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Clinical Radiology Aug 2023IgG4-related disease is a multisystem immune-mediated disorder associated with lesions manifesting an IgG4-rich plasma cell infiltrate and often raised serum IgG4... (Review)
Review
IgG4-related disease is a multisystem immune-mediated disorder associated with lesions manifesting an IgG4-rich plasma cell infiltrate and often raised serum IgG4 concentrations. The disease can mimic neoplastic, infective, and inflammatory processes due to features such as development of masses or organ enlargement. Prompt consideration of this diagnosis is essential to avoid unnecessary investigations and offer appropriate treatments, which can include steroids and other immunosuppressive agents. Although histology is typically diagnostic, imaging is critical to assess disease burden, determine biopsy targets, and evaluate response to treatment. Characteristic imaging features can also point towards the diagnosis in the absence of biopsy. This review highlights these features, as well as more atypical findings, grouped by organ or system. Differential diagnoses are emphasised. The full spectrum of imaging methods is discussed. Whole-body imaging with integrated 2-[F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography (PET)/computed tomography (CT) has an evolving role in the detection of multi-organ involvement and subsequent follow-up.
Topics: Humans; Immunoglobulin G4-Related Disease; Fluorodeoxyglucose F18; Radiopharmaceuticals; Positron-Emission Tomography; Tomography, X-Ray Computed; Positron Emission Tomography Computed Tomography; Immunoglobulin G
PubMed: 37217396
DOI: 10.1016/j.crad.2023.03.003 -
Journal of Clinical Oncology : Official... Aug 2023Patients with locally advanced breast cancer (LABC) typically undergo staging tests at presentation. If staging does not detect metastases, treatment consists of... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
Patients with locally advanced breast cancer (LABC) typically undergo staging tests at presentation. If staging does not detect metastases, treatment consists of curative intent combined modality therapy (neoadjuvant chemotherapy, surgery, and regional radiation). Positron emission tomography-computed tomography (PET-CT) may detect more asymptomatic distant metastases, but the evidence is based on uncontrolled studies.
METHODS
For inclusion, patients had histological evidence of invasive ductal carcinoma of the breast and TNM stage III or IIb (T3N0, but not T2N1). Consenting patients from six regional cancer centers in Ontario were randomly assigned to F-labeled fluorodeoxyglucose PET-CT or conventional staging (bone scan, CT of the chest/abdomen and pelvis). The primary end point was upstaging to stage IV. A key secondary outcome was receiving curative intent combined modality therapy (ClinicalTrials.gov identifier: NCT02751710).
RESULTS
Between December 2016 and April 2022, 184 patients were randomly assigned to whole-body PET-CT and 185 patients to conventional staging. Forty-three (23%) PET-CT patients were upstaged to stage IV compared with 21 (11%) conventional staged patients (absolute difference, 12.3% [95% CI, 3.9 to 19.9]; = .002). Consequently, treatment was changed in 35 (81.3%) of 43 upstaged PET-CT patients and 20 (95.2%) of the 21 upstaged conventional patients. Subsequently, 149 (81%) patients in the PET-CT group received combined modality treatment versus 165 (89.2%) patients in the conventional staging group (absolute difference, 8.2% [95% CI, 0.1 to 15.4]; = .03).
CONCLUSION
In patients with LABC, PET-CT detected more distant metastases than conventional staging, and fewer PET-CT patients received combined modality therapy. Our randomized trial demonstrates the utility of the PET-CT staging strategy.
