The impact of respiratory motion on tumor quantification and delineation in static PET/CT imaging

Purpose The aim of this prospective study was to assess the incidence and the nature of solitary extrapulmonary [18F] fluorodeoxyglucose (FDG) accumulations in patients with non–small-cell lung cancer (NSCLC) staged with integrated positron emission tomography and computed tomography (PET/CT) and to evaluate the impact on management. Patients and Methods A total of 350 patients with NSCLC underwent whole-body PET/CT imaging. All solitary extrapulmonary FDG accumulations were evaluated by histopathology, further imaging, or clinical follow-up. Results PET/CT imaging revealed extrapulmonary lesions in 110 patients. In 72 patients (21%), solitary lesions were present. A diagnosis was obtained in 69 of these patients, including 37 (54%) with solitary metastases and 32 (46%) with lesions unrelated to the lung primary. Histopathologic examinations of these 32 lesions revealed a second clinically unsuspected malignancy or a recurrence of a previous diagnosed carcinoma in six patients (19%) and a benign tumor or inflammatory lesion in 26 patients (81%). The six malignancies consisted of carcinoma of the breast in two patients, and carcinoma of the orbit, esophagus, prostate, and non-Hodgkin's lymphoma in one patient each. Benign tumors and inflammatory lesions included eight colon adenomas, four Warthin's tumors, one granuloma of the lower jaw, one adenoma of the thyroid gland, one compensatory muscle activity due to vocal chord palsy, two occurrences of arthritis, three occurrences of reflux esophagitis, two occurrences of pancreatitis, two occurrences of diverticulitis, one hemorrhoidal inflammation, and one rib fracture. Conclusion Solitary extrapulmonary FDG accumulations in patients with newly diagnosed lung cancer should be analyzed critically for correct staging and optimal therapy, given that up to half of the lesions may represent unrelated malignancies or benign disease.

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A single institution’s experience with the value of FDG-PET-CT imaging in patients with newly diagnosed stage IIB-IIIB breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.7_suppl.123 ◽

2016 ◽

Vol 34 (7_suppl) ◽

pp. 123-123

Author(s):

Gary Schnur ◽

Katherine Glass ◽

Chad W Cummings ◽

Alberto J. Montero ◽

Jame Abraham ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Fdg Pet ◽

Ct Imaging ◽

Stage Iiib ◽

Breast Cancer Patients ◽

Pet Ct ◽

Tumor Boards ◽

Fdg Pet Ct ◽

The Impact

123 Background: The Cleveland Clinic is utilizing disease specific teams to craft care paths for value based disease management. The report by Groheux (JNCI 2012; 104:1879-1887), reported 18 FDG-PET-CT detected distant metastasis in 10.7, 17.5 and 36.5% of stage IIB- IIIB breast cancer patients. Based on this report, the breast team incorporated 18 FDG-PET- CT imaging for initial staging of IIB-IIIB patients. Methods: Treatment algorithms were developed by a multi-disciplinary breast cancer team. The content was reviewed by stakeholders throughout the health system, and feedback was incorporated into the care paths as appropriate. Content was communicated using physician meetings, electronic communication, tumor boards, and operational pilots. The treatment algorithm, along with the supporting narrative, was placed on the cancer center intranet, accessible to all practicing physicians. Additional intranet analysis was performed using Google Analytics, which identifies the site location and frequency of document downloads. We retrospectively examined the impact of this posting after one year (7/2014-7/2015). Manual chart review identified new patient consults for Stage IIB-IIIB breast cancer at our main campus and highest volume regional sites. Results: PET scans were ordered in 36 stage IIB, 19 stage IIIA, and 3 stage IIIB patients. Of the 36 IIB patients scanned, occult metastatic disease was noted in 1, and 2 patients migrated to IIIA without a change in treatment. 19 IIIA patients had no change in stage, although an asymptomatic second primary lung cancer was discovered in 1 .Three stage IIIB patients were without staging change. Conclusions: PET/CT imaging did not contribute to patient management for stage IIB-IIIB breast cancer patients at our institution, unlike the results reported elsewhere. Analysis of care path metrics allows us to expediently review and adjust recommendations to affiliated physicians.

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Characterization of continuous bed motion effects on patient breathing and respiratory motion correction in PET/CT imaging

Journal of Applied Clinical Medical Physics ◽

10.1002/acm2.12785 ◽

2019 ◽

Vol 21 (1) ◽

pp. 158-165

Author(s):

Joseph G. Meier ◽

Jeremy J. Erasmus ◽

Gregory W. Gladish ◽

Christine B. Peterson ◽

Radwan H. Diab ◽

...

