scholarly journals FDG-PET SCAN: A NEW PARADIGM FOR FOLLICULAR LYMPHOMA MANAGEMENT.

2017 ◽  
Vol 9 (1) ◽  
pp. e2017029 ◽  
Author(s):  
Andrea Gallamini ◽  
Anna Borra
Keyword(s):  
Fdg Pet ◽  
Residual Disease ◽  
Term Treatment ◽  
Pet Scan ◽  
Special Focus ◽  
New Paradigm ◽  
Pet Ct ◽  
Long Term Treatment ◽  
Fdg Pet Scan ◽  
Fdg Pet Ct

In the present review the reader will be led across the most relevant observations that prompted oncologists and haematologist to consider FDG-PET/CT as a new paradigm for FL management in clinical practice. The contribute of functional imaging for lymphoma staging, restaging, prognostication, and tumour burden definition before radio-chemo-immunotherapy will be reviewed in detail. Moreover, a special focus will be addressed to technical and practical aspects of PET scan reporting, which have been set during the last decade in order to ensure the reproducibility of the therapeutic results. Finally, the predictive role of PET/CT on long-term treatment outcome will be compared with other well-known prognosticator as minimal residual disease (MRD) detection by gene rearrangement assessment by molecular biology.

scholarly journals Long-term treatment with tocilizumab in giant cell arteritis: efficacy and safety in a monocentric cohort of patients

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Francesca Regola ◽  
Elisabetta Cerudelli ◽  
Giovanni Bosio ◽  
Laura Andreoli ◽  
Angela Tincani ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Ct Scanning ◽  
Term Treatment ◽  
Efficacy And Safety ◽  
Randomized Controlled Studies ◽  
Pet Ct ◽  
Long Term Treatment ◽  
Maintenance Of Remission ◽  
Fdg Pet Ct

Abstract Objective The efficacy of tocilizumab (TCZ) in GCA is supported by two randomized controlled studies, in which TCZ allowed remission to be achieved after 52 weeks of treatment. However, after discontinuation of treatment, half of the patients relapsed. The aim of this study was to analyse the efficacy and safety of long-term treatment with TCZ and the role of fluorodeoxyglucose (FDG)-PET/CT scanning in the follow-up of these patients. Methods We collected the clinical data of a monocentric cohort of GCA patients retrospectively. Results Thirty-two patients were treated with TCZ [25 males and 7 females; age = 74 (59–81) years]. Most of them achieved and maintained clinical remission (1 month: 69%; 3 months: 91%; 6 months: 96%; 12 months: 100%), with serological and FDG-PET/CT scan improvement and a reduction of concomitant glucocorticoid therapy. Nineteen patients were treated for >52 weeks, and in 13 of them a dose tapering was performed, whereas in 2 cases TCZ was suspended for disease remission. Only two patients relapsed: one during TCZ tapering and one after TCZ discontinuation. Ten cases of mild infections and a case of urinary sepsis were reported; in patients treated for >1 year there was no increase in the incidence of side effects compared with patients treated for <12 months. Conclusion In our cohort of patients, we confirmed the efficacy of TCZ in the induction and maintenance of remission of GCA, demonstrating an important steroid-sparing effect and a good safety profile. Long-term treatment seems to prevent relapse of the disease, suggesting that TCZ treatment can be continued for >52 weeks with efficacy and safety.

scholarly journals FDG PET Application for Management of Breast Cancer Patient: A Narrative Review

2020 ◽  
pp. 54-58
Author(s):  
Saeed Farzanehfar ◽  
Farahnaz Aghahoseini ◽  
Marzieh Peyman ◽  
Mehrshad Abbasi
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Fdg Pet ◽  
Pet Scan ◽  
Advantages And Disadvantages ◽  
Clinical Scenarios ◽  
Pet Ct ◽  
Fdg Pet Scan ◽  
Fdg Pet Ct ◽  
The Cost

Background: The application of FDG PET/CT scan for assessment of patients with breast cancer is increasing. The cost effectiveness of the application could be different in a developing country with limited PET scanners and treatment prioritiesMethods: Open discussions of the PET reviewers from 2 out of 4 PET centers of Tehran, the capital city of Iran, were organized to provide insight into their opinions on the indications of FDG PET in breast cancer patients. Results: The sensitivity of FDG PET scan is high for detection of distant metastases; however, assessment of lymph node pathology and the local extension of the breast cancer are questionable. Considering the cost of the procedure itself and the downstream diagnostic procedures, its application and diagnostic accuracy are hindered for breast cancer screening, staging, and assessment of response to treatment and prognosis. The advantages and disadvantages of FDG PET CT and dedicated breast FDG PET scan have been briefed in different clinical scenarios with a focus on limitations faced by a developing country.Conclusion: We suggest reserving the use of FDG PET for selected cases of suspected but not proven recurrent disease and in patients with high risk of metastasis before high risk surgery.