Topics: Humans; Female; Positron Emission Tomography Computed Tomography; Breast Neoplasms; Radiopharmaceuticals; Neoplasm Staging; Fluorodeoxyglucose F18; Positron-Emission Tomography
PubMed: 37235845
DOI: 10.1200/JCO.23.00249 -
Magnetic Resonance Imaging Clinics of... Nov 2023Hybrid positron emission tomography (PET)/magnetic resonance imaging (MRI) is highly suited for abdominal pathologies. A precise co-registration of anatomic and... (Review)
Review
Hybrid positron emission tomography (PET)/magnetic resonance imaging (MRI) is highly suited for abdominal pathologies. A precise co-registration of anatomic and metabolic data is possible thanks to the simultaneous acquisition, leading to accurate imaging. The literature shows that PET/MRI is at least as good as PET/CT and even superior for some indications, such as primary hepatic tumors, distant metastasis evaluation, and inflammatory bowel disease. PET/MRI allows whole-body staging in a single session, improving health care efficiency and patient comfort.
Topics: Humans; Magnetic Resonance Imaging; Positron Emission Tomography Computed Tomography; Abdomen; Positron-Emission Tomography; Inflammatory Bowel Diseases
PubMed: 37741642
DOI: 10.1016/j.mric.2023.06.003 -
Cell Aug 2023Development of radiopharmaceuticals for in vivo positron emission tomography imaging of alpha-synuclein aggregates has the potential to revolutionize Lewy body disease...
Development of radiopharmaceuticals for in vivo positron emission tomography imaging of alpha-synuclein aggregates has the potential to revolutionize Lewy body disease diagnosis and treatment. Reporting in this issue of Cell, Xiang et al. developed a high-affinity positron emission tomography tracer for alpha-synuclein.
Topics: Humans; alpha-Synuclein; Lewy Body Disease; Positron-Emission Tomography; Radiopharmaceuticals
PubMed: 37541192
DOI: 10.1016/j.cell.2023.06.018 -
Seminars in Nuclear Medicine Jan 2024Prostate cancer (PCa) is the most common cancer diagnosed in men in most developed countries and a leading cause of cancer-related morbidity and mortality.... (Review)
Review
Prostate cancer (PCa) is the most common cancer diagnosed in men in most developed countries and a leading cause of cancer-related morbidity and mortality. Prostate-specific membrane antigen positron emission tomography (PSMA-PET) has become a valuable tool in the staging and assessment of disease recurrence in PCa, and more recently for assessment for treatment eligibility to PSMA radioligand therapy (RLT). Harmonization of PSMA-PET interpretation and synoptic reports are needed to communicate concisely and reproducibly PSMA-PET/CT to referring physicians and to support clinician therapeutic management decisions in various stages of the disease. Uniform image interpretation is also important to provide comparable data between clinical trials and to translate such data from research to daily practice. This review provides an overview of the value of PSMA-PET across the different clinical stages of PCa, discusses published reporting criteria for PSMA-PET, identifies pitfalls in reporting PSMA, and provides recommendations for synoptic reports.
Topics: Male; Humans; Positron Emission Tomography Computed Tomography; Neoplasm Recurrence, Local; Prostatic Neoplasms; Positron-Emission Tomography; Gallium Radioisotopes
PubMed: 37558507
DOI: 10.1053/j.semnuclmed.2023.07.007 -
Current Problems in Cardiology Nov 2023Traditional atherosclerosis imaging modalities are limited to late stages of disease, prior to which patients are frequently asymptomatic. Positron emission tomography... (Review)
Review
Traditional atherosclerosis imaging modalities are limited to late stages of disease, prior to which patients are frequently asymptomatic. Positron emission tomography (PET) imaging allows for the visualization of metabolic processes underscoring disease progression via radioactive tracer, allowing earlier-stage disease to be identified. 2-deoxy-2-[fluorine-18]fluoro-D-glucose (18F-FDG) uptake largely reflects the metabolic activity of macrophages, but is unspecific and limited in its utility. By detecting areas of microcalcification, 18F-Sodium Fluoride (18F-NaF) uptake also provides insight into atherosclerosis pathogenesis. Gallium-68 DOTA-0-Tyr3-Octreotate (68Ga-DOTATATE) PET has also shown potential in identifying vulnerable atherosclerotic plaques with high somatostatin receptor expression. Finally, 11-carbon (11C)-choline and 18F-fluoromethylcholine (FMCH) tracers may identify high-risk atherosclerotic plaques by detecting increased choline metabolism. Together, these radiotracers quantify disease burden, assess treatment efficacy, and stratify risk for adverse cardiac events.
