Arnoldo Piccardo, Gianluca Bottoni, Cristina Puppo, Michela Massollo, Martina Ugolini, Mehrdad Shoushtari Zadeh Naseri, Enrico Melani, Laura Tomasello, Monica Boitano, Andrea DeCensi, Beatrice Sambucco, Fabio Campodonico, Vania Altrinetti, Marco Ennas, Alessia Urru, Carlo Luigi Augusto Negro, Luca Timossi, Giorgio Treglia, Carlo Introini, Francesco Fiz
{"title":"64CuCl2 PET/CT 在肌浸润性膀胱癌的检测和分期中的作用：与对比增强 CT 和 18F-FDG PET/CT 的比较。","authors":"Arnoldo Piccardo, Gianluca Bottoni, Cristina Puppo, Michela Massollo, Martina Ugolini, Mehrdad Shoushtari Zadeh Naseri, Enrico Melani, Laura Tomasello, Monica Boitano, Andrea DeCensi, Beatrice Sambucco, Fabio Campodonico, Vania Altrinetti, Marco Ennas, Alessia Urru, Carlo Luigi Augusto Negro, Luca Timossi, Giorgio Treglia, Carlo Introini, Francesco Fiz","doi":"10.2967/jnumed.124.267474","DOIUrl":null,"url":null,"abstract":"<p><p>Molecular imaging of muscle-invasive bladder cancer (MBC) is restricted to its locoregional and distant metastases, since most radiopharmaceuticals have a urinary excretion that limits the visualization of the primary tumor. <sup>64</sup>CuCl<sub>2</sub> <sub>,</sub> a positron-emitting radiotracer with nearly exclusive biliary elimination, could be well suited to exploring urinary tract neoplasms. In this study, we evaluated the feasibility of <sup>64</sup>CuCl<sub>2</sub>-based staging of patients with MBC; furthermore, we compared the diagnostic capability of this method with those of the current gold standards, that is, contrast-enhanced CT (ceCT) and <sup>18</sup>F-FDG PET/CT. <b>Methods:</b> We prospectively enrolled patients referred to our institution for pathology-confirmed MBC staging/restaging between September 2021 and January 2023. All patients underwent ceCT, <sup>18</sup>F-FDG, and <sup>64</sup>CuCl<sub>2</sub> PET/CT within 2 wk. Patient-based analysis and lesion-based analysis were performed for all of the potentially affected districts (overall, bladder wall, lymph nodes, skeleton, liver, lung, and pelvic soft tissue). <b>Results:</b> Forty-two patients (9 women) were enrolled. Thirty-six (86%) had evidence of disease, with a total of 353 disease sites. On patient-based analysis, ceCT and <sup>64</sup>CuCl<sub>2</sub> PET/CT showed higher sensitivity than <sup>18</sup>F-FDG PET/CT in detecting the primary tumor (<i>P</i> < 0.001); moreover, <sup>64</sup>CuCl<sub>2</sub> PET/CT was slightly more sensitive than <sup>18</sup>F-FDG PET/CT in disclosing soft-tissue lesions (<i>P</i> < 0.05). Both PET methods were more specific and accurate than ceCT in classifying nodal lesions (<i>P</i> < 0.05). On lesion-based analysis, <sup>64</sup>CuCl<sub>2</sub> PET/CT outperformed <sup>18</sup>F-FDG PET/CT and ceCT in detecting disease localizations overall (<i>P</i> < 0.001), in the lymph nodes (<i>P</i> < 0.01), in the skeleton (<i>P</i> < 0.001), and in the soft tissue (<i>P</i> < 0.05). <b>Conclusion:</b> <sup>64</sup>CuCl<sub>2</sub> PET/CT appears to be a sensitive modality for staging/restaging of MBC and might represent a \"one-stop shop\" diagnostic method in these scenarios.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":"1357-1363"},"PeriodicalIF":0.0000,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Role of <sup>64</sup>CuCl<sub>2</sub> PET/CT in Detecting and Staging Muscle-Invasive Bladder Cancer: Comparison with Contrast-Enhanced CT and <sup>18</sup>F-FDG PET/CT.\",\"authors\":\"Arnoldo Piccardo, Gianluca Bottoni, Cristina Puppo, Michela Massollo, Martina Ugolini, Mehrdad Shoushtari Zadeh Naseri, Enrico Melani, Laura Tomasello, Monica Boitano, Andrea DeCensi, Beatrice Sambucco, Fabio Campodonico, Vania Altrinetti, Marco Ennas, Alessia Urru, Carlo Luigi Augusto Negro, Luca Timossi, Giorgio Treglia, Carlo Introini, Francesco Fiz\",\"doi\":\"10.2967/jnumed.124.267474\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Molecular imaging of muscle-invasive bladder cancer (MBC) is restricted to its locoregional and distant metastases, since most radiopharmaceuticals have a urinary excretion that limits the visualization of the primary tumor. <sup>64</sup>CuCl<sub>2</sub> <sub>,</sub> a positron-emitting radiotracer with nearly exclusive biliary elimination, could be well suited to exploring urinary tract neoplasms. In this study, we evaluated the feasibility of <sup>64</sup>CuCl<sub>2</sub>-based staging of patients with