Keyword(s):

Motion Correction ◽

Respiratory Motion ◽

Ct Imaging ◽

Respiratory Motion Correction ◽

Pet Ct

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Faculty Opinions recommendation of The Impact of 68Ga-DOTATATE PET/CT Imaging on Management of Patients with Neuroendocrine Tumors: Experience from a National Referral Center in the United Kingdom.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.727546573.793531192 ◽

2017 ◽

Author(s):

Christos Dervenis ◽

Dionysia Kelgiorgi

Keyword(s):

United Kingdom ◽

Neuroendocrine Tumors ◽

Ct Imaging ◽

Referral Center ◽

The United Kingdom ◽

Pet Ct ◽

The Impact

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The Impact of 18F-DCFPyL PET-CT Imaging on Initial Staging, Radiation, and Systemic Therapy Treatment Recommendations for Veterans With Aggressive Prostate Cancer

Advances in Radiation Oncology ◽

10.1016/j.adro.2020.08.014 ◽

2020 ◽

Vol 5 (6) ◽

pp. 1364-1369

Author(s):

Neil R. Parikh ◽

Sonny Tsai ◽

Carol Bennett ◽

Michael Lewis ◽

Ahmad Sadeghi ◽

...

Keyword(s):

Prostate Cancer ◽

Systemic Therapy ◽

Treatment Recommendations ◽

Ct Imaging ◽

Aggressive Prostate Cancer ◽

Pet Ct ◽

The Impact ◽

Initial Staging ◽

Therapy Treatment

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The impact of Ga-68 DOTATATE PET/CT imaging on management of patients with paragangliomas

Nuclear Medicine Communications ◽

10.1097/mnm.0000000000001130 ◽

2020 ◽

Vol 41 (2) ◽

pp. 169-174 ◽

Cited By ~ 2

Author(s):

Evangelia Skoura ◽

Dimitrios Priftakis ◽

Fuad Novruzov ◽

Martyn E. Caplin ◽

Gopinath Gnanasegaran ◽

...

Keyword(s):

Ct Imaging ◽

Pet Ct ◽

The Impact

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The Impact of 68Gallium DOTA PET/CT in Managing Patients With Sporadic and Familial Pancreatic Neuroendocrine Tumours

Frontiers in Endocrinology ◽

10.3389/fendo.2021.654975 ◽

2021 ◽

Vol 12 ◽

Author(s):

Daniel J. Cuthbertson ◽

Jorge Barriuso ◽

Angela Lamarca ◽

Prakash Manoharan ◽

Thomas Westwood ◽

...

Keyword(s):

Functional Imaging ◽

Neuroendocrine Tumours ◽

Locally Advanced ◽

Ct Imaging ◽

Imaging Findings ◽

Imaging Data ◽

Cross Sectional ◽

Pet Ct ◽

Pancreatic Neuroendocrine Tumours ◽

The Impact

ObjectivePancreatic neuroendocrine tumours (panNETs) arise sporadically or as part of a genetic predisposition syndrome. CT/MRI, endoscopic ultrasonography and functional imaging using Octreoscan localise and stage disease. This study aimed to evaluate the complementary role of 68Gallium (68Ga)-DOTA PET/CT in managing patients with panNETs.DesignA retrospective study conducted across three tertiary UK NET referral centres.MethodsDemographic, clinical, biochemical, cross-sectional and functional imaging data were collected from patients who had undergone a 68Ga-DOTA PET/CT scan for a suspected panNET.ResultsWe collected data for 183 patients (97 male): median (SD) age 63 (14.9) years, 89.1 vs. 9.3% (n=163 vs. 17) alive vs. dead (3 data missing), 141 sporadic vs. 42 familial (MEN1, n=36; 85.7%) panNETs. Non-functional vs. functional tumours comprised 73.2 vs. 21.3% (n=134 vs. 39) (10 missing). Histological confirmation was available in 89% of individuals (n=163) but tumour grading (Ki67 classiifcation) was technically possible only in a smaller cohort (n=143): grade 1, 50.3% (n=72); grade 2, 46.2% (n=66) and grade 3, 3.5% (n=5) (40 histopathological classification either not technically feasible or biopsy not perfomed). 60.1% (n=110) were localised, 14.2% (n=26) locally advanced and 23.5% (n=43) metastatic (4 missing). 224 68Ga-DOTA PET/CT scans were performed in total for: diagnosis/staging 40% (n=88), post-operative assessment/clinical surveillance 53% (n=117) and consideration of peptide receptor radionuclide therapy (PRRT) 8% (n=17) (2 missing). PET/CT results confirmed other imaging findings (53%), identified new disease sites (28.5%) and excluded suspected disease (5%). Overall, 68Ga-DOTA PET/CT imaging findings provided additional information in 119 (54%) patients and influenced management in 85 (39%) cases.Conclusion68Ga-DOTA PET/CT imaging more accurately stages and guides treatment in patients with sporadic/familial panNETs with newly diagnosed/recurrent disease.

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