EJNMMI reports最新文献

{"title":"FDG-PET-based brain network analysis: a brief review of metabolic connectivity.","authors":"Pham Minh Tuan, Mouloud Adel, Nguyen Linh Trung, Tatiana Horowitz, Ismail Burak Parlak, Eric Guedj","doi":"10.1186/s41824-024-00232-6","DOIUrl":"10.1186/s41824-024-00232-6","url":null,"abstract":"<p><strong>Background: </strong>Over the past decades, the analysis metabolic connectivity patterns has received significant attention in exploring the underlying mechanism of human behaviors, and the neural underpinnings of brain neurological disorders. Brain network can be considered a powerful tool and play an important role in the analysis and understanding of brain metabolic patterns. With the advantages and emergence of metabolic-based network analysis, this study aims to systematically review how brain properties, under various conditions, can be studied using Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) images and graph theory, as well as applications of this approach. Additionally, this study provides a brief summary of graph metrics and their uses in studying and diagnosing different types of brain disorders using FDG-PET images.</p><p><strong>Main body: </strong>In this study, we used several databases in Web of Science including Web of Science Core Collection, MEDLINE to search for related studies from 1980 up to the present, focusing on FDG-PET images and graph theory. From 68 articles that matched our keywords, we selected 28 for a full review in order to find out the most recent findings and trends. Our results reveal that graph theory and its applications in analyzing metabolic connectivity patterns have attracted the attention of researchers since 2015. While most of the studies are focusing on group-level based analysis, there is a growing trend in individual-based network analysis. Although metabolic connectivity can be applied to both neurological and psychiatric disorders, the majority of studies concentrate on neurological disorders, particularly Alzheimer's Disease and Parkinson's Disease. Most of the findings focus on changes in brain network topology, including brain segregation and integration.</p><p><strong>Conclusion: </strong>This review provides an insight into how graph theory can be used to study metabolic connectivity patterns under various conditions including neurological and psychiatric disorders.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11743410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary staging with 2[18F]-FDG-PET/CT and -PET/MRI and radiotherapy response evaluation with MRI in uterine cervical cancer: an interim analysis of a prospective clinical trial.","authors":"Maja Aasa, David Lindquist, Ulrika Ottander, Sara N Strandberg","doi":"10.1186/s41824-024-00236-2","DOIUrl":"10.1186/s41824-024-00236-2","url":null,"abstract":"<p><strong>Background: </strong>In uterine cervical cancer (UCC), tumour staging is performed according to the 2018 International Federation of Gynecology and Obstetrics (FIGO) system, where imaging is incorporated, or the more generic Tumour Node Metastasis (TNM) classification. With the technical development in diagnostic imaging, continuous prospective evaluation of the different imaging methods contributing to stage determination is warranted. The aims of this interim study were to (1) evaluate the performance of radiological FIGO (rFIGO) and T staging (rT) with 2-fluorine-18-fluoro-deoxy-glucose (2[18F]-FDG)-positron emission tomography with computed tomography (PET/CT) and with magnetic resonance imaging (PET/MRI), compared to clinical FIGO (cFIGO) and T (cT) staging based on clinical examination and conventional imaging, in treatment-naïve UCC, and to (2) identify possible MRI biomarkers for early treatment response after radiotherapy.</p><p><strong>Methods: </strong>Ten consecutive patients with newly diagnosed UCC from the prospective PRODIGYN (Prognostic and Diagnostic Added Value of Medical Imaging in Staging and Treatment Planning of Gynecological Cancer) study (ethical approval number 2022-04207-01; NCT05855941) were included. Study participants underwent 2[18F]FDG-PET/CT and -PET/MRI, and an additional MRI one week after radiotherapy. Agreement between rFIGO and cFIGO was analysed using Cohen's kappa. Differences in rFIGO between 2[18F]FDG-PET/CT and -PET/MRI were evaluated with Wilcoxon signed ranks test, and added value of rFIGO for metastasis assessment was demonstrated with descriptive statistics.