Refine
Has Fulltext
- yes (72)
Is part of the Bibliography
- yes (72)
Year of publication
Document Type
- Journal article (65)
- Preprint (4)
- Conference Proceeding (3)
Language
- English (72)
Keywords
- PET (17)
- prostate cancer (13)
- theranostics (13)
- positron emission tomography (11)
- CXCR4 (10)
- PET/CT (10)
- Positronen-Emissions-Tomografie (10)
- PSMA (9)
- multiple myeloma (8)
- neuroendocrine tumor (8)
- radioligand therapy (8)
- PRRT (7)
- molecular imaging (7)
- RADS (4)
- SPECT (4)
- SSTR (4)
- somatostatin receptor (4)
- 18F-DCFPyL (3)
- DaTscan (3)
- FDG (3)
- NET (3)
- PSMA-RADS (3)
- Prostate Cancer (3)
- adrenocortical carcinoma (3)
- chemokine receptor (3)
- endoradiotherapy (3)
- medicine (3)
- peptide receptor radionuclide therapy (3)
- prostate-specific membrane antigen (3)
- 18F-FDG (2)
- 18F-FDG PET/CT (2)
- C-X-C motif chemokine receptor 4 (2)
- Ioflupane (2)
- MAG3 (2)
- PSMA I&T (2)
- PSMA-PET (2)
- Parkinson (2)
- Parkinson Disease (2)
- Parkinson-Krankheit (2)
- Parkinson’s disease (2)
- Positron Emission Tomography (2)
- SSTR-RADS (2)
- SUV (2)
- TKI (2)
- Virchow Node (2)
- [177Lu]-DOTATATE/-DOTATOC (2)
- [68Ga] (2)
- [68Ga]PentixaFor (2)
- bone disease (2)
- fibroblast activation protein (2)
- lymphoma (2)
- personalized medicine (2)
- prostate-specific membrane antigen (PSMA) (2)
- radionuclide therapy (2)
- reporting and data system (2)
- salvage radiotherapy (2)
- tumor heterogeneity (2)
- vandetanib (2)
- 11C-Methionine PET/CT (1)
- 123I-Ioflupane (1)
- 177Lu (1)
- 18-F-fluorothymidine uptake (1)
- 18F-DCFPL (1)
- 2-deoxy-2-(18F)fluoro-D-glucose (1)
- 68Ga-DOTANOC (1)
- 68Ga-DOTATATE (1)
- 68Ga-DOTATOC (1)
- 68Ga-Pentixafor PET/CT (1)
- <sup>18</sup>F-FDG (1)
- <sup>68</sup>Ga-Pentixafor (1)
- Arginine (1)
- COVID-19 (1)
- CTCAE (1)
- CXCR4-targeting (1)
- CXCR4/SDF-1 (1)
- CYP11B enzymes (1)
- DLBCL (1)
- DNA repair (1)
- DOTA-EB-TATE (1)
- DOTATOC (1)
- DSB damage (1)
- FDG PET/CT (1)
- FDG-PET (1)
- FLT-PET (1)
- GCA (1)
- GPR54 (1)
- Ganglia (1)
- HMDP hydroxymethylene diphosphonate (1)
- Hyperkalaemia (1)
- IBA-1 (1)
- IMAZA (1)
- Imaging pitfalls (1)
- KISS1 receptor (1)
- KISS1-54 (1)
- Lysine (1)
- MI-RADS (1)
- MRI (1)
- Merkel cell carcinoma (1)
- Molecular imaging (1)
- Myocardial-perfusion SPECT (1)
- NEC (1)
- NVP-BGT226 (1)
- PMR (1)
- PROMISE (1)
- PSA (1)
- PSA response (1)
- PSMA PET/CT (1)
- PSMA-617 (1)
- PSMA-TV (1)
- PSMA‐617 (1)
- Pancreas (1)
- Parkinsonism (1)
- Pentixafor (1)
- Pitfall (1)
- Positron emission tomography (1)
- Prostata (1)
- RLT (1)
- Radiofluorine (1)
- Radiotracer (1)
- SARS-CoV-2 (1)
- SPECT/CT (1)
- SSTR-PET (1)
- Single-Photon-Emissions-Computertomographie (1)
- Somatostatin receptor expression (1)
- TBI (1)
- TSPO (1)
- Tracer (1)
- [177Lu]/[90Y]PentixaTher (1)
- [177Lu]Lu-PSMA I&T (1)
- [177Lu]PentixaTher (1)
- [18F]FDG PET/CT (1)
- [18F]Fluorodeoxythymidine (1)
- [68Ga]DOTATOC (1)
- [68Ga]Pentixafor (1)
- [90Y]PentixaTher (1)
- [\(^{68}\)Ga] pentixafor (1)
- [\(^{68}\)Ga]Ga-FAPI (1)
- [\(^{68}\)Ga]Pentixafor (1)
- [\(^{68}\)]KISS1-54 (1)
- \(^{11}\)C-Methionine-PET (1)
- \(^{11}\)C-methionine (1)
- \(^{177}\)Lu (1)
- \(^{18}\)F (1)
- \(^{18}\)F-FDG PET/CT (1)
- \(^{18}\)F-PSMA-1007 (1)
- \(^{68}\)Ga (1)
- \(^{68}\)Ga-Pentixafor (1)
- adrenal incidentaloma (1)
- ageing (1)
- agreement (1)
- amino acids (1)
- attention deficit/hyperactivity disorder (ADHD) (1)
- autologous transplantation (1)
- autoradiography (1)
- biokinetics (1)
- biomarker (1)
- bone-marrow (1)
- cancer (1)
