Frontiers in nuclear medicine (Lausanne, Switzerland)最新文献

{"title":"The changing landscape of nuclear medicine and a new era: the \"NEW (Nu) CLEAR Medicine\": a framework for the future.","authors":"Mehdi Djekidel","doi":"10.3389/fnume.2023.1213714","DOIUrl":"10.3389/fnume.2023.1213714","url":null,"abstract":"<p><p>Nuclear Medicine is witnessing a revolution across a large spectrum of patient care applications, hardware, software and novel radiopharmaceuticals. We propose to offer a framework of the nuclear medicine practice of the future that incorporates multiple novelties and coined as the NEW (nu) Clear medicine. All these new developments offer a significant clarity and real clinical impact, and we need a concerted effort from all stakeholders in the field for bedside implementation and success.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":" ","pages":"1213714"},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47411619","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":"A brief overview of targeted radionuclide therapy trials in 2022.","authors":"Aidan Healy, Elaine Ho, Phillip Kuo, Katherine Zukotynski","doi":"10.3389/fnume.2023.1169650","DOIUrl":"10.3389/fnume.2023.1169650","url":null,"abstract":"<p><p>There is a growing use of radionuclide therapy for the medical care of oncology patients, where radioactive pharmaceuticals are used to target and treat various cancer types. This paper provides a brief overview illustrating the spectrum of ongoing and recently completed radionuclide therapy clinical trials in oncology. The trials selected highlight the potential of radionuclide therapies to provide a promising treatment option across a spectrum of cancer patients, while also discussing the importance of patient selection and monitoring, as well as potential side effects and safety concerns. Ultimately, the results of these trials will be crucial in determining the future use of radionuclide therapies in cancer treatment.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":" ","pages":"1169650"},"PeriodicalIF":0.0,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11459975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41633025","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":"Investigation and optimization of PET-guided SPECT reconstructions for improved radionuclide therapy dosimetry estimates.","authors":"Harry Marquis, Kathy P Willowson, C Ross Schmidtlein, Dale L Bailey","doi":"10.3389/fnume.2023.1124283","DOIUrl":"10.3389/fnume.2023.1124283","url":null,"abstract":"<p><strong>Introduction: </strong>To investigate and optimize the SPECTRE (Single Photon Emission Computed Theranostic REconstruction) reconstruction approach, using the hybrid kernelised expectation maximization (HKEM) algorithm implemented in the software for tomographic image reconstruction (STIR) software library, and to demonstrate the feasibility of performing algorithm exploration and optimization in 2D. Optimal SPECTRE parameters were investigated for the purpose of improving SPECT-based radionuclide therapy (RNT) dosimetry estimates.</p><p><strong>Materials and methods: </strong>Using the NEMA IEC body phantom as the test object, SPECT data were simulated to model an early and late imaging time point following a typical therapeutic dose of 8 GBq of ¹⁷⁷Lu. A theranostic ⁶⁸Ga PET-prior was simulated for the SPECTRE reconstructions. The HKEM algorithm parameter space was investigated for SPECT-unique and PET-SPECT mutual features to characterize optimal SPECTRE parameters for the simulated data. Mean and maximum bias, coefficient of variation (COV %), recovery, SNR and root-mean-square error (RMSE) were used to facilitate comparisons between SPECTRE reconstructions and OSEM reconstructions with resolution modelling (OSEM_RM). 2D reconstructions were compared to those performed in 3D in order to evaluate the utility of accelerated algorithm optimization in 2D. Segmentation accuracy was evaluated using a 42% fixed threshold (FT) on the 3D reconstructed data.</p><p><strong>Results: </strong>SPECTRE parameters that demonstrated improved image quality and quantitative accuracy were determined through investigation of the HKEM algorithm parameter space. OSEM_RM and SPECTRE reconstructions performed in 2D and 3D were qualitatively and quantitatively similar, with SPECTRE showing an average reduction in background COV % by a factor of 2.7 and 3.3 for the 2D case and 3D case respectively. The 42% FT analysis produced an average % volume difference from ground truth of 158% and 26%, for the OSEM_RM and SPECTRE reconstructions, respectively.