MBC; furthermore, we compared the diagnostic capability of this method with those of the current gold standards, that is, contrast-enhanced CT (ceCT) and <sup>18</sup>F-FDG PET/CT. <b>Methods:</b> We prospectively enrolled patients referred to our institution for pathology-confirmed MBC staging/restaging between September 2021 and January 2023. All patients underwent ceCT, <sup>18</sup>F-FDG, and <sup>64</sup>CuCl<sub>2</sub> PET/CT within 2 wk. Patient-based analysis and lesion-based analysis were performed for all of the potentially affected districts (overall, bladder wall, lymph nodes, skeleton, liver, lung, and pelvic soft tissue). <b>Results:</b> Forty-two patients (9 women) were enrolled. Thirty-six (86%) had evidence of disease, with a total of 353 disease sites. On patient-based analysis, ceCT and <sup>64</sup>CuCl<sub>2</sub> PET/CT showed higher sensitivity than <sup>18</sup>F-FDG PET/CT in detecting the primary tumor (<i>P</i> < 0.001); moreover, <sup>64</sup>CuCl<sub>2</sub> PET/CT was slightly more sensitive than <sup>18</sup>F-FDG PET/CT in disclosing soft-tissue lesions (<i>P</i> < 0.05). Both PET methods were more specific and accurate than ceCT in classifying nodal lesions (<i>P</i> < 0.05). On lesion-based analysis, <sup>64</sup>CuCl<sub>2</sub> PET/CT outperformed <sup>18</sup>F-FDG PET/CT and ceCT in detecting disease localizations overall (<i>P</i> < 0.001), in the lymph nodes (<i>P</i> < 0.01), in the skeleton (<i>P</i> < 0.001), and in the soft tissue (<i>P</i> < 0.05). <b>Conclusion:</b> <sup>64</sup>CuCl<sub>2</sub> PET/CT appears to be a sensitive modality for staging/restaging of MBC and might represent a \\\"one-stop shop\\\" diagnostic method in these scenarios.</p>\",\"PeriodicalId\":94099,\"journal\":{\"name\":\"Journal of nuclear medicine : official publication, Society of Nuclear Medicine\",\"volume\":\" \",\"pages\":\"1357-1363\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-09-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of nuclear medicine : official publication, Society of Nuclear Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2967/jnumed.124.267474\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2967/jnumed.124.267474","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Role of 64CuCl2 PET/CT in Detecting and Staging Muscle-Invasive Bladder Cancer: Comparison with Contrast-Enhanced CT and 18F-FDG PET/CT.
Molecular imaging of muscle-invasive bladder cancer (MBC) is restricted to its locoregional and distant metastases, since most radiopharmaceuticals have a urinary excretion that limits the visualization of the primary tumor. 64CuCl2, a positron-emitting radiotracer with nearly exclusive biliary elimination, could be well suited to exploring urinary tract neoplasms. In this study, we evaluated the feasibility of 64CuCl2-based staging of patients with MBC; furthermore, we compared the diagnostic capability of this method with those of the current gold standards, that is, contrast-enhanced CT (ceCT) and 18F-FDG PET/CT. Methods: We prospectively enrolled patients referred to our institution for pathology-confirmed MBC staging/restaging between September 2021 and January 2023. All patients underwent ceCT, 18F-FDG, and 64CuCl2 PET/CT within 2 wk. Patient-based analysis and lesion-based analysis were performed for all of the potentially affected districts (overall, bladder wall, lymph nodes, skeleton, liver, lung, and pelvic soft tissue). Results: Forty-two patients (9 women) were enrolled. Thirty-six (86%) had evidence of disease, with a total of 353 disease sites. On patient-based analysis, ceCT and 64CuCl2 PET/CT showed higher sensitivity than 18F-FDG PET/CT in detecting the primary tumor (P < 0.001); moreover, 64CuCl2 PET/CT was slightly more sensitive than 18F-FDG PET/CT in disclosing soft-tissue lesions (P < 0.05). Both PET methods were more specific and accurate than ceCT in classifying nodal lesions (P < 0.05). On lesion-based analysis, 64CuCl2 PET/CT outperformed 18F-FDG PET/CT and ceCT in detecting disease localizations overall (P < 0.001), in the lymph nodes (P < 0.01), in the skeleton (P < 0.001), and in the soft tissue (P < 0.05). Conclusion:64CuCl2 PET/CT appears to be a sensitive modality for staging/restaging of MBC and might represent a "one-stop shop" diagnostic method in these scenarios.
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