Detection of neuroendocrine tumours in the small intestines using contrast-enhanced multiphase Ga-68 DOTATOC PET/CT: the potential role of arterial hyperperfusion

Abstract Background. Interpretation of small intestinal neuroendocrine tumours (NETs) by Ga-68 DOTATOC PET/CT can be difficult. The potential benefit of arterial hyperperfusion for the detection of NETs was evaluated. Methods. Between 2006 and 2009, 320 consecutive Ga-68 DOTATOC PET/CT examinations, performed for NETs, revealed 40 lesions suggesting intestinal NETs in 25 patients. Two groups of lesions were distinguished: epigastric lesions evaluable in the arterial and venous CT scan (Group 1) and hypogastrial lesions evaluable in the venous CT scan only (Group 2). Lesions were jointly rated by two radiologists and a nuclear medicine physician. Maximum standard uptake values (SUVmax) of lesions and background were assessed. The reference standard was histology (available for 28 lesions) or follow-up (for a mean of 22.9 months). Results. PET detected all suspicious lesions but was false positive in 3 lesions. In Group 1 the arterial scan performed significantly better than the venous scan (p = 0.008). Diagnostic performance was better in Group 1 than in Group 2 (p < 0.001). SUVmax of true positive lesions were significantly higher than background SUVmax (p < 0.001) and SUVmax of false positive lesions (p = 0.005). Conclusions. The arterial phase of multiphase Ga-68 DOTATOC PET/CT might improve the localization of intestinal NETs and, thereby, improve the overall diagnostic accuracy of this modality in the assessment of intestinal NETs by adding information about lesion perfusion not available when only venous CT is performed

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Contrast Enhanced Ultrasound in the Diagnosis and Evaluation of the Efficiency of Chemotherapy in Patients with Colorectal Liver Metastases

Journal of radiology and nuclear medicine ◽

10.20862/0042-4676-2020-101-6-324-332 ◽

2021 ◽

Vol 101 (6) ◽

pp. 324-332

Author(s):

E. V. Kovaleva ◽

G. T. Sinyukova ◽

T. Yu. Danzanova ◽

P. I. Lepedatu ◽

E. A. Gudilina ◽

...

Keyword(s):

Contrast Agent ◽

Liver Metastases ◽

Colorectal Liver Metastases ◽

Arterial Phase ◽

Contrast Enhanced Ultrasound ◽

Time Curve ◽

Entire Volume ◽

Contrast Enhanced ◽

Group 2 ◽

Group 1

Objective: to determine the possibilities of contrast-enhanced ultrasound (CEUS) in identifying and evaluating the efficiency of chemotherapy in patients with colorectal liver metastases (CLM).Material and methods. The investigation enrolled 28 patients with CLM. The patients were divided into two groups: Group 1 – 15 pretreatment patients; Group 2 – 13 posttreatment patients with process stabilization. All the patients underwent standard B-mode ultrasound of the liver and that using the contrast agent SonoVue ® (Bracco, Italy), by recording and estimating the parameters of the intensity-time curve (CIV). Liver CEUS assesses the nature of contrasting metastases in three phases (arterial, venous, and delay ones).Results. The investigators identified three types of contrast agent accumulation in CLM in the arterial phase: along the periphery of the lesions (in 60% of the patients of Group 1, in 76.9% in Group 2), homogeneously over the entire volume (in 26.7% in Group 1 and in 0.08% in Group 2), in parallel with intact liver parenchyma (13.3% in Group 1 and 23.02% in Group 2). In the delay phase, more metastases were detected in 4 cases (14.3%). Estimation of CIV parameters showed a difference at the beginning of contrast enhancement stages between the patients in both groups. Group 1 exhibited the early contrasting of liver metastases (19.3 sec); Group 2 displayed the late washout of a contrast agent (65.9 sec).Conclusion. CEUS versus B-mode ultrasound improves the imaging of liver metastases. The change in the vascular architectonics and hemodynamics in CLM after chemotherapy is reflected in the alteration of the rate of contrast accumulation and washout from the metastases, which allows CEUS to be used in the evaluation of the efficiency of this treatment.

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Role Of PET/CT In The Management Of Burkitt Lymphoma

Blood ◽

10.1182/blood.v122.21.4311.4311 ◽

2013 ◽

Vol 122 (21) ◽

pp. 4311-4311

Author(s):

Estrella Carrillo ◽

Fatima De la Cruz ◽

Víctor Marín ◽

María Solé ◽

Isabel Borrego ◽

...

