scholarly journals Clinical and Prognostic Value of PET/CT Imaging with Combination of 68Ga-DOTATATE and 18F-FDG in Gastroenteropancreatic Neuroendocrine Neoplasms

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Panpan Zhang ◽  
Jiangyuan Yu ◽  
Jie Li ◽  
Lin Shen ◽  
Nan Li ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Clinicopathological Characteristics ◽  
Neuroendocrine Neoplasms ◽  
Ki 67 ◽  
Gastroenteropancreatic Neuroendocrine Neoplasms ◽  
Pet Ct ◽  
Group A ◽  
Well Differentiated ◽  
Group B ◽  
Fdg Pet Ct

Background. To evaluate the clinical and prognostic value of PET/CT with combination of 68Ga-DOTATATE and 18F-FDG in gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs). Method. 83 patients of GEP-NENs who underwent 68Ga-DOTATATE and 18F-FDG PET/CT were enrolled between June 2013 and December 2016. Well-differentiated (WD) NETs are divided into group A (Ki-67 < 10%) and group B (Ki-67 ≥ 10%), and poorly differentiated (PD) NECs are defined as group C. The relationship between PET/CT results and clinicopathological characteristics was retrospectively investigated. Result. For groups A/B/C, the sensitivities of 68Ga-DOTATATE and 18F-FDG were 78.8%/83.3%/37.5% and 52.0%/72.2%/100.0%. A negative correlation between Ki-67 and SUVmax of 68Ga-DOTATATE (R = −0.415; P ≤ 0.001) was observed, while a positive correlation was noted between Ki-67 and SUVmax of 18F-FDG (R = 0.683; P ≤ 0.001). 62.5% (5/8) of patients showed significantly more lesions in the bone if 68Ga-DOTATATE was used, and 22.7% (5/22) of patients showed more lymph node metastases if 18F-FDG was used. Conclusions. The sensitivity of dual tracers was correlated with cell differentiation, and a correlation between Ki-67 and both SUVmax of PET-CTs could be observed. 68Ga-DOTATATE is suggested for WD-NET and 18F-FDG is probably suitable for patients with Ki-67 ≥ 10%.

5965Perimatrial inflammation measured by fluoine-18-fluorodeoxyglucose-positron emission tomography/computed tomography to predict new-onset atrial fibrillation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y Hada ◽  
S Iwamiya ◽  
S Hijikata ◽  
T Yoshitake ◽  
H Sato ◽  
...  
Keyword(s):  
Blood Pool ◽  
Emission Tomography ◽  
Positron Emission ◽  
Pet Ct ◽  
Significant Difference ◽  
Group A ◽  
Arterial Inflammation ◽  
Group B ◽  
Fdg Pet Ct ◽  
New Onset

Abstract Background Fluoine-18-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) is a useful modality of inflammatory disease. Epicardial adipose tissue (EAT) contains abundant ganglionated plexi, therefore EAT inflammation may cause atrial arrhythmia, such as atrial premature contraction (APC) and atrial fibrillation (AF). Previous studies have shown that inflammatory activity of EAT has relation to the presence of AF. However, it is unknown whether EAT inflammation contributes to the occurrence of AF. Methods Out of 20720 examinees who underwent FDG-PET/CT for screening of cancer in the years 2012–2018, 151 (aged 65.6±12.0 years old, 62 females) had ambulatory electrocardiographic monitoring (Holter ECG) within a year and non-detection of AF. Standardized uptake value (SUV) was measured in fat adjacent to roof of left atrium (ROOF), atrioventricular groove (AV), left main coronary artery (LMT), and right ventricular blood pool (RV). In order to correct for blood pool activity, SUV of ROOF, AV, and LMT were divided by SUV of RV respectively, yielding target-to-background ratio (TBR). As regards to arterial inflammation, measurements were performed with SUV in ascending aorta (A-Ao) and in superior vena cava (SVC) as blood pool. In the same way, SUV of A-Ao was divided by SUV of SVC, yielding TBR. Results According to Holter ECG, APC≥100 beats per day was seen in 60 patients (Group A), but not in the other 91 (Group B). In Group A, TBR of ROOF, AV, and LMT were all significantly higher than Group B (p<0.001, p=0.004, and p=0.008, respectively). During a median follow-up of 179 days, new-onset AF was diagnosed in 7 patients (4 in Group A (6.7%), 3 in Group B (3.3%), p=0.046). There was significant difference in TBR of ROOF between patients with and without new-onset AF (p<0.001), but not in TBR of AV and LMT. In addition, no significant difference was observed in TBR of A-Ao between these two groups. In the Cox proportional hazard analysis, TBR of ROOF was found to be an independent predictor of new-onset AF (odds ratio 40.1, 95% confidence interval 6.05 to 265.9, p<0.001). Conclusions Although EAT inflammation evaluated by SUV is related to frequent APCs, only in fat adjacent to roof of left atrium is associated with and predicts future occurrence of AF. Arterial inflammation measured by SUV has no relation to atrial arrhythmia.

