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
16818
2018
eng
1
44
article
1
2018-09-12
--
--
Visual and Semiquantitative Accuracy in Clinical Baseline 123I-Ioflupane SPECT/CT Imaging
PURPOSE:
We aimed to (a) elucidate the concordance of visual assessment of an initial I-ioflupane scan by a human interpreter with comparison to results using a fully automatic semiquantitative method and (b) to assess the accuracy compared to follow-up (f/u) diagnosis established by movement disorder specialists.
METHODS:
An initial I-ioflupane scan was performed in 382 patients with clinically uncertain Parkinsonian syndrome. An experienced reader performed a visual evaluation of all scans independently. The findings of the visual read were compared with semiquantitative evaluation. In addition, available f/u clinical diagnosis (serving as a reference standard) was compared with results of the human read and the software.
RESULTS:
When comparing the semiquantitative method with the visual assessment, discordance could be found in 25 (6.5%) of 382 of the cases for the experienced reader (ĸ = 0.868). The human observer indicated region of interest misalignment as the main reason for discordance. With neurology f/u serving as reference, the results of the reader revealed a slightly higher accuracy rate (87.7%, ĸ = 0.75) compared to semiquantification (86.2%, ĸ = 0.719, P < 0.001, respectively). No significant difference in the diagnostic performance of the visual read versus software-based assessment was found.
CONCLUSIONS:
In comparison with a fully automatic semiquantitative method in I-ioflupane interpretation, human assessment obtained an almost perfect agreement rate. However, compared to clinical established diagnosis serving as a reference, visual read seemed to be slightly more accurate as a solely software-based quantitative assessment.
Clinical Nuclear Medicine
1536-0229
urn:nbn:de:bvb:20-opus-168181
Clinical Nuclear Medicine 2019, 44, 1, p 1–3 doi: 10.1097/RLU.0000000000002333
701983
false
true
CC BY-NC-ND: Creative-Commons-Lizenz: Namensnennung, Nicht kommerziell, Keine Bearbeitungen 4.0 International
Rudolf A. Werner
Charles Marcus
Sara Sheikhbahaei
Lilja B. Solnes
Jeffrey P. Leal
Yong Du
Steven P. Rowe
Takahiro Higuchi
Andreas K. Buck
Constantin Lapa
Mehrbod S. Javadi
deu
uncontrolled
Single-Photon-Emissions-Computertomographie
deu
swd
SPECT
eng
uncontrolled
Parkinson’s disease
eng
uncontrolled
Parkinsonism
eng
uncontrolled
DaTscan
eng
uncontrolled
123I-Ioflupane
eng
uncontrolled
SPECT
eng
uncontrolled
SPECT/CT
Medizin und Gesundheit
open_access
Klinik und Poliklinik für Nuklearmedizin
OpenAIRE
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/16818/Werner_Visual_and_Semiquantitative_Accuracy_Clinical_Nuclear_Medicine_2019.pdf
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