- cancer treatment (1)
- caudate nucleus (1)
- cells (1)
- chemokine receptor-4 (1)
- cholinergic activity (1)
- combination (1)
- comparability (1)
- diffuse (1)
- dopamine transporter (DAT) (1)
- early response (1)
- ejection fraction (1)
- esophagogastric junction (1)
- evans blue (1)
- experience (1)
- flare phenomenon (1)
- focal (1)
- follicular lymphoma (1)
- giant cell arteritis (1)
- glioblastoma (1)
- glioblastoma multiforme (1)
- glioma (1)
- head and neck cancer (1)
- health care (1)
- hematotoxicity (1)
- human tumor cell lines (1)
- hyperkalemia (1)
- imaging (1)
- imaging proliferation (1)
- imaging techniques (1)
- immunohistochemistry (1)
- immunostaining (1)
- in vivo imaging (1)
- in-vivo (1)
- inflammation (1)
- inhibition (1)
- interobserver (1)
- interreader (1)
- intraindividual comparison (1)
- involvement (1)
- irradiation (1)
- isotopes (1)
- kidney function (1)
- kisspeptin (1)
- late response (1)
- left-ventricular function (1)
- levodopa-induced dyskinesia (1)
- macrophages (1)
- macroscopic recurrence (1)
- magnetic resonance imaging (1)
- malignancies (1)
- mammalian target of rapamycin (1)
- management (1)
- matched pair (1)
- medullary thyroid carcinoma (1)
- metabolic tumor volume (MTV) (1)
- metabolic tumour volume (MTV) (1)
- methionine (1)
- methylphenidate (1)
- microenvironment (1)
- microglial cells (1)
- mouse (1)
- nephrotoxicity (1)
- neuroendocrine neoplasia (1)
- neuroinflammation (1)
- non-Hodgkin's lymphoma (1)
- non-hodgkins-lymphoma (1)
- ollimator (1)
- overall survival (1)
- pancreas (1)
- papillary thyroid carcinoma (PTC) (1)
- pattern (1)
- peptide receptor (1)
- phosphatidylinositol-3-kinase (1)
- photons (1)
- pleural mesothelioma (1)
- polymyalgia rheumatica (1)
- positron emission tomography/computed tomography (1)
- post-reconstruction filtering (1)
- prediction (1)
- progression (1)
- quality (1)
- quantification (1)
- radiogenomics (1)
- radioiodine (1)
- recurrence (1)
- relapse (1)
- renal scintigraphy (1)
- repair (1)
- reporting and data systems (1)
- responsivity (1)
- sarcoidosis (1)
- scanner (1)
- selpercatinib (1)
- signal to noise ratio (1)
- signaling pathway (1)
- simultaneous integrated boost (1)
- single photon emission computed tomography (SPECT) (1)
- skeletal (1)
- small animal SPECT (1)
- small-animal imaging (1)
- smoldering myeloma (1)
- software (1)
- solid tumors (1)
- somatostatin (1)
- somatostatin receptor (SSTR) (1)
- somatostatin receptors (1)
- staging (1)
- standardization (1)
- standardized reporting (1)
- standardized reporting system (1)
- stem-cell transplantation (1)
- striatum (1)
- super ultraviolet (1)
- survival (1)
- target (1)
- taxane (1)
- thyroid carcinoma (TC) (1)
- thyroid carcinomas (1)
- total lesion PSMA (1)
- total lesion glycolysis (TLG) (1)
- total lesion methionine uptake (TLMU) (1)
- treatment response (1)
- tumor (1)
- tyrosine kinase inhibitor (1)
- vasculature (1)
- vasculitis (1)
- vestibular schwannoma (1)
- weight drop (1)
- α-Particle (1)
- γ-H2AX (1)
Institute
- Klinik und Poliklinik für Nuklearmedizin (72) (remove)
Sonstige beteiligte Institutionen
Purpose: The metabolically most active lesion in 2-deoxy-2-(\(^{18}\)F)fluoro-D-glucose (\(^{18}\)F-FDG) PET/CT can predict progression-free survival (PFS) in patients with medullary thyroid carcinoma (MTC) starting treatment with the tyrosine kinase inhibitor (TKI) vandetanib. However, this metric failed in overall survival (OS) prediction. In the present proof of concept study, we aimed to explore the prognostic value of intratumoral textural features (TF) as well as volumetric parameters (total lesion glycolysis, TLG) derived by pre-therapeutic \(^{18}\)F-FDG PET.
