scholarly journals Novel FAP ligands enable improved imaging contrast in sarcoma patients due to FAPI-PET/CT

2021 ◽  
Author(s):  
Stefan A. Koerber ◽  
R. Finck ◽  
K. Dendl ◽  
M. Uhl ◽  
T. Lindner ◽  
...  
Keyword(s):  
Hybrid Imaging ◽  
Background Activity ◽  
The Novel ◽  
Malignant Tissue ◽  
Primary Tumors ◽  
Aggressive Disease ◽  
Standardized Uptake Values ◽  
Pet Ct ◽  
Pet Scans

Abstract Purpose A high expression of fibroblast activation protein (FAP) was observed in multiple sarcomas, indicating an enormous potential for PET/CT using 68Ga-radiolabeled inhibitors of FAP (FAPI). Therefore, this retrospective study aimed to evaluate the role of the novel hybrid imaging probe for sarcomas as a first clinical evaluation. Methods A cohort of 15 patients underwent 68Ga-FAPI-PET/CT for staging or restaging. The acquisition of PET scans was performed 60 min after administration of 127 to 308 MBq of the tracer. The uptake of 68Ga-FAPI in malignant tissue as well as in healthy organs was quantified by standardized uptake values SUVmean and SUVmax. Results Excellent tumor-to-background ratios (> 7) could be achieved due to low background activity and high SUVmax in primary tumors (median 7.16), local relapses (median 11.47), and metastases (median 6.29). The highest uptake was found for liposarcomas and high-grade disease (range 18.86–33.61). A high SUVmax (> 10) was observed for clinically more aggressive disease. Conclusion These preliminary findings suggest a high potential for the clinical use of 68Ga-FAPI-PET/CT for patients diagnosed with sarcoma.

Role of Functional Imaging in the Management of Lymphoma

2011 ◽  
Vol 29 (14) ◽  
pp. 1844-1854 ◽  
Author(s):  
Bruce D. Cheson
Keyword(s):  
Fdg Pet ◽  
B Cell Lymphoma ◽  
Post Treatment ◽  
Metabolic Imaging ◽  
Interim Pet ◽  
Positron Emission ◽  
Pet Ct ◽  
Pretreatment Assessment ◽  
Pet Scans

18-F-fluorodeoxyglucose (FDG) –positron emission tomography (PET), and more recently PET/computed tomography (CT), is the most sensitive and specific imaging technique currently available for patients with lymphoma. Nevertheless, despite being increasingly used in pretreatment assessment, midtreatment evaluation of response, post-treatment restaging, and surveillance during follow-up of patients with lymphoma, its impact on clinical outcome in most clinical situations remains to be confirmed. PET/CT provides its greatest clinical benefit in the post-treatment evaluation of Hodgkin's lymphoma and diffuse large B-cell lymphoma; however, the role of metabolic imaging in other indications and in other histologies remains to be demonstrated. Ongoing risk-adapted studies will hopefully provide evidence for clinical improvement on the basis of altering treatment as a result of interim PET results. Efforts are ongoing to better standardize the conduct and interpretation of FDG-PET scans. FDG-PET has the potential to improve lymphoma patient management; however, its usefulness will likely vary by histology, stage, therapy, and clinical setting.

The role of Ga-68 DOTATOC PET/CT in the detection of primary tumors in CUP-syndrome of neuroendocrine tumors (NETs)

2009 ◽  
Vol 47 (06) ◽  
Author(s):  
S Strobel ◽  
W Bohle ◽  
TM Welzel ◽  
WG Zoller ◽  
T Eichele ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Cup Syndrome ◽  
Primary Tumors ◽  
Pet Ct

scholarly journals The role of 18FDG PET/CT in evaluation of unknown primary tumors

2019 ◽  
Vol 70 (1) ◽  
pp. 39-42
Author(s):  
Bogdan Marković ◽  
Dragana Šobić-Šaranović
Keyword(s):  
Unknown Primary ◽  
Primary Tumors ◽  
18Fdg Pet ◽  
Pet Ct ◽  
Unknown Primary Tumors

scholarly journals Impact of Primary Staging with Fibroblast Activation Protein Specific Enzyme Inhibitor (FAPI)-PET/CT on Radio-Oncologic Treatment Planning of Patients with Esophageal Cancer

2020 ◽  
Vol 22 (6) ◽  
pp. 1495-1500 ◽  
Author(s):  
J. Ristau ◽  
F. L. Giesel ◽  
M. F. Haefner ◽  
F. Staudinger ◽  
T. Lindner ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Enzyme Inhibitor ◽  
Regional Lymph Node ◽  
Perfect Match ◽  
Tracer Uptake ◽  
Radiotherapy Planning ◽  
Primary Tumors ◽  
Standardized Uptake Values ◽  
Volume Delineation ◽  
Pet Ct

