Pilot study to enhance FDG-PET imaging of prostate cancers with the metabolic inhibitor ranolazine.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e16551-e16551
Author(s):  
Isabel R. Schlaepfer ◽  
Elizabeth R Kessler ◽  
Jennifer J Kwak ◽  
Lauren Liebman ◽  
Paul Maroni ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Pilot Study ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Imaging Modality ◽  
Small Sample ◽  
Metabolic Inhibitor ◽  
Acid Oxidation ◽  
Absolute Change ◽  
Fdg Uptake

e16551 Background: 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography (FDG-PET) is a widely-used imaging modality for many cancers; however, its utility in prostate cancer is limited. Fatty acid oxidation (FAO) is a primary source of energy for early prostate cancer. We previously demonstrated that FAO inhibition in prostate cancer mouse models resulted in increased glucose metabolism and enhanced tumor FDG uptake, with peak uptake at 24 hours. To validate these preclinical findings, we conducted a pilot study to evaluate whether a partial FAO inhibitor, ranolazine, increases tumor FDG uptake on PET imaging for prostate cancer. Methods: Prostate cancer patients with untreated localized cancer (arm 1) and with metastatic disease on hormonal or other therapy (arm 2) were enrolled and underwent baseline and post-treatment FDG-PET/CT scans (standard dose of 10 mCi FDG). Ranolazine 1000mg PO BID x 2 doses was given within 24-48 hours of the second scan. The primary objective was to evaluate the rate of successful enhancement of FDG uptake on PET imaging, based on one or more of the following criteria: 30% increase in maximum SUV with an absolute change of 2 units; 30% increase in mean SUV with an absolute change of 0.75 units; or 20% increase in mean SUV with an absolute change of 1 unit. Results: Eleven patients (four in arm 1, seven in arm 2) were enrolled. Ranolazine was well tolerated by all participants, with no adverse effects observed. Both increases and decreases in SUV uptake were observed on the post-ranolazine scans. No patient met the predefined criteria for successful enhancement of FDG uptake. There was an incidental finding of thyroid cancer seen in one patient that was discovered on PET imaging. The study was closed early due to the emerging clinical availability of alternative and effective PET imaging modalities such as [11C] choline, [18F] fluciclovine, [68Ga] PSMA, and [18F] sodium fluoride. Conclusions: Given the small sample size, we were not able to make any firm conclusions. In this limited study, ranolazine treatment did not result in enhanced FDG-PET-tumor detection. ClinicalTrials.gov identifier: NCT01992016. Supported by the William Meyn Foundation; NIH/NCI P30CA46934, 5K12CA086913, CA168934; ACS RSG-16-256-01-TBE; Colorado Translational Research Imaging Center Pilot Award; Paul Sandoval Cancer Research Summer Fellowship. Clinical trial information: NCT01992016.

Tumor-directed PET imaging of bone metastases in metastatic castration-resistant prostate cancer (mCRPC) using Zr-89 labeled anti-prostate specific membrane antigen (PSMA) antibody J591.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 25-25 ◽  
Author(s):  
Michael J. Morris ◽  
Neeta Pandit-Taskar ◽  
Scott T. Tagawa ◽  
David M. Nanus ◽  
Stephen Barnett Solomon ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Imaging Modality ◽  
Bone Lesions ◽  
Castration Resistant Prostate Cancer ◽  
Cancer Metastases ◽  
External Domain ◽  
Tumor Distribution ◽  
Bone Scans

25 Background: There is no standard imaging modality that specifically and accurately images prostate cancer metastases, hampering assessments of tumor distribution, prognostication, and response. J591 is a humanized antibody that targets the external domain of PSMA, which is copiously expressed in metastatic disease and upregulated in mCRPC. We have previously reported on the feasibility, and PK and biodistribution properties of Zr-89-J591 in 10 patients (Morris et al, GU ASCO 2013). We now report on the targeting/accuracy in 49 patients with mCRPC. Methods: Following standard CT/MRI, bone scintigraphy, and FDG PET imaging, 5 mCi of Zr-89-J591 was administered intravenously. Zr-89-J591 was imaged 6-8 days after injection. Positive scan findings were confirmed, where possible, with biopsies in the following preference: Zr-89-J591 and FDG positivity, then Zr-89-J591 and FDG mismatch, and lastly standard imaging and any PET mismatch. Results: A total of 535 unique bone lesions in 49 patients were identified using all imaging modalities. 339 (63%) of these were evident on bone scans, 302 (56%) on CT, 202 (38%) on FDG PET, and 490 (92%) on Zr-89-J591 PET. The concordance between bone scans and Zr-89-J591 was 303/490 (62%). 102 sites were seen only on Zr-89-J591 and not on any other imaging modality. 44 biopsies were performed from 33 patients; 21 of those biopsies were bone. The histopathologic correlation for bone is provided in the table below. All positive biopsies were J591 positive (16/16); sensitivity of J591 was =100%, and positive predictive value (16/18) was 89%. Conclusions: Imaging using J591 PET/CT detects bone disease at greater rates than any other imaging modality tested. Biopsy data of J591 positive lesions suggest that most J591 positive lesions represent biopsy confirmed prostate metastasis. We are now testing minibodies based on J591 that may target faster, offering a more favorable imaging schedule. Clinical trial information: NCT01543659. [Table: see text]