Methods: Eighteen patients with progressive MTC underwent baseline \(^{18}\)F-FDG PET/CT prior to and 3 months after vandetanib initiation. By manual segmentation of the tumor burden at baseline and follow-up PET, intratumoral TF and TLG were computed. The ability of TLG, imaging-based TF, and clinical parameters (including age, tumor marker doubling times, prior therapies and RET (rearranged during transfection) mutational status) for prediction of both PFS and OS were evaluated.
Results: The TF Complexity and the volumetric parameter TLG obtained at baseline prior to TKI initiation successfully differentiated between low- and high-risk patients. Complexity allocated 10/18 patients to the high-risk group with an OS of 3.3y (vs. low-risk group, OS=5.3y, 8/18, AUC=0.78, P=0.03). Baseline TLG designated 11/18 patients to the high-risk group (OS=3.5y vs. low-risk group, OS=5y, 7/18, AUC=0.83, P=0.005). The Hazard Ratio for cancer-related death was 6.1 for Complexity (TLG, 9.5). Among investigated clinical parameters, the age at initiation of TKI treatment reached significance for PFS prediction (P=0.02, OS, n.s.).
Conclusions: The TF Complexity and the volumetric parameter TLG are both independent parameters for OS prediction.
Objectives: Recently, the standardized reporting and data system for prostate-specific membrane antigen (PSMA)-targeted positron emission tomography (PET) imaging studies, termed PSMA-RADS version 1.0, was introduced. We aimed to determine the interobserver agreement for applying PSMA-RADS to imaging interpretation of 18F-DCFPyL PET examinations in a prospective setting mimicking the typical clinical work-flow at a prostate cancer referral center.
Methods: Four readers (two experienced readers (ER, > 3 years of PSMA-targeted PET interpretation experience) and two inexperienced readers (IR, < 1 year of experience)), who had all read the initial publication on PSMA-RADS 1.0, assessed 50 18F-DCFPyL PET/computed tomography (CT) studies independently. Per scan, a maximum of 5 target lesions were selected by the observers and a PSMA-RADS score for every target lesion was recorded. No specific pre-existing conditions were placed on the selection of the target lesions, although PSMA-RADS 1.0 suggests that readers focus on the most highly avid or largest lesions. An overall scan impression based on PSMA-RADS was indicated and interobserver agreement rates on a target lesion-based, on an organ-based, and on an overall PSMA-RADS score-based level were computed.
Results: The number of target lesions identified by each observer were as follows: ER 1, 123; ER 2, 134; IR 1, 123; and IR 2, 120. Among those selected target lesions, 125 were chosen by at least two individual observers (all four readers selected the same target lesion in 58/125 (46.4%) instances, three readers in 40/125 (32%) and two observers in 27/125 (21.6%) instances). The interobserver agreement for PSMA-RADS scoring among identical target lesions was good (intraclass correlation coefficient (ICC) for four, three and two identical target lesions, ≥0.60, respectively). For lymph nodes, an excellent interobserver agreement was derived (ICC=0.79). The interobserver agreement for an overall scan impression based on PSMA-RADS was also excellent (ICC=0.84), with a significant difference for ER (ICC=0.97) vs. IR (ICC=0.74, P=0.005).