Abstract Purpose Quinoline-based ligands targeting cancer-associated fibroblasts have emerged as promising radiopharmaceuticals in different tumor entities. The aim of this retrospective study was to explore the potential of FAPI-PET/CT in the initial staging of esophageal cancer patients and its usefulness in radiotherapy planning as a first clinical analysis. Methods Seven patients with treatment-naive esophageal cancer underwent FAPI-PET/CT. Tracer uptake was quantified by standardized uptake values (SUV)max and (SUV)mean. Six patients received definitive and one neoadjuvant (chemo)radiation therapy. Endo-esophageal clipping, the gold standard to define tumor margins not delineable per CT, was performed in three patients. Results Primary tumors demonstrated high FAPI uptake with a median SUVmax of 17.2. Excellent tumor-to-background ratios resulted in accurate target volume delineation and were found in perfect match with clipping. Detection of regional lymph node metastases facilitated the use of simultaneous integrated boost radiotherapy plans for these patients. Conclusion FAPI-PET/CT may be beneficial for the management of esophageal cancer particularly in planning radiotherapy, but further research is necessary to increase patient number and statistical reliability.

Role of pet/ct in detection of tumor of unknown origin

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Khadija R Elsayed ◽  
Khaled E Allam ◽  
Omar F Kamel ◽  
Ahmed H Soliman ◽  
Huda F Elsayed
Keyword(s):  
Primary Tumor ◽  
Predictive Value ◽  
Unknown Origin ◽  
Whole Body ◽  
Unknown Primary ◽  
Primary Tumors ◽  
Negative Results ◽  
Number Of Patients ◽  
Pet Ct

Abstract Purpose To evaluate the role of combined positron emission tomography and computed tomography (PET/CT) imaging in the detection of tumors of unknown origin. Methods This study included 20 cases presented with pathologically proved metastases of unknown primary or with clinic-radiological suspicion of metastases with unknown primary. Results The number of patients with true positive primary tumor sites was 14 (70%), 2 patients with false-positive results (10%), 2 patients with true negative results (10%) and 2 patients with false-negative results (10%). A sensitivity of 87.5% was achieved, with a specificity of 50% and a total accuracy of 80%. The Positive predictive value was 87.5%%, while the negative predictive value was 50%. The detection rate of the origin of the primary tumor was 70%. Conclusion whole-body FDG-PET/CT has to be considered a useful tool in evaluating metastases from UPT, allowing identification of primary tumors and modifying the stage of the disease and affect the management.

scholarly journals FAP and FAPI-PET/CT Malignant and Non-Malignant Diseases: A Perfect Symbiosis?

Cancers ◽  
2021 ◽  
Vol 13 (19) ◽  
pp. 4946
Author(s):  
Katharina Dendl ◽  
Stefan Koerber ◽  
Clemens Kratochwil ◽  
Jens Cardinale ◽  
Rebecca Finck ◽  
...  
Keyword(s):  
Heart Tissue ◽  
Peptidase Activity ◽  
Type Ii ◽  
Benign Diseases ◽  
Additional Information ◽  
Pet Ct ◽  
Transmembrane Serine Protease ◽  
Pathologic Processes ◽  
Pet Scans

A fibroblast activation protein (FAP) is an atypical type II transmembrane serine protease with both endopeptidase and post-proline dipeptidyl peptidase activity. FAP is overexpressed in cancer-associated fibroblasts (CAFs), which are found in most epithelial tumors. CAFs have been implicated in promoting tumor cell invasion, angiogenesis and growth and their presence correlates with a poor prognosis. However, FAP can generally be found during the remodeling of the extracellular matrix and therefore can be detected in wound healing and benign diseases. For instance, chronic inflammation, arthritis, fibrosis and ischemic heart tissue after a myocardial infarction are FAP-positive diseases. Therefore, quinoline-based FAP inhibitors (FAPIs) bind with a high affinity not only to tumors but also to a variety of benign pathologic processes. When these inhibitors are radiolabeled with positron emitting radioisotopes, they provide new diagnostic and prognostic tools as well as insights into the role of the microenvironment in a disease. In this respect, they deliver additional information beyond what is afforded by conventional FDG PET scans that typically report on glucose uptake. Thus, FAP ligands are considered to be highly promising novel tracers that offer a new diagnostic and theranostic potential in a variety of diseases.

scholarly journals The Role of Positron Emission Tomography/Computed Tomography (PET/CT) for Staging and Disease Response Assessment in Localized and Locally Advanced Pancreatic Cancer

Cancers ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 4155
Author(s):  
Michele Ghidini ◽  
Marta Vuozzo ◽  
Barbara Galassi ◽  
Paola Mapelli ◽  
Virginia Ceccarossi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pancreatic Cancer ◽  
Positron Emission Tomography ◽  
Locally Advanced ◽  
Emission Tomography ◽  
Metabolic Imaging ◽  
Primary Tumors ◽  
Positron Emission ◽  
Pet Ct

