17026
2018
eng
6088-6100
22
8
article
1
2018-10-26
--
--
The theranostic promise for neuroendocrine tumors in the late 2010s – Where do we stand, where do we go?
More than 25 years after the first peptide receptor radionuclide therapy (PRRT), the concept of somatostatin receptor (SSTR)-directed imaging and therapy for neuroendocrine tumors (NET) is seeing rapidly increasing use. To maximize the full potential of its theranostic promise, efforts in recent years have expanded recommendations in current guidelines and included the evaluation of novel theranostic radiotracers for imaging and treatment of NET. Moreover, the introduction of standardized reporting framework systems may harmonize PET reading, address pitfalls in interpreting SSTR-PET/CT scans and guide the treating physician in selecting PRRT candidates. Notably, the concept of PRRT has also been applied beyond oncology, e.g. for treatment of inflammatory conditions like sarcoidosis. Future perspectives may include the efficacy evaluation of PRRT compared to other common treatment options for NET, novel strategies for closer monitoring of potential side effects, the introduction of novel radiotracers with beneficial pharmacodynamic and kinetic properties or the use of supervised machine learning approaches for outcome prediction. This article reviews how the SSTR-directed theranostic concept is currently applied and also reflects on recent developments that hold promise for the future of theranostics in this context.
Theranostics
urn:nbn:de:bvb:20-opus-170264
Johns Hopkins School of Medicine
Theranostics 2018; 8(22):6088-6100. doi:10.7150/thno.30357
701983
CC BY-NC: Creative-Commons-Lizenz: Namensnennung, Nicht kommerziell 4.0 International
Rudolf A. Werner
Alexander Weich
Malte Kircher
Lilja B. Solnes
Mehrbod S. Javadi
Takahiro Higuchi
Andreas K. Buck
Martin G. Pomper
Steven Rowe
Constantin Lapa
eng
uncontrolled
theranostics
deu
swd
Positronen-Emissions-Tomografie
eng
uncontrolled
PRRT
eng
uncontrolled
somatostatin receptor
eng
uncontrolled
peptide receptor radionuclide therapy
eng
uncontrolled
neuroendocrine tumor
Medizin und Gesundheit
open_access
Klinik und Poliklinik für Nuklearmedizin
Medizinische Klinik und Poliklinik II
OpenAIRE
Förderzeitraum 2018
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/17026/Werner_Theranostics_2018.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
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
16220
2018
eng
626
Supplement No. 1
59
conferenceobject
1
2018-05-27
--
--
Diagnostic Accuracy of Visual Assessment of an Initial DaT-Scan in Comparison to a Fully Automatic Semiquantitative Method
No abstract available.
Journal of Nuclear Medicine
0161-5505
http://jnm.snmjournals.org/content/59/supplement_1/626.abstract
urn:nbn:de:bvb:20-opus-162208
This research was originally published in JNM. Rudolf A. Werner, Charles Marcus, Sara Sheikhbahaei, Takahiro Higuchi, Lilja B. Solnes, Steven P. Rowe, Andreas K. Buck, Constantin Lapa, Mehrbod S. Javadi. Diagnostic Accuracy of Visual Assessment of an Initial DaT-Scan in Comparison to a Fully Automatic Semiquantitative Method. J Nucl Med. May 1, 2018; vol. 59 no. supplement 1:626. © SNMMI.
Johns Hopkins School of Medicine
701983
Journal of Nuclear Medicine May 1, 2018 vol. 59 no. supplement 1 626
Deutsches Urheberrecht
Rudolf A. Werner
Charles Marcus
Sara Sheikhbahaei
Takahiro Higuchi
Lilja B. Solnes
Steven P. Rowe
Andreas K. Buck
Constantin Lapa
Mehrbod S. Javadi
deu
swd
Parkinson-Krankheit
eng
uncontrolled
SPECT
eng
uncontrolled
Parkinson
eng
uncontrolled
Parkinson Disease
eng
uncontrolled
DaTscan
eng
uncontrolled
Ioflupane
eng
uncontrolled
molecular imaging
Medizin und Gesundheit
open_access
Klinik und Poliklinik für Nuklearmedizin
OpenAIRE
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/16220/Werner_Rudolf_Accuracy_DaT-Scan_JNM_accepted_version.pdf
16221
2018
eng
1646
Supplement No 1
59
conferenceobject
1
2018-05-27
--
--
The Impact of Ageing on Dopamine Transporter Imaging
No abstract available.
