scholarly journals RADT-39. 68Ga- DOTATATE CT/PET FOR GAMMA KNIFE RADIOSURGERY PLANNING AND TARGET DELINEATION IN PATIENTS WITH MENINGIOMA

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii190-ii190
Author(s):  
Daniel Ma ◽  
Zaker Rana ◽  
Sirisha Viswanatha ◽  
Louis Potters ◽  
Jenghwa Chang ◽  
...  
Keyword(s):  
Pet Imaging ◽  
Target Identification ◽  
Gamma Knife Radiosurgery ◽  
Pet Scan ◽  
Target Delineation ◽  
Prior Surgery ◽  
Pet Scans ◽  
Extent Of Disease ◽  
Dural Lesion ◽  
Dice Index

Abstract BACKGROUND Stereotactic radiosurgery (SRS) planning for patients with meningiomas can be confounded by difficulty in identifying the tumor boundary, especially in those who have had prior surgery. Recent data have suggested the benefit of 68Ga-DOTATATE CT/PET scans in delineation of meningioma compared to MRI alone. We propose that incorporating 68Ga-DOTATATE PET scans in addition to MRI in SRS planning will provide better target identification and tumor coverage compared to MRI alone. METHODS We reviewed patients with meningioma who had MRI and 68Ga-DOTATATE PET imaging over 12 months. Images were imported into Velocity treatment planning software and separated into two different sessions, one in which only the MRI was accessible, and a second which had the PET scan fused to the MRI. Three different users were asked to contour the residual meningioma as gross tumor volume (GTV) first with MRI alone, and then with the PET/MRI fusion. The volume of each GTV pre-and post-PET fusion was compared and a Dice index was generated. RESULTS Four patients with 6 GTV targets were identified. PET fusion identified new lesions close to the initial GTV targets in 2 patients. The first was a discontinuous dural lesion in the post-op bed. The second was a nodular dural lesion along the left high parietal convexity adjacent to a prior craniectomy and mesh duraplasty site. In the third patient, PET scan identified a greater extent of disease in the skull base. Across all observers, GTV volumes were significantly increased when PET fusion was used. The average volume (cc) increase was 111.6%±66.2%. The average Dice index was 0.58±0.17. CONCLUSION 68Ga-DOTATATE PET scan fused with MRI improved the visualization of meningiomas in patients undergoing SRS. A larger experience is needed to confirm this trend. We have begun to use DOTATATE-PET imaging regularly when imaging patients with meningiomas for SRS.

FDG PET Scan Alone Better Predicts Progression Free Survival at 2 Years Compared to CT Imaging in Aggressive Histology Non-Hodgkin’s Lymphoma Following Initial Anthracycline-Based Chemotherapy.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3299-3299 ◽  
Author(s):  
Gregory A. Wiseman ◽  
Malik E. Juweid ◽  
Eric M. Rohren ◽  
James E. Wooldridge ◽  
Michael M. Graham
Keyword(s):  
Bone Marrow ◽  
Tumor Cells ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Ct Imaging ◽  
Pet Scan ◽  
Predictive Values ◽  
Viable Tumor ◽  
Fdg Pet Scan ◽  
Pet Scans

Abstract Background: CT imaging has routinely been used for assessing therapy response in most malignancies including Non-Hodgkins Lymphoma (NHL). The presence of residual tumor is generally categorized using the International Workshop Criteria from CT imaging and bone marrow biopsies for assessing response after treatment. CT imaging has limitations in assessment of response to therapy in NHL with false positive results due to residual masses having viable tumor cells in less than 20% and the remainder being fibrosis or necrosis. In addition false negative CT results are seen due to viable tumor cells in nodes measuring less than 1.5 cm in size. F-18 FDG PET scans provide metabolic imaging of viable tumor cells due to uptake and retention of F-18 fluorodeoxyglucose preferentially in malignant cells. Method: Forty-eight patients with aggressive NHL having completed anthracycline-based chemotherapy had the post therapy FDG PET scans and CT scans reviewed by experienced readers blinded from the comparison scan and from the clinical history. PET scans were read as positive or negative for abnormal FDG consistent with residual viable tumor and the CT was read as positive or negative for nodes greater than 1.5 cm in diameter. Records were reviewed for tumor histology and evidence of tumor relapse with a median follow-up of 35 months. Results: The FDG PET and CT imaging prediction of PFS at 2 years had positive predictive values of 67% and 38%, negative predictive values of 88% and 78%, and accuracy of 81% and 50% respectively. The sensitivity and specificity of the FDG PET scan was 71% and 82% for predicting disease progression within 2 years from beginning treatment. Conclusion: FDG PET imaging was compared with CT imaging done after completing initial chemotherapy for aggressive NHL and demonstrated superior prediction of tumor response status at 2 years. These results indicate that FDG PET imaging should be combined with bone marrow biopsy for restaging aggressive NHL after completion of chemotherapy. The use of FDG PET is more accurate and should replace response assessment by CT imaging in most pateints with aggressive NHL following treatment.

