Comparisons between glucose analogue 2-deoxy-2-((18)F)fluoro-D-glucose and (18)F-sodium fluoride positron emission tomography/computed tomography in breast cancer patients with bone lesions

To compare 2-deoxy-2-((18)F)fluoro-D-glucose((18)F-FDG) and (18)F-sodium ((18)F-NaF) positron emission tomography/computed tomography (PET/CT) accuracy in breast cancer patients with clinically/radiologically suspected or known bone metastases

A review discussing fluciclovine (18F) PET/CT imaging in the detection of recurrent prostate cancer

A significant number of patients radically treated for prostate cancer (PCa) will develop prostate-specific antigen recurrence (27-53%). Localizing the anatomical site of relapse is critical, in order to achieve the optimal treatment management. To date the diagnostic accuracy of standard imaging is low. Several desirable features have been identified for the amino-acid-based PET agent, fluciclovine (18F) including: long 18F half-life which allows more practical use in centers without a cyclotron onsite; acting as a substrate for amino acid transporters upregulated in PCa or associated with malignant phenotype; lacking of incorporation into protein; and limited urinary excretion. Fluciclovine (18F) is currently approved both in USA and Europe with specific indication in adult men with suspected recurrent PCa based on elevated prostate-specific antigen following prior treatment

Standardized Uptake Value Ratio-Independent Evaluation of Brain Amyloidosis

The assessment of in vivo18F images targeting amyloid deposition is currently carried on by visual rating with an optional quantification based on standardized uptake value ratio (SUVr) measurements. We target the difficulties of image reading and possible shortcomings of the SUVr methods by validating a new semi-quantitative approach named ELBA. ELBA involves a minimal image preprocessing and does not rely on small, specific regions of interest (ROIs). It evaluates the whole brain and delivers a geometrical/intensity score to be used for ranking and dichotomic assessment. The method was applied to adniimages 18F-florbetapir images from the ADNI database. Five expert readers provided visual assessment in blind and open sessions. The longitudinal trend and the comparison to SUVr measurements were also evaluated. ELBA performed with area under the roc curve (AUC) = 0.997 versus the visual assessment. The score was significantly correlated to the SUVr values (r = 0.86, p < 10-4). The longitudinal analysis estimated a test/retest error of ≃2.3%. Cohort and longitudinal analysis suggests that the ELBA method accurately ranks the brain amyloid burden. The expert readers confirmed its relevance in aiding the visual assessment in a significant number (85) of difficult cases. Despite the good performance, poor and uneven image quality constitutes the major limitation

Nigro-caudate dopaminergic deafferentation: A marker of REM sleep behavior disorder?

Forty-nine consecutive, drug na\uefve outpatients with de novo Parkinson's disease (PD) and 12 patients with idiopathic rapid eye movement sleep behavior disorder (iRBD) underwent clinical examination and dopamine transporter single photon emission computed tomography with [(123)I]-2\u3b2-carbomethoxy-3\u3b2-(4-iodophenyl)-N-(3-fluoropropyl)nortropane as a biomarker of nigro-striatal function. PD patients were grouped into rapid eye movement sleep behavior disorder (RBD) negative (PD-RBD-) and RBD positive (PD-RBD+). Repeated measures and univariate analysis of variance were used to compare dopaminergic and clinical impairment among groups. The variations of dopamine transporter-single photon emission computed tomography specific binding ratios (SBR) as a function of group belonging were significantly different (p = 0.0013) at caudate with respect to putamen level. Indeed, putamen SBR progressively decreased from iRBD to PD-RBD- and PD-RBD+ groups while caudate SBR were higher in PD-RBD- group than in PD-RBD+ and even than in iRBD group. Motor impairment was more severe in PD patients with RBD than in those without RBD. Our data suggest that a more severe nigro-caudate dopaminergic deafferentation is related to RBD, both in its idiopathic form and in PD patients

Brain 18F-DOPA PET and cognition in de novo Parkinson's disease.

