Pub Date : 2024-09-18DOI: 10.1186/s41824-024-00219-3
Younes Abadi, Magdalena Mileva, Marc-André Léger, Paschalis Sidiras, Carlos Artigas, Patrick Flamen, Ioannis Karfis
Tumor-induced osteomalacia (TIO) is a paraneoplastic syndrome caused by abnormally high levels of fibroblast growth factor 23 (FGF-23), most commonly produced and secreted by small phosphaturic mesenchymal tumors (PMT). These tumors can show various anatomic locations throughout soft tissue and bone. The presence of the tumor itself rarely causes symptoms. Nonspecific symptoms such as muscle weakness and musculoskeletal pain are related to the developing hypophosphatemia and osteomalacia as a secondary effect of the increased circulating levels of FGF-23. Therefore, as the initial presentation can mimic a wide range of metabolic or inflammatory diseases, proper diagnosis is often delayed. Localization of the tumor is crucial, as its complete surgical resection is the only curative treatment. Whole-body functional imaging targeting the overexpression of somatostatin receptors (SSTR) on the surface of the PMT cells, is a highly specific and sensitive imaging method to detect the primary tumor site. Here, we discuss a case of TIO in a patient initially presenting with symptoms of inflammatory spondyloarthritis. SSTR positron emission imaging using 68Ga-DOTATATE was central in diagnosing and localizing the primary tumor.
{"title":"Phosphaturic mesenchymal tumor demonstrated by 68Ga-DOTATATE PET/CT in a patient: a case report","authors":"Younes Abadi, Magdalena Mileva, Marc-André Léger, Paschalis Sidiras, Carlos Artigas, Patrick Flamen, Ioannis Karfis","doi":"10.1186/s41824-024-00219-3","DOIUrl":"https://doi.org/10.1186/s41824-024-00219-3","url":null,"abstract":"Tumor-induced osteomalacia (TIO) is a paraneoplastic syndrome caused by abnormally high levels of fibroblast growth factor 23 (FGF-23), most commonly produced and secreted by small phosphaturic mesenchymal tumors (PMT). These tumors can show various anatomic locations throughout soft tissue and bone. The presence of the tumor itself rarely causes symptoms. Nonspecific symptoms such as muscle weakness and musculoskeletal pain are related to the developing hypophosphatemia and osteomalacia as a secondary effect of the increased circulating levels of FGF-23. Therefore, as the initial presentation can mimic a wide range of metabolic or inflammatory diseases, proper diagnosis is often delayed. Localization of the tumor is crucial, as its complete surgical resection is the only curative treatment. Whole-body functional imaging targeting the overexpression of somatostatin receptors (SSTR) on the surface of the PMT cells, is a highly specific and sensitive imaging method to detect the primary tumor site. Here, we discuss a case of TIO in a patient initially presenting with symptoms of inflammatory spondyloarthritis. SSTR positron emission imaging using 68Ga-DOTATATE was central in diagnosing and localizing the primary tumor.","PeriodicalId":36160,"journal":{"name":"European Journal of Hybrid Imaging","volume":"6 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-13DOI: 10.1186/s41824-024-00216-6
Stephen J. Sozio, William Raynor, Murray C. Becker, Anthony Yudd, Jeffrey S. Kempf
Lutetium-177-Dotatate (Lutathera®) is a combined radionuclide-peptide that is FDA-approved for the treatment of well-differentiated, somatostatin receptor-positive, gastroenteropancreatic neuroendocrine tumors. Carcinoid crisis is a rare, but potentially life-threatening risk of this radiopharmaceutical, of which prompt recognition and treatment is essential to reducing morbidity. This manuscript provides an overview of the topic to promote awareness of this adverse event, with emphasis on early recognition and management. In addition, we present our institution’s experience with Lutetium-177-Dotatate-associated complications across a five-year period. A literature review of lutetium-177-dotatate therapy and its potential implication of carcinoid crisis was performed. Additionally, a review of our institution’s experience is presented. The incidence of carcinoid crisis induced by Lutetium-177-Dotatate therapy is estimated to range between 1 and 2% of treatment recipients. Those who have tumors located within the midgut, higher tumor burden, and the presence of metastasis have an increased risk of developing carcinoid crisis, among other risk factors. Carcinoid crisis is most often encountered within 12–48 h of receiving the first treatment dose, with the most common symptoms being nausea/vomiting, flushing, and diarrhea. Carcinoid crisis is a rare but potentially life-threatening complication of Lutetium-177-Dotatate therapy. Knowledge of risk factors and prompt recognition of symptoms is essential to successful treatment, with early initiation of intravenous octreotide serving a critical step in reducing morbidity of this adverse event.
