The role of positron emission tomography fused with computed tomography (PET/CT) versus CT alone in detecting oligoprogressive disease (OPD) in oncogene-addicted non-small cell lung cancer (NSCLC) receiving tyrosine kinase inhibitor (TKI) therapy.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e20683-e20683
Author(s):  
Terry L. Ng ◽  
Rustain Morgan ◽  
Tejas Patil ◽  
Anna E. Barón ◽  
D. Ross Camidge
Keyword(s):  
Kinase Inhibitor ◽  
Randomized Study ◽  
Time To Progression ◽  
Rank Tests ◽  
Positron Emission ◽  
Pet Ct ◽  
Chi Squared ◽  
Egfr Mutant ◽  
The Impact

e20683 Background: OPD represents limited extra-central nervous system (eCNS) progression. In oncogene-addicted NSCLC, OPD can be treated with local ablative therapy to prolong TKI control. The impact of PET/CT vs CT to detect OPD at first eCNS progression has not been assessed previously. Methods: Patients with metastatic EGFR-mutant (EGFR-MT), ALK or ROS-1 rearranged (ALK+, ROS-1+) NSCLC with eCNS progression on a relevant TKI (2010-2016) were identified. Scan methodology at first eCNS progression was noted and progression was categorized as OPD using 2 definitions (≤ 2 or ≤ 4 progressing lesions) or non-OPD. Median time-to-progression (MTTP) was calculated from start of TKI to first eCNS progression. Data was analyzed using Chi squared and log rank tests as appropriate using p < 0.05 as significant. Results: Sixty-seven patients (EGFR-MT = 37, ALK+ = 28, ROS-1 = 2) were analyzable. OPD (≤ 2 lesions) occurred in 62.5% (20/32) noted by PET/CT vs. 54.3 % (19/35) by CT (p = 0.496). OPD (≤ 4 lesions) occurred in 84.4 % (27/32) noted by PET/CT vs. 65.7 % (23/35) by CT (p = 0.080). MTTP in PET/CT-detected OPD (≤ 2) (N = 20) was 332.5 days vs. 143 days in CT-detected OPD (N = 19) (p = 0.0092). MTTP in PET/CT-detected non-OPD ( > 2) (N = 12) was 185 days vs. 109 days in CT-detected non-OPD (N = 17) (p = 0.0503). MTTP in PET/CT-detected OPD (≤ 4) (N = 27) was 298 days vs. 143 days in CT-detected OPD (N = 23) (p = 0.0128). MTTP in PET/CT-detected non-OPD ( > 4) (N = 5) was 167 days vs. 104.5 days in CT-detected non-OPD (N = 12) (p = 0.1090). Conclusions: In this non-randomized retrospective study the proportion of OPD (≤ 2 or ≤ 4 progressing lesions) at first eCNS progression did not differ significantly for PET/CT vs. CT. MTTP was significantly longer for PET/CT vs CT detected OPD, but not for non-OPD progression. Potentially longer MTTP in the PET/CT OPD subgroup may reflect preselecting patients with disease difficult to detect by CT (e.g., bone/lymph node) which is more indolent. A prospective randomized study is required to assess the true impact of PET/CT vs CT on detecting OPD in oncogene-addicted NSCLC on TKI therapy.

scholarly journals The impact of particulate electron paramagnetic resonance oxygen sensors on fluorodeoxyglucose imaging characteristics detected via positron emission tomography

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Philip E. Schaner ◽  
Ly-Binh-An Tran ◽  
Bassem I. Zaki ◽  
Harold M. Swartz ◽  
Eugene Demidenko ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Oxygen Sensor ◽  
Oxygen Sensors ◽  
Paramagnetic Resonance ◽  
Imaging Characteristics ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
The Impact ◽  
Electron Paramagnetic

