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OBJECTIVE: We aimed to compare different segmentation methods used to calculate prognostically valuable volumetric parameters, somatostatin receptor expressing tumor volume (SRETV), and total lesion somatostatin receptor expression (TLSRE), measured by 68 Ga-DOTATATE PET/CT and to find the optimal segmentation method to predict prognosis. PATIENTS AND METHODS: Images of 34 patients diagnosed with gastroenteropancreatic neuroendocrine tumor (GEPNET) who underwent 68 Ga-DOTATATE PET/CT imaging were reanalyzed. Four different threshold-based methods (fixed relative threshold method, normal liver background threshold method, fixed absolute standardized uptake value (SUV) threshold method, and adaptive threshold method) were used to calculate SRETV and TLSRE values. SRETV of all lesions of a patient was summarized as whole body SRETV (WB-SRETV) and TLSRE of all lesions of a patient was computed as whole body TLSRE (WB-TLSRE). RESULTS: WB-SRETVs calculated with all segmentation methods were statistically significantly associated with progression-free survival except WB-SRETV at which was calculated using adaptive threshold method. The fixed relative threshold methods calculated by using 45% (WB-SRETV 45% ) and 60% (WB-SRETV 60% ) of the SUV value as threshold respectively, were found to have statistically significant highest prognostic value (C-indexâ =â 0.704, CIâ =â 0.622-0.786, P â =â 0.007). Among WB-TLSRE parameters, WB-TLSRE 35% , WB-TLSRE 40% , and WB-TLSRE 50% had the highest prognostic value (C-indexâ =â 0.689, CIâ =â 0.604-0.774, P â =â 0.008). CONCLUSION: The fixed relative threshold method was found to be the most effective and easily applicable method to measure SRETV on pretreatment 68 Ga-DOTATATE PET/CT to predict prognosis in GEPNET patients. WB-SRETV 45% (cutoff value of 11.8â cm 3 ) and WB-SRETV 60% (cutoff value of 6.3 cm 3 ) were found to be the strongest predictors of prognosis in GEPNET patients.
Assuntos
Neoplasias Intestinais , Tumores Neuroendócrinos , Compostos Organometálicos , Neoplasias Pancreáticas , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Receptores de Somatostatina , Neoplasias Gástricas , Carga Tumoral , Humanos , Tumores Neuroendócrinos/diagnóstico por imagem , Tumores Neuroendócrinos/metabolismo , Tumores Neuroendócrinos/patologia , Receptores de Somatostatina/metabolismo , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/metabolismo , Neoplasias Pancreáticas/patologia , Masculino , Neoplasias Intestinais/diagnóstico por imagem , Neoplasias Intestinais/metabolismo , Neoplasias Intestinais/patologia , Feminino , Pessoa de Meia-Idade , Neoplasias Gástricas/diagnóstico por imagem , Neoplasias Gástricas/metabolismo , Neoplasias Gástricas/patologia , Prognóstico , Adulto , Idoso , Processamento de Imagem Assistida por Computador/métodos , Estudos Retrospectivos , Idoso de 80 Anos ou maisRESUMO
ABSTRACT: Desmoid fibromatosis, also called desmoid tumors, is a group of locally aggressive fibromatous proliferative disorders. They represent less than 3% of all soft tissue sarcoma and are multifocal in approximately 10% of cases. However, there are only a few cases in the literature describing 18F-FDG PET/CT and 99mTc-MDP bone scan features of extra-abdominal desmoid fibromas, and all were solitary bone lesions. Herein, we presented a unique case of multifocal desmoid fibromatosis of bone illustrating the prospective value of 18F-FDG PET/CT and 99mTc-MDP bone scan in the evaluation of desmoid tumors.