</p><p><strong>Conclusions: </strong>The SPECTRE reconstruction approach demonstrates significant potential for improved SPECT image quality, leading to more accurate RNT dosimetry estimates when conventional segmentation methods are used. Exploration and optimization of SPECTRE benefited from both fast reconstruction times afforded by first considering the 2D case. This is the first in-depth exploration of the SPECTRE reconstruction approach, and as such, it reveals several insights for reconstructing SPECT data using PET side information.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":" ","pages":"1124283"},"PeriodicalIF":0.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45294159","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":"Diagnostic accuracy of the latest-generation digital PET/CT scanner for detection of metastatic lymph nodes in head and neck cancer.","authors":"Frederick Butt, Lillian Dominguez-Konicki, Noah Tocci, Joseph Paydarfar, Marc Seltzer, David Pastel","doi":"10.3389/fnume.2023.1184448","DOIUrl":"10.3389/fnume.2023.1184448","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this retrospective analysis was to assess the diagnostic accuracy of the latest-generation digital positron emission tomography/computed tomography (PET/CT) scanner in the detection of cervical lymph node metastasis in patients undergoing staging work-up for head and neck cancer.</p><p><strong>Materials and methods: </strong>A total of 55 consecutive patients with head and neck cancer at our institution who had a PET/CT after installation of the latest-generation PET/CT (Siemens Biograph Vision) who subsequently underwent surgical neck dissection were included. The nodal station location and number of reported PET/CT-positive metastatic lymph nodes were compared to a gold standard of final surgical pathology after neck dissection.</p><p><strong>Results: </strong>In total, 188 neck levels and 1,373 lymph nodes were resected; 56 neck levels (118 nodes) in 31 (56%) patients contained nodal metastases on surgical pathology. On a nodal level-by-level analysis, the overall sensitivity for the detection of lymph node metastases on the latest-generation PET/CT scanner was 96.4% and the specificity was 86.4%. The sensitivity and specificity for the neck side analysis were 94.0% and 63.7%, and for the individual patient analysis were 100% and 71%, respectively.</p><p><strong>Conclusions: </strong>In this single-institution study, latest-generation PET/CT had a high sensitivity and moderate to high specificity for detecting cervical node metastasis in head and neck cancer. Compared to data from older PET/CT scanners, the sensitivity of the latest-generation PET/CT was slightly higher, while the specificity was similar or slightly lower. Physicians involved in the management of head and neck cancer should be aware of possible changes in the overall diagnostic accuracy when changing to a latest-generation PET/CT scanner.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":" ","pages":"1184448"},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44040322","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":"Development and validation of radiomic signature for predicting overall survival in advanced-stage cervical cancer.","authors":"Ashish Kumar Jha, Sneha Mithun, Umeshkumar B Sherkhane, Vinay Jaiswar, Sneha Shah, Nilendu Purandare, Kumar Prabhash, Amita Maheshwari, Sudeep Gupta, Leonard Wee, V Rangarajan, Andre Dekker","doi":"10.3389/fnume.2023.1138552","DOIUrl":"10.3389/fnume.2023.1138552","url":null,"abstract":"<p><strong>Background: </strong>The role of artificial intelligence and radiomics in prediction model development in cancer has been increasing every passing day. Cervical cancer is the 4th most common cancer in women worldwide, contributing to 6.5% of all cancer types. The treatment outcome of cervical cancer patients varies and individualized prediction of disease outcome is of paramount importance.</p><p><strong>Purpose: </strong>The purpose of this study is to develop and validate the digital signature for 5-year overall survival prediction in cervical cancer using robust CT radiomic and clinical features.</p><p><strong>Materials and methods: </strong>Pretreatment clinical features and CT radiomic features of 68 patients, who were treated with chemoradiation therapy in our hospital, were used in this study. Radiomic features were extracted using an in-house developed python script and pyradiomic package. Clinical features were selected by the recursive feature elimination technique. Whereas radiomic feature selection was performed using a multi-step process i.e., step-1: only robust radiomic features were selected based on our previous study, step-2: a hierarchical clustering was performed to eliminate feature redundancy, and step-3: recursive feature elimination was performed to select the best features for prediction model development. Four machine algorithms i.e., Logistic regression (LR), Random Forest (RF), Support vector classifier (SVC), and Gradient boosting classifier (GBC), were used to develop 24 models (six models using each algorithm) using clinical, radiomic and combined features. Models were compared based on the prediction score in the internal validation.