scholarly journals Temporal metabolic response to mRNA COVID-19 vaccinations in oncology patients

2021 ◽  
Vol 35 (11) ◽  
pp. 1264-1269 ◽  
Author(s):  
Pooja Advani ◽  
Saranya Chumsri ◽  
Tanmayi Pai ◽  
Zhuo Li ◽  
Akash Sharma ◽  
...  
Keyword(s):  
Immune Response ◽  
Lymph Nodes ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Time Course ◽  
Metabolic Response ◽  
Standard Of Care ◽  
Oncology Patients ◽  
Absolute Change

Abstract Background mRNA COVID-19 vaccines are known to provide an immune response seen on FDG PET studies. However, the time course of this metabolic response is unknown. We here present a temporal metabolic response to mRNA COVID-19 vaccination in oncology patients undergoing standard of care FDG PET. Methods 262 oncology patients undergoing standard of care FDG PET were included in the analysis. 231 patients had at least one dose of mRNA COVID-19 vaccine while 31 patients had not been vaccinated. The SUVmax of the lymph nodes ipsilateral to the vaccination was compared to the contralateral to obtain an absolute change in SUVmax (ΔSUVmax). Results ΔSUVmax was more significant at shorter times between FDG PET imaging and COVID-19 mRNA vaccination, with a median ΔSUVmax of 2.6 (0–7 days), 0.8 (8–14 days), and 0.3 (> 14 days), respectively. Conclusion Consideration should be given to performing FDG PET at least 2 weeks after the COVID-19 vaccine.

scholarly journals [18F]-Fluorodeoxyglucose Uptake in Lymphoid Tissue Serves as a Predictor of Disease Outcome in the Nonhuman Primate Model of Monkeypox Virus Infection

2017 ◽  
Vol 91 (21) ◽  
Author(s):  
Julie Dyall ◽  
Reed F. Johnson ◽  
Svetlana Chefer ◽  
Christopher Leyson ◽  
David Thomasson ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Immune Response ◽  
Lymph Nodes ◽  
Metabolic Activity ◽  
Fdg Pet ◽  
Ct Imaging ◽  
Lymphoid Tissues ◽  
Fdg Uptake ◽  
Pet Ct ◽  
Fdg Pet Ct

ABSTRACT Real-time bioimaging of infectious disease processes may aid countermeasure development and lead to an improved understanding of pathogenesis. However, few studies have identified biomarkers for monitoring infections using in vivo imaging. Previously, we demonstrated that positron emission tomography/computed tomography (PET/CT) imaging with [18F]-fluorodeoxyglucose (FDG) can monitor monkeypox disease progression in vivo in nonhuman primates (NHPs). In this study, we investigated [18F]-FDG-PET/CT imaging of immune processes in lymphoid tissues to identify patterns of inflammation in the monkepox NHP model and to determine the value of [18F]-FDG-PET/CT as a biomarker for disease and treatment outcomes. Quantitative analysis of [18F]-FDG-PET/CT images revealed differences between moribund and surviving animals at two sites vital to the immune response to viral infections, bone marrow and lymph nodes (LNs). Moribund NHPs demonstrated increased [18F]-FDG uptake in bone marrow 4 days postinfection compared to surviving NHPs. In surviving, treated NHPs, increase in LN volume correlated with [18F]-FDG uptake and peaked 10 days postinfection, while minimal lymphadenopathy and higher glycolytic activity were observed in moribund NHPs early in infection. Imaging data were supported by standard virology, pathology, and immunology findings. Even with the limited number of subjects, imaging was able to differentiate the difference between disease outcomes, warranting additional studies to demonstrate whether [18F]-FDG-PET/CT can identify other, subtler effects. Visualizing altered metabolic activity at sites involved in the immune response by [18F]-FDG-PET/CT imaging is a powerful tool for identifying key disease-specific time points and locations that are most relevant for pathogenesis and treatment. IMPORTANCE Positron emission tomography and computed tomography (PET/CT) imaging is a universal tool in oncology and neuroscience. The application of this technology to infectious diseases is far less developed. We used PET/CT imaging with [18F]-labeled fluorodeoxyglucose ([18F]-FDG) in monkeys after monkeypox virus exposure to monitor the immune response in lymphoid tissues. In lymph nodes of surviving monkeys, changes in [18F]-FDG uptake positively correlated with enlargement of the lymph nodes and peaked on day 10 postinfection. In contrast, the bone marrow and lymph nodes of nonsurvivors showed increased [18F]-FDG uptake by day 4 postinfection with minimal lymph node enlargement, indicating that elevated cell metabolic activity early after infection is predictive of disease outcome. [18F]-FDG-PET/CT imaging can provide real-time snapshots of metabolic activity changes in response to viral infections and identify key time points and locations most relevant for monitoring the development of pathogenesis and for potential treatment to be effective.