Pilot Study: Texture Analysis of PET Imaging Demonstrates Changes in 18F-FDG Uptake of the Brain After Prophylactic Cranial Irradiation

2020 ◽  
Vol 49 (1) ◽  
pp. 34-38
Author(s):  
David M. Sawyer ◽  
Travis W. Sawyer ◽  
Naghmehossadat Eshghi ◽  
Charles Hsu ◽  
Russell J. Hamilton ◽  
...  
Keyword(s):  
Pilot Study ◽  
Texture Analysis ◽  
Pet Imaging ◽  
Cranial Irradiation ◽  
Prophylactic Cranial Irradiation ◽  
Fdg Uptake ◽  
18F Fdg ◽  
The Brain

scholarly journals Temporal metabolic response to mRNA COVID-19 vaccinations in oncology patients

2021 ◽  
Vol 35 (11) ◽  
pp. 1264-1269 ◽  
Author(s):  
Pooja Advani ◽  
Saranya Chumsri ◽  
Tanmayi Pai ◽  
Zhuo Li ◽  
Akash Sharma ◽  
...  
Keyword(s):  
Immune Response ◽  
Lymph Nodes ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Time Course ◽  
Metabolic Response ◽  
Standard Of Care ◽  
Oncology Patients ◽  
Absolute Change

Abstract Background mRNA COVID-19 vaccines are known to provide an immune response seen on FDG PET studies. However, the time course of this metabolic response is unknown. We here present a temporal metabolic response to mRNA COVID-19 vaccination in oncology patients undergoing standard of care FDG PET. Methods 262 oncology patients undergoing standard of care FDG PET were included in the analysis. 231 patients had at least one dose of mRNA COVID-19 vaccine while 31 patients had not been vaccinated. The SUVmax of the lymph nodes ipsilateral to the vaccination was compared to the contralateral to obtain an absolute change in SUVmax (ΔSUVmax). Results ΔSUVmax was more significant at shorter times between FDG PET imaging and COVID-19 mRNA vaccination, with a median ΔSUVmax of 2.6 (0–7 days), 0.8 (8–14 days), and 0.3 (> 14 days), respectively. Conclusion Consideration should be given to performing FDG PET at least 2 weeks after the COVID-19 vaccine.

scholarly journals Additional Value of PET Radiomic Features for the Initial Staging of Prostate Cancer: A Systematic Review from the Literature

Cancers ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 6026
Author(s):  
Priscilla Guglielmo ◽  
Francesca Marturano ◽  
Andrea Bettinelli ◽  
Michele Gregianin ◽  
Marta Paiusco ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Imaging Modality ◽  
Small Sample ◽  
High Order ◽  
Lesion Detection ◽  
Qualitative Assessment ◽  
Number Of Patients ◽  
Additional Value ◽  
Initial Staging

We performed a systematic review of the literature to provide an overview of the application of PET radiomics for the prediction of the initial staging of prostate cancer (PCa), and to discuss the additional value of radiomic features over clinical data. The most relevant databases and web sources were interrogated by using the query “prostate AND radiomic* AND PET”. English-language original articles published before July 2021 were considered. A total of 28 studies were screened for eligibility and 6 of them met the inclusion criteria and were, therefore, included for further analysis. All studies were based on human patients. The average number of patients included in the studies was 72 (range 52–101), and the average number of high-order features calculated per study was 167 (range 50–480). The radiotracers used were [68Ga]Ga-PSMA-11 (in four out of six studies), [18F]DCFPyL (one out of six studies), and [11C]Choline (one out of six studies). Considering the imaging modality, three out of six studies used a PET/CT scanner and the other half a PET/MRI tomograph. Heterogeneous results were reported regarding radiomic methods (e.g., segmentation modality) and considered features. The studies reported several predictive markers including first-, second-, and high-order features, such as “kurtosis”, “grey-level uniformity”, and “HLL wavelet mean”, respectively, as well as PET-based metabolic parameters. The strengths and weaknesses of PET radiomics in this setting of disease will be largely discussed and a critical analysis of the available data will be reported. In our review, radiomic analysis proved to add useful information for lesion detection and the prediction of tumor grading of prostatic lesions, even when they were missed at visual qualitative assessment due to their small size; furthermore, PET radiomics could play a synergistic role with the mpMRI radiomic features in lesion evaluation. The most common limitations of the studies were the small sample size, retrospective design, lack of validation on external datasets, and unavailability of univocal cut-off values for the selected radiomic features.

