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Ludmila S Almeida, Maidane C Araújo, Denise E Zantut-Wittmann, Lígia V Assumpção, Thiago F Souza, Cleide M Silva, Juliana L Argenton, Allan O Santos, Jair Mengatti, Celso D Ramos, Elba C Etchebehere
BACKGROUND: Radioiodine-refractory thyroid carcinomas (RAIRs) are characterized by reduced expression of sodium-iodine symporter, rising serum thyroglobulin levels, and negative whole-body radioiodine scans. Interestingly, RAIRs continue to express somatostatin receptors and can be identified with Ga-DOTATATE PET/CT imaging. OBJECTIVE: The objective of this study was to compare lesion detectability in Ga-DOTATATE PET/CT performed with elevated thyroid-stimulating hormone (eTSH) levels with suppressed thyroid-stimulating hormone (sTSH) levels...
March 14, 2018: Nuclear Medicine Communications
C Boy, T Poeppel, J Kotzerke, B J Krause, H Amthauer, R P Baum, I Buchmann, S Ezziddin, D Führer, M Gabriel, T Kuwert, H Lahner, T Lauenstein, H R Maecke, J Nagarajah, F Rösch, K Scheidhauer, M Schmidt, M A Walter, A Bockisch
The present guideline is focused on quality assurance of somatostatin receptor PET/CT (SSTR-PET/CT) in oncology patients. The document has been developed by a multidisciplinary board of specialists providing consensus of definitions, prerequisites, methodology, operating procedures, assessment, and standardized reporting. In particular, imaging procedures for the two most commonly used radioligands of human SSTR, i. e. 68Ga-DOTATOC and 68Ga-DOTATATE are presented. Overall, SSTR-PET/CT requires close interdisciplinary communication and cooperation of referring and executing medical disciplines, taking into account existing guidelines and recommendations of the European and German medical societies, including the European Association of Nuclear Medicine (EANM), German Society for Endocrinology (DGE), German Society for Nuclear Medicine (DGN) and German Society for Radiology (DRG)...
February 2018: Nuklearmedizin. Nuclear Medicine
David Taïeb, Abhishek Jha, Carole Guerin, Ying Pang, Karen T Adams, Clara C Chen, Pauline Romanet, Philippe Roche, Wassim Essamet, Alexander Ling, Martha M Quezado, Frédéric Castinetti, Fréderic Sebag, Karel Pacak
Context: MYC associated factor X (MAX) has been recently described as a new susceptibility pheochromocytoma (PHEO) gene with a total of approximately 40 reported cases. At present, no study has specifically described the functional imaging phenotype of MAX-related PHEO. Objective, Patients, and Design: The objective of this study was to present our experience with contrast-enhanced CT and 18F-FDOPA PET/CT imaging in 6 consecutive patients (4 at initial diagnosis and 2 at follow-up evaluation) with rare but clinically important MAX-related PHEOs...
March 8, 2018: Journal of Clinical Endocrinology and Metabolism
Lucy F Matthews, Ivor W Jones
BACKGROUND: The kidneys are the dose-limiting organ in lutetium-177 DOTATATE therapy. Therefore, it is advisable to perform critical organ dosimetry focussed on renal dose in treated patients. A key uncertainty in such dose estimates is the use of standard phantoms to represent the individual patient. The primary aim of this study was to investigate the accuracy of methods for estimating kidney size, and hence absorbed kidney dose, by comparison with individual measurements from computed tomography (CT) imaging...
March 9, 2018: Nuclear Medicine Communications
Emily Vaughan, Joseph Machta, Martin Walker, Christos Toumpanakis, Martyn Caplin, Shaunak Navalkissoor
OBJECTIVE: To evaluate the efficacy and toxicity of a repeat peptide receptor radionuclide therapy (PRRT) course in neuroendocrine tumour (NET) patients who have progressed following previous PRRT and to identify factors contributing to retreatment outcomes. METHODS: This was a retrospective analysis of 47 consecutive patients who had been treated with PRRT (PRRT1) and following disease progression were retreated with a second course of PRRT (PRRT2). We reviewed patient, tumour and treatment characteristics, time to progression after PRRT1 and PRRT2, overall survival and toxicity...
March 7, 2018: British Journal of Radiology
(no author information available yet)
The FDA recently approved the radiopharmaceutical lutetium Lu 177 dotatate to treat patients with somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors. The approval was based on results of the phase III NETTER-1 trial.
February 27, 2018: Cancer Discovery
Mitsutomi Ishiyama, Hubert Vesselle
Sixty six-year-old woman status post ileocecal resection for well-differentiated neuroendocrine tumor in the terminal ileum 7 years ago, who is on octreotide therapy for liver metastases. Ga DOTATATE PET/CT showed soft tissue masses with mildly increased radiotracer uptake in the bilateral subscapular/infrascapular regions. In retrospective image review, these soft tissue masses were first noted 7 years prior and have gradually increased in size over the years. Given the characteristic location and imaging findings, these masses are consistent with benign elastofibroma dorsi instead of metastasis...