scholarly journals Targeted PET imaging strategy to differentiate malignant from inflamed lymph nodes in diffuse large B-cell lymphoma

2017 ◽  
Vol 114 (36) ◽  
pp. E7441-E7449 ◽  
Author(s):  
Jun Tang ◽  
Darin Salloum ◽  
Brandon Carney ◽  
Christian Brand ◽  
Susanne Kossatz ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
B Cell ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Large B Cell Lymphoma ◽  
Imaging Approach ◽  
Imaging Strategy ◽  
Large B Cell

Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoma in adults. DLBCL exhibits highly aggressive and systemic progression into multiple tissues in patients, particularly in lymph nodes. Whole-body 18F-fluodeoxyglucose positron emission tomography ([18F]FDG-PET) imaging has an essential role in diagnosing DLBCL in the clinic; however, [18F]FDG-PET often faces difficulty in differentiating malignant tissues from certain nonmalignant tissues with high glucose uptake. We have developed a PET imaging strategy for DLBCL that targets poly[ADP ribose] polymerase 1 (PARP1), the expression of which has been found to be much higher in DLBCL than in healthy tissues. In a syngeneic DLBCL mouse model, this PARP1-targeted PET imaging approach allowed us to discriminate between malignant and inflamed lymph nodes, whereas [18F]FDG-PET failed to do so. Our PARP1-targeted PET imaging approach may be an attractive addition to the current PET imaging strategy to differentiate inflammation from malignancy in DLBCL.

Pilot study to enhance FDG-PET imaging of prostate cancers with the metabolic inhibitor ranolazine.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e16551-e16551
Author(s):  
Isabel R. Schlaepfer ◽  
Elizabeth R Kessler ◽  
Jennifer J Kwak ◽  
Lauren Liebman ◽  
Paul Maroni ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Pilot Study ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Imaging Modality ◽  
Small Sample ◽  
Metabolic Inhibitor ◽  
Acid Oxidation ◽  
Absolute Change ◽  
Fdg Uptake

e16551 Background: 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography (FDG-PET) is a widely-used imaging modality for many cancers; however, its utility in prostate cancer is limited. Fatty acid oxidation (FAO) is a primary source of energy for early prostate cancer. We previously demonstrated that FAO inhibition in prostate cancer mouse models resulted in increased glucose metabolism and enhanced tumor FDG uptake, with peak uptake at 24 hours. To validate these preclinical findings, we conducted a pilot study to evaluate whether a partial FAO inhibitor, ranolazine, increases tumor FDG uptake on PET imaging for prostate cancer. Methods: Prostate cancer patients with untreated localized cancer (arm 1) and with metastatic disease on hormonal or other therapy (arm 2) were enrolled and underwent baseline and post-treatment FDG-PET/CT scans (standard dose of 10 mCi FDG). Ranolazine 1000mg PO BID x 2 doses was given within 24-48 hours of the second scan. The primary objective was to evaluate the rate of successful enhancement of FDG uptake on PET imaging, based on one or more of the following criteria: 30% increase in maximum SUV with an absolute change of 2 units; 30% increase in mean SUV with an absolute change of 0.75 units; or 20% increase in mean SUV with an absolute change of 1 unit. Results: Eleven patients (four in arm 1, seven in arm 2) were enrolled. Ranolazine was well tolerated by all participants, with no adverse effects observed. Both increases and decreases in SUV uptake were observed on the post-ranolazine scans. No patient met the predefined criteria for successful enhancement of FDG uptake. There was an incidental finding of thyroid cancer seen in one patient that was discovered on PET imaging. The study was closed early due to the emerging clinical availability of alternative and effective PET imaging modalities such as [11C] choline, [18F] fluciclovine, [68Ga] PSMA, and [18F] sodium fluoride. Conclusions: Given the small sample size, we were not able to make any firm conclusions. In this limited study, ranolazine treatment did not result in enhanced FDG-PET-tumor detection. ClinicalTrials.gov identifier: NCT01992016. Supported by the William Meyn Foundation; NIH/NCI P30CA46934, 5K12CA086913, CA168934; ACS RSG-16-256-01-TBE; Colorado Translational Research Imaging Center Pilot Award; Paul Sandoval Cancer Research Summer Fellowship. Clinical trial information: NCT01992016.