</p><p><strong>Results: </strong>In 2/10 patients, a higher stage was obtained with rFIGO compared to cFIGO, where presence of metastases led to upstaging. In 3/10, rFIGO was lower than cFIGO, and in 5/10 rFIGO and cFIGO were similar. Degree of agreement between rFIGO and cFIGO was poor, (κ = 0.091, p < 0.005) with 2[18F]FDG-PET/CT and (κ = - 0.010, p > 0.05) with FDG/PET/MRI). There was no significant difference between 2[18F]FDG-PET/CT and -PET/MRI for rFIGO (p = 0.18), or rT stage assessment (p = 0.32). MRI-derived tumour volume and apparent diffusion coefficient (ADC) were most affected on MRI one week after radiotherapy.</p><p><strong>Conclusions: </strong>Our results indicate that there is an added value of rFIGO staging with 2[18F]FDG-PET/CT and -PET/MRI compared to clinical examination and conventional radiology, for metastasis assessment in treatment-naïve UCC. In early treatment response evaluation with MRI, ADC and tumour volume may be predictive parameters of interest in future prognostic analyses.</p><p><strong>Trial registration: </strong>Clinical Trials, NCT05855941. Registered 02 May 2023, https://clinicaltrials.gov/study/NCT05855941?term=NCT05855941&rank=1 .</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142961100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"B-CLL with negative ¹⁸F-FDG PET/CT and intensive solitary lesion on PSMA PET/CT mimicking prostate cancer bone metastases.","authors":"Theresa Jung, Daniel Neureiter, Gregor Schweighofer-Zwink, Gundula Rendl, Christian Pirich, Mohsen Beheshti","doi":"10.1186/s41824-024-00235-3","DOIUrl":"https://doi.org/10.1186/s41824-024-00235-3","url":null,"abstract":"<p><p>Positron emission tomography/computed tomography (PET/CT) using prostate-specific membrane antigen (PSMA)-radioligands is currently suggested by several clinical guidelines for the assessment of prostate cancer (PCa) in various clinical settings. However, PSMA will also be overexpressed in different cancers, which should be considered on the PSMA PET/CT reading in patients with concomitant neoplastic diseases. We report a case of 82-year-old male presented with prostate and history of oesophageal cancer and B-cell chronic lymphocytic leukemia (B-CLL). Both ⁶⁸Ga-PSMA-11 and 2-(3-(1-carboxy-5-((6-(18f)fluoro-pyridine-3-carbonyl)-amino)-pentyl)-ureido)-pentanedioic acid (¹⁸F-DCFPyL) PET/CT, which were performed for prostate cancer staging and re-staging in about 1 year interval, showed focal uptake in the primary prostate tumor as well as an intense focal lesion in L2, suggestive of bone metastasis. ¹⁸F-FDG PET/CT scans performed before and after PSMA PET/CT examinations showed no abnormal uptake related to oesophageal and/or B-CLL. This pattern could present an oligometastatic PCa disease, which might change the treatment plan of the patient to radiation of the bone metastasis. However, bone biopsy of the detected lesion on L2 revealed infiltrates of B-CLL. The role of ⁶⁸Ga- and ¹⁸F-labeled PSMA PET/CT in prostate cancer is evolving and has been demonstrated to have high sensitivity, but may present limited specificity in patients with coexisting cancer(s), which should be considered in PSMA PET/CT reading.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934399","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}