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Neoplasias Ósseas , Fibroma , Fibromatose Agressiva , Humanos , Medronato de Tecnécio Tc 99m , Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Fibromatose Agressiva/diagnóstico por imagem , Estudos Prospectivos , Tomografia Computadorizada por Raios X , Neoplasias Ósseas/diagnóstico por imagemRESUMO
OBJECTIVES: There is a lack of sufficient evidence regarding the use of extended shelf-life (ExSL) Yttrium-90 ( 90 Y) glass radiomicrospheres in metastatic colorectal cancer (mCRC) patients. We aimed to investigate the efficacy of ExSL 90 Y glass radiomicrospheres with a personalized treatment approach by analyzing 18 F-FDG PET/CT quantitative parameters [metabolic tumor volume (MTV) and total lesion glycolysis (TLG)] separately before and after the treatment. METHODS: A total of 93 radioembolization sessions involving 77 patients were included. Simplicit 90 Y software was utilized to perform multicompartmental voxel-based dosimetry. Adverse events were recorded using the CTCAE v5.0 criteria. The survival data were recorded in detail. RESULTS: The overall disease control rate was 84.9%, with a median overall survival (OS) of 12.7 months and median progression-free survival (PFS) of 8.3 months. A statistically significant increase in treatment response rate was observed when there was an increase in absorbed tumor dose for pre-treatment unit MTV ( P â =â 0.005) and TLG ( P â =â 0.004) values. We didn't observe any additional side effects/vital risks that could be considered clinically significant. CONCLUSION: Our study has provided evidence on the therapeutic effectiveness and safety in terms of dose-toxicity profile of ExSL 90 Y glass microspheres in a large cohort of mCRC patients. With a personalized treatment approach, the increase in radiation dose absorbed by the tumor has shown a significant contribution to treatment response rate, as indicated by quantitative measurements obtained through 18 F-FDG PET/CT.
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Neoplasias Colorretais , Neoplasias Hepáticas , Radioisótopos de Ítrio , Humanos , Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Compostos Radiofarmacêuticos/uso terapêutico , Microesferas , Neoplasias Colorretais/diagnóstico por imagem , Neoplasias Colorretais/radioterapia , Neoplasias Colorretais/tratamento farmacológico , Estudos Retrospectivos , Prognóstico , Neoplasias Hepáticas/secundárioRESUMO
ABSTRACT: Pulmonary carcinoid tumors are a very rare type of neuroendocrine tumor, accounting for only 1% to 2% of all primary lung cancers. Pulmonary carcinoids most commonly metastasize to the mediastinal lymph nodes, liver, and bones. Metastasis of pulmonary carcinoids to the skin and subcutaneous tissue is extremely rare and has been reported in only a small number of cases. We presented 68 Ga-DOTATATE PET/CT findings of an exceptional case of a pulmonary carcinoid tumor with extensive skin, subcutaneous, thyroid, and intramuscular metastases.
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Tumor Carcinoide , Carcinoma Neuroendócrino , Neoplasias Pulmonares , Tumores Neuroendócrinos , Compostos Organometálicos , Humanos , Tumor Carcinoide/diagnóstico por imagem , Tumor Carcinoide/patologia , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Tumores Neuroendócrinos/patologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tela Subcutânea/patologiaRESUMO
ABSTRACT: The role of 68 Ga-DOTATATE PET/CT in the evaluation of neuroendocrine tumors is well defined. Nevertheless, 68 Ga-DOTATATE uptake may be seen in some tumors other than neuroendocrine tumors as a reflection of tumor blood supply and somatostatin receptor expression. Although 68 Ga-DOTATATE uptake has been described in a number of nonneuroendocrine tumors, no case of 68 Ga-DOTATATE uptake in esophagus adenocarcinoma has been reported. We present the case of a 52-year-old man who had a metastatic esophageal adenocarcinoma showing 68 Ga-DOTATATE uptake.