Comparative analysis of uptake for 18F-fluorodeoxyglucose (FDG) versus 18F-fluorodeoxythymidine (FLT) PET scans in rectal cancer.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 657-657
Author(s):  
Arshin Sheybani ◽  
Sudershan Bhatia ◽  
Yusuf Menda ◽  
Laura Boles-Ponto ◽  
Brandie Ann Gross ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Lymph Nodes ◽  
Pet Imaging ◽  
Cellular Proliferation ◽  
Tumor Regression ◽  
Standard Of Care ◽  
Nodal Metastasis ◽  
Response Monitoring ◽  
Flt Pet ◽  
Pet Scans

657 Background: FLT PET is a novel metabolite for imaging cellular proliferation and has shown promise for treatment response monitoring. The utility of FLT PET imaging in rectal adenocarcinomas (RA) has not previously been established. We set out to compare FDG and FLT uptake in RA and correlate FLT response during treatment to tumor regression. Methods: We evaluated 6 patients with RA who were treated on an institutional prospective clinical trial (NCT01717391). Patients were treated neoadjuvantly with concurrent chemoradiation therapy per standard of care. Patients had both FDG and FLT PET scans prior to starting treatment and FLT scans after 1 and 2 weeks of radiotherapy. Tumor volumes and pelvic lymph nodes measuring greater than 6 mm were contoured on the simulation CT scan and adjusted for bladder and rectal filling based on the attenuation correction CT for each PET scan. FLT and FDG SUVs were collected from a total of 40 lymph nodes among the six patients. Pretreatment and change in tumor FLT SUVs were correlated with histopathological regression. The sensitivity of FLT and FDG for identifying lymph nodes was compared using a Student’s t-test. Results: At the time of this analysis, there were post-treatment pathological data on five patients. All but one patient had a decline in the FLT tumor SUV after 2 weeks of treatment. This non-responder was the only patient who did not have histopathological tumor regression after treatment and was the only patient whose pretreatment FLT SUV was below 2. Tumor FDG SUV (4.54 ± 1.03) was consistently higher compared to FLT (2.42 ± 0.51) values, however nodal uptake for FDG (1.89 ± 1.08) was not higher compared to FLT (1.98 ± 0.96). To account for this difference, nodal uptake was normalized to the SUV of each patient’s primary tumor for both FLT and FDG. Mean normalized lymph node FLT SUVs were significantly higher (0.80 ± 0.36) than normalized FDG SUVs (0.44 ± 0.25) (p<0.001). Conclusions: Preliminary data supports using FLT SUV as a biomarker for tumor response early during treatment. Relative FLT uptake in nodal metastasis also appears to be higher when compared to FDG. This indicates potential response and diagnostic applications for FLT PET imaging in RA Clinical trial information: NCT01717391.

Lymph node staging in extracranial head and neck cancer with FDG PET – appropriate uptake period and size-dependence of the results

2002 ◽  
Vol 41 (02) ◽  
pp. 108-113 ◽  
Author(s):  
Th. Klenzner ◽  
Th. Krause ◽  
M. Mix ◽  
U. H. Ross ◽  
E. Moser ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Head And Neck ◽  
Neck Cancer ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Lymph Node Staging ◽  
Cellular Activity ◽  
Plateau Phase

Summary Aim: Identification of a rationale for the appropriate uptake period for static clinical extracranial head and neck PET imaging and evaluation of the diagnostic accuracy of such an optimized FDG PET approach for lymph node staging in the head and neck region. Methods: In a subset of 5 patients, kinetic tumour studies were performed in order to identify the cellular activity plateau phase of FDG accumulation for head and neck cancer. Seventy-eight consecutive patients (11 women, 67 men; mean age ± SD: 55 ± 11 years; range, 36-78 years), presenting with histologically proven squamous cell carcinoma and sonographically detected lymph nodes in 86 neck sides, underwent clinically indicated FDG PET imaging. PET results were compared to those derived from histological examinations and follow-up imaging results after 6 months in order to calculate sensitivity and specificity for lymph node staging. Results: FDG kinetics in head and neck cancer indicate that the cellular activity plateau of FDG accumulation is reached after an uptake period of 90 min. Using this protocol metastatic involvement of neck sides with lymph nodes less than 1 cm in diameter was correctly identified with a sensitivity of 71.4% and a specificity of 92.3%. Sensitivity increased with the lymph node diameter (1.1-1.5 cm 83.3%, 1.6-2.0 cm 100%, > 2 cm 88.9%). Conclusion: The appropriate uptake period for static clinical extracranial head and neck PET imaging that allows measurements in the activity plateau phase is about 90 min. FDG PET may add some significant information regarding metastatic spread into regional lymph nodes.

