tumor from radiation-induced necrosis after radiotherapy, and to compare it to the accuracy of quantitative analysis.A total of 73 brain lesions (glioma: 31, brain metastasis: 42 in 70 patients who underwent MET-PET were included in this study. Visual analysis was performed by comparison of MET uptake in the brain lesion with MET uptake in one of four regions (around the lesion, contralateral frontal lobe, contralateral area, and contralateral cerebellar cortex. The concordance rate and logistic regression analysis were used to evaluate the diagnostic ability of visual assessment. Receiver-operating characteristic curve analysis was used to compare visual assessment with quantitative assessment based on the lesion-to-normal (L/N ratio of MET uptake.Interobserver and intraobserver κ-values were highest at 0.657 and 0.714, respectively, when assessing MET uptake in the lesion compared to that in the contralateral cerebellar cortex. Logistic regression analysis showed that assessing MET uptake in the contralateral cerebellar cortex with brain metastasis was significantly related to the final result. The highest area under the receiver-operating characteristic curve (AUC with visual assessment for brain metastasis was 0.85, showing no statistically significant difference with L/Nmax of the contralateral brain (AUC = 0.89 or with L/Nmean of the contralateral cerebellar cortex (AUC = 0.89, which were the areas that were the highest in the quantitative assessment. For evaluation of gliomas, no specific candidate was confirmed among the four areas used in visual assessment, and no significant difference was seen between visual assessment and quantitative assessment.The visual assessment showed no significant difference from quantitative assessment of MET-PET

  10. 18F FDOPA PET/CT or PET/MRI in Measuring Tumors in Patients With Newly Diagnosed or Recurrent Gliomas

    2016-06-22

    Adult Anaplastic Ependymoma; Adult Anaplastic Oligodendroglioma; Adult Brain Stem Glioma; Adult Diffuse Astrocytoma; Adult Giant Cell Glioblastoma; Adult Glioblastoma; Adult Gliosarcoma; Adult Mixed Glioma; Adult Oligodendroglioma; Adult Pilocytic Astrocytoma; Adult Pineal Gland Astrocytoma; Adult Subependymal Giant Cell Astrocytoma; Childhood High-grade Cerebellar Astrocytoma; Childhood High-grade Cerebral Astrocytoma; Childhood Low-grade Cerebellar Astrocytoma; Childhood Low-grade Cerebral Astrocytoma; Recurrent Adult Brain Tumor; Recurrent Childhood Anaplastic Astrocytoma; Recurrent Childhood Anaplastic Oligoastrocytoma; Recurrent Childhood Anaplastic Oligodendroglioma; Recurrent Childhood Brain Stem Glioma; Recurrent Childhood Cerebellar Astrocytoma; Recurrent Childhood Cerebral Astrocytoma; Recurrent Childhood Diffuse Astrocytoma; Recurrent Childhood Fibrillary Astrocytoma; Recurrent Childhood Gemistocytic Astrocytoma; Recurrent Childhood Giant Cell Glioblastoma; Recurrent Childhood Glioblastoma; Recurrent Childhood Gliomatosis Cerebri; Recurrent Childhood Gliosarcoma; Recurrent Childhood Oligoastrocytoma; Recurrent Childhood Oligodendroglioma; Recurrent Childhood Pilomyxoid Astrocytoma; Recurrent Childhood Protoplasmic Astrocytoma; Recurrent Childhood Subependymal Giant Cell Astrocytoma; Recurrent Childhood Visual Pathway and Hypothalamic Glioma; Recurrent Childhood Visual Pathway Glioma; Untreated Childhood Anaplastic Astrocytoma; Untreated Childhood Anaplastic Oligoastrocytoma; Untreated Childhood Anaplastic Oligodendroglioma; Untreated Childhood Brain Stem Glioma; Untreated Childhood Cerebellar Astrocytoma; Untreated Childhood Cerebral Astrocytoma; Untreated Childhood Diffuse Astrocytoma; Untreated Childhood Fibrillary Astrocytoma; Untreated Childhood Gemistocytic Astrocytoma; Untreated Childhood Giant Cell Glioblastoma; Untreated Childhood Glioblastoma; Untreated Childhood Gliomatosis Cerebri; Untreated Childhood Gliosarcoma; Untreated Childhood

  11. Histogram analysis reveals a better delineation of tumor volume from background in 18F-FET PET compared to CBV maps in a hybrid PET–MR studie in gliomas

    Anatomical imaging with magnetic resonance imaging (MRI) is currently the method of first choice for diagnostic investigation of glial tumors. However, different MR sequences may over- or underestimate tumor size and thus it may not be possible to delineate tumor from adjacent brain. In order to compensate this confinement additonal MR sequences like perfusion weighted MRI (PWI) with regional cerebral blood volume (rCBV) or positron emission tomography (PET) with aminoacids are used to gain further information. Recent studies suggest that both of theses image modalities provide similar diagnostic information. For comparison tumor to brain ratios (TBR) with mean and maximum values are frequently used but results from different studies can often not be checked against each other. Furthermore, especially the maximum TBR in rCBV is at risk to be falsified by artifacts (e.g. blood vessels). These confinements are reduced by the use of histograms since all information of the VOIs are equally displayed. In this study we measured and compared the intersection of tumor and reference tissue histograms in 18F-FET PET and rCBV maps in glioma patients. Methods: Twenty-seven glioma patients with contrast enhancing lesion on T1-weighted MR images were investigated using static 18F-FET PET and rCBV in MRI using a PET–MR hybrid scanner. In all patients diagnosis was confirmed histologically (7 grade II gliomas, 6 grade III gliomas and 14 grade IV gliomas). We generated a set of tumor and reference tissue Volumes-of-Interest (VOIs) based on T1 weighted images in MRI with the tumor VOI defined by contrast enhancement and transferred these VOIs to the corresponding 18F-FET PET scans and rCBV maps. From these VOIs we generated tumor and reference tissue histograms with a unity of one for each curve integral and measured the proportion of the area under the tumor curve that falls into the reference curve for 18F-FET PET and rCBV maps for each patient. Results: The mean proportion of

  12. Fully automated synthesis of 11C-acetate as tumor PET tracer by simple modified solid-phase extraction purification

    Introduction: Automated synthesis of 11C-acetate (11C-AC) as the most commonly used radioactive fatty acid tracer is performed by a simple, rapid, and modified solid-phase extraction (SPE) purification. Methods: Automated synthesis of 11C-AC was implemented by carboxylation reaction of MeMgBr on a polyethylene Teflon loop ring with 11C-CO2, followed by acidic hydrolysis with acid and SCX cartridge, and purification on SCX, AG11A8 and C18 SPE cartridges using a commercially available 11C-tracer synthesizer. Quality control test and animals positron emission tomography (PET) imaging were also carried out. Results: A high and reproducible decay-uncorrected radiochemical yield of (41.0±4.6)% (n=10) was obtained from 11C-CO2 within the whole synthesis time about 8 min. The radiochemical purity of 11C-AC was over 95% by high-performance liquid chromatography (HPLC) analysis. Quality control test and PET imaging showed that 11C-AC injection produced by the simple SPE procedure was safe and efficient, and was in agreement with the current Chinese radiopharmaceutical quality control guidelines. Conclusion: The novel, simple, and rapid method is readily adapted to the fully automated synthesis of 11C-AC on several existing commercial synthesis module. The method can be used routinely to produce 11C-AC for preclinical and clinical studies with PET imaging. - Highlights: • A fully automated synthesis of 11C-acetate by simple modified solid-phase extraction purification has been developed. • Typical non-decay-corrected yields were (41.0±4.6)% (n=10) • Radiochemical purity was determined by radio-HPLC analysis on a C18 column using the gradient program, instead of expensive organic acid column or anion column. • QC testing (RCP>99%)

  13. Prospective study of 18FDG-PET in the detection and management of patients with lymph node metastases to the neck from an unknown primary tumor. Results from the DAHANCA-13 study

    Johansen, Jørgen; Buus, Simon; Loft, Annika;

    2008-01-01

    BACKGROUND.: The benefit of a complementary fluorodeoxyglucose-positron emission tomography (FDG-PET) scan to standard workup for carcinoma of unknown primary (CUP) and metastatic neck lesions was prospectively studied. METHODS.: Sixty-seven patients underwent standardized diagnostic workup...... according to national guidelines including panendoscopies, multiple mucosal biopsies, and diagnostic CT/MRI scans. Median follow-up was 40 months (range, 2-65 months). RESULTS.: In 60 eligible patients, FDG-PET indicated a primary tumor or metastatic disease in 30 patients (50%). Additional investigations...

  14. PET imaging of hypoxia

    Hypoxia in tumors has been related to poor response to conventional therapies. This paper will discuss the methods, both invasive and non-invasive, used to determine hypoxia levels within tumors. PET imaging with two lead compounds 18F-fluoro misonidazole (18FMISO) and Cu-(II)-diacetyl-bis(N4-methylthiosemicarbazone (Cu-ATSM) and their relative effectiveness in delineating hypoxic regions will be discussed. The advantages of Cu-ATSM-PET over existing imaging agents will be discussed along with its potential application as a direct-and/or surrogate marker for the determination of oncological hypoxia in vivo

  15. 18F-FDG PET/CT在乳腺癌术后肿瘤标志物升高中的价值%THE VALUE OF 18F-FDG PET/CT IN MONITORING PATIENTS WITH INCREASED TUMOR MAKERS AFTER BREAST CANCER SURGERY

    郭佳; 陈跃

    2011-01-01

    [目的]探讨18F-脱氧葡萄糖(Fluorine-18 fluorodeoxyglucose,FDG)正电子发射计算机断层显像(Positron Emission Computer Tomography,PET/CT)在乳腺癌术后肿瘤标志物(CA153,CA125,CEA)升高患者中的应用价值.[方法]对22例乳腺癌术后伴肿瘤标志物升高的患者临床资料进行回顾性分析,18F-FDG PET/CT全身显像探测有无复发或/和转移灶.[结果]18F-FDG PET/CT诊断阳性11例,其中1例经针吸病理证实为假阳性;18F-FDG PET/CT诊断阴性11例,经随访证实为真阴性.18F-FDG PET/CT诊断乳腺癌转移的灵敏度100%(10/10),特异性91.67%(11/12),阳性预测值90.91%(10/11),阴性预测值100%(11/11).[结论]18F-FDG PET/CT显像能可靠地鉴别肿瘤标志物升高的乳腺癌术后患者有无转移或复发,准确探测复发()转移灶,改变治疗方案,是其他影像学方法和肿瘤标志物监测的重要补充.%[Objective] To evaluate the value of 18F-FDG PET/CT in monitoring patients with increased tumor makers after breast cancer surgery. [Methods] 22 patients underwent chemoradiotherapy after operation with increased tumor makers (one or two or three) were performed 18F-FDG PET/CT for monitoring recurrence or metastasis. Finally, the results of PET/CT imaging were proved by pathology and clinical follow-up. The duration of the clinical follow-up varied from 3 months to 7 months. [Results] 18F-FDG PET/CT diagnosed 11 positive, but one of the 11 was proven as false positive by needle sampling. 18F-FDG PET/CT diagnosed the other 11 negative which were proven true negative by follow-up. The sensitivity, specificity, positive predictive value and negative predictive value obtained by 18F-FDG PET/CT were 100% (10/10), 91.67% (11/12), 90.91% (10/11) and 100% (11/11), respectively. [Conclusion] I8F-FDG PET/CT imaging can reliably identify and detect recurrences or metastasis in breast cancer patients with increased tumor makers, change treatment plans. It can be the critical supplement

  16. Comparison of six methods of segmentation of tumor volume on the 18F-F.D.G. PET scan with reference histological volume in non small cell bronchopulmonary cancers

    The 18F-F.D.G. PET has demonstrated its importance in oncology, for initial extension and efficacy of anti tumoral therapeutics. Several studies have attempted to prove its utility to define tumoral volumes for conformational radiotherapy in non small cell lung cancers. Some authors have suggested the use of threshold of tumor intensity uptake with 40 or 50% of maximal intensity. Black et al. have determined contouring with linear regression formula of mean semi-quantitative index of tumor uptake (standard uptake value): SUVthreshold = 0.307 Subaverage + 0.588. Nestle et al. have taken into account the background noise intensity and mean intensity of the tumor: Ithreshold = β Iaverage +Inoise with β 0.15. Our study was done in collaboration with Inserm U618 team and has compared volumes defined on PET scan defined according to different methods based on intensity or S.U.V. to the tumour volume determined on CT scan by radio physicist. We have compared those volumes with histological volume that we considered for reference. Four patients have been included. They had 18F-F.D.G. PET scan followed by complete tumoral removal surgery. Specific histological procedure allowed to define complete size of the tumor in re expanded lung. Comparatively to pathology, the volumes obtained using Imax 40 and Imax 50 are all underestimated. The volumes defined by Black's et al. method are under evaluated for the two largest tumours (15.8% to 22%) and overestimated for the two smallest ones (17.9 to 82.9%). Nestle's et al. method, using β = 0.15, correctly estimates two tumor volumes over 2 cm, but overestimates the two small tumors (79.6 to 124%). Finally, the corrected Nestle's et al. formula (using β = 0.264) overestimates three tumours. Volumes defined on CT scan by radio physicist are correct for one lesion, underestimated for one and overestimated for two other ones (44 and 179.5%). Nestle's et al. method seems to be the most accurate for tumours over 2 cm of diameter

  17. (64)Cu- and (68)Ga-Based PET Imaging of Folate Receptor-Positive Tumors: Development and Evaluation of an Albumin-Binding NODAGA-Folate.

