scholarly journals PET/CT scan and biopsy-driven approach for safe anti-PD-1 therapy discontinuation in patients with advanced melanoma

2021 ◽  
Vol 9 (10) ◽  
pp. e002955
Author(s):  
Geoffrey T. Gibney ◽  
Jacob Zaemes ◽  
Shelly Shand ◽  
Neil J. Shah ◽  
David Swoboda ◽  
...  
Keyword(s):  
Ct Scan ◽  
Systemic Therapy ◽  
Advanced Melanoma ◽  
Therapy Discontinuation ◽  
Tumor Biopsy ◽  
Pet Ct ◽  
Baseline Characteristics ◽  
Fdg Pet Ct ◽  
Pet Ct Scan ◽  
Active Disease

BackgroundLimited data exist on safe discontinuation of antiprogrammed cell death protein 1 (PD-1) therapy in responding patients with advanced melanoma. The use of 18fluorodeoxyglucose (18FDG)-PET/CT scan and tumor biopsy for assessment of active disease may be an effective predictive biomarker to guide such treatment decisions.MethodsA retrospective study of 122 patients with advanced melanoma treated with anti-PD-1 monotherapy or anti-PD-1/anticytotoxic T-lymphocyte-associated protein 4 combination therapy at Georgetown Lombardi Comprehensive Cancer Center was conducted. Uveal melanoma patients and those receiving concurrent experimental therapy were excluded. Baseline characteristics, treatment outcomes, and survival were analyzed. Patients who decided to come off treatment typically after 12 months using CT scan radiographic complete response (CR), 18FDG-PET/CT scan complete metabolic response (CMR) or tumor biopsy of a non-CR/CMR tumor site negative for active disease (possible pathological CR) were identified and compared with patients who discontinued treatment due to toxicity while their disease was in control. Event-free survival (EFS) was assessed from the last dose of anti-PD-1 therapy to progression requiring subsequent treatment (surgery, radiation, and/or systemic therapy) or referral to hospice/death due to melanoma.Results24 (20%) patients discontinued treatment by choice with no active disease and 28 (23%) patients discontinued treatment due to toxicity with disease control after 12-month and 4-month median treatment durations, respectively. Similar baseline characteristics were observed between cohorts except higher prior receipt of ipilimumab (29% vs 7%; p=0.036) and fewer BRAF mutant positive disease (17% vs 41%; p=0.064) in patients off treatment by choice. Three-year EFS rates were 95% and 71%, respectively. No significant associations between EFS and sex, disease stage, lactate dehydrogenase elevation, BRAF status, prior systemic therapy, ECOG performance status, presence of brain metastases, or combination versus monotherapy were observed. Tumor biopsies led to alternative management in 3/10 patients due to active metastatic melanoma or second malignancy.ConclusionsAnti-PD-1 therapy discontinuation after 12 months when no active disease is observed on CT scan, PET/CT scan or tumor biopsy may have low rates of disease relapse in patients with advanced melanoma. Biopsy of residual disease may frequently lead to a change in management. These findings are undergoing validation in the EA6192 trial.

scholarly journals 18F FDG PET-CT Imaging in the Evaluation of Diagnosed Extra Pulmonary Tuberculosis

2019 ◽  
Vol 22 (1) ◽  
pp. 9-14
Author(s):  
Fatema Tuz Zohra ◽  
Shamim MF Begum ◽  
ASM Fateh Akram ◽  
Md Abdus Shakur Khan ◽  
Fatima Begum
Keyword(s):  
Ct Scan ◽  
Metabolic Activity ◽  
Fdg Pet ◽  
Disease Status ◽  
Pet Ct ◽  
18F Fdg ◽  
Extra Pulmonary ◽  
Fdg Pet Ct ◽  
Pet Ct Scan ◽  
Active Disease