{"title":"Carcinoid crisis in Lutetium-177-Dotatate therapy of neuroendocrine tumors: an overview of pathophysiology, risk factors, recognition, and treatment","authors":"Stephen J. Sozio, William Raynor, Murray C. Becker, Anthony Yudd, Jeffrey S. Kempf","doi":"10.1186/s41824-024-00216-6","DOIUrl":"https://doi.org/10.1186/s41824-024-00216-6","url":null,"abstract":"Lutetium-177-Dotatate (Lutathera®) is a combined radionuclide-peptide that is FDA-approved for the treatment of well-differentiated, somatostatin receptor-positive, gastroenteropancreatic neuroendocrine tumors. Carcinoid crisis is a rare, but potentially life-threatening risk of this radiopharmaceutical, of which prompt recognition and treatment is essential to reducing morbidity. This manuscript provides an overview of the topic to promote awareness of this adverse event, with emphasis on early recognition and management. In addition, we present our institution’s experience with Lutetium-177-Dotatate-associated complications across a five-year period. A literature review of lutetium-177-dotatate therapy and its potential implication of carcinoid crisis was performed. Additionally, a review of our institution’s experience is presented. The incidence of carcinoid crisis induced by Lutetium-177-Dotatate therapy is estimated to range between 1 and 2% of treatment recipients. Those who have tumors located within the midgut, higher tumor burden, and the presence of metastasis have an increased risk of developing carcinoid crisis, among other risk factors. Carcinoid crisis is most often encountered within 12–48 h of receiving the first treatment dose, with the most common symptoms being nausea/vomiting, flushing, and diarrhea. Carcinoid crisis is a rare but potentially life-threatening complication of Lutetium-177-Dotatate therapy. Knowledge of risk factors and prompt recognition of symptoms is essential to successful treatment, with early initiation of intravenous octreotide serving a critical step in reducing morbidity of this adverse event.","PeriodicalId":36160,"journal":{"name":"European Journal of Hybrid Imaging","volume":"45 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142177985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1186/s41824-024-00198-5
Jorian P. Krol, Frank B.M. Joosten, Hans de Boer, Marie Louise E. Bernsen, Cornelis H. Slump, Wim J.G. Oyen
To determine the use of four-dimensional CT as first-line imaging compared to the traditional combination of ultrasound and [99mTc]Tc-Sestamibi SPECT. Retrospective review of preoperative imaging in patients with primary hyperparathyroidism, who underwent parathyroidectomy between 2012 and 2021. In one group, the combination ultrasound and [99mTc]Tc-Sestamibi SPECT was used as first-line imaging (n = 54), in the other group four-dimensional CT was the first-line imaging modality (n = 51). Sensitivity and positive predictive value were calculated on patient, lateralisation and localisation level. The need for additional imaging was also assessed for both groups. Four-dimensional CT had a significantly higher sensitivity compared to the combination of ultrasound/[99mTc]Tc-Sestamibi SPECT on patient and localisation level (70.6% vs. 51.9%, p = 0.049 and 60.8% vs. 35.2%, p = 0.009 respectively). Sensitivity for lateralisation also appeared higher, but did not reach significance (62.7% vs. 44.4%, p = 0.060). Positive predictive value was not significantly higher for four-dimensional CT compared to ultrasound and [99mTc]Tc-Sestamibi SPECT (88.9% vs. 85.7% for lateralisation and 86.1% vs. 67.9% for localisation respectively). Additional imaging was required in 14 patients with four-dimensional CT as first-line imaging (27.4%) consisting of 2 ultrasound/[99mTc]Tc-Sestamibi SPECT and 13 [18F]fluorocholine PET/CT, compared to 24 patients with ultrasound/[99mTc]Tc-Sestamibi SPECT as first-line imaging (44.4%), requiring 22 four-dimensional CT and 9 [18F]fluorocholine PET/CT. Four-dimensional CT as the sole first-line parathyroid imaging modality had higher sensitivity than the combination of ultrasound and [99mTc]Tc-Sestamibi SPECT, therefore requiring fewer additional procedures. Although the most costly, [18F]fluorocholine PET/CT was the most effective technique to localise parathyroid adenoma in case all other imaging was negative.
