Imaging of Early Response in Cancer Management 2019

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 November 2019) | Viewed by 15807

Special Issue Editor

Special Issue Information

Dear Colleagues,

The editorial team of Diagnostics is setting up a new Special Issue on PET in early response evaluation in cancer management.

This Special Issue will cover advances in PET methodology, with special consideration of its application in the field of early response in chemotherapy and radiation therapy. Submissions will be invited covering the clinical role of PET tracers, such as FDG and FLT, in the follow-up of oncologic malignancies.

This publication will especially address early response in the therapy monitoring of new pharmaceuticals and biologicals. In addition, new radiopharmaceuticals will be discussed for their potential in this section of clinical oncology.

Prof. Dr. Kalevi Kairemo
Guest Editor

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Keywords

  • PET methodology
  • early response
  • cancer management
  • chemotherapy
  • radiation therapy
  • FDG
  • FLT

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Published Papers (4 papers)

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Research

10 pages, 2144 KiB  
Article
Molecular Imaging with 3′-deoxy-3′[(18)F]-Fluorothymidine (18F-FLT) PET/CT for Early Response to Targeted Therapies in Sarcomas: A Pilot Study
by Kalevi Kairemo, Elmer B. Santos, Homer A. Macapinlac, Shreyaskumar Patel, Anthony P. Conley, David S. Hong and Vivek Subbiah
Diagnostics 2020, 10(3), 125; https://doi.org/10.3390/diagnostics10030125 - 25 Feb 2020
Cited by 6 | Viewed by 3336
Abstract
Although 3′-deoxy-3′[(18)F]-fluorothymidine (FLT)-positron emission tomography (PET) has been utilized for tumor response assessment to neoadjuvant chemotherapy in soft tissue sarcomas, it has not been exploited for the assessment of early response to systematically targeted therapies. Herein, we investigated the 18F-FLT PET/CT kinetics [...] Read more.
Although 3′-deoxy-3′[(18)F]-fluorothymidine (FLT)-positron emission tomography (PET) has been utilized for tumor response assessment to neoadjuvant chemotherapy in soft tissue sarcomas, it has not been exploited for the assessment of early response to systematically targeted therapies. Herein, we investigated the 18F-FLT PET/CT kinetics in patients with sarcoma who received targeted therapies. Among 15 patients with sarcoma who underwent 18F-FLT PET/CT, 5 patients (33%) patients were imaged at three time points: At baseline and at 1–15 weeks (MDM2-inhibitor treatment), and 10 patients (67%) were imaged twice: At baseline and at 1–4 weeks (MDM2 inhibitor, n = 5; c-met inhibitor n = 5). The patients with sarcoma had a total of 18 identifiable tumors. Twelve of 15 patients (80%) demonstrated 18F-FLT concentrations changes early, i.e., at 1–4 weeks. Eight patients responded (53.3%), four patients progressed (26.7%) based on FLT change of more than 10% increase, and three patients (20%) demonstrated no change. 18F-FLT PET/CT may be used for early response imaging to molecularly targeted therapies in patients with sarcoma. Further larger studies in specific sarcoma sub-types are warranted. Full article
(This article belongs to the Special Issue Imaging of Early Response in Cancer Management 2019)
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7 pages, 2847 KiB  
Article
Early Response Assessment to Targeted Therapy Using 3′-deoxy-3′[(18)F]-Fluorothymidine (18F-FLT) PET/CT in Lung Cancer
by Kalevi Kairemo, Elmer B. Santos, Homer A. Macapinlac and Vivek Subbiah
Diagnostics 2020, 10(1), 26; https://doi.org/10.3390/diagnostics10010026 - 6 Jan 2020
Cited by 12 | Viewed by 4231
Abstract
Although 2-deoxy-2-[18F]-fluoro-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) is a sensitive nuclear medicine modality, specificity for characterizing lung cancer is limited. Tumor proliferation and early response to molecularly targeted therapy could be visualized using 3′-deoxy-3′[(18)F]-fluorothymidine (18F-FLT) PET/CT. The superiority [...] Read more.
Although 2-deoxy-2-[18F]-fluoro-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) is a sensitive nuclear medicine modality, specificity for characterizing lung cancer is limited. Tumor proliferation and early response to molecularly targeted therapy could be visualized using 3′-deoxy-3′[(18)F]-fluorothymidine (18F-FLT) PET/CT. The superiority of 18F-FLT PET/CT over 18F-FDG PET/CT in early therapeutic monitoring has been well described in patients after chemotherapy, radiotherapy, and/or chemo/radiotherapy. In thispilot study, we explorethe use of 18F-FLT PET/CT as an early response evaluation modality in patients with lung cancerand provide specific case studies of patients with small cell lung cancer and non-small cell lung cancer who received novel targeted therapies. Early response for c-MET inhibitor was observed in four weeks and for MDM2 inhibitor in nine days. Full article