Pancreatic Cancer (PC) has a poor prognosis, with a 5-year survival rate of only 9%. Even after radical surgical procedures, PC patients have poor survival rates, with a high chance of relapse (70–80%). Imaging is involved in all aspects of the clinical management of PC, including detection and characterization of primary tumors and their resectability, assessment of vascular, perineural and lymphatic invasion and detection of distant metastases. The role of Positron Emission Tomography/Computed Tomography (PET/CT) in detecting PC is still controversial, with the international guidelines not recommending its routine use. However, in resectable PC, PET/CT may play a role in assessing PC stage and grade and potential resectability after neoadjuvant treatment. Quantitative image analysis (radiomics) and new PET/CT radiotracers account for future developments in metabolic imaging and may further improve the relevance of this technique in several aspects of PC. In the present review, the current state of the art and future directions of PET/CT in resectable PC are presented.

scholarly journals Multimodality imaging of adult rhabdomyosarcoma: the added value of hybrid imaging

2020 ◽  
Vol 93 (1112) ◽  
pp. 20200250
Author(s):  
Nicolò Gennaro ◽  
Andrea Marrari ◽  
Salvatore Lorenzo Renne ◽  
Ferdinando Carlo Maria Cananzi ◽  
Vittorio Lorenzo Quagliuolo ◽  
...  
Keyword(s):  
Hybrid Imaging ◽  
Multimodality Imaging ◽  
Added Value ◽  
Positron Emission ◽  
Pet Ct ◽  
Relevant Role ◽  
Work Up ◽  
Ct And Mri

Rhabdomyosarcoma (RMS) represents more than 50% of paediatric soft tissue tumours. Conversely, it is extremely rare among adults, where it shows peculiar biological and clinical features that are still poorly investigated. RMS patients should be referred to a Sarcoma Centre, where the contribution of experienced radiologists plays a relevant role in the diagnostic assessment of the disease, including precise localisation, staging, image-guided biopsy, response evaluation after treatment and follow-up. Besides CT and MRI, hybrid imaging including positron emission tomography (PET)/CT and PET/MRI are giving an increasing contribution to provide functional insights about tumour biology and to improve the diagnostic accuracy of the imaging work-up. This review paper provides a revision of the pathology, clinical and radiological features of adult RMS, with a particular focus on the growing role of hybrid PET-based imaging.

scholarly journals Aberrant patterns of PET response during treatment for DLBCL patients with MYC gene rearrangements

2021 ◽  
Author(s):  
J. J. Eertink ◽  
A. I. J. Arens ◽  
J. E. Huijbregts ◽  
F. Celik ◽  
B. de Keizer ◽  
...  
Keyword(s):  
B Cell Lymphoma ◽  
Metabolic Tumor Volume ◽  
Gene Rearrangements ◽  
Predictive Values ◽  
Interim Pet ◽  
Standardized Uptake Values ◽  
Positron Emission ◽  
Pet Ct ◽  
Myc Gene ◽  
Pet Scans

Abstract Purpose MYC gene rearrangements in diffuse large B-cell lymphoma (DLBCL) patients are associated with poor prognosis. Our aim was to compare patterns of 2[18F]fluoro-2-deoxy-D-glucose positron emission tomography computed tomography (PET/CT) response in MYC + and MYC- DLBCL patients. Methods Interim PET/CT (I-PET) and end of treatment PET/CT (EoT-PET) scans of 81 MYC + and 129 MYC- DLBCL patients from 2 HOVON trials were reviewed using the Deauville 5-point scale (DS). DS1-3 was regarded as negative and DS4-5 as positive. Standardized uptake values (SUV) and metabolic tumor volume (MTV) were quantified at baseline, I-PET, and EoT-PET. Negative (NPV) and positive predictive values (PPV) were calculated using 2-year overall survival. Results MYC + DLBCL patients had significantly more positive EoT-PET scans than MYC- patients (32.5 vs 15.7%, p = 0.004). I-PET positivity rates were comparable (28.8 vs 23.8%). In MYC + patients 23.2% of the I-PET negative patients converted to positive at EoT-PET, vs only 2% for the MYC- patients (p = 0.002). Nine (34.6%) MYC + DLBCL showed initially uninvolved localizations at EoT-PET, compared to one (5.3%) MYC- patient. A total of 80.8% of EoT-PET positive MYC + patients showed both increased lesional SUV and MTV compared to I-PET. In MYC- patients, 31.6% showed increased SUV and 42.1% showed increased MTV. NPV of I-PET and EoT-PET was high for both MYC subgroups (81.8–94.1%). PPV was highest at EoT-PET for MYC + patients (61.5%). Conclusion MYC + DLBCL patients demonstrate aberrant PET response patterns compared to MYC- patients with more frequent progression during treatment after I-PET negative assessment and new lesions at sites that were not initially involved. Trial registration number and date of registration HOVON-84: EudraCT: 2006–005,174-42, retrospectively registered 01–08-2008. HOVON-130: EudraCT: 2014–002,654-39, registered 26–01-2015

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