{"title":"Four-dimensional computed tomography as first-line imaging in primary hyperparathyroidism, a retrospective comparison to conventional imaging in a predominantly single adenoma population","authors":"Jorian P. Krol, Frank B.M. Joosten, Hans de Boer, Marie Louise E. Bernsen, Cornelis H. Slump, Wim J.G. Oyen","doi":"10.1186/s41824-024-00198-5","DOIUrl":"https://doi.org/10.1186/s41824-024-00198-5","url":null,"abstract":"To determine the use of four-dimensional CT as first-line imaging compared to the traditional combination of ultrasound and [99mTc]Tc-Sestamibi SPECT. Retrospective review of preoperative imaging in patients with primary hyperparathyroidism, who underwent parathyroidectomy between 2012 and 2021. In one group, the combination ultrasound and [99mTc]Tc-Sestamibi SPECT was used as first-line imaging (n = 54), in the other group four-dimensional CT was the first-line imaging modality (n = 51). Sensitivity and positive predictive value were calculated on patient, lateralisation and localisation level. The need for additional imaging was also assessed for both groups. Four-dimensional CT had a significantly higher sensitivity compared to the combination of ultrasound/[99mTc]Tc-Sestamibi SPECT on patient and localisation level (70.6% vs. 51.9%, p = 0.049 and 60.8% vs. 35.2%, p = 0.009 respectively). Sensitivity for lateralisation also appeared higher, but did not reach significance (62.7% vs. 44.4%, p = 0.060). Positive predictive value was not significantly higher for four-dimensional CT compared to ultrasound and [99mTc]Tc-Sestamibi SPECT (88.9% vs. 85.7% for lateralisation and 86.1% vs. 67.9% for localisation respectively). Additional imaging was required in 14 patients with four-dimensional CT as first-line imaging (27.4%) consisting of 2 ultrasound/[99mTc]Tc-Sestamibi SPECT and 13 [18F]fluorocholine PET/CT, compared to 24 patients with ultrasound/[99mTc]Tc-Sestamibi SPECT as first-line imaging (44.4%), requiring 22 four-dimensional CT and 9 [18F]fluorocholine PET/CT. Four-dimensional CT as the sole first-line parathyroid imaging modality had higher sensitivity than the combination of ultrasound and [99mTc]Tc-Sestamibi SPECT, therefore requiring fewer additional procedures. Although the most costly, [18F]fluorocholine PET/CT was the most effective technique to localise parathyroid adenoma in case all other imaging was negative.","PeriodicalId":36160,"journal":{"name":"European Journal of Hybrid Imaging","volume":"32 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140832158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-26DOI: 10.1186/s41824-024-00193-w
Friedrich Weitzer, Susanne Stanzel, Elisabeth Plhak, Reingard Maria Aigner
The value of somatostatin-analogon PET tracers in theranostics in cranial meningioma has been demonstrated in several studies; however, the value of semi-quantitative parameters for therapy and patient outcome is still unclear. A retrospective study was performed comparing measured semi-quantitative 68Ga-DOTANOC PET/CT parameters (maximum standardized uptake value = SUVmax, mean standardized uptake value = SUVmean, and metabolic tumor volume = MTV) and calculated ratios (SUVmax tumor to pituitary gland and SUVmax tumor to superior sinus sagittalis), versus the WHO grades and overall outcome. Patients with histological confirmed meningioma or high probability for meningioma in the previous cranial MRI were eligible. Thirty-two patients from January 2018 to February 2023 were retrospectively included. The WHO grade I meningioma was confirmed in 17 patients, the WHO grade II in five patients, and the WHO grade III in two patients, while in eight patients, diagnosis was solely based on MRI and 68Ga-DOTANOC PET/CT findings. In 12 cases, stable disease was present, in 15 cases, radiation therapy was chosen, in three cases, neurosurgery was preferred, while in two cases, palliative care was chosen. Median SUVmax values increased with the WHO grade (15.84, 17.22, and 28.4, p = 0.134, Kruskal–Wallis test), and no statistically significant difference was present for MTV, SUVmax, and calculated ratios. Increased SUVmax values in the tumor in 68Ga-DOTANOC PET/CT are associated with higher WHO grade, although further studies including larger patient collectives are needed to solidify this hypothesis.
多项研究已经证明了体生长抑素类似物 PET 示踪剂在颅脑膜瘤治疗中的价值；然而，半定量参数对治疗和患者预后的价值仍不明确。一项回顾性研究比较了测量的半定量 68Ga-DOTANOC PET/CT 参数（最大标准化摄取值 = SUVmax、平均标准化摄取值 = SUVmean 和代谢肿瘤体积 = MTV）和计算的比率（肿瘤与垂体的 SUVmax 值和肿瘤与上窦的 SUVmax 值）与 WHO 分级和总体预后。既往头颅磁共振成像中组织学确诊为脑膜瘤或脑膜瘤可能性高的患者符合条件。回顾性纳入了2018年1月至2023年2月的32名患者。17例患者确诊为WHO I级脑膜瘤，5例患者确诊为WHO II级脑膜瘤，2例患者确诊为WHO III级脑膜瘤，8例患者仅根据MRI和68Ga-DOTANOC PET/CT结果确诊。12例患者病情稳定，15例患者选择放射治疗，3例患者选择神经外科手术，2例患者选择姑息治疗。中位 SUVmax 值随着 WHO 分级的升高而升高（15.84、17.22 和 28.4，P = 0.134，Kruskal-Wallis 检验），MTV、SUVmax 和计算比率在统计学上无显著差异。68Ga-DOTANOC PET/CT 中肿瘤 SUVmax 值的增加与 WHO 分级的升高有关，但还需要更多的研究（包括更大规模的患者群体）来证实这一假设。