{"title":"Semi-standardized evaluation of extraprostatic extension and seminal vesicle invasion with [¹⁸F]PSMA-1007 PET/CT: a comparison to MRI using histopathology as reference.","authors":"Erland Hvittfeldt, Fredrik Hedeer, Erik Thimansson, Kevin Sandeman, David Minarik, Jacob Ingvar, Anders Bjartell, Elin Trägårdh","doi":"10.1186/s41824-024-00234-4","DOIUrl":"10.1186/s41824-024-00234-4","url":null,"abstract":"<p><strong>Background: </strong>Positron emission tomography/computed tomography (PET/CT) with prostate specific membrane antigen ligands (PSMA) is established for use in primary staging of prostate cancer to screen for metastases. It has also shown promise in local tumor staging, including detection of extraprostatic extension (EPE) and seminal vesicle invasion (SVI). Previous studies have shown high heterogeneity in methods and results. Our aim was to compare [¹⁸F]PSMA-1007 PET/CT to magnetic resonance imaging (MRI) in evaluation of EPE and SVI, building on a previously described method for standardized evaluation. We retrospectively included 124 patients who had undergone MRI, PSMA PET/CT and prostatectomy. PSMA PET/CT images were evaluated by two nuclear medicine physicians. Using a standardized method, they measured length of capsular contact (LCC) and assessed EPE and SVI visually with the use of 5-point Likert scales. A radiologist evaluated MRI images using criteria based on Prostate Imaging-Reporting and Data System version and incorporating LCC measurement and Likert scales. We evaluated diagnostic performance with histopathology as reference, and the interrater reliability of the PET evaluations.</p><p><strong>Results: </strong>The sensitivity and specificity for detecting EPE with the quantitative LCC method for PSMA PET/CT was 0.46/0.91, for the visual method 0.28/0.82 and for the combination of the two 0.54/0.76. AUC in ROC analysis for the LCC method was 0.70. For MRI the sensitivity and specificity were 0.80/0.64. For SVI, PET/CT and MRI had sensitivity and specificity of 0.14/1.0 and 0.50/0.92 respectively. The intraclass correlation coefficient for the PET LCC measurement was 0.68, the kappa values for the visual Likert scales for PET were 0.53 for EPE and 0.63 for SVI.</p><p><strong>Conclusions: </strong>In this study, we attempted to standardize quantitative and qualitative PSMA PET/CT evaluation of EPE and SVI and compare the method with MRI. MRI had a higher sensitivity for EPE while PSMA had a higher specificity. For SVI, both methods had high specificity. The interrater reliability for the PSMA PET/CT evaluations was moderate to substantial.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real world experience with [^99mTc]Tc-HYNIC-iPSMA SPECT prostate cancer detection: interim results from the global NOBLE registry.","authors":"Pete Tually, Virginia García Quinto, Yehia Omar, Fuad Novruzov, Ryan Yudistiro, Mike Sathekge, Geoffrey Currie, Paul Galette, Neel Patel, Tracey Brown, Gabriel Bolland, Rebecca Lo Bue, David Cade","doi":"10.1186/s41824-024-00226-4","DOIUrl":"10.1186/s41824-024-00226-4","url":null,"abstract":"<p><strong>Purpose: </strong>[^99mTc]Tc-HYNIC-iPSMA is a novel technetium-99m-labelled small molecule inhibitor of the prostate-specific membrane antigen (PSMA) for detecting prostate cancer (PC). The objective of this registry was to collect and evaluate [^99mTc]Tc-HYNIC-iPSMA patient data and images to establish the safety and tolerability, and clinical utility of this agent in imaging at different stages of PC.</p><p><strong>Methods: </strong>Patients 18 to 80 years old with primary staging and metastatic PC were eligible. Patients unable to perform prescribed examinations, undergo a [^99mTc]Tc-HYNIC-iPSMA planar and SPECT or SPECT/CT (when available), or sign a patient informed consent form were excluded from the registry. All eligible patients underwent a screening and baseline visit before imaging with [^99mTc]Tc-HYNIC-iPSMA. The primary safety endpoint was assessed by collecting and grading all treatment-related adverse events using the Common Terminology Criteria for Adverse Events. Patients were followed until disease progression, death, serious or intolerable adverse events, registry termination by the sponsor, patient withdrawal, or lost to follow-up. Analysis was planned for when data was available from 40 enrolled patients.</p><p><strong>Results: </strong>40 patients enrolled in 6 countries and received [^99mTc]Tc-HYNIC-iPSMA tracer administration followed by planar and SPECT imaging. Of the 40 patients included, investigators reported a change in management due to the [^99mTc]Tc-HYNIC-iPSMA imaging in 17/40 of patients (42.5%). No adverse events were reported.