February 27, 2018: Clinical Nuclear Medicine
James R Ballinger
Although use of the term "theranostic" is relatively recent, the concept goes back to the earliest days of nuclear medicine, with the use of radioiodine for diagnosis and therapy of benign and malignant thyroid disease being arguably the most successful molecular radiotherapy in history. A diagnostic scan with123 I-,124 I-, or a low activity of131 I-iodide is followed by therapy with high activity131 I-iodide. Similarly, adrenergic tumours such as phaeochromocytoma and neuroblastoma can be imaged with123 I-metaiodobenzylguanidine (MIBG) and treated with131 I-MIBG...
February 23, 2018: British Journal of Radiology
Duygu Has Şimşek, Yasemin Şanlı, Serkan Kuyumcu, Bora Başaran, Ayşe Mudun
OBJECTIVE: The aim of this study was to present our experience in the baseline evaluation of carotid body paragangliomas (CBP) with68 Ga-DOTATATE PET-CT. METHODS: Five patients (4F, 1M; age 24-73 years) with CBPs who underwent68 Ga-DOTATATE PET-CT scan before the treatment were evaluated retrospectively. PET-CT images were analyzed visually as well as semiquantitatively, with measurement of maximum standardized uptake value (SUVmax ). RESULTS: All patients had unilateral CBP lesion, showed intense68 Ga-DOTATATE uptake in PET-CT...
February 21, 2018: Annals of Nuclear Medicine
Christof Rottenburger, Dimitrios Papantoniou, Dalvinder Mandair, Martyn Caplin, Shaunak Navalkissoor
Glucagonoma is an extremely rare, glucagon-secreting neuroendocrine tumor of the pancreas. Only sparse data are available about the characteristics of this tumor in somatostatin receptor imaging and only for the situation of initial diagnosis. We present a series of 3 glucagonoma patients who underwent at least 1 Ga-DOTATATE PET/CT scan. All patients were diagnosed by either histology and/or elevated serum levels of glucagon. The presented cases suggest that somatostatin receptor-based imaging can probably be used for re-evaluation of disease status in patients with glucagonoma in a similar way as it is already established for neuroendocrine tumors of other origin...
February 9, 2018: Clinical Nuclear Medicine
Marcus Unterrainer, Cornelius Maihoefer, Clemens C Cyran, Peter Bartenstein, Maximilian Niyazi, Nathalie Lisa Albert
In this case of suspected sphenoid wing meningioma, Ga-DOTATATE PET/CT showed a somatostatin receptor (SSR)-expressing tumor with extension to the nasopharynx and SSR-expressing cervical lymph nodes. Subsequent biopsy from the nasopharynx revealed an Epstein-Barr virus (EBV)-associated, undifferentiated World Health Organization type 3 nasopharyngeal carcinoma (NPC), a potential clinical pitfall due to the reported high SSR expression of this tumor subtype. In consideration of the high target-to-background contrast, SSR ligands might be superior to F-FDG for EBV-associated NPC PET imaging, particularly at the skull base...
February 3, 2018: Clinical Nuclear Medicine
Chinna Naik, Sandip Basu
The aim was to assess the effect of standard fixed-dose protocol of177 Lu-DOTATATE peptide receptor radionuclide therapy (PRRT) in patients with borderline low renal function of one parameter (glomerular filtration rate [GFR], effective renal plasma flow [ERPF] or serum creatinine), that was discordant with the remaining parameters and determine the feasibility of this procedure in this group of patients. Renal toxicity of PRRT is a routine issue or concern for such cases. We compared different renal parameters used for pretherapy assessment in patients with borderline low single parameter at baseline and their potential significance with regards to deterioration of renal function subsequently...
January 2018: World Journal of Nuclear Medicine
Silvia Nicolini, Stefano Severi, Annarita Ianniello, Maddalena Sansovini, Alice Ambrosetti, Alberto Bongiovanni, Emanuela Scarpi, Francesca Di Mauro, Alice Rossi, Federica Matteucci, Giovanni Paganelli
PURPOSE: In the 2010 WHO classification, a Ki-67 proliferation index of 20% is the cut-off between intermediate-grade and high-grade gastroenteropancreatic neuroendocrine neoplasia (GEP-NEN). However, in clinical practice, tumours with a Ki-67 index of >15% are often considered high grade and treated with chemotherapy. In 40-70% of high-grade NENs, somatostatin receptors are overexpressed, enabling peptide receptor radionuclide therapy (PRRT) to be performed. We investigated the role of PRRT with177 Lu-DOTATATE in patients with GEP-NEN and a high Ki-67 proliferation index...