    Farkas, Renáta; Siwowska, Klaudia; Ametamey, Simon M; Schibli, Roger; van der Meulen, Nicholas P; Müller, Cristina

    2016-06-01

    A number of folate-based radioconjugates have been synthesized and evaluated for nuclear imaging purposes of folate receptor (FR)-positive tumors and potential therapeutic application. A common shortcoming of radiofolates is, however, a significant accumulation of radioactivity in the kidneys. This situation has been faced by modifying the folate conjugate with an albumin-binding entity to increase the circulation time of the radiofolate, which led to significantly improved tumor-to-kidney ratios. The aim of this study was to develop an albumin-binding folate conjugate with a NODAGA-chelator (rf42) for labeling with (64)Cu and (68)Ga, allowing application for PET imaging. The folate conjugate rf42 was synthesized in 8 steps, with an overall yield of 5%. Radiolabeling with (64)Cu and (68)Ga was carried out at room temperature within 10 min resulting in (64)Cu-rf42 and (68)Ga-rf42 with >95% radiochemical purity. (64)Cu-rf42 and (68)Ga-rf42 were stable (>95% intact) in phosphate-buffered saline over more than 4 half-lives of the corresponding radionuclide. In vitro, the plasma protein-bound fraction of (64)Cu-rf42 and (68)Ga-rf42 was determined to be >96%. Cell experiments proved FR-specific uptake of both radiofolates, as it was reduced to DOTA-folate conjugate (cm10) clearly proved the superiority of NODAGA for stable coordination of (64)Cu. (64)Cu-cm10 showed high liver uptake, most probably as a consequence of released (64)Cu(2+). The data reported in this study clearly proved the promising features of (64)Cu-rf42, particularly in terms of favorable tumor-to-kidney ratios. The relatively long half-life of (64)Cu (T1/2 = 12.7 h) matches well with the enhanced circulation time of the albumin-binding NODAGA-folate, allowing PET imaging at longer time points after injection than is possible when using (68)Ga (T1/2 = 68 min). PMID:27145400

  18. Quantitative imaging values of CT, MR, and FDG-PET to differentiate pineal parenchymal tumors and germinomas: are they useful?

    Quantitative values of CT attenuation, apparent diffusion coefficient (ADC), and standardized uptake value (SUV) were investigated for differentiation between pineal parenchymal tumors (PPTs) and germinomas. Differences in age, sex, and calcification pattern were also evaluated. Twenty-three patients with PPTs and germinomas in 20 years were retrospectively enrolled under the approval of the institutional review board. CT attenuation, ADC, and SUV (20, 13, and 10 patients, respectively) were statistically compared between the two tumors. Differences in sex and patterns of calcification (''exploded'' or ''engulfed'') were also examined. Mean patient ages were compared among three groups of pineoblastoma, pineal parenchymal tumor of intermediate differentiation, (PPTID) and pineocytoma and germinoma. None of the quantitative values of CT attenuation, ADC, and SUV showed significant differences between PPTs and germinomas (p >.05). However, there was a significant difference in age (p <.05) among the three groups of pineoblastoma (mean age ± standard deviation 7.0 ± 8.7 years), PPTID, and pineocytoma (53.7 ± 11.4 years) and germinoma (19.1 ± 8.1 years). Sex also showed significant differences between PPTs and germinomas (p =.039). Exploded pattern of calcification was found in 9 of 11 PPT patients and engulfed pattern in 7 of 9 patients with germinomas. No reverse pattern was observed, and the patterns of calcification were considered highly specific of tumor types. None of the quantitative imaging values could differentiate PPTs from germinomas. Age, sex, and calcification patterns were confirmed useful in differentiating these tumors to some degree. (orig.)

  19. Methodological studies into the applicability of positron emission tomography (PET) in light-ion beam tumor therapy

    For reconstruction of measured activity distributions, a multiplicative iteration scheme was used which, however, does not fulfill the clinical requirement of availability of reconstructed activity distributions within a few minutes after measuring. This disadvantage was set off by the development of an empirical algorithm for determination of the 3D-distribution of the intersection points of all possible coincidence line pairs. This algorithm was then applied for the reconstruction of the positron emitter distributions measured during range measurement of light ions. For the simple, compact source distributions and small number of measured coincidences in this case, the method of intersecting point computation is better than the iterative method in that it is significantly faster and yields images of comparable quality. On the basis of these results, a PET system was set up for clinical applications at the irradiation system for experimental light-ion beam therapy at GSI Darmstadt. (orig./DG)

  20. Defining PET standardized uptake value threshold for tumor delineation with metastatic lymph nodes in head and neck cancer

    Hot spots of F-18 fluorodeoxyglucose positron emission tomograms are variable in size according to window settings of standardized uptake values. The purpose of this study was to determine the standardized uptake value threshold that represents the target volume. Sixty-three patients who underwent fluorodeoxyglucose positron emission tomographic computed tomography and were diagnosed as having head and neck cancer with cervical lymphadenopathy were studied. The horizontal and vertical diameters of metastatic lymph nodes (LN-CT) were measured at the center of computed tomographic images. Of the corresponding nodes, the maximal standardized uptake value (SUVmax) and standardized uptake value profiles along the central horizontal and vertical axes were calculated on positron emission tomographic images (LN-PET). On the standardized uptake value profiles, the standardized uptake value levels (SUVeq) where the size of LN-PET was equivalent to the diameters of LN-CT were obtained. The regression formula between SUVeq and SUVmax was obtained. The regression formula of SUVeq was validated in subsequent 30 positron emission tomographic computed tomography studies. The mean horizontal and vertical diameters of LN-CT were 14.9 and 16.4 mm, respectively. SUVmax ranged from 1.88 to 9.07, and SUVeq was between 1.16 and 6.42. The regression formula between SUVeq and SUVmax was as follows: SUVeq =1.21+0.34 x SUVmax (coefficient of correlation: R=0.69). The validation study resulted in a good correlation between the volume of lymph nodes on computed tomography and positron emission tomographic computed tomography (R2=0.93). The formula with a relatively high coefficient of correlation is considered to indicate that SUVeq is not constant, but is a complex of an absolute standardized uptake value and is proportional to SUVmax. (author)

  1. Dynamic {sup 18}F-FDG PET for Assessment of Tumor Physiology in Two Breast Carcinoma Xenografts

    Kristian, Alexandr; Nilsen, Line B.; Roe, Kathrine; Revheim, Monaelisabeth; Engebraten, Olav; Maelandsmo, Gunhild M.; Holm, Ruth; Malinen Eirik; Seierstad, Therese [Oslo Univ. Hospital, Oslo (Norway)

    2013-09-15

    To compare dynamic 2-deoxy-2-[{sup 18}F]fluoro-D-glucose positron emission tomography ({sup 18}F-FDG PET) parameters in two selected human breast cancer xenografts and to evaluate associations with immunohistochemistry and histology. Dynamic {sup 18}F-FDG PET of luminal-like MAS98.06 and basal-like MAS98.12 xenografts was performed, and the compartmental transfer rates (k{sub 1}, k{sub 2}, k{sub 3}), blood volume fraction (v{sub B}) and metabolic rate of {sup 18}F-FDG(MR{sub FDG}) were estimated from pharmacokinetic model analysis. After sacrifice, analyses of hypoxia (pimonidazole), proliferation (Ki-67), vascularization (CD31), glucose transport receptor (GLUT1) and necrosis (HE) was performed. The level of hexokinase 2 (HK2) was estimated from Western blot analysis. The {sup 18}F-FDG uptake curves for the two xenografts were significantly different (p<0.05). k{sub 1} and v{sub B} were higher for MAS98.12 (p<0.01), while k{sub 3} was higher for MAS98.06 (p<0.01). MAS98.12 had a higher fraction of stromal tissue and higher microvessel density (MVD), and it was less necrotic and hypoxic than MAS98.06 MAS98.12 had stronger positive GLUT1 staining and lower Ki-67 than MAS98.06. In both models significant correlations were found between k{sub 1} and the GLUT1 score, between k{sub 3} and the level of HK2, and between v{sub B} and MVD. Significant differences in dynamic {sup 18}F-FDG parameters between the two human breast cancer xenografts were found. The differences could be explained by underlying histological and physiological characteristics.

  2. PET - CT联合检测肿瘤标志物对肺癌术后随访的价值%The clinical value of PET - CT combined with detection of serum tumor markers in follow-up of patients with lung cancer postoperatively

    江吕泉; 高坤祥; 郑建; 陈建; 吴昊

    2011-01-01

    目的 探讨肿瘤标志物和正电子发射断层/计算机断层扫描( PET - CT)对肺癌术后随访的作用及相互关系.方法 97例肺癌术后患者做全身PET - CT检查,并在l周内检测血癌胚抗原(carcinoembryonic antigen,CEA)、细胞角蛋白19片段(cytokeratin 19 fragment 21 -1,CYFRA 21 -1)和神经元特异性烯醇化酶(neuron specific enolase,NSE),同时与最终诊断进行比较,分析两种检查之间差异和相互关系.结果 97例中,89例诊断肺癌复发或转移.肿瘤标志物诊断肺癌术后复发或转移的敏感性为68.5%,特异性75.0%,准确性为69.1%;PET - CT诊断肺癌术后复发或转移的敏感性为92.1%,特异性75.0%,准确性为90.7%.两者联合诊断的敏感性为100%,特异性为92.0%,准确性为95.6%.结论 PET - CT诊断肺癌术后的复发或转移敏感性和准确性较肿瘤标志物检测高,肿瘤标志物对PET - CT诊断具有补充作用,两者联合应用对于肺癌术后的随访有重要的临床价值.%Objective To study the value of and correlations between positron emission tomography/computed tomography ( PET/CT) and serum tumor markers in the follow - up of lung cancer after operation. Methods In 97 patients with a surgical history of lung cancer, PET/CT was performed and serum carcinoembryonic antigen ( CEA), cytokeratin 19 fragment 21 - 1 (CYFRA21 - 1) and neuron specific enolase (NSE) were detected within the following week. The results were compared with the final diagnosis. The difference and correlations between the two methods of examination was analyzed. Results Recurrence or metastasis was found in 89 of the 97 patients with a surgical history of lung cancer. The sensitivity , specificity and accuracy of tumor marker detection for diagnosis of recurrence or metastasis were 68.5% ,75.0% and 69. 1% respectively, those of PET/CT were 92. 1% ,75.0% and 90.7% respectively, and those of combined PET/CT with detection of tumor markers were 100% ,92. 0

  3. SU-E-J-123: Assessing Segmentation Accuracy of Internal Volumes and Sub-Volumes in 4D PET/CT of Lung Tumors Using a Novel 3D Printed Phantom

    Purpose: To assess the accuracy of internal target volume (ITV) segmentation of lung tumors for treatment planning of simultaneous integrated boost (SIB) radiotherapy as seen in 4D PET/CT images, using a novel 3D-printed phantom. Methods: The insert mimics high PET tracer uptake in the core and 50% uptake in the periphery, by using a porous design at the periphery. A lung phantom with the insert was placed on a programmable moving platform. Seven breathing waveforms of ideal and patient-specific respiratory motion patterns were fed to the platform, and 4D PET/CT scans were acquired of each of them. CT images were binned into 10 phases, and PET images were binned into 5 phases following the clinical protocol. Two scenarios were investigated for segmentation: a gate 30–70 window, and no gating. The radiation oncologist contoured the outer ITV of the porous insert with on CT images, while the internal void volume with 100% uptake was contoured on PET images for being indistinguishable from the outer volume in CT images. Segmented ITVs were compared to the expected volumes based on known target size and motion. Results: 3 ideal breathing patterns, 2 regular-breathing patient waveforms, and 2 irregular-breathing patient waveforms were used for this study. 18F-FDG was used as the PET tracer. The segmented ITVs from CT closely matched the expected motion for both no gating and gate 30–70 window, with disagreement of contoured ITV with respect to the expected volume not exceeding 13%. PET contours were seen to overestimate volumes in all the cases, up to more than 40%. Conclusion: 4DPET images of a novel 3D printed phantom designed to mimic different uptake values were obtained. 4DPET contours overestimated ITV volumes in all cases, while 4DCT contours matched expected ITV volume values. Investigation of the cause and effects of the discrepancies is undergoing

  4. Gallium-67/Gallium-68-[DFO]-octreotide-a potential radiopharmaceutical for PET imaging of somatostatin receptor-positive tumors: Synthesis and radiolabeling in vitro and preliminary in vivo studies

    When labeled with gamma-emitting radionuclides, somatostatin analogs have the potential to localize somatostatin receptor-positive tumors using gamma camera scintigraphy. The authors present a somatostatin analog, [DFO]-octreotide (SDZ 216-927), that comprises desferrioxamine B coupled to octreotide via a succinyl linker. This conjugate can be labeled with either 67Ga-labeled conjugate is stable in vitro to autoradiolysis over a 24-hr period. Rats bearing a somatostatin receptor-positive pancreatic islet cell tumor were injected with 20 MBq of 67Ga[DFO] octreotide (33 GBq 67Ga/μmole). After 1 hr, the accumulation of 67Ga[DFO]-octreotide was 0.38 ± 0.08 %ID/g and the tumor-to-nontumor ratios for blood, muscle, liver and intestine were 2.5, 7.4, 1.98 and 1.6, respectively. PET studies with 68Ga[DFO]-octreotide recorded a very rapid accumulation at the tumor and a subsequent residence half-life of about 6 hr. Gallium-68-[DFO]-octreotide can be used in PET studies to diagnose receptor-positive tumors such as gastroentero-pancreatic, small-cell lung and breast tumors. 40 refs., 7 figs., 3 tabs

  5. Quantitative imaging values of CT, MR, and FDG-PET to differentiate pineal parenchymal tumors and germinomas: are they useful?