scholarly journals Increased [18F]FMISO accumulation under hypoxia by multidrug-resistant protein 1 inhibitors

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoichi Shimizu ◽  
Yukihiro Nakai ◽  
Hiroyuki Watanabe ◽  
Shimpei Iikuni ◽  
Masahiro Ono ◽  
...  
Keyword(s):  
Cyclosporine A ◽  
Pet Imaging ◽  
Multidrug Resistant ◽  
Ct Images ◽  
Pet Scan ◽  
Reduced Form ◽  
Pet Ct ◽  
Fadu Cells ◽  
Hypoxic State

Abstract Background [18F]Fluoromisonidazole ([18F]FMISO) is a PET imaging probe widely used for the detection of hypoxia. We previously reported that [18F]FMISO is metabolized to the glutathione conjugate of the reduced form in hypoxic cells. In addition, we found that the [18F]FMISO uptake level varied depending on the cellular glutathione conjugation and excretion ability such as enzyme activity of glutathione-S-transferase and expression levels of multidrug resistance-associated protein 1 (MRP1, an efflux transporter), in addition to the cellular hypoxic state. In this study, we evaluated whether MRP1 activity affected [18F]FMISO PET imaging. Methods FaDu human pharyngeal squamous cell carcinoma cells were pretreated with MRP1 inhibitors (cyclosporine A, lapatinib, or MK-571) for 1 h, incubated with [18F]FMISO for 4 h under hypoxia, and their radioactivity was then measured. FaDu tumor-bearing mice were intravenously injected with [18F]FMISO, and PET/CT images were acquired at 4 h post-injection (1st PET scan). Two days later, the same mice were pretreated with MRP1 inhibitors (cyclosporine A, lapatinib, or MK-571) for 1 h, and PET/CT images were acquired (2nd PET scan). Results FaDu cells pretreated with MRP1 inhibitors exhibited significantly higher radioactivity than those without inhibitor treatment (cyclosporine A: 6.91 ± 0.27, lapatinib: 10.03 ± 0.47, MK-571: 10.15 ± 0.44%dose/mg protein, p < 0.01). In the in vivo PET study, the SUVmean ratio in tumors [calculated as after treatment (2nd PET scan)/before treatment of MRP1 inhibitors (1st PET scan)] of the mice treated with MRP1 inhibitors was significantly higher than those of control mice (cyclosporine A: 2.6 ± 0.7, lapatinib: 2.2 ± 0.7, MK-571: 2.2 ± 0.7, control: 1.2 ± 0.2, p < 0.05). Conclusion In this study, we revealed that MRP1 inhibitors increase [18F]FMISO accumulation in hypoxic cells. This suggests that [18F]FMISO-PET imaging is affected by MRP1 inhibitors independent of the hypoxic state.

scholarly journals PET Scan Perfusion Imaging in the Prader–Willi Syndrome: New Insights into the Psychiatric and Social Disturbances

2010 ◽  
Vol 31 (1) ◽  
pp. 275-282 ◽  
Author(s):  
Carine Mantoulan ◽  
Pierre Payoux ◽  
Gwenaëlle Diene ◽  
Mélanie Glattard ◽  
Bernadette Rogé ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Severe Disabilities ◽  
Brain Regions ◽  
Pet Scan ◽  
Prader Willi Syndrome ◽  
Behavioral Skills ◽  
Positron Emission ◽  
Functional Consequences ◽  
Magnetic Resonance Imaging Mri ◽  
Pet Scans