scholarly journals Prediction of the aggressiveness of non-functional pancreatic neuroendocrine tumors based on the dual-tracer PET/CT

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Susanna Majala ◽  
Hanna Seppänen ◽  
Jukka Kemppainen ◽  
Jari Sundström ◽  
Camilla Schalin-Jäntti ◽  
...  
Keyword(s):  
Pet Imaging ◽  
Fdg Pet ◽  
Tumor Grade ◽  
Pancreatic Neuroendocrine Tumors ◽  
Ki 67 ◽  
Pet Ct ◽  
Well Differentiated ◽  
Fdg Pet Ct ◽  
Dual Tracer

Abstract Background Predicting the aggressive behavior of non-functional pancreatic neuroendocrine tumors (NF-PNET) remains controversial. We wanted to explore, in a prospective setting, whether the diagnostic accuracy can be improved by dual-tracer functional imaging 68Ga-DOTANOC and 18F-FDG-PET/CT in patients with NF-PNETs. Methods Thirty-one patients with NF-PNET (90% asymptomatic) underwent PET-imaging with 18F-FDG and 68Ga-DOTANOC, followed by surgery (n = 20), an endoscopic ultrasonography and fine-needle biopsy (n = 2) or follow-up (n = 9). A focal activity on PET/CT greater than the background that could not be identified as physiological activity was considered to indicate tumor tissue. The imaging results were compared to histopathology. The mean follow-up time was 31.3 months. Results Thirty-one patients presented a total of 53 lesions (40 histologically confirmed) on PET/CT. Thirty patients had a 68Ga-DOTANOC-positive tumor (sensitivity 97%) and 10 patients had an 18F-FDG-positive tumor. In addition, one 68Ga-DOTANOC-negative patient was 18F-FDG-positive. 18F-FDG-PET/CT was positive in 19% (3/16) of the G1 tumors, 63% (5/8) of the G2 tumors and 1/1 of the well-differentiated G3 tumor. 68Ga-DOTANOC-PET/CT was positive in 94% of the G1 tumors, 100% of the G2 tumors and 1/1 of the well-differentiated G3 tumor. Two out of six (33%) of the patients with lymph node metastases (LN+) were 18F-FDG-positive. The 18F-FDG-PET/CT correlated with tumor Ki-67 (P = 0.021). Further, the Krenning score correlated with tumor Ki-67 (P = 0.013). 18F-FDG-positive tumors were significantly larger than the 18F-FDG-negative tumors (P = 0.012). 18F-FDG-PET/CT showed a positive predictive value of 78% in the detection of potentially aggressive tumors (G2, G3, or LN + PNETs); the negative predictive value was 69%. Conclusions 18F-FDG-PET/CT is useful to predict tumor grade but not the LN+ of NF-PNETs. Patients with 18F-FDG-avid NF-PNETs should be referred for surgery. The 68Ga-DOTANOC-PET/CT also has prognostic value since the Krenning score predicts the histopathological tumor grade. Trial registration The study has been registered at ClinicalTrials.gov; Non-functional Pancreatic NET and PET imaging, NCT02621541.