Topics: Humans; Plaque, Atherosclerotic; Radiopharmaceuticals; Positron-Emission Tomography; Atherosclerosis; Choline
PubMed: 37392979
DOI: 10.1016/j.cpcardiol.2023.101925 -
Radiologic Clinics of North America Jul 2023Patients with gynecologic malignancies often require a multimodality imaging approach for initial staging, treatment response assessment, and surveillance. MRI imaging... (Review)
Review
Patients with gynecologic malignancies often require a multimodality imaging approach for initial staging, treatment response assessment, and surveillance. MRI imaging and PET are two well-established and widely accepted modalities in this setting. Although PET and MRI imaging are often acquired separately on two platforms (a PET/computed tomography [CT] and an MRI imaging scanner), hybrid PET/MRI scanners offer the potential for comprehensive disease assessment in one visit. Gynecologic malignancies have been one of the most successful areas for implementation of PET/MRI. This article provides an overview of the role of this platform in the care of patients with gynecologic malignancies.
Topics: Humans; Female; Genital Neoplasms, Female; Positron-Emission Tomography; Magnetic Resonance Imaging; Tomography, X-Ray Computed; Multimodal Imaging; Neoplasm Staging; Fluorodeoxyglucose F18; Radiopharmaceuticals; Positron Emission Tomography Computed Tomography
PubMed: 37169433
DOI: 10.1016/j.rcl.2023.02.013 -
Seminars in Hematology Nov 2023F-fluorodeoxyglucose positron emission tomography-computerized tomography (FDG-PET/CT) is the gold-standard imaging modality for staging and response assessment for most... (Review)
Review
F-fluorodeoxyglucose positron emission tomography-computerized tomography (FDG-PET/CT) is the gold-standard imaging modality for staging and response assessment for most lymphomas. This review focuses on the utility of FDG-PET/CT, and its role in staging, prognostication and response assessment in diffuse large B-cell lymphoma (DLBCL), including emerging possibilities for future use.
Topics: Humans; Positron Emission Tomography Computed Tomography; Fluorodeoxyglucose F18; Positron-Emission Tomography; Lymphoma, Large B-Cell, Diffuse
PubMed: 38326144
DOI: 10.1053/j.seminhematol.2023.12.003 -
Clinical Rheumatology Jul 2023
Topics: Humans; Voriconazole; Periostitis; Positron Emission Tomography Computed Tomography; Antifungal Agents; Positron-Emission Tomography
PubMed: 36811806
DOI: 10.1007/s10067-023-06547-2 -
PET Clinics Oct 2023Metabolic PET, most commonly 18F-fluorodeoxyglucose (FDG) PET/computed tomography (CT), has had a major impact on the imaging of breast cancer and can have important... (Review)
Review
Metabolic PET, most commonly 18F-fluorodeoxyglucose (FDG) PET/computed tomography (CT), has had a major impact on the imaging of breast cancer and can have important clinical applications in appropriate patients. While limited for screening, FDG PET/CT outperforms conventional imaging in locally advanced breast cancer. FDG PET/CT is more sensitive than conventional imaging in assessing treatment response, accurately predicting complete response or nonresponse in early-stage cases. It also aids in determining disease extent and treatment response in the metastatic setting. Further research, including randomized controlled trials with FDG and other metabolic agents such as fluciclovine, is needed for optimal breast cancer imaging.
Topics: Humans; Female; Breast Neoplasms; Fluorodeoxyglucose F18; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Tomography, X-Ray Computed; Radiopharmaceuticals
PubMed: 37369614
DOI: 10.1016/j.cpet.2023.04.004