scholarly journals [18 F]-Fludarabine Positron Emission Tomography in Diffuse Large B-Cell Lymphoma (DLBCL) Patients: Results of a Phase I Study

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 3917-3917
Author(s):  
Sylvain P Chantepie ◽  
Narinée Hovhannisyan ◽  
Stéphane Guillouet ◽  
Alain Manrique ◽  
Oumedaly Reman ◽  
...  

Abstract Introduction: [18 F]-Fludarabine is a promising novel positron emission tomography (PET) radiotracer for lymphoid malignancies. The rationale for its development is the high selectivity of fludarabine uptake within lymphoid cells, irrespective of their cycle activity, and the fluorine atom within the molecule, which is replaced by [18 F] and leads to a positron emitting biomarker. Pre-clinical studies (Dhilly et al, Mol Imaging Biol 2014,16:118-26 ; Hovhannisyan et al, EJNMMI Res 2015,5:23) showed a marked tumor uptake in lymphoma-bearing mice. The aim of this study was to describe anatomical sites with abnormal [18F]-fludarabine uptake in DLBCL patients. This study was designed as a clinical proof of concept. Methods: [18F]-Fludarabine was produced according to a method already described (Guillouet et al, Mol Imaging Biol 2014,16:28-35). [18F]-Fludarabine PET/CT (Discovery RX VCT 64, GE Healthcare) was performed in 5 histologically confirmed and treatment naïve DLBCL patients (65 ± 8 years old). Successive partial body PET scans (skull vertex to mid-thigh) were acquired for 250 min after intravenous injection of [18F]-fludarabine with an activity of 4MBq/kg. PET images were analyzed drawing VOIs over the uptake sites on a late scan and projected onto all co-registered scans of the same subject. The intensity of tracer uptake was evaluated with standardized uptake value (SUVmax). The performance of [18F]fludarabine PET/CT was visually compared with conventional assessments (high-resolution CT) and [18F]-FDG PET. Results: CT and [18F]-FDG PET staging of the 5 patients was I to IV. No adverse event was recorded during and after the procedure. In all 5 patients, the uptake of [18F]-fludarabine coincides with sites expected to be involved following conventional staging. SUVmax were significantly higher in involved sites in comparison with non-lymphoma sites (Figure 1). As previously demonstrated in an animal model, we found no uptake in the cardiac muscle and brain in contrast to [18F]-FDG PET. Bone marrow was histologically normal in the 5 patients and [18F]-fludarabine PET displayed no hypermetabolism. A progressive splenic uptake (x4 to x8 at 250 min) was observed in every patient. The possibility of an unexpected splenic infiltration appears to be a better explanation than uptake by physiologically normal lymphoid tissue. Comparison of [18F]-FDG and [18F]-fludarabine PET showed discrepancies in 2 patients. The first had bilateral hilar [18F]-FDG uptakes (Figure 1C), not present in [18F]-fludarabine PET, which persisted on [18F]-FDG PET after completion of the treatment and disappearance of all suspected pathological sites. This pattern suggests a non-specific [18F]-FDG hypermetabolism. The second patient had a right testis positive [18F]-FDG PET, not evident with [18F]-fludarabine PET. Histology of the testis confirmed the presence of NHL. The interpretation of this would require further extensive data. Conclusion: [18F]-Fludarabine PET/CT appears to be a promising tool to diagnose discordance and follow-up NHL. These preliminary results showed a clear specificity of this novel radiotracer for lymphoma tissues and support the development of this innovative biomarker for lymphoproliferative diseases. Studies for a more detailed comparison with [18F]-FDG PET are in progress. Figure 2. Figure 2. Disclosures No relevant conflicts of interest to declare.

2021 ◽  
Author(s):  
Özlem Şahin ◽  
Buğra Kaya ◽  
Zeynep Aydın ◽  
Ahmet Eren Şen ◽  
Mehmet Sinan İyisoy ◽  
...  

Abstract Objective To evaluate whether volumetric PET parameters such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG) contributed to maximum standardized uptake value (SUVmax) in predicting prostate carcinoma in the prostate incidentalomas (PI) in 18F-FDG PET/CT. Materials and methods This retrospective study comprised 107 patients with PI of 4723 male patients who had undergone 18F-FDG PET/CT. SUVmax and volumetric PET parameters of PIs were assessed. MTV and TLG were acquired with each SUV threshold as 2.5, 3.0, 3.5, 4.0, 4.5, and 5.0. Results The PI incidence was 2.3%, and the malignancy ratio of PI was 15.9%. According to further analysis results, 17 patients were in the malignant group, and 46 patients were in the benign group. Malignant PIs had higher SUVmax (10.6 vs. 6.4 and p<0.01), MTV (all p < 0.01) and TLG (all p < 0.01) than benign incidentalomas. All volumetric PET parameters had higher area under the curve (AUC) than SUVmax. SUVmax AUC was 0.835 [95% confidence interval (CI): 0.728–0.942]. MTV 2.5 and TLG 2.5 had the highest performance for predicting malignant PI.MTV2.5 AUC was 0.871 (95% CI: 0.775–0.968), and TLG2.5 AUC was 0.882 (95% CI: 0.797–0.967). Using TLG 2.5 greater than 29.8 as the cut-off point, the sensitivity and specificity for malignancy prediction were 94.1% and 82.6%, respectively. Conclusion In this study, in which the effectiveness of volumetric parameters in the diagnosis of PI was evaluated for the first time, it was shown that they could potentially have clinical value along with SUVmax.