scholarly journals Correlation of Somatostatin Receptor 1–5 Expression, [68Ga]Ga-DOTANOC, [18F]F-FDG PET/CT and Clinical Outcome in a Prospective Cohort of Pancreatic Neuroendocrine Neoplasms

Cancers ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 162
Author(s):  
Susanna Majala ◽  
Tiina Vesterinen ◽  
Hanna Seppänen ◽  
Harri Mustonen ◽  
Jari Sundström ◽  
...  
Keyword(s):  
Prospective Study ◽  
Fdg Pet ◽  
Somatostatin Receptor ◽  
Proliferation Index ◽  
Neuroendocrine Neoplasms ◽  
Ki 67 ◽  
Pet Ct ◽  
Sstr Subtype ◽  
Node Metastases ◽  
Fdg Pet Ct

Purpose: The aim of this study was to correlate immunohistochemical (IHC) tissue levels of SSTR1-5 with the receptor density generated from [68Ga]Ga-DOTANOC uptake in a prospective series of NF-PNENs. Methods: Twenty-one patients with a total of thirty-five NF-PNEN-lesions and twenty-one histologically confirmed lymph node metastases (LN+) were included in this prospective study. Twenty patients were operated on, and one underwent endoscopic ultrasonography and core-needle biopsy. PET/CT with both [68Ga]Ga-DOTANOC and [18F]F-FDG was performed on all patients. All histological samples were re-classified and IHC-stained with monoclonal SSTR1-5 antibodies and Ki-67 and correlated with [68Ga]Ga-DOTANOC and [18F]F-FDG PET/CT. Results: Expression of SSTR1-5 was detected in 74%, 91%, 80%, 14%, and 77% of NF-PNENs. There was a concordance of SSTR2 IHC with positive/negative [68Ga]Ga-DOTANOC finding (Spearman’s rho 0.382, p = 0.043). All [68Ga]Ga-DOTANOC-avid tumors expressed SSTR2 or SSTR3 or SSTR5. Expression of SSTR5 was higher in tumors with a low Ki-67 proliferation index (PI) (−0.353, 95% CI −0.654–0.039, p = 0.038). The mean Ki-67 PI for SSTR5 positive tumors was 2.44 (SD 2.56, CI 1.0–3.0) and 6.38 (SD 7.25, CI 2.25–8.75) for negative tumors. Conclusion: SSTR2 was the only SSTR subtype to correlate with [68Ga]Ga-DOTANOC PET/CT. Our prospective study confirms SSTR2 to be of the highest impact for SST PET/CT signal.

scholarly journals Brown adipose tissue (BAT) activation at 18F-FDG PET/CT: correlation with clinicopathological characteristics in breast cancer

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Nadia M. Mostafa ◽  
Nsreen R. A. Mohamadien ◽  
Mohamed H. M. Sayed
Keyword(s):  
Breast Cancer ◽  
Distant Metastasis ◽  
Fdg Pet ◽  
Age Groups ◽  
Clinicopathological Characteristics ◽  
Ki 67 ◽  
Luminal B ◽  
Younger Age ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background There is conflicting results of few published human 18F-FDG PET/CT studies about BAT activation in breast cancer (BC). The aim of the study is to evaluate the association between the levels of BAT metabolic activity detected by 18F-FDG PET/CT and clinicopathological characteristics of a tumor in patients with primary BC. Results BAT was activated in 16 out of 157 (10.2%) consecutive female patients with BC who underwent 18F-FDG PET/CT for initial evaluation. The majority of patients (15/16) had bilateral uptake in the supraclavicular regions. The mean values of the highest SUVmax and total metabolic activity (TMA) of activated BAT were 13.3 ± 9.9 and 79.6 ± 45, respectively. Median outdoor temperature was significantly lower in the activated BAT group (P value=0.035). Patients with BAT activation tended to have a lower median primary tumor size and primary SUVmax, but not statistically significant than those without BAT activation. BAT activation was significantly more frequent among younger age groups (14/16) and patients with lower body mass index (BMI) (10/16), but it was insignificantly more frequent among estrogen receptor-positive (ER+), progesterone receptor-positive (PR+), human epidermal growth factor receptor2 negative (HER2-), invasive ductal carcinoma (IDC), grade II, luminal B subtype, high Ki-67 expression level, patients with positive nodal metastasis, and in patients without distant metastasis. TMA was significantly higher among HER2+ patients (P value=0.019), but insignificantly higher among the younger age groups, stages I and II, invasive lobular carcinoma (ILC), grade I, luminal B subtype, ER+, PR−, higher Ki-67 expression level, patients with positive nodal, and distant metastasis. BMI and patient’s age were the significant independent predictor factors for BAT activation on multivariate regression analysis. Conclusion BAT activation in young age females is sex hormone-dependent, positively associated with less aggressive molecular subtypes of BC, less frequent in patients with distant metastasis. BAT activation may be a prognostic factor that carries a better prognosis in BC.