{"title":"Clinical value of semi-quantitative parameters in 68Ga-DOTANOC PET/CT in treatment and diagnostics of cranial meningioma in a single-center retrospective analysis","authors":"Friedrich Weitzer, Susanne Stanzel, Elisabeth Plhak, Reingard Maria Aigner","doi":"10.1186/s41824-024-00193-w","DOIUrl":"https://doi.org/10.1186/s41824-024-00193-w","url":null,"abstract":"The value of somatostatin-analogon PET tracers in theranostics in cranial meningioma has been demonstrated in several studies; however, the value of semi-quantitative parameters for therapy and patient outcome is still unclear. A retrospective study was performed comparing measured semi-quantitative 68Ga-DOTANOC PET/CT parameters (maximum standardized uptake value = SUVmax, mean standardized uptake value = SUVmean, and metabolic tumor volume = MTV) and calculated ratios (SUVmax tumor to pituitary gland and SUVmax tumor to superior sinus sagittalis), versus the WHO grades and overall outcome. Patients with histological confirmed meningioma or high probability for meningioma in the previous cranial MRI were eligible. Thirty-two patients from January 2018 to February 2023 were retrospectively included. The WHO grade I meningioma was confirmed in 17 patients, the WHO grade II in five patients, and the WHO grade III in two patients, while in eight patients, diagnosis was solely based on MRI and 68Ga-DOTANOC PET/CT findings. In 12 cases, stable disease was present, in 15 cases, radiation therapy was chosen, in three cases, neurosurgery was preferred, while in two cases, palliative care was chosen. Median SUVmax values increased with the WHO grade (15.84, 17.22, and 28.4, p = 0.134, Kruskal–Wallis test), and no statistically significant difference was present for MTV, SUVmax, and calculated ratios. Increased SUVmax values in the tumor in 68Ga-DOTANOC PET/CT are associated with higher WHO grade, although further studies including larger patient collectives are needed to solidify this hypothesis.","PeriodicalId":36160,"journal":{"name":"European Journal of Hybrid Imaging","volume":"29 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140800257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-19DOI: 10.1186/s41824-024-00191-y
Owais Dar, Mansimran Singh Dulay, Fernando Riesgo-Gil, Andrew Morley-Smith, Paul Brookes, Haifa Lyster, Alexandra Rice, Stephen R. Underwood, John Dunning, Kshama Wechalekar
Rejection is a major cause of mortality and morbidity in heart transplant (HTx) recipients. Current methods for diagnosing rejection have limitations. Imaging methods to map the entire left ventricle and reliably identify potential sites of rejection is lacking. Animal studies suggest FDG PET-CT (FDG PET) could have potential application in human HTx recipients. Between December 2020 and February 2022, all HTx recipients at Harefield Hospital, London, with definite or suspected rejection underwent FDG PET in addition to routine work-up. Thirty HTx recipients (12 with definite and 18 with suspected rejection) underwent FDG PET scans. Overall, 12 of the 30 patients had FDG PET with increased myocardial avidity, of whom 2 died (17%). Eighteen patients of the 30 patients had FDG PET with no myocardial avidity and all are alive (100%, p = 0.15). All patients with definite rejection, scanned within 2 weeks of starting anti-rejection treatment, showed increased myocardial avidity. In 5 cases, FDG PET showed myocardial avidity beyond 6 weeks despite pulsed steroid treatment, suggesting unresolved myocardial rejection. Preliminary findings suggest FDG PET may have a role in diagnosing cardiac transplant rejection. Future blinded studies are needed to help further validate this.
排斥反应是心脏移植（HTx）受者死亡和发病的主要原因。目前诊断排斥反应的方法存在局限性。目前还缺乏映射整个左心室并可靠识别潜在排斥部位的成像方法。动物实验表明，FDG PET-CT （FDG PET）有可能应用于人类移植受者。2020 年 12 月至 2022 年 2 月期间，伦敦 Harefield 医院所有确诊或疑似排斥反应的 HTx 受体在常规检查之外都接受了 FDG PET 检查。30 名热处理受体（12 名明确存在排斥反应，18 名疑似排斥反应）接受了 FDG PET 扫描。总体而言，30 名患者中有 12 名患者的 FDG PET 显示心肌酶活性升高，其中 2 人死亡（17%）。在 30 名患者中，有 18 名患者的 FDG PET 没有出现心肌嗜性，他们全部存活（100%，P = 0.15）。所有明确存在排斥反应的患者都在开始接受抗排斥治疗后两周内接受了扫描，结果显示心肌avidity增加。有5例患者尽管接受了脉冲类固醇治疗，但6周后FDG PET仍显示出心肌avidity，这表明心肌排斥反应尚未缓解。初步研究结果表明，FDG PET 可用于诊断心脏移植排斥反应。未来还需要盲法研究来进一步验证这一点。
{"title":"Cardiac transplant rejection assessment with 18F-FDG PET-CT: initial single-centre experience for diagnosis and management","authors":"Owais Dar, Mansimran Singh Dulay, Fernando Riesgo-Gil, Andrew Morley-Smith, Paul Brookes, Haifa Lyster, Alexandra Rice, Stephen R. Underwood, John Dunning, Kshama Wechalekar","doi":"10.1186/s41824-024-00191-y","DOIUrl":"https://doi.org/10.1186/s41824-024-00191-y","url":null,"abstract":"Rejection is a major cause of mortality and morbidity in heart transplant (HTx) recipients. Current methods for diagnosing rejection have limitations. Imaging methods to map the entire left ventricle and reliably identify potential sites of rejection is lacking. Animal studies suggest FDG PET-CT (FDG PET) could have potential application in human HTx recipients. Between December 2020 and February 2022, all HTx recipients at Harefield Hospital, London, with definite or suspected rejection underwent FDG PET in addition to routine work-up. Thirty HTx recipients (12 with definite and 18 with suspected rejection) underwent FDG PET scans. Overall, 12 of the 30 patients had FDG PET with increased myocardial avidity, of whom 2 died (17%). Eighteen patients of the 30 patients had FDG PET with no myocardial avidity and all are alive (100%, p = 0.15). All patients with definite rejection, scanned within 2 weeks of starting anti-rejection treatment, showed increased myocardial avidity. In 5 cases, FDG PET showed myocardial avidity beyond 6 weeks despite pulsed steroid treatment, suggesting unresolved myocardial rejection. Preliminary findings suggest FDG PET may have a role in diagnosing cardiac transplant rejection. Future blinded studies are needed to help further validate this.","PeriodicalId":36160,"journal":{"name":"European Journal of Hybrid Imaging","volume":"50 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140623801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-15DOI: 10.1186/s41824-024-00200-0