Assuntos
Adenocarcinoma , Neoplasias Esofágicas , Tumores Neuroendócrinos , Compostos Organometálicos , Masculino , Humanos , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Neoplasias Esofágicas/diagnóstico por imagem , Adenocarcinoma/diagnóstico por imagem , Tumores Neuroendócrinos/patologia , Compostos Organometálicos/metabolismoRESUMO
BACKGROUND: Prognostic markers in metastatic renal cell cancer (mRCC) are still insufficient. Any prognostic model objectively determines disease burden. PURPOSE: To investigate the relationship between 18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) parameters and outcomes in mRCC, and to define a revised International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) model for the intermediate-risk group. MATERIAL AND METHODS: A retrospective study of mRCC was conducted. To investigate the prognostic significance of 18F-FDG PET/CT parameters, maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG), and metabolic tumor volume (MTV) were determined in pre-treatment images. Cutoff values were defined by ROC curve analyses and their association with outcomes was analyzed. Additionally, a TLG-adjusted IMDC model was created by stratifying intermediate-risk group patients according to TLG levels. RESULTS: The study included 52 patients. The disease control rate (DCR) was 61.5% and median overall survival (OS) was 18 months (95% confidence interval=9.2-25.8). In the univariate analyses, IMDC score, MTV, and TLG were prognostic factors for Disease Control Rate (DCR), and Eastern Cooperative Oncology Group (ECOG)-Performance Status (PS), IMDC score, lactate dehydrogenase (LDH), treatment option, MTV, and TLG were prognostic factors for OS (P < 0.05 each). In the multivariate analyses, MTV was an independent prognostic factor for DCR, and ECOG-PS, LDH, IMDC score, and TLG were independent prognostic factors for OS. According to the revised-IMDC model, the intermediate-favorable group showed longer OS than the intermediate-unfavorable group. CONCLUSION: Pretreatment MTV was independent prognostic factor for DCR and ECOG-PS, LDH, IMDC score, and TLG were independent prognostic factors for OS. Revised-IMDC model could identify patients with a worse prognosis among the IMDC intermediate-risk group.
Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Fluordesoxiglucose F18/metabolismo , Carcinoma de Células Renais/diagnóstico por imagem , Prognóstico , Estudos Retrospectivos , Neoplasias Renais/diagnóstico por imagem , Carga Tumoral , Compostos RadiofarmacêuticosRESUMO
Nasolacrimal duct obstruction (NLDO) is a rare complication after radioiodine therapy and may cause false positive 131I uptake at the point of obstruction in 131I whole body scan. Here, we report a 59-year-old female patient with papillary thyroid cancer treated with total thyroidectomy followed by 131I therapy. 131I whole body scan revealed focal uptake in the head. Single photon emission computed tomography/computed tomography (CT) showed focal uptake at the right proximal nasolacrimal duct. The ophthalmologic examination and the diagnostic maxillofacial CT confirmed the diagnosis of NLDO.
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Langerhans cell histiocytosis (LCH) is a rare disease that occurs mainly in pediatric patients and most adult LCH is considered a part of multisystem or multifocal disease. Only 7.3% of cases present as unifocal bone lesion. Herein, we present a case of an isolated scapular lesion of LCH in a 48-year-old man.
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OBJECTIVE: We aimed to evaluate whether baseline 68Ga-PSMA PET/CT-derived whole-body volumetric parameters could be used as predictive biomarkers for survival in metastatic castration-resistant prostate cancer (mCRPC) patients receiving first-line treatment. MATERIALS AND METHODS: This retrospective study included 54 mCRPC patients, who underwent baseline 68Ga-PSMA PET/CT imaging within 1 month before starting first-line treatment. Pre-treatment prostate-specific antigen (PSA) levels and treatments were recorded. SUVmax, SUVmean, whole-body PSMA-derived tumor volume (wbPSMA-TV), and whole-body total lesion PSMA (wbTL-PSMA) were calculated for all patients. PSA response was defined as a decline of ≥ 50% from pre-treatment value at 12 weeks. Overall survival (OS) was measured from the start of the first-line treatment for mCRPC. RESULTS: Docetaxel and abiraterone/enzalutamide were administered to 32 and 22 patients in the first-line setting, respectively. wbPSMA-TV (rho = 0.582, p = 0.004) and wbTL-PSMA (rho = 0.564, p = 0.007) showed moderate positive correlations with PSA levels. Older age (p = 0.02), higher wbPSMA-TV (p = 0.007), higher PSA (p = 0.01), higher number of bone metastases (p = 0.02), and lack of PSA response (p = 0.03) were significantly associated with an increased risk of mortality. Multivariate analysis determined wbPSMA-TV (HR: 1.003, 95% CI 1.001-1.004, p = 0.001) and PSA response (HR: 2.241, 95% CI 1.189-4.222, p = 0.01) as independent predictors of OS. CONCLUSION: The wbPSMA-TV may be a useful tool to reflect tumor burden and predict survival outcomes in patients with mCRPC.
