Nuclear Medicine Communications

Our medical research library holds 8 studies published in Nuclear Medicine Communications (2001–2020). Each entry links to the study's record on PubMed and, where there is one, to the publisher's page and a free full text. 8 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it.

About the journal

• Publisher: Lippincott Williams & Wilkins
• Published: 1980 to the present, England
• Language: English
• ISSN: 0143-3636 (print), 1473-5628 (electronic)
• Its record in the NLM Catalog

2020s

• Comparison of modified Response Evaluation Criteria in Solid Tumors, European Organization for Research and Treatment of Cancer criteria, and PET Response Criteria in Solid Tumors for evaluation of tumor response to chemotherapy and prognosis prediction in patients with unresectable malignant pleural mesothelioma. K. Kitajima, M. Maruyama, T. Minami, et al. 2020;41(8):790-799. PubMed · Publisher

  Abstract

  Objective: To compare modified RECIST (mRECIST), EORTC criteria, and PERCIST for response evaluation and prognosis prediction in advanced malignant pleural mesothelioma (MPM) patients treated with chemotherapy.

  Methods: Patients with MPM and not curative surgery candidates (n = 75) underwent standard chemotherapy with cisplatin and pemetrexed. CT and [F]fluorodeoxyglucose PET/CT scans were performed at baseline and after three chemotherapy cycles. Chemotherapeutic response was evaluated according to mRECIST, EORTC, and PERCIST, then concordance among those was assessed using Cohen's κ coefficient. PFS and OS were examined using log-rank and Cox methods.

  Results: With EORTC, 27 patients had PMD, 23 SMD, 17 PMR, and eight CMR, while with PERCIST those were 28, 22, 11, and 14, respectively. Using mRECIST, 28 had PD, 29 SD, 18 PR, and 0 CR. Although there was high concordance between EORTC and PERCIST (82.7% of patients; κ = 0.83), that between mRECIST and EORTC (38.7%; κ = 0.27) and mRECIST and PERCIST (36.0%; κ = 0.26) was low. According to both EORTC and PERCIST, patients with no progression (CMR/PMR/SMD) showed significantly longer PFS and OS than PMD patients (EORTC: P = 0.0024 and P = 0.039, respectively, PERCIST: P = 0.0012 and P = 0.024, respectively), while according to mRECIST, those who achieved no progression (PR/SD) showed significantly longer PFS than PD patients (P = 0.011), but not significantly longer OS (P = 0.11).

  Conclusion: EORTC and PERCIST are more accurate than mRECIST for evaluation of tumor response to chemotherapy and predicting prognosis in unresectable MPM patients.

2010s

• In-vivo imaging of methionine metabolism in patients with suspected malignant pleural mesothelioma. E. Lopci, P. Novellis, A. Testori, et al. 2019;40(11):1179-1186. PubMed · Publisher

  Abstract

  Objectives: In-vivo characterization of malignant pleural mesothelioma (MPM) with C-methionine PET/computed tomography (MET PET).

  Methods: Between September 2014 and February 2016, 30 consecutive patients with clinical suspicion of MPM were prospectively recruited. The study was approved and registered at www.clinicaltrials.gov (NCT02519049). Patients were evaluated at baseline with MET PET (experimental) and fluorine-18 fluorodeoxyglucose PET/computed tomography (FDG PET) (standard). Principal parameters analyzed were SUVmax, SUVmean, metabolic tumor volume (MTV), and metabolic tumor burden (MTB = MTV ×SUVmean). The reference standard for diagnostic performance was based on histology.

  Results: The presence of malignancy was confirmed in 29/30 patients: 23 (76.6%) with MPM (20 epithelioid, two biphasic, and one sarcomatoid), five (16.6%) with adenocarcinoma of the lung, and one (3.3%) with an undifferentiated carcinoma. In one case, diagnosis was benign pleural inflammation. All tumors showed increased uptake of C-methionine: median SUVmax, SUVmean, MTV, and MTB were, respectively, 5.70 [95% confidence interval (CI): 4.51-6.79], 3.15 (95% CI: 2.71-3.40), 33.85 (95% CI: 14.08-66.64), and 105.25 (95% CI: 41.77-215.25). Pathology data revealed MTV and MTB to be significantly higher in nonepithelioid histology (P < 0.05). The other parameters showed a homogeneous distribution across the tumor types. Overall, MET PET identified 49 lymph nodes, compared with 34 nodes on FDG PET, demonstrating a sensitivity of 91% (95% CI: 80-96%), a positive predictive value of 92% (95% CI: 82- 97%), and an accuracy of 85% (P = 0.0042).