</p><p><strong>Results: </strong>The average prediction accuracy was found to be 0.65 (95% CI: 0.60-0.70), 0.72 (95% CI: 0.63-0.81), and 0.77 (95% CI: 0.72-0.82) for clinical, radiomic, and combined models developed using four prediction algorithms respectively. The average prediction accuracy was found to be 0.69 (95% CI: 0.62-0.76), 0.79 (95% CI: 0.72-0.86), 0.71 (95% CI: 0.62-0.80), and 0.72 (95% CI: 0.66-0.78) for LR, RF, SVC and GBC models developed on three datasets respectively.</p><p><strong>Conclusion: </strong>Our study shows the promising predictive performance of a robust radiomic signature to predict 5-year overall survival in cervical cancer patients.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"3 1","pages":"1138552"},"PeriodicalIF":0.0,"publicationDate":"2023-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41476058","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":"Case report: Intraosseous hibernoma (IOH) mimics osseous metastasis: another rare pitfall in FDG-PET-CT.","authors":"Sebastian J Stolte, Hanna Geiger, Flavio Forrer, Regulo Rodriguez, Joachim Müller","doi":"10.3389/fnume.2023.1150143","DOIUrl":"10.3389/fnume.2023.1150143","url":null,"abstract":"<p><p>Intraosseous hibernoma (IOH) mimicking osseous metastasis is a rare and little-known pitfall in nuclear medicine and radiology. Referring to a clinical case, we show imaging features in FDG-PET and CT as well as pathological characteristics and discuss MRI and differential diagnoses. A 73-year-old woman was assigned for an FDG-PET/CT examination after the incidental finding of a suspicious pulmonary nodule. The FDG-PET/CT examination detected a small slightly FDG-avid pulmonary nodule suspicious for malignancy and a small slightly sclerotic lesion with mild FDG-uptake in the upper pubic bone. Histopathology revealed an intraosseous hibernoma, a rare benign soft-tissue tumor arising from brown fat. In the sparse literature available, intraosseous hibernomas may or may not be positive on bone scans. As in our case, most are slightly sclerotic on CT but lytic lesions have also been described. On MRI, they are T1 hypointense to subcutaneous fat and hyperintense to skeletal muscle; they are usually T2 hyperintense and may show peripheral contrast enhancement. According to the literature, IOHs are mostly incidental findings with solitary lesions in the spine, pelvis, ribs, or, very rarely, in the extremities with low to moderately increased glucose metabolism. IOHs present as painless tumors in general; a few painful cases could be successfully treated with radiofrequency ablation or surgery. Differential diagnoses include metastases, lymphoma, fibrous dysplasia, and non-ossifying fibroma among others. Intraosseous hibernoma is a rare benign tumor that can mimic metastases in FDG-PET, CT, bone scan, and MRI. IOHs might be indistinguishable from metastases or malignant lesions, which makes a biopsy or follow-up mandatory in clinically relevant cases. Given the benign nature of IOHs, radiofrequency ablation or surgery is only an option in symptomatic cases.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":" ","pages":"1150143"},"PeriodicalIF":0.0,"publicationDate":"2023-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41669490","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":"Initial results of the INSPIRE clinical trial-investigating radiation dosimetry for differentiated thyroid cancer patients.","authors":"Jan Taprogge, Carla Abreu, Lenka Vávrová, Lily Carnegie-Peake, Dominic Rushforth, Paul Gape, Jonathan Gear, Iain Murray, Kee H Wong, Kate Newbold, Siraj Yusuf, Glenn Flux","doi":"10.3389/fnume.2023.964478","DOIUrl":"10.3389/fnume.2023.964478","url":null,"abstract":"<p><strong>Introduction: </strong>The optimal strategy for differentiated thyroid cancer (DTC) patients treated with radioiodine (RAI) following thyroidectomy remains controversial. Multi-centre clinical studies are essential to identify strategies to improve patient outcomes while minimising treatment-induced toxicity.