</p><p><strong>Conclusions: </strong>[^99mTc]Tc-HYNIC-iPSMA is a promising option to identify PSMA-positive prostate cancer on SPECT and could improve patient access to PSMA imaging worldwide.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"8 1","pages":"43"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive role of [¹⁸F]FDG PET-CT radiomic parameters for KRAS/BRAF/EGFR mutations in metastatic colorectal cancer patients.","authors":"Magdi A Ali, Omar Shebl Zahra, Mohmed I Morsi, Mohamed M El Safwany, Shaymaa Essam El Feky","doi":"10.1186/s41824-024-00233-5","DOIUrl":"10.1186/s41824-024-00233-5","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to evaluate the predictive value of ¹⁸F-fluorodeoxyglucose [¹⁸F]FDG positron emission tomography (PET-CT) radiomic parameters in relation to KRAS/BRAF/EGFR mutations in patients with metastatic colorectal cancer (mCRC).</p><p><strong>Methods: </strong>Blood samples were collected from 90 mCRC patients to assess KRAS G13V, BRAF V600E, and EGFR exon 20 mutations. [¹⁸F]FDG PET-CT scans were performed, and radiomic parameters, including the SUV max, max TBR, total MTV, and total TLG, were calculated and correlated with different genotypes and haplotypes of the aforementioned mutations.</p><p><strong>Results: </strong>The SUV max, TLG, and TBR were significantly greater in patients with the KRAS G13V and BRAF V600E mutations than in patients with the wild-type genotype. The SUVmax was also significantly greater in patients with EGFR exon 20 mutations. Haplotype analysis revealed that the SUVmax was significantly greater in patients with KRAS/BRAF/EGFR mutations than in other patients, with a specificity of 68.18% and sensitivity of 65.28%.</p><p><strong>Conclusion: </strong>The results suggest that [¹⁸F] FDG PET-CT radiomic parameters, particularly the SUV max, have the potential to serve as noninvasive tools for predicting the KRAS/BRAF/EGFR mutation status in mCRC patients.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"8 1","pages":"42"},"PeriodicalIF":0.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Christie score for post-treatment response assessment PET/CT in patients with head and neck squamous cell carcinoma: a safe and simple scoring system.","authors":"N Baguley, C Barker, S Bonington, S Mak, A Chander, J Price, A Datta, R Nadir, G Betts","doi":"10.1186/s41824-024-00230-8","DOIUrl":"10.1186/s41824-024-00230-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Radiotherapy with or without concurrent chemotherapy is a standard of care treatment for patients with head and neck squamous cell carcinoma (HNSCC). Upon completion, patients are referred for a post-treatment &lt;sup&gt;18&lt;/sup&gt;F-FDG PET/CT (Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography) scan to help guide ongoing management by assessing for the presence or absence of residual or recurrent disease and differentiating this from post-treatment inflammation. To improve objective reporting of response, we developed the Christie score. The study aims to assess the validity of the Christie score as a response assessment tool in patients with HNSCC and to compare its performance against the widely used Hopkins score.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods and materials: &lt;/strong&gt;All newly diagnosed head and neck cancers between July 2018 and July 2020 were retrospectively reviewed. In total, 291 patients (224 men and 67 women) were included in the study. Patients with squamous cell carcinoma of the nasopharynx, oropharynx or oral cavity, hypopharynx or larynx were included. All other cell lineages or anatomical locations were excluded. Hopkins and Christie scores were applied to post-treatment PET/CT, and sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratio assessed for each score. Fisher's exact tests and receiver-operating characteristic (ROC) curves were used to determine the ability of the Hopkins and Christie scores to differentiate residual or recurrent disease from treatment response. p values &lt; 0.05 were considered to indicate statistical significance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;39 patients (13%) were confirmed to have residual or recurrent disease. This was significantly more likely in patients with positive Hopkins (p &lt; 0.0001) and Christie (p &lt; 0.0001) scores. The Christie score has a higher sensitivity (92% vs. 85%) and negative predictive value (99% vs. 97%) compared to Hopkins, though the differences were not statistically significant. Comparison of the ROC curves for the Hopkins and Christie score revealed no significant difference between the two scores' ability to discriminate patients with residual or recurrent disease from cases where disease is absent (p = 0.382). 