Long-term Trace of Radiation Pneumonitis With 18F-Fluoroestradiol

International audienceRadiation pneumonitis (RP) can be an adverse complication of radiotherapy and usually occurs as an acute reaction from 6 to 12 weeks after radiotherapy. FDG PET is described as an early and adequate barometer for RP diagnosis. Only 1 case of fluoroestradiol uptake contemporary of metabolic FDG changes attributed to RP is reported. We report a case of a breast cancer patient with asymptomatic RP, who at 1 year later, at sequelar stage on CT, showed long-term memory of RP by 18 F-fluoroestradiol PET imaging with nonmetabolic FDG PET. (Clin Nucl Med 2020;45: e403-e405) REFERENCES 1. Demirev AK, Kostadinova ID, Gabrovski IR. 18 F-FDG PET/CT in patients with parenchymal changes attributed to radiation pneumonitis. Mol Imaging Radionucl Ther. 2018;27:107-112. 2. Liao GJ, Clark AS, Schubert EK, et al. 18 F-fluoroestradiol PET: current status and potential future clinical applications

Effective Management of 177Lu-DOTA0-Tyr3-Octreotate Extravasation

International audienceRadiopharmaceutical extravasation is a known nuclear medicine adverse effect, mostly with no complication in case of diagnostic radiopharmaceutical. However, a therapeutic radiopharmaceutical extravasation may have clinical consequences and must be treated quickly and effectively. We report here a case of 177Lu-DOTA0-Tyr3-octreotate extravasation

68 Ga‐PSMA PET/CT prospective study in prostate cancer patients with occult recurrence: Diagnostic performance and impact on therapeutic decision‐making and long-term benefits

International audienc

68Ga‐PSMA‐11 PET‐CT study in prostate cancer patients with biochemical recurrence and non‐contributive 18F‐Choline PET‐CT: Impact on therapeutic decision‐making and biomarker changes

International audienceBACKGROUND:In this retrospective study, we investigated the impact of 68 Ga-PSMA-11 PET-CT (PSMA PET-CT) upon the treatment plan and therapeutic response obtained for Prostate Cancer (PCa) patients presenting an occult biochemical recurrence.METHODS:Forty-two patients with previously negative or doubtful 18F-Choline (FCH) were enrolled. PET images were recorded 1 h after injection of tracer. Only a few months after treatment ended, a PSA assay was requested to evaluate the therapeutic efficacy of the treatment based on PSMA results.RESULTS:PSMA-positive lesions were detected in 34/42 (80.9%) patients. Detection rates were 85.7% and 89.3% for serum PSA levels lower than 2 ng/mL, and >2 ng/mL, respectively. One hundred seventy-three lesions were detected: 132/173 in lymph nodes (76.3%), 22/173 as metastatic sites (bone or lung) (12.7%), and 19/173 in the prostate bed (10.9%). As a result of the PSMA PET-CT, therapeutic management changed in 31/42 patients (73.8%). With a follow-up of 4.9 ± 2.27 months, 32/42 (76.2%) PSA assays after treatment guided by PSMA PET-CT were collected. For 37.5% (12/32) of patients, the serum PSA level was lower than 0.2 ng/mL and a PSA decrease of over 50% in 8 (25.0%) other patients were obtained.CONCLUSION:Performing a PSMA PET-CT when FCH PET-CT was doubtful or negative allows the recurrence localization in more 80% of patients and this had a major clinical impact, as it resulted in treatment change in more than 70% of patients as well as a significant decrease in PSA levels in more than 60% of them

Head-to-Head Comparison of 18F-DOPA PET/CT and 68Ga-DOTANOC PET/CT in Patients With Midgut Neuroendocrine Tumors

International audiencePurpose: The aim of this study was to compare retrospectively F-DOPA PET/CT versus Ga-DOTANOC PET/CT in a group of patients affected by midgut NET.Patients and methods: Patients with histologically proven grade 1 or grade 2 midgut NET were explored after injection of 150 MBq of Ga-DOTANOC and 210 MBq of F-DOPA. The PET/CTs were analyzed visually and semiquantitatively at the patient level, regional level (7 defined regions), and lesion level (maximum of 5 lesions/organ). The criterion standard was determined on the basis of histology and imaging follow-up.Results: Thirty patients (17 males and 13 females; median age, 63.5 years [37-82 years]) were included. Both PET/CTs were negative in 3 patients and positive in 25 patients. PET/CTs were discordant in 2 patients, with F-DOPA positive and Ga-DOTANOC negative. F-DOPA PET/CT detected more involved regions and more metastatic lesions than Ga-DOTANOC PET/CT in 6 (20%) and 10 (33.3%) patients, respectively. Of the 81 confirmed affected regions, 77 (95%) were detected by F-DOPA PET/CT and 71 (87.7%) by Ga-DOTANOC PET/CT (P < 0.0001). F-DOPA PET/CT detected significantly more lesions (211/221) than Ga-DOTANOC PET/CT (195/221), corresponding to a sensitivity of 95.5% and 88.2%, respectively (P < 0.0001). Tumor-to-background ratios were more favorable in liver for F-DOPA than for Ga-DOTANOC. Interestingly, a correlation was found between F-DOPA SUVmax and tumor burden and especially with the number of regions involved by the disease (P = 0.019).Conclusions: F-DOPA PET/CT is superior to Ga-DOTANOC PET/CT for the detection of lesions, and when available, this tracer may be recommended as the first-line examination for an accurate staging of midgut NET

Prognostic Impact of Pretherapeutic FDG-PET in Localized Anal Cancer

International audienceDue to the heterogeneity of tumour mass segmentation methods and lack of consensus, our study evaluated the prognostic value of pretherapeutic positron emission tomography with fluorodeoxyglucose (FDG-PET) metabolic parameters using different segmentation methods in patients with localized anal squamous cell carcinoma (SCC). Eighty-one patients with FDG-PET before radiochemotherapy were retrospectively analyzed. Semiquantitative data were measured with three fixed thresholds (35%, 41% and 50% of Maximum Standardized Uptake Value (SUVmax)) and four segmentation methods based on iterative approaches (Black, Adaptive, Nestle and Fitting). Metabolic volumes of primary anal tumour (P-MTV) and total tumour load (T-MTV: P-MTV+ lymph node MTV) were calculated. The primary endpoint was event-free survival (EFS). Seven multivariate models were created to compare FDG-PET tumour volumes prognostic impact. For all segmentation thresholds, PET metabolic volume parameters were independent prognostic factor and T-MTV variable was consistently better associated with EFS than P-MTV. Patient's sex was an independent variable and significantly correlated with EFS. With fixed threshold segmentation methods, 35% of SUVmax threshold seemed better correlated with EFS and the best cutoff for discrimination between a low and high risk of event occurrence was 40 cm 3. Determination of T-MTV by FDG-PET using fixed threshold segmentation is useful for predicting EFS for primary anal SCC. If these data are confirmed in larger studies, FDG-PET could contribute to individualized patient therapies