    Kakigi, Takahide; Okada, Tomohisa; Kanagaki, Mitsunori; Yamamoto, Akira; Fushimi, Yasutaka; Sakamoto, Ryo; Togashi, Kaori [Kyoto University Graduate School of Medicine, Department of Diagnostic Imaging and Nuclear Medicine, Sakyo-ku, Kyoto (Japan); Arakawa, Yoshiki; Takahashi, Jun C. [Kyoto University Graduate School of Medicine, Department of Neurosurgery, Kyoto (Japan); Mikami, Yoshiki [Kyoto University Graduate School of Medicine, Department of Pathology, Kyoto (Japan); Shimono, Taro [Osaka City University Graduate School of Medicine, Department of Radiology, Osaka (Japan)

    2014-04-15

    Quantitative values of CT attenuation, apparent diffusion coefficient (ADC), and standardized uptake value (SUV) were investigated for differentiation between pineal parenchymal tumors (PPTs) and germinomas. Differences in age, sex, and calcification pattern were also evaluated. Twenty-three patients with PPTs and germinomas in 20 years were retrospectively enrolled under the approval of the institutional review board. CT attenuation, ADC, and SUV (20, 13, and 10 patients, respectively) were statistically compared between the two tumors. Differences in sex and patterns of calcification (''exploded'' or ''engulfed'') were also examined. Mean patient ages were compared among three groups of pineoblastoma, pineal parenchymal tumor of intermediate differentiation, (PPTID) and pineocytoma and germinoma. None of the quantitative values of CT attenuation, ADC, and SUV showed significant differences between PPTs and germinomas (p >.05). However, there was a significant difference in age (p <.05) among the three groups of pineoblastoma (mean age ± standard deviation 7.0 ± 8.7 years), PPTID, and pineocytoma (53.7 ± 11.4 years) and germinoma (19.1 ± 8.1 years). Sex also showed significant differences between PPTs and germinomas (p =.039). Exploded pattern of calcification was found in 9 of 11 PPT patients and engulfed pattern in 7 of 9 patients with germinomas. No reverse pattern was observed, and the patterns of calcification were considered highly specific of tumor types. None of the quantitative imaging values could differentiate PPTs from germinomas. Age, sex, and calcification patterns were confirmed useful in differentiating these tumors to some degree. (orig.)

  6. Double tracer / double isotope gives Ga-68 dota-noc and F-18 FDG PET / CT. Protocol 1 day in a child with neuroblastoma to determine the clinical state and tumor metabolic state

    We report on a 6-year-old carrier of a neuroblastoma. The tumor was diagnosed in March 2004, under the right adrenal gland and confirmed by FNAB, ultrasound, CT and tumor markers. Because of its size and extent of the tumor was inoperable at the time due to which was subject to two cycles of chemotherapy (vincristine, cisplatin, etoposide and cyclophosphamide alternating with vincristine, carboplatin, etoposide and cyclophosphamide). After these two cycles of chemotherapy the patient underwent retroperitoneal surgery getting totally dry right adrenal gland and tumor. After surgery the patient received four additional cycles of chemotherapy until March 2005. During the months of August and September 2005 the patient complained of abdominal pain and were suspected of recurrence. She received ultrasound and CT scan were not conclusive. In December 2005 he made a scan with I-131-MIBG (148 MBq, 4 mCi intravenous, is flat and SPECT imaging performed 24 hours to 6 days after injection) showing only the normal left adrenal gland but not recurrence was visualized, which showed that the tumor did not grasp MIBG. In January 2006 the boy (121 cm.'s Height, weight 21 kg) was referred to the Centre for PET / CT of the Bad Berka Central Clinic in Germany for a PET / CT using Ga-68/DOTA- receptor NOC, a high affinity analogue of somatostatin. The tumor marker NSE was determined in serum before the PET / CT whose outcome was high (24.8 ng / ml, cutoff 15). The patient received 46 MBq (1.24 mCi) of Ga-68 DOTA-NOC intravenous and PET / CT whole body was performed at 75 minutes post-injection. No abnormal uptake was observed which indicated that the appellants had no somatostatin receptors. By having this negative result was decided to perform an additional PET / CT with F-18 FDG (with a low dose of contrast to improve the TAC). After fasting for 6 hours, the patient received 151 MBq (4.1 mCi) of F-18 FDG. A PET / CT whole body was performed at 75 minutes after administration of

  7. 18F-FDG PET/CT monitoring for early tumor response to cisplatin in VX2 tumor-bearing rabbits%18F-FDG PET/CT评价兔VX2移植瘤对顺铂化疗的早期反应

    原凌; 赵铭; 张红雨; 田蓉蓉; 邢军; 崔洁; 靳宏星

    2015-01-01

    Objective To evaluate the value of 18F-FDG PET/CT in early in vivo monitoring of tumor response to cisplatin,and analyze the relationship between 18F-FDG uptake in tumor and the corresponding pathological changes.Methods Thirty VX2 rabbits were divided into 5 groups by random number table with 6 in each group,including 4 treatment groups and 1 control group.18F-FDG PET/CT were performed before and after (6,12,24 and 36 h post-injection respectively) intravenous administration of cisplatin (7 mg/kg) in the treatment groups,respectively.The control group was injected with physiological saline followed by 18F-FDG PET/CT.The ROI was drawn and the SUVmax and T/NT ratio were calculated.The tumor necrosis rate and apoptosis index were observed by histopathologic examination.Paired t test,GamesHowell test and arcuation correlation analysis were used to analyze the data.Results Significant differences were found in SUVmax and T/NT of the control group before and after injection of physiological saline (6.58±1.67 vs 9.77±2.45,52.93±3.90 vs 29.34±3.31;t=-5.480,17.593,both P<0.05).18F-FDG uptake decreased after 6 h post-injection of cisplatin,with the mean SUVmax decrease rate of (11.83±8.89) % and the mean T/NT decrease rate of (59.00±8.22)%.In the 24 h treatment group,18F-FDG uptake decreased most,and the mean SUVmax decrease rate was (42.33±33.80)%,the mean T/NT decrease rate was (83.50± 7.69) %.The SUVmax and T/NT of those 2 groups were significantly different from those of the control group,and no difference was found between the 2 treatment groups(all P<0.05).The changes of SUVmax and T/NT were positively correlated with apoptosis index and tumor necrosis rate (r=0.750,0.794,0.804,0.874,all P<0.05).Conclusion 18F-FDG PET/CT is a sensitive method for monitoring early response to tumor chemotherapy in VX2 tumor-bearing rabbits at 24 h after treatment.%目的 探讨18F-FDG PET/CT评价兔VX2移植瘤顺铂化疗早期反应的最佳时间,观察移植

  8. Efficacy of 68Ga-DOTATOC Positron Emission Tomography (PET) CT in Children and Young Adults With Brain Tumors

    2016-06-17

    Acoustic Schwannoma; Adult Anaplastic Astrocytoma; Adult Anaplastic Ependymoma; Adult Anaplastic Meningioma; Adult Anaplastic Oligodendroglioma; Adult Brain Stem Glioma; Adult Choroid Plexus Tumor; Adult Craniopharyngioma; Adult Diffuse Astrocytoma; Adult Ependymoblastoma; Adult Ependymoma; Adult Giant Cell Glioblastoma; Adult Glioblastoma; Adult Gliosarcoma; Adult Grade I Meningioma; Adult Grade II Meningioma; Adult Medulloblastoma; Adult Meningeal Hemangiopericytoma; Adult Mixed Glioma; Adult Myxopapillary Ependymoma; Adult Oligodendroglioma; Adult Papillary Meningioma; Adult Pilocytic Astrocytoma; Adult Pineal Gland Astrocytoma; Adult Pineoblastoma; Adult Pineocytoma; Adult Subependymal Giant Cell Astrocytoma; Adult Subependymoma; Adult Supratentorial Primitive Neuroectodermal Tumor (PNET); Childhood Choroid Plexus Tumor; Childhood Craniopharyngioma; Childhood Ependymoblastoma; Childhood Grade I Meningioma; Childhood Grade II Meningioma; Childhood Grade III Meningioma; Childhood High-grade Cerebellar Astrocytoma; Childhood High-grade Cerebral Astrocytoma; Childhood Infratentorial Ependymoma; Childhood Low-grade Cerebellar Astrocytoma; Childhood Low-grade Cerebral Astrocytoma; Childhood Medulloepithelioma; Childhood Supratentorial Ependymoma; Meningeal Melanocytoma; Newly Diagnosed Childhood Ependymoma; Recurrent Adult Brain Tumor; Recurrent Childhood Anaplastic Astrocytoma; Recurrent Childhood Anaplastic Oligoastrocytoma; Recurrent Childhood Anaplastic Oligodendroglioma; Recurrent Childhood Brain Stem Glioma; Recurrent Childhood Cerebellar Astrocytoma; Recurrent Childhood Cerebral Astrocytoma; Recurrent Childhood Diffuse Astrocytoma; Recurrent Childhood Ependymoma; Recurrent Childhood Fibrillary Astrocytoma; Recurrent Childhood Gemistocytic Astrocytoma; Recurrent Childhood Giant Cell Glioblastoma; Recurrent Childhood Glioblastoma; Recurrent Childhood Gliomatosis Cerebri; Recurrent Childhood Gliosarcoma; Recurrent Childhood Medulloblastoma; Recurrent Childhood

  9. The early predictive value of a decrease of metabolic tumor volume in repeated {sup 18}F-FDG PET/CT for recurrence of locally advanced non-small cell lung cancer with concurrent radiochemotherapy

    Huang, Wei, E-mail: weihuang@mcw.com [Department of Radiation Oncology (Chest Section), Shandong' s Key Laboratory of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan 250117 (China); Liu, Bo; Fan, Min [Department of Internal Medicine Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan (China); Zhou, Tao [Department of Radiation Oncology (Chest Section), Shandong' s Key Laboratory of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan 250117 (China); Fu, Zheng [PET/CT center, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan (China); Zhang, Zicheng; Li, Hongsheng [Department of Radiation Oncology (Chest Section), Shandong' s Key Laboratory of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan 250117 (China); Li, Baosheng, E-mail: alvinbird@163.com [Department of Radiation Oncology (Chest Section), Shandong' s Key Laboratory of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan 250117 (China)

    2015-03-15

    Highlights: •The patients underwent the second FDG PET during the early stage of concurrent chemoradiotherapy (CCRT). •To our knowledge, this could be the first study showing that the repeated FDG PET during the early stage of CCRT has added value by being a prognostic factor for recurrence of the locally advanced NSCLC patients. •This is a result of continuous research. •The decrease of MTV was the only significant risk factor for recurrence. -- Abstract: Purpose: The aim of this study is to investigate the value of [{sup 18}F] fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18}F FDG PET/CT) to predict recurrence of patients with locally advanced non-small cell lung cancer (NSCLC) during the early stage of concurrent chemoradiotherapy (CCRT). Methods: A total of 53 stage III NSCLC patients without diabetics or undergoing surgery were enrolled in the prospective study. Those patients were evaluated by FDG PET before and following 40 Gy radiotherapy (RT) with a concurrent cisplatin-based heterogeneous chemotherapy regimen. Semiquantitative assessment was used to determine maximum and mean SUVs (SUVmax/SUVmean) and metabolic tumor volume (MTV) of the primary tumor. The prognostic significance of PET/CT parameters and other clinical variables was assessed using Cox regression analyses. The cutoffs of PET/CT parameters which have been determined by the previous study were used to separate the groups with Kaplan–Meier curves. Results: Recurrence rates at 1- and 2-years were 18.9% (10/53) and 50.9% (27/53) for all patients, respectively. Cox regression analysis showed that the only prognostic factor for recurrence was a decrease of MTV. Using the cutoff of 29.7%, a decrease of MTV can separate the patients into 2 groups with Kaplan–Meier curve successfully. Conclusion: The prospective study has reinforced the early predictive value of MTV in repeated {sup 18}F-FDG PET/CT for recurrence in a subgroup of locally advanced NSCLC who

  10. Combination of 18F-FDG and '11C-acetate PET/CT for detection of hepatocellular carcinoma and surveillance of residual tumor and recurrence

    Objective: To investigate the value of 18F-FDG combined with 11C-acetate PET/CT for detecting newly diagnosed and recurrent HCC. Methods: Fourteen patients with newly diagnosed HCC and 12 HCC patients after treatment underwent both whole body 18F-FDG PET/CT and upper abdomen 11C-acetate PET/CT imaging. For semiquantitative analysis, the tumor-to-liver (T/L) ratio was calculated by comparing the SUVmax in HCC lesions to that in adjacent normal liver tissue. Final diagnosis was determined by histopathology examination or follow-up results after more than 6 months. The correlation analysis between histopathologic differentiation and uptake of 18F-FDG and 11C-acetate was performed with SPSS 13.0 software. T-test, analysis of variance, χ2 test and Fisher exact test were used. Results: For HCC patients,the overall diagnostic sensitivities of 18F-FDG, 11C-acetate and the combination of the tracers were 57.7% (15/26), 61.5% (16/26) and 92.3% (24/26), respectively. The combined examination was superior to the single modality (χ2=7.11 and 6.13, both P<0.05). Uptake of 18F-FDG in well (n=10), moderately (n=16) and poorly (n=8) differentiated tumors increased in ascending order, with the T/L ratios of 0.98±0.08 (0.8 to 1.1), 1.59±0.92 (0.8 to 3.7) and 2.12±1.03 (0.7 to 3.7), respectively (F=4.52, P=0.02); while uptake of 11C-acetate in well and moderately differentiated HCC was higher than that in poorly differentiated HCC, with T/L ratios of 1.69 ± 0.85 (0.9 to 3.7), 1.58 ± 0.47 (0.5 to 2.2) and 0.94±0.42 (0.5 to 1.8), respectively (F=4.17, P=0.03). Accordingly, the sensitivity of 18F-FDG from well to poorly differentiated HCC grades gradually increased, with the detection rate of 0 (0/10), 50.0% (8/16) and 87.5% (7/8), respectively (χ2=14.23, P<0.05). 11C-acetate exhibited a better detection rate for well and moderately differentiated HCC than for poorly differentiated HCC (70.0% (7/10), 81.2% (13/16) and 25.0% (2/8), respectively, χ2=7.56, P<0.05). For well

  11. Early prediction of histopathological response of rectal tumors after one week of preoperative radiochemotherapy using 18 F-FDG PET-CT imaging. A prospective clinical study

    Goldberg Natalia

    2012-08-01

    Full Text Available Abstract Background Preoperative radiochemotherapy (RCT is standard in locally advanced rectal cancer (LARC. Initial data suggest that the tumor’s metabolic response, i.e. reduction of its 18 F-FDG uptake compared with the baseline, observed after two weeks of RCT, may correlate with histopathological response. This prospective study evaluated the ability of a very early metabolic response, seen after only one week of RCT, to predict the histopathological response to treatment. Methods Twenty patients with LARC who received standard RCT regimen followed by radical surgery participated in this study. Maximum standardized uptake value (SUV-MAX, measured by PET-CT imaging at baseline and on day 8 of RCT, and the changes in FDG uptake (ΔSUV-MAX, were compared with the histopathological response at surgery. Response was classified by tumor regression grade (TRG and by achievement of pathological complete response (pCR. Results Absolute SUV-MAX values at both time points did not correlate with histopathological response. However, patients with pCR had a larger drop in SUV-MAX after one week of RCT (median: -35.31% vs −18.42%, p = 0.046. In contrast, TRG did not correlate with ΔSUV-MAX. The changes in FGD-uptake predicted accurately the achievement of pCR: only patients with a decrease of more than 32% in SUV-MAX had pCR while none of those whose tumors did not show any decrease in SUV-MAX had pCR. Conclusions A decrease in ΔSUV-MAX after only one week of RCT for LARC may be able to predict the achievement of pCR in the post-RCT surgical specimen. Validation in a larger independent cohort is planned.