'Subjectivity rates' of the 291 patients are as follows. Six patients (2.1%; 95% CI 0.76-4.5%) were assigned borderline scores on the Hopkins criteria, compared to only a single patient (0.3%; 95% CI 0-1.9%) on the Christie criteria. The 'subjectivity rate' difference is 0.017 (95% CI - 0.06 to 3.5%; p = 0.06) and the ratio is 6.0 (95% CI 0.73-276; p = 0.07).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our study identifies three clear results: (a) the Christie score is an excellent treatment follow-up assessment tool; (b) it is comparable with current gold standard methodology showing no statistically significant differences in performance when compared with the Hopkins score; and (c) th","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"8 1","pages":"41"},"PeriodicalIF":0.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142884021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brown tumors in primary hyperparathyroidism initially interpreted as bone metastases and multiple gigantocelular tumors: case report.","authors":"Vedrana Gladić Nenadić, Marija Punda, Anita Tabain, Tomislav Jukić","doi":"10.1186/s41824-024-00229-1","DOIUrl":"10.1186/s41824-024-00229-1","url":null,"abstract":"<p><p>Brown tumors or osteitis fibrosa cystica are a rare bone metabolism disorder that may mimic cancer metastasis. It represents a late manifestation of prolonged and mostly unrecognized hyperparathyroidism. In this case report we present a 44-year-old female patient with multiple lesions detected on bone scintigraphy and ¹⁸F- FDG-PET/CT, initially interpreted as a bone metastatic disease, rather than multiple gigantocellular bone tumors. Additionally, the presented case emphasizes the importance of a multidisciplinary approach in diagnosing brown tumors as part of hyperparathyroidism, and the treatment decision.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"8 1","pages":"40"},"PeriodicalIF":0.0,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inter- and intra-tumoral heterogeneity on [⁶⁸Ga]Ga-DOTA-TATE/[⁶⁸Ga]Ga-DOTA-TOC PET/CT predicts response to [¹⁷⁷Lu]Lu-DOTA-TATE PRRT in neuroendocrine tumor patients.","authors":"Camila Gadens Zamboni, Ayca Dundar, Sanchay Jain, Marc Kruzer, Bradley T Loeffler, Stephen A Graves, Janet H Pollard, Sarah L Mott, Joseph S Dillon, Michael M Graham, Yusuf Menda, Ahmad Shariftabrizi","doi":"10.1186/s41824-024-00227-3","DOIUrl":"10.1186/s41824-024-00227-3","url":null,"abstract":"<p><strong>Background: </strong>Indices of tumor heterogeneity on somatostatin receptor PET/CT scans may potentially serve as predictive biomarkers of treatment efficacy in neuroendocrine tumor (NET) patients undergoing [¹⁷⁷Lu]Lu-DOTA-TATE PRRT.</p><p><strong>Methods: </strong>NET patients who underwent [¹⁷⁷Lu]Lu-DOTA-TATE therapy at the University of Iowa from August 2018 to February 2021 were retrospectively evaluated. Radiomic features on the pre-PRRT somatostatin receptor PET/CT were evaluated using a custom MIM Software® LesionID workflow. Conventional PET/CT metrics of tumor burden, such as somatostatin receptor expression and tumor volume, were calculated in addition to the indices of tumor heterogeneity for each lesion (intra-lesional) and then summarized across all lesions throughout the body (inter-lesional). Endpoints included post-PRRT 24-month time to progression (TTP) and overall survival (OS). Cox regression models were used to assess the predictive ability of the imaging factors on post-PRRT 24-month TTP and OS. LASSO-penalized Cox regression was used to build a multivariable model for each outcome.