scholarly journals Radionuclide Detection of Multiple Soft Tissue Metastases of Osteosarcoma Masquerading as Bone Metastasis

2012 ◽  
Vol 21 (6) ◽  
pp. 582-584 ◽  
Author(s):  
Mustafa Takesh ◽  
Henry Zoller ◽  
Husam Ghazi ◽  
Majdi Zein ◽  
Hussam Sahli
2021 ◽  
Author(s):  
Naresh Kumar Regula ◽  
Vasileios Kostaras ◽  
Silvia Johansson ◽  
Carlos Trampal ◽  
Elin Lindström ◽  
...  

Abstract 18F-NaF positron emission tomography/computed tomography (fluoride PET/CT) is considered the most sensitive technique to detect bone metastasis in prostate cancer (PCa). 68Ga-PSMA-11 (PSMA) PET/CT is increasingly used for staging of PCa. This study primarily aimed to compare the diagnostic performance of fluoride PET/CT and Gallium based PSMA PET/CT in identifying bone metastasis followed by a comparison of PSMA PET/CT with contrast-enhanced CT (CE-CT) in identifying soft tissue lesions as a secondary objective. Methods: Twenty-eight PCa patients with high suspicion of disseminated disease following curative treatment were prospectively evaluated. PET/CT examinations using fluoride and PSMA were performed. All suspicious bone lesions were counted, and the tracer uptake was measured as standardized uptake values (SUV) for both tracers. In patients with multiple findings, ten bone lesions with highest SUVmax were selected from which identical lesions from both scans were considered for direct comparison of SUVmax. Soft tissue findings of local and lymph node lesions from CE-CT were compared with PSMA PET/CT. Results: Both scans were negative for bone lesions in 7 patients (25%). Of 699 lesions consistent with skeletal metastasis in 21 patients on fluoride PET/CT, PSMA PET/CT identified 579 lesions (83%). In 69 identical bone lesions fluoride PET/CT showed significantly higher uptake (mean SUVmax: 73.1±36.8) compared to PSMA PET/CT (34.5±31.4; p<0.001). Compared to CE-CT, PSMA PET/CT showed better diagnostic performance in locating local (96% vs 61%, p=0.004) and lymph node (94% vs 46%, p<0.001) metastasis. Conclusion: In this prospective comparative study PSMA PET/CT detected the majority of bone lesions that were positive on fluoride PET/CT. Further, this study indicates better diagnostic performance of PSMA PET/CT to locate soft tissue lesions compared to CE-CT.


2021 ◽  
Author(s):  
Naresh Kumar Regula ◽  
Vasileios Kostaras ◽  
Silvia Johansson ◽  
Carlos Trampal ◽  
Elin Lindström ◽  
...  

Abstract 18F-NaF positron emission tomography/computed tomography (fluoride PET/CT) is considered the most sensitive technique to detect bone metastasis in prostate cancer (PCa). 68Ga-PSMA-11 (PSMA) PET/CT is increasingly used for staging of PCa. This study primarily aimed to compare the diagnostic performance of fluoride PET/CT and PSMA PET/CT in identifying bone metastasis followed by a comparison of PSMA PET/CT with contrast-enhanced CT (CE-CT) in identifying soft tissue lesions as a secondary objective. Methods: Twenty-eight PCa patients with high suspicion of disseminated disease following curative treatment were prospectively evaluated. PET/CT examinations using fluoride and PSMA were performed. All suspicious bone lesions were counted, and the tracer uptake was measured as standardized uptake values (SUV) for both tracers. In patients with multiple findings, ten bone lesions with highest SUVmax were selected from which identical lesions from both scans were considered for direct comparison of SUVmax. PSA at scan was correlated with findings of both scans. Results: Both scans were negative for bone lesions in 7 patients (25%). Of 699 lesions consistent with skeletal metastasis in 21 patients on fluoride PET/CT, PSMA PET/CT identified 579 lesions (83%). In 69 identical bone lesions fluoride PET/CT showed significantly higher uptake (mean SUVmax:73.1 ± 36.8) compared to PSMA PET/CT (34.5 ± 31.4; p < 0.001). PSA at scan was correlated with SUVmax of PSMA PET/CT (r = 0.58; p = 0.01). No correlation was observed between PSA and fluoride PET/CT measurements. Compared to CE-CT, PSMA PET/CT showed better diagnostic performance in locating local (96% vs 61%, p = 0.004) and lymph node (94% vs 46%, p < 0.001) metastasis. Conclusion: PSMA PET/CT was able to detect majority of bone lesions that were positive on fluoride PET/CT and was better correlated with PSA at time of scan. Further, this study indicates better diagnostic performance of PSMA PET/CT to locate soft tissue lesions compared to CE-CT.


