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Positron Emission Tomography in the Era of Precision Medicine: FDG...
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Positron Emission Tomography in the Era of Precision Medicine: FDG and Beyond

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (30 April 2022) | Viewed by 12584

Special Issue Editors

Dr. Silvia Morbelli

E-Mail Website
Guest Editor
1. Nuclear Medicine Unit, Department of Health Science, University of Genova, 16132 Genoa, Italy
2. IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
Interests: imaging biomarkers; brain PET and SPECT; neurodegenerative diseases; molecular imaging in oncology; lymphomas; theragnostic
Special Issues, Collections and Topics in MDPI journals
Dr. Matteo Bauckneht

E-Mail Website
Guest Editor
Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
Interests: imaging biomarkers; positron emission tomography; nuclear neurology; prostate cancer; nuclear cardiology; theranostics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

18F-Fluorodeoxyglucose (18F-FDG)-based positron emission tomography/computed tomography (PET/CT) has become the state-of-the-art radionuclide imaging technique in clinical oncology. At present, more than 95% of PET studies worldwide in oncologic patients are performed using this tracer. Similarly, it has become increasingly important to characterize specific biological features of cancer at a single patient level in order to select more precise targeted therapies that will deliver rational and efficient cancer control (so-called “precision medicine”). In the era of precision medicine, numerous new anticancer agents, such as molecular targeted agents and immune checkpoint inhibitors, have been developed to improve outcomes in cancer patients. FDG PET imaging plays a key role in evaluating the effects of these novel treatments because it can detect changes in the metabolic activity of tumors before any reduction in their size is visible on other imaging modalities. Accordingly, FDG PET is of prognostic as well as diagnostic value and allows quick changes in patient management. However, despite the excellent clinical performance of FDG as a cancer-imaging PET agent in several onco-/hematological disorders, false positive and false negative results can be observed in specific cases. Radiopharmaceutical development has thus focused on research for new PET tracers that could complement or replace FDG in such settings. Thanks to the introduction of non-FDG PET tracers into clinical practice, molecular imaging allows in vivo characterization and measurement of biological processes at the cellular and molecular level, or the expression and activity of specific target molecules (e.g., enzymes and cell surface receptors) as well as biological processes (e.g., non-glucose metabolism), improving early detection, risk stratification, and assessing accumulation of the drug in the lesion, an approach known as theranostics.

The aim of this Special Issue of Diagnostics is to provide a comprehensive update on the emerging role of molecular imaging in the context of precision medicine with a particular focus on clinical oncology. However, given the increasing applications of precision medicine approaches in non-oncological fields in which molecular imaging may play a role, these topics will also be considered eligible for the present Special Issue.

Dr. Silvia Morbelli
Dr. Matteo Bauckneht
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Positron emission tomography
  • 18F-Fluorodeoxyglucose
  • Non-FDG PET tracers
  • Precision medicine
  • Prognosis
  • Risk stratification
  • Early detection
  • Evaluation of response
  • Theranostics

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Published Papers (3 papers)

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Research

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13 pages, 1749 KiB  
Article
Prediction for Mitosis-Karyorrhexis Index Status of Pediatric Neuroblastoma via Machine Learning Based 18F-FDG PET/CT Radiomics
by Lijuan Feng, Luodan Qian, Shen Yang, Qinghua Ren, Shuxin Zhang, Hong Qin, Wei Wang, Chao Wang, Hui Zhang and Jigang Yang
Diagnostics 2022, 12(2), 262; https://doi.org/10.3390/diagnostics12020262 - 20 Jan 2022
Cited by 16 | Viewed by 3213
Abstract
Accurate differentiation of intermediate/high mitosis-karyorrhexis index (MKI) from low MKI is vital for the further management of neuroblastoma. The purpose of this research was to investigate the efficacy of 18F-FDG PET/CT–based radiomics features for the prediction of MKI status of pediatric neuroblastoma [...] Read more.
Accurate differentiation of intermediate/high mitosis-karyorrhexis index (MKI) from low MKI is vital for the further management of neuroblastoma. The purpose of this research was to investigate the efficacy of 18F-FDG PET/CT–based radiomics features for the prediction of MKI status of pediatric neuroblastoma via machine learning. A total of 102 pediatric neuroblastoma patients were retrospectively enrolled and divided into training (68 patients) and validation sets (34 patients) in a 2:1 ratio. Clinical characteristics and radiomics features were extracted by XGBoost algorithm and were used to establish radiomics and clinical models for MKI status prediction. A combined model was developed, encompassing clinical characteristics and radiomics features and presented as a radiomics nomogram. The predictive performance of the models was evaluated by AUC and decision curve analysis. The radiomics model yielded AUC of 0.982 (95% CI: 0.916, 0.999) and 0.955 (95% CI: 0.823, 0.997) in the training and validation sets, respectively. The clinical model yielded AUC of 0.746 and 0.670 in the training and validation sets, respectively. The combined model demonstrated AUC of 0.988 (95% CI: 0.924, 1.000) and 0.951 (95% CI: 0.818, 0.996) in the training and validation sets, respectively. The radiomics features could non-invasively predict MKI status of pediatric neuroblastoma with high accuracy. Full article
(This article belongs to the Special Issue Positron Emission Tomography in the Era of Precision Medicine: FDG and Beyond)
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Review

