scholarly journals Positron Emission Tomography for Response Evaluation in Microenvironment-Targeted Anti-Cancer Therapy

Biomedicines ◽  
2020 ◽  
Vol 8 (9) ◽  
pp. 371
Author(s):  
Noboru Oriuchi ◽  
Shigeyasu Sugawara ◽  
Tohru Shiga
Keyword(s):  
Positron Emission Tomography ◽  
Tumor Microenvironment ◽  
Cancer Therapy ◽  
Fdg Pet ◽  
Cell Tracking ◽  
Therapeutic Response ◽  
Tumor Response ◽  
Checkpoint Inhibitors ◽  
Emission Tomography ◽  
Positron Emission

Therapeutic response is evaluated using the diameter of tumors and quantitative parameters of 2-[18F] fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET). Tumor response to molecular-targeted drugs and immune checkpoint inhibitors is different from conventional chemotherapy in terms of temporal metabolic alteration and morphological change after the therapy. Cancer stem cells, immunologically competent cells, and metabolism of cancer are considered targets of novel therapy. Accumulation of FDG reflects the glucose metabolism of cancer cells as well as immune cells in the tumor microenvironment, which differs among patients according to the individual immune function; however, FDG-PET could evaluate the viability of the tumor as a whole. On the other hand, specific imaging and cell tracking of cancer cell or immunological cell subsets does not elucidate tumor response in a complexed interaction in the tumor microenvironment. Considering tumor heterogeneity and individual variation in therapeutic response, a radiomics approach with quantitative features of multimodal images and deep learning algorithm with reference to pathologic and genetic data has the potential to improve response assessment for emerging cancer therapy.

scholarly journals 18F-FDG-PET/CT in Patients with Advanced, Radioiodine Refractory Thyroid Cancer Treated with Lenvatinib

Cancers ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 317
Author(s):  
Freba Ahmaddy ◽  
Caroline Burgard ◽  
Leonie Beyer ◽  
Viktoria Florentine Koehler ◽  
Peter Bartenstein ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Tumor Response ◽  
Response Assessment ◽  
Emission Tomography ◽  
Morphological Response ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

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.

[18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in aggressive lymphoma: an early prognostic tool for predicting patient outcome

Blood ◽  
2005 ◽  
Vol 106 (4) ◽  
pp. 1376-1381 ◽  
Author(s):  
Corinne Haioun ◽  
Emmanuel Itti ◽  
Alain Rahmouni ◽  
Pauline Brice ◽  
Jean-Didier Rain ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Therapeutic Response ◽  
Risk Groups ◽  
Diagnostic Methods ◽  
Emission Tomography ◽  
Metabolic Imaging ◽  
Aggressive Lymphoma ◽  
Induction Treatment ◽  
Positron Emission

AbstractAssessment of early therapeutic response using metabolic imaging is potentially useful to determine prognosis in aggressive lymphoma. Between January 2000 and January 2004, 90 patients with newly diagnosed aggressive lymphoma (median age 53 years, 94% diffuse large B-cell) were prospectively explored with [18F]fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) prior to induction chemotherapy, after 2 cycles (“early PET”), and after induction completion. Therapeutic response was evaluated using conventional diagnostic methods at 4 cycles. Induction treatment with an anthracycline-containing regimen was administered to all patients, associated with rituximab in 41%. According to the International Prognostic Index (IPI), 37 patients and 53 patients belonged to the lower- and higher-risk groups, respectively. At midinduction, “early PET” was considered negative in 54 patients and positive in 36. After completion of induction, 83% of PET-negative patients achieved complete remission compared with only 58% of PET-positive patients. Outcome differed significantly between PET-negative and PET-positive groups; the 2-year estimates of event-free survival reached 82% and 43%, respectively (P < .001), and the 2-year estimates of overall survival reached 90% and 61%, respectively (P = .006). Predictive value of “early PET” was observed in both the lower-risk and higher-risk groups, indicating prognostic independence from the IPI. Therefore, FDG-PET should be an early guide to first-line strategies in aggressive lymphoma. (Blood. 2005;106:1376-1381)

The Use of PET in Evaluating Tumor Response and Cancer Therapy

2001 ◽  
Vol 14 (5) ◽  
pp. 361-367
Author(s):  
Adriaan A. Lammertsma
Keyword(s):  
Positron Emission Tomography ◽  
Cancer Therapy ◽  
Tumor Response ◽  
Response To Therapy ◽  
Emission Tomography ◽  
Response Monitoring ◽  
Study Group ◽  
European Organization ◽  
Future Directions ◽  
Positron Emission

In this article, an overview is given for the use and potential of positron emission tomography (PET) in monitoring tumor response to therapy. First, the rationale for using PET to monitor response is presented. This is followed by a discussion of response monitoring using [F-18]-2-fluoro-2-deoxy-D-glucose (FDG), concentrating on the various methods that can be used to analyze the data. Thereafter, a brief summary is given of the European Organization for Research and Treatment of Cancer (EORTC) PET Study Group recommendations for standardization of data acquisition and analysis, which is needed for comparing and pooling data from different institutes. Finally, some thoughts on future directions for the use of PET in evaluating tumor response and cancer therapy are offered.

