Diagnostics

Research

16 pages, 1903 KiB

Open AccessArticle

Influence of [¹⁸F]FDG-PET/CT on Clinical Management Decisions in Breast Cancer Patients—A PET/CT Registry Study

by Sebastian Werner, Julia Sekler, Brigitte Gückel, Christian la Fougère, Konstantin Nikolaou, Christina Pfannenberg, Heike Preibsch, Tobias Engler and Susann-Cathrin Olthof

Diagnostics 2023, 13(14), 2420; https://doi.org/10.3390/diagnostics13142420 - 20 Jul 2023

Cited by 1 | Viewed by 1063

Abstract

There is a lack of evidence regarding the clinical impact of [¹⁸F]fluorodeoxyglucose positron emission tomography/computed tomography ([¹⁸F]FDG-PET/CT, hereinafter referred to as PET/CT), especially regarding management changes and their link to overall survival. We analyzed 52 PET/CTs in 47 stage [...] Read more.

There is a lack of evidence regarding the clinical impact of [¹⁸F]fluorodeoxyglucose positron emission tomography/computed tomography ([¹⁸F]FDG-PET/CT, hereinafter referred to as PET/CT), especially regarding management changes and their link to overall survival. We analyzed 52 PET/CTs in 47 stage I-IV breast cancer patients, selected from a prospective oncological PET/CT registry. Indications for PET/CT were primary staging (n = 15), restaging (n = 17), and suspected recurrence (n = 20). PET/CT-induced management changes were categorized as major or minor. PET/CT-induced management changes in 41 of 52 scans (78.8%; 38 of 47 patients (80.9%)), of which major changes were suggested in 18 of 52 scans (34.6%, 17 of 47 patients, 36.2%). PET/CT downstaged 6 of 15 primary staging patients, excluding distant metastases. Major management changes were documented in 3 of 17 restaging exams. PET/CT ruled out clinically suspected recurrence in 6 of 20 cases and confirmed it in 11 of 20. In three cases, locoregional recurrence had already been diagnosed via biopsy. In 30 of 52 exams, additional diagnostic tests were avoided, of which 13 were invasive. PET/CT-based management changes resulted in a 5-year survival rate of 72.3% for the whole study group, 93.3% for the staging group, 53.8% for the restaging group, and 68.4% for the recurrence group. This study shows that PET/CT significantly impacts clinical management decisions in breast cancer patients in different clinical scenarios, potentially determining the patient’s tumor stage as the basis for further therapy more reliably and by avoiding unnecessary diagnostic tests. Full article

(This article belongs to the Special Issue The Impact of PET/CT Imaging in Oncology)

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10 pages, 1298 KiB

Open AccessArticle

Deep Learning-Based Image Quality Improvement in Digital Positron Emission Tomography for Breast Cancer

by Mio Mori, Tomoyuki Fujioka, Mayumi Hara, Leona Katsuta, Yuka Yashima, Emi Yamaga, Ken Yamagiwa, Junichi Tsuchiya, Kumiko Hayashi, Yuichi Kumaki, Goshi Oda, Tsuyoshi Nakagawa, Iichiroh Onishi, Kazunori Kubota and Ukihide Tateishi

Diagnostics 2023, 13(4), 794; https://doi.org/10.3390/diagnostics13040794 - 20 Feb 2023

Viewed by 1464

Abstract

We investigated whether ¹⁸F-fluorodeoxyglucose positron emission tomography (PET)/computed tomography images restored via deep learning (DL) improved image quality and affected axillary lymph node (ALN) metastasis diagnosis in patients with breast cancer. Using a five-point scale, two readers compared the image quality of [...] Read more.

We investigated whether ¹⁸F-fluorodeoxyglucose positron emission tomography (PET)/computed tomography images restored via deep learning (DL) improved image quality and affected axillary lymph node (ALN) metastasis diagnosis in patients with breast cancer. Using a five-point scale, two readers compared the image quality of DL-PET and conventional PET (cPET) in 53 consecutive patients from September 2020 to October 2021. Visually analyzed ipsilateral ALNs were rated on a three-point scale. The standard uptake values SUV_max and SUV_peak were calculated for breast cancer regions of interest. For “depiction of primary lesion”, reader 2 scored DL-PET significantly higher than cPET. For “noise”, “clarity of mammary gland”, and “overall image quality”, both readers scored DL-PET significantly higher than cPET. The SUV_max and SUV_peak for primary lesions and normal breasts were significantly higher in DL-PET than in cPET (p < 0.001). Considering the ALN metastasis scores 1 and 2 as negative and 3 as positive, the McNemar test revealed no significant difference between cPET and DL-PET scores for either reader (p = 0.250, 0.625). DL-PET improved visual image quality for breast cancer compared with cPET. SUV_max and SUV_peak were significantly higher in DL-PET than in cPET. DL-PET and cPET exhibited comparable diagnostic abilities for ALN metastasis. Full article