</p><p><strong>Materials and methods: </strong>The INSPIRE clinical trial (ClinicalTrials.gov Identifier: NCT04391244) aims to investigate patient-specific dosimetry for DTC patients and to determine the range of absorbed doses delivered to target and non-target tissues and their relationship with treatment outcome and toxicity.</p><p><strong>Results: </strong>We report here initial results of the first 30 patients enrolled onto the INSPIRE trial. A large range of absorbed doses are observed for both thyroid remnants and salivary glands, with median values of 4.8 Gy (Range 0.2 - 242 Gy) and 0.3 Gy (Range 0.1 to 1.7 Gy), respectively.</p><p><strong>Discussion: </strong>The preliminary study results are encouraging and could help to improve our understanding of absorbed doses to thyroid remnants and normal organs following RAI therapy. Such knowledge could potentially enable patient-specific treatment planning with improved clinical outcomes and quality-of-life of patients.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":" ","pages":"964478"},"PeriodicalIF":0.0,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48693682","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":"Non-invasive in vivo imaging of porcine islet xenografts in a preclinical model with [⁶⁸Ga]Ga-exendin-4.","authors":"Felix Lindheimer, Magdalena Julia Lindner, Rosel Oos, Mohsen Honarpisheh, Yichen Zhang, Yutian Lei, Lelia Wolf-van Buerck, Franz Josef Gildehaus, Simon Lindner, Peter Bartenstein, Elisabeth Kemter, Eckhard Wolf, Jochen Seissler, Sibylle Ziegler","doi":"10.3389/fnume.2023.1157480","DOIUrl":"10.3389/fnume.2023.1157480","url":null,"abstract":"<p><strong>Introduction: </strong>Islet xenotransplantation may be a therapeutic option in type 1 diabetes. Recent advances in generating genetically modified source pigs offer advantages as immune suppressants can potentially be eliminated after the transplantation. Therapy monitoring would greatly benefit from noninvasive methods for assessing the viability of transplanted islets. Peptide-based positron emission tomography (PET) targeting the glucagon-like peptide-1 receptor (GLP1R) expression on beta cells may offer a procedure that can directly be translated from an experimental setting to the clinic. The aim of this study was to establish the labeling of the GLP1R ligand [⁶⁸Ga]Ga-exendin-4, to demonstrate the feasibility of imaging porcine islet xenografts <i>in vivo</i> and to compare signal quality for three different transplantation sites in a mouse model.</p><p><strong>Materials and methods: </strong>Mice with engrafted neonatal porcine islet cell clusters (NPICCs) under the kidney capsule, into the inguinal fold, or the lower hindlimb muscle were studied. After reaching normoglycemia, the mice were injected with [⁶⁸Ga]Ga-exendin-4 for PET data acquisition. Subsequent autoradiography (AR) was used for comparing <i>ex vivo</i> data with <i>in vivo</i> uptake.</p><p><strong>Results: </strong>NPICCs in the lower right hindlimb muscle could be detected <i>in vivo</i> and in AR. Due to the high background in the kidney and urinary bladder, islets could not be detected in the PET data at transplantation sites close to these organs, while AR showed a clear signal for the islets in the inguinal fold.</p><p><strong>Discussion: </strong>PET with [⁶⁸Ga]Ga-exendin-4 detects islets transplanted in the hindlimb muscle tissue of mice, offering the potential of longitudinal monitoring of viable porcine islets. Other sites are not suitable for <i>in vivo</i> imaging owing to high activity accumulation of Exendin-4 in kidney and bladder.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":" ","pages":"1157480"},"PeriodicalIF":0.0,"publicationDate":"2023-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43352972","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":"Prediction of angiographic coronary disease and mortality with a cadmium-zinc-telluride camera: a comparison of upright and supine ejection fractions and left ventricular volumes.","authors":"Jackson Walker, Annette Christianson, Muhammad Athar, Fahad Waqar, Myron Gerson","doi":"10.3389/fnume.2023.1162784","DOIUrl":"10.3389/fnume.2023.1162784","url":null,"abstract":"<p><strong>Introduction: </strong>Perfusion imaging strongly predicts coronary artery disease (CAD), whereas cardiac volumes and left ventricular ejection fraction (LVEF) strongly predict mortality. Compared to conventional Anger single-photon emission computed tomography (SPECT) cameras, cadmium-zinc-telluride (CZT) cameras provide higher resolution, resulting in different left ventricular volumes. The cadmium-zinc-telluride D-SPECT camera is commonly used to image in the upright position, which introduces changes in left ventricular loading conditions and potentially alters left ventricular volumes. However, little or no data exist on the predictive value of left ventricular volumes and ejection fraction when acquired in the upright position. We investigated models for the prediction of CAD and mortality, comparing upright and supine imaging.