Conclusions: PSMA-RADS demonstrates a high concordance rate in this study, even among readers with different levels of experience. This suggests that PSMA-RADS can be effectively used for communication with clinicians and can be implemented in the collection of data for large prospective trials.
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.
Standardized reporting is more and more routinely implemented in clinical practice and such structured reports have a major impact on a large variety of medical fields, e.g. laboratory medicine, pathology, and, recently, radiology. Notably, the field of nuclear medicine is constantly evolving, as novel radiotracers for numerous clinical applications are developed. Thus, framework systems for standardized reporting in this field may a) increase clinical acceptance of new radiotracers, b) allow for inter- and intra-center comparisons for quality assurance, and c) may be used in (global) multi-center studies to ensure comparable results and enable efficient data abstraction. In the last two years, several standardized framework systems for positron emission tomography (PET) radiotracers with potential theranostic applications have been proposed. These include systems for prostate-specific membrane antigen (PSMA)-targeted PET agents for the diagnosis and treatment of prostate cancer (PCa) and somatostatin receptor (SSTR)-targeted PET agents for the diagnosis and treatment of neuroendocrine neoplasias. In the present review, those standardized framework systems for PSMA- and SSTR-targeted PET will be briefly introduced followed by an overview of their advantages and limitations. In addition, potential applications will be defined, approaches to validate such concepts will be proposed, and future perspectives will be discussed.
Peptide Receptor Radionuclide Therapy (PRRT) for the treatment of neuroendocrine tumors may lead to kidney deterioration. This study aimed to evaluate the suitability of \(^{99m}\)Tc-mercaptoacetyltriglycine (\(^{99m}\)Tc-MAG3) clearance for the early detection of PRRT-induced changes on tubular extraction (TE). TE rate (TER) was measured prior to 128 PRRT cycles (7.6±0.4 GBq \(^{177}\)Lu-octreotate/octreotide each) in 32 patients. TER reduction during PRRT was corrected for age-related decrease and analyzed for the potential to predict loss of glomerular filtration (GF). The GF rate (GFR) as measure for renal function was derived from serum creatinine. The mean TER was 234 ± 53 ml/min/1.73 m² before PRRT (baseline) and 221 ± 45 ml/min/1.73 m² after a median follow-up of 370 days. The age-corrected decrease (mean: -3%, range: -27% to +19%) did not reach significance (p=0.09) but significantly correlated with the baseline TER (Spearman p=-0.62, p<0.001). Patients with low baseline TER showed an improved TER after PRRT, high decreases were only observed in individuals with high baseline TER. Pre-therapeutic TER data were inferior to plasma creatinine-derived GFR estimates in predicting late nephropathy. TER assessed by \(^{99m}\)Tc-MAG3clearance prior to and during PRRT is not suitable as early predictor of renal injury and an increased risk for late nephropathy.
We aimed to elucidate the diagnostic potential of the C-X-C motif chemokine receptor 4 (CXCR4)-directed positron emission tomography (PET) tracer \(^{68}\)Ga-Pentixafor in patients with poorly differentiated neuroendocrine carcinomas (NEC), relative to the established reference standard \(^{18}\)F-FDG PET/computed tomography (CT). In our database, we retrospectively identified 11 treatment-naïve patients with histologically proven NEC, who underwent \(^{18}\)F-FDG and CXCR4-directed PET/CT for staging and therapy planning. The images were analyzed on a per-patient and per-lesion basis and compared to immunohistochemical staining (IHC) of CXCR4 from PET-guided biopsies. \(^{68}\)Ga-Pentixafor visualized tumor lesions in 10/11 subjects, while \(^{18}\)F-FDG revealed sites of disease in all 11 patients. Although weak to moderate CXCR4 expression could be corroborated by IHC in 10/11 cases, \(^{18}\)F-FDG PET/CT detected significantly more tumor lesions (102 vs. 42; total lesions, n = 107; p < 0.001). Semi-quantitative analysis revealed markedly higher 18F-FDG uptake as compared to \(^{68}\)Ga-Pentixafor (maximum and mean standardized uptake values (SUV) and tumor-to-background ratios (TBR) of cancerous lesions, SUVmax: 12.8 ± 9.8 vs. 5.2 ± 3.7; SUVmean: 7.4 ± 5.4 vs. 3.1 ± 3.2, p < 0.001; and, TBR 7.2 ± 7.9 vs. 3.4 ± 3.0, p < 0.001). Non-invasive imaging of CXCR4 expression in NEC is inferior to the reference standard \(^{18}\)F-FDG PET/CT.