(This article belongs to the Special Issue The Impact of PET/CT Imaging in Oncology)

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12 pages, 1234 KiB

Open AccessArticle

PET/CT of the Spleen with Gallium-Oxine-Labeled, Heat-Damaged Red Blood Cells: Clinical Experience and Technical Aspects

by Robert Drescher, Philipp Seifert, Sebastian Gröber, Julia Greiser, Christian Kühnel, Falk Gühne and Martin Freesmeyer

Diagnostics 2023, 13(3), 566; https://doi.org/10.3390/diagnostics13030566 - 3 Feb 2023

Cited by 1 | Viewed by 1479

Abstract

Several scintigraphic techniques have been supplemented or replaced by PET/CT methods because of their superior sensitivity, high resolution, and absolute activity quantification capability. The purpose of this project was the development of a PET tracer for splenic imaging, its radiopharmaceutical validation, and its [...] Read more.

Several scintigraphic techniques have been supplemented or replaced by PET/CT methods because of their superior sensitivity, high resolution, and absolute activity quantification capability. The purpose of this project was the development of a PET tracer for splenic imaging, its radiopharmaceutical validation, and its application in selected patients in whom unclear constellations of findings could not be resolved with established imaging methods. Heat-damaged red blood cells (RBCs) were labeled with [⁶⁸Ga]gallium-oxine, which was produced from [⁶⁸Ga]gallium and 8-Hydroxyquinoline (oxine) on an automated synthesizer. Ten patients underwent [⁶⁸Ga]gallium-oxine-RBC-PET/CT for the classification of eleven unclear lesions (3 intra-, 8 extrapancreatic). [⁶⁸Ga]gallium-oxine and [68Ga]gallium-oxine-labeled RBCs could be synthesized reproducibly and reliably. The products met GMP quality standards. The tracer showed high accumulation in splenic tissue. Of the 11 lesions evaluated by PET/CT, 3 were correctly classified as non-splenic, 6 as splenic, 1 as equivocal, and 1 lesion as a splenic hypoplasia. All lesions classified as non-splenic were malignant, and all lesions classified as splenic did not show malignant features during follow-up. PET/CT imaging of the spleen with [⁶⁸Ga]gallium-oxine-labeled, heat-damaged RBCs is feasible and allowed differentiation of splenic from non-splenic tissues, and the diagnosis of splenic anomalies. Full article

(This article belongs to the Special Issue The Impact of PET/CT Imaging in Oncology)

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Review

Jump to: Research, Other

13 pages, 286 KiB

Open AccessReview

Clinical Utility of ¹⁸F-2-Fluoro-deoxy-d-glucose PET Imaging in Locally Advanced Esophageal/Gastroesophageal Junction Adenocarcinoma

by Darren Cowzer, Fergus Keane and Geoffrey Y. Ku

Diagnostics 2023, 13(11), 1884; https://doi.org/10.3390/diagnostics13111884 - 28 May 2023

Viewed by 1132

Abstract

Esophageal adenocarcinoma, including adenocarcinoma of the gastroesophageal junction, is uncommon in the United States, but is associated with a rising incidence in young adults, and has a traditionally poor prognosis. Despite the incremental benefits that have been made with multimodality approaches to locally [...] Read more.