Noninvasive monitoring of tumor metabolism using fluorodeoxyglucose and positron emission tomography in colorectal cancer liver metastases: correlation with tumor response to fluorouracil.

1996 ◽  
Vol 14 (3) ◽  
pp. 700-708 ◽  
Author(s):  
M Findlay ◽  
H Young ◽  
D Cunningham ◽  
A Iveson ◽  
B Cronin ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Positron Emission Tomography ◽  
Liver Metastases ◽  
Fdg Pet ◽  
Tumor Response ◽  
Standardized Uptake Value ◽  
Emission Tomography ◽  
Large Area ◽  
Colorectal Cancer Liver Metastases ◽  
Positron Emission

PURPOSE To investigate and measure the metabolism of colorectal cancer liver metastases using 18F-fluorodeoxyglucose positron emission tomography (FDG PET), before and during the first month of chemotherapy. The findings were compared with tumor outcome conventionally assessed using changes in tumor size. PATIENTS AND METHODS Patients with colorectal cancer liver metastases were treated with fluorouracil (5FU) as a protracted venous infusion (300 mg/m2/d), with or without interferon-alpha 2b for two 10-week blocks separated by a 2-week break. Before and at 1 to 2 and 4 to 5 weeks on treatment, FDG PET scans were performed. Patients fasted, were injected intravenously with FDG (50 to 100 MBq), and scanned using a large-area positron camera; the image data was processed such that regions of interest could be identified. The results were expressed as a ratio of FDG uptake in the tumor and normal liver (T:L) or as a semiquantitative standardized uptake value (SUV). These measures were compared with the tumor dimensions measured on a computed tomographic (CT) scan performed at 12 weeks from commencement of chemotherapy. RESULTS Twenty patients were studied; however, two did not have assessable liver metastases. Objective partial responses were observed in 11 of 18 patients. A total of 27 metastatic lesions were assessable. Pretreatment T:L ratios and SUVs did not correlate with tumor response, although response was associated with lower 1- to 2-week (1.84 v 2.17; t=2.667; P < .02) and 4- to 5-week (1.36 v 2.28; t=5.02; P < .001) T:L ratios, and 4- to 5-week (3.57 v 4.95; t=2.492; P < .05) SUVs. Expressed as a percent of the baseline values of the T:L ratio, responding lesions had a greater reduction in metabolism (67% v 99%; t=7.53; P < .001). The 4- to 5-week T:L ratio was able to discriminate response from nonresponse both in a lesion-by-lesion and overall patient response assessment (sensitivity 100%; specificity 90% and 75%, respectively). CONCLUSION Positron emission tomography used to evaluate the uptake of FDG in tumors yields data that correlate with the antitumor effect of chemotherapy in patients with liver metastases from colorectal cancer.

scholarly journals Positron Emission Tomography-Based Response to Target and Immunotherapies in Oncology

Medicina ◽  
2020 ◽  
Vol 56 (8) ◽  
pp. 373 ◽  
Author(s):  
Maria Isabella Donegani ◽  
Giulia Ferrarazzo ◽  
Stefano Marra ◽  
Alberto Miceli ◽  
Stefano Raffa ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Immune Checkpoint ◽  
Fdg Pet ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Emission Tomography ◽  
Positron Emission ◽  
Target Therapies ◽  
18F Fdg ◽  
Complementary Value

2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) is a promising tool to support the evaluation of response to either target therapies or immunotherapy with immune checkpoint inhibitors both in clinical trials and, in selected patients, at the single patient’s level. The present review aims to discuss available evidence related to the use of [18F]FDG PET (Positron Emission Tomography) to evaluate the response to target therapies and immune checkpoint inhibitors. Criteria proposed for the standardization of the definition of the PET-based response and complementary value with respect to morphological imaging are commented on. The use of PET-based assessment of the response through metabolic pathways other than glucose metabolism is also relevant in the framework of personalized cancer treatment. A brief discussion of the preliminary evidence for the use of non-FDG PET tracers in the evaluation of the response to new therapies is also provided.

scholarly journals [18F]fluoro-2-deoxy-d-glucose ([18F]FDG) positron emission tomography imaging of thymic carcinoid tumor presenting with recurrent Cushing’s syndrome

2005 ◽  
Vol 152 (4) ◽  
pp. 521-525 ◽  
Author(s):  
Athina Markou ◽  
Patrick Manning ◽  
Banu Kaya ◽  
Sam N Datta ◽  
Jamshed B Bomanji ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
High Resolution ◽  
Carcinoid Tumor ◽  
Fdg Pet ◽  
Pet Scan ◽  
Emission Tomography ◽  
Thymic Carcinoid ◽  
Acth Secretion ◽  
Positron Emission ◽  
Thymic Carcinoid Tumor

