FDG-PET/CT imaging for staging and target volume delineation in conformal radiotherapy of anal carcinoma

Background: FDG-PET/CT imaging has an emerging role in staging and treatment planning of various tumor locations and a number of literature studies show that also the carcinoma of the anal canal may benefit from this diagnostic approach. We analyzed the potential impact of FDG-PET/CT in stage definition and target volume delineation of patients affected by carcinoma of the anal canal and candidates for curative radiotherapy. Methods: Twenty seven patients with biopsy proven anal carcinoma were enrolled. Pathology was squamous cell carcinoma in 20 cases, cloacogenic carcinoma in 3, adenocarcinoma in 2, and basal cell carcinoma in 2. Simulation was performed by PET/CT imaging with patient in treatment position. Gross Tumor Volume (GTV) and Clinical Target Volume (CTV) were drawn on CT and on PET/CT fused images. PET-GTV and PET-CTV were respectively compared to CT-GTV and CT-CTV by Wilcoxon rank test for paired data. Results: PET/CT fused images led to change the stage in 5/27 cases (18.5%): 3 cases from N0 to N2 and 2 from M0 to M1 leading to change the treatment intent from curative to palliative in a case. Based on PET/CT imaging, GTV and CTV contours changed in 15/27 (55.6%) and in 10/27 cases (37.0%) respectively. PET-GTV and PET-CTV resulted significantly smaller than CT-GTV (p = 1.2 7 10-4) and CT-CTV (p = 2.9 7 10-4). PET/CT-GTV and PET/CT-CTV, that were used for clinical purposes, were significantly greater than CT-GTV (p = 6 7 10-5) and CT-CTV (p = 6 7 10-5). Conclusions: FDG-PET/CT has a potential relevant impact in staging and target volume delineation of the carcinoma of the anal canal. Clinical stage variation occurred in 18.5% of cases with change of treatment intent in 3.7%. The GTV and the CTV changed in shape and in size based on PET/CT imaging

Agreement between left ventricular ejection fraction assessed in patients with gated IQ-SPECT and conventional imaging

BACKGROUND: The aim of the study was to assess the agreement between the left ventricular ejection fraction (LVEF) values obtained with IQ-SPECT and those obtained with a conventional gamma camera equipped with low-energy high-resolution (LEHR), considered as the method of reference. METHODS: Gated-stress MPI using 99mTc-tetrofosmin was performed in 55 consecutive patients. The patients underwent two sequential acquisitions (Method A and B) performed on Symbia-IQ SPECT with different acquisition times and one (Method C) on a Ecam SPECT equipped with LEHR collimators. The values of the different datasets were compared using the Bland-Altman analysis method: the bias and the limits of agreement (LA) were estimated in a head-to-head comparison of the three protocols. RESULTS: In the (Method A-Method C) comparison for LVEF, the bias was 3.8% and the LAs ranged from - 9.3% to 16.8%. The agreement was still lower between Method B and C, whilst only slightly improved when Methods A and B were compared. CONCLUSIONS: The wide amplitude in LA intervals of about 30% indicates that IQ and LEHR GSPECT are not interchangeable. The values obtained with IQ-SPECT should only be used with caution when evaluating the functional state of the heart

Does baseline [18F] FDG-PET/CT correlate with tumor staging, response after neoadjuvant chemoradiotherapy, and prognosis in patients with rectal cancer?

Abstract Background [18F] fluorodeoxyglucose positron emission tomography/computed tomography ([18F] FDG-PET/CT) may be used for tumor staging and prognosis in several tumors but its role in rectal cancer is still debated. The aim of the present study was to assess the correlation of baseline [18F] FDG-PET parameters with tumor staging, tumor response (tumor regression grade (TRG)), and outcome in a series of patients affected by locally advanced rectal cancer (LARC) treated with neoadjuvant chemoradiotherapy (CRT). Methods One hundred patients treated with neoadjuvant CRT and radical surgery were enrolled in the present study. Maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) at the baseline [18F] FDG-PET were calculated. These PET parameters were correlated with tumor staging, histopathological data (TRG1 vs. TRG2–5 and TRG1–2 vs. TRG3–5), disease-free survival, and overall survival. Results SUVmax and SUVmean of primary tumor were statistically associated with T4-stage. SUVmax, SUVmean, and TLG did not result statistically associated with TRG (TRG1 or TRG1–2). MTV resulted statistically associated with TRG1–2 group (OR 2.9; 95% CI 1.2–7.1). Finally, no PET parameter was significantly associated with disease-free or overall survival. Conclusion Our results showed that baseline [18F] FDG-PET parameters correlated with tumor staging, and only MTV correlated with TRG 1–2. PET parameters failed to predict disease-free and overall survival after treatment completion. The results leave open to further studies the issue of identifying patients suitable for conservative approaches