2018 ◽  
Vol 43 (11) ◽  
pp. 854-856
Author(s):  
Derya Çayir ◽  
Mehmet Bozkurt ◽  
Salih Sinan Gültekin ◽  
Alper Özgür Karaçalioğlu

2007 ◽  
Vol 39 (3) ◽  
pp. 104 ◽  
Author(s):  
Sangwon Kim ◽  
Mison Chun ◽  
Heejung Wang ◽  
Sungwon Cho ◽  
Young-Taek Oh ◽  
...  

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 4621-4621 ◽  
Author(s):  
S. Wu ◽  
E. Jones ◽  
J. Gulley ◽  
P. Arlen ◽  
C. Chen ◽  
...  

4621 Background: Bone is the most common metastatic site in AIPC and the only site of metastasis for many patients. However, some pts with only bone metastasis will eventually develop soft tissue disease. Thus many clinical trials include CT monitoring to exclude new soft tissue disease as the only manifestation of disease progression. The true incidence of the asymptomatic development of soft tissue metastases without PSA or bone scan progression is unknown. Here we have identified pts with bone metastasis only at the time of protocol enrollment. We analyzed their disease progression pattern to determine the utility of routine interval CT scans. Methods: We reviewed 100 pts with metastatic AIPC from three phase II clinical trials (docetaxel/thalidomide, docetaxel/vaccine, and ketoconazole/alendronate) between 1995 and 2004. Pts were assessed every 4 weeks with PSA measurement. CT and bone scans were performed 2 months after start of the trial and then at least every 3 months. Median follow-up time was 8 months (1–44 months). The pts with bone metastasis only were examined for the occurrence of soft tissue diseases by subsequent CT scans in association with bone scan and PSA. Results: Of 100 pts with metastatic AIPC, 33% had soft tissue disease alone or soft tissue and bone disease. 67% had no soft tissue involvement identified by CT but had bone metastasis revealed by bone scan. Of the pts with only bone metastasis, 3% (2 pts) developed new soft tissue disease. One pt developed new right illiac fossa lymphadenopathy after 8 months, and another a peri-rectal mass after 12 months. The one with new lymphadenopathy also had multiple new bone lesions identified by bone scan and PSA progression. The one with a peri-rectal mass had PSA progression and a palpable abnormality. Conclusions: The incidence of asymptomatic new soft tissue disease as the only manifestation of disease progression appears to be quite low in pts with only bone metastasis. Scheduled interval examination with CT to exclude new soft tissue disease does not appear to be warranted. CT scans should probably only be done at the time of disease progression shown by bone scan/PSA or when there are clinical signs or symptoms of new soft tissue disease. No significant financial relationships to disclose.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 5076-5076
Author(s):  
D. C. Danila ◽  
M. A. Leversha ◽  
R. Gonzalez-Espinoza ◽  
A. Anand ◽  
B. Gu ◽  
...  

