AIM: Evaluate the therapy impact of initial staging in patients diagnosed with prostate cancer by 18 F-choline PET/MRI hybrid technique. MATERIAL: A prospective study which included 31 patients diagnosed with prostate cancer; Gleason > 7; mean PSA 13.6 ng/mL (range 6.3-20.6). PET/MRI studies were acquired simultaneously with hybrid equipment (SIGNA.3T, GE) following intravenous injection of 185 ± 18.5MBq of 18F-choline: - Early/prostate imaging: PET emission + multiparametric MR: DIXON-T1-T2-diffusion-gadolinium. - Late/whole-body imaging: PET emission + MR: DIXON-T1-T2-diffusion-STIR sequences. Images were visually evaluated. SUV & ADC & textures were also calculated. Treatment selection was based upon Oncology Committee consensus decision. RESULTS: Procedure was well tolerated in all patients, and no artifacts were reported. MRI was superior in T staging in eight patients (25.8%) (Likert: 2-3), whereas PET increased MRI sensitivity in three patients (9.7%) (PIRADS: 3). PROSTATE LESION LOCATION: Peripheral 91.4%, transitional 8.6%. SUVmax threshold: 2.95: sensitivity 92.9%, specificity 66.7%. No correlation SUV vs. ADC. Better distinction between stage T2 vs. T3 using the DiscrLin model with NG = 16 (AUC 0.7767 ± 0.3386). PET was superior to T2 in textures analysis (0.588 vs. 0.412). Seventeen patients (54.8%) were staged ≥ T3, with surgical treatment being contraindicated. Fifteen patients (48.4%) presented with extra-prostatic disease: 8/31 oligometastatic and 7/31 multiple metastasis. Therapy approach following PET/MRI was: radical treatment in 24/31 patients (77.4%), 14 radical prostatectomy and 10 MRI-guided radiotherapy; systemic treatment in 7/31 patients (22.6%). CONCLUSION: 18F-choline PET/MRI had a complementary role for the T staging, with a high detection rate for NM infiltration. PET/MRI findings allowed patients to be directed either to prostatectomy or MRI-guided radiotherapy, and thus avoiding radicaltreatment in 22.6% of patients.
OBJETIVO: Evaluar la tasa de detección de la PET/RM con 18F-colina y los cambios en el manejo terapéutico de los pacientes con cáncer de próstata tratados con prostatectomía que presentan elevación del PSA <1 ng/ml. MÉTODO: Estudio prospectivo de los 36 primeros pacientes con cáncer de próstata tratados con prostatectomía, con elevación de PSA<1 ng/ml, a los que hemos realizado una PET/RM con 18F-colina. Tras la administración de 185±10% MBq de 18F-colina se ha adquirido un estudio en dos fases: 1) precoz prostática (inmediatamente tras la administración del trazador): emisión PET/RM multiparamétrica. 2) Estudio una hora postinyección de cuerpo completo: emisión PET/RM: T1, T2, STIR, difusión. El comité oncológico ha decidido la estrategia terapéutica de los pacientes según los hallazgos de la PET/RM con 18F-colina. RESULTADOS: De los 36 pacientes, 20 (55,6%) han mostrado positividad del estudio PET/RM con 18F-colina: en 8 (22,2%) lecho de prostatectomía, en 7 (19,4%) adenopatías infradiafragmáticas, en 4 (11,1%) recidiva local y adenopatías infradiafragmáticas, en 1 (2,8%) una metástasis ósea. De los 36 pacientes, en 16 (44,4%) el estudio PET/RM con 18F-colina ha sido negativo. Los hallazgos de la PET/RM con 18F-colina han condicionado la estrategia terapéutica: en 15 pacientes (41,6%) enfermedad oligometastásica tratada con radioterapia guiada por la imagen, en 5 (13,9%) enfermedad multimetastásica tratada con privación androgénica, en 16 (44,4%) negativo en vigilancia activa. CONCLUSIÓN: La técnica híbrida PET/RM con 18F-colina ha demostrado una elevada tasa de detección de la recidiva en los pacientes tratados con prostatectomía que presentan PSA <1 ng/ml, permitiendo una estrategia terapéutica personalizada según los hallazgos de la exploración