</p><p><strong>Results: </strong>Eighty patients with a mean age of 65.1 years were included, with most (71.3%) completing 4 cycles of PRRT. Median TTP was 19.1 months, and OS at 60 months was 50%. A large degree of variability between patients was evidenced for imaging features related to somatostatin receptor expression. On multivariable analysis, total receptor expression and mean liver-corrected SUVmean were selected for 24-month TTP. The model was not able to significantly predict progression (C-statistic = 0.58, 95% CI 0.50-0.62). Total receptor expression and mean skewness were selected for OS. The resulting model was able to significantly predict death (C-statistic = 0.62, 95% CI 0.53-0.67), but the predictive ability was limited, as evidenced by the low C-statistic.</p><p><strong>Conclusions: </strong>Our exploratory analysis provides preliminary results showing that imaging indices of inter- and intra-tumor heterogeneity from pretreatment PET/CT images may potentially predict treatment efficacy in NET patients undergoing [¹⁷⁷Lu]Lu-DOTA-TATE therapy. However, prospective evaluation in a larger cohort is needed to further assess whether a comprehensive characterization of tumor heterogeneity within a patient can help guide treatment decisions.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"8 1","pages":"39"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[¹⁸F]PSMA-1007 PET for biochemical recurrence of prostate cancer, a comparison with [¹⁸F]Fluciclovine.","authors":"Cato C Loeff, Willemijn van Gemert, Bastiaan M Privé, Inge M van Oort, Rick Hermsen, Diederik M Somford, James Nagarajah, Linda Heijmen, Marcel J R Janssen","doi":"10.1186/s41824-024-00228-2","DOIUrl":"10.1186/s41824-024-00228-2","url":null,"abstract":"<p><strong>Aim: </strong>The objective of this study was to compare the detection rates of [¹⁸F]PSMA-1007 and [¹⁸F]Fluciclovine in early biochemical recurrence (BCR) of prostate cancer, i.e. with low prostate-specific antigen (PSA) levels (0.2-5.0 µg/L).</p><p><strong>Methods: </strong>This was a prospective, single-center (Radboudumc; Nijmegen, The Netherlands), comparative phase II diagnostic imaging study (NCT04239742). The main inclusion criteria were histologically proven adenocarcinoma of the prostate, BCR after radical treatment with two consecutive (rising) PSA values (0.2-5.0 µg/L). Patients underwent both [¹⁸F]PSMA-1007 PET/CT and [¹⁸F]Fluciclovine PET/CT within two weeks. Both scans were blindly scored by three independent nuclear medicine physicians. Hereafter, a result per scan and region was generated by consensus. The primary outcome was to compare the detection rate on a patient and region level. Secondary objectives were to determine detection rate stratified for PSA value, inter-reader agreement, and SUV measurements. For lesion confirmation a composite reference score was established using follow-up data.</p><p><strong>Results: </strong>Data of fifty patients were included, median age of 71 (IQR: 67-74) years and median PSA value of 0.38 (IQR: 0.30-1.55) µg/L. Detection rates were 68% (34/50) for [¹⁸F]PSMA-1007 and 42% (21/50) for [¹⁸F]Fluciclovine on a patient level (p < 0.001). Detection rates stratified for PSA value of [¹⁸F]PSMA-1007 in comparison with [¹⁸F]Fluciclovine were for PSA 0.2-0.5 µg/L; 60.7% versus 25.0% (p = 0.002); and for PSA ≥ 0.5 µg/L; 77.3% versus 63.6% (p = 0.250). There was a trend for higher inter-reader agreement with [¹⁸F]PSMA-1007. SUV_max (p < 0.001) was significantly higher for [¹⁸F]PSMA-1007 in comparison to [¹⁸F]Fluciclovine.</p><p><strong>Conclusion: </strong>In patients with early BCR of prostate cancer after radical surgery or radiotherapy, [¹⁸F]PSMA-1007 demonstrated a significantly higher detection rate than [¹⁸F]Fluciclovine. This is particularly relevant since earlier and more accurate detection of a BCR can guide salvage therapy into a tailored strategy which may improve outcomes.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, NCT04239742. Registered 02 January 2020, https://clinicaltrials.gov/study/NCT04239742 .</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"8 1","pages":"38"},"PeriodicalIF":0.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}