2021 ◽  
Vol 5 (1) ◽  
pp. 1151-1160
Author(s):  
A.S. Lukashevich ◽  

Purpose. The purpose of the article is to evaluate the diagnostic significance of positron emission tomography / computed tomography with 18F -fluorodeoxyglucose (18F -FDG PET/CT) for the diagnosis of prosthetic endocarditis. Methods of research. The study included 82 patients with suspected prosthetic endocarditis in accordance with the criteria proposed by Duke University [1-5]. The patients received hospital treatment at the State Institution RSPC "Cardiology" from January 2016 to March 2021. The study was of a prospective, non-randomized, single-center cohort design. The duration of the monitor period was 12 months from the moment of patients’ inclusion in the study. Whole-body positron emission tomography / computed tomography (PET/CT) examinations were performed in 82 patients. 27 patients were selected for surgical treatment. Conservative treatment group included 16 patients. 27 patients were selected into the observation group, they were suspected to have prosthetic heart valve infection in the primary referral and underwent PET/CT scanning, according to which the diagnosis of prosthetic endocarditis was excluded. The event under the study did not develop in this group during the year of observation. Results and conclusion. The history of infective endocarditis was not statistically significant and did not increase the risk of developing prosthetic endocarditis in the sample presented. The Duke criteria are less reliable in establishing the diagnosis of prosthetic endocarditis. The median number of days from the date of the first prosthesis implantation to the onset of prosthetic endocarditis was about 4 years. This study revealed that the development of the infectious process in the area of the prosthesis was noted in a more distant postoperative period compared to literature data. Histological confirmation of infection was noted in 100% (27 patients) of cases in reoperated patients. The presence of a more formidable complication such as valve ring abscess located mainly in the projection of the aortic valve ring was quite common in both groups. Presepsin and Interleukin-6 have a statistically significant (U = 394,50 p = 0,01 and U = 94,50 p = 0.004) value in the prognosis of prosthetic endocarditis. Considering the data obtained from ROC analysis, it can be said that the cut-off point at which it is possible to diagnose prosthetic endocarditis based on PETCT is 2.85. The presented methods for the interpretation of whole-body FDG-PET/CT images of patients with suspected infectious complications after cardiac surgery, as well as with the presence of prosthetic endocarditis, show high sensitivity and specificity.


Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1042
Author(s):  
Annachiara Arnone ◽  
Riccardo Laudicella ◽  
Federico Caobelli ◽  
Priscilla Guglielmo ◽  
Marianna Spallino ◽  
...  

In this review, the performance of fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in the diagnostic workup of pancreatic ductal adenocarcinoma (PDAC) is evaluated. A comprehensive literature search up to September 2020 was performed, selecting studies with the presence of: sample size ≥10 patients and index test (i.e., “FDG” or “18F-FDG” AND “pancreatic adenocarcinoma” or “pancreas cancer” AND “PET” or “positron emission tomography”). The methodological quality was evaluated using the revised quality assessment of diagnostic accuracy studies (QUADAS-2) tool and presented according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Basic data (authors, year of publication, country and study design), patients’ characteristics (number of enrolled subjects and age), disease phase, type of treatment and grading were retrieved. Forty-six articles met the adopted research criteria. The articles were divided according to the considered clinical context. Namely, besides conventional anatomical imaging, such as computed tomography (CT) and magnetic resonance imaging (MRI), molecular imaging with FDG PET/CT is an important tool in PDAC, for all disease stages. Further prospective studies will be necessary to confirm the cost-effectiveness of such imaging techniques by testing its real potential improvement in the clinical management of PDAC.


Medicina ◽  
2021 ◽  
Vol 57 (12) ◽  
pp. 1289
Author(s):  
Mio Mori ◽  
Kazunori Kubota ◽  
Tomoyuki Fujioka ◽  
Leona Katsuta ◽  
Yuka Yashima ◽  
...  