OBJECTIVE: To assess the detection rate of 18F-Choline PET/MRI and subsequent changes in therapy approach for patients with prostate cancer treated by prostatectomy and with rising levels of PSA <1 ng/ml. METHODS: Prospective study with our first 36 patients with prostatectomy for prostate cancer and rising levels of PSA, who were referred for an 18F-Choline PET/MRI study. A dual-phase study was acquired after intravenous administration of 185±10% MBq of 18F-Choline: 1) early imaging (immediately after tracer administration) of prostate area (emission PET/Multiparametric MRI). 2) whole-body imaging 1 h after tracer injection (emission PET/MRI: T1, T2, STIR, diffusion). The therapy approach for patients was decided upon the Oncology Committee consensus based on 18F-Choline PET/MRI findings. RESULTS: Twenty out of 36 patients (55.6%) were positive for the 18F-Choline PET/MRI study: 8 (22.2%) within the prostatectomy bed, 7 (19.4%) with infradiaphragmatic lymph nodes, 4 (11.1%) with local recurrence and infradiaphragmatic lymph nodes, and 1 (2.8%) with bone metastasis. Sixteen out of the 36 patients (44.4%) were negative for the 18F-Choline PET/MRI study. 18F-Choline PET/MRI findings had an impact on the therapy approach to follow: 15 patients (41.6%) showed oligometastatic disease which was treated by imaging-guided radiotherapy, 5 (13.9%) with multiple metastatic disease were treated by androgen deprivation therapy, 16 (44.4%) negative were under active surveillance. CONCLUSION: Hybrid 18F-Choline PET/MRI procedure showed a high detection rate for recurrence in prostate cancer patients treated with prostatectomy and rising PSA levels <1 ng/ml, and 18F-Choline PET/MRI findings resulted in a better tailored therapy approach delivered to our patients
Humans , Male , Middle Aged , Aged , Positron Emission Tomography Computed Tomography/methods , Magnetic Resonance Spectroscopy/methods , Prostatic Neoplasms/diagnostic imaging , Multimodal Imaging/methods , Prostatectomy/statistics & numerical data , Prostate-Specific Antigen/analysis , Prospective Studies , Radiopharmaceuticals/administration & dosage , Neoplasm Recurrence, Local/diagnostic imaging , Neoplasm Staging/methods
No disponible
Humans , Male , Middle Aged , Carcinoid Tumor/diagnostic imaging , Fluorodeoxyglucose F18 , Lung Neoplasms/diagnostic imaging , Multiple Pulmonary Nodules/diagnostic imaging , Tomography, X-Ray Computed , Radiopharmaceuticals , Carcinoid Tumor/metabolism , Carcinoid Tumor/pathology , Fluorodeoxyglucose F18/pharmacokinetics , Lung Neoplasms/metabolism , Lung Neoplasms/pathology , Multiple Pulmonary Nodules/metabolism , Multiple Pulmonary Nodules/pathology , Positron-Emission Tomography , Radiopharmaceuticals/pharmacokinetics
OBJECTIVE: To assess the detection rate of 18F-Choline PET/MRI and subsequent changes in therapy approach for patients with prostate cancer treated by prostatectomy and with rising levels of PSA <1 ng/ml. METHODS: Prospective study with our first 36 patients with prostatectomy for prostate cancer and rising levels of PSA, who were referred for an 18F-Choline PET/MRI study. A dual-phase study was acquired after intravenous administration of 185±10% MBq of 18F-Choline: 1) early imaging (immediately after tracer administration) of prostate area (emission PET/Multiparametric MRI). 2) whole-body imaging 1 h after tracer injection (emission PET/MRI: T1, T2, STIR, diffusion). The therapy approach for patients was decided upon the Oncology Committee consensus based on 18F-Choline PET/MRI findings. RESULTS: Twenty out of 36 patients (55.6%) were positive for the 18F-Choline PET/MRI study: 8 (22.2%) within the prostatectomy bed, 7 (19.4%) with infradiaphragmatic lymph nodes, 4 (11.1%) with local recurrence and infradiaphragmatic lymph nodes, and 1 (2.8%) with bone metastasis. Sixteen out of the 36 patients (44.4%) were negative for the 18F-Choline PET/MRI study. 18F-Choline PET/MRI findings had an impact on the therapy approach to follow: 15 patients (41.6%) showed oligometastatic disease which was treated by imaging-guided radiotherapy, 5 (13.9%) with multiple metastatic disease were treated by androgen deprivation therapy, 16 (44.4%) negative were under active surveillance. CONCLUSION: Hybrid 18F-Choline PET/MRI procedure showed a high detection rate for recurrence in prostate cancer patients treated with prostatectomy and rising PSA levels <1 ng/ml, and 18F-Choline PET/MRI findings resulted in a better tailored therapy approach delivered to our patients.