Nahla Bashank, Seham Sharef, Taha Zaki Mohran, Maha Khalil
To evaluate the efficacy of PET/CT using18F-FDG (18F-fluorodeoxyglucose) as a radiotracer compared to conventional bone marrow biopsy (BMB) in detecting infiltration to bone marrow (BM) in pediatric patients with lymphoma at the time of initial diagnosis. 66 pediatric patients with lymphoma (47Hodgkin’s and 19non-Hodgkin’s lymphoma) were referred for initial staging by18F-FDG PET/CT study. All patients underwent bilateral iliac BMB and 18F-FDG PET/CT scan with no more than 2 weeks interval in-between. Follow-up for at least 6 months was used as a reference standard to compare diagnostic performance between two modalities in detecting bone marrow infiltration (BMI). Sensitivity, specificity, accuracy, as well as positive and negative predictive values of 18F-FDG PET/CT in detecting BMI were (80%, 86%, 85%, 63%, and 94%) in contrast to BMB (80%, 53%, 59%, 33%, and 90%) respectively. 18F-FDG PET/CT was concordant to BMB in 39/66 patients (59%). 18F-FDG PET/CT was more accurate and specific, with higher predictive values than BMB in detecting BMI during initial staging of pediatric lymphoma. In most pediatric lymphoma patients, 18F-FDG PET/CT can be used instead of BMB to determine BMI during their initial staging process.
{"title":"18F-FDG PET/CT versus bone marrow biopsy in detecting bone marrow infiltration in initial staging of pediatric lymphoma","authors":"Nahla Bashank, Seham Sharef, Taha Zaki Mohran, Maha Khalil","doi":"10.1186/s41824-024-00200-0","DOIUrl":"https://doi.org/10.1186/s41824-024-00200-0","url":null,"abstract":"To evaluate the efficacy of PET/CT using18F-FDG (18F-fluorodeoxyglucose) as a radiotracer compared to conventional bone marrow biopsy (BMB) in detecting infiltration to bone marrow (BM) in pediatric patients with lymphoma at the time of initial diagnosis. 66 pediatric patients with lymphoma (47Hodgkin’s and 19non-Hodgkin’s lymphoma) were referred for initial staging by18F-FDG PET/CT study. All patients underwent bilateral iliac BMB and 18F-FDG PET/CT scan with no more than 2 weeks interval in-between. Follow-up for at least 6 months was used as a reference standard to compare diagnostic performance between two modalities in detecting bone marrow infiltration (BMI). Sensitivity, specificity, accuracy, as well as positive and negative predictive values of 18F-FDG PET/CT in detecting BMI were (80%, 86%, 85%, 63%, and 94%) in contrast to BMB (80%, 53%, 59%, 33%, and 90%) respectively. 18F-FDG PET/CT was concordant to BMB in 39/66 patients (59%). 18F-FDG PET/CT was more accurate and specific, with higher predictive values than BMB in detecting BMI during initial staging of pediatric lymphoma. In most pediatric lymphoma patients, 18F-FDG PET/CT can be used instead of BMB to determine BMI during their initial staging process.","PeriodicalId":36160,"journal":{"name":"European Journal of Hybrid Imaging","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140570972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1186/s41824-024-00195-8
Jaber Alyami
Radiological image analysis using machine learning has been extensively applied to enhance biopsy diagnosis accuracy and assist radiologists with precise cures. With improvements in the medical industry and its technology, computer-aided diagnosis (CAD) systems have been essential in detecting early cancer signs in patients that could not be observed physically, exclusive of introducing errors. CAD is a detection system that combines artificially intelligent techniques with image processing applications thru computer vision. Several manual procedures are reported in state of the art for cancer diagnosis. Still, they are costly, time-consuming and diagnose cancer in late stages such as CT scans, radiography, and MRI scan. In this research, numerous state-of-the-art approaches on multi-organs detection using clinical practices are evaluated, such as cancer, neurological, psychiatric, cardiovascular and abdominal imaging. Additionally, numerous sound approaches are clustered together and their results are assessed and compared on benchmark datasets. Standard metrics such as accuracy, sensitivity, specificity and false-positive rate are employed to check the validity of the current models reported in the literature. Finally, existing issues are highlighted and possible directions for future work are also suggested.