  12. Early prediction of histopathological response of rectal tumors after one week of preoperative radiochemotherapy using 18 F-FDG PET-CT imaging. A prospective clinical study

    Preoperative radiochemotherapy (RCT) is standard in locally advanced rectal cancer (LARC). Initial data suggest that the tumor’s metabolic response, i.e. reduction of its 18 F-FDG uptake compared with the baseline, observed after two weeks of RCT, may correlate with histopathological response. This prospective study evaluated the ability of a very early metabolic response, seen after only one week of RCT, to predict the histopathological response to treatment. Twenty patients with LARC who received standard RCT regimen followed by radical surgery participated in this study. Maximum standardized uptake value (SUV-MAX), measured by PET-CT imaging at baseline and on day 8 of RCT, and the changes in FDG uptake (ΔSUV-MAX), were compared with the histopathological response at surgery. Response was classified by tumor regression grade (TRG) and by achievement of pathological complete response (pCR). Absolute SUV-MAX values at both time points did not correlate with histopathological response. However, patients with pCR had a larger drop in SUV-MAX after one week of RCT (median: -35.31% vs −18.42%, p = 0.046). In contrast, TRG did not correlate with ΔSUV-MAX. The changes in FGD-uptake predicted accurately the achievement of pCR: only patients with a decrease of more than 32% in SUV-MAX had pCR while none of those whose tumors did not show any decrease in SUV-MAX had pCR. A decrease in ΔSUV-MAX after only one week of RCT for LARC may be able to predict the achievement of pCR in the post-RCT surgical specimen. Validation in a larger independent cohort is planned

  13. Pet Health

    ... of safety to your life. Before getting a pet, think carefully about which animal is best for your family. What is each family member looking for in a pet? Who will take care of it? Does anyone ...

  14. Tumor Metabolism and Perfusion in Head and Neck Squamous Cell Carcinoma: Pretreatment Multimodality Imaging With 1H Magnetic Resonance Spectroscopy, Dynamic Contrast-Enhanced MRI, and [18F]FDG-PET

    Purpose: To correlate proton magnetic resonance spectroscopy (1H-MRS), dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), and 18F-labeled fluorodeoxyglucose positron emission tomography ([18F]FDG PET) of nodal metastases in patients with head and neck squamous cell carcinoma (HNSCC) for assessment of tumor biology. Additionally, pretreatment multimodality imaging was evaluated for its efficacy in predicting short-term response to treatment. Methods and Materials: Metastatic neck nodes were imaged with 1H-MRS, DCE-MRI, and [18F]FDG PET in 16 patients with newly diagnosed HNSCC, before treatment. Short-term patient radiological response was evaluated at 3 to 4 months. Correlations among 1H-MRS (choline concentration relative to water [Cho/W]), DCE-MRI (volume transfer constant [Ktrans]; volume fraction of the extravascular extracellular space [ve]; and redistribution rate constant [kep]), and [18F]FDG PET (standard uptake value [SUV] and total lesion glycolysis [TLG]) were calculated using nonparametric Spearman rank correlation. To predict short-term responses, logistic regression analysis was performed. Results: A significant positive correlation was found between Cho/W and TLG (ρ = 0.599; p = 0.031). Cho/W correlated negatively with heterogeneity measures of standard deviation std(ve) (ρ = −0.691; p = 0.004) and std(kep) (ρ = −0.704; p = 0.003). Maximum SUV (SUVmax) values correlated strongly with MRI tumor volume (ρ = 0.643; p = 0.007). Logistic regression indicated that std(Ktrans) and SUVmean were significant predictors of short-term response (p 1H-MRS, DCE-MRI, and [18F]FDG PET is feasible in HNSCC patients with nodal metastases. Additionally, combined DCE-MRI and [18F]FDG PET parameters were predictive of short-term response to treatment.

  15. Pet Health

    Pets can add fun, companionship and a feeling of safety to your life. Before getting a pet, think carefully about which animal is best for ... is each family member looking for in a pet? Who will take care of it? Does anyone ...

  16. 18F-FDG PET/CT在肝转移癌及其原发灶和肝外转移灶诊断中的价值%The value of 18F-FDG PET/CT in the diagnosis of liver metastases and primary tumors and other metastases outside liver metastases

    罗家伦; 徐慧琴; 黄薇园; 薛央扬; 王雪梅

    2011-01-01

    Objective To study the value of 18F-FDG PET/CT in the diagnosis of liver metastases and primary tumors and other metastases outside liver metastases . Methods 61 patients who were diagnosed as liver metastases and verified by clinic or pathology were underwent F-FDG PET / CT examination. Then the characteristics of liver metastases , primary tumor lesions and other metastases outside liver metastases on PET/ CT imagings were evaluated and SUVmax values were measured. Results The liver metastatic lesions of 58 patients were positive on PET/ CT imagings (positive rate was 95. 1% ). The value of SUVmax was 3. 2 to 16.0 (average 5. 1).47 patients (77. 1%) had multifocal liver lesions,and the liver lesions of 58 patiens (95. 1 % ) showed slightly low or low density in plain CT scan. Of all the patients, primary gastrointestinal cancer accounted for 50. 8% ,lung cancer for 24. 6% ;but the value of SUVmax of liver metastatic lesions were not statistically significant, although the primary tumors were different. Meanwhile, 80. 33% of patients had other metastases outside liver metastases at the same time , and 29% of patients with gastrointestinal cancer for primary tumor had only liver metastases , otherwise for lung cancer had all accompanied with other metastases outside liver metastases. Conclusions F-FDG PET / CT have important value in the diagnosis of liver metastases and to find the primary tumor and other metastases . The majority of liver metastases derive from gastrointestinal cancer and lung cancer , most of them have multifocal liver lesions and accompanied by other metastases outside liver metastases.%目的 探讨18F-FDG PET/CT在肝转移癌及其原发灶和肝外转移灶诊断中的价值.方法 对61例临床或病理确诊为肝转移癌的患者进行18F-FDG PET/CT检查,对肝转移病灶、原发肿瘤病灶及肝外转移病灶进行图像分析,并分别测量其SUVmax值.结果 61例肝转移癌患者中18F-FDG PET/CT

  17. Dual tracer/dual isotope Ga-68 DOTA-NOC and F-18 FDG PET/CT - A one day protocol in a child with neuroblastoma for determining the receptor status and the metabolic tumor state

    We report on a 6-year-old boy with a history of neuroblastoma. The tumor was first diagnosed in March 2004, arising from the right adrenal gland as confirmed by fine needle aspiration biopsy, ultrasound, CT scan as well as tumor markers. Due to the size and extension, the tumor was inoperable at this time and two cycles of chemotherapy (vincristin, cisplatin, etopoxid and cyclophosphamid alternating with vincristin, carboplatin, etopoxid and cyclophosphamid) were given. Then, the patient underwent retroperitoneal surgery and the right adrenal gland and the tumor were completely resected. After the operation, the patient received 4 additional cycles of chemotherapy until March 2005. During August and September 2005 the patient complained about abdominal pain and recurrence was suspected. Ultrasound and CT scan were repeatedly performed, but were unclear. In December 2005, a 1-131 MIBG scan (148 MBq, 4 mCi iv, planar images and SPECT from 24 hrs until 6 d p.i.) revealed only a normal left adrenal gland but no recurrence, proving that the tumor had no MIBG uptake. In January 2006 the child (121 cm height, weight 21 kg) was submitted to the PET/CT Center of the Zentralklinic Bad Berka, Germany for receptor PET/CT using Ga-68/DOTA-NOC, a high affinity pansomatostatin analogue. NSE was determined in serum prior to the PET/CT study and was elevated (24.8 ng/ml, cutoff 15). The patient received 46 MBq (1.24 mC) Ga-68 DOTA-NOC i.v. and a wholebody PET/CT was performed 75 min. p.i.. There was no abnormal uptake proving that the recurrence had no somatostatin receptors. After this negative result it was decided to perform additionally a F-18 FDG PET/CT study (with contrast enhanced low dose CT scan). After a fasting time of 6 hours, the patient received 151 MBq (4.1 mCi) F-18 FDG. Whole-body PET/CT was performed 75 min. p.1. and a recurrence was clearly depicted as hypermetabolic tumor (SUVmax. 8.1, molecular tumor volume (MTV) 15,2 cm3, 27 x 27 x 40 mm in diameter

  18. PET/MRI in cancer patients

    Kjær, Andreas; Loft, Annika; Law, Ian;

    2013-01-01

    described include brain tumors, pediatric oncology as well as lung, abdominal and pelvic cancer. In general the cases show that PET/MRI performs well in all these types of cancer when compared to PET/CT. However, future large-scale clinical studies are needed to establish when to use PET/MRI. We envision......Combined PET/MRI systems are now commercially available and are expected to change the medical imaging field by providing combined anato-metabolic image information. We believe this will be of particular relevance in imaging of cancer patients. At the Department of Clinical Physiology, Nuclear...... Medicine & PET at Rigshospitalet in Copenhagen we installed an integrated PET/MRI in December 2011. Here, we describe our first clinical PET/MR cases and discuss some of the areas within oncology where we envision promising future application of integrated PET/MR imaging in clinical routine. Cases...

  19. PET、PET-CT与磁共振弥散加权成像在肿瘤诊断中的对比研究进展%Progression of comparison study between PET or PET-CT and magnetic resonance diffusion-weighted imaging in the investigation of tumor

    王冬艳; 苏成海

    2011-01-01

    PET-CT and magnetic resonance diffusion-weighted imaging(DWI)are two types important imaging modalities in tumor detection,the former could provide functional metabolism information,such as glucose metabolism,amino acids metabolism and so on.While the latter could offer the water molecules motion information in tissues.The two modalities both have advantages,disadvantages and indications of themselves.We will obtain more morphology and metabolism informations while the two modalities were combined favorably.The combiriation of the two were useful to decide the quality of local lesions and systematic stage,and to increase the diagnostic accuracy,that could provide the most effective informations for clinic to choose optimal treatment plan.%PET-CT和磁共振弥散加权成像是两类检测恶性肿瘤的重要成像方法,前者提供肿瘤组织的功能代谢信息,比如葡萄糖代谢、氨基酸代谢等信息,后者反映水分子的运动状况,二者各有优缺点及适应证,二者有机结合能够对病变获得尽可能多的形态学与代谢学信息,有利于病变的局部定性和系统分期,显著提高诊断的准确率,为临床选择最优化的治疗方案提供最有效的信息.