Journal of Nuclear Medicine
0161-5505
urn:nbn:de:bvb:20-opus-162213
http://jnm.snmjournals.org/content/59/supplement_1/1646.abstract
This research was originally published in JNM. Rudolf A. Werner, Charles Marcus, Sara Sheikhbahaei, Takahiro Higuchi, Lilja B. Solnes, Steven P. Rowe, Andreas K. Buck, Constantin Lapa, Mehrbod S. Javadi. The Impact of Ageing on Dopamine Transporter Imaging. J Nucl Med. May 1, 2018; vol. 59 no. supplement 1:1646. © SNMMI.
Johns Hopkins School of Medicine
701983
Journal of Nuclear Medicine May 1, 2018 vol. 59 no. supplement 1 1646
Deutsches Urheberrecht
Rudolf A. Werner
Charles Marcus
Sara Sheikhbahaei
Takahiro Higuchi
Lilja B. Solnes
Steven P. Rowe
Andreas K. Buck
Constantin Lapa
Mehrbod S. Javadi
deu
swd
Parkinson-Krankheit
eng
uncontrolled
Parkinson
eng
uncontrolled
Parkinson Disease
eng
uncontrolled
DaTscan
eng
uncontrolled
Ioflupane
eng
uncontrolled
SPECT
eng
uncontrolled
molecular imaging
eng
uncontrolled
ageing
Medizin und Gesundheit
open_access
Klinik und Poliklinik für Nuklearmedizin
OpenAIRE
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/16221/Werner_Rudolf_Ageing_DaTscan_JNM_accepted_version.pdf
17218
2018
eng
159–163
4
4
article
1
2018-11-19
--
--
Generative Adversarial Networks for the Creation of Realistic Artificial Brain Magnetic Resonance Images
Even as medical data sets become more publicly accessible, most are restricted to specific medical conditions. Thus, data collection for machine learning approaches remains challenging, and synthetic data augmentation, such as generative adversarial networks (GAN), may overcome this hurdle. In the present quality control study, deep convolutional GAN (DCGAN)-based human brain magnetic resonance (MR) images were validated by blinded radiologists. In total, 96 T1-weighted brain images from 30 healthy individuals and 33 patients with cerebrovascular accident were included. A training data set was generated from the T1-weighted images and DCGAN was applied to generate additional artificial brain images. The likelihood that images were DCGAN-created versus acquired was evaluated by 5 radiologists (2 neuroradiologists [NRs], vs 3 non-neuroradiologists [NNRs]) in a binary fashion to identify real vs created images. Images were selected randomly from the data set (variation of created images, 40%-60%). None of the investigated images was rated as unknown. Of the created images, the NRs rated 45% and 71% as real magnetic resonance imaging images (NNRs, 24%, 40%, and 44%). In contradistinction, 44% and 70% of the real images were rated as generated images by NRs (NNRs, 10%, 17%, and 27%). The accuracy for the NRs was 0.55 and 0.30 (NNRs, 0.83, 0.72, and 0.64). DCGAN-created brain MR images are similar enough to acquired MR images so as to be indistinguishable in some cases. Such an artificial intelligence algorithm may contribute to synthetic data augmentation for "data-hungry" technologies, such as supervised machine learning approaches, in various clinical applications.
Tomography
10.18383/j.tom.2018.00042
urn:nbn:de:bvb:20-opus-172185
Johns Hopkins School of Medicine
Tomography (2018) 4(4): 159–163. doi: 10.18383/j.tom.2018.00042
701983
false
true
CC BY-NC-ND: Creative-Commons-Lizenz: Namensnennung, Nicht kommerziell, Keine Bearbeitungen 4.0 International
Koshino Kazuhino
Rudolf A. Werner
Fuijo Toriumi
Mehrbod S. Javadi
Martin G. Pomper
Lilja B. Solnes
Franco Verde
Takahiro Higuchi
Steven P. Rowe
eng
uncontrolled
AI
deu
swd
Magnetresonanztomografie
eng
uncontrolled
artificial intelligence
eng
uncontrolled
magnetic resonance imaging
eng
uncontrolled
MRI
eng
uncontrolled
DCGAN
eng
uncontrolled
GAN
eng
uncontrolled
stroke
eng
uncontrolled
machine learning
Medizin und Gesundheit
open_access
Klinik und Poliklinik für Nuklearmedizin
OpenAIRE
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/17218/Werner_Tomography_2018.pdf