{"title":"Computer-aided analysis of radiological images for cancer diagnosis: performance analysis on benchmark datasets, challenges, and directions","authors":"Jaber Alyami","doi":"10.1186/s41824-024-00195-8","DOIUrl":"https://doi.org/10.1186/s41824-024-00195-8","url":null,"abstract":"Radiological image analysis using machine learning has been extensively applied to enhance biopsy diagnosis accuracy and assist radiologists with precise cures. With improvements in the medical industry and its technology, computer-aided diagnosis (CAD) systems have been essential in detecting early cancer signs in patients that could not be observed physically, exclusive of introducing errors. CAD is a detection system that combines artificially intelligent techniques with image processing applications thru computer vision. Several manual procedures are reported in state of the art for cancer diagnosis. Still, they are costly, time-consuming and diagnose cancer in late stages such as CT scans, radiography, and MRI scan. In this research, numerous state-of-the-art approaches on multi-organs detection using clinical practices are evaluated, such as cancer, neurological, psychiatric, cardiovascular and abdominal imaging. Additionally, numerous sound approaches are clustered together and their results are assessed and compared on benchmark datasets. Standard metrics such as accuracy, sensitivity, specificity and false-positive rate are employed to check the validity of the current models reported in the literature. Finally, existing issues are highlighted and possible directions for future work are also suggested.","PeriodicalId":36160,"journal":{"name":"European Journal of Hybrid Imaging","volume":"7 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140570948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To determine the efficacy and safety of target volume determination by 18F-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) for intensity-modulated radiation therapy (IMRT) for locally advanced head and neck squamous cell carcinoma (HNSCC) extending into the oral cavity or oropharynx. We prospectively treated 10 consecutive consenting patients with HNSCC using IMRT, with target volumes determined by PET-CT. Gross tumor volume (GTV) and clinical target volume (CTV) at the oral level were determined by two radiation oncologists for CT, magnetic resonance imaging (MRI), and PET-CT. Differences in target volume (GTVPET, GTVCT, GTVMRI, CTVPET, CTVCT, and CTVMRI) for each modality and the interobserver variability of the target volume were evaluated using the Dice similarity coefficient and Hausdorff distance. Clinical outcomes, including acute adverse events (AEs) and local control were evaluated. The mean GTV was smallest for GTVPET, followed by GTVCT and GTVMRI. There was a significant difference between GTVPET and GTVMRI, but not between the other two groups. The interobserver variability of target volume with PET-CT was significantly less than that with CT or MRI for GTV and tended to be less for CTV, but there was no significant difference in CTV between the modalities. Grade ≤ 3 acute dermatitis, mucositis, and dysphagia occurred in 55%, 88%, and 22% of patients, respectively, but no grade 4 AEs were observed. There was no local recurrence at the oral level after a median follow-up period of 37 months (range, 15–55 months). The results suggest that the target volume determined by PET-CT could safely reduce GTV size and interobserver variability in patients with locally advanced HNSCC extending into the oral cavity or oropharynx undergoing IMRT. Trial registration UMIN, UMIN000033007. Registered 16 jun 2018, https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000037631
{"title":"Efficacy and safety of FDG-PET for determining target volume during intensity-modulated radiotherapy for head and neck cancer involving the oral level","authors":"Yasuo Kosugi, Keisuke Sasai, Naoya Murakami, Tatsuki Karino, Yoichi Muramoto, Terufumi Kawamoto, Masaki Oshima, Noriyuki Okonogi, Jun Takatsu, Kotaro Iijima, Shuhei Karube, Akira Isobe, Naoya Hara, Mitsuhisa Fujimaki, Shinichi Ohba, Fumihiko Matsumoto, Koji Murakami, Naoto Shikama","doi":"10.1186/s41824-024-00197-6","DOIUrl":"https://doi.org/10.1186/s41824-024-00197-6","url":null,"abstract":"To determine the efficacy and safety of target volume determination by 