Prediction of Response to Preoperative Chemotherapy in Gastric Carcinoma by Metabolic Imaging: Results of a Prospective Trial

2003 ◽  
Vol 21 (24) ◽  
pp. 4604-4610 ◽  
Author(s):  
Katja Ott ◽  
Ulrich Fink ◽  
Karen Becker ◽  
Alexander Stahl ◽  
Hans-Joachim Dittler ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Preoperative Chemotherapy ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Patient Survival ◽  
Metabolic Response ◽  
Resected Specimen ◽  
Fdg Uptake ◽  
Histopathologic Response

Purpose: We prospectively evaluated the predictive value of therapy-induced reduction of tumor glucose use for subsequent response and patient survival in patients with gastric cancer treated by preoperative chemotherapy. Patients and Methods: Forty-four consecutive patients with locally advanced gastric carcinomas were studied by positron emission tomography with the glucose analog fluorine-18 fluorodeoxyglucose (FDG-PET) at baseline and 14 days after initiation of cisplatin-based polychemotherapy. On the basis of a previous study, a reduction of tumor FDG uptake by more than 35% was used as a criterion for a metabolic response. The metabolic response in FDG-PET was correlated with histopathologic response after completion of therapy (< 10% viable tumor cells in the resected specimen) and patient survival. Results: Thirty-five (80%) of the 44 tumors were visualized with sufficient contrast for quantitative analysis (two of 19 intestinal and seven of 25 nonintestinal tumors showed only low FDG uptake). In the 35 assessable patients, PET imaging after 14 days of therapy correctly predicted histopathologic response after 3 months of therapy in 10 (77%) of 13 responders and 19 (86%) of 22 nonresponders. Median overall survival for patients with a metabolic response has not been reached (2-year survival rate, 90%); for patients without a metabolic response, median survival was only 18.9 months (2-year survival rate, 25%; P = .002) Conclusion: This study prospectively demonstrates that in patients with gastric cancer, response to preoperative chemotherapy can be predicted by FDG-PET early during the course of therapy. By avoiding the morbidity and costs of ineffective therapy, FDG-PET imaging may markedly facilitate the use of preoperative chemotherapy.

scholarly journals Dynamic Metabolic Changes during the First 3 Months after90Y-Ibritumomab Tiuxetan Radioimmunotherapy

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Miwako Takahashi ◽  
Toshimitsu Momose ◽  
Keitaro Koyama ◽  
Motoshi Ichikawa ◽  
Mineo Kurokawa ◽  
...  
Keyword(s):  
Metabolic Activity ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Time Course ◽  
Tumor Response ◽  
Standard Uptake Value ◽  
Metabolic Changes ◽  
Ibritumomab Tiuxetan ◽  
Before And After ◽  
Pet Scans

Objective. To elucidate the time course of tumor metabolism during the first 3 months after90Y-ibritumomab tiuxetan radioimmunotherapy (RIT) in patients with refractory malignant lymphoma.Materials and Methods. Seven patients with recurrent follicular lymphoma underwent FDG-PET imaging before and after 1-, 4-, and 12-week RIT with90Y-ibritumomab tiuxetan. Tumor metabolic activity on FDG-PET scans was assessed as the maximum standard uptake value (SUVmax).Results. Decrease in metabolism was detected 1 week after RIT. In the most decreased lesion, SUVmax decreased to 20% of the baseline value during the first week. Most lesions continued to decrease for up to 4 weeks. Some lesions showed increased metabolism from 4 to 12 weeks, while the level of FDG accumulations at 12 weeks was still lower than the baseline.Conclusions. Tumor response to RIT could be observed as early as 1 week after the administration of RIT. After tumor activity decreases, the metabolism may increase at least between 4 and 12 weeks. It suggests that the metabolic changes should be carefully evaluated during this period.