Keyword(s):

Ct Scan ◽

Burkitt Lymphoma ◽

False Positive ◽

Response Assessment ◽

Line Treatment ◽

First Line ◽

Imaging Test ◽

Pet Ct ◽

First Line Treatment

Abstract Introduction Burkitt lymphoma (BL) is a highly aggressive and chemosensitive B cell non-Hodgkin lymphoma derived from germinal or post-germinal center B cells, which affects commonly extranodal sites. Although studies have described 100% of 18F-FDG avidity in BL, PET/CT is not routinely used in those patients being only recommended in the context of a clinical trial. The aim of the present study is to evaluate retrospectively, the role of PET/CT instead of CT scan alone both to stage newly diagnosed BL patients as well as to evaluate disease response after chemotherapy. Patients and Methods 53 PET/CT (20 PET/CT at diagnosis, 28 after first line treatment and 5 to monitor residual disease detected in response assessment PET/CT) were performed in 32 patients, between 2006 y 2012. Locations of involved areas were registered comparing staging CT and PET/CT and were classified as discrepancy or not. Results Patientxs baseline characteristics are summarized in table 1. At diagnosis, abdominal adenopathies had the highest SUVmax with a mean of 14,83 (3,5-35). Discrepancies were found in 64,7% of patients who had both imaging test available at diagnosis (n=17), almost all of them in extranodal sites. These findings upstaged 12% patients from localized to advanced disease. Sensitivity of PET/CT and CT was 100% and 53%, respectively. Regarding the response assessment, in 5 patients out of 13 (38%) who had both imaging test, the PET/CT after first-line treatment was negative whereas the CT demonstrated residual masses. No relapses were observed in those patients. Among 28 patients with a PET/CT available after first-line treatment, CR was attained in 22 patients; one true-positive and 5 false-positive lesions (FP) (1 nodal and 4 extranodal) were detected after completing treatment. SUVmax of FP single nodal site was 2,6 as compared to a mean of 14,9 for the positive lesions at diagnosis while the mean SUVmax of false-positive extranodal sites was 4,4 as compared to 12,1 at diagnosis. NPV was 100% and PPV 16%. SUVmax value of FP lesion was<60% of diagnosis in all cases. Thus, with a cut-off value SUVmax above 60% of that of diagnosis, the PPV is also 100%. Conclusion as compared to CT scan, a more accurate staging in BL can be obtained using PET/CT. Regarding response assessment, NPV reaches 100% and, using a cut-off value for the SUVmax of 60% below the value of diagnosis, also a 100% PPV is observed. Disclosures: No relevant conflicts of interest to declare.

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Contrast-Enhanced Ultrasound in Residual Tumor of Hepatocellular Carcinoma following Transarterial Chemoembolization: Is It Helpful for Tumor Response?

BioMed Research International ◽

10.1155/2018/8632069 ◽

2018 ◽

Vol 2018 ◽

pp. 1-11 ◽

Cited By ~ 2

Author(s):

Tian’an Jiang ◽

Qiyu Zhao ◽

Min Huang ◽

Junhui Sun ◽

Guo Tian

Keyword(s):

Hepatocellular Carcinoma ◽

Rise Time ◽

Transarterial Chemoembolization ◽

Residual Tumor ◽

Arterial Phase ◽

Peak Time ◽

Enhancement Pattern ◽

Contrast Enhanced ◽

Group 2 ◽

Group 1

Aim. To investigate the enhancement pattern of residual tumor on contrast-enhanced ultrasonography (CEUS) in patients with hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE).Methods. Our study initially included 76 patients with HCC, 73 of which were finally allocated into two groups: group 1 (43 patients, post-TACE group) and group 2 (30 patients, untreated HCC group). All patients were performed with CEUS using SonoVue, and qualitative and quantitative enhancement characteristics (rise time, peak time, and washout time) were evaluated for the residual tumors. T test orχ2test was used to estimate for differences between two groups.Results. In group 1, the mean rise time, peak time, and washout times in group 1 were 16.1±2.7 sec, 31.3±3.1 sec, and 191.0±31.3 sec, respectively. In group 2, these were 15.1±3.5 sec, 30.9±3.2 sec, and 142.6±16.1 sec, respectively. The differences in rise time and peak time were not statistically significant (P=0.09 and 0.30, respectively), but the washout time was significantly prolonged in group 1 (P<0.01). The enhanced pattern in arterial phase was inhomogeneous (n=11), regular homogeneous (n=11), partial (n=12), peripheral (n=7), and peripheral rim-like (n=2) in group 1. The average of the longest tumor size of the whole lesion in the 5 types was 4.7±1.3cm, 2.9±1.0cm, 3.1±1.7cm, 2.5±0.6cm, and 2.1 cm.Conclusion. It suggested that the washout time of post-TACE residual lesions was prolonged compared with untreated HCC nodules on CEUS imaging. Combined with the triple-phase enhancement pattern seen on CEUS, the washout time may provide additional information to guide further treatment for residual tumors.