scholarly journals EP-1065: Post-treatment FDG-PET CT in detecting residual disease in head & neck squamous cell carcinoma

2016 ◽  
Vol 119 ◽  
pp. S513
Author(s):  
J. Price ◽  
A. Pascoe ◽  
C. Weston ◽  
S. Kathirgamakarthigeyan ◽  
M. Griffin ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Fdg Pet ◽  
Residual Disease ◽  
Post Treatment ◽  
Neck Squamous Cell Carcinoma ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Head Neck

scholarly journals The role of FDG-PET/CT in the evaluation of residual disease in paediatric non-Hodgkin lymphoma

2014 ◽  
Vol 168 (6) ◽  
pp. 845-853 ◽  
Author(s):  
Deepa Bhojwani ◽  
Mary B. McCarville ◽  
John K. Choi ◽  
Jennifer Sawyer ◽  
Monika L. Metzger ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Fdg Pet ◽  
Residual Disease ◽  
Non Hodgkin Lymphoma ◽  
Pet Ct ◽  
Fdg Pet Ct

scholarly journals Resonancia Magnética de cuerpo con difusión una alternativa diagnóstica en la evaluación y estadiaje de pacientes con cáncer de próstata.

2020 ◽  
Vol 8 (1) ◽  
pp. 23-28
Author(s):  
Rodolfo Ibarra ◽  
Hugo Arriaga
Keyword(s):  
Fdg Pet ◽  
Pet Scan ◽  
Cáncer De Próstata ◽  
Pet Ct ◽  
Fdg Pet Scan ◽  
Metástasis Óseas

Objetivo: Presentar el uso de la Resonancia Magnética Nuclear de Cuerpo con difusión (RMN C+ difusión) como herramienta accesible para el diagnóstico de metástasis loco regional y a distancia en paciente con Cáncer de Próstata. Material y Métodos: se describe el caso de un paciente de clínica privada y los estudios realizados de Tomografía Computada Abdominal (TAC), Centellograma Óseo, FDG PET Scan y RMN C + difusión   para el diagnóstico y estadificación de Cáncer de Próstata Metastásico. Resultado: paciente masculino de 70 años quien presentó Antígeno Prostático Específico (APE) de 16 ng/ml a quien se realiza biopsia de próstata evidenciando Adenocarcinoma de Próstata Gleason 7 (4+7). Posteriormente se le realiza prostatectomía radical en agosto del 2017, variando el resultado de patología a Gleason 8 y tras la elevación del APE a los 2 meses se da Radioterapia de Salvamento en noviembre del 2017. Presenta APE en niveles bajos hasta enero 2020 que consulta por tener APE 65 ng/ml por lo cual se realizan estudios de diagnóstico y estadificación los cuales se describen. Discusión: La RMN C+ difusión tiene mejor sensibilidad y especificidad que el Centellograma Óseo en la detección de metástasis óseas por Cáncer de Próstata, mejor sensibilidad que la TAC abdominal en detección metástasis ganglionares y muy similares con PET-CT. Conclusiones: El uso de la RMN C+ difusión en pacientes con Cáncer de Próstata es una herramienta que se puede utilizar como examen único para el diagnóstico de metástasis óseas, ganglionares y viscerales. Se recomienda realizar estudios comparativos locales para su validación.

scholarly journals Functional Imaging for Therapeutic Assessment and Minimal Residual Disease Detection in Multiple Myeloma

2020 ◽  
Vol 21 (15) ◽  
pp. 5406 ◽  
Author(s):  
Bastien Jamet ◽  
Elena Zamagni ◽  
Cristina Nanni ◽  
Clément Bailly ◽  
Thomas Carlier ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Fdg Pet ◽  
Metabolic Response ◽  
Residual Disease ◽  
Complete Response ◽  
Therapeutic Assessment ◽  
Complete Metabolic Response ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Minimal Residual