Diffuse Bone Marrow Involvement of Hodgkin Lymphoma Mimics Hematopoietic Cytokine-Mediated FDG uptake on FDG PET Imaging

2003 ◽  
Vol 28 (8) ◽  
pp. 674-676 ◽  
Author(s):  
Stephen B. Chiang ◽  
Alan Rebenstock ◽  
Liang Guan ◽  
Abass Alavi ◽  
Hongming Zhuang
Keyword(s):  
Bone Marrow ◽  
Hodgkin Lymphoma ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Bone Marrow Involvement ◽  
Fdg Uptake

FDG-PET Predicts Response to Fractionated Radioimmunotherapy with 90Y-Epratuzumab Anti-CD22 MAB in Patients with NHL.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4782-4782
Author(s):  
Caroline Bodet-Milin ◽  
Caroline Rousseau ◽  
Loic Campion ◽  
Catherine Ansquer ◽  
Benoit Dupas ◽  
...  
Keyword(s):  
Pet Imaging ◽  
Fdg Pet ◽  
Residual Disease ◽  
Complete Response ◽  
Standard Uptake Value ◽  
Ct Scans ◽  
Fdg Uptake ◽  
Focal Uptake ◽  
Progression Of Disease ◽  
Conventional Ct

Abstract Objective: To evaluate FDG-PET imaging for early prediction of response in patients with NHL treated with fractionated radioimmunotherapy (RIT). Methods: Ten patients from a larger ongoing, multicenter, Phase I/II trial of fractionated RIT (2–3 injections 1-week apart of humanized anti-CD22 antibody, epratuzumab, labeled with 90Y) underwent FDG-PET imaging together with CT scans of the chest, abdomen and pelvis at baseline and 6 weeks post-RIT, and then every 3 months until progression. Tumor responses evaluated from CT images were classified using Cheson lymphoma criteria as complete response (CR), unconfirmed CR (CRu), partial response (PR), stable disease (SD) or progression of disease (PD). PET images were evaluated for abnormal focal uptake visually, using standard uptake value (SUV) quantitation, and were classified as CR when all tumor foci disappeared, incomplete response (IR) when FDG uptake decreased with persistent foci, or PD when FDG uptake increased or new foci developed. Results: A total of 36 paired imaging studies were obtained post RIT (including 3 patients after retreatment) and evaluated as CR (n=7), CRu (n=14), SD (n=5) or PD (n=10) by CT and CR (n= 13), IR (n= 8) or PD (n=15) by PET. Of the 14 studies evaluated as CRu by CT, 7 were definitively evaluated by PET as CR, 3 as IR, and 4 as PD. Of 22 studies not evaluated as CRu by CT, PET identified PD in one case evaluated as CR by CT and was otherwise concordant with CT (10 PD/PD, 6 CR/CR, 5 SD/IR). Among PET images acquired at 6 weeks post-RIT, the mean time-to-progression (TTP) was 9.6 months for negative PET images (CR) compared to 4.1 months for positive PET findings (IR, PD) (P=0.16). Conclusion: In our study, FDG-PET appeared superior to conventional CT in evaluating response to fractionated RIT. For CT scans frequently evaluated as CRu, PET resolved uncertainty regarding residual disease, and PET images acquired 6 weeks after RIT predicted later relapse.