18F-FDG PET/CT Cannot Substitute Endoscopy in the Staging of Gastrointestinal Involvement in Mantle Cell Lymphoma. A Retrospective Multi-Center Cohort Analysis

The detection of gastrointestinal (GI) involvement in Mantle Cell Lymphoma is often underestimated and may have an impact on outcome and clinical management. We aimed to evaluate whether baseline 18F-FDG PET/CT presents comparable results to endoscopic biopsy in the diagnosis of GI localizations. In our retrospective cohort of 79 patients, sensitivity and specificity of 18F-FDG PET/CT were low for the stomach, with a fair concordance (k = 0.32), while higher concordance with pathologic results (k = 0.65) was detected in the colorectal tract. Thus, gastric biopsy remains helpful in the staging of MCL despite 18F-FDG PET/CT, while colonoscopy could be omitted in asymptomatic patients. The validation of our data in prospective cohorts is desirabl

Prevalence of interstitial pneumonia suggestive of COVID-19 at 18F-FDG PET/CT in oncological asymptomatic patients in a high prevalence country during pandemic period: a national multi-centric retrospective study

67sinonenoneAlbano, Domenico; Bertagna, Francesco; Alongi, Pierpaolo; Baldari, Sergio; Baldoncini, Alfonso; Bartolomei, Mirco; Boccaletto, Franco; Boero, Michele; Borsatti, Eugenio; Bruno, Andrea; Burroni, Luca; Capoccetti, Francesca; Castellani, Massimo; Cervino, Anna Rita; Chierichetti, Franca; Ciarmiello, Andrea; Corso, Angelo; Cuocolo, Alberto; De Rimini, Maria Luisa; Deandreis, Desiree’; Dottorini, Massimo Eugenio; Esposito, Filomena; Farsad, Mohsen; Gasparini, Massimo; Grana, Chiara Maria; Gregianin, Michele; Guerra, Luca; Loreti, Fabio; Lupi, Andrea; Martino, Gianluigi; Milan, Elisa; Modoni, Sergio; Morbelli, Silvia; Muni, Alfredo; Nicolai, Emanuele; Palumbo, Barbara; Papa, Sergio; Papaleo, Alberto; Pellerito, Riccardo; Poti, Carlo; Romano, Pasquale; Rossetti, Claudio; Rossini, Pierluigi; Rubini, Giuseppe; Ruffini, Livia; Sacchetti, Gianmauro; Savelli, Giordano; Schiavariello, Saverio; Sciagrà, Roberto; Sciuto, Rosa; Seregni, Ettore; Sestini, Stelvio; Sicolo, Michele; Spanu, Angela; Storto, Giovanni; Balducci, Massimo Tosti; Trifirò, Giuseppe; Versari, Annibale; Vignati, Alberto; Volterrani, Duccio; Calcagni, Maria Lucia; Marzola, Maria Cristina; Garufo, Antonio; Evangelista, Laura; Maroldi, Roberto; Schillaci, Orazio; Giubbini, RaffaeleAlbano, Domenico; Bertagna, Francesco; Alongi, Pierpaolo; Baldari, Sergio; Baldoncini, Alfonso; Bartolomei, Mirco; Boccaletto, Franco; Boero, Michele; Borsatti, Eugenio; Bruno, Andrea; Burroni, Luca; Capoccetti, Francesca; Castellani, Massimo; Cervino, Anna Rita; Chierichetti, Franca; Ciarmiello, Andrea; Corso, Angelo; Cuocolo, Alberto; De Rimini, Maria Luisa; Deandreis, Desiree’; Dottorini, Massimo Eugenio; Esposito, Filomena; Farsad, Mohsen; Gasparini, Massimo; Grana, Chiara Maria; Gregianin, Michele; Guerra, Luca; Loreti, Fabio; Lupi, Andrea; Martino, Gianluigi; Milan, Elisa; Modoni, Sergio; Morbelli, Silvia; Muni, Alfredo; Nicolai, Emanuele; Palumbo, Barbara; Papa, Sergio; Papaleo, Alberto; Pellerito, Riccardo; Poti, Carlo; Romano, Pasquale; Rossetti, Claudio; Rossini, Pierluigi; Rubini, Giuseppe; Ruffini, Livia; Sacchetti, Gianmauro; Savelli, Giordano; Schiavariello, Saverio; Sciagrà, Roberto; Sciuto, Rosa; Seregni, Ettore; Sestini, Stelvio; Sicolo, Michele; Spanu, Angela; Storto, Giovanni; Balducci, Massimo Tosti; Trifirò, Giuseppe; Versari, Annibale; Vignati, Alberto; Volterrani, Duccio; Calcagni, Maria Lucia; Marzola, Maria Cristina; Garufo, Antonio; Evangelista, Laura; Maroldi, Roberto; Schillaci, Orazio; Giubbini, Raffael