Prospective Evaluation of Immune Activation Associated with Response to Radioembolization Assessed with PET/CT in Women with Breast Cancer Liver Metastasis.

Background The impact of transarterial radioembolization (TARE) of breast cancer liver metastasis (BCLM) on antitumor immunity is unknown, which hinders the optimal selection of candidates for TARE. Purpose To determine whether response to TARE at PET/CT in participants with BCLM is associated with specific immune markers (cytokines and immune cell populations). Materials and Methods This prospective pilot study enrolled 23 women with BCLM who planned to undergo TARE (June 2018 to February 2020).

Treatment Response and Clinical Outcomes of Well-Differentiated High-Grade Neuroendocrine Tumors to Lutetium-177-DOTATATE.

Introduction: Lutetium-177 (177Lu)-DOTATATE received FDA approval in 2018 to treat somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors (NETs). Little data are available on response and outcomes for well-differentiated (WD) high-grade (HG) NETs treated with 177Lu-DOTATATE.

Materials And Methods: Patients with WD HG NETs treated with 177Lu-DOTATATE at MSK from 2018 to 2020 were identified.

Prospective testing of clinical Cerenkov luminescence imaging against standard-of-care nuclear imaging for tumour location.

In oncology, the feasibility of Cerenkov luminescence imaging (CLI) has been assessed by imaging superficial lymph nodes in a few patients undergoing diagnostic F-fluoro-2-deoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT). However, the weak luminescence signal requires the removal of ambient light. Here we report the development of a clinical CLI fiberscope with a lightproof enclosure, and the clinical testing of the setup using five different radiotracers.

Malignant perivascular epithelioid cell tumor of the ileum on F-fluorodeoxyglucose positron emission tomography/ computed tomography with pathological correlation.

A 75-year-old woman presented with a 1-month history of abdominal pain. Contrast-enhanced computed tomography (CT) demonstrated a large solid mass in the left lower abdominal quadrant, suspicious for malignancy. Staging with F-fluorodeoxyglucose (FDG) positron emission tomography/CT imaging demonstrated intense FDG uptake in the mass with no evidence of metastatic disease.

Preclinical and first-in-human-brain-cancer applications of [F]poly (ADP-ribose) polymerase inhibitor PET/MR.

Background: We report preclinical and first-in-human-brain-cancer data using a targeted poly (ADP-ribose) polymerase 1 (PARP1) binding PET tracer, [F]PARPi, as a diagnostic tool to differentiate between brain cancers and treatment-related changes.

Methods: We applied a glioma model in p53-deficient nestin/tv-a mice, which were injected with [F]PARPi and then sacrificed 1 h post-injection for brain examination. We also prospectively enrolled patients with brain cancers to undergo dynamic [F]PARPi acquisition on a dedicated positron emission tomography/magnetic resonance (PET/MR) scanner.

PET/MRI for neuroendocrine tumors: a match made in heaven or just another hype?

Purpose: To evaluate the current literature on technical feasibility and diagnostic value of PET/MRI in management of patients with neuroendocrine tumors (NETs).

Methods: A systematic literature search of the PubMed/MEDLINE database identified studies that evaluated the role of simultaneous PET/MRI for the evaluation of neuroendocrine tumors in human subjects. Exclusion criteria included studies lacking simultaneous PET/MRI, absence of other than attenuation-correction MRI pulse sequences, and case reports.

Regional Lymph Node Involvement Among Patients With De Novo Metastatic Breast Cancer.

Importance: Regional nodal irradiation (RNI) for node-positive breast cancer reduces distant metastases and improves survival, albeit with limited reduction in regional nodal recurrences. The mechanism by which RNI robustly reduces distant metastases while modestly influencing nodal recurrences (ie, the presumed target of RNI) remains unclear.

Objective: To determine whether some distant metastases putatively arise from occult regional nodal disease and whether regional recurrences otherwise remain largely undetected until an advanced cancer presentation.

18F-FDG PET/CT Helps Differentiate Peripheral Nerve Myeloid Sarcoma From a Presumed Benign Nerve Sheath Tumor.

A 21-year-old man with NF1 (neurofibromatosis type 1) mutation and in remission from acute myeloid leukemia presented with a painless mass in the left upper limb. MRI showed a soft-tissue mass involving the ulnar nerve presumed to be a nerve sheath tumor. F-FDG PET/CT was performed demonstrating high FDG avidity in the mass, prompting a biopsy.