  20. Tumor metabolism and perfusion ratio assessed by 18F-FDG PET/CT and DCE-MRI in breast cancer patients: Correlation with tumor subtype and histologic prognostic factors

    An, Young-Sil [Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine (Korea, Republic of); Kang, Doo Kyoung [Department of Radiology, Ajou University School of Medicine (Korea, Republic of); Jung, Yong Sik; Han, Sehwan [Department of Surgery, Ajou University School of Medicine (Korea, Republic of); Kim, Tae Hee, E-mail: medhand@ajou.ac.kr [Department of Radiology, Ajou University School of Medicine (Korea, Republic of)

    2015-07-15

    Highlights: • In non-triple negative breast cancer, metabolic parameter (SUVmax) was significantly correlated with perfusion parameters (Kep and Ve). • In triple negative cancers, any perfusion parameters did not correlated with metabolic parameters. • Higher SUVmax, higher SUVmax/Ktrans, higher MTV50/Ktrans, higher TLG50/Ktrans, higher TLG50/Ve ratios were significantly correlated with TNBC. • In triple negative breast cancer, perfusion and metabolic parameters are not significantly correlated. • Triple negative breast cancer showed higher metabolic–perfusion ratios compared to non-triple negative breast cancer. - Abstract: Objective: Our purpose was to evaluate whether breast cancer with high metabolic–perfusion ratio would be associated with poor histopathologic prognostic factors and whether triple negative breast cancer (TNBC) would show high metabolic–perfusion ratio compared to non-triple negative breast cancer (non-TNBC). Methods: From March 2011 to November 2011, 67 females with invasive ductal carcinoma of breast who underwent both MRI and 18F-FDG PET/CT were included. Perfusion parameters including Ktrans, Kep and Ve were acquired from Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Metabolic parameters including the standardized uptake value (SUV) and volumetric metabolic parameters including metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were obtained from F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). Results: In non-TNBC, SUVmax was significantly correlated with Kep (ρ = 0.298, p = 0.036) and Ve (ρ = −0.286, p = 0.044). In TNBC, there was no significant correlation between all perfusion and metabolic parameters. Compared to non-TNBC, higher SUVmax (10.2 vs 5.3, p < 0.001), higher SUVmax/Ktrans (56.02 vs 20.3, p < 0.001), higher MTV50/Ktrans (7.8 vs 16.54, p < 0.001), higher TLG50/Ktrans (36.49 vs 12.3, p < 0.001), higher TLG50/Ve (91.34 vs 27.1 p = 0.022) were

  1. Tumor metabolism and perfusion ratio assessed by 18F-FDG PET/CT and DCE-MRI in breast cancer patients: Correlation with tumor subtype and histologic prognostic factors

    Highlights: • In non-triple negative breast cancer, metabolic parameter (SUVmax) was significantly correlated with perfusion parameters (Kep and Ve). • In triple negative cancers, any perfusion parameters did not correlated with metabolic parameters. • Higher SUVmax, higher SUVmax/Ktrans, higher MTV50/Ktrans, higher TLG50/Ktrans, higher TLG50/Ve ratios were significantly correlated with TNBC. • In triple negative breast cancer, perfusion and metabolic parameters are not significantly correlated. • Triple negative breast cancer showed higher metabolic–perfusion ratios compared to non-triple negative breast cancer. - Abstract: Objective: Our purpose was to evaluate whether breast cancer with high metabolic–perfusion ratio would be associated with poor histopathologic prognostic factors and whether triple negative breast cancer (TNBC) would show high metabolic–perfusion ratio compared to non-triple negative breast cancer (non-TNBC). Methods: From March 2011 to November 2011, 67 females with invasive ductal carcinoma of breast who underwent both MRI and 18F-FDG PET/CT were included. Perfusion parameters including Ktrans, Kep and Ve were acquired from Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Metabolic parameters including the standardized uptake value (SUV) and volumetric metabolic parameters including metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were obtained from F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). Results: In non-TNBC, SUVmax was significantly correlated with Kep (ρ = 0.298, p = 0.036) and Ve (ρ = −0.286, p = 0.044). In TNBC, there was no significant correlation between all perfusion and metabolic parameters. Compared to non-TNBC, higher SUVmax (10.2 vs 5.3, p < 0.001), higher SUVmax/Ktrans (56.02 vs 20.3, p < 0.001), higher MTV50/Ktrans (7.8 vs 16.54, p < 0.001), higher TLG50/Ktrans (36.49 vs 12.3, p < 0.001), higher TLG50/Ve (91.34 vs 27.1 p = 0.022) were

  2. Assessment of regional tumor hypoxia using 18F-fluoromisonidazole and 64Cu(II)-diacetyl-bis(N4-methylthiosemicarbazone) positron emission tomography: Comparative study featuring microPET imaging, PO2 probe measurement, autoradiography, and fluorescent microscopy in the R3327-AT and FaDu rat tumor models

    Purpose: To compare two potential positron emission tomography (PET) tracers of tumor hypoxia in an animal model. Methods and Materials: The purported hypoxia imaging agents 18F-fluoromisonidazole (FMISO) and 64Cu(II)-diacetyl-bis(N4-methylthiosemicarbazone) (Cu-ATSM) were compared by serial microPET imaging of Fisher-Copenhagen rats bearing the R3327-AT anaplastic rat prostate tumor. Probe measurements of intratumoral PO2 were compared with the image data. At the microscopic level, the relationship between the spatial distributions of 64Cu (assessed by digital autoradiography) and tumor hypoxia (assessed by immunofluorescent detection of pimonidazole) was examined. 18F-FMISO and 64Cu-ATSM microPET images were also acquired in nude rats bearing xenografts derived from the human squamous cell carcinoma cell line, FaDu. Results: In R3327-AT tumors, the intratumoral distribution of 18F-FMISO remained relatively constant 1-4 h after injection. However, that of 64Cu-ATSM displayed a significant temporal evolution for 0.5-20 h after injection in most tumors. In general, only when 64Cu-ATSM was imaged at later times (16-20 h after injection) did it correspond to the distribution of 18F-FMISO. Oxygen probe measurements were broadly consistent with 18F-FMISO and late 64Cu-ATSM images but not with early 64Cu-ATSM images. At the microscopic level, a negative correlation was found between tumor hypoxia and 64Cu distribution when assessed at early times and a positive correlation when assessed at later times. For the FaDu tumor model, the early and late 64Cu-ATSM microPET images were similar and were in general concordance with the 18F-FMISO scans. Conclusion: The difference in behavior between the R3327-AT and FaDu tumor models suggests a tumor-specific dependence of Cu-ATSM uptake and retention under hypoxic conditions

  3. Molecular Imaging in Breast Cancer: From Whole-Body PET/CT to Dedicated Breast PET

    B. B. Koolen

    2012-01-01

    Full Text Available Positron emission tomography (PET, with or without integrated computed tomography (CT, using 18F-fluorodeoxyglucose (FDG is based on the principle of elevated glucose metabolism in malignant tumors, and its use in breast cancer patients is frequently being investigated. It has been shown useful for classification, staging, and response monitoring, both in primary and recurrent disease. However, because of the partial volume effect and limited resolution of most whole-body PET scanners, sensitivity for the visualization of small tumors is generally low. To improve the detection and quantification of primary breast tumors with FDG PET, several dedicated breast PET devices have been developed. In this nonsystematic review, we shortly summarize the value of whole-body PET/CT in breast cancer and provide an overview of currently available dedicated breast PETs.

  4. Application of PET and PET/CT imaging for cancer screening

    The aim of this study was to evaluate the potential application of 18F-fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) and PET/CT for cancer screening in asymptomatic individuals. Methods: The subjects consisted of 3631 physical check up examinees (1947 men, 1684 women; mean age ±SD, 52.1±8.2 y) with non-specific medical histories. Whole-body FDG PET (or PET/CT), ultrasound and tumor markers were performed on all patients. Focal hypermetabolic areas with intensities equal to or exceeding the level of FDG uptake in the brain and bladder were considered abnormal and interpreted as neoplasia. Follow-up periods were longer than one year. Results: Among the 3631 FDG PET (including 1687 PET/CT), ultrasound and tumor markers examinations, malignant tumors were discovered in 47 examinees (1.29%). PET findings were true-positive in 38 of the 47 cancers (80.9%). In addition, 32 of the 47 cancers were performed with the PET-CT scan. PET detected cancer lesions in 28 of the 32 examinees. However, the CT detected cancer lesions in only 15 of 32 examinees. Conclusion: The sensitivity of FDG PET in the detection of a wide variety of cancers is high. Most cancer can be detected with FDG PET in a resectable stage. CT of the PET/CT for localization and characteristics of the lesion shows an increased specificity of the PET scan. Using ultrasound and tumor markers may complement the PET scan in cancer screening for hepatic and urologic neoplasms. (authors)

  5. Rare solitary focal tuberculous involvement of liver masquerading as hepatic metastasis on FDG PET/CT in a case of fibular round cell tumor

    Finding of focal 18F-fluoro-deoxyglucose (FDG) uptake in liver on FDG positron emission tomography/computed tomography (FDG PET/CT) in a known case of malignancy is often considered to be metastases. We report a similar finding on FDG PET/CT in a case of Ewing's sarcoma of thigh, which turned out to be of tuberculous etiology, an unusual cause of false positive FDG uptake in the liver

  6. A comparison of 111In- or 64Cu-DOTA-trastuzumab Fab fragments for imaging subcutaneous HER2-positive tumor xenografts in athymic mice using microSPECT/CT or microPET/CT

    Chan, Conrad; Scollard, Deborah A; McLarty, Kristin; Smith, Serena; Reilly, Raymond M

    2011-01-01

    Background Our objective was to compare 111In- or 64Cu-DOTA-trastuzumab Fab fragments for imaging small or large s.c. tumor xenografts in athymic mice that display a wide range of human epidermal growth factor receptor-2 (HER2) expression using microSPECT/CT or microPET/CT. Methods Trastuzumab Fab were labeled with 111In or 64Cu by conjugation to 1,4,7,10-tetraazacyclododecane N, N', N'', N'''-tetraacetic acid (DOTA). The purity of 111In- and 64Cu-DOTA-trastuzumab Fab was measured by SDS-PAGE...

  7. Mammary tumors

    Mammary neoplasia is one of the more common malignancies affecting domestic species. Despite their importance, they are often over- diagnosed, undertreated and subject to several misconceptions propagated by veterinarians and pet owners alike. Mammary neoplasia is the most frequent tumor type encountered in the female accounting for almost half of all malignancies reported. The canine has the highest incidence of mammary tumors of all domestic species. In the dog, about 65 percent of mammary tumors are benign mixed tumors, and 25 percent are carcinomas. The rest are adenomas, myoepitheliomas, and malignant mixed tumors. The age distribution of mammary tumors closely follows the age distribution of most tumors in the dog. Mammary tumors are rare in dogs 2 years old, but incidence begins to increase sharply at approximately 6 years of age. Median age at diagnosis is about 10 years. No breed predilection has been consistently reported

  8. PET-CT imaging in pediatric oncology

    McCarville, M. Beth

    2009-01-01

    Abstract Positron emission tomography (PET)-computed tomography (CT) is emerging as a valuable tool for assessing a wide variety of pediatric malignancies, including lymphomas, soft-tissue tumors, and bone sarcomas. PET-CT may provide information that is not apparent on conventional imaging performed to stage these diseases and monitor their response to treatment. The use of PET-CT in children requires an awareness of the technical and logistical issues unique to this patient population. In a...

  9. Is 99mTc Glucarate a tracer of tumor necrosis?. Comparison with 18F-FDG-PET in an animal model of breast cancer and preliminary clinical experience in oncology patients

    Introduction: 99mTc-Glucarate has a structural similarity to fructose suggesting that it may enter cells using fructose transporters. Moreover, it has been suggested that 99mTc -Glucarate could interact with hystones of necrotic cells. This radiopharmaceutical has been also evaluated in patients with cerebral and myocardial necrosis and in some tumors. The aim of our study is to evaluate the effects of breast cancer microenvironment in the localization and uptake of 99mTc - Glucarate and 18F-FDG in a preclinical study performed in mice bearing human breast cancer and to evaluate the potential application of 99mTc - Glucarate as a tracer of different solid tumors. Material and methods: Micro PET-CT with 18F-FDG, micro SPECT-CT with 99mTc - Glucarate and micro magnetic resonance imaging (MRI) in MDA-435 breast cancer xenografted SCID mice were performed. We studied 3 patients with breast cancer, 3 patients with non small cell lung cancer and 3 patients with head and neck squamous cell cancer. All of them were locally advanced. Results: Micro SPECT-CT imaging showed a uniform tracer uptake in the tumoral volume whereas PET-CT images demonstrated a higher uptake in the tumor periphery with less accumulation in its center. Micro MRI imaging confirmed the central tumor necrosis. Besides, 99mTc - Glucarate was accumulated by primary and secondary lesions of breast, lung and head and neck cancer. Conclusion: 99mTc - Glucarate has the potential to constitute a relevant clinical agent for the evaluation of patients with breast, lung and head and neck cancer. These results need to be confirmed in an adequate series of patients (au)

  10. FDG PET or PET/CT in Evaluation of Renal Angiomyolipoma

    Lin, Chun-Yi; Chen, Hui-Yi; Ding, Hueisch-Jy; Yen, Kuo-Yang; Kao, Chia-Hung

    2013-01-01

    Objective Angiomyolipoma is the most common benign kidney tumor. However, literature describing FDG PET findings on renal angiomyolipoma (AML) is limited. This study reports the FDG PET and PET/CT findings of 21 cases of renal AML. Materials and Methods The study reviews FDG PET and PET/CT images of 21 patients diagnosed with renal AML. The diagnosis is based on the classical appearance of an AML on CT scan with active surveillance for 6 months. The study is focused on the observation of clin...

  11. Synthesis of 2'-deoxy-2'-[18F]-fluoro-5-iodo-1-β-D-arabinofuranosyluracil ([18F]-FIAU) and micro-PET imaging of suicide gene expression in tumor-bearing nude mice

    Herpes simplex virus type-1 thymidine kinase (HSV1-tk) is being used as a suicide gene for gene therapy of cancer. An in vivo method to assess the HSV1-tk enzyme activity after gene transfer is desirable to monitor gene expression as an indicator of gene delivery. Imaging of the HSV1-tk reporter gene along with various reporter probes is of current interest. We originally developed [18F]-FHPG and [18F]-FHBG for PET imaging of HSV1-tk gene expression and demonstrated that [18F]-FHBG is more useful than [18F]-FHPG for this purpose. [124I]-FIAU has been shown to be a potential PET imaging agent for HSV1-tk gene expression, and is superior to [18F]-FHPG and [18F]-FHBG. We also demonstrated that radiolabeled FMAU can be used as a marker for HSV-tk gene expression, and is superior to [18F]-FHPG and [18F]-FHBG. Earlier we reported a synthesis for 2'-deoxy-2'-[18F]fluoro-5-methyl-1-β-D-arabinofuranosyluracil ([18F]-FMAU) and some other 5-substituted nucleosides. We have synthesized now [18F]-FIAU, used the tracer for micro-PET imaging of suicide gene expression in tumor-bearing nude mice, and compared the results with earlier studies using [14C]-FMAU. (orig.)