5076 Background: Blood-based assays are urgently needed to provide molecular information on the specific targets expressed in tumor cells to optimize treatment selection. Antibody-capture technologies have been applied to isolate circulating tumor cells (CTC) from small volumes of peripheral blood from patients with progressive castrate metastatic prostate cancer. It has been demonstrated previously that CTC isolated from these patients represent authentic prostate cancer cells. Methods: CTC, positive for EpCAM (epithelial cellular adhesion molecule) and nuclear DAPI, and CD45 negative, were isolated from 120 patients with clinical castrate metastatic disease. All patients had rising PSA levels and were on stable treatment regimens at the time of CTC sampling. We tested the association between CTC counts and PSA levels, and the extent of disease to bone, and soft tissue metastasis by Wilcoxon rank sum. Fluorescence in situ hybridization was performed for AR and ERBB2 genes by an adapted method in CTC. Results: The average age in this patient cohort was 69 years, and median PSA at the time when CTC were drawn was 111 ng/mL (range 0.86–12147 ng/mL). The patterns of metastatic spread included disease in soft tissue only in 12 patients (10%), in bone and soft tissue in 67 (56%), and in bone only in 41 patients (34%). CTC counts ranged from 0 to 1958 cells per 7.5 mL of blood. A large number of patients (54, 45%) had 10 or more circulating tumor cells, while only 33 patients (27.5%) had 1 or less CTC per sample of blood. Significantly higher numbers of CTC were detected in patients with bone metastasis compared to those without bone metastasis (11 vs. 2.5, p<0.01). In patients with marked amplification of AR locus (five patients), tetraploidy was noted in the majority of cases (four cases). Two patients without AR amplification showed apparent tetraploidy, while no analyzed samples (nine) had amplification of ERBB2. Conclusions: The analysis of cancer-related gene alterations in CTC is feasible in a hospital-based laboratory. Further gene expression studies focused on the patients with higher numbers of CTC in correlation with clinical outcomes, as well as the investigation of CTC gene expression during specific treatments are under way. No significant financial relationships to disclose.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 11531-11531
Author(s):  
Katsuhito Takahashi ◽  
Yasutomo Miyaji ◽  
Hajime Higuchi ◽  
Yoshihiro Komohara ◽  
Koichi Doi ◽  
...  

11531 Background: Malignant soft tissue tumor is a rare cancer with few therapeutic options. Although recent genomic characterization of soft tissue sarcoma revealed massive CNA and an excess of polygenic burden of pathological germline variants, their clinical and therapeutic significance remains to be understood. Methods: We recruited 155 patients with malignant soft tissue tumors (135 female and 20 male, mean age 51, 100 LMS, 19 LPS, 4 ESS, 3 UPS, 3 AS, 3 MPT, 3 GIST and others) of confirmed metastasis/recurrence. Whole exome sequencing was performed as reported in 2018ASCO. The MSI status was analyzed by PCR. Tumor immune microenvironment was assessed by immunohistochemistry. Results: Of the 595 COSMIC genes, heterozygous germline mutations/variants of the genome-wide 0-44 genes (av. 9.7/tumor) showed somatic loss-of-heterozygosity (LOH) with allele frequency of more than 70%. Patients with less than 33% LOH (n=53) in the total of somatic and LOH mutations showed improved 5-year survival rate compared with those (n=102) with more LOH (71% vs 52%, p=0.037). LMS (n=100) had higher value of LOH mutations than other tumors (n=55)(av. 55.5 vs 31.2%, p<0.001). Two patients with bone metastasis, one from liver undifferentiated sarcoma (case 1) and the other from uterine LMS (case 2) were identified as MSI-High and resultant higher TMB of 6.48 and 6.60/Mb, respectively than 1.47/Mb in av. Tumors from both cases had de novo mutations of MMR deficiency as EXO I (A153V) and WRN (S1120F) in case 1 and MSH2 (G674D) in case 2. Case 1 with pleural dissemination was treated with 5 cycles of Pembrolizumab (200mg/body, d1 q3weeks) but was progressive disease, while case 2 had no evaluable lesion after surgical removal of bone metastasis. Number of CD8+ T-cell infiltration (TIL), one of the best parameter with response to PD-1 blockade, was much higher in case 2 than in case 1 (av. 907 vs 290/mm2). Case 2 had no LOH mutations while case 1 had 37% LOH with more total mutations in tumor (16.1 vs 85.9/Mb). Higher values of LOH (av. 67 vs 19%) were clearly correlated with decreased density of CD8+TIL in tumor tissues (av. 9.6 vs 429/mm2, n=5, p=0.018). Conclusions: Our results, for the first time, suggest that in malignant soft tissue tumors, accumulation of genome-wide LOH of germline mutations/variants, from which self-antigens could be generated, may influence tumor immune microenvironment, and thus influence immunotherapy response and survival of the patients.


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