Correlation between FDG PET/CT and the expression of Ki-67, MMP-2, micro-vessel density (MVD), and pathological grading in squamous cell carcinoma of the esophagus

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e15556-e15556
Author(s):  
L. Liu ◽  
Y. Huang ◽  
J. Guo ◽  
Z. H. Wang ◽  
D. G. Song
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Fdg Pet ◽  
Ki 67 ◽  
Pet Ct ◽  
Poorly Differentiated ◽  
The Mean ◽  
Well Differentiated ◽  
Fdg Pet Ct

e15556 Background: Variable uptake of 18FDG has been noticed in positron emission tomography (PET) studies of patients with esophageal squamous cell carcinoma (ESCC). The aim of the present study was to determine if 18F-FDG PET/CT standardized uptake value (SUV) could quantitatively reflect tumor proliferation, invasion and angiogenesis, and to reveal the relationship between SUV and pathological grading of ESCC. Methods: Preoperative PET scans were performed in 47 patients with histologically proven ESCC. 18FDG uptake was semiquantitatively measured by SUV.Tumour sections were HE stained to determine the pathological grading,and were stained by immunohistochemistry for proliferation marker (Ki67), invasion marker (MMP-2), and angiogenic marker (CD34). The correlations between FDG SUVmax and Ki67 expression, MMP-2 expression, corresponding MVD were statistically analysed respectively. Results: Among all the 47 cases,there were 13 well- differentiated squamous cell tumors, 16 moderately differentiated tumors and 18 poorly differentiated tumors,45 of 47 tumors revealed FDG. accumulation in primary tumor foci confirmed by subsequently histopathologically. The mean FDG SUVmax value was 12.504 ± 6.805. Average Ki-67 index was (7.837±29.798) %, average MMP-2 index was (71.551%±27.126) % and average MVD was (18.429±9.603) accordingly. The SUV and Ki-67 index, MMP-2 index were positively correlated (r=0.581,0.594), and it was not correlated with MVD(P>0.05). The mean SUV of well-differentiated, moderately differentiated and poorly differentiated tumors were 9.787±1.477, 12.313±0.479, 15.053±2.147 respectively, and a significant difference could be determined between them by statistical analysis(P=0.000). Conclusions: A significant positive correlation is demonstrated between FDG PET/CT SUV and Ki-67 index, MMP-2 index of the primary ESCC. SUV could reflect proliferation and invasion potential of tumor. However, there is no significant correlation between SUV and MVD, thus it could not reflect tumor angiogenesis in ESCC. To some extent, SUV could reflect pathologic grading of ESCC. No significant financial relationships to disclose.