We report a case of a young woman with Cushing’s syndrome (CS), in whom although endocrine investigations and negative pituitary imaging were suggestive of ectopic ACTH secretion, the results of inferior petrosal sinus (IPS) sampling after coricotropin-releasing hormone (CRH) stimulation were suggestive of pituitary ACTH hypersecretion. 111In-labelled octreotide and high-resolution computer tomography (CT) revealed a lesion possibly responsible for the ACTH source in the thymus. Thymectomy confirmed concomitant ectopic CRH and probable ACTH production by a thymic neuroendocrine carcinoma. After an 8-year remission period the patient developed a clinical and biochemical relapse. A high-resolution computed tomography (CT) scan of the thorax showed a 2-cm nodule in the thymic bed, which was positive on a [18F]fluoro-2-deoxy-d-glucose ([18F]FDG) positron emission tomography (PET) scan. However, a repeated thymectomy did not result in remission. A repeat [18F]FDG PET study showed persistent disease in the thymic bed and also uptake in the adrenals. The patient underwent bilateral adrenalectomy, which resulted in clinical remission. A further [18F]FDG PET scan 8 months later showed no progression of the thymic tumor and confirmed complete excision of the adrenals. This is a rare case of concomitant CRH and ACTH secretion from a thymic carcinoid tumor; the case illustrates the usefulness of functional imaging with [18F]FDG PET in the diagnosis, management and follow-up of neuroendocrine tumors.

scholarly journals Imaging Assessment of Tumor Response in the Era of Immunotherapy

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1041
Author(s):  
Jun Nakata ◽  
Kayako Isohashi ◽  
Yoshihiro Oka ◽  
Hiroko Nakajima ◽  
Soyoko Morimoto ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Solid Tumors ◽  
False Positive ◽  
Progressive Disease ◽  
Tumor Response ◽  
Metabolic Response ◽  
Evaluation Criteria ◽  
Emission Tomography ◽  
Response Criteria ◽  
Positron Emission

Assessment of tumor response during treatment is one of the most important purposes of imaging. Before the appearance of immunotherapy, response evaluation criteria in solid tumors (RECIST) and positron emission tomography response criteria in solid tumors (PERCIST) were, respectively, the established morphologic and metabolic response criteria, and cessation of treatment was recommended when progressive disease was detected according to these criteria. However, various types of immunotherapy have been developed over the past 20 years, which show novel false positive findings on images, as well as distinct response patterns from conventional therapies. Antitumor immune response itself causes 18F-fluorodeoxyglucose (FDG) uptake in tumor sites, known as “flare phenomenon”, so that positron emission tomography using FDG can no longer accurately identify remaining tumors. Furthermore, tumors often initially increase, followed by stability or decrease resulting from immunotherapy, which is called “pseudoprogression”, so that progressive disease cannot be confirmed by computed tomography or magnetic resonance imaging at a single time point. As a result, neither RECIST nor PERCIST can accurately predict the response to immunotherapy, and therefore several new response criteria fixed for immunotherapy have been proposed. However, these criteria are still controversial, and also require months for response confirmation. The establishment of optimal response criteria and the development of new imaging technologies other than FDG are therefore urgently needed. In this review, we summarize the false positive images and the revision of response criteria for each immunotherapy, in order to avoid discontinuation of a truly effective immunotherapy.

scholarly journals Positron Emission Tomography (PET) Imaging of Multiple Myeloma in a Post-Treatment Setting

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 230
Author(s):  
Giulia Ferrarazzo ◽  
Silvia Chiola ◽  
Selene Capitanio ◽  
Maria Isabella Donegani ◽  
Alberto Miceli ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Multiple Myeloma ◽  
Fdg Pet ◽  
Therapy Monitoring ◽  
Emission Tomography ◽  
Clinical Value ◽  
Pet Tracers ◽  
Interpretation Criteria ◽  
Monitoring Therapy ◽  
Positron Emission

2-deoxy-2-[18F]fluoro-D-glucose (FDG) positron emission tomography/computed tomography (FDG PET/CT) has an established clinical value in the diagnosis and initial staging of multiple myeloma (MM). In the last ten years, a vast body of literature has shown that this tool can also be of high relevance for monitoring therapy responses, making it the recommended imaging approach in this field. Starting from the strengths and weaknesses of radiological imaging in MM, the present review aims to analyze FDG PET/CT’s current clinical value focusing on therapy response assessment and objective interpretation criteria for therapy monitoring. Given the potential occurrence of patients with MM showing non-FDG-avid bone disease, new opportunities can be provided by non-FDG PET tracers. Accordingly, the potential role of non-FDG PET tracers in this setting has also been discussed.

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