18F-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) for intensity-modulated radiation therapy (IMRT) for locally advanced head and neck squamous cell carcinoma (HNSCC) extending into the oral cavity or oropharynx. We prospectively treated 10 consecutive consenting patients with HNSCC using IMRT, with target volumes determined by PET-CT. Gross tumor volume (GTV) and clinical target volume (CTV) at the oral level were determined by two radiation oncologists for CT, magnetic resonance imaging (MRI), and PET-CT. Differences in target volume (GTVPET, GTVCT, GTVMRI, CTVPET, CTVCT, and CTVMRI) for each modality and the interobserver variability of the target volume were evaluated using the Dice similarity coefficient and Hausdorff distance. Clinical outcomes, including acute adverse events (AEs) and local control were evaluated. The mean GTV was smallest for GTVPET, followed by GTVCT and GTVMRI. There was a significant difference between GTVPET and GTVMRI, but not between the other two groups. The interobserver variability of target volume with PET-CT was significantly less than that with CT or MRI for GTV and tended to be less for CTV, but there was no significant difference in CTV between the modalities. Grade ≤ 3 acute dermatitis, mucositis, and dysphagia occurred in 55%, 88%, and 22% of patients, respectively, but no grade 4 AEs were observed. There was no local recurrence at the oral level after a median follow-up period of 37 months (range, 15–55 months). The results suggest that the target volume determined by PET-CT could safely reduce GTV size and interobserver variability in patients with locally advanced HNSCC extending into the oral cavity or oropharynx undergoing IMRT. Trial registration UMIN, UMIN000033007. Registered 16 jun 2018, https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000037631 ","PeriodicalId":36160,"journal":{"name":"European Journal of Hybrid Imaging","volume":"40 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140152488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1186/s41824-024-00188-7
Sara Strandberg, Joakim Jonsson, Maryam Zarei, Kristina Aglund, Lennart Blomqvist, Karin Söderkvist
Should early response imaging predict tumor response to therapy, personalized treatment adaptations could be feasible to improve outcome or reduce the risk of adverse events. This prospective single-center observational study on 2-fluorine-18-fluoro-deoxy-glucose (2-[18F]FDG) positron-emission tomography/magnetic resonance imaging (PET/MRI) features aims to investigate the association between semantic 2-[18F]FDG-PET/MRI imaging parameters and outcome prediction in uterine cervical squamous cell carcinoma (CSCC) treated with radiotherapy. Eleven study participants with previously untreated CSCC were examined with 2-[18F]FDG-PET/MRI at baseline and approximately one week after start of curative radiotherapy. All study participants had at least 24 months clinical follow-up. Two patients relapsed during the follow-up period. Reduced tumor size according to visual assessment was present in 9/11 participants (median change in sum of largest diameters (SLD) − 10.4%; range − 2.5 to − 24.6%). The size reduction was less pronounced in the relapse group compared to the no relapse group, with median change in SLD − 4.9%, versus − 10.4%. None of the reductions qualified as significantly reduced or increased in size according to RECIST 1.1., hence all participants were at this stage classified as non-responders/stable disease. Median baseline functional tumor volume (FTV) for the relapse group was 126 cm3, while for the no relapse group 9.3 cm3. Median delta FTV in the relapse group was 50.7 cm3, representing an actual increase in metabolically active volume, while median delta FTV in the no relapse group was − 2.0 cm3. Median delta apparent diffusion coefficient (ADC) was lower in the relapse group versus the no relapse group (− 3.5 mm2/s vs. 71 mm2/s). Early response assessment with 2-[18F]FDG-PET/MRI identified potentially predictive functional imaging biomarkers for prediction of radiotherapy outcome in CSCC, that could not be recognized with tumor measurements according to RECIST 1.1. These biomarkers (delta FTV and delta ADC) should be further evaluated. Trial registration Clinical Trials, NCT02379039. Registered 4 March 2015—Retrospectively registered, https://classic.clinicaltrials.gov/ct2/show/study/NCT02379039 .