In Patients with Aggressive Non-Hodgkin Lymphoma Treated with CHOP Therapy the Rapidity of Early Response, as Determined by Residual FDG Uptake, Does Not Impact on the Overall Prognosis.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2328-2328 ◽  
Author(s):  
Eldad J. Dann ◽  
Eyal Fuchs ◽  
Ada Tamir ◽  
Irit Avivi ◽  
Diana Gaitini ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Predictive Value ◽  
Study Group ◽  
Fdg Uptake ◽  
Interim Pet ◽  
Non Hodgkin Lymphoma ◽  
Pet Ct ◽  
Group A ◽  
Group B ◽  
Fdg Pet Ct

Abstract The role of interim FDG PET/CT for the evaluation of response and prediction of prognosis during the treatment of Hodgkin lymphoma has been demonstrated in several studies; however, its function in aggressive non-Hodgkin lymphoma has not been established. This study assesses the value of interim FDG-PET/CT performed after 2 cycles of chemotherapy for predicting response to CHOP-like regimen and prognosis of these patients. There was no change of therapy based on interim PET results. 85 patients (51 males, 34 females; median age 47, range 19–69 years) diagnosed and treated between 2001 and 2006 at the Rambam Medical Center with aggressive lymphoma were evaluated. Patients were treated either with standard CHOP or high-dose cyclophosphamide (3g/m2) CHOP with (n=52) or without (n=33) rituximab. All patients had PET/CT scan after 2 cycles and at the end of therapy. Results of interim PET/CT were considered negative or positive for active disease in the absence or presence of any abnormal FDG uptake. Positive pre-treatment PET/CT study was available in 71 patients. Baseline Gallium67 scan was performed in 9 patients and 5 patients had no baseline study. Only patients with a baseline scintigraphy were included in this analysis. Patients with a negative interim study were defined as negative (group A - 51 patients). Patients with positive interim study showing a decrease in the number or intensity of pre-therapy FDG abnormalities (≤50% of the initial visual uptake) were defined as having improved PET/CT (group B - 27 patients). PET/CT results after 2 cycles and at the end of therapy were assessed for overall (OS) and progression-free survival (PFS), estimated at 30 months. Median follow-up was 22 months (range 4–56 months). 61/85 patients (72%) achieved complete remission and 9/85 patients (10%) achieved partial remission after therapy. Twenty eight patients relapsed or had disease progression within 30 months, with PFS of 61% and OS of 88%. Interim PET was negative in 51 and improved in 27 patients. Tumor progression or relapse occurred in 14/51 (27%) and 9/27 (33%) of these patients, respectively. Thirty month PFS for low risk international prognostic index (IPI), intermediate risk (2) and high risk IPI (3–5) were 82%, 80% and 42%, respectively. Interim PET/CT after 2 cycles of therapy did not correlate with a difference in PFS or OS for patients with improved compared to those with a complete negative study outcome, treated by standard CHOP or CHOP-like protocol (Table). At the end of therapy PET/CT remained positive in 12 patients and became negative in 67 patients in groups A and B. In these two cohorts PFS was 64% and 70% and OS was 81% and 92%, respectively. These data suggest that, in contrast to Hodgkin Disease, an early PET/CT demonstrating residual FDG uptake may not have impact on the long-term outcome. Whether this is due to the different biology of these diseases needs to be determined. 30 month PFS 30 month OS Predictive value of study Interim PET with baseline PET or Gallium 67 scan (n=78) n % % % *NPV - negative predictive value; **PPV - positive predictive value Negative study: Group A (n=51) 37/51 68% 90% *NPV=73% Improved study: Group B (n=27) 18/27 60% 88% **PPV=33%

The role of F-18 FDG PET/CT and breast MRI in the management of breast cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10778-10778
Author(s):  
A. Iagaru ◽  
R. Masamed ◽  
H. Silberman ◽  
S. Keesara ◽  
P. S. Conti
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Fdg Pet ◽  
Breast Mri ◽  
Pet Ct ◽  
Group A ◽  
Group B ◽  
Fdg Pet Ct ◽  
Work Up

