Value of somatostatin receptor PET/CT in MEN1 patients at various stages of their disease

2021 ◽  
Author(s):  
Clément Mennetrey ◽  
Maëlle Le Bras ◽  
Aurélie Bando-Delaunay ◽  
Laure Al-Mansour ◽  
Magalie Haissaguerre ◽  
...  
Keyword(s):  
Somatostatin Receptor ◽  
Distant Metastases ◽  
Added Value ◽  
Clinical Scenario ◽  
Reference Standard ◽  
Imaging Studies ◽  
Clinical Value ◽  
Patient Journey ◽  
Detection Rates ◽  
Pet Ct

Abstract Context Despite the growing evidence of the clinical value of somatostatin receptor (SSTR) PET in the evaluation of neuroendocrine tumors/NET, its role remains to be clarified at different time points in the MEN1 patient journey. The rareness of the disease is however a significant impediment to prospective clinical trials. Objectives The goals of the study were to assess the indications and value of SSTR PET/CT in MEN1 patients. Methods We retrospectively included patients from 7 French expert centres for whom data on SSTR PET/CT and morphological imaging performed at the same period were available. Detection rates of PET study were analysed. Results One hundred eight patients were included. SSTR PET/CT was performed at screening (n=33), staging (n=34), restaging (n=37) and for PRRT selection (n=4). PET detected positive pancreatic lesions in 91% of cases at screening, with comparable results to MRI but superiority to CT (P=0.049). Metastases (mostly LN) were present at the screening phase in 28% of cases, possibly due to the suboptimal value of screening morphological imaging in the assessement of nodal metastases and/or a long delay between imaging studies. SSTR PET/CT was considered as superior or complementary to the reference standard in the assessment of LN or distant metastases in the vast majority of cases and regardless of the clinical scenario. Conclusion This study shows the potential added value of SSTR PET in the assessment of MEN1-associated NETs and provides a great impetus towards its implementation in the evaluation of MEN1 patients.

scholarly journals The Added Value of [18F]FDG PET/CT in the Management of Invasive Fungal Infections

Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 137
Author(s):  
Alfred O. Ankrah ◽  
Dina Creemers-Schild ◽  
Bart de Keizer ◽  
Hans C. Klein ◽  
Rudi A. J. O. Dierckx ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Fungal Infections ◽  
Invasive Fungal Infections ◽  
Added Value ◽  
X Rays ◽  
Imaging Studies ◽  
Imaging Methods ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Anatomy-based imaging methods are the usual imaging methods used in assessing invasive fungal infections (IFIs). [18F]FDG PET/CT has also been used in the evaluation of IFIs. We assessed the added value of [18F]FDG PET/CT when added to the most frequently used anatomy-based studies in the evaluation of IFIs. The study was conducted in two University Medical Centers in the Netherlands. Reports of [18F]FDG PET/CT and anatomy-based imaging performed within two weeks of the [18F]FDG PET/CT scan were retrieved, and the presence and sites of IFI lesions were documented for each procedure. We included 155 [18F]FDG PET/CT scans performed in 73 patients. A total of 216 anatomy-based studies including 80 chest X-rays, 89 computed tomography studies, 14 magnetic resonance imaging studies, and 33 ultrasound imaging studies were studied. The anatomy-based studies were concordant with the [18F]FDG PET/CT for 94.4% of the scans performed. [18F]FDG PET/CT detected IFI lesions outside of the areas imaged by the anatomy-based studies in 48.6% of the scans. In 74% of the patients, [18F]FDG PET/CT added value in the management of the IFIs.

scholarly journals Effective localization in tumor-induced osteomalacia using 68Ga-DOTATOC-PET/CT, venous sampling and 3T-MRI

2017 ◽  
Vol 2017 ◽  
Author(s):  
Shintaro Kawai ◽  
Hiroyuki Ariyasu ◽  
Yasushi Furukawa ◽  
Reika Yamamoto ◽  
Shinsuke Uraki ◽  
...  
Keyword(s):  
Fibroblast Growth Factor 23 ◽  
Somatostatin Receptor ◽  
List Type ◽  
Conventional Imaging ◽  
Imaging Studies ◽  
Venous Sampling ◽  
3T Mri ◽  
Positron Emission ◽  
Pet Ct ◽  
The Right