{"title":"Baseline and early response 2-[18F]FDG-PET/MRI for prediction of radiotherapy outcome in uterine cervical squamous cell carcinoma: a prospective single-center observational cohort study","authors":"Sara Strandberg, Joakim Jonsson, Maryam Zarei, Kristina Aglund, Lennart Blomqvist, Karin Söderkvist","doi":"10.1186/s41824-024-00188-7","DOIUrl":"https://doi.org/10.1186/s41824-024-00188-7","url":null,"abstract":"Should early response imaging predict tumor response to therapy, personalized treatment adaptations could be feasible to improve outcome or reduce the risk of adverse events. This prospective single-center observational study on 2-fluorine-18-fluoro-deoxy-glucose (2-[18F]FDG) positron-emission tomography/magnetic resonance imaging (PET/MRI) features aims to investigate the association between semantic 2-[18F]FDG-PET/MRI imaging parameters and outcome prediction in uterine cervical squamous cell carcinoma (CSCC) treated with radiotherapy. Eleven study participants with previously untreated CSCC were examined with 2-[18F]FDG-PET/MRI at baseline and approximately one week after start of curative radiotherapy. All study participants had at least 24 months clinical follow-up. Two patients relapsed during the follow-up period. Reduced tumor size according to visual assessment was present in 9/11 participants (median change in sum of largest diameters (SLD) − 10.4%; range − 2.5 to − 24.6%). The size reduction was less pronounced in the relapse group compared to the no relapse group, with median change in SLD − 4.9%, versus − 10.4%. None of the reductions qualified as significantly reduced or increased in size according to RECIST 1.1., hence all participants were at this stage classified as non-responders/stable disease. Median baseline functional tumor volume (FTV) for the relapse group was 126 cm3, while for the no relapse group 9.3 cm3. Median delta FTV in the relapse group was 50.7 cm3, representing an actual increase in metabolically active volume, while median delta FTV in the no relapse group was − 2.0 cm3. Median delta apparent diffusion coefficient (ADC) was lower in the relapse group versus the no relapse group (− 3.5 mm2/s vs. 71 mm2/s). Early response assessment with 2-[18F]FDG-PET/MRI identified potentially predictive functional imaging biomarkers for prediction of radiotherapy outcome in CSCC, that could not be recognized with tumor measurements according to RECIST 1.1. These biomarkers (delta FTV and delta ADC) should be further evaluated. Trial registration Clinical Trials, NCT02379039. Registered 4 March 2015—Retrospectively registered, https://classic.clinicaltrials.gov/ct2/show/study/NCT02379039 .","PeriodicalId":36160,"journal":{"name":"European Journal of Hybrid Imaging","volume":"24 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140010045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-14DOI: 10.1186/s41824-024-00194-9
Isabella Hoi Kei Leung, Mark William Strudwick
PET/MRI is a hybrid imaging modality that boasts the simultaneous acquisition of high-resolution anatomical data and metabolic information. Having these exceptional capabilities, it is often implicated in clinical research for diagnosing and grading, as well as tracking disease progression and response to interventions. Despite this, its low level of clinical widespread use is questioned. This is especially the case with Parkinson’s disease (PD), the fastest progressively disabling and neurodegenerative cause of death. To optimise the clinical applicability of PET/MRI for diagnosing, differentiating, and tracking PD progression, the emerging novel uses, and current challenges must be identified. This systematic review aimed to present the specific challenges of PET/MRI use in PD. Further, this review aimed to highlight the possible resolution of these challenges, the emerging applications and future direction of PET/MRI use in PD. EBSCOHost (indexing CINAHL Plus, PsycINFO) Ovid (Medline, EMBASE) PubMed, Web of Science, and Scopus from 2006 (the year of first integrated PET/MRI hybrid system) to 30 September 2022 were used to search for relevant primary articles. A total of 933 studies were retrieved and following the screening procedure, 18 peer-reviewed articles were included in this review. This present study is of great clinical relevance and significance, as it informs the reasoning behind hindered widespread clinical use of PET/MRI for PD. Despite this, the emerging applications of image reconstruction developed by PET/MRI research data to the use of fully automated systems show promising and desirable utility. Furthermore, many of the current challenges and limitations can be resolved by using much larger-sampled and longitudinal studies. Meanwhile, the development of new fast-binding tracers that have specific affinity to PD pathological processes is warranted.
{"title":"A systematic review of the challenges, emerging solutions and applications, and future directions of PET/MRI in Parkinson’s disease","authors":"Isabella Hoi Kei Leung, Mark William Strudwick","doi":"10.1186/s41824-024-00194-9","DOIUrl":"https://doi.org/10.1186/s41824-024-00194-9","url":null,"abstract":"PET/MRI is a hybrid imaging modality that boasts the simultaneous acquisition of high-resolution anatomical data and metabolic information. Having these exceptional capabilities, it is often implicated in clinical research for diagnosing and grading, as well as tracking disease progression and response to interventions. Despite this, its low level of clinical widespread use is questioned. This is especially the case with Parkinson’s disease (PD), the fastest progressively disabling and neurodegenerative cause of death. To optimise the clinical applicability of PET/MRI for diagnosing, differentiating, and tracking PD progression, the emerging novel uses, and current challenges must be identified. This systematic review aimed to present the specific challenges of PET/MRI use in PD. Further, this review aimed to highlight the possible resolution of these challenges, the emerging applications and future direction of PET/MRI use in PD. EBSCOHost (indexing CINAHL Plus, PsycINFO) Ovid (Medline, EMBASE) PubMed, Web of Science, and Scopus from 2006 (the year of first integrated PET/MRI hybrid system) to 30 September 2022 were used to search for relevant primary articles. A total of 933 studies were retrieved and following the screening procedure, 18 peer-reviewed articles were included in this review. This present study is of great clinical relevance and significance, as it informs the reasoning behind hindered widespread clinical use of PET/MRI for PD. Despite this, the emerging applications of image reconstruction developed by PET/MRI research data to the use of fully automated systems show promising and desirable utility. Furthermore, many of the current challenges and limitations can be resolved by using much larger-sampled and longitudinal studies. Meanwhile, the development of new fast-binding tracers that have specific affinity to PD pathological processes is warranted. ","PeriodicalId":36160,"journal":{"name":"European Journal of Hybrid Imaging","volume":"18 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139755066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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