The Prader–Willi syndrome (PWS), a rare multisystem genetic disease, leads to severe disabilities, such as morbid obesity, endocrine dysfunctions, psychiatric disorders, and social disturbances. We explored the whole brain of patients with PWS to detect abnormalities that might explain the behavioral and social disturbances, as well as the psychiatric disorders of these patients. Nine patients with PWS (six males, three females; mean age 16.4 years) underwent a positron emission tomography (PET) scan with H215O as a tracer to measure regional cerebral blood flow (rCBF). The images were compared with those acquired from nine controls (six males, three females; mean age 21.2 years). A morphologic magnetic resonance imaging (MRI) was also performed in PWS patients, and their cognitive and behavioral skills were assessed with Wechsler Intelligence Scale for Children III and the Child Behavior Check List (CBCL). The MRI images showed no evident anatomic abnormalities, whereas PET scans revealed hypoperfused brain regions in PWS patients compared with controls, particularly in the anterior cingulum and superior temporal regions. We observed a significant relationship ( P<0.05) between rCBF in the hypoperfused regions and CBCL scores. The functional consequences of these perfusion abnormalities in specific brain regions might explain the behavioral and social problems observed in these individuals.

PO-1050 11C-Methionine-PET scan for target delineation in patients treated with IMPT for CNS tumors.

2021 ◽  
Vol 161 ◽  
pp. S874-S875
Author(s):  
S. Martin Pastor ◽  
F.A. Calvo Manuel ◽  
A. Garcia-Consuegra ◽  
J. Serrano Andreu ◽  
J. Arbizu Lostao ◽  
...  
Keyword(s):  
Pet Scan ◽  
Cns Tumors ◽  
Target Delineation

scholarly journals Risk-Adapted Dose-Dense Immunochemotherapy Determined by Interim FDG-PET in Advanced-Stage Diffuse Large B-Cell Lymphoma

2010 ◽  
Vol 28 (11) ◽  
pp. 1896-1903 ◽  
Author(s):  
Craig H. Moskowitz ◽  
Heiko Schöder ◽  
Julie Teruya-Feldstein ◽  
Camelia Sima ◽  
Alexia Iasonos ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Progression Free Survival ◽  
B Cell Lymphoma ◽  
Pet Scan ◽  
Free Survival ◽  
Large B Cell Lymphoma ◽  
Positive Biopsy ◽  
Fdg Pet Scan ◽  
Dose Dense ◽  
Pet Scans

Purpose In studies of diffuse large B-cell lymphoma, positron emission tomography with [18F]fluorodeoxyglucose (FDG-PET) performed after two to four cycles of chemotherapy has demonstrated prognostic significance. However, some patients treated with immunochemotherapy experience a favorable long-term outcome despite a positive interim FDG-PET scan. To clarify the significance of interim FDG-PET scans, we prospectively studied interim FDG-positive disease within a risk-adapted sequential immunochemotherapy program. Patients and Methods From March 2002 to November 2006, 98 patients at Memorial Sloan-Kettering Cancer Center received induction therapy with four cycles of accelerated R-CHOP (rituximab + cyclophosphamide, doxorubicin, vincristine, and prednisone) followed by an interim FDG-PET scan. If the FDG-PET scan was negative, patients received three cycles of ICE (ifosfamide, carboplatin, and etoposide) consolidation therapy. If residual FDG-positive disease was seen, patients underwent biopsy; if the biopsy was negative, they also received three cycles of ICE. Patients with a positive biopsy received ICE followed by autologous stem-cell transplantation. Results At a median follow-up of 44 months, overall and progression-free survival were 90% and 79%, respectively. Ninety-seven patients underwent interim FDG-PET scans; 59 had a negative scan, 51 of whom are progression free. Thirty-eight patients with FDG-PET–positive disease underwent repeat biopsy; 33 were negative, and 26 remain progression free after ICE consolidation therapy. Progression-free survival of interim FDG-PET–positive/biopsy-negative patients was identical to that in patients with a negative interim FDG-PET scan (P = .27). Conclusion Interim or post-treatment FDG-PET evaluation did not predict outcome with this dose-dense, sequential immunochemotherapy program. Outside of a clinical trial, we recommend biopsy confirmation of an abnormal interim FDG-PET scan before changing therapy.