Summary Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome characterized by renal phosphate wasting leading to hypophosphatemia due to excessive actions of fibroblast growth factor 23 (FGF23) produced by the tumors. Although the best way of curing TIO is complete resection, it is usually difficult to detect the culprit tumors by general radiological modalities owing to the size and location of the tumors. We report a case of TIO in which the identification of the tumor by conventional imaging studies was difficult. Nonetheless, a diagnosis was made possible by effective use of multiple modalities. We initially suspected that the tumor existed in the right dorsal aspect of the scapula by 68Ga-DOTATOC positron emission tomography/computed tomography (68Ga-DOTATOC-PET/CT) and supported the result by systemic venous sampling (SVS). The tumor could also be visualized by 3T-magnetic resonance imaging (MRI), although it was not detected by 1.5T-MRI, and eventually be resected completely. In cases of TIO, a stepwise approach of 68Ga-DOTATOC-PET/CT, SVS and 3T-MRI can be effective for confirmation of diagnosis. Learning points: TIO shows impaired bone metabolism due to excessive actions of FGF23 produced by the tumor. The causative tumors are seldom detected by physical examinations and conventional radiological modalities. In TIO cases, in which the localization of the culprit tumors is difficult, 68Ga-DOTATOC-PET/CT should be performed as a screening of localization and thereafter SVS should be conducted to support the result of the somatostatin receptor (SSTR) imaging leading to increased diagnosability. When the culprit tumors cannot be visualized by conventional imaging studies, using high-field MRI at 3T and comparing it to the opposite side are useful after the tumor site was determined.

scholarly journals Clinical value of 18 FDG PET/CT in screening for distant metastases in head and neck squamous cell carcinoma

2018 ◽  
Vol 43 (3) ◽  
pp. 875-881 ◽  
Author(s):  
S.E. Deurvorst ◽  
O.S. Hoekstra ◽  
J.A. Castelijns ◽  
B.I. Witte ◽  
C.R. Leemans ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Fdg Pet ◽  
Distant Metastases ◽  
Neck Squamous Cell Carcinoma ◽  
Clinical Value ◽  
Pet Ct ◽  
Fdg Pet Ct

A prospective phase II/III multicenter study of PSMA-targeted 18F-DCFPyL PET/CT imaging in patients with prostate cancer (OSPREY): A sub-analysis of regional and distant metastases detection rates at initial staging by 18F-DCFPyL PET/CT.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 9-9 ◽  
Author(s):  
Frederic Pouliot ◽  
Peter Carroll ◽  
Stephan Probst ◽  
Kenneth J. Pienta ◽  
Steven P. Rowe ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Distant Metastases ◽  
Metastatic Lesion ◽  
Tnm Staging ◽  
Cross Sectional ◽  
Detection Rates ◽  
Positron Emission ◽  
Pet Ct ◽  
Initial Staging