  12. Correlating tumor metabolic progression index measured by serial FDG PET-CT, apparent diffusion coefficient measured by magnetic resonance imaging (MRI) and blood genomics to patient’s outcome in advanced colorectal cancer: the CORIOLAN study

    Metastatic colorectal cancer (mCRC) may present various behaviours that define different courses of tumor evolution. There is presently no available tool designed to assess tumor aggressiveness, despite the fact that this is considered to have a major impact on patient outcome. CORIOLAN is a single-arm prospective interventional non-therapeutic study aiming mainly to assess the natural tumor metabolic progression index (TMPI) measured by serial FDG PET-CT without any intercurrent antitumor therapy as a prognostic factor for overall survival (OS) in patients with mCRC. Secondary objectives of the study aim to test the TMPI as a prognostic marker for progression-free survival (PFS), to assess the prognostic value of baseline tumor FDG uptake on PFS and OS, to compare TMPI to classical clinico-biological assessment of prognosis, and to test the prognostic value on OS and PFS of MRI-based apparent diffusion coefficient (ADC) and variation of vADC using voxel-based diffusion maps. Additionally, this study intends to identify genomic and epigenetic factors that correlate with progression of tumors and the OS of patients with mCRC. Consequently, this analysis will provide information about the signaling pathways that determine the natural and therapy-free course of the disease. Finally, it would be of great interest to investigate whether in a population of patients with mCRC, for which at present no known effective therapy is available, tumor aggressiveness is related to elevated levels of circulating tumor cells (CTCs) and to patient outcome. Tumor aggressiveness is one of the major determinants of patient outcome in advanced disease. Despite its importance, supported by findings reported in the literature of extreme outcomes for patients with mCRC treated with chemotherapy, no objective tool allows clinicians to base treatment decisions on this factor. The CORIOLAN study will characterize TMPI using FDG-PET-based metabolic imaging of patients with chemorefractory m

  13. Report of research and development of next generation PET equipments

    This is a report of the meeting concerning the next generation PET, held January 26, 2004, National Institute of Radiological Sciences in Chiba (NIRS), and contains the list of investigators, the first part of current status of investigations on the research and development of the PET equipments in NIRS and co-working facilities, the second part of comments of investigators of nuclear medicine, and list of published works. The first part describes the summarized current state of the works, examinations of correction of sensitivity with application of PET simulator, scintillator for PET, development of depth of interaction (DOI) detector for jPET-D4, 4-layer DOI detector for PET of small animals, evaluation of 256 channel-flat pane (FP)-position sensitive photomultiplier tube (PMT), detector simulation, correction of detector elements, development of coincidence imaging detector during surgery, circuit for processing the detector signals, development of front-end encoder ASIC, coincidence circuit, evaluation of jPET-D4 images, statistical reconstruction of DOI-PET images, Monte Carlo simulation technology, measurement and correction of body movement, and pioneer/original works. The second part; trend of clinical PET, development of in vivo radiopharmaceuticals and PET, trend of new PET equipments, demands for the new PET equipment from clinical neurology, investigations of human brain functions by PET, PET and tumors, evaluation of PET equipment NEMA NU2-2001, and PET and MRI. (N.I.)

  14. 放射性核素标记胆碱与18F-FDG PET肿瘤显像的对比研究%Comparison choline with 18F-FDG PET in various tumors imaging

    李亚军; 张慧娟

    2010-01-01

    18F-FDG PET has become the preferred method of staging and restaging of many malignant neoplasms. Its application has increased diagnostic accuracy and exerted a considerable impact on the treatment of patients. 18F-FDG PET has also become extremely valuable in therapy efficacy monitoring of many malignant neoplasms. Choline is critical for cellular membrane structures and function. Choline metabolism increases in malignant neoplasms. 11C-/18F-choline PET has been used in diagnosis and detection of many malignant neoplasms and metastases. This paper reviews the value of 18F-FDG and 11C-/18F-choline PET in tumors imaging and compares their advantages and limitations.%18F-FDG PET是目前临床上许多恶性肿瘤分期和再分期的首选检查方法,可明显提高恶性肿瘤的诊断准确性,对患者的治疗方案的选择产生了很大影响,而且在恶性肿瘤的疗效监测中也有很大价值.胆碱是保持细胞膜结构和功能完整性的重要成分,恶性肿瘤的胆碱代谢增高.11C-/18F-胴碱PET在临床上已用于许多恶性肿瘤的诊断及转移瘤的检出.该文回顾了18F-FDG和11C-/18F-胆碱PET在肿瘤显像中的应用价值,并比较了其优势和限度.

  15. Optimization, biological evaluation and microPET imaging of copper-64-labeled bombesin agonists, [{sup 64}Cu-NO2A-(X)-BBN(7-14)NH{sub 2}], in a prostate tumor xenografted mouse model

    Lane, Stephanie R., E-mail: srlf36@mail.missouri.ed [Department of Radiology, University of Missouri-Columbia School of Medicine, Columbia, MO 65211 (United States); Research Division, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO 65201 (United States); Department of Chemistry, University of Missouri-Columbia, Columbia, MO 65211 (United States); Nanda, Prasanta [Department of Radiology, University of Missouri-Columbia School of Medicine, Columbia, MO 65211 (United States); Rold, Tammy L. [Department of Internal Medicine, University of Missouri-Columbia School of Medicine, Columbia, MO 65211 (United States); Sieckman, Gary L. [Research Division, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO 65201 (United States); Figueroa, Said D. [Department of Radiology, University of Missouri-Columbia School of Medicine, Columbia, MO 65211 (United States); Research Division, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO 65201 (United States); Hoffman, Timothy J. [Research Division, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO 65201 (United States); The Radiopharmaceutical Sciences Institute, University of Missouri-Columbia School of Medicine, Columbia, MO 65211 (United States); Department of Chemistry, University of Missouri-Columbia, Columbia, MO 65211 (United States); Jurisson, Silvia S. [Department of Chemistry, University of Missouri-Columbia, Columbia, MO 65211 (United States); Smith, Charles J., E-mail: smithcj@health.missouri.ed [Department of Radiology, University of Missouri-Columbia School of Medicine, Columbia, MO 65211 (United States); Research Division, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO 65201 (United States); University of Missouri Research Reactor Center, University of Missouri-Columbia, Columbia, MO 65211 (United States); The Radiopharmaceutical Sciences Institute, University of Missouri-Columbia School of Medicine, Columbia, MO 65211 (United States)

    2010-10-15

    Gastrin-releasing peptide receptors (GRPr) are a member of the bombesin (BBN) receptor family. GRPr are expressed in high numbers on specific human cancers, including human prostate cancer. Therefore, copper-64 ({sup 64}Cu) radiolabeled BBN(7-14)NH{sub 2} conjugates could have potential for diagnosis of human prostate cancer via positron-emission tomography (PET). The aim of this study was to produce [{sup 64}Cu-NO2A-(X)-BBN(7-14)NH{sub 2}] conjugates for prostate cancer imaging, where X=pharmacokinetic modifier (beta-alanine, 5-aminovaleric acid, 6-aminohexanoic acid, 8-aminooctanoic acid, 9-aminonanoic acid or para-aminobenzoic acid) and NO2A=1,4,7-triazacyclononane-1,4-diacetic acid [a derivative of NOTA (1,4,7-triazacyclononane-1,4,7-triacetic acid)]. Methods: [(X)-BBN(7-14)NH{sub 2}] Conjugates were synthesized by solid-phase peptide synthesis (SPPS), after which NOTA was added via manual conjugation. The new peptide conjugates were radiolabeled with {sup 64}Cu radionuclide. The receptor-binding affinity was determined in human prostate PC-3 cells, and tumor-targeting efficacy was determined in PC-3 tumor-bearing severely combined immunodeficient (SCID) mice. Whole-body maximum intensity microPET/CT images of PC-3 tumor-bearing SCID mice were obtained 18 h postinjection (pi). Results: Competitive binding assays in PC-3 cells indicated high receptor-binding affinity for the [NO2A-(X)-BBN(7-14)NH{sub 2}] and [{sup nat}Cu-NO2A-(X)-BBN(7-14)NH{sub 2}] conjugates. In vivo biodistribution studies of the [{sup 64}Cu-NO2A-(X)-BBN(7-14)NH{sub 2}] conjugates at 1, 4 and 24 h pi showed very high uptake of the tracer in GRPr-positive tissue with little accumulation and retention in nontarget tissues. High-quality, high-contrast microPET images were obtained, with xenografted tumors being clearly visible at 18 h pi. Conclusions: NO2A chelator sufficiently stabilizes copper(II) radiometal under in vivo conditions, producing conjugates with very high uptake and retention in

  16. Optimization, biological evaluation and microPET imaging of copper-64-labeled bombesin agonists, [64Cu-NO2A-(X)-BBN(7-14)NH2], in a prostate tumor xenografted mouse model

    Gastrin-releasing peptide receptors (GRPr) are a member of the bombesin (BBN) receptor family. GRPr are expressed in high numbers on specific human cancers, including human prostate cancer. Therefore, copper-64 (64Cu) radiolabeled BBN(7-14)NH2 conjugates could have potential for diagnosis of human prostate cancer via positron-emission tomography (PET). The aim of this study was to produce [64Cu-NO2A-(X)-BBN(7-14)NH2] conjugates for prostate cancer imaging, where X=pharmacokinetic modifier (beta-alanine, 5-aminovaleric acid, 6-aminohexanoic acid, 8-aminooctanoic acid, 9-aminonanoic acid or para-aminobenzoic acid) and NO2A=1,4,7-triazacyclononane-1,4-diacetic acid [a derivative of NOTA (1,4,7-triazacyclononane-1,4,7-triacetic acid)]. Methods: [(X)-BBN(7-14)NH2] Conjugates were synthesized by solid-phase peptide synthesis (SPPS), after which NOTA was added via manual conjugation. The new peptide conjugates were radiolabeled with 64Cu radionuclide. The receptor-binding affinity was determined in human prostate PC-3 cells, and tumor-targeting efficacy was determined in PC-3 tumor-bearing severely combined immunodeficient (SCID) mice. Whole-body maximum intensity microPET/CT images of PC-3 tumor-bearing SCID mice were obtained 18 h postinjection (pi). Results: Competitive binding assays in PC-3 cells indicated high receptor-binding affinity for the [NO2A-(X)-BBN(7-14)NH2] and [natCu-NO2A-(X)-BBN(7-14)NH2] conjugates. In vivo biodistribution studies of the [64Cu-NO2A-(X)-BBN(7-14)NH2] conjugates at 1, 4 and 24 h pi showed very high uptake of the tracer in GRPr-positive tissue with little accumulation and retention in nontarget tissues. High-quality, high-contrast microPET images were obtained, with xenografted tumors being clearly visible at 18 h pi. Conclusions: NO2A chelator sufficiently stabilizes copper(II) radiometal under in vivo conditions, producing conjugates with very high uptake and retention in targeted GRPr. Preclinical evaluation of these new peptide

  17. SU-E-J-262: Variability in Texture Analysis of Gynecological Tumors in the Context of An 18F-FDG PET Adaptive Protocol

    Purpose: This study examines the effect on texture analysis due to variable reconstruction of PET images in the context of an adaptive FDG PET protocol for node positive gynecologic cancer patients. By measuring variability in texture features from baseline and intra-treatment PET-CT, we can isolate unreliable texture features due to large variation. Methods: A subset of seven patients with node positive gynecological cancers visible on PET was selected for this study. Prescribed dose varied between 45–50.4Gy, with a 55–70Gy boost to the PET positive nodes. A baseline and intratreatment (between 30–36Gy) PET-CT were obtained on a Siemens Biograph mCT. Each clinical PET image set was reconstructed 6 times using a TrueX+TOF algorithm with varying iterations and Gaussian filter. Baseline and intra-treatment primary GTVs were segmented using PET Edge (MIM Software Inc., Cleveland, OH), a semi-automatic gradient-based algorithm, on the clinical PET and transferred to the other reconstructed sets. Using an in-house MATLAB program, four 3D texture matrices describing relationships between voxel intensities in the GTV were generated: co-occurrence, run length, size zone, and neighborhood difference. From these, 39 textural features characterizing texture were calculated in addition to SUV histogram features. The percent variability among parameters was first calculated. Each reconstructed texture feature from baseline and intra-treatment per patient was normalized to the clinical baseline scan and compared using the Wilcoxon signed-rank test in order to isolate variations due to reconstruction parameters. Results: For the baseline scans, 13 texture features showed a mean range greater than 10%. For the intra scans, 28 texture features showed a mean range greater than 10%. Comparing baseline to intra scans, 25 texture features showed p <0.05. Conclusion: Variability due to different reconstruction parameters increased with treatment, however, the majority of texture

  18. Dynamics of tumor hypoxia assessed by 18F-FAZA PET/CT in head and neck and lung cancer patients during chemoradiation: Possible implications for radiotherapy treatment planning strategies

    Introduction: To define the optimal time point for the integration of hypoxia 18F-FAZA-PET/CT information into radiotherapy treatment planning to benefit from hypoxia modification or dose escalation treatment. Therefore, we performed a prospective cohort study, using serial hypoxic imaging (18F-FAZA-PET/CT) prior to and at several time-points during (chemo)radiotherapy (CHRT) in six head and neck squamous cell (HNSCC) and six non-small cell lung cancer (NSCLC) patients. Methods: The spatio-temporal dynamics of tumor hypoxia and fractional hypoxic volumes (FHV) were evaluated using a voxel-by-voxel analysis based on a 18F-FAZA-T/B ratio of 1.4 at four time points in HNSCC patients, at baseline (FAZA-BL), at week one (FAZA-W1), two (FAZA-W2), and four (FAZA-W4) during CHRT and at three time points in NSCLC patients (baseline; W2, W4). Results: Ten out of twelve patients showed a substantial pre-treatment tumor hypoxia representing a FHV ⩾ 1.4 assessed by 18F-FAZA-PET/CT. The median FHV was 38% (FAZA-BL), 15% (FAZA-W1), 17% (FAZA-W2) and 1.5% (FAZA-W4) in HNSCC patients, and 34% (FAZA-BL), 26% (FAZA-W2) and 26% (FAZA-W4) in NSCLC patients, respectively. Stable tumor hypoxia was observed in three HNSCC patients and two NSCLC patients at FAZA-W2. In three HNSCC patients and two NSCLC patients FHVs declined to non-detectable hypoxia levels at FAZA-W4 during CHRT, while two NSCLC patients, showed increasing FHVs. Conclusion: Our results indicate that, instead of using the FAZA-BL scan as the basis for the dose escalation, FAZA-W2 of CHRT is most suitable and might provide a more reliable basis for the integration of 18F-FAZA-PET/CT information into radiotherapy treatment planning for hypoxia-directed dose escalation strategies

  19. PET: functional imaging applications in oncology

    PET imaging plays an important role in the diagnosis, staging and management of tumors. At present, its principal application is in lung cancer, but interest in other applications is growing rapidly. (orig.)