Objectives: Extra Pulmonary Tuberculosis (EPTB) presents with atypical symptoms and heterogeneous clinical features. Management of EPTB including diagnosis, localization, extension and monitoring treatment response of active disease is quite challenging. Moreover, localization of active disease, differentiation between active and latent disease by conventional methods is troublesome. So this study was done to evaluate the metabolic activity of active disease by 18F Flurodeoxyglucose (FDG) PET-CT in diagnosed cases of EPTB patients. Patients and methods: A total of 17 patients with EPTB were included in this study. FDG PET-CT scan was performed to evaluate the metabolic activity of tubercular lesions before anti-TB treatment. Clinical features, biochemical changes including ESR, WBC count, CRP, MT test and maximum standardized uptake value (SUVmax) of most intense FDG avid lesions and sizes were recorded in 18F FDG PET-CT scan. Results: All 17 patients (09 female, 08 male) had lymph node involvement, two had bone TB and two had abdominal TB. Active TB lesions showed increased FDG uptake in extra-pulmonary tubercular lesions in 16 patients. The mean SUVmax value of the involved lymph nodes were 9.4 ± 6.0 and the mean size (maximum diameter) 19.8 ± 10.4 mm (mean ± SD). One histologically proven EPTB patient had non avid lesions in FDG PET-CT scan. Conclusion: 18F FDG PET-CT scan plays an important role in the localization, extension and differentiation between active and latent TB. In this study, the metabolic activity and size of the involved tubercular lymph nodes were increased in active lesions. Increased FDG uptake in active tubercular lesions may help in treatment monitoring of EPTB. Non avid lesions in EPTB patients revealed suggested latent TB which can change further management plan. Although PET-CT is an expensive technology, application of this sophisticated imaging technique in atypical or doubtful cases of EPTB might modify the treatment plan significantly after proper evaluation of the disease status. , 18F FDG PET-CT scan will be helpful to evaluate the disease status and modification of treatment regime in non-responders cost-effectively. A nationwide large-scale study would be the better way for clinical validation. Bangladesh J. Nuclear Med. 22(1): 9-14, Jan 2019   

Total-body 18F-FDG PET/CT scan in oncology patients: how fast could it be?

2021 ◽  
Author(s):  
Pengcheng Hu ◽  
Yiqiu Zhang ◽  
Haojun Yu ◽  
Shuguang Chen ◽  
Hui Tan ◽  
...  
Keyword(s):  
Ct Scan ◽  
Fdg Pet ◽  
Oncology Patients ◽  
Pet Ct ◽  
18F Fdg ◽  
Total Body ◽  
Fdg Pet Ct ◽  
Pet Ct Scan

scholarly journals Dual-tracer (68Ga-DOTATOC and 18F-FDG-)-PET/CT scan and G1-G2 non-functioning pancreatic neuroendocrine tumors: A single-center retrospective evaluation of 124 non-metastatic resected cases

2021 ◽  
Author(s):  
Salvatore Paiella ◽  
Luca Landoni ◽  
Sarah Tebaldi ◽  
Michele Zuffante ◽  
Matteo Salgarello ◽  
...  
Keyword(s):  
Ct Scan ◽  
Neuroendocrine Tumors ◽  
Fdg Pet ◽  
Pancreatic Neuroendocrine Tumors ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct ◽  
Work Up ◽  
Pet Ct Scan ◽  
Dual Tracer

Introduction:The combined use of 68Gallium [68GA]-DOTA-peptides and 18Fluorine-fluoro-2-deoxyglucose [18F-FDG] PET/TC scans in the work-up of pancreatic neuroendocrine tumors (PanNETs) is controversial. This study aimed at assessing both tracers’ capability to identify tumors and to assess its association with pathological predictors of recurrence. Methods:Prospectively collected, preoperative, dual-tracer PET/CT scan data of G1-G2, non-metastatic, PanNETs that underwent surgery between January 2013 and October 2019 were retrospectively analyzed. Results:The final cohort consisted of 124 cases. There was an approximately equal distribution of males and females(50.8%/49.2%), and G1 and G2 tumors(49.2%/50.8%). The disease was detected in 122(98.4%) and 64(51.6%) cases by 68Ga-DOTATOC and by 18F-FDG PET/CT scans, respectively, with a combined sensitivity of 99.2%. 18F-FDG-positive examinations found G2 tumors more often than G1 (59.4% versus 40.6%;p = 0.036), and 18F-FDG-positive PanNETs were larger than negative ones (median tumor size 32 mm, IQR 21 versus 26 mm, IQR 20;p = 0.019). The median Ki67 for 18F-FDG-positive and -negative examinations was 3(IQR 4) and 2(IQR 4), respectively, (p = 0.029). At least one pathologic predictor of recurrence was present in 74.6% of 18F-FDG-positive cases (versus 56.7%;p = 0.039), whereas this was not found when dichotomizing the PanNETs by their dimensions (≤/> 20 mm). None of the two tracers predicted nodal metastasis. ROC curve analysis showed that 18F-FDG uptake higher than 4.2 had a sensitivity of 49.2%, and specificity of 73.3% for differentiating G1 from G2 (AUC=0.624, p=0.009). Conclusion: The complementary adoption of 68Ga-DOTATOC and 18F-FDG tracers may be valuable in the diagnostic work-up of PanNETs despite not being a game-changer for the management of PanNETs ≤ 20 mm.