9 Background: Current imaging modalities are suboptimal for the initial staging of men at risk of harboring occult metastatic prostate cancer (PCa). PSMA-based imaging is considered highly promising for PCa detection. 18F-DCFPyL is a novel PSMA-targeted radiopharmaceutical for positron emission tomography (PET) that may be useful in staging of pts with high risk PCa. The diagnostic performance of 18F-DCFPyL regarding regional and distant metastases has been previously reported. Here we report on detection rates and the resulting impact 18F-DCFPyL may have on staging of pts with high risk PCa. Methods: 18F-DCFPyL PET/CT was evaluated in 252 men with high-risk PCa who were planned for radical prostatectomy with lymphadenectomy (RP-PLND). 9 mCi (333 MBq) of 18F-DCFPyL was administered 1-2 hours prior to PET/CT. Based on TNM staging, 18F-DCFPyL PET/CT detection rates including lesion counts were systematically analyzed: prostatic (T), pelvic LN (N), extra-pelvic LN (M1a), bone (M1b) & other visceral organs/soft tissue (M1c). Three central, blinded, and independent readers evaluated the 18F-DCFPyL scans. Results: At study entry, 97% and 99% of all evaluable pts had no known nodal or metastatic disease, respectively, based on standard cross-sectional imaging. Of these, 18F-DCFPyL PET/CT staged 37 (14.7%) pts with N1 disease and 27 (10.7%) pts with M1 disease (1 [0.4%] M1a, 23 [9.1%] M1b, and 3 [1.2%] M1c). In total, 56 (22%) of patients were upstaged to N1 or M1 disease by 18F-DCFPyL. The positive predictive value of 18F-DCFPyL based on histopathologic validation for pelvic LNs was 86.7% (95% CI: 70, 95). Only one patient in Cohort A underwent a biopsy of their 18F-DCFPyL detected M1 finding; histopathology confirmed the metastatic lesion in the spine to be a true positive. Conclusions: A total of 22% of pts with high-risk PCa planned for RP-PLND had regional or distant metastatic lesions detected on 18F-DCFPyL PET/CT. These results suggest the potential utility of 18F-DCFPyL PET/CT in the staging of men with newly diagnosed high risk PCa to develop optimized treatment paradigms. Clinical trial information: NCT02981368.

scholarly journals Characteristics and Clinical Value of 18F-FDG PET/CT in the Management of Adult-Onset Still’s Disease: 35 Cases

2021 ◽  
Vol 10 (11) ◽  
pp. 2489
Author(s):  
Josselin Brisset ◽  
Yvan Jamilloux ◽  
Stephanie Dumonteil ◽  
Guillaume Lades ◽  
Martin Killian ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Lymph Node ◽  
Differential Diagnoses ◽  
Adult Onset Still’S Disease ◽  
Still’S Disease ◽  
Clinical Value ◽  
Fdg Uptake ◽  
Pet Ct ◽  
18F Fdg ◽  
Adult Onset Still's Disease

While the diagnosis of adult-onset Still’s disease (AOSD) involves the exclusion of differential diagnoses, the characteristics and value of 18F-Fluorodeoxyglucose (18F-FDG) Positron Emission Tomography coupled with CT (PET/CT) in the management of AOSD remain poorly known. Our retrospective study included patients from four centers, fulfilling Yamaguchi or Fautrel criteria, who underwent a PET/CT during an active AOSD. Thirty-five patients were included. At the time of PET/CT, the Yamaguchi criteria were met in 23 of 29 evaluable cases. PET/CT showed bone marrow (74.3%), lymph node (74.3%), and splenic (48.6%) FDG uptake. Despite arthralgia or arthritis in most patients, joints were rarely the sites of 18F-FDG accumulation. The spatial distribution of 18F-FDG uptake was nonspecific, and its intensity could be similar to malignant disease. Lymph node or bone marrow biopsy was performed after PET/CT in 20 patients (57.1%). The intensity of bone marrow; splenic and lymph node hypermetabolism appeared to be correlated with disease activity. Abnormal PET/CT in the cervical lymph nodes and age ≥ 60 years seemed to be predictive factors for monocyclic evolution. The clinical value of PET/CT is not in direct diagnosis; but as an aid in excluding differential diagnoses by searching for their scintigraphic features and guiding biopsy.

scholarly journals Preoperative Screening CT and PET/CT Scanning for Acral Melanoma: Is it Necessary?