  20. Novel carbon-11 labeled 4-dimethylamino-but-2-enoic acid [4-(phenylamino)-quinazoline-6-yl]-amides: potential PET bioprobes for molecular imaging of EGFR-positive tumors

    We have previously reported of labeled reversible and irreversible EGFR inhibitors, such as 4-(3,4-dichloro-6-fluoroanilino)-6,7-dimethoxyquinazoline (ML01) and 6-acrylamido-4-(3,4-dichloro-6-fluoroanilino)quinazoline (ML03), to be suboptimal as imaging agents. On the basis of these studies, a new generation of novel, more chemically stable irreversible inhibitors was labeled with carbon-11 as potential positron emission tomography (PET) biomarkers for molecular imaging of epidermal growth factor receptor (EGFR)-positive tumors. In these new labeled, irreversible inhibitors the acryl-amide group at the 6-position of the quinazoline ring was replaced with a 4-dimethylamino-but-2-enoic amide. The nonlabeled compounds were evaluated in vitro to determine their EGFR autophosphorylation IC50 values. The IC50 values indicated that these new irreversible compounds possess similar potencies towards the EGFR, as the parent compound, ML03. These compounds were labeled with carbon-11 at the dimethylamine moiety, using the well known labeling reagent C-11 MeI. The labeling procedure was automated using a commercial module. The final products were obtained with 10% decay corrected radiochemical yield, 99% radiochemical purity, 96% chemical purity, and a high specific activity of 2.7 Ci/μmol EOB. The high potency of these new labeled bioprobes towards the EGFR establishes their potential to serve as PET agents for molecular imaging of EGFR-positive tumors

  1. FDG PET or PET/CT in evaluation of renal angiomyolipoma

    Lin, Chun Yi [Dept. of Nuclear Medicine, Show Chwan Memorial Hospital, Changhua (China); Chen, Hui Yi [Dept. of Radiology, China Medical University Hospital, Taichung (China); Ding, Hueisch Jy [Dept. of Nuclear Medicine, E-DA Hospital I-Shou University, Kaohsiung (China); Yen, Kuo Yang; Kao, Chia Hung [Dept. of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung (China)

    2013-04-15

    Angiomyolipoma is the most common benign kidney tumor. However, literature describing FDG PET findings on renal angiomyolipoma (AML) is limited. This study reports the FDG PET and PET/CT findings of 21 cases of renal AML. The study reviews FDG PET and PET/CT images of 21 patients diagnosed with renal AML. The diagnosis is based on the classical appearance of an AML on CT scan with active surveillance for 6 months. The study is focused on the observation of clinical and radiographic features. Six men and 15 women were included in our study. The mean age of the patients was 57.14 ± 9.67 years old. The mean diameter of 21 renal AML on CT scans was 1.76 ± 1.00 cm (Min: 0.6 cm; Max: 4.4 cm). CT scans illustrated renal masses typical of AMLs, and the corresponding FDG PET scans showed minimal FDG activities in the area of the tumors. None of the 21 AMLs showed a maximum standardized uptake value (SUV{sub max}) greater than 1.98. No statistically significant correlation was present between SUV{sub max} and tumor size. Renal AMLs demonstrate very low to low uptake on FDG PET and PET/CT imaging in this study. When a fat-containing tumor in the kidney is found on a CT scan, it is critical to differentiate an AML from a malignant tumor including an RCC, liposarcoma, and Wilms tumor. This study suggests that FDG PET or PET/CT imaging is useful for differentiating a renal AML from a fat-containing malignant tumor.

  2. FDG PET or PET/CT in evaluation of renal angiomyolipoma

    Angiomyolipoma is the most common benign kidney tumor. However, literature describing FDG PET findings on renal angiomyolipoma (AML) is limited. This study reports the FDG PET and PET/CT findings of 21 cases of renal AML. The study reviews FDG PET and PET/CT images of 21 patients diagnosed with renal AML. The diagnosis is based on the classical appearance of an AML on CT scan with active surveillance for 6 months. The study is focused on the observation of clinical and radiographic features. Six men and 15 women were included in our study. The mean age of the patients was 57.14 ± 9.67 years old. The mean diameter of 21 renal AML on CT scans was 1.76 ± 1.00 cm (Min: 0.6 cm; Max: 4.4 cm). CT scans illustrated renal masses typical of AMLs, and the corresponding FDG PET scans showed minimal FDG activities in the area of the tumors. None of the 21 AMLs showed a maximum standardized uptake value (SUVmax) greater than 1.98. No statistically significant correlation was present between SUVmax and tumor size. Renal AMLs demonstrate very low to low uptake on FDG PET and PET/CT imaging in this study. When a fat-containing tumor in the kidney is found on a CT scan, it is critical to differentiate an AML from a malignant tumor including an RCC, liposarcoma, and Wilms tumor. This study suggests that FDG PET or PET/CT imaging is useful for differentiating a renal AML from a fat-containing malignant tumor.

  3. PET/CT and PET - application in pediatric oncology; PET/CT und PET - Einsatz in der paediatrischen Onkologie

    Franzius, C.; Lang, K.; Schober, O. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Muenster (Germany); Wormanns, D. [Inst. fuer klinische Radiologie, Univ. Muenster (Germany); Vormoor, J. [Klinik und Poliklinik fuer Kinder- und Jugendmedizin - Paediatrische Haematologie und Onkologie, Univ. Muenster (Germany)

    2004-12-01

    PET-CT is a new imaging technology with a high capability to improve oncologic imaging. Introduction into clinical practise started approximately 3 years ago. Consequently, the available literature data are preliminary. There are no studies concerning PET-CT in pediatric patients. Nevertheless, it can already be supposed that the synthesis of structural and metabolic information improves the accuracy of staging and has the realistic potential to change patient management in a relevant percentage rate in pediatric patients. In this article, the advantages and special features of the application of PET-CT in young oncologic patients are pointed out. Potential clinical applications of PET-CT in this patient group include Hodgkin and non-Hodgkin lymphomas, Ewing tumors, osteosarcomas, rhabdomyosarcomas and neuroblastomas. (orig.)

  4. Clinical oncologic applications of PET/MRI: a new horizon

    Partovi, Sasan; Kohan, Andres; Rubbert, Christian; Vercher-Conejero, Jose Luis; Gaeta, Chiara; Yuh, Roger; Zipp, Lisa; Herrmann, Karin A.; Robbin, Mark R.; Lee, Zhenghong; Muzic, Raymond F.; Faulhaber, Peter; Ros, Pablo R

    2014-01-01

    Positron emission tomography/magnetic resonance imaging (PET/MRI) leverages the high soft-tissue contrast and the functional sequences of MR with the molecular information of PET in one single, hybrid imaging technology. This technology, which was recently introduced into the clinical arena in a few medical centers worldwide, provides information about tumor biology and microenvironment. Studies on indirect PET/MRI (use of positron emission tomography/computed tomography (PET/CT) images softw...

  5. Diabetic Pets

    ... health or management, contact your veterinarian. In addition, diabetic pets should be monitored for long-term complications such as cataracts, which commonly develop in diabetic dogs and cats. Other problems that can occur ...

  6. Senior Pets

    ... Future AVMA Meeting Dates Meetings & CE Calendar Symposiums & Summits Pet Health Awareness Events About AVMA Who We ... and small dogs are generally considered “senior” at seven years of age. Larger breed dogs tend to ...

  7. A Comparative Study of the Hypoxia PET Tracers [{sup 18}F]HX4, [{sup 18}F]FAZA, and [{sup 18}F]FMISO in a Preclinical Tumor Model

    Peeters, Sarah G.J.A., E-mail: sarah.peeters@maastrichtuniversity.nl [Department of Radiation Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht (Netherlands); Zegers, Catharina M.L.; Lieuwes, Natasja G.; Elmpt, Wouter van [Department of Radiation Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht (Netherlands); Eriksson, Jonas; Dongen, Guus A.M.S. van [Department of Radiology and Nuclear Medicine, VU University Medical Center Amsterdam, Amsterdam (Netherlands); Dubois, Ludwig; Lambin, Philippe [Department of Radiation Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht (Netherlands)

    2015-02-01

    Purpose: Several individual clinical and preclinical studies have shown the possibility of evaluating tumor hypoxia by using noninvasive positron emission tomography (PET). The current study compared 3 hypoxia PET tracers frequently used in the clinic, [{sup 18}F]FMISO, [{sup 18}F]FAZA, and [{sup 18}F]HX4, in a preclinical tumor model. Tracer uptake was evaluated for the optimal time point for imaging, tumor-to-blood ratios (TBR), spatial reproducibility, and sensitivity to oxygen modification. Methods and Materials: PET/computed tomography (CT) images of rhabdomyosarcoma R1-bearing WAG/Rij rats were acquired at multiple time points post injection (p.i.) with one of the hypoxia tracers. TBR values were calculated, and reproducibility was investigated by voxel-to-voxel analysis, represented as correlation coefficients (R) or Dice similarity coefficient of the high-uptake volume. Tumor oxygen modifications were induced by exposure to either carbogen/nicotinamide treatment or 7% oxygen breathing. Results: TBR was stabilized and maximal at 2 hours p.i. for [{sup 18}F]FAZA (4.0 ± 0.5) and at 3 hours p.i. for [{sup 18}F]HX4 (7.2 ± 0.7), whereas [{sup 18}F]FMISO showed a constant increasing TBR (9.0 ± 0.8 at 6 hours p.i.). High spatial reproducibility was observed by voxel-to-voxel comparisons and Dice similarity coefficient calculations on the 30% highest uptake volume for both [{sup 18}F]FMISO (R = 0.86; Dice coefficient = 0.76) and [{sup 18}F]HX4 (R = 0.76; Dice coefficient = 0.70), whereas [{sup 18}F]FAZA was less reproducible (R = 0.52; Dice coefficient = 0.49). Modifying the hypoxic fraction resulted in enhanced mean standardized uptake values for both [{sup 18}F]HX4 and [{sup 18}F]FAZA upon 7% oxygen breathing. Only [{sup 18}F]FMISO uptake was found to be reversible upon exposure to nicotinamide and carbogen. Conclusions: This study indicates that each tracer has its own strengths and, depending on the question to be answered, a different tracer can be put

  8. FDG-PET in gynecologic cancer

    Whole-body positron emission tomography (PET) imaging with 18-F deoxyglucose (FDG) is a molecular imaging modality that detects metabolic alternation in tumor cells. In various human cancers, FDG-PET shows a potential clinical benefit in screening, tumor characterization, staging, therapeutic follow-up and detecting recurrence. In gynecologic cancers, FDG-PET is also known to be effective in characterization of adnexal masses, detection of recurrence, and lymph node invasion. This review discusses the clinical feasibility and future clinical application of this imaging modality in patients with cervical cancer, ovarian cancer and other gynecologic cancers

  9. [18F]FLT PET for Non-Invasive Assessment of Tumor Sensitivity to Chemotherapy: Studies with Experimental Chemotherapy TP202377 in Human Cancer Xenografts in Mice

    Jensen, Mette Munk; Erichsen, Kamille Dumong; Björkling, Fredrik;

    2012-01-01

    3'-deoxy-3'-[¹⁸F]fluorothymidine ([18F]FLT) is a tracer used to assess cell proliferation in vivo. The aim of the study was to use [18F]FLT positron emission tomography (PET) to study non-invasively early anti-proliferative effects of the experimental chemotherapeutic agent TP202377 in both sensi...

  10. Positron Emission Tomography (PET)

    Positron emission tomography (PET) assesses biochemical processes in the living subject, producing images of function rather than form. Using PET, physicians are able to obtain not the anatomical information provided by other medical imaging techniques, but pictures of physiological activity. In metaphoric terms, traditional imaging methods supply a map of the body's roadways, its, anatomy; PET shows the traffic along those paths, its biochemistry. This document discusses the principles of PET, the radiopharmaceuticals in PET, PET research, clinical applications of PET, the cost of PET, training of individuals for PET, the role of the United States Department of Energy in PET, and the futures of PET. 22 figs

  11. PET/MRI in cancer patients

    Kjær, Andreas; Loft, Annika; Law, Ian;

    2013-01-01

    Combined PET/MRI systems are now commercially available and are expected to change the medical imaging field by providing combined anato-metabolic image information. We believe this will be of particular relevance in imaging of cancer patients. At the Department of Clinical Physiology, Nuclear...... described include brain tumors, pediatric oncology as well as lung, abdominal and pelvic cancer. In general the cases show that PET/MRI performs well in all these types of cancer when compared to PET/CT. However, future large-scale clinical studies are needed to establish when to use PET/MRI. We envision...... that PET/MRI in oncology will prove to become a valuable addition to PET/CT in diagnosing, tailoring and monitoring cancer therapy in selected patient populations....