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Comparison of 68Ga-DOTANOC PET/CT and contrast-enhanced CT in localisation of tumours in ectopic ACTH syndrome

Endocrine Connections ◽

10.1530/ec-16-0010 ◽

2016 ◽

Vol 5 (2) ◽

pp. 83-91 ◽

Cited By ~ 6

Author(s):

Majunath R Goroshi ◽

Swati S Jadhav ◽

Anurag R Lila ◽

Rajeev Kasaliwal ◽

Shruti Khare ◽

...

Keyword(s):

Contrast Enhancement ◽

False Positive ◽

Somatostatin Receptor ◽

Tertiary Care ◽

Ectopic Acth ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Pet Ct ◽

Enhanced Ct ◽

Medicine Physician

Background Localising ectopic adrenocorticotrophic hormone (ACTH) syndrome (EAS) tumour source is challenging. Somatostatin receptor-based PET imaging has shown promising results, but the data is limited to case reports and small case series. We reviewed here the performance of 68Ga-DOTANOC positron emission tomography (PET)/computed tomography (CT) and contrast-enhanced CT (CECT) in our cohort of 12 consecutive EAS patients. Materials and methods Retrospective data analysis of 12 consecutive patients of EAS presenting to a single tertiary care centre in a period between January 2013 and December 2014 was done. CECT and 68Ga-DOTANOC PET/CT were reported (blinded) by an experienced radiologist and a nuclear medicine physician, respectively. The performance of CECT and 68Ga-DOTANOC PET/CT was compared. Results Tumours could be localised in 11 out of 12 patients at initial presentation (overt cases), whereas in one patient, tumour remained occult. Thirteen lesions were identified in 11 patients as EAS source (true positives). CECT localised 12 out of these 13 lesions (sensitivity 92.3%) and identified five false-positive lesions (positive predictive value (PPV) 70.5%). Compared with false-positive lesions, true-positive lesions had greater mean contrast enhancement at 60s (33.2 vs 5.6 Hounsfield units (HU)). 68Ga-DOTANOC PET/CT was able to identify 9 out of 13 lesions (sensitivity 69.2%) and reported no false-positive lesions (PPV 100%). Conclusion CECT remains the first-line investigation in localisation of EAS. The contrast enhancement pattern on CECT can further aid in characterisation of the lesions. 68Ga-DOTANOC PET/CT can be added to CECT, to enhance positive prediction of the suggestive lesions.

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A Prospective Study Comparing the Role of 18 FDG PET-CT with Contrast-Enhanced Computed Tomography and Tc99m Bone Scan for Staging Locally Advanced Breast Cancer

Indian Journal of Surgical Oncology ◽

10.1007/s13193-021-01299-4 ◽

2021 ◽

Author(s):

Sandeep Bhoriwal ◽

S. V. S. Deo ◽

Rakesh Kumar ◽

Sanjay Thulkar ◽

Ajay Gogia ◽

...

Keyword(s):

Bone Scan ◽

Locally Advanced Breast Cancer ◽

Locally Advanced ◽

Contrast Enhanced ◽

Pet Ct ◽

Enhanced Computed Tomography ◽

A Prospective Study ◽

Fdg Pet Ct ◽

Contrast Enhanced Computed Tomography

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The role of 18F-FDG PET/CT scan compared to CT-scan alone for lymph node staging before radical cystectomy in patients with bladder cancer

Urologic Oncology Seminars and Original Investigations ◽

10.1016/j.urolonc.2021.04.027 ◽

2021 ◽

Author(s):

Mohamad Moussa ◽

Mohamad Abou Chakra ◽

Wajih Saad ◽

Athanasios Dellis ◽

Athanasios Papatsoris

Keyword(s):

Bladder Cancer ◽

Lymph Node ◽

Ct Scan ◽

Fdg Pet ◽

Lymph Node Staging ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Pet Ct Scan

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The role of inhibition of osteocyte apoptosis in mediating orthodontic tooth movement and periodontal remodeling: a pilot study

Progress in Orthodontics ◽

10.1186/s40510-021-00366-4 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Michele Kaplan ◽

Zana Kalajzic ◽

Thomas Choi ◽

Imad Maleeh ◽

Christopher L. Ricupero ◽

...