Purpose
For somatostatin receptor (SSTR)-positron emission tomography/computed tomography (PET/CT), a standardized framework termed SSTR-reporting and data system (RADS) has been proposed. We aimed to elucidate the impact of a RADS-focused training on reader’s anxiety to report on SSTR-PET/CT, the motivational beliefs in learning such a system, whether it increases reader’s confidence, and its implementation in clinical routine.
Procedures
A 3-day training course focusing on SSTR-RADS was conducted. Self-report questionnaires were handed out prior to the course (Pre) and thereafter (Post). The impact of the training on the following categories was evaluated: (1) test anxiety to report on SSTR-PET/CT, (2) motivational beliefs, (3) increase in reader’s confidence, and (4) clinical implementation. To assess the effect size of the course, Cohen’s d was calculated (small, d = 0.20; large effect, d = 0.80).
Results
Of 22 participants, Pre and Post were returned by 21/22 (95.5%). In total, 14/21 (66.7%) were considered inexperienced (IR, < 1 year experience in reading SSTR-PET/CTs) and 7/21 (33.3%) as experienced readers (ER, > 1 year). Applying SSTR-RADS, a large decrease in anxiety to report on SSTR-PET/CT was noted for IR (d = − 0.74, P = 0.02), but not for ER (d = 0.11, P = 0.78). For the other three categories motivational beliefs, reader’s confidence, and clinical implementation, agreement rates were already high prior to the training and persisted throughout the course (P ≥ 0.21).
Conclusions
A framework-focused reader training can reduce anxiety to report on SSTR-PET/CTs, in particular for inexperienced readers. This may allow for a more widespread adoption of this system, e.g., in multicenter trials for better intra- and interindividual comparison of scan results.
Simple Summary
Prostate cancer often relapses after initial radical prostatectomy, and salvage radiotherapy offers a second chance of cure for relapsed patients. Modern imaging techniques, especially prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT), enable radiation oncologists to target radiotherapy at the involved sites of disease. In a group of patients, PSMA PET/CT imaging can detect a macroscopic local recurrence with or without locoregional lymph node metastasis. In these cases, an escalation of the radiotherapy dose is often considered for controlling the visible tumor mass. As the evidence for dose-escalated salvage radiotherapy for macroscopic recurrent prostate cancer after PSMA PET/CT imaging is still limited, we address this topic in the current analysis. We found that the outcome of patients with dose-escalated salvage radiotherapy for macroscopic prostate cancer recurrence is encouragingly favorable, while the toxicity is very limited.
Abstract
Background: The purpose of this study was to access the oncological outcome of prostate-specific membrane antigen positron emission tomography (PSMA PET/CT)-guided salvage radiotherapy (SRT) for localized macroscopic prostate cancer recurrence. Methods: Between February 2010 and June 2021, 367 patients received SRT after radical prostatectomy. Out of the 367 screened patients, 111 patients were staged by PSMA PET/CT before SRT. A total of 59 out of these 111 (53.2%) patients were treated for PSMA PET-positive macroscopic prostatic fossa recurrence. Dose-escalated SRT was applied with a simultaneous integrated boost at a median prescribed dose of 69.3 Gy (IQR 69.3–72.6 Gy). The oncological outcome was investigated using Kaplan-Meier and Cox regression analyses. The genitourinary (GU)/gastrointestinal (GI) toxicity evaluation utilized Common Toxicity Criteria for Adverse Events (version 5.0). Results: The median follow-up was 38.2 months. The three-year biochemical progression-free survival rate was 89.1% (95% CI: 81.1–97.8%) and the three-year metastasis-free survival rate reached 96.2% (95% CI: 91.2–100.0%). The cumulative three-year late grade 3 GU toxicity rate was 3.4%. No late grade 3 GI toxicity occurred. Conclusions: Dose-escalated PSMA PET/CT-guided salvage radiotherapy for macroscopic prostatic fossa recurrence resulted in favorable survival and toxicity rates.