AbstractDuring a first-in-humans clinical trial investigating electron paramagnetic resonance tumor oximetry, a patient injected with the particulate oxygen sensor Printex ink was found to have unexpected fluorodeoxyglucose (FDG) uptake in a dermal nodule via positron emission tomography (PET). This nodule co-localized with the Printex ink injection; biopsy of the area, due to concern for malignancy, revealed findings consistent with ink and an associated inflammatory reaction. Investigations were subsequently performed to assess the impact of oxygen sensors on FDG-PET/CT imaging. A retrospective analysis of three clinical tumor oximetry trials involving two oxygen sensors (charcoal particulates and LiNc-BuO microcrystals) in 22 patients was performed to evaluate FDG imaging characteristics. The impact of clinically used oxygen sensors (carbon black, charcoal particulates, LiNc-BuO microcrystals) on FDG-PET/CT imaging after implantation in rat muscle (n = 12) was investigated. The retrospective review revealed no other patients with FDG avidity associated with particulate sensors. The preclinical investigation found no injected oxygen sensor whose mean standard uptake values differed significantly from sham injections. The risk of a false-positive FDG-PET/CT scan due to oxygen sensors appears low. However, in the right clinical context the potential exists that an associated inflammatory reaction may confound interpretation.

The role of CT, PET-CT, and MRI in ovarian cancer

2021 ◽  
Vol 94 (1125) ◽  
pp. 20210117
Author(s):  
Maurits Peter Engbersen ◽  
Willemien Van Driel ◽  
Doenja Lambregts ◽  
Max Lahaye
Keyword(s):  
Ovarian Cancer ◽  
Essential Role ◽  
Advanced Ovarian Cancer ◽  
Emission Tomography ◽  
Current Position ◽  
Positron Emission ◽  
Pet Ct ◽  
New Treatment ◽  
Ct And Mri

New treatment developments in ovarian cancer have led to a renewed interest in staging advanced ovarian cancer. The treatment of females with ovarian cancer patients has a strong multidisciplinary character with an essential role for the radiologist. This review aims to provide an overview of the current position of CT, positron emission tomography-CT, and MRI in ovarian cancer and how imaging can be used to guide multidisciplinary team discussions.

scholarly journals Radionuclide imaging of arterial inflammation in HIV-infected patients with vascular atherosclerosis

2019 ◽  
pp. 45-57
Author(s):  
Pavel Korol ◽  
Oleg Shcherbina
Keyword(s):  
Vascular Inflammation ◽  
Key Words Atherosclerosis ◽  
Infected People ◽  
Positron Emission ◽  
Pathogenic Factors ◽  
Pet Ct ◽  
Arterial Inflammation ◽  
Fdg Pet Ct ◽  
Preclinical And Clinical Studies

The review examined the role of arterial inflammation in atherogenesis and the pathogenic factors responsible for the high risk of cardiovascular diseases (CVD) among HIV-infected patients. Inflammation has been shown to play an important role in all phases of atherosclerotic CVD. HIV-infected patients have an increased tendency to CVD. The most effective radionuclide method of imaging the inflammatory process in the pathogenesis of CVD among HIV-infected people is F-18 FDG PET/CT. At the present stage, several ligands for visualization were synthesized, which were used to identify vascular inflammation in preclinical and clinical studies. These tracers, in addition to F-18 FDG, have significant potential for future use among HIV-infected patients. Key words: atherosclerosis, cardiovascular disease, positron emission tomography, HIV infection.

Radiology of the head and neck

2021 ◽  
pp. 973-976
Author(s):  
Ivan Zammit-Maempel
Keyword(s):  
Head And Neck ◽  
Imaging Techniques ◽  
Cone Beam Ct ◽  
Neck Mass ◽  
Positron Emission ◽  
Pet Ct ◽  
Magnetic Resonance Imaging Mri ◽  
Video Fluoroscopy

Various imaging techniques are used in the staging and follow-up of head and neck cancer and evaluating patients presenting with a neck mass. The workhorses in imaging the neck are ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) with positron emission tomography CT (PET-CT) increasingly being requested. Plain radiographs, contrast studies, video fluoroscopy, angiography, and cone beam CT have limited but important roles. This chapter discusses the role of some of these modalities.

Etiology of Solitary Extrapulmonary Positron Emission Tomography and Computed Tomography Findings in Patients With Lung Cancer

2005 ◽  
Vol 23 (28) ◽  
pp. 6846-6853 ◽  
Author(s):  
Didier Lardinois ◽  
Walter Weder ◽  
Marina Roudas ◽  
Gustav K. von Schulthess ◽  
Michaela Tutic ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Positron Emission Tomography ◽  
Ct Imaging ◽  
Emission Tomography ◽  
Whole Body ◽  
Benign Tumors ◽  
Positron Emission ◽  
Pet Ct ◽  
The Impact