Keyword(s):

Bone Density ◽

Alveolar Bone ◽

Tooth Movement ◽

Orthodontic Tooth Movement ◽

Tartrate Resistant Acid Phosphatase ◽

Osteocyte Apoptosis ◽

Saline Administration ◽

Group 2 ◽

Group 1

Abstract Background Orthodontic tooth movement (OTM) has been shown to induce osteocyte apoptosis in alveolar bone shortly after force application. However, how osteocyte apoptosis affects orthodontic tooth movement is unknown. The goal of this study was to assess the effect of inhibition of osteocyte apoptosis on osteoclastogenesis, changes in the alveolar bone density, and the magnitude of OTM using a bisphosphonate analog (IG9402), a drug that affects osteocyte and osteoblast apoptosis but does not affect osteoclasts. Material and methods Two sets of experiments were performed. Experiment 1 was used to specifically evaluate the effect of IG9402 on osteocyte apoptosis in the alveolar bone during 24 h of OTM. For this experiment, twelve mice were divided into two groups: group 1, saline administration + OTM24-h (n=6), and group 2, IG9402 administration + OTM24-h (n=6). The contralateral unloaded sides served as the control. The goal of experiment 2 was to evaluate the role of osteocyte apoptosis on OTM magnitude and osteoclastogenesis 10 days after OTM. Twenty mice were divided into 4 groups: group 1, saline administration without OTM (n=5); group 2, IG9402 administration without OTM (n=5); group 3, saline + OTM10-day (n=6); and group 4, IG9402 + OTM10-day (n=4). For both experiments, tooth movement was achieved using Ultra Light (25g) Sentalloy Closed Coil Springs attached between the first maxillary molar and the central incisor. Linear measurements of tooth movement and alveolar bone density (BVF) were assessed by MicroCT analysis. Cell death (or apoptosis) was assessed by terminal dUTP nick-end labeling (TUNEL) assay, while osteoclast and macrophage formation were assessed by tartrate-resistant acid phosphatase (TRAP) staining and F4/80+ immunostaining. Results We found that IG9402 significantly blocked osteocyte apoptosis in alveolar bone (AB) at 24 h of OTM. At 10 days, IG9402 prevented OTM-induced loss of alveolar bone density and changed the morphology and quality of osteoclasts and macrophages, but did not significantly affect the amount of tooth movement. Conclusion Our study demonstrates that osteocyte apoptosis may play a significant role in osteoclast and macrophage formation during OTM, but does not seem to play a role in the magnitude of orthodontic tooth movement.

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Regional Cerebral Plasma Volume Response to Carbon Dioxide Using Magnetic Resonance Imaging

Anesthesiology ◽

10.1097/00000542-199804000-00019 ◽

1998 ◽

Vol 88 (4) ◽

pp. 984-992 ◽

Cited By ~ 27

Author(s):

Jean-Francois Payen ◽

Albert Vath ◽

Blanche Koenigsberg ◽

Virginie Bourlier ◽

Michel Decorps

Keyword(s):

Magnetic Resonance Imaging ◽

Carbon Dioxide ◽

Magnetic Resonance ◽

Plasma Volume ◽

Resonance Imaging ◽

Contrast Enhanced ◽

Group 3 ◽

Group 2 ◽

Agent Group ◽

Group 1

Background Noninvasive techniques used to determine the changes in cerebral blood volume in response to carbon dioxide are hampered by their limited spatial or temporal resolution or both. Using steady state contrast-enhanced magnetic resonance imaging, the authors determined regional changes in cerebral plasma volume (CPV) induced by hypercapnia in halothane-anesthetized rats. Methods Cerebral plasma volume was determined during normocapnia, hypercapnia and recovery in the dorsoparietal neocortex and striatum of each hemisphere, in cerebellum, and in extracerebral tissue of rats with either intact carotid arteries (group 1) or unilateral common carotid ligation (group 2). Another group was studied without injection of a contrast agent (group 3). Results Hypercapnia (partial pressure of carbon dioxide in arterial blood [PaCO2] approximately 65 mmHg) resulted in a significant increase in CPV in the striatum (+42 +/- 8%), neocortex (+34 +/- 6%), and cerebellum (+49 +/- 12%) compared with normocapnic CPV values (group 1). Carotid ligation (group 2) led to a marked reduction of the CPV response to hypercapnia in the ipsilateral striatum (+23 +/- 14%) and neocortex (+27 +/- 17%) compared with the unclamped side (+34 +/- 15% and +38 +/- 16%, respectively). No significant changes in CPV were found in extracerebral tissue. In both groups, the CPV changes were reversed by the carbon dioxide washout period. Negligible changes in contrast imaging were detected during hypercapnia without administration of the contrast agent (group 3). Conclusions The contrast-enhanced magnetic resonance imaging technique is sensitive to detect noninvasively regional CPV changes induced by hypercapnia in rat brain. This could be of clinical interest for determining the cerebrovascular reactivity among different brain regions.

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