Esophageal adenocarcinoma, including adenocarcinoma of the gastroesophageal junction, is uncommon in the United States, but is associated with a rising incidence in young adults, and has a traditionally poor prognosis. Despite the incremental benefits that have been made with multimodality approaches to locally advanced disease, most patients will go on to develop metastatic disease, and long-term outcomes remain suboptimal. Over the last decade, PET-CT has emerged as a key tool in the management of this disease, with several prospective and retrospective studies evaluating its role in this disease. Herein, we review the key data pertaining to the use of PET-CT in the management of locally advanced esophageal and GEJ adenocarcinoma, with a focus on staging, prognostication, PET-CT adapted therapy in the neoadjuvant setting, and surveillance. Full article

(This article belongs to the Special Issue The Impact of PET/CT Imaging in Oncology)

11 pages, 564 KiB

Open AccessReview

Preliminary Findings of the Role of FAPi in Prostate Cancer Theranostics

by Riccardo Laudicella, Alessandro Spataro, Ludovica Crocè, Giulia Giacoppo, Davide Romano, Valerio Davì, Maria Lopes, Maria Librando, Antonio Nicocia, Andrea Rappazzo, Greta Celesti, Flavia La Torre, Benedetta Pagano, Giuseppe Garraffa, Matteo Bauckneht, Irene A Burger, Fabio Minutoli and Sergio Baldari

Diagnostics 2023, 13(6), 1175; https://doi.org/10.3390/diagnostics13061175 - 19 Mar 2023

Cited by 6 | Viewed by 2036

Abstract

Prostate cancer (PCa) is the most frequently diagnosed cancer worldwide and the second most common cause of cancer-related deaths among men. Progress in molecular imaging has magnified its clinical management; however, an unmet clinical need involves the identification of new imaging biomarkers that [...] Read more.

Prostate cancer (PCa) is the most frequently diagnosed cancer worldwide and the second most common cause of cancer-related deaths among men. Progress in molecular imaging has magnified its clinical management; however, an unmet clinical need involves the identification of new imaging biomarkers that complement the gold standard of prostate-specific membrane antigen (PSMA) positron emission tomography (PET) in cases of clinically significant PCa that do not express PSMA. Fibroblast activation protein (FAP) is a type II transmembrane serine overexpressed in many solid cancers that can be imaged through quinoline-based PET tracers derived from an FAP inhibitor (FAPi). Preliminary results of FAPi application in PCa (in PSMA-negative lesions, and in comparison with fluorodeoxyglucose—FDG) are now available in the literature. FAP-targeting ligands for PCa are not limited to detection, but could also include therapeutic applications. In this preliminary review, we provide an overview of the clinical applications of FAPi ligands in PCa, summarising the main results and highlighting contemporary strengths and limitations. Full article

(This article belongs to the Special Issue The Impact of PET/CT Imaging in Oncology)

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26 pages, 3867 KiB

Open AccessReview

The Role of PET/CT in Breast Cancer

by Bawinile Hadebe, Lerwine Harry, Tasmeera Ebrahim, Venesen Pillay and Mariza Vorster

Diagnostics 2023, 13(4), 597; https://doi.org/10.3390/diagnostics13040597 - 6 Feb 2023

Cited by 12 | Viewed by 8686

Abstract

Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer worldwide, with an estimated 2.3 million new cases (11.7%), followed by lung cancer (11.4%) The current literature and the National Comprehensive Cancer Network (NCCN) guidelines state that ¹⁸F-FDG PET/CT [...] Read more.

Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer worldwide, with an estimated 2.3 million new cases (11.7%), followed by lung cancer (11.4%) The current literature and the National Comprehensive Cancer Network (NCCN) guidelines state that ¹⁸F-FDG PET/CT is not routine for early diagnosis of breast cancer, and rather PET/CT scanning should be performed for patients with stage III disease or when conventional staging studies yield non-diagnostic or suspicious results because this modality has been shown to upstage patients compared to conventional imaging and thus has an impact on disease management and prognosis. Furthermore, with the growing interest in precision therapy in breast cancer, numerous novel radiopharmaceuticals have been developed that target tumor biology and have the potential to non-invasively guide the most appropriate targeted therapy. This review discusses the role of ¹⁸F-FDG PET and other PET tracers beyond FDG in breast cancer imaging. Full article

(This article belongs to the Special Issue The Impact of PET/CT Imaging in Oncology)

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17 pages, 2393 KiB

Open AccessReview

The Impact of PET/CT on Paediatric Oncology

by Anita Brink, Khanyisile N. Hlongwa and Stuart More

Diagnostics 2023, 13(2), 192; https://doi.org/10.3390/diagnostics13020192 - 5 Jan 2023

Cited by 1 | Viewed by 2324

Abstract

This review paper will discuss the use of positron emission tomography/computed tomography (PET/CT) in paediatric oncology. Functional imaging with PET/CT has proven useful to guide treatment by accurately staging disease and limiting unnecessary treatments by determining the metabolic response to treatment. ¹⁸F-Fluorodeoxyglucose [...] Read more.