Adenocarcinoma/diagnostic imaging , Choline/analogs & derivatives , Fluorine Radioisotopes , Kallikreins/blood , Multimodal Imaging , Multiparametric Magnetic Resonance Imaging/methods , Positron Emission Tomography Computed Tomography/methods , Prostate-Specific Antigen/blood , Prostatic Neoplasms/diagnostic imaging , Radiopharmaceuticals , Adenocarcinoma/blood , Adenocarcinoma/secondary , Adenocarcinoma/surgery , Aged , Bone Neoplasms/diagnostic imaging , Bone Neoplasms/secondary , Disease Management , False Negative Reactions , False Positive Reactions , Humans , Lymphatic Metastasis/diagnostic imaging , Male , Middle Aged , Neoplasm Recurrence, Local/diagnostic imaging , Prospective Studies , Prostatectomy , Prostatic Neoplasms/blood , Prostatic Neoplasms/surgery , Salvage Therapy
Carcinoid Tumor/diagnostic imaging , Fluorodeoxyglucose F18 , Lung Neoplasms/diagnostic imaging , Multiple Pulmonary Nodules/diagnostic imaging , Positron Emission Tomography Computed Tomography , Radiopharmaceuticals , Carcinoid Tumor/metabolism , Carcinoid Tumor/pathology , Fluorodeoxyglucose F18/pharmacokinetics , Humans , Lung Neoplasms/metabolism , Lung Neoplasms/pathology , Male , Middle Aged , Multiple Pulmonary Nodules/metabolism , Multiple Pulmonary Nodules/pathology , Radiopharmaceuticals/pharmacokinetics
No disponible
Humans , Middle Aged , Adenocarcinoma of Lung/diagnostic imaging , Adenocarcinoma of Lung/radiotherapy , Fluorodeoxyglucose F18 , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/radiotherapy , Positron Emission Tomography Computed Tomography , Radiopharmaceuticals , Positron Emission Tomography Computed Tomography/methods , Treatment Outcome
Adenocarcinoma of Lung/diagnostic imaging , Adenocarcinoma of Lung/radiotherapy , Fluorodeoxyglucose F18 , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/radiotherapy , Positron Emission Tomography Computed Tomography , Radiopharmaceuticals , Humans , Middle Aged , Positron Emission Tomography Computed Tomography/methods , Treatment Outcome
Objetivo: Evaluar el impacto de la 18F-FDG PET/TC en la identificación de focos de enfermedad activa y el seguimiento terapéutico en un grupo de pacientes pediátricos con histiocitosis de células de Langerhans (HCL). Método: Entre 2007-2013 se efectuaron 13 estudios 18F-FDG PET/TC de seguimiento en 7 pacientes diagnosticados de HCL (4 niñas, 3 varones; 1-12 años). Se analizaron los hallazgos PET y se correlacionaron con los de la TC y la RM, así como el seguimiento evolutivo con estas técnicas. Resultados: La PET fue negativa en 4 pacientes (todos diagnosticados de lesiones óseas y afectación hipofisaria en un caso). La TC mostró persistencia de lesiones, de carácter residual, en todos los pacientes, y la RM de hipófisis mostró su normalización. La PET permaneció negativa a los 10, 14, 25 y 28 meses, sin detectar nuevas lesiones mediante TC ni RM. La PET fue positiva en 3 pacientes (uno con adenopatías cervicales y 2 con lesiones óseas y afectación hipofisaria en uno de ellos, no identificada por la PET). Los hallazgos de la TC fueron adenopatía cervical patológica (n=1) y lesiones óseas (n=2), y de la RM, lesión hipofisaria (n=1). En el paciente con adenopatía cervical la anatomía patológica mostró afectación por HCL. En los otros 2 pacientes, la PET permaneció positiva, con aumento de la captación ósea de 18F-FDG a los 17 y 19 meses. Conclusión: En este estudio preliminar, la 18F-FDG PET constituye una técnica de imagen útil, junto con otras pruebas diagnósticas, para identificar lesiones activas y monitorizar la respuesta terapéutica en pacientes pediátricos con HCL (AU)
Purpose: We evaluated the impact of 18F-FDG PET/CT in identifying sites of active disease and to assess therapeutic follow up in a group of pediatric patients with Langerhans cell histiocytosis (LCH). Method: During 2007-2013, 13 18F-FDG PET/CT studies were performed for follow-up in 7 patients with a diagnosis of LCH (4 female, 3 male; 1-12 years-old). PET findings were analyzed and correlated with the CT and MRI. Findings were also follow-up by these techniques. Results: PET was negative in 4 patients (all diagnosed with bone lesions and one with pituitary involvement also). CT findings showed residual morphological bone lesions in all patients, and hypophysis MRI study showed no abnormal signal. PET remained negative at 10, 14, 25 and 28 months, and no new lesions on CT and MRI were detected. PET was positive in 3 patients (one with cervical lymphadenopathy and 2 with bone lesions, one also with pituitary involvement not identified by PET). CT findings showed pathological cervical lymphadenopathy (n=1), bone lesions (n=2) and also a pituitary MRI lesion (n=1). In a patient with cervical lymphadenopathy histology demonstrated LCH involvement. In the other 2 patients, PET remained positive with an increase of 18F-FDG bone uptake at 17 and 19 months. Conclusion: In our preliminar study, 18F-FDG PET is a useful imaging procedure, along with other diagnostic tools, for identification of active lesions (AU)
Humans , Male , Female , Infant , Child, Preschool , Child , Histiocytosis, Langerhans-Cell , Positron-Emission Tomography/instrumentation , Positron-Emission Tomography/methods , Fluorodeoxyglucose F18/analysis , Follow-Up Studies , Pathology/trends , Neoplasm Metastasis
PURPOSE: We evaluated the impact of 18F-FDG PET/CT in identifying sites of active disease and to assess therapeutic follow up in a group of pediatric patients with Langerhans cell histiocytosis (LCH). METHOD: During 2007-2013, 13 18F-FDG PET/CT studies were performed for follow-up in 7 patients with a diagnosis of LCH (4 female, 3 male; 1-12 years-old). PET findings were analyzed and correlated with the CT and MRI. Findings were also follow-up by these techniques. RESULTS: PET was negative in 4 patients (all diagnosed with bone lesions and one with pituitary involvement also). CT findings showed residual morphological bone lesions in all patients, and hypophysis MRI study showed no abnormal signal. PET remained negative at 10, 14, 25 and 28 months, and no new lesions on CT and MRI were detected. PET was positive in 3 patients (one with cervical lymphadenopathy and 2 with bone lesions, one also with pituitary involvement not identified by PET). CT findings showed pathological cervical lymphadenopathy (n=1), bone lesions (n=2) and also a pituitary MRI lesion (n=1). In a patient with cervical lymphadenopathy histology demonstrated LCH involvement. In the other 2 patients, PET remained positive with an increase of 18F-FDG bone uptake at 17 and 19 months. CONCLUSION: In our preliminar study, 18F-FDG PET is a useful imaging procedure, along with other diagnostic tools, for identification of active lesions.
Fluorodeoxyglucose F18 , Histiocytosis, Langerhans-Cell/diagnostic imaging , Positron Emission Tomography Computed Tomography , Radiopharmaceuticals , Child , Child, Preschool , Female , Follow-Up Studies , Histiocytosis, Langerhans-Cell/therapy , Humans , Infant , Male
Mesothelioma/secondary , Neoplasm Staging/methods , Peritoneal Neoplasms/secondary , Pleural Neoplasms/diagnostic imaging , Positron Emission Tomography Computed Tomography , Aged , Fluorine Radioisotopes , Fluorodeoxyglucose F18 , Humans , Lymphatic Metastasis , Male , Mesothelioma/diagnostic imaging , Mesothelioma/pathology , Peritoneal Neoplasms/diagnostic imaging , Peritoneal Neoplasms/pathology , Pleural Effusion, Malignant/diagnostic imaging , Pleural Effusion, Malignant/pathology , Pleural Neoplasms/pathology , Radiopharmaceuticals , Tomography, Spiral Computed