scholarly journals Development of a deep neural network derived from contours defined by consensus-based guidelines for automatic target segmentation in hepatocellular carcinoma radiotherapy: A study protocol

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1929
Author(s):  
Jiandong Zhao ◽  
Jiazhou Wang ◽  
Mingxia Cheng
Keyword(s):  
Machine Learning ◽  
Hepatocellular Carcinoma ◽  
Study Protocol ◽  
Target Identification ◽  
Machine Learning Algorithms ◽  
Machine Learning Techniques ◽  
Intraobserver Variability ◽  
Target Delineation ◽  
Artificial Intelligence Technology ◽  
Contouring Guidelines

Hepatocellular carcinoma (HCC) is a leading cause of cancer death in China and around the world. Tumoricidal doses of modern radiation therapy (RT) can now be safely delivered with excellent local control and minimal toxicity. Delivering adequate doses of radiation to the primary tumor, while preserving adjacent healthy organs, depends on accurate target identification. In recent years, different novel machine learning techniques, including artificial intelligence technology, have been exploited in RT with impressive results in automatic image segmentation. If the machine learning algorithms are trained on delineated contours, according to consensus contouring guidelines, it promises greatly reduced interobserver and intraobserver variability in target delineation, thus substantially improving the quality and efficiency of HCC radiotherapy. This study protocol proposes to develop a fully-automated target structure contouring system, which is based on deep neural networks trained on contours delineated according to consensus contouring guidelines in HCC radiotherapy. In addition, the study will evaluate the contouring system’s feasibility and performance during application in normal clinical operations. The study is ongoing (data analysis).

scholarly journals Detection of Lymphoma in Bone Marrow by Whole-Body Positron Emission Tomography

Blood ◽  
1998 ◽  
Vol 91 (9) ◽  
pp. 3340-3346 ◽  
Author(s):  
Robert Carr ◽  
Sally F. Barrington ◽  
Bella Madan ◽  
Michael J. O'Doherty ◽  
Catherine A.B. Saunders ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Disease Status ◽  
Pet Scan ◽  
Emission Tomography ◽  
Whole Body ◽  
Whole Body Imaging ◽  
Visual Interpretation ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Pet Scans

Abstract Positron emission tomography (PET) is a whole-body imaging technique using 18 fluorine-fluorodeoxyglucose (FDG), whose uptake is increased in tumor cells. Published studies have shown PET to be an effective method of staging lymphoma and to be more sensitive than CT at detecting extranodal disease. The purpose of this study was to determine whether the increased marrow uptake of FDG observed in some lymphoma patients during routine staging PET scans represented marrow involvement by disease. PET scans of 50 patients with Hodgkin's (12) and non-Hodgkin's (38) lymphoma were analyzed by three independent observers and the marrow graded as normal or abnormal using a visual grading system. Unilateral iliac crest marrow aspirates and biopsies were performed on all patients. The PET scan and marrow histology agreed in 39 patients (78%), being concordant positive in 13 and concordant negative in 26 patients. In 8 patients the PET scan showed increased FDG uptake but staging biopsy was negative; in 4 of these 8 patients the PET scan showed a normal marrow background with focal FDG “hot spots” distant from the site biopsied. In 3 patients the marrow biopsy specimen was positive but the PET scan normal; 2 of these 3 patients had non-Hodgkin's lymphoma whose malignant cells did not take up FDG at lymph node or marrow disease sites. Therefore, there were only 5 patients (10%) in whom there was a difference between the PET scan and biopsy result which could not be fully explained. Visual interpretation of marrow FDG uptake during whole-body staging PET scans can correctly assess marrow disease status in a high proportion of lymphoma patients. PET has the potential to reduce the need for staging marrow biopsy.