Purpose The aim of this prospective study was to assess the incidence and the nature of solitary extrapulmonary [18F] fluorodeoxyglucose (FDG) accumulations in patients with non–small-cell lung cancer (NSCLC) staged with integrated positron emission tomography and computed tomography (PET/CT) and to evaluate the impact on management. Patients and Methods A total of 350 patients with NSCLC underwent whole-body PET/CT imaging. All solitary extrapulmonary FDG accumulations were evaluated by histopathology, further imaging, or clinical follow-up. Results PET/CT imaging revealed extrapulmonary lesions in 110 patients. In 72 patients (21%), solitary lesions were present. A diagnosis was obtained in 69 of these patients, including 37 (54%) with solitary metastases and 32 (46%) with lesions unrelated to the lung primary. Histopathologic examinations of these 32 lesions revealed a second clinically unsuspected malignancy or a recurrence of a previous diagnosed carcinoma in six patients (19%) and a benign tumor or inflammatory lesion in 26 patients (81%). The six malignancies consisted of carcinoma of the breast in two patients, and carcinoma of the orbit, esophagus, prostate, and non-Hodgkin's lymphoma in one patient each. Benign tumors and inflammatory lesions included eight colon adenomas, four Warthin's tumors, one granuloma of the lower jaw, one adenoma of the thyroid gland, one compensatory muscle activity due to vocal chord palsy, two occurrences of arthritis, three occurrences of reflux esophagitis, two occurrences of pancreatitis, two occurrences of diverticulitis, one hemorrhoidal inflammation, and one rib fracture. Conclusion Solitary extrapulmonary FDG accumulations in patients with newly diagnosed lung cancer should be analyzed critically for correct staging and optimal therapy, given that up to half of the lesions may represent unrelated malignancies or benign disease.

scholarly journals P273 The role of multimodality imaging in the evaluation of arteritis

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
T M Matajira Chia ◽  
M Castineira Busto ◽  
M Cespon Fernandez ◽  
B Gimena Reyes ◽  
F Calvo Iglesias ◽  
...  
Keyword(s):  
Antinuclear Antibodies ◽  
Aortic Wall ◽  
Multimodality Imaging ◽  
Lateral Wall ◽  
Ascending Aorta ◽  
Iliac Arteries ◽  
Positron Emission ◽  
Nuclear Antigens ◽  
Pet Ct

Abstract A 61-year-old man was admitted to the hospital with an atypical pain lumbar with oligoanuria. Other comorbidities were: arterial hypertension, diabetes mellitus and smoking .On examination the patient was comfortable at rest, with a heart rate of 89 b.p.m. and a blood pressure of 147/2 mmHg. Normal S1 and S2 heart sounds were present. There were no signs of heart failure present. Patients complained of pain in hypogastrium on palpation. Creatinine 2.33 mg / dL. PCR 72. The immunological studies were normal (including IgG and IgA serological levels, antinuclear antibodies, extractable nuclear antigens, anti-neutrophil cytoplasmic antibodies. An Body CT was performed, it shows mass that includes the ureters as well as the iliac arteries and parietal thickening in aorta wall. The positron emission tomography–computed tomography (PET CT) scans was performed that evidences pathological hypermetabolism that surrounds both primitive iliac arteries with maximum SUV 12 g / ml. Pathological hypermetabolism in ascending aorta until reaching arch with maximum SUV of 9.1 mg / ml compatible with periaortitis in the ascending aorta. A study was completed with retroperitoneal mass biopsy that showed areas of retroperitoneal fibrosis with predominantly lymphoplasmacytic areas. IgG4 / IgG&gt; 40% , Obliterative involvement of small venules suggestive of IgG4 disease. A transthoracic echocardiogram was performed which showed normal biventricular function, absence of significant valvular disease and thickening of the aortic wall compatible with periaortitis. The patient started glucocorticoid therapy with favorable response. A PET CT control was performed that showed disappearing retroperitoneal masses around iliac vessels and disappearance of activity in lateral wall of aorta and decrease activity about ascendent aorta. DIAGNOSIS : IgG4 -related aortitis Abstract P273 Figure.

scholarly journals EGFR-Mutant Lung Adenocarcinoma Mimicking a Pneumonia

2012 ◽  
Vol 2012 ◽  
pp. 1-2
Author(s):  
Álvaro Taus ◽  
Flavio Zuccarino ◽  
Carlos Trampal ◽  
Edurne Arriola
Keyword(s):  
Lung Cancer ◽  
Lung Adenocarcinoma ◽  
Ct Scan ◽  
Kinase Inhibitor ◽  
Specific Treatment ◽  
Diagnostic Errors ◽  
Pet Ct ◽  
Egfr Mutant ◽  
Histological Confirmation ◽  
Pet Ct Scan