We used virtual navigator real-time ultrasound (US) fusion imaging with 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) to identify a lesion that could not be detected on the US alone in a preoperative breast cancer patient. Of the patient’s two lesions of breast cancer, the calcified lesion could not be identified by US alone. By fusing US with 18F-FDG PET/CT, which had been performed in advance, the location of the lesion could be estimated and marked, which benefited planning an appropriate surgery. The fusion of US and 18F-FDG PET/CT was a simple and noninvasive method for identifying the lesions detected by 18F-FDG PET/CT.


Diagnostics ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 101
Author(s):  
Veronika Ballova ◽  
Barbara Muoio ◽  
Domenico Albano ◽  
Francesco Bertagna ◽  
Luca Canziani ◽  
...  

Background: Some studies evaluated the diagnostic performance of fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography or positron emission tomography/computed tomography (PET or PET/CT) for the detection of post-transplant lymphoproliferative disorder (PTLD). As there is no clear consensus about the diagnostic accuracy of these imaging methods, we performed a meta-analysis on this topic. Methods: A comprehensive computer literature search of PubMed, Embase, and Cochrane library databases through December 2019 was performed. Pooled sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR−), and diagnostic odds ratio (DOR) of 18F-FDG PET or PET/CT for detection of PTLD were calculated. Results: Five studies reporting data on the diagnostic performance of 18F-FDG PET or PET/CT in 336 transplant recipients were included in the systematic review and bivariate meta-analysis. Pooled sensitivity and specificity for detection of PTLD were 89.7% (95% confidence interval (95%CI): 84.6–93.2%) and 90.9% (95%CI: 85.9–94.3%), respectively. Pooled LR+, LR−, and DOR were 8.9 (95%CI: 5.7–14), 0.13 (95%CI: 0.08–0.2), and 70.4 (95%CI: 35.4–140), respectively. A significant heterogeneity among studies was not detected. Conclusions: Despite limited literature data, 18F-FDG PET or PET/CT demonstrated good diagnostic performance for the detection of PTLD, but large prospective studies are needed to strengthen these findings.


CNS Oncology ◽  
2019 ◽  
Vol 8 (4) ◽  
pp. CNS46 ◽  
Author(s):  
Meetakshi Gupta ◽  
Tejpal Gupta ◽  
Nilendu Purandare ◽  
Venkatesh Rangarajan ◽  
Ameya Puranik ◽  
...  

Aim: To prospectively assess the clinical utility of pretreatment flouro-deoxy-glucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in patients with primary central nervous system (CNS) lymphoma (PCNSL). Materials & methods: Patients with suspected/proven PCNSL underwent baseline whole-body 18F-FDG-PET/CT. Maximum standardized uptake value and tumor/normal tissue ratios were compared between CNS lymphoma and other histological diagnoses. Results: The mean maximum standardized uptake value (27.5 vs 18.2; p = 0.001) and mean tumor/normal tissue ratio (2.34 vs 1.53; p < 0.001) of CNS lymphoma was significantly higher than other histologic diagnoses. Five of 50 (10%) patients with biopsy-proven CNS lymphomas had pathologically increased FDG-uptake at extraneuraxial sites uncovering systemic lymphoma. Conclusion: Pretreatment whole-body 18F-FDG-PET/CT provides valuable complementary information in the diagnostic and staging evaluation of patients with PCNSL to guide therapeutic decision-making.


Cancers ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 317
Author(s):  
Freba Ahmaddy ◽  
Caroline Burgard ◽  
Leonie Beyer ◽  
Viktoria Florentine Koehler ◽  
Peter Bartenstein ◽  
...  

Background: The tyrosine kinase inhibitor (TKI) Lenvatinib represents one of the most effective therapeutic options in patients with advanced radioiodine refractory differentiated thyroid carcinoma (DTC). We aimed to assess the role of 2-deoxy-2-[18F] fluoro-D-glucose positron-emission-tomography/computed-tomography (18F-FDG-PET/CT) in the monitoring of functional tumor response compared to morphological response. Methods: In 22 patients, a modified Positron Emission Tomography Response Criteria In Solid Tumors (mPERCIST) evaluation before treatment with Lenvatinib and at 3 and 6 month follow up was performed. Further PET-parameters and morphologic tumor response using Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 were assessed and their prediction of progression-free survival (PFS) and disease-specific survival (DSS) was evaluated. Results: Most patients were rated stable in morphological evaluation and progressive using a metabolic response. All patients who responded to therapy through RECIST showed a decline in nearly all Positron Emission Tomography (PET)-parameters. For both time-points, non-responders according to mPERCIST showed significantly lower median PFS and DSS, whereas according to RECIST, only DSS was significantly lower. Conclusion: Tumor response assessment by 18F-FDG-PET outperforms morphological response assessment by CT in patients with advanced radioiodine refractory DTC treated with Lenvatinib, which seems to be correlated with clinical outcomes.


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