  Conclusions: MET PET is able to characterize MPM lesions regardless of histology. This technique shows higher sensitivity than FDG PET for the identification of secondary lymph nodes.

• 18F-Fluorodeoxyglucose PET/CT and dynamic contrast-enhanced MRI as imaging biomarkers in malignant pleural mesothelioma. D.O. Hall, C.E. Hooper, J. Searle, et al. 2018;39(2):161-170. PubMed · Publisher

  Abstract

  Purpose: The purpose of this study was to compare the use of fluorine-18-fluorodeoxyglucose (F-FDG) PET with computed tomography (CT) and dynamic contrast-enhanced (DCE) MRI to predict prognosis and monitor treatment in malignant pleural mesothelioma.

  Patients And Methods: F-FDG PET/CT and DCE-MRI studies carried out as part of the South West Area Mesothelioma Pemetrexed trial were used. F-FDG PET/CT and DCE-MRI studies were carried out before treatment, and after two cycles of chemotherapy, on patients treated with pemetrexed and cisplatin. A total of 73 patients were recruited, of whom 65 had PET/CT and DCE-MRI scans. Baseline measurements from F-FDG PET/CT (maximum standardized uptake value, metabolic tumour volume and total lesion glycolysis) and DCE-MRI (integrated area under the first 90s of the curve and washout slope) were compared with overall survival (OS) using Kaplan-Meier and Cox regression analyses, and changes in imaging measurements were compared with disease progression.

  Results: PET/CT and DCE-MRI measurements were not correlated with each other. Maximum standardized uptake value, metabolic tumour volume and total lesion glycolysis were significantly related to OS with Cox regression analysis and Kaplan-Meir analysis, and DCE-MRI washout curve shape was significantly related to OS. DCE-MRI curve shape can be combined with F-FDG PET/CT to give additional prognostic information. Changes in measurements were not related to progression-free survival.

  Conclusions: F-FDG PET/CT and DCE-MRI give prognostic information in malignant pleural mesothelioma. Neither PET/CT nor DCE-MRI is useful for monitoring disease progression.

• 18F-FDG-PET/CT of peritoneal tumors: a pictorial essay. J. Dubreuil, F. Giammarile, P. Rousset, et al. 2017;38(1):1-9. Review PubMed · Publisher

  Abstract

  Cancer imaging on the peritoneum is quite difficult on PET/CT because of the particular anatomical features of this membrane. The abdominal cavity can be the seat of very different primary or secondary tumoral lesions, with heterogeneous aggressiveness and variable fluorine-18 fluorodeoxyglucose uptake and patterns. We aimed to depict a spectrum of appearances with abnormal fluorine-18 fluorodeoxyglucose uptakes localized on the peritoneum in frequent conditions such as peritoneal carcinomatosis and in rarer disease such as desmoplastic round cell tumor.

• The role of 18F-FDG-PET/ceCT in peritoneal mesothelioma. J. Dubreuil, F. Giammarile, P. Rousset, et al. 2017;38(4):312-318. PubMed · Publisher

  Abstract

  Purpose: The aim of this study was to assess glucose metabolism of multicystic peritoneal mesothelioma and epithelioid peritoneal mesothelioma by fluorine-18 fluorodeoxyglucose (F-FDG)-PET/contrast-enhanced computed tomography (ceCT) and to assess its prognostic impact.

  Materials And Methods: Twenty-three (14 women) patients, without previous treatment, underwent F-FDG-PET/ceCT before peritoneal mesothelioma cytoreductive surgery and intraperitoneal chemotherapy. F-FDG-PET/ceCT was interpreted prospectively as positive or negative. Maximum standardized uptake value (SUVmax) of each lesion was measured retrospectively on the basis of postsurgery data. At laparotomy, disease extension was estimated with the Peritoneal Cancer Index. The median follow-up was 27 months (95% confidence interval: 12.9-37.8); progression-free survival (PFS) was recorded.