(This article belongs to the Special Issue Imaging of Early Response in Cancer Management 2019)
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10 pages, 1952 KiB  
Article
Improved Quantification of 18F-FDG PET during 131I-Rituximab Therapy on Mouse Lymphoma Models after 131I Prompt Emission Correction
by Young Sub Lee, Hee-Joung Kim and Jin Su Kim
Diagnostics 2019, 9(4), 144; https://doi.org/10.3390/diagnostics9040144 - 8 Oct 2019
Cited by 1 | Viewed by 2635
Abstract
18F-FDG Positron Emission Tomography (PET) is used to monitor tumor response to 131I-therapy, but is confounded by prompt emissions (284, 364, 637, and 723 keV) from 131I, particularly in animal PET imaging. We propose a method for correcting this emission [...] Read more.
18F-FDG Positron Emission Tomography (PET) is used to monitor tumor response to 131I-therapy, but is confounded by prompt emissions (284, 364, 637, and 723 keV) from 131I, particularly in animal PET imaging. We propose a method for correcting this emission in 18F-FDG PET. The 131I prompt emission effect was assessed within various energy windows and various activities. We applied a single gamma correction method to a phantom and in vivo mouse model. The 131I prompt emission fraction was 12% when 300 µCi of 131I and 100 µCi of FDG were administered, and increased exponentially with escalating 131I activity for all energy windows. The difference in spill-over ratio was reduced to <5% after 131I prompt emission correction. In the mouse model, the standard uptake value (SUV) did not differ significantly between FDG PET only (gold standard) and FDG PET after 131I prompt emission-correction, whereas it was overestimated by 38% before correction. Contrast was improved by 18% after 131I prompt emission correction. We first found that count contamination on 18F-FDG follow-up scans due to 131I spilled-over count after 131I rituximab tumor targeted therapy. Our developed 131I prompt emission-correction method increased accuracy during measurement of standard uptake values on 18F-FDG PET. Full article
(This article belongs to the Special Issue Imaging of Early Response in Cancer Management 2019)
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13 pages, 840 KiB  
Article
Very Early Response Evaluation by PET/MR in Patients with Lung Cancer—Timing and Feasibility
by Natasha Hemicke Langer, Seppo W. Langer, Helle Hjorth Johannesen, Adam Espe Hansen, Junia Costa, Thomas Levin Klausen, Julie Forman, Anders Olin, Sine Hvid Rasmussen, Jens Benn Sørensen, Johan Löfgren, Andreas Kjær and Barbara Malene Fischer
Diagnostics 2019, 9(1), 35; https://doi.org/10.3390/diagnostics9010035 - 26 Mar 2019
Cited by 5 | Viewed by 5120
Abstract
Purpose: With the increasing number of therapy options available for patients with lung cancer, early response evaluation is needed. We performed this pilot study to assess the feasibility of early, repeated Positron emission tomography-magnetic resonance (PET/MR), the impact of timing and the capability [...] Read more.
Purpose: With the increasing number of therapy options available for patients with lung cancer, early response evaluation is needed. We performed this pilot study to assess the feasibility of early, repeated Positron emission tomography-magnetic resonance (PET/MR), the impact of timing and the capability for response prediction in lung tumors during chemotherapy. Methods: Patients with stage IV non-small cell lung cancer referred for chemotherapy were prospectively recruited. Fluorine-18-Fluorodeoxyglucose(18F-FDG)-PET/MR scans were performed prior to, during and after the first or second cycle of chemotherapy. Primary tumors were defined on all scans and size, FDG-uptake and apparent diffusion coefficient (ADC) were measured. Early response was described over time and a Standard Linear Mixed Model was applied to analyze changes over time. Results: 45 FDG-PET/MR scans were performed in 11 patients. Whereas the overall changes measured by ADC did not change significantly, there was an overall significant decrease in FDG-uptake from pre to post treatment scans. There was no difference in the FDG-uptake measured 1 or 3 weeks after therapy, but uptake measured 2 weeks after therapy differed from measurements at week 3. Changes measured in patients scanned during the first treatment cycle appeared more pronounced than during the second cycle. Conclusions: This pilot study indicates that response evaluation shortly after initiation of chemotherapy appears concordant with later evaluation and probably more reliable than evaluation midway between cycles. Responses during or after the first cycle of chemotherapy rather than during subsequent cycles are likely to be more readily measured. Full article
(This article belongs to the Special Issue Imaging of Early Response in Cancer Management 2019)
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