  12. A comparison of PET/CT with PET and CT in staging of NSCLC

    Objective: To determine the diagnostic accuracy of PET/CT in the staging of NSCLC, as compared with that of CT alone, PET alone and conventional visual correlation of CT and PET. Methods: Eighty-three consecutive patients, diagnosed clinically as NSCLC, underwent PET/CT scanning for staging. A diagnostic group performed blinded interpretation of CT alone, PET alone and visually correlated CT and PET, sequentially for each test. Similarly, blinded interpretation of PET alone, CT alone and PET/CT was performed sequentially by another diagnostic group. Tumor node metastasis (TNM) staging was deduced on the basis of image analysis. Node stations were identified to the mapping system of the American Thoracic Society (ATS). Abnormalities on each of these staging examinations were recorded and compared with surgical pathology result or with clinical and imaging follow-up results. Results: Sixty-four patients were proved to be NSCLC and nineteen patients had a benign process according to pathology result or follow-up results. 58 cases in those 64 NSCLC patients undergone invasive surgical staging. Overall tumor stage was accurately classified as 0-IV with CT in 43 patients, with PET in 46 patients, and with PET/CT in 53 patients. PET/CT provided additional information in 23 of 58 patients (39 percent) and was superior to that provided by visually correlated CT and PET. PET/CT findings were significantly more accurate when compared with CT alone findings (Pprocedures, there will be less invasive examinations needed in NSCLC staging after the use of PET/CT. (authors)

  13. Tumor thrombus

    Ravina, Mudalsha; Hess, Søren; Chauhan, Mahesh Singh; Jacob, Mattakorottu Joseph; Alavi, Abass

    2014-01-01

    PURPOSE: Thrombosis in cancer may manifest itself as venous thromboembolic disease or tumor thrombosis (TT). We present our experience with incidentally detected TT on FDG PET/CT in 21 oncologic patients. PATIENTS AND METHODS: We retrospectively reviewed all FDG PET/CT examinations during a 5-year......-one patients were included; the most common malignancies were renal cell carcinoma (n=6), hepatocellular carcinoma (n=3), and lung cancer (n=3). Indication for the scan was initial staging (n=15) and suspected recurrence (n=6). Several vessels were affected, the most common was the inferior vena cava (n=14...

  14. CT与18F-FDG PET-CT分别联合血清肿瘤标记物对肺癌诊断准确率的比较%The Comparison of CT and 18F-FDG PET-CT Combined with Serum Tu-mor Markers Diagnostic Accuracy of the Different Stages of Lung Cancer

    王佳; 刘焱; 牛俊巧

    2015-01-01

    目的:CT与18F-FDG正电子发射型计算机断层显像( positron emission tomography,18F-FDG PET-CT)联合血清肿瘤标记物对于不同临床分期肺癌诊断准确率的比较。方法整群选取2013年8月—2014年12月该院收治的81例经手术或穿刺活检、细胞灌洗细胞学检查、临床随访、诊断性治疗等方法诊断为肺癌的患者,其中74例有明确病理组织学类型。全部患者均在术前行肺部CT、血清肿瘤标记物检测及肺部PET-CT扫描。分析它们对不同临床分期肺癌诊断准确率的有无差异。结果CT与肿瘤标记物联合检测对肺癌的准确率为84.21%,PET-CT与肿瘤标记物联合检测的准确率为92.10%,差异有统计学意义(P<0.05)。74例有明确病理组织学类型的患者,其中鳞癌38例,诊断准确率分别为84.2%、94.7%,差异有统计学意义(P<0.05);腺癌28例,诊断准确率分别为85.7%、96.4%;小细胞型肺癌6例,诊断准确率分别66.67%、83.33%;大细胞肺癌和鳞腺癌各1例,诊断准确率均为100%、100%。结论18F-FDG PET-CT联合血清肿瘤标记物对肺癌的诊断率高于CT联合肿瘤标记物检查,对肺癌的诊断有很高价值。%Objective CT and 18F-FDG combined with serum tumor markers positron emission tomography (18F-FDG PET-CT) for the comparison of the diagnostic accuracy of different clinical stages of lung cancer. Methods Collected 81 cases by surgery or biopsy, cells lavage cytology, clinical follow-up, diagnostic treatment method for the diagnosis of lung cancer patients, including 74 cases of clear histological types. All patients in the preoperative lung CT, PET-CT, serum tumor markers detection and lung scan. Analysis of their differences on the presence or absence of the different clinical stages of lung cancer diagnostic accuracy. Results CT and tumor markers combined detection of lung cancer, the accuracy rate is 84.21%, PET-CT and tumor markers combined de-tection rate of 92.10%difference was

  15. Present and future aspects of PET examinations

    The PET examination gives the body distribution image of a compound labeled with the positron emitter manufactured by cyclotron. Recently, PET with F18-deoxyglucose (FDG) attracts considerable attention because the imaging is particularly useful for cancer detection. Since the technique was authorized by the United States (US) official health insurance in 1998, the number of the examination is increasing, which is also under similar situation in Japan due to the latest partial authorization for some malignant tumors. In Japan, about 30,000 examinations per year are carried out, half of which, in private hospitals. Their purpose is increasingly for cancer detection. For future PET examination, awaited are improvement of PET camera and development of a novel imaging agent. PET/CT imaging is for the former and F18-α-methyltyrosine, for the latter. Miniaturization of cyclotron, FDG delivery system, improved FDG synthetic method, popularization of PET/CT, development of PET camera for health examination, clinical trial of a novel imaging agent, and spread of PET health examination and operation of PET Center, are expected for future progress of PET technique. (N.I.)

  16. Long-Term Survival, Toxicity Profile, and role of F-18 FDG PET/CT scan in Patients with Progressive Neuroendocrine Tumors Following Peptide Receptor Radionuclide Therapy with High Activity In-111 Pentetreotide

    Ebrahim S. Delpassand, Amin Samarghandi, Jennifer Sims Mourtada, Sara Zamanian, Gregory D. Espenan, Roozbeh Sharif, Shawn MacKenzie, Kambiz Kosari, Omar Barakat, Shagufta Naqvi, John E. Seng, Lowell Anthony

    2012-01-01

    Full Text Available Aim: To study the long term benefits, toxicity and survival rate in patients with neuroendocrine tumors receiving multiple cycles of high activity In-111 Pentetreotide therapy. Moreover, our secondary aim was to evaluate the value of F-18 FDG PET-CT scan as prognostic indicator in this group of patients.Background: Neuroendocrine tumors are a heterogeneous group of malignancies which are usually metastatic at diagnosis. Standard chemotherapy in these patients is associated with appreciable adverse events and low effectiveness. Since 1990s, Peptide receptor radionuclide therapy (PRRT with radio-labeled somatostatin analogues has been introduced as a new method of treatment in patients with unresectable and/or metastatic neuroendocrine tumors expressing high levels of Somatostatin receptors.Methods: 112 patients with progressive disseminated and unresectable neuroendocrine tumor (stage III and stage IV were enrolled in a non-randomized trial in an out-patient setting. High activity In-111 Pentetreotide (500 mCi (18.5 GBq per cycle was administered as an intravenous infusion over 3 hours and repeated therapy cycles every 9-12 weeks in eligible patients up to maximum of 4 cycles. Response to therapy was evaluated by clinical imaging using the RECIST criteria, metabolic criteria and patient's quality of life questionnaire. Dosimetry and biodistribution studies were also performed. Finally, Kaplan-Meier survival analysis was performed for patients followed for greater than 12 months. The relationship between pretreatment F-18 FDG PET-CT scan status and survival was determined by two-tailed Student's t-test in 42 patients who underwent pre-therapy PET scans.Results: For an average of 25 (median 18.65 months following the therapy, patients were evaluated for any evidence of toxicity. No significant acute toxicity was observed in patients. Grade II or III hematological toxicity (7.6% of patients, liver toxicity (18.4% and also grade I renal toxicity (6

  17. PET in diagnosing exocrine pancreatic cancer

    Despite dramatic improvements in diagnostic imaging (ultrasonography, in particular endoscopic ultrasound, CT, MRI) treatment results of pancreatic cancer are still poor. Due to the lack of early symptoms, most tumors are diagnosed at an advanced stage of disease which excludes curative surgical treatment. FDG-PET has been shown to be effective in detecting pancreatic cancer as well as differentiating benign from malignant pancreatic tumors. Results might be further improved by applying quantitative analyses, in particular kinetic modelling of FDG metabolism. Nevertheless false negative as well as false positive findings may occur. Small lesions (lymphnode or liver metastases < 1 cm) might be missed, furthermore hyperglycemia often present in patients with pancreatic disease might reduce tumor uptake and subsequently tumor detectability by PET. False positive findings were reported in active pancreatitis and some benign tumors. Although PET proved to be superior to CT or ERCP in detecting cancer, clinical relevance of PET is limited due to the absence of therapeutic consequences to be derived from PET. As a consequence PET should only be used in patients with equivocal findings of morphological imaging (CT, ERCP) who are potential candidates for surgical treatment. (orig.)

  18. Patterns of extension of gastrointestinal stromal tumors (GIST) treated with imatinib (Gleevec®) by 18F-FDG PET/CT Patrones de extensión de los tumores del estroma gastrointestinal (GIST) tratados con imatinib (Gleevec®) mediante PET/TC con 18F-FDG

    Eulalia Valls-Ferrusola; Juan Ramón García-Garzón; Ana Ponce-López; Marina Soler-Peter; Silvia Fuertes-Cabero; Merce Moragas-Solanes; Eduard Riera-Gil; Ignasi Carrió-Gasset; Francisco Lomeña-Caballero

    2012-01-01

    Background and aim: currently it is recognized the usefulness of 18F-FDG PET in assessing response to therapy with imatinib (Gleevec®) in the gastrointestinal tract sarcomas (GIST). To facilitate the follow-up of these studies is important to know the patterns of metastatic spread. The aim of this paper is to describe patterns observed in the 18F-FDG PET/CT. Method: retrospective study included 29 patients who underwent 18F-FDG PET/CT after being diagnosed with unresectable or metastatic GIST...

  19. Multimodality approach of perioperative 18F-FDG PET/CT imaging, intraoperative 18F-FDG handheld gamma probe detection, and intraoperative ultrasound for tumor localization and verification of resection of all sites of hypermetabolic activity in a case of occult recurrent metastatic melanoma

    Walker Michael J

    2008-01-01

    Full Text Available Abstract Background The use of diagnostic 18F-fluorodeoxyglucose (18F-FDG positron emission tomography/computed tomography (PET/CT imaging for the staging, restaging, and treatment monitoring of melanoma patients has become a well-recognized standard of care. It plays a key role in detecting sites of occult disease and is widely utilized in the medical and surgical planning of such patients. In the current report, we describe an innovative multimodality approach of perioperative 18F-FDG PET/CT imaging, intraoperative 18F-FDG handheld gamma probe detection, and intraoperative ultrasound for tumor localization and verification of resection of all sites of hypermetabolic tumor foci in a case of occult recurrent metastatic melanoma. Case presentation This report discusses a case of occult recurrent metastatic melanoma, isolated to three separate sites within the subcutaneous tissues of the left thigh region, which was not clinically apparent but was found on diagnostic restaging whole body 18F-FDG PET/CT scan utilizing an intravenous injection of 14.8 mCi 18F-FDG. Then, on the day of surgery, the patient received an intravenous injection of 12.8 mCi 18F-FDG. A multimodality approach of intraoperative handheld gamma probe detection, intraoperative ultrasound tumor localization, specimen PET/CT imaging, and postoperative PET/CT imaging was utilized for accomplishing and verifying the excision of all three sites of occult recurrent metastatic melanoma within the left thigh region. Conclusion This innovative multimodality approach of perioperative 18F-FDG PET/CT imaging, intraoperative 18F-FDG handheld gamma probe detection, and intraoperative ultrasound is promising combined technology for aiding in tumor localization and verification of excision and may ultimately impact positively upon long-term outcome of selected patients.

  20. System a amino acid transport-targeted brain and systemic tumor PET imaging agents 2-amino-3-[18 F]fluoro-2-methylpropanoic acid and 3-[18 F]fluoro-2-methyl-2-(methylamino)propanoic acid

    Introduction: Amino acid based radiotracers target tumor cells through increased uptake by membrane-associated amino acid transport (AAT) systems. In the present study, four structurally related non-natural 18 F-labeled amino acids, (R)- and (S)-[18 F]FAMP 1 and (R)- and (S)-[18 F]MeFAMP 2 have been prepared and evaluated in vitro and in vivo for their potential utility in brain and systemic tumor imaging based upon primarily system A transport with positron emission tomography (PET). Methods: The transport of enantiomers of [18 F]FAMP 1 and [18 F]MeFAMP 2 was measured through in vitro uptake assays in human derived cancer cells including A549 (lung), DU145 (prostate), SKOV3 (ovary), MDA MB468 (breast) and U87 (brain) in the presence and absence of amino acid transporter inhibitors. The in vivo biodistribution of these tracers was evaluated using tumor mice xenografts at 15, 30, 60 and 120 min post injection. Results: All four tracers showed moderate to high levels of uptake (1–9%ID/5 × 105 cells) by the cancer cell lines tested in vitro. AAT cell inhibition assays demonstrated that (R)-[18 F]1 and (S)-[18 F]1 entered these tumor cells via mixed AATs, likely but not limited to system A and system L. In contrast, (R)-[18 F]2 and (S)-[18 F]2 showed high selectivity for system A AAT. Similar to the results of in vitro cell studies, the tumor uptake of all four tracers was good to high and persisted over the 2 hours time course of in vivo studies. The accumulation of these tracers was higher in tumor than most normal tissues including blood, brain, muscle, bone, heart, and lung, and the tracers with the highest in vitro selectivity for system A AAT generally demonstrated the best tumor imaging properties. Higher uptake of these tracers was observed in the pancreas, kidney and spleen compared to tumors. Conclusions: These preclinical studies demonstrate good imaging properties in a wide range of tumors for all four amino acids evaluated with (R)-[18 F]2 having the