Response to neoadjuvant chemotherapy as measured by PET predicts outcome after liver resection for colorectal metastases

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 3056-3056 ◽  
Author(s):  
T. J. Akhurst ◽  
M. Gonen ◽  
S. Tuorto ◽  
L. Schwartz ◽  
L. Brody ◽  
...  
Keyword(s):  
Liver Resection ◽  
Neoadjuvant Chemotherapy ◽  
Liver Metastases ◽  
Fdg Pet ◽  
Imaging Modality ◽  
Prognostic Significance ◽  
Clinical Parameter ◽  
Colorectal Metastases ◽  
Clinical Predictors ◽  
Fdg Uptake

3056 Background: Patients with hepatic colorectal metastases are often treated with neoadjuvant chemotherapy prior to liver resection. FDG PET is a standard imaging modality for such patients. We have shown the amount of FDG uptake in liver metastases is reduced by recent chemotherapy (chemo) administration and this is associated with a reduction in FDG uptake mediated by a reduction in hexokinase activity. We sought to determine if the amount of FDG uptake in the hepatic colorectal metastasis post chemo correlates with survival and to compare the prognostic significance of this single biologic scan to standard clinical predictors of outcome. Methods: A group of 149 patients enrolled in a prospective clinical trial examining the efficacy of FDG PET imaging in patients undergoing hepatic resection of colorectal cancer metastases to the liver formed the dataset. The maximal SUV within the liver was recorded for each patient, and the median of those maximums was determined across the patient group. Patients were then stratified by the median SUV, by the presence or absence of any chemo within 6 months of PET and by the clinical risk score (CRS) (a standard score for prognosis based on five clinical parameter (nodal status of primary, disease-free interval before liver metastases, size of largest liver tumor, number of tumors, and CEA). Multivariate analysis (MVA) and hazard ratios of death (HRD) were assessed. Results: The median of maximal SUVs was 7.9. In MVA in the patients without recent chemo, the CRS≥3 was an excellent predictor of survival (HRD=2.53; p=0.008), while SUV>8 was not (HRD=1.02; p=0.96). Conversely, in patients who had chemo within 6 months, SUV>8 (HRD 3.34; p=0.03) was a much superior predictor of outcome than CRS≥3 (HRD=1.25; p=0.57). Conclusions: In those patients without recent chemo CRS is the best predictor of survival confirming the utility of this scoring system, In those patients who had had chemo within 6 months of PET prior to surgery PET SUV was the best predictor of survival. No significant financial relationships to disclose.

Does incidental FDG PET uptake in the prostate have significance?

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 115-115
Author(s):  
Anna Mary Brown ◽  
Maria Liza Lindenberg ◽  
Sandeep Sankineni ◽  
Linda M Johnson ◽  
Suneha Pruthy ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Fdg Pet ◽  
Final Analysis ◽  
Multiple Comparisons ◽  
Dynamic Contrast Enhancement ◽  
Predictive Values ◽  
Fdg Uptake ◽  
Standardized Uptake Values ◽  
Pet Ct ◽  
Fdg Pet Ct

115 Background: 18F-FDG PET/CT is widely used to diagnose malignancy, but is not recommended for localized prostate cancer. This study explores the value of multi-parametric MRI (mpMRI) in characterizing incidentally detected prostate FDG uptake. Methods: Thirty-one patients who underwent FDG PET/CT and prostate MRI were eligible for this study. 14 patients were excluded (n=8 insufficient histopathology, n=6 radical prostatectomy before PET), with final analysis of 17 patients. The mpMRI sequences included T2-weighted, dynamic contrast enhancement (DCE), apparent diffusion coefficient (ADC), and MR spectroscopy (MRS). Nuclear medicine physicians, blinded to clinicopathologic findings, identified suspicious areas and maximum standardized uptake values (SUVmax) on FDG PET/CT. The lesion and sector-based imaging findings were correlated with annotated histopathology from whole-mount or MRI/TRUS fusion biopsy samples. Positive predictive values (PPVs) were estimated using generalized estimating equations with logit link. Results were evaluated with Kruskal-Wallis and Dunn’s multiple comparisons tests. Results: The PPV of FDG PET alone in detecting prostate cancer was 0.56. Combining FDG (base parameter) with mpMRI modalities (T2, DCE, ADC, MRS) increased the sector-based PPV to 0.79, 0.82, 0.80, and 0.89, respectively. All benign lesions had SUVmax < 5, and malignant lesions had higher mean SUVmax values that correlated with Gleason scores [Table]. This relationship between SUVmax and Gleason score was significant, with p=0.012 on the Kruskal-Wallis test and p=0.015 on the Dunn’s multiple comparisons test for Gleason 0 vs Gleason ≥ 4+5. Conclusions: Incidental prostate FDG uptake has low clinical utility alone, but these areas may harbor high-grade prostate cancer, especially if the SUVmax is greater than 5. [Table: see text]

