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OBJECTIVE: To analyse the efficacy of integrated assessment of [18F]F-PSMA-1007 PET/MRI on the early detection of local recurrence (LR) for prostate cancer patients with PSA levels <0.5ng/ml after radical prostatectomy. To assess the location of recurrence so that therapy may be tailored to patient. METHODS: Prospective study including 35 patients with prostate cancer (PCa), who were referred for a [18F]F-PSMA-1007 PET/MR after prostatectomy with a very initial PSA value increase (PSA<0,5ng/ml). Simultaneous acquisition in a PET/MRI hybrid equipment (SIGNA-GE), 1h after administration of 370%±10% MBq of [18F]F-PSMA-1007: Prostate selective imaging (20min): multiparametric PET+MRI (MRImp): DIXON, T1, T2, diffusion sequences post-gadolinium administration. Whole body image (30min): PET+MRI: DIXON, T1, T2, diffusion, STIR sequences. A nuclear physician and a radiologist jointly reviewed the studies: In order to assess LR, the "Prostate Imaging for Recurrence Reporting" system was used on MRI, as well as the Likert scale on the PET prostate imaging. The remaining lesions were classified as N1 and M1a. RESULTS: PET/MRI was positive in 25 patients (71,4%) and negative in 10 patients (28,6%). RL was detected in 15 patients (42.9%): in 2 (5.7%) MRI was superior; in 3 (8.6%) PET was superior; integrated PET/MRI showed improved results in 5 patients (14.3%) for the detection of LR. Location of recurrences: LR in 11 patients (44.0%); N1 in 10 (40.0%); LR+N1 (8.0%) in 2; LR+N1+M1a in 2 (8.0%). In 20 patients (80%) the PET/MRI findings allowed radioguided radiotherapy implementation (11 on LR, and 9 on N1), whereas hormonal treatment was decided in 5 patients (20%) due to multimetastases/spread disease. CONCLUSION: [18F]F-PSMA-1007 PET/MRI has a 71.4% recurrence detection rate after prostatectomy with PSA<0.5ng/ml. Its combined PET and MRI study increases the detection of LR by 14.3%, with a high N1+M1a detection rate (56%), allowing radioguided radiotherapy in 80% of patients.
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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.
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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
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Humanos , Masculino , Persona de Mediana Edad , Anciano , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Espectroscopía de Resonancia Magnética/métodos , Neoplasias de la Próstata/diagnóstico por imagen , Imagen Multimodal/métodos , Prostatectomía/estadística & datos numéricos , Antígeno Prostático Específico/análisis , Estudios Prospectivos , Radiofármacos/administración & dosificación , Recurrencia Local de Neoplasia/diagnóstico por imagen , Estadificación de Neoplasias/métodosRESUMEN
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Humanos , Masculino , Persona de Mediana Edad , Tumor Carcinoide/diagnóstico por imagen , Fluorodesoxiglucosa F18 , Neoplasias Pulmonares/diagnóstico por imagen , Nódulos Pulmonares Múltiples/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Radiofármacos , Tumor Carcinoide/metabolismo , Tumor Carcinoide/patología , Fluorodesoxiglucosa F18/farmacocinética , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/patología , Nódulos Pulmonares Múltiples/metabolismo , Nódulos Pulmonares Múltiples/patología , Tomografía de Emisión de Positrones , Radiofármacos/farmacocinéticaRESUMEN
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.
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Adenocarcinoma/diagnóstico por imagen , Colina/análogos & derivados , Radioisótopos de Flúor , Calicreínas/sangre , Imagen Multimodal , Imágenes de Resonancia Magnética Multiparamétrica/métodos , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/diagnóstico por imagen , Radiofármacos , Adenocarcinoma/sangre , Adenocarcinoma/secundario , Adenocarcinoma/cirugía , Anciano , Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/secundario , Manejo de la Enfermedad , Reacciones Falso Negativas , Reacciones Falso Positivas , Humanos , Metástasis Linfática/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/diagnóstico por imagen , Estudios Prospectivos , Prostatectomía , Neoplasias de la Próstata/sangre , Neoplasias de la Próstata/cirugía , Terapia RecuperativaAsunto(s)
Tumor Carcinoide/diagnóstico por imagen , Fluorodesoxiglucosa F18 , Neoplasias Pulmonares/diagnóstico por imagen , Nódulos Pulmonares Múltiples/diagnóstico por imagen , Tomografía Computarizada por Tomografía de Emisión de Positrones , Radiofármacos , Tumor Carcinoide/metabolismo , Tumor Carcinoide/patología , Fluorodesoxiglucosa F18/farmacocinética , Humanos , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Nódulos Pulmonares Múltiples/metabolismo , Nódulos Pulmonares Múltiples/patología , Radiofármacos/farmacocinéticaRESUMEN
No disponible
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Humanos , Persona de Mediana Edad , Adenocarcinoma del Pulmón/diagnóstico por imagen , Adenocarcinoma del Pulmón/radioterapia , Fluorodesoxiglucosa F18 , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/radioterapia , Tomografía Computarizada por Tomografía de Emisión de Positrones , Radiofármacos , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Resultado del TratamientoAsunto(s)
Adenocarcinoma del Pulmón/diagnóstico por imagen , Adenocarcinoma del Pulmón/radioterapia , Fluorodesoxiglucosa F18 , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/radioterapia , Tomografía Computarizada por Tomografía de Emisión de Positrones , Radiofármacos , Humanos , Persona de Mediana Edad , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Resultado del TratamientoRESUMEN
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)
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Humanos , Masculino , Femenino , Lactante , Preescolar , Niño , Histiocitosis de Células de Langerhans , Tomografía de Emisión de Positrones/instrumentación , Tomografía de Emisión de Positrones/métodos , Fluorodesoxiglucosa F18/análisis , Estudios de Seguimiento , Patología/tendencias , Metástasis de la NeoplasiaRESUMEN
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.
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Fluorodesoxiglucosa F18 , Histiocitosis de Células de Langerhans/diagnóstico por imagen , Tomografía Computarizada por Tomografía de Emisión de Positrones , Radiofármacos , Niño , Preescolar , Femenino , Estudios de Seguimiento , Histiocitosis de Células de Langerhans/terapia , Humanos , Lactante , MasculinoRESUMEN
No disponible
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Humanos , Masculino , Anciano , Estadificación de Neoplasias/métodos , Mesotelioma , Epitelio/patología , Fluorodesoxiglucosa F18 , Tomografía de Emisión de Positrones/métodos , Derrame Pleural/etiología , Derrame Pleural Maligno/etiologíaAsunto(s)
Mesotelioma/secundario , Estadificación de Neoplasias/métodos , Neoplasias Peritoneales/secundario , Neoplasias Pleurales/diagnóstico por imagen , Tomografía Computarizada por Tomografía de Emisión de Positrones , Anciano , Radioisótopos de Flúor , Fluorodesoxiglucosa F18 , Humanos , Metástasis Linfática , Masculino , Mesotelioma/diagnóstico por imagen , Mesotelioma/patología , Neoplasias Peritoneales/diagnóstico por imagen , Neoplasias Peritoneales/patología , Derrame Pleural Maligno/diagnóstico por imagen , Derrame Pleural Maligno/patología , Neoplasias Pleurales/patología , Radiofármacos , Tomografía Computarizada EspiralRESUMEN
No disponible