Procedural recommendations of cardiac PET/CT imaging: standardization in inflammatory-, infective-, infiltrative-, and innervation (4Is)-related cardiovascular diseases: a joint collaboration of the EACVI and the EANM

Abstract With this document, we provide a standard for PET/(diagnostic) CT imaging procedures in cardiovascular diseases that are inflammatory, infective, infiltrative, or associated with dysfunctional innervation (4Is). This standard should be applied in clinical practice and integrated in clinical (multicenter) trials for optimal procedural standardization. A major focus is put on procedures using [18F]FDG, but 4Is PET radiopharmaceuticals beyond [18F]FDG are also described in this document. Whilst these novel tracers are currently mainly applied in early clinical trials, some multicenter trials are underway and we foresee in the near future their use in clinical care and inclusion in the clinical guidelines. Finally, PET/MR applications in 4Is cardiovascular diseases are also briefly described. Diagnosis and management of 4Is-related cardiovascular diseases are generally complex and often require a multidisciplinary approach by a team of experts. The new standards described herein should be applied when using PET/CT and PET/MR, within a multimodality imaging framework both in clinical practice and in clinical trials for 4Is cardiovascular indications.

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Procedural recommendations of cardiac PET/CT imaging: standardization in inflammatory-, infective-, infiltrative-, and innervation- (4Is) related cardiovascular diseases: a joint collaboration of the EACVI and the EANM: summary

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa299 ◽

2020 ◽

Vol 21 (12) ◽

pp. 1320-1330

Author(s):

Riemer H J A Slart ◽

Andor W J M Glaudemans ◽

Olivier Gheysens ◽

Mark Lubberink ◽

Tanja Kero ◽

...

Keyword(s):

Clinical Trials ◽

Clinical Practice ◽

Cardiovascular Diseases ◽

Multimodality Imaging ◽

Clinical Care ◽

Ct Imaging ◽

Positron Emission ◽

Pet Ct ◽

Multicentre Trials ◽

18F Fdg

Abstract With this summarized document we share the standard for positron emission tomography (PET)/(diagnostic)computed tomography (CT) imaging procedures in cardiovascular diseases that are inflammatory, infective, infiltrative, or associated with dysfunctional innervation (4Is) as recently published in the European Journal of Nuclear Medicine and Molecular Imaging. This standard should be applied in clinical practice and integrated in clinical (multicentre) trials for optimal standardization of the procedurals and interpretations. A major focus is put on procedures using [18F]-2-fluoro-2-deoxyglucose ([18F]FDG), but 4Is PET radiopharmaceuticals beyond [18F]FDG are also described in this summarized document. Whilst these novel tracers are currently mainly applied in early clinical trials, some multicentre trials are underway and we foresee in the near future their use in clinical care and inclusion in the clinical guidelines. Diagnosis and management of 4Is related cardiovascular diseases are generally complex and often require a multidisciplinary approach by a team of experts. The new standards described herein should be applied when using PET/CT and PET/magnetic resonance, within a multimodality imaging framework both in clinical practice and in clinical trials for 4Is cardiovascular indications.

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The rise and fall of PET and PET/CT

Nuklearmedizin ◽

10.1055/s-0038-1625217 ◽

2005 ◽

Vol 44 (S 01) ◽

pp. S58-S60 ◽

Cited By ~ 8

Author(s):

W. Mohnike

Keyword(s):

Clinical Practice ◽

General Hospital ◽

Private Practice ◽

Ct Imaging ◽

Hospital Environment ◽

Governmental Organizations ◽

Pet Ct

Summary:PET is being considered a diagnostic commodity in clinical practice worldwide and thus receives increasing attention by health insurances and governmental organizations. In Germany, however, neither PET nor PET/CT are subject to reimbursement. This renders clinical PET and PET/CT imaging a challenge both in a general hospital environment and in private practice. This article describes briefly these challenges, which are not solely related to turf battles and associated costs.

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Evaluations of cardiovascular diseases with hybrid PET-CT imaging

Hybrid Imaging in Cardiovascular Medicine ◽

10.1201/9781315374031-15 ◽

2017 ◽

pp. 351-364

Author(s):

Antti Saraste ◽

Sami Kajander ◽

Juhani Knuuti

Keyword(s):

Cardiovascular Diseases ◽

Ct Imaging ◽

Pet Ct

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TU-A-213A-02: Quantitative PET/CT Imaging for Drug Discovery, Clinical Trials, and Individual Response to Therapy

Medical Physics ◽

10.1118/1.3182312 ◽

2009 ◽

Vol 36 (6Part22) ◽

pp. 2717-2718

Author(s):

P Kinahan

Keyword(s):

Clinical Trials ◽

Drug Discovery ◽

Ct Imaging ◽

Response To Therapy ◽

Individual Response ◽

Quantitative Pet ◽

Pet Ct

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New requirements for phase I trials: a challenge for Italian clinical research

Tumori Journal ◽

10.5301/tj.5000668 ◽

2018 ◽

Vol 104 (1) ◽

pp. 15-21 ◽

Cited By ~ 1

Author(s):

Emanuela Marchesi ◽

Manuela Monti ◽

Oriana Nanni ◽

Lisette Bassi ◽

Martina Piccinni-Leopardi ◽

...