  Results: Nine patients were affected by multicystic and 14 were affected by epithelioid peritoneal mesothelioma. PET showed mild focal uptake in one case of multicystic peritoneal mesothelioma, whereas in eight patients, no abnormal uptake was observed. PET was positive in 12/14 patients with epithelioid peritoneal mesothelioma. Sensitivity, specificity and accuracy were respectively 86, 89 and 87%; the qualitative assessment was statistically different (P=0.0020, χ). Multicystic peritoneal mesothelioma histology was significantly associated with lower SUVmaxlesion (P=0.0061), SUVmaxlesion/liver (P=0.0025), Peritoneal Cancer Index, younger age, and it was observed only in women.Recurrence was observed on nine patients affected by epithelioid peritoneal mesothelioma, whereas no recurrences were observed among multicystic peritoneal mesothelioma patients. SUVmaxlesion (P=0.0278) and age (P=0.0241) were significantly associated with PFS in patients with epithelioid peritoneal mesothelioma.

  Conclusion: F-FDG-PET/ceCT showed significant differences between multicystic and epithelioid peritoneal mesothelioma, whereas SUVmaxlesion was associated with PFS in the latter. Although multicentre prospective studies are necessary, F-FDG-PET/ceCT appears to be a promising tool in patients affected by peritoneal mesothelioma.

• Patterns of disease progression on 18F-fluorodeoxyglucose positron emission tomography-computed tomography in patients with malignant pleural mesothelioma undergoing multimodality therapy with pleurectomy/decortication. A. Bille, S. Chicklore, L. Okiror, et al. 2013;34(11):1075-83. PubMed · Publisher

  Abstract

  Introduction: The aim of this study was to evaluate the patterns of disease progression in patients treated with pleurectomy/decortication (P/D), hyperthermic pleural lavage with povidone-iodine, prophylactic radiotherapy and adjuvant chemotherapy, using F-fluorodeoxyglucose (18F-FDG) PET/computed tomography (PET/CT).

  Materials And Methods: This was a retrospective study of 65 patients treated with a multimodality therapy including P/D between October 2004 and March 2012. Thirty-two patients underwent 18F-FDG PET/CT within 6 weeks of completion of adjuvant chemotherapy and 6-monthly thereafter at our institution. The first site of relapse on 18F-FDG PET/CT was recorded, and all scans were reviewed by an independent observer.

  Results: Thirty-two patients (27 male, median age 61 years, range 45-73) underwent their 18F-FDG PET/CT scans at our institution. Eighteen of the 32 patients were alive at last follow-up (median follow-up 42 months, range 16-76). Nine patients were alive with disease recurrence. Fourteen patients died of disease progression (median survival 24.7 months, range 15-38). The median maximum standardized uptake value (SUVmax) in relapsing mesothelioma was 10.9 (range 4.9-27.3). There was a statistically significant correlation between the SUVmax and tumour lesion glycolysis of recurrent mesothelioma and overall survival (P=0.05). The site of disease recurrence was the pleura in the majority of the alive patients and was extrapleural in the dead patients. There was a statistically significant correlation between disease-free survival and complete macroscopic resection (P=0.02).

  Conclusion: After P/D with hyperthermic pleural lavage with povidone-iodine, prophylactic radiotherapy and adjuvant chemotherapy, the most frequent site of recurrence is the pleural cavity. Peritoneal seeding is rare. The tumour SUVmax and tumour lesion glycolysis correlate significantly with overall survival.

• The role of fluorodeoxyglucose-positron emission tomography/computed tomography in differentiating between benign and malignant adrenal lesions. P. Ozcan Kara, T. Kara, G. Kara Gedik, et al. 2011;32(2):106-12. PubMed · Publisher

  Abstract

  Objectives: This retrospective study was designed to investigate the clinical role of whole-body positron emission tomography/computed tomography (PET/CT) by using 2-[18F]fluoro-2-deoxy-D-glucose (FDG), for the evaluation of adrenal lesions and to find the best index to distinguish benign from malignant lesions in various cancer patients.

