16697
2017
eng
696-702
9
31
article
1
2018-08-10
--
--
Patterns of uptake of prostate-specific membrane antigen (PSMA)-targeted \(^{18}\)F-DCFPyL in peripheral ganglia
Objective: Radiotracers targeting prostate-specific membrane antigen (PSMA) have increasingly been recognized as showing uptake in a number of normal structures, anatomic variants, and non-prostate-cancer pathologies. We aimed to explore the frequency and degree of uptake in peripheral ganglia in patients undergoing PET with the PSMA-targeted agent \(^{18}\)F-DCFPyL.
Methods: A total of 98 patients who underwent \(^{18}\)F-DCFPyL PET/CT imaging were retrospectively analyzed. This included 76 men with prostate cancer (PCa) and 22 patients with renal cell carcinoma (RCC; 13 men, 9 women). Scans were evaluated for uptake in the cervical, stellate, celiac, lumbar and sacral ganglia. Maximum standardized uptake value corrected to body weight (SUV\(_{max}\)), and maximum standardized uptake value corrected to lean body mass (SUL\(_{max}\)) were recorded for all ganglia with visible uptake above background. Ganglia-to-background ratios were calculated by dividing the SUV\(_{max}\) and SUL\(_{max}\) values by the mean uptake in the ascending aorta (Aortamean) and the right gluteus muscle (Gluteusmean).
Results: Overall, 95 of 98 (96.9%) patients demonstrated uptake in at least one of the evaluated peripheral ganglia. With regard to the PCa cohort, the most frequent sites of radiotracer accumulation were lumbar ganglia (55/76, 72.4%), followed by the cervical ganglia (51/76, 67.1%). Bilateral uptake was found in the majority of cases [lumbar 44/55 (80%) and cervical 30/51 (58.8%)]. Additionally, discernible radiotracer uptake was recorded in 50/76 (65.8%) of the analyzed stellate ganglia and in 45/76 (59.2%) of the celiac ganglia, whereas only 5/76 (6.6%) of the sacral ganglia demonstrated \(^{18}\)F-DCFPyL accumulation. Similar findings were observed for patients with RCC, with the most frequent locations of radiotracer uptake in both the lumbar (20/22, 90.9%) and cervical ganglia (19/ 22, 86.4%). No laterality preference was found in mean PSMA-ligand uptake for either the PCa or RCC cohorts.
Conclusion: As PSMA-targeted agents become more widely disseminated, the patterns of uptake in structures that are not directly relevant to patients’ cancers must be understood. This is the first systematic evaluation of the uptake of \(^{18}\)F-DCFPyL in ganglia demonstrating a general trend with a descending frequency of radiotracer accumulation in lumbar, cervical, stellate, celiac, and sacral ganglia. The underlying biology that leads to variability of PSMA-targeted radiotracers in peripheral ganglia is not currently understood, but may provide opportunities for future research.
Annals of Nuclear Medicine
10.1007/s12149-017-1201-4
0914-7187
28831739
urn:nbn:de:bvb:20-opus-166971
Johns Hopkis School of Medicine
Annals of Nuclear Medicine (2017) 31:696–702 DOI 10.1007/s12149-017-1201-4
701983
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Rudolf A. Werner
Sara Sheikhbahaei
Krystyna M. Jones
Mehrbod S. Javadi
Lilja B. Solnes
Ashley E. Ross
Mohamad E. Allaf
Kenneth J. Pienta
Constantin Lapa
Andreas K. Buck
Takahiro Higuchi
Martin G. Pomper
Micheal A. Gorin
Steven P. Rowe
eng
uncontrolled
18F-DCFPL
deu
swd
Positronen-Emissions-Tomografie
eng
uncontrolled
Prostata
eng
uncontrolled
PSMA
eng
uncontrolled
Ganglia
eng
uncontrolled
Pitfall
eng
uncontrolled
PET
eng
uncontrolled
Tracer
eng
uncontrolled
Radiotracer
eng
uncontrolled
Imaging pitfalls
eng
uncontrolled
Prostate Cancer
Medizin und Gesundheit
open_access
Klinik und Poliklinik für Nuklearmedizin
OpenAIRE
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/16697/Werner_Annals_Nuclear_Medicine_PatternsOfUptake_2017.pdf
16699
2018
eng
article
1
2018-08-10
--
--
MI-RADS: Molecular Imaging Reporting and Data Systems – A Generalizable Framework for Targeted Radiotracers with Theranostic Implications
Both prostate-specific membrane antigen (PSMA)- and somatostatin receptor (SSTR)-targeted positron emission tomography (PET) imaging agents for staging and restaging of prostate carcinoma or neuroendocrine tumors, respectively, are seeing rapidly expanding use. In addition to diagnostic applications, both classes of radiotracers can be used to triage patients for theranostic endoradiotherapy. While interpreting PSMA- or SSTR-targeted PET/computed tomography (CT) scans, the reader has to be aware of certain pitfalls. Adding to the complexity of the interpretation of those imaging agents, both normal biodistribution, and also false-positive and -negative findings differ between PSMA- and SSTR-targeted PET radiotracers. Herein summarized under the umbrella term molecular imaging reporting and data systems (MI-RADS), two novel RADS classifications for PSMA- and SSTR-targeted PET imaging are described (PSMA- and SSTR-RADS). Both framework systems may contribute to increase the level of a reader’s confidence and to navigate the imaging interpreter through indeterminate lesions, so that appropriate workup for equivocal findings can be pursued. Notably, PSMA- and SSTR-RADS are structured in a reciprocal fashion, i.e. if the reader is familiar with one system, the other system can readily be applied as well. In the present review we will discuss the most common pitfalls on PSMA- and SSTR-targeted PET/CT, briefly introduce PSMA- and SSTR-RADS, and define a future role of the umbrella framework MI-RADS compared to other harmonization systems.
Annals of Nuclear Medicine
0914-7187
urn:nbn:de:bvb:20-opus-166995
10.1007/s12149-018-1291-7
Johns Hopkins School of Medicine
Annals of Nuclear Medicine (2018). https://doi.org/10.1007/s12149-018-1291-7
701983
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Rudolf A. Werner
Ralph A. Bundschuh
Lena Bundschuh
Mehrbod S. Javadi
Takahiro Higuchi
Alexander Weich
Sara Sheikhbahaei
Kenneth J. Pienta
Andreas K. Buck
Martin G. Pomper
Michael A. Gorin
Constantin Lapa
Steven P. Rowe
eng
uncontrolled
PET
deu
swd
Positronen-Emissions-Tomografie
eng
uncontrolled
prostate cancer
eng
uncontrolled
neuroendocrine tumor
eng
uncontrolled
prostate-specific membrane antigen (PSMA)
eng
uncontrolled
somatostatin receptor (SSTR)
eng
uncontrolled
positron emission tomography
eng
uncontrolled
theranostics
eng
uncontrolled
standardization
eng
uncontrolled
RADS
eng
uncontrolled
reporting and data systems
eng
uncontrolled
personalized medicine
Medizin und Gesundheit
open_access
Klinik und Poliklinik für Nuklearmedizin
Medizinische Klinik und Poliklinik II
OpenAIRE
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/16699/Werner_MI-RDAS_Annals_Nuclear_Medicine_2018.pdf