Serum markers and bone marrow examination are commonly used for monitoring therapy response in multiple myeloma (MM), but this fails to identify minimal residual disease (MRD), which frequently persists after therapy even in complete response patients, and extra-medullary disease escape. Positron emission tomography with computed tomography using 18F-deoxyglucose (FDG-PET/CT) is the reference imaging technique for therapeutic assessment and MRD detection in MM. To date, all large prospective cohort studies of transplant-eligible newly diagnosed MM patients have shown a strong and independent pejorative prognostic impact of not obtaining complete metabolic response by FDG-PET/CT after therapy, especially before maintenance. The FDG-PET/CT and MRD (evaluated by flow cytometry or next-generation sequencing at 10−5 and 10−6 levels, respectively) results are complementary for MRD detection outside and inside the bone marrow. For patients with at least a complete response, to reach double negativity (FDG-PET/CT and MRD) is a predictive surrogate for patient outcome. Homogenization of FDG-PET/CT interpretation after therapy, especially clarification of complete metabolic response definition, is currently underway. FDG-PET/CT does not allow MRD to be evaluated when it is negative at initial workup of symptomatic MM. New PET tracers such as CXCR4 ligands have shown high diagnostic value and could replace FDG in this setting. New sensitive functional magnetic resonance imaging (MRI) techniques such as diffusion-weighted MRI appear to be complementary to FDG-PET/CT for imaging MRD detection. The goal of this review is to examine the feasibility of functional imaging, especially FDG-PET/CT, for therapeutic assessment and MRD detection in MM.

FA06.05: DETECTING RESIDUAL ESOPHAGEAL CANCER AFTER NEOADJUVANT CHEMORADIATION BY ENDOSCOPIC BIOPSIES, EUS AND FDG-PET: A SYSTEMATIC REVIEW AND META-ANALYSIS

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 12-13
Author(s):  
B Eyck ◽  
B Noordman ◽  
B Onstenk ◽  
Daan Nieboer ◽  
M C W Spaander ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Fdg Pet ◽  
Residual Disease ◽  
Meta Analysis ◽  
Primary Tumor Site ◽  
Endoscopic Biopsies ◽  
Pet Ct ◽  
Subgroup Analyses ◽  
18F Fdg ◽  
Fdg Pet Ct

Abstract Background After curatively intended neoadjuvant chemoradiotherapy (nCRT) according to CROSS plus surgery for esophageal cancer, 29% of patients have a pathologic complete response. Active surveillance after nCRT, in which patients undergo frequent clinical examinations and where esophagectomy is only offered to those with a locoregional regrowth without distant metastases, has been proposed as novel treatment option. This study provides a systematic review and meta-analysis of the literature regarding the accuracy of endoscopic biopsies, endoscopic ultrasound (EUS) and 18F-FDG PET(-CT) for detecting residual disease after nCRT for esophageal cancer. Methods A systematic literature search in Embase, Medline, Cochrane and Web of Science was performed. Two reviewers independently collected studies on the diagnostic accuracy of endoscopic biopsies, EUS and 18F-FDG PET(-CT) for detecting residual disease after nCRT at the primary tumor site or in regional lymph nodes for potentially curable esophageal adenocarcinoma (AC) or squamous cell carcinoma (SCC). Histopathological examination of the resection specimen was the reference standard. Study quality was appraised with the QUADAS-2 tool. Sensitivity and specificity values were calculated and pooled using meta-analyses. Subgroup analyses were performed to investigate possible sources of heterogeneity. Results 60 studies were included for qualitative analysis and 40 for quantitative analysis. For detecting residual disease at the primary tumor site, 11 studies evaluated endoscopic biopsies, 11 described EUS qualitatively, 14 evaluated PET qualitatively, 12 evaluated PET quantitatively, 6 of them using SUVmax and 6 of them using DSUVmax. Summary sensitivity values were 0.36 (95%CI 0.27–0.45), 0.97 (95%CI 0.94–0.98), 0.74 (95%CI 0.66–0.81), 0.68 (95%CI 0.61–0.74) and 0.68 (95%CI 0.54–0.79), respectively. Summary specificity values were 0.93 (95%CI 0.85–0.97), 0.09 (95%CI 0.04–0.19), 0.52 (95%CI 0.40–0.63), 0.70 (95%CI 0.61–0.78), 0.70 (95%CI 0.60–0.78) and respectively. For detecting residual malignant lymph nodes, 11 studies evaluated EUS with a summary sensitivity of 0.68 (95%CI 0.54–0.80) and a summary specificity of 0.58 (95%CI 0.45–0.70). Subgroup analyses demonstrated that sensitivity of endoscopic biopsy, PET DSUVmax and EUS for nodal was higher in SCC than in AC. Conclusion Current literature suggests insufficient accuracy of endoscopic biopsies, EUS and 18F-FDG PET(-CT) as individual modalities for detecting residual disease after nCRT for potentially curable esophageal cancer. Disclosure All authors have declared no conflicts of interest.