PET-CT scan has demonstrated to be very effective in lung cancer diagnosis and staging, but lung cancer has multiple ways of presentation, which can lead to an error in diagnosis imaging and a delay on the beginning of specific treatment. We present a case of a 77-year-old man with an initial PET-CT scan showing high 18F-FDG intake, suggesting a bilateral pneumonia, who was finally diagnosed of an EGFR-mutant lung adenocarcinoma. EGFR-activating mutation allowed us to start treatment with the oral tyrosin kinase inhibitor Gefitinib, obtaining a rapid and sustained response. Histological confirmation of imaging findings is always necessary to avoid diagnostic errors.

Role of Functional Imaging in the Management of Lymphoma

2011 ◽  
Vol 29 (14) ◽  
pp. 1844-1854 ◽  
Author(s):  
Bruce D. Cheson
Keyword(s):  
Fdg Pet ◽  
B Cell Lymphoma ◽  
Post Treatment ◽  
Metabolic Imaging ◽  
Interim Pet ◽  
Positron Emission ◽  
Pet Ct ◽  
Pretreatment Assessment ◽  
Pet Scans

18-F-fluorodeoxyglucose (FDG) –positron emission tomography (PET), and more recently PET/computed tomography (CT), is the most sensitive and specific imaging technique currently available for patients with lymphoma. Nevertheless, despite being increasingly used in pretreatment assessment, midtreatment evaluation of response, post-treatment restaging, and surveillance during follow-up of patients with lymphoma, its impact on clinical outcome in most clinical situations remains to be confirmed. PET/CT provides its greatest clinical benefit in the post-treatment evaluation of Hodgkin's lymphoma and diffuse large B-cell lymphoma; however, the role of metabolic imaging in other indications and in other histologies remains to be demonstrated. Ongoing risk-adapted studies will hopefully provide evidence for clinical improvement on the basis of altering treatment as a result of interim PET results. Efforts are ongoing to better standardize the conduct and interpretation of FDG-PET scans. FDG-PET has the potential to improve lymphoma patient management; however, its usefulness will likely vary by histology, stage, therapy, and clinical setting.

scholarly journals PET Imaging in Recurrent Medullary Thyroid Carcinoma

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Giorgio Treglia ◽  
Vittoria Rufini ◽  
Massimo Salvatori ◽  
Alessandro Giordano ◽  
Luca Giovanella
Keyword(s):  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Fdg Pet ◽  
Medullary Thyroid ◽  
Primary Surgery ◽  
Pet Tracer ◽  
Positron Emission ◽  
Pet Ct ◽  
Pet Radiopharmaceuticals

Purpose. To perform an overview about the role of positron emission tomography (PET) or PET/computed tomography (PET/CT) using different radiopharmaceuticals in recurrent medullary thyroid carcinoma (MTC) based on biochemical findings (increased tumor marker levels after primary surgery). Methods. A comprehensive literature search of studies published in PubMed/MEDLINE, Scopus, and Embase databases through February 2012 regarding PET or PET/CT in patients with recurrent MTC was performed. Results. Twenty-nine studies comprising 714 patients with suspected recurrent MTC were retrieved. Twenty-seven articles evaluated the role of fluorine-18-fluorodeoxyglucose (FDG) PET or PET/CT in recurrent MTC with conflicting results. Diagnostic accuracy of FDG-PET and PET/CT increased in MTC patients with higher calcitonin and carcinoembryonic antigen values, suggesting that these imaging methods could be very useful in patients with more advanced and aggressive disease. Eight articles evaluated the role of fluorine-18-dihydroxyphenylalanine (FDOPA) PET or PET/CT in recurrent MTC reporting promising results. Overall, FDOPA seems to be superior but complementary compared to FDG in detecting recurrent MTC. Few studies evaluating other PET tracers are also discussed. Conclusions. PET radiopharmaceuticals reflect different metabolic pathways in MTC. FDOPA seems to be the most useful PET tracer in detecting recurrent MTC based on rising levels of tumor markers. FDG may complement FDOPA in patients with more aggressive MTC.

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