2021 ◽  
Vol 10 (4) ◽  
pp. 811
Author(s):  
Taketoshi Ide ◽  
Takamichi Ito ◽  
Maiko Wada-Ohno ◽  
Masutaka Furue
Keyword(s):  
Sensitivity And Specificity ◽  
Clinical Signs ◽  
Ct Scanning ◽  
Distant Metastases ◽  
Nodal Metastasis ◽  
Preoperative Imaging ◽  
Histopathological Analysis ◽  
Preoperative Screening ◽  
Acral Melanoma ◽  
Pet Ct

The efficacy of preoperative imaging for acral melanoma (AM) has not been fully evaluated. We examined the accuracy of imaging modalities in the detection of nodal and distant metastases in patients with AM. A retrospective review of 109 patients with AM was performed. All patients had no clinical signs suggestive of distant metastases, and underwent preoperative screening computed tomography (CT) and positron emission tomography (PET)/CT scans. Of 100 patients without lymphadenopathy, 17 patients were suspected of having nodal metastasis in CT and PET/CT, but only two of them were confirmed on histopathological analysis. On the other hand, 12 out of 83 negatively imaged patients showed histopathological signs of nodal metastasis; thus, the sensitivity and specificity of nodal detection were 14.3% and 82.6%, respectively. Regard to the detection of distant metastases, four patients were suspected of having metastasis, but this was later ruled out. The remaining 96 negatively imaged patients were confirmed to have no metastasis at the time of CT and PET/CT by the follow-up. In contrast, distant metastases were found by CT and PET/CT in four of nine patients (44.4%) with lymphadenopathy. Routine preoperative CT and PET/CT for AM patients without lymphadenopathy may not be warranted because of low sensitivity and specificity, but it can be considered for those with lymphadenopathy.

scholarly journals A method for evaluation of patient-specific lean body mass from limited-coverage CT images and its application in PERCIST: comparison with predictive equation

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Jingjie Shang ◽  
Zhiqiang Tan ◽  
Yong Cheng ◽  
Yongjin Tang ◽  
Bin Guo ◽  
...  
Keyword(s):  
Lean Body Mass ◽  
Body Mass ◽  
Whole Body ◽  
Patient Specific ◽  
Predictive Equation ◽  
Reference Standard ◽  
Pet Ct ◽  
Before And After ◽  
Percist 1.0 ◽  
Limited Coverage

Abstract Background Standardized uptake value (SUV) normalized by lean body mass ([LBM] SUL) is recommended as metric by PERCIST 1.0. The James predictive equation (PE) is a frequently used formula for LBM estimation, but may cause substantial error for an individual. The purpose of this study was to introduce a novel and reliable method for estimating LBM by limited-coverage (LC) CT images from PET/CT examinations and test its validity, then to analyse whether SUV normalised by LC-based LBM could change the PERCIST 1.0 response classifications, based on LBM estimated by the James PE. Methods First, 199 patients who received whole-body PET/CT examinations were retrospectively retrieved. A patient-specific LBM equation was developed based on the relationship between LC fat volumes (FVLC) and whole-body fat mass (FMWB). This equation was cross-validated with an independent sample of 97 patients who also received whole-body PET/CT examinations. Its results were compared with the measurement of LBM from whole-body CT (reference standard) and the results of the James PE. Then, 241 patients with solid tumours who underwent PET/CT examinations before and after treatment were retrospectively retrieved. The treatment responses were evaluated according to the PE-based and LC-based PERCIST 1.0. Concordance between them was assessed using Cohen’s κ coefficient and Wilcoxon’s signed-ranks test. The impact of differing LBM algorithms on PERCIST 1.0 classification was evaluated. Results The FVLC were significantly correlated with the FMWB (r=0.977). Furthermore, the results of LBM measurement evaluated with LC images were much closer to the reference standard than those obtained by the James PE. The PE-based and LC-based PERCIST 1.0 classifications were discordant in 27 patients (11.2%; κ = 0.823, P=0.837). These discordant patients’ percentage changes of peak SUL (SULpeak) were all in the interval above or below 10% from the threshold (±30%), accounting for 43.5% (27/62) of total patients in this region. The degree of variability is related to changes in LBM before and after treatment. Conclusions LBM algorithm-dependent variability in PERCIST 1.0 classification is a notable issue. SUV normalised by LC-based LBM could change PERCIST 1.0 response classifications based on LBM estimated by the James PE, especially for patients with a percentage variation of SULpeak close to the threshold.

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