Comparison of gross tumor volume delineated by anatomic imaging and FDG PET/CT for esophageal carcinoma and validation with pathological specimen

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15090-15090
Author(s):  
J. M. Yu ◽  
X. J. Zhong ◽  
B. J. Zhang ◽  
D. B. Mu ◽  
A. Q. Han ◽  
...  
Keyword(s):  
Esophageal Carcinoma ◽  
Ct Scan ◽  
Fdg Pet ◽  
Gross Tumor Volume ◽  
Tumor Volume ◽  
Pet Scan ◽  
Pathologic Examination ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Pet Ct Scan

15090 Background: Although results of clinical studies have demonstrated FDG PET/CT improved target volume delineation in various tumors, only few studies compared delineation based on PET/CT with pathologic examination. Aim of our study was to compare anatomic imaging modalities including computed tomography (CT), esophagram, endoscopy with FDG PET/CT for delineation of gross tumor volume (GTV) in esophageal carcinoma and to validate the results with the pathologic examination. Methods: Thirty patients with stages II-III squamous cell carcinoma underwent transthoracic esophagectomy were enrolled. PET/CT, esophagram and endoscopy were performed with patients before operations. The length of the lesion on the PET/CT scan and on the CT portion of the PET/CT and the PET scan alone was determined independently by 3 separate investigative groups. PET/CT scan was evaluated by visual inspection for abnormality. A standard uptake value (SUV) of 2.5 was used in the PET scan to delineate the tumor extent. The lengths of GTVs determined with the five modalities (PET/CT, PET, CT, esophagram and endoscopy) were compared quantitatively and validated with the pathologic specimen. The sizes of the tumors were measured by pathologic examination which was considered as the gold standard. Results: Of the 30 patients, 9 had T2 tumors, 20 had T3 tumors and 1 had T4 tumor with an involvement of pleura. Three tumors were located at the upper esophagus, 14 at the middle esophagus, 13 at the lower esophagus. The mean length of the carcinoma was 5.85cm(SD 2.50cm) measured by pathologic examination, 5.79cm (SD 2.04cm) as determined by PET scan, 5.14cm (SD 1.65cm) by PET/CT scan, 5.42 cm(SD 2.42cm)by CT scan, 5.50cm(SD 2.79cm) by endoscopy, and 6.07cm(SD 2.75cm) by esophagram respectively. Although the lengths of the tumors as measured by the five imaging modalities were no significant difference, the result of PET was the most accurate. Conclusions: Compared with tumor lengths measured by pathologic examination, PET with a SUV 2.5 was found to be the most accurate modality and can help the radiation oncologist delineate the GTV of esophageal carcinoma precisely. No significant financial relationships to disclose.

The impact of FDG-PET/CT on the management of gynecologic cancers: A retrospective study.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16500-e16500
Author(s):  
Ramiz Ahmad Abu-Hijlih ◽  
Akram Al-Ibraheem ◽  
Yazan Asad Abuodeh ◽  
Imada A. Jaradat
Keyword(s):  
Ct Scan ◽  
Treatment Response ◽  
Cancer Patients ◽  
Fdg Pet ◽  
Gynecological Cancer ◽  
Pet Scan ◽  
Cancer Center ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
The Impact

e16500 Background: Fluoro-Deoxyglucose (FDG-PET) coupled with Magnetic Resonance Imaging (MRI) and Computerized Tomography (CT) provides valuable information in primary staging and evaluation of therapeutic response in gynecological cancer patients. The aim of this study is to investigate the additional value of PET/CT to MRI and CT scan, in patients recently diagnosed with a gynecological tumor or for evaluation of treatment response. Methods: Between January 2010 and June 2012, forty patients with gynecologic tumors (23 cervical, 8 endometrial and 9 ovarian) were evaluated at King Hussein Cancer Center. These patients were divided into two groups: (1) PET scan at presentation for initial staging workup (15 patients) and (2)PET scan at follow up for treatment response evaluation (25 patients). Results: The FDG-PET/CT scan yielded the following additional information: upstaging in 7.5% (3 in 40 patients) and down staging in 32.5% (13 in 40 patients). As a result, treatment strategy was changed from curative to palliative in one patient, and additional curative therapy was implemented following exclusion of distant metastasis in eight patients. Moreover, the discrepancy in nodal status found with FDG-PET/CT compared with anatomical imaging was detected in 8 patients (20%), which led to modifications in radiotherapy field and customizing the radiation dose with minimizing treatment-related toxicity. Conclusions: This study has demonstrated the effectiveness of FDG-PET/CT in the management of gynecological cancer patients. It is a highly valuable utility that raised the accuracy of patients’ stratification to curative or palliative treatments. Furthermore it helped radiotherapy to be more precisely targeted towards the malignant process. However, further prospective studies are still required to identify the group of patients who would benefit the most from this procedure.

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