Impact of FDG-PET Imaging Versus Conventional Staging Modalities on Staging and Treatment Decisions in Large B-Cell, Follicular, and Hodgkin’s Lymphomas.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4565-4565
Author(s):  
Ivan Maillard ◽  
Rebecca L. Elstrom ◽  
Rakesh Kumar ◽  
Murat F. Bozkurt ◽  
Srikant Sankaran ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Lymph Nodes ◽  
B Cell ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Response Assessment ◽  
Treatment Decisions ◽  
The Impact ◽  
Large B Cell ◽  
Conventional Staging

Abstract Clinical staging of lymphomas has a critical role in determining appropriate therapy and in therapeutic response assessment. While anatomic imaging by CT or MRI, together with physical examination and bone marrow biopsy (conventional staging modalities or CSM), have historically provided the basis for staging and response assessment, positron emission tomography using 18-fluoro-2-deoxyglucose (FDG-PET) has increasingly been employed in the management of patients (pts) with lymphomas. Studies comparing FDG-PET with anatomic imaging have generally found that FDG-PET identifies more sites of disease; however, the impact of FDG-PET imaging on assignment of clinical stage and treatment decisions is unclear. We retrospectively examined the impact of FDG-PET imaging on assignment of disease stage and treatment decisions compared with CSM alone in 91 pts with large B-cell lymphoma (LBCL; n=30), follicular lymphoma (FL; n=29) and Hodgkin’s lymphoma (HL; n=32). 25/30 LBCL (83%), 26/32 HD (81%) and 17/29 FL pts (59%) were evaluated at initial diagnosis by FDG-PET imaging and CSM, while others were evaluated during subsequent relapse. FDG-PET and CSM defined the same stage in 69/91 pts (76%). Stage assignment was most concordant in LBCL with only 5/30 (17%) of cases having different stages, while stage assignments were discrepant in 7/32 (22%) of cases of HL and in 10/29 (34%) of cases of FL. Of the 22 pts with discrepant results, FDG-PET resulted in upstaging of disease in 11 pts and downstaging in 11 pts. Independent confirmatory tests resolving the discrepancy were obtained in 3 of 11 pts upstaged (27%) and 7 of 11 pts downstaged by FDG-PET (64%). Abnormal FDG uptake in lymph nodes accounted for all cases upstaged by FDG-PET in which no confirmatory test was available (8/8 pts). Among 10 cases resolved by biopsy, discrepant sites included bone marrow (n = 4), bone (n = 1), pelvic or abdominal structures (n = 3), and lymph nodes (n = 2). FDG-PET results were true positive in 2/10, true negative in 1/10, false positive in 1/10, and false negative in 6/10 cases (including 4 cases with BM involvement). Incorporation of FDG-PET led to treatment changes in a minority of patients (2%). We conclude that FDG-PET is an efficient single imaging modality in pts with LBCL, FL and HL, providing information complementary to CSM. However, changes in treatment based on FDG-PET results are rare. Discrepancies between FDG-PET and CSM should be resolved by biopsy when feasible, particularly in cases in which treatment would be altered.

Prediction of lymph node metastase in NSCLC

2010 ◽  
Vol 01 (05) ◽  
pp. 219-226 ◽  
Author(s):  
F. Beyer ◽  
B. Buerke ◽  
J. Gerss ◽  
K. Scheffe ◽  
M. Puesken ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Fdg Pet ◽  
Automatic Segmentation ◽  
Correlation Coefficients ◽  
Mediastinal Lymph Nodes ◽  
Intra Class Correlation ◽  
Axial Diameter ◽  
Pet Ct ◽  
Fdg Pet Ct

SummaryPurpose: To distinguish between benign and malignant mediastinal lymph nodes in patients with NSCLC by comparing 2D and semiautomated 3D measurements in FDG-PET-CT.Patients, material, methods: FDG-PET-CT was performed in 46 patients prior to therapy. 299 mediastinal lymph-nodes were evaluated independently by two radiologists, both manually and by semi-automatic segmentation software. Longest-axial-diameter (LAD), shortest-axial-diameter (SAD), maximal-3D-diameter, elongation and volume were obtained. FDG-PET-CT and clinical/FDG-PET-CT follow up examinations and/or histology served as the reference standard. Statistical analysis encompassed intra-class-correlation-coefficients and receiver-operator-characteristics-curves (ROC). Results: The standard of reference revealed involvement in 87 (29%) of 299 lymph nodes. Manually and semi-automatically measured 2D parameters (LAD and SAD) showed a good correlation with mean

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