A prospective study of DWI, DCE-MRI and FDG PET imaging for target delineation in brachytherapy for cervical cancer

2016 ◽  
Vol 120 (3) ◽  
pp. 519-525 ◽  
Author(s):  
Kathy Han ◽  
Jennifer Croke ◽  
Warren Foltz ◽  
Ur Metser ◽  
Jason Xie ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Prospective Study ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Target Delineation ◽  
Dce Mri ◽  
A Prospective Study

Prognostic Value of Positron Emission Tomography (PET) Scan in Patients with Relapsed Hodgkin Lymphoma or Aggressive Non-Hodgkin Lymphoma Receiving Salvage Chemotherapy Followed by Reduced-Intensity Allogeneic Stem Cell Transplantation.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3039-3039 ◽  
Author(s):  
Anna Dodero ◽  
Roberto Crocchiolo ◽  
Francesca Patriarca ◽  
Fabio Ciceri ◽  
Nicolo’ Frungillo ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Hodgkin Lymphoma ◽  
Prognostic Value ◽  
Pet Scan ◽  
Emission Tomography ◽  
Non Hodgkin Lymphoma ◽  
Positron Emission ◽  
18F Fdg ◽  
Pet Scans ◽  
Reduced Intensity

Abstract Positron emission tomography (PET) scan using 18-fluorodeoxyglucose [18F-FDG] has a prognostic value in patients (pts) with Hodgkin Lymphoma (HL) or aggressive Non-Hodgkin lymphoma (NHL) receiving chemotherapy. Chemosensitive disease is a critical prognostic factor for the success of both autologous and allogeneic stem cell transplantation (allo-SCT). We have recently shown a lower risk of death or progression for pts in CR versus those in PR before reduced-intensity conditioning (RIC) allo-SCT (Corradini P, Leukemia 2007). Thus, to better assess the value of pre-transplant disease response, we retrospectively assessed the prognostic role of PET scan before allotransplant. Between 2000 and 2007, 64 consecutive patients with a histologically proven diagnosis of aggressive NHL [n=30: diffuse large B cell lymphoma (n=18), peripheral T-cell lymphomas (n=11), Burkitt lymphoma (n=1)] or HL [n=34], responding to salvage therapy, were evaluated with a PET scan before and after allo-SCT. PET scans were performed at 3 different Nuclear Medicine Units. Presence (PET-positive) or absence (PET-negative) of abnormal 18F-FDG uptake was correlated to progression-free survival (PFS) and overall survival (OS) curves. Patients’ median age was 37 years (range, 17–65 years). Thirty-three pts (52%) were allografted from a HLA-identical sibling donor, 14 from a haploidentical donor and 17 from an unrelated donor. Pts had relapsed disease: 52 pts (81%) had failed autologous SCT, the median number of prior chemotherapy regimens was 3 (range, 1–6). All pts received a RIC regimen followed by allo-SCT. PET scans were performed at a median of 30 days prior to allograft (range, 3–90 days): 34 out of 64 pts showed an abnormal 18F-FDG uptake [NHL (n=16), HL (n=18)] whereas 30 were completely negative [NHL (n=14), HL (n=16)]. Patients with PET-positive or PET-negative scans were balanced in terms of diagnosis, previous treatments, and type of donor. At a median follow-up of 24 months (range, 6–86 months), 41 pts are alive and 23 died [toxicity n=10 (n= 5 NHL, n=5 HL), disease n=13 (n=8 NHL, n=5 HL)]. Overall, the estimated 3-year PFS in pts with negative or positive PET scans were 64% (95% CI, 42%–86%) versus 28% (95% CI, 8%–48%), respectively (p<0.005). A statistically significant higher cumulative risk of relapse was observed in pts with a positive PET scan before allografting as compared to the PET negatives (53% versus 21%, p< 0.022). The estimated 3-year OS in pts with negative or positive PET scans were 69% (95% CI; 51%–87%) versus 44% (95% CI;23%-65%), respectively (p=0.05). For NHL pts, the estimated 3-year PFS was 59% for PET-negative as compared to 38% for PET-positive (p<0.04). For HL pts, the estimated 3-year PFS was 70% for PET-negative as compared to 23% for PET-positive (p<0.05). PET scan has a clinical relevance before allo-SCT. Pts with a positive PET scan have a worse outcome, and should receive experimental therapies to target chemoresistant tumor cells.

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