scholarly journals Quantitative 18F-FDG PET-CT scan characteristics correlate with tuberculosis treatment response

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Stephanus T. Malherbe ◽  
Ray Y. Chen ◽  
Patrick Dupont ◽  
Ilse Kant ◽  
Magdalena Kriel ◽  
...  
Keyword(s):  
Ct Scan ◽  
Treatment Response ◽  
Fdg Pet ◽  
Tuberculosis Treatment ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct ◽  
Pet Ct Scan

Pediatric Presentation of Splenic Marginal Zone Lymphoma on FDG PET/CT Scan

2014 ◽  
Vol 39 (2) ◽  
pp. 178-180 ◽  
Author(s):  
Alireza Rezaee ◽  
Xianfeng Frank Zhao ◽  
Vasken Dilsizian ◽  
Wengen Chen
Keyword(s):  
Ct Scan ◽  
Fdg Pet ◽  
Marginal Zone ◽  
Marginal Zone Lymphoma ◽  
Splenic Marginal Zone Lymphoma ◽  
Pet Ct ◽  
Pediatric Presentation ◽  
Fdg Pet Ct ◽  
Pet Ct Scan

Mo1406 Functional Role of 18F-FDG PET/CT Scan in Diabetic Patients With Pancreatic Ductal Adenocarcinomas

2013 ◽  
Vol 144 (5) ◽  
pp. S-658
Author(s):  
Kwang Hyun Chung ◽  
Yoon Suk Lee ◽  
Joo Kyung Park ◽  
Sang Hyub Lee ◽  
Jin-Hyeok Hwang
Keyword(s):  
Ct Scan ◽  
Fdg Pet ◽  
Functional Role ◽  
Diabetic Patients ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct ◽  
Pet Ct Scan

Lipomatous Hypertrophy of the Interatrial Septum. Findings in the 18F-FDG PET/CT Scan; MRI

2011 ◽  
Vol 30 (6) ◽  
pp. 382-383
Author(s):  
J.R. García ◽  
I. Vollmer ◽  
M. Soler ◽  
F.J. Álvarez-Moro ◽  
S. Fuertes ◽  
...  
Keyword(s):  
Ct Scan ◽  
Fdg Pet ◽  
Interatrial Septum ◽  
Pet Ct ◽  
Lipomatous Hypertrophy ◽  
18F Fdg ◽  
Fdg Pet Ct ◽  
Pet Ct Scan

scholarly journals EVALUATING THE ROLE OF FDG PET-CT SCAN AS A SOLE IMAGING MODALITY IN THE MANAGEMENT OF MUO NECK

2020 ◽  
pp. 39-41
Author(s):  
Krishnappa Krishnappa ◽  
Krishna Prasad ◽  
Shruti Satish ◽  
Murali R Nadig
Keyword(s):  
Ct Scan ◽  
Predictive Value ◽  
Fdg Pet ◽  
Imaging Modality ◽  
False Negative ◽  
Unknown Primary ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Pet Ct Scan

Aim:to study the role of PET- CT SCAN as a single imaging modality in the diagnosis of MUO neck. methodology: retrospective study analysis of 51 cases of clinical unknown primary with cervical metastasis . RESULTS: FDG PET CT tracer uptake was detected in 24/51. true positive in 18 cases out of 24,false positive in 6 cases, false negative in 2 cases with sensitivity of 90%, specificity of 82%,positive predictive value of 75%,negative predictive value of 93% and accuracy of 84.91%. conclusion: FDG PET CT can be used as a sole imaging modality in the diagnosis of MUO neck.it is complimentary to endoscopy.

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