10778 Background: F-18 FDG PET/CT combines functional and morphologic information in a single study, thus becoming a powerful imaging tool for diagnosis, staging and establishing the response to therapy in various malignancies, including breast cancer (BC). Breast MRI (BMRI) is gaining a major role in the management of high risk BC patients (pts), demonstrating high sensitivity and specificity for detection of small lesions. It is not clear whether to request both studies prior to therapy or opt only for one. We were therefore prompted to review our experience with PET/CT and BMRI in BC. Methods: This is a retrospective study of 21 pts with BC, 30–76 years old (average: 52±13.5), who had BMRI and PET/CT from June 2002 to May 2005. 6 pts (group A) had BMRI and PET/CT in the preoperative period (3–78 days, average: 25) and 15 pts (group B) had BMRI and PET/CT as follow-up after surgery (4–175 days, average: 51.3). The interval between the PET/CT and BMRI ranged 2–188 days (average: 52.7). Specificities and sensitivities for BC and metastases detection using PET/CT and MRI were calculated using pathology (17 pts) or clinical follow-up (4 pts) as gold standard. Results: In group A, BMRI identified BC in 4 pts, while PET/CT did so in 5 pts. All were proven to be malignancy on pathology. In group B, BMRI detected recurrent BC in 8 pts, with 88.9% sensitivity (95% CI: 56.5–98) and 83.3% specificity (95% CI: 43.6–96.9). In the same patient population, PET/CT was 33.3% sensitive and 91.7% specific. As a whole body exam, PET/CT revealed metastases in 6 pts (100% sensitive and 90% specific). Overall, sensitivities and specificities for BC detection were 85.7% (95% CI: 60.1–95.9) and 85.7% (95% CI: 48.7–97.4) for breast MRI, and 75% (95% CI: 40.9–92.8) and 92.3% (95% CI: 66.7–98.6) for PET/CT. Conclusions: BMRI is more sensitive than PET/CT for detection of breast lesions. However, PET/CT detected distant metastases in 6 of the 21 pts (100% sensitive, 90% specific). Larger prospective studies, with the addition of dedicated breast PET and dual time imaging are needed to define the sequence of studies during initial work-up. Our study suggests that PET/CT and BMRI should be considered complimentary imaging tools in the pre- and perioperative work-up of pts diagnosed with BC and at high risk for metastatic disease. No significant financial relationships to disclose.

scholarly journals HIGH-GRADE GASTROENTEROPANCREATIC NEUROENDOCRINE NEOPLASMS. MODERN CLASSIFICATION, DIAGNOSTICS AND TREATMENT

2018 ◽  
Vol 8 (3) ◽  
pp. 13-20
Author(s):  
A. A. Kolomeytseva ◽  
V. A. Gorbunova ◽  
N. F. Orel ◽  
G. S. Emelianova ◽  
A. M. Ivanov ◽  
...  
Keyword(s):  
World Health ◽  
Neuroendocrine Neoplasms ◽  
Ki 67 ◽  
First Line Therapy ◽  
Gastroenteropancreatic Neuroendocrine Neoplasms ◽  
Platinum Based Chemotherapy ◽  
Poorly Differentiated ◽  
Net G3 ◽  
Well Differentiated ◽  
Health Organization

Poorly differentiated gastroenteropancreatic neuroendocrine neoplasms (GEP NENs) are rare malignancies, most of which are characterized by aggressiveness, a tendency to rapid metastasis and an unfavorable prognosis even when localized. In 2017 World Health Organization (WHO) updated classification of GEP NENs and recognized the category of well-differentiated pancreatic NET G3, associated with Ki‑67 index usually over 20%. The upper level of Ki‑67 is not defined. Usually it is 55%. Highgrade poorly differentiated pancreatic NENs are defined as pancreatic neuroendocrine carcinomas (panNECs). Although the NET G3 category is recognized for pancreatic neuroendocrine neoplasms only, many specialists consider it reasonable to apply this term to all well-differentiated GEP NETs with Ki‑67 index in the 20 to 55 percent range. Clinical behavior and therapeutic approaches for advanced GEP NECs and NETs G3 are different. Standard palliative chemotherapy for GEP NECs consists of cisplatin or carboplatin combined with etoposide. The second-line regimens include irinotecan-, oxaliplatin, fluoropyrimidine- and temozolomide-based regimens. Temozolomide-based chemotherapy regimens, as well as targeted therapy are more preferable as first line therapy for patients with NETs G3. The platinum-based chemotherapy regimens are considered at the time of disease progression. Further clinical studies with the inclusion of much more patients will determine the optimal treatment strategy for this category of patients.

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