This review paper will discuss the use of positron emission tomography/computed tomography (PET/CT) in paediatric oncology. Functional imaging with PET/CT has proven useful to guide treatment by accurately staging disease and limiting unnecessary treatments by determining the metabolic response to treatment. ¹⁸F-Fluorodeoxyglucose (2-[¹⁸F]FDG) PET/CT is routinely used in patients with lymphoma. We highlight specific considerations in the paediatric population with lymphoma. The strengths and weaknesses for PET/CT tracers that compliment Meta-[¹²³I]iodobenzylguanidine ([¹²³I]mIBG) for the imaging of neuroblastoma are summarized. 2-[¹⁸F]FDG PET/CT has increasingly been used in the staging and evaluation of disease response in sarcomas. The current recommendations for the use of PET/CT in sarcomas are given and potential future developments and highlighted. 2-[¹⁸F]FDG PET/CT in combination with conventional imaging is currently the standard for disease evaluation in children with Langerhans-cell Histiocytosis (LCH) and the non-LCH disease spectrum. The common pitfalls of 2-[¹⁸F]FDG PET/CT in this setting are discussed. Full article

(This article belongs to the Special Issue The Impact of PET/CT Imaging in Oncology)

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13 pages, 895 KiB

Open AccessReview

The Role of Positron Emission Tomography and Computed Tomographic (PET/CT) Imaging for Radiation Therapy Planning: A Literature Review

by Abba Mallum, Thokozani Mkhize, John M. Akudugu, Wilfred Ngwa and Mariza Vorster

Diagnostics 2023, 13(1), 53; https://doi.org/10.3390/diagnostics13010053 - 24 Dec 2022

Cited by 5 | Viewed by 2557

Abstract

PET/CT is revolutionising radiotherapy treatment planning in many cancer sites. While its utility has been confirmed in some cancer sites, and is used in routine clinical practice, it is still at an experimental stage in many other cancer sites. This review discusses the [...] Read more.

PET/CT is revolutionising radiotherapy treatment planning in many cancer sites. While its utility has been confirmed in some cancer sites, and is used in routine clinical practice, it is still at an experimental stage in many other cancer sites. This review discusses the utility of PET/CT in cancer sites where the role of PET/CT has been established in cases such as head and neck, cervix, brain, and lung cancers, as well as cancer sites where the role of PET/CT is still under investigation such as uterine, ovarian, and prostate cancers. Finally, the review touches on PET/CT utilisation in Africa. Full article

(This article belongs to the Special Issue The Impact of PET/CT Imaging in Oncology)

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Other

Jump to: Research, Review

4 pages, 1435 KiB

Open AccessInteresting Images

Clinical Challenge of Two Competing Targetable Mutations in Non-Small-Cell Lung Cancer: A Case Report

by Sonya Youngju Park, Hyuk** Yoon, Eun Ji Han and Ie Ryung Yoo

Diagnostics 2023, 13(19), 3112; https://doi.org/10.3390/diagnostics13193112 - 2 Oct 2023

Viewed by 965

Abstract

The development of therapeutic agents targeting products of epidermal growth factor receptor (EGFR) gene mutation and anaplastic lymphoma kinase (ALK) rearrangements has improved survival in patients with non-small-cell lung cancer. EGFR and ALK mutations are generally regarded as mutually exclusive, and the presence [...] Read more.

The development of therapeutic agents targeting products of epidermal growth factor receptor (EGFR) gene mutation and anaplastic lymphoma kinase (ALK) rearrangements has improved survival in patients with non-small-cell lung cancer. EGFR and ALK mutations are generally regarded as mutually exclusive, and the presence of one in lieu of another influences the response to targeted therapy. We herein present an interesting case following the course of progression of a patient with synchronous lung cancers with a discordant mutation profile. The importance of this modality in the follow-up of lung cancer patients is illustrated, and the therapeutic implications of coexisting oncogenic drivers are briefly discussed. Full article

(This article belongs to the Special Issue The Impact of PET/CT Imaging in Oncology)

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