  Materials And Methods: A total of 81 patients (55 male and 26 female, age range: 31-81 years, mean: 61.5) who had confirmed primary malignancies (lung cancer in 47 patients, gastrointestinal malignancies in 13 patients, malignant melanoma in one patient, renal cell cancer in three patients, mesothelioma in two patients, breast carcinoma in nine patients, cervical cancer in one patient, ovarian cancer in two patients, pheochromocytoma in one patient, unknown primary in two patients) underwent PET/CT examinations for cancer screening, staging, restaging, and detection of suspected recurrence. Of the 81 patients, 104 adrenal lesions (34 benign and 70 malignant adrenal lesions) were shown by CT. On visual analysis of PET/CT imaging, adrenal uptake was based on a three-scale grading system. For final assessment standards of references for adrenal malignant lesions was based on biopsy (n=2), interval growth, or reduction after chemotherapy. An adrenal lesion, which remained unchanged on clinical and imaging follow-up of at least 7 months (mean follow-up time 19.31 months±6.46, range 7-30 months), was decided as a benign lesion.

  Results: In adrenal malignant lesions maximum standardized uptake value (SUVmax) (8.82±4.47) was higher than that of adrenal benign lesions (3.02±1.15, P<0.0001). In the differentiation of adrenal benign and malignant lesions, a CT threshold of 10 Hounsfield units corresponded to a sensitivity of 64.7%, specificity of 98.6%, and accuracy of 87.5%. An SUVmax cut-off value of 2.5 corresponded to a sensitivity of 100%, specificity of 38.2%, and accuracy of 80%. An SUVmax cut-off value of 4.2 corresponded to a sensitivity of 88.6%, specificity of 88.2%, and accuracy of 88.5%. The ratio of tumor SUVmax to liver SUVmean was 3.61±1.77 for adrenal malignant lesions whereas it was 1.20±0.38 for adrenal benign lesions (P<0.0001). T/L SUV ratio cut-off value of 1.8 corresponded to a sensitivity of 87%, specificity of 91%, and accuracy of 88.5%. T/L SUV ratio cut-off value of 1.68 corresponded to a sensitivity of 90%, specificity of 91.1%, and accuracy of 90.4%.

  Conclusion: 2-[18F]fluoro-2-deoxy-D-glucose-PET/CT improves the diagnostic accuracy in the differentiation of benign from malignant adrenal lesions in various cancer patients. Combined information obtained from PET/CT (SUVmax, T/L SUV ratio, visual analysis) and unenhanced CT (size, Hounsfield units measurement) is recommended for better differentiation.

2000s

• Do high glucose levels have differential effect on FDG uptake in inflammatory and malignant disorders?. H.M. Zhuang, A. Cortés-Blanco, M. Pourdehnad, et al. 2001;22(10):1123-8. PubMed · Publisher

  Abstract

  Background: The association of hyperglycaemia with reduced fluorodeoxyglucose (FDG) uptake by tumour cells is well established. Therefore, it is standard practice that all patients must fast for at least several hours prior to FDG positron emission tomography (PET) imaging. However, the effect of hyperglycaemia on FDG uptake by inflammatory and infectious lesions is unknown. The aim of this study was to investigate this important issue.

  Methods: For in vitro studies human mononuclear cells were isolated from 12 normal volunteers and FDG uptake was determined in medium containing differing concentrations of glucose. FDG uptake by human mesothelioma cells was also measured for comparison. For studies involving patients, 416 FDG PET scans of patients with confirmed malignancy (n=321) or benign lesions (n=95) were reviewed retrospectively. The relationship between serum glucose level and FDG uptake by the lesions was assessed utilizing the standardized uptake value (SUV) technique.

  Results: In the in vitro studies, while FDG uptake by mesothelioma cells decreased as glucose concentration increased, there was no differential uptake of FDG uptake by mononuclear cells at glucose concentrations less than 250 mg x dl(-1). In clinical patients, FDG uptake by malignant lesions was slightly, but negatively affected by serum glucose level (r= -0.21, P<0.01) (glucose range 49-187 mg x dl(-1)). In contrast, FDG uptake by inflammatory lesions was positively associated with serum glucose level (r=0.43, P<0.01) (glucose range 54-215 mg x dl(-1)).

  Discussion And Conclusion: While the degree of FDG uptake is primarily influenced by the nature of the underlying lesion, serum glucose concentration appears to have a small effect on FDG uptake, which differs between malignant disorders and inflammatory processes. Our data suggest that below a certain level, elevated glucose concentration might not have a negative effect on FDG uptake in inflammatory cells, contrary to that observed in malignant disorders.

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