</p><p><strong>Methods: </strong>A retrospective study of patients with upright/supine stress and rest imaging and coronary angiography within 3 months was performed. Univariate and multivariable analyses were performed to predict abnormal angiograms and all-cause mortality.</p><p><strong>Results: </strong>Of the 392 patients, 210 (53.6%) had significant angiographic CAD; 78 (19.9%) patients died over 75 months. The best multivariable model for CAD included the supine summed stress score and supine stress LVEF, with an area under the receiver operating characteristic of 0.862, a sensitivity of 76.7%, and a specificity of 82.4%, but this model was not statistically superior to the best upright model. The best multivariable models for mortality included age, diabetes, history of cardiovascular disease, and end-systolic volume, with the upright and supine models being equivalent.</p><p><strong>Discussion: </strong>Angiographic CAD was best predicted by the supine summed stress score and LVEF but was not statistically superior to the next-best upright model. Mortality was best predicted by end-systolic volume in combination with age, diabetes status, and cardiovascular disease status, with equivalent results from the upright and supine images.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":" ","pages":"1162784"},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44095918","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 complementary role of MRI and FET PET in high-grade gliomas to differentiate recurrence from radionecrosis.","authors":"Arpita Sahu, Ronny Mathew, Renuka Ashtekar, Archya Dasgupta, Ameya Puranik, Abhishek Mahajan, Amit Janu, Amitkumar Choudhari, Subhash Desai, Nandakumar G Patnam, Abhishek Chatterjee, Vijay Patil, Nandini Menon, Yash Jain, Venkatesh Rangarajan, Indraja Dev, Sridhar Epari, Ayushi Sahay, Prakash Shetty, Jayant Goda, Aliasgar Moiyadi, Tejpal Gupta","doi":"10.3389/fnume.2023.1040998","DOIUrl":"10.3389/fnume.2023.1040998","url":null,"abstract":"<p><strong>Introduction: </strong>Conventional magnetic resonance imaging (MRI) has limitations in differentiating tumor recurrence (TR) from radionecrosis (RN) in high-grade gliomas (HGG), which can present with morphologically similar appearances. Multiparametric advanced MR sequences and Positron Emission Tomography (PET) with amino acid tracers can aid in diagnosing tumor metabolism. The role of both modalities on an individual basis and combined performances were investigated in the current study.</p><p><strong>Materials and methods: </strong>Patients with HGG with MRI and PET within three weeks were included in the retrospective analysis. The multiparametric MRI included T1-contrast, T2-weighted sequences, perfusion, diffusion, and spectroscopy. MRI was interpreted by a neuroradiologist without using information from PET imaging. 18F-Fluoroethyl-Tyrosine (FET) uptake was calculated from the areas of maximum enhancement/suspicion, which was assessed by a nuclear medicine physician (having access to MRI to determine tumor-to-white matter ratio over a specific region). A definitive diagnosis of TR or RN was made based on the combination of multidisciplinary joint clinic decisions, histopathological examination, and clinic-radiological follow-up as applicable.</p><p><strong>Results: </strong>62 patients were included in the study between July 2018 and August 2021. The histology during initial diagnosis was glioblastoma, oligodendroglioma, and astrocytoma in 43, 7, and 6 patients, respectively, while in 6, no definitive histological characterization was available. The median time from radiation (RT) was 23 months. 46 and 16 patients had TR and RN recurrence, respectively. Sensitivity, specificity, and accuracy using MRI were 98, 77, and 94%, respectively. Using PET imaging with T/W cut-off of 2.65, sensitivity, specificity, and accuracy were 79, 84, and 80%, respectively. The best results were obtained using both imaging combined with sensitivity, specificity, and accuracy of 98, 100, and 98%, respectively.</p><p><strong>Conclusion: </strong>Combined imaging with MRI and FET-PET offers multiparametric assessment of glioma recurrence that is correlative and complimentary, with higher accuracy and clinical value.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":" ","pages":"1040998"},"PeriodicalIF":0.0,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44935995","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}