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13 pages, 3316 KiB  
Review
Beyond the Prognostic Value of 2-[18F]FDG PET/CT in Prostate Cancer: A Case Series and Literature Review Focusing on the Diagnostic Value and Impact on Patient Management
by Roberto Borea, Diletta Favero, Alberto Miceli, Maria Isabella Donegani, Stefano Raffa, Annalice Gandini, Malvina Cremante, Cecilia Marini, Gianmario Sambuceti, Elisa Zanardi, Silvia Morbelli, Giuseppe Fornarini, Sara Elena Rebuzzi and Matteo Bauckneht
Diagnostics 2022, 12(3), 581; https://doi.org/10.3390/diagnostics12030581 - 24 Feb 2022
Cited by 4 | Viewed by 2852
Abstract
The role of 2-deoxy-2-[18F]fluoro-D-glucose Positron Emission Tomography/Computed Tomography (FDG PET/CT) in the management of prostate cancer (PCa) patients is increasingly recognised. However, its clinical role is still controversial. Many published studies showed that FDG PET/CT might have a prognostic value in [...] Read more.
The role of 2-deoxy-2-[18F]fluoro-D-glucose Positron Emission Tomography/Computed Tomography (FDG PET/CT) in the management of prostate cancer (PCa) patients is increasingly recognised. However, its clinical role is still controversial. Many published studies showed that FDG PET/CT might have a prognostic value in the metastatic castration-resistant phase of the disease, but its role in other settings of PCa and, more importantly, its impact on final clinical management remains to be further investigated. We describe a series of six representative clinical cases of PCa in different clinical settings, but all characterised by a measurable clinical impact of FDG PET/CT on the patients’ management. Starting from their clinical history, we report a concise narrative literature review on the advantages and limitations of FDG PET/CT beyond its prognostic value in PCa. What emerges is that in selected cases, this imaging technique may represent a useful tool in managing PCa patients. However, in the absence of dedicated studies to define the optimal clinical setting of its application, no standard recommendations on its use in PCa patients can be made. Full article
(This article belongs to the Special Issue Positron Emission Tomography in the Era of Precision Medicine: FDG and Beyond)
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Other

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7 pages, 1256 KiB  
Case Report
Differential Diagnosis of Hepatic Mass with Central Scar: Focal Nodular Hyperplasia Mimicking Fibrolamellar Hepatocellular Carcinoma
by Teodoro Rudolphi-Solero, Eva María Triviño-Ibáñez, Antonio Medina-Benítez, Javier Fernández-Fernández, Daniel José Rivas-Navas, Alejandro José Pérez-Alonso, Manuel Gómez-Río, Tarik Aroui-Luquin and Antonio Rodríguez-Fernández
Diagnostics 2022, 12(1), 44; https://doi.org/10.3390/diagnostics12010044 - 27 Dec 2021
Viewed by 5600
Abstract
Fibrolamellar hepatocellular carcinoma is a primary hepatic tumor that usually appears in young adults. Radical surgery is considered curative for this kind of tumor, so early diagnosis becomes essential for the prognosis of the patients. The main characteristic of this entity is the [...] Read more.
Fibrolamellar hepatocellular carcinoma is a primary hepatic tumor that usually appears in young adults. Radical surgery is considered curative for this kind of tumor, so early diagnosis becomes essential for the prognosis of the patients. The main characteristic of this entity is the central scar, which is the center of differential diagnosis. We report the case of a 30-year-old man who was diagnosed with fibrolamellar hepatocellular carcinoma by ultrasonography. Contrast-enhanced CT confirmed this diagnosis, and the patient underwent a [18F] fluorocholine PET/CT. Hypermetabolism and the morphology in the nuclear medicine exploration suggest neoplastic nature of the lesion. Radical surgery was performed, and histopathologic analysis was performed, which resulted in focal nodular hyperplasia. Hepatic masses with central scar could have a difficult differential diagnosis, and focal nodular hyperplasia could mimic fibrolamellar hepatocellular carcinoma imaging patterns. These morphofunctional characteristics have not been described in [18F] Fluorocholine PET/CT, so there is a need to find out the potential role PET/CT in the differential diagnosis of hepatic mass with central scar. Full article
(This article belongs to the Special Issue Positron Emission Tomography in the Era of Precision Medicine: FDG and Beyond)
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