none13noPURPOSE: The role of mesocortical dopaminergic pathways in the cognitive function of patients with early Parkinson's disease (PD) needs to be further clarified. METHODS: The study groups comprised 15 drug-naive patients with de novo PD and 10 patients with essential tremor (controls) who underwent 18F-DOPA PET (static acquisition, normalization on mean cerebellar counts) and an extended neuropsychological test battery. Factor analysis with varimax rotation was applied to the neuropsychological test scores, to yield five factors from 16 original scores, which explained 82 % of the total variance. Correlations between cognitive factors and 18F-DOPA uptake were assessed with SPM8, taking age and gender as nuisance variables. RESULTS: 18F-DOPA uptake was significantly lower in PD patients than in controls in the bilateral striatum, mainly in the more affected (right) hemisphere, and in a small right temporal region. Significant positive correlations were found only in PD patients between the executive factor and 18F-DOPA uptake in the bilateral anterior cingulate cortex (ACC) and the middle frontal gyrus, between the verbal fluency factor and 18F-DOPA uptake in left BA 46 and the bilateral striatum, and between the visuospatial factor and 18F-DOPA uptake in the left ACC and bilateral striatum. No correlations were found between 18F-DOPA uptake and either the verbal memory factor or the abstraction-working memory factor. CONCLUSION: These data clarify the role of the mesocortical dopaminergic pathways in cognitive function in early PD, highlighting the medial frontal lobe, anterior cingulate, and left BA 46 as the main sites of cortical correlation with executive and language functions.Picco, A; Morbelli, S; Piccardo, A; Arnaldi, D; Girtler, N; Brugnolo, A; Bossert, I; Marinelli, L; Castaldi, A; De Carli, F; Campus, C; Abbruzzese, G; Nobili, F.Picco, Agnese; Morbelli, Silvia; Piccardo, A; Arnaldi, Dario; Girtler, NICOLA GIOVANNI; Brugnolo, Andrea; Bossert, Irene; Marinelli, Lucio; Castaldi, A; DE CARLI, Fabrizio; Campus, C; Abbruzzese, Giovanni; Nobili, FLAVIO MARIAN

Contrast-enhanced [¹⁸\ue2\u88\u88F] fluorodeoxyglucose-positron emission tomography/computed tomography in clinical oncology: Tumor-, site-, and question-based comparison with standard positron emission tomography/computed tomography

Background: The present study aimed to evaluate the added value of contrast-enhanced computed tomography (ceCT) in comparison to standard, non-enhanced CT in the context of a combined positron emission tomography (PET)/CT examination by means of a tumor-, site-, and clinical question-based approach. Methods: Analysis was performed in 202 patients undergoing PET/CT consisting of a multiphase CT protocol followed by a whole-body PET. The Cochran Q test was performed, followed by a multiple comparisons correction (McNemar test and Bonferroni adjustment), to compare standard and contrast-enhanced PET (cePET/CT). Histopathology or clinical-radiologic follow-up greater than 1 year was used as a reference. Results: cePET/CT showed significantly different results with respect to standard PET/CT in head and neck and gastrointestinal cancer (P\ue2\u88\u88=\ue2\u88\u880.02 and 0.0002, respectively), in the evaluation of lesions located in the abdomen (P\ue2\u88\u88=\ue2\u88\u880.009), and in the context of disease restaging (P\ue2\u88\u88=\ue2\u88\u880.003). In all these clinical scenarios, adding ceCT resulted in a distinct benefit, by yielding a higher percentage of change in patient management. Conclusion: These data strongly underline the importance of strictly selecting patients for the combined exam. In particular, patient selection should not be driven solely by mere tumor classification, but should also account for the clinical question and the anatomical location of the neoplastic disease, which can significantly impact patient management

Mapping brain morphological and functional conversion patterns in predementia late-onset bvFTD

none15Morbelli, Silvia; Ferrara, Michela; Fiz, Francesco; Dessi, Barbara; Arnaldi, Dario; Picco, Agnese; Bossert, Irene; Buschiazzo, Ambra; Accardo, Jennifer; Picori, Lorena; Girtler, Nicola; Mandich, Paola; Pagani, Marco; Sambuceti, Gianmario; Nobili, FlavioMorbelli, Silvia; Ferrara, Michela; Fiz, Francesco; Dessi, Barbara; Arnaldi, Dario; Picco, Agnese; Bossert, Irene; Buschiazzo, Ambra; Accardo, Jennifer; Picori, Lorena; Girtler, NICOLA GIOVANNI; Mandich, Paola; Pagani, Marco; Sambuceti, Gianmario; Nobili, FLAVIO MARIAN