Keyword(s):

Clinical Trials ◽

Clinical Practice ◽

Phase I ◽

Good Clinical Practice ◽

Phase I Trials ◽

Highly Qualified ◽

Phase I Clinical Trials ◽

Oncology Research ◽

Standard Operating ◽

Near Future

Background: In 2015, the Italian Medicines Agency (Agenzia Italiana del Farmaco; AIFA) issued the Determination 809/2015 with new requirements for phase I clinical trials. Before it came into force, we explored the extent to which several Italian oncology centers were working to implement it. Methods: A survey was conducted among 80 Italian centers involved in clinical trials. Investigators and research coordinators were surveyed. Results: Answers from 42 institutions were collected: among them 88.1% were involved in oncology research. In the last 5 years, 55% had conducted from 1 to 5 phase I trials, and only 16.7% more than 5. A third were involved in not-first-in-human research and none with healthy volunteers. The majority (57.1%) of the centers did not run any projects and trials are non-commercial, and about 35%, no more than 2. While 9.5% already met the standards for self-certification, 71.4% were working to achieve them. Standard operating procedures dedicated to research and the required good clinical practice training had been established by 57.1% and 76.2%, respectively. Fifty percent of laboratories were almost compliant with the Determination. After 10 months from its coming into force, 98 sites had applied for certification, of which 34 were oncology units. Conclusions: The new AIFA Determination imposes a certified organizational model on units and laboratories involved in phase I trials. Our results showed that great efforts were made to qualify for phase I research suggesting that other oncology units will apply for certification in the near future. Predictably, Italy will set the pace as a highly qualified country in which to conduct early-phase research.

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Dynamic and Parametric Whole-Body FDG PET/CT Imaging in Oncology: Is it Feasible in Routine Clinical Practice?

Clinical Radiology & Imaging Journal ◽

10.23880/crij-16000185 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Sundaraiya S

Keyword(s):

Clinical Practice ◽

Fdg Pet ◽

Ct Imaging ◽

Routine Clinical Practice ◽

Whole Body ◽

Pet Ct ◽

Fdg Pet Ct

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F-18 FDG PET/CT Imaging in Normal Variants, Pitfalls and Artifacts in the Abdomen and Pelvis

Frontiers in Nuclear Medicine ◽

10.3389/fnume.2021.826109 ◽

2022 ◽

Vol 1 ◽

Author(s):

Mboyo D. T. Vangu ◽

Jaleelat I. Momodu

Keyword(s):

Fdg Pet ◽

Multimodality Imaging ◽

Ct Imaging ◽

Variable Degree ◽

Normal Variants ◽

Pet Ct ◽

Technical Artifacts ◽

Fdg Pet Ct ◽

Metallic Hardware ◽

Imaging Pitfalls

Since its introduction into clinical practice, multimodality imaging has revolutionized diagnostic imaging for both oncologic and non-oncologic pathologies. 18F-fluorodeoxyglucose (18F-FDG) PET/CT imaging which takes advantage of increased anaerobic glycolysis that occurs in tumor cells (Warburg effect) has gained significant clinical relevance in the management of most, if not all oncologic conditions. Because FDG is taken by both normal and abnormal tissues, PET/CT imaging may demonstrate several normal variants and imaging pitfalls. These may ultimately impact disease detection and diagnostic accuracy. Imaging specialists (nuclear medicine physicians and radiologists) must demonstrate a thorough understanding of normal and physiologic variants in the distribution of 18F-FDG; including potential imaging pitfalls and technical artifacts to minimize misinterpretation of images. The normal physiologic course of 18F-FDG results in a variable degree of uptake in the stomach, liver, spleen, small and large bowel. Urinary excretion results in renal, ureteric, and urinary bladder uptake. Technical artifacts can occur due to motion, truncation as well as the effects of contrast agents and metallic hardware. Using pictorial illustrations, this paper aims to describe the variants of physiologic 18F-FDG uptake that may mimic pathology as well as potential benign conditions that may result in misinterpretation of PET/CT images in common oncologic conditions of the abdomen and pelvis.

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Feasibility of blood testing combined with PET-CT to screen for cancer and guide intervention

Science ◽

10.1126/science.abb9601 ◽

2020 ◽

Vol 369 (6499) ◽

pp. eabb9601 ◽

Cited By ~ 28

Author(s):

Anne Marie Lennon ◽

Adam H. Buchanan ◽

Isaac Kinde ◽

Andrew Warren ◽

Ashley Honushefsky ◽

...

Keyword(s):

Clinical Care ◽

Standard Of Care ◽

Ct Imaging ◽

Cancer Treatments ◽

Blood Testing ◽

Blood Tests ◽

Positron Emission ◽

Pet Ct ◽

Invasive Diagnostic Procedure ◽

Guide Intervention

Cancer treatments are often more successful when the disease is detected early. We evaluated the feasibility and safety of multicancer blood testing coupled with positron emission tomography–computed tomography (PET-CT) imaging to detect cancer in a prospective, interventional study of 10,006 women not previously known to have cancer. Positive blood tests were independently confirmed by a diagnostic PET-CT, which also localized the cancer. Twenty-six cancers were detected by blood testing. Of these, 15 underwent PET-CT imaging and nine (60%) were surgically excised. Twenty-four additional cancers were detected by standard-of-care screening and 46 by neither approach. One percent of participants underwent PET-CT imaging based on false-positive blood tests, and 0.22% underwent a futile invasive diagnostic procedure. These data demonstrate that multicancer blood testing combined with PET-CT can be safely incorporated into routine clinical care, in some cases leading to surgery with intent to cure.

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