February 1, 2018: European Journal of Nuclear Medicine and Molecular Imaging
Athar Haroon, Asim Afaq, Soujanya Nuthakki, Alex Freeman, Lorenzo Biassoni, Stefano Fanti, Mohsen Beheshti, Hikmat Jan, Sobhan Vinjamuri, Mark Emberton, Jamshed Bomanji
The objective of this study was to highlight the role of multimodality imaging and present the differential diagnosis of abnormal tracer accumulation in the prostate and periprostatic tissue. Our departments have performed molecular imaging of the prostate utilizing PET-CT and PET-MRI with a range of biomarkers including F-FDG, radiolabelled choline, Ga-DOTATATE PET-CT and Ga-PSMA images. We retrospectively reviewed the varying appearances of the prostate gland in different diseases and incidental findings in periprostatic region...
March 2018: Nuclear Medicine Communications
Osamu Manabe, Tatsuya Kikuchi, Arthur J H A Scholte, Mohammed El Mahdiui, Ryuichi Nishii, Ming-Rong Zhang, Eriko Suzuki, Keiichiro Yoshinaga
Regrettably the original version of the above article contained errors in the three chemical structures presented in the 'Atherosclerosis imaging' section of Table 5, namely: 99mTc annexin V, 68Ga DOTATATE, and 64Cu DOTATATE; the chemical structures have been corrected in Table presented here. In addition, the radiopharmaceutical for isotope 67Ga has been corrected to 67Ga citrate, and many of the radiopharmaceuticals presented at the end of the table have been corrected.
January 24, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Sarah Y Qian, Matthew J L Hare, Alan Pham, Duncan J Topliss
Insulinomas are rare neuroendocrine tumours that classically present with fasting hypoglycaemia. This case report discusses an uncommon and challenging case of insulinoma soon after upper gastrointestinal surgery. A 63-year-old man presented with 6 months of post-prandial hypoglycaemia beginning after a laparoscopic revision of Toupet fundoplication. Hyperinsulinaemic hypoglycaemia was confirmed during a spontaneous episode and in a mixed-meal test. Localisation studies including magnetic resonance imaging (MRI), endoscopic ultrasound (EUS) and gallium dotatate positron emission tomography ( 68 Ga Dotatate PET) were consistent with a small insulinoma in the mid-body of the pancreas...
2018: Endocrinology, Diabetes & Metabolism Case Reports
Jacobo Cal-Gonzalez, Juan José Vaquero, Joaquín L Herraiz, Mailyn Pérez-Liva, María Luisa Soto-Montenegro, Santiago Peña-Zalbidea, Manuel Desco, José Manuel Udías
PURPOSE: Image quality of positron emission tomography (PET) tracers that emits high-energy positrons, such as Ga-68, Rb-82, or I-124, is significantly affected by positron range (PR) effects. PR effects are especially important in small animal PET studies, since they can limit spatial resolution and quantitative accuracy of the images. Since generators accessibility has made Ga-68 tracers wide available, the aim of this study is to show how the quantitative results of [68Ga]DOTA-labeled PET/X-ray computed tomography (CT) imaging of neuroendocrine tumors in mice can be improved using positron range correction (PRC)...
January 19, 2018: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
Ashley K Clift, Oskar Kornasiewicz, Panagiotis Drymousis, Omar Faiz, Harpreet S Wasan, James M Kinross, Thomas Cecil, Andrea Frilling
Goblet cell carcinomas (GCC) are a rare, aggressive sub-type of appendiceal tumours with neuroendocrine features, and controversy exists with regards to therapeutic strategy. We undertook a retrospective review of GCC patients surgically treated at two tertiary referral centres. Clinical and histopathological data were extracted from a prospectively maintained database. Survival analyses utilised Kaplan-Meier methodology. Twenty-one patients were identified (9 females). Median age at diagnosis was 55 years (range 32-77)...
February 2018: Endocrine Connections
Anastassia Löser, Sarah M Schwarzenböck, Martin Heuschkel, Holger S Willenberg, Bernd J Krause, Jens Kurth
OBJECTIVES: Peptide receptor radionuclide therapy (PRRT) with lutetium-177 (Lu)-DOTATATE is regarded as a safe treatment option with promising results for patients with neuroendocrine neoplasia (NEN). We aimed to study the absorbed organ and tumor doses, the renal and hematological toxicity as well as their mutual interaction. Another aim was the identification of adverse effects as possible predictors which may affect survival. METHODS: A total of 30 (14 female and 16 male) patients with inoperable/metastatic NEN were treated with 7...
March 2018: Nuclear Medicine Communications
T Rydén, J Heydorn Lagerlöf, J Hemmingsson, I Marin, J Svensson, M Båth, P Gjertsson, P Bernhardt
BACKGROUND: Full Monte Carlo (MC)-based SPECT reconstructions have a strong potential for correcting for image degrading factors, but the reconstruction times are long. The objective of this study was to develop a highly parallel Monte Carlo code for fast, ordered subset expectation maximum (OSEM) reconstructions of SPECT/CT images. The MC code was written in the Compute Unified Device Architecture language for a computer with four graphics processing units (GPUs) (GeForce GTX Titan X, Nvidia, USA)...
January 4, 2018: EJNMMI Physics
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