Head-to-Head Evaluation of F-FES and F-FDG PET/CT in Metastatic Invasive Lobular Breast Cancer.

Invasive lobular carcinoma (ILC) demonstrates lower conspicuity on F-FDG PET than the more common invasive ductal carcinoma. Other molecular imaging methods may be needed for evaluation of this malignancy. As ILC is nearly always (95%) estrogen receptor (ER)-positive, ER-targeting PET tracers such as 16α-F-fluoroestradiol (F-FES) may have value.

Identification of HER2-Positive Metastases in Patients with HER2-Negative Primary Breast Cancer by Using HER2-targeted Zr-Pertuzumab PET/CT.

Background Human epidermal growth factor receptor 2 (HER2)-targeted therapies are successful in patients with HER2-positive malignancies; however, spatial and temporal heterogeneity of HER2 expression may prevent identification of optimal patients for these therapies. Purpose To determine whether imaging with the HER2-targeted PET tracer zirconium 89 (Zr)-pertuzumab can depict HER2-positive metastases in women with HER2-negative primary breast cancer. Materials and Methods From January to June 2019, women with biopsy-proven HER2-negative primary breast cancer and biopsy-proven metastatic disease were enrolled in a prospective clinical trial ( NCT02286843) and underwent Zr-pertuzumab PET/CT for noninvasive whole-biopsy evaluation of potential HER2-positive metastases.

[18F]FDG-PET/CT Radiomics for Prediction of Bone Marrow Involvement in Mantle Cell Lymphoma: A Retrospective Study in 97 Patients.

Biopsy is the standard for assessment of bone marrow involvement in mantle cell lymphoma (MCL). We investigated whether [18F]FDG-PET radiomic texture features can improve prediction of bone marrow involvement in MCL, compared to standardized uptake values (SUV), and whether combination with laboratory data improves results. Ninety-seven MCL patients were retrospectively included.

CD38-targeted Immuno-PET of Multiple Myeloma: From Xenograft Models to First-in-Human Imaging.

Background Current measurements of multiple myeloma disease burden are suboptimal. Daratumumab is a monoclonal antibody that targets CD38, an antigen expressed on nearly all myeloma cells. Purpose To demonstrate preclinical and first-in-human application of an antibody composed of the native daratumumab labeled with the positron-emitting radionuclide zirconium 89 (Zr) through the chelator deferoxamine (DFO), or Zr-DFO-daratumumab, for immunologic PET imaging of multiple myeloma.

Lymph Node Imaging in Patients with Primary Breast Cancer: Concurrent Diagnostic Tools.

The detection of lymph node metastasis affects the management of patients with primary breast cancer significantly in terms of staging, treatment, and prognosis. The main goal for the radiologist is to determine and detect the presence of metastatic disease in nonpalpable axillary lymph nodes with a positive predictive value that is high enough to initially select patients for upfront axillary lymph node dissection. Features that are suggestive of axillary adenopathy may be seen with different imaging modalities, but ultrasound is the method of choice for evaluating axillary lymph nodes and for performing image-guided lymph node interventions.

PET/CT Imaging Characteristics After Radioembolization of Hepatic Metastasis from Breast Cancer.

Purpose: To define positron emission tomography/computed tomography (PET/CT) imaging characteristics during follow-up of patients with metastatic breast cancer (MBC) treated with yttrium-90 (Y90) radioembolization (RE).

Materials And Methods: From January 2011 to October 2017, 30 MBC patients underwent 38 Y90 glass or resin RE treatments. Pre-RE PET/CT was performed on average 51 days before RE.

Patient Repositioning Reveals a Malignant Pleura Effusion Initially Mistaken as a Bone Metastasis on 18FDG PET/CT.

A 70-year-old woman with breast cancer underwent F-FDG PET/CT for restaging. An FDG-avid focus corresponding to a rib on CT images was identified and interpreted as suggestive of an osseous metastasis. A PET/CT-guided biopsy was planned with the patient in prone position.

Radiomic features of glucose metabolism enable prediction of outcome in mantle cell lymphoma.

Purpose: To determine whether [F]FDG PET/CT-derived radiomic features alone or in combination with clinical, laboratory and biological parameters are predictive of 2-year progression-