Assuntos
Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Neoplasias de Próstata Resistentes à Castração , Masculino , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Antígeno Prostático Específico , Neoplasias de Próstata Resistentes à Castração/diagnóstico por imagem , Neoplasias de Próstata Resistentes à Castração/radioterapia , Neoplasias de Próstata Resistentes à Castração/patologia , Docetaxel , Estudos Retrospectivos , Radioisótopos de Gálio , Resultado do Tratamento , Compostos Heterocíclicos com 1 AnelRESUMO
ABSTRACT: Dysregulation of the cyclin D-CDK4/6-INK4-RB pathway, which leads to uncontrolled cell proliferation, is frequently observed in breast cancer. Recently, 3 CDK4/6 inhibitors have been FDA approved as first-line treatment for patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer. Despite promising clinical results, the metabolic response to treatment with these new drugs has not been elaborately demonstrated yet. Herein, we presented a patient with hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer who demonstrated a complete metabolic response on 18F-FDG PET/CT to treatment with a CDK4/6 inhibitor (ribociclib).
Assuntos
Neoplasias da Mama , Neoplasias de Mama Triplo Negativas , Protocolos de Quimioterapia Combinada Antineoplásica , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/metabolismo , Quinase 4 Dependente de Ciclina/uso terapêutico , Quinase 6 Dependente de Ciclina/uso terapêutico , Ciclinas/uso terapêutico , Feminino , Fluordesoxiglucose F18 , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Inibidores de Proteínas Quinases/farmacologia , Inibidores de Proteínas Quinases/uso terapêutico , Receptor ErbB-2RESUMO
ABSTRACT: Neurofibromatosis type 2 (NF2) is an autosomal-dominant tumor predisposing syndrome that results from mutations in the NF2 tumor suppressor gene on chromosome 22. The development of bilateral vestibular schwannomas is the characteristic feature of the disease. However, other nervous system tumors, including meningiomas, ependymomas, and schwannomas, can be seen frequently. Herein, we present 68 Ga-DOTATATE PET/CT findings of 2 siblings with NF2.
Assuntos
Neoplasias Meníngeas , Meningioma , Neurofibromatose 2 , Neuroma Acústico , Humanos , Neurofibromatose 2/diagnóstico por imagem , Neuroma Acústico/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia por Emissão de Pósitrons , CintilografiaRESUMO
ABSTRACT: A 71-year-old man who was diagnosed with carotid body paraganglioma was referred to 68 Ga-DOTATATE PET/CT for primary evaluation, which revealed unknown bony metastasis with intense 68 Ga-DOTATATE uptake. Head and neck paragangliomas are rare neuroendocrine tumors, with a 10% of malignancy rate, and identification of metastatic sites is important in staging and prognosis of the disease. We aimed to highlight the impact of 68 Ga-DOTATATE PET/CT on patient management, especially for equivocal lesions, as in our case.
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Doenças da Medula Óssea , Corpo Carotídeo , Tumores Neuroendócrinos , Compostos Organometálicos , Idoso , Radioisótopos de Gálio , Humanos , Masculino , Tumores Neuroendócrinos/secundário , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia por Emissão de Pósitrons , Cintilografia , Compostos RadiofarmacêuticosRESUMO
ABSTRACT: Obstruction of the blood flow from the superior vena cava (SVC) to the right atrium causes the SVC syndrome. The azygos system is the most important way to overcome SVC obstruction. Azygos vein enlargement can be seen secondary to the SVC syndrome. Although a few cases showing 18 F-FDG uptake along the SVC in SVC syndrome were reported before, 18 F-FDG PET/CT findings of azygos vein enlargement have not been documented yet. Herein, we presented an intriguing case of azygos vein enlargement secondary to SVC syndrome on 18 F-FDG PET/CT.
Assuntos
Síndrome da Veia Cava Superior , Veia Ázigos/diagnóstico por imagem , Fluordesoxiglucose F18 , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/efeitos adversos , Síndrome da Veia Cava Superior/complicações , Síndrome da Veia Cava Superior/diagnóstico por imagem , Veia Cava Superior/diagnóstico por imagemRESUMO
ABSTRACT: Von Hippel-Lindau (VHL) disease is an autosomal dominant hereditary cancer syndrome that is characterized by the presence of various malignant and benign tumors, including retinal and central nervous system hemangioblastomas. Hemangioblastomas are highly vascular tumors that can occur sporadically or within VHL disease. Herein, we present 68 Ga-DOTATATE PET/CT findings of a unique case of suprasellar hemangioblastoma in a 52-year-old man with VHL disease.
Assuntos
Hemangioblastoma , Doença de von Hippel-Lindau , Radioisótopos de Gálio , Hemangioblastoma/diagnóstico por imagem , Hemangioblastoma/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia por Emissão de Pósitrons , Cintilografia , Compostos Radiofarmacêuticos , Doença de von Hippel-Lindau/complicações , Doença de von Hippel-Lindau/diagnóstico por imagem , Doença de von Hippel-Lindau/patologiaRESUMO
ABSTRACT: Nasal-type extranodal natural killer/T-cell lymphoma is an aggressive rare type of lymphoma that mostly affects the nasal cavity and adjacent areas. However, some patients can present with distant nodal or extranodal involvement including the Waldeyer ring, gastrointestinal tract, genitourinary organs, lung, thyroid, skin, or adrenal glands. Herein, we present a unique case of extranodal natural killer/T-cell lymphoma with widespread cutaneous and subcutaneous involvement on 18 F-FDG PET/CT.
Assuntos
Fluordesoxiglucose F18 , Linfoma Extranodal de Células T-NK , Humanos , Linfoma Extranodal de Células T-NK/diagnóstico por imagem , Linfoma Extranodal de Células T-NK/patologia , Cavidade Nasal/patologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia por Emissão de PósitronsRESUMO
ABSTRACT: Glomus tumors are rare, slow-growing extra-adrenal paragangliomas of the head and neck. Treatment and prevention of neurological deficits become more difficult as these tumors aggressively grow in size and infiltrate adjacent anatomical structures. Because glomus tumors are paragangliomas of neuroendocrine origin, 68Ga-DOTATATE PET/CT can be used as imaging method in the diagnosis and follow-up. In this case, we presented a recurrent glomus jugulare tumor that invaded to the cerebellum on 68Ga-DOTATATE PET/CT imaging.
Assuntos
Tumor do Glomo Jugular , Tumores Neuroendócrinos , Compostos Organometálicos , Paraganglioma , Cerebelo/patologia , Humanos , Paraganglioma/diagnóstico por imagem , Paraganglioma/patologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Tomografia por Emissão de Pósitrons , CintilografiaRESUMO
ABSTRACT: Pituitary carcinomas are extremely rare and aggressive tumors that comprise only 0.2% of all pituitary tumors. Because of its rarity, pituitary carcinomas are difficult to diagnose. Conventional imaging methods are inadequate to detect metastatic lesions. Pituitary carcinomas are neuroendocrine tumors and express somatostatin receptors; therefore, 68Ga-DOTATATE PET/CT may be used in the staging of these rare tumors. Herein, we present an exceptional case of pituitary carcinoma with sclerotic skeletal metastases showing 68Ga-DOTATATE uptake.
Assuntos
Tumores Neuroendócrinos , Compostos Organometálicos , Neoplasias Hipofisárias , Humanos , Neoplasias Hipofisárias/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia por Emissão de Pósitrons , Cintilografia , Receptores de SomatostatinaRESUMO
Primary lung cancers in children are rare, and most children are diagnosed incidentally while being investigated for another medical problem. The diagnosis of primary lung tumors in children is very difficult because many children are asymptomatic until the advanced stages of the disease and nonspecific imaging findings. Although the usage of 68Ga-tetraazacyclododecane tetraacetic acid-DPhe1-Tyr3-octreotate (68Ga-DOTATATE) positron emission tomography/computed tomography (PET/CT) in adult patients is well known, it is a relatively new imaging modality for the pediatric patient group. Herein, we presented a unique case of large-cell neuroendocrine carcinoma of the lung in a child on 68Ga-DOTATATE PET/CT.
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Tertiary hyperparathyroidism (TH) is a rare condition that develops from secondary hyperparathyroidism in cases when the secretion becomes autonomous. Brown tumors (BTs) are rare skeletal lesions of hyperparathyroidism that may mimic cancer metastasis. We report a case of a patient who was diagnosed with TH with multiple BTs which mimics osteolytic/osteoblastic metastases that were evaluated with two fluorodeoxyglucose positron emission tomography scans with an interval of 23 months in the preoperative and postoperative period.