Detection of Inflammatory Lesions by F-18 Fluorodeoxyglucose Positron Emission Tomography in Patients with Polymyositis and Dermatomyositis

2012 ◽  
Vol 39 (8) ◽  
pp. 1659-1665 ◽  
Author(s):  
TAKAYOSHI OWADA ◽  
REIKA MAEZAWA ◽  
KAZUHIRO KURASAWA ◽  
HARUTSUGU OKADA ◽  
SATOKO ARAI ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Inflammatory Myopathy ◽  
Emission Tomography ◽  
Fluorodeoxyglucose Positron Emission Tomography ◽  
Muscle Diseases ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Fluorodeoxyglucose Positron Emission

Objective.To evaluate the usefulness of F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) imaging in the management of patients with inflammatory myopathy. We examined whether FDG-PET scanning detects myositis or extramuscular lesions in patients with polymyositis (PM) and dermatomyositis (DM).Methods.FDG-PET imaging was performed in 24 patients with active inflammatory myopathy (PM, 11; DM, 13). The images were read by radiologists in a blinded manner. FDG uptake into muscles was judged positive when the intensity of muscles was higher than or equal to that of the liver. As controls, FDG imaging findings of patients with a lung mass and without muscle diseases were used. To investigate associations between FDG-PET findings and clinical/laboratory findings, the patients’ medical records were reviewed retrospectively.Results.Increased FDG uptake in muscles was found in 8 of 24 (33%) patients. In 67 of 69 (97%) controls without muscle diseases, no muscle FDG uptake was detected. The sensitivity of FDG-PET to detect myositis was lower than that of electromyogram (EMG), magnetic resonance imaging, and muscle biopsy. There were no significant differences in clinical manifestations between patients with and without increased FDG uptake in muscles, although patients with FDG muscle uptake had a tendency to have extended myositis with endomysial cell infiltration. FDG-PET detected neoplasms in patients with associated malignancy. FDG uptake in lungs was found in 7 of 18 patients with interstitial lung disease.Conclusion.FDG-PET imaging has limited usefulness for the evaluation of myositis in patients with PM/DM because of its low sensitivity, although it might be useful for detection of malignancy in these patients.

Positron emission tomography with [18F]fluorodeoxyglucose to evaluate neutrophil kinetics during acute lung injury

2004 ◽  
Vol 286 (4) ◽  
pp. L834-L840 ◽  
Author(s):  
Delphine L. Chen ◽  
Daniel P. Schuster
Keyword(s):  
Acute Lung Injury ◽  
Lung Injury ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Pulmonary Sequestration ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Activated Neutrophils ◽  
Neutrophil Kinetics

We measured neutrophil glucose uptake with positron emission tomographic imaging and [18F]fluorodeoxyglucose ([18F]FDG-PET) in anesthetized dogs after intravenous oleic acid-induced acute lung injury (ALI; OA group, n = 6) or after low-dose intravenous endotoxin (known to activate neutrophils without causing lung injury) followed by OA (Etx + OA group, n = 7). The following two other groups were studied as controls: one that received no intervention ( n = 5) and a group treated with Etx only ( n = 6). PET imaging was performed ∼1.5 h after initiating experimental interventions. The rate of [3H]deoxyglucose ([3H]DG) uptake was also measured in vitro in cells recovered from bronchoalveolar lavage (BAL) performed after PET imaging. Circulating neutrophil counts fell significantly in animals treated with Etx but not in the other two groups. The rate of [18F]FDG uptake, measured by the influx constant Ki, was significantly elevated ( P < 0.05) in both Etx-treated groups (7.9 ± 2.6 × 10-3ml blood·ml lung-1·min-1in the Etx group, 9.3 ± 4.8 × 10-3ml blood·ml lung-1·min-1in the Etx + OA group) but not in the group treated only with OA (3.4 ± 0.8 × 10-3ml blood·ml lung-1·min-1) when compared with the normal control (1.6 ± 0.4 × 10-3ml blood·ml lung-1·min-1). [3H]DG uptake was increased (73 ± 7%) in BAL neutrophils recovered from the Etx + OA group ( P < 0.05) but not in the OA group. Kiand [3H]DG uptake rates were linearly correlated ( R2= 0.65). We conclude that the rate of [18F]FDG uptake in the lungs during ALI reflects the state of neutrophil activation. [18F]FDG-PET imaging can detect pulmonary sequestration of activated neutrophils, despite the absence of alveolar neutrophilia. Thus [18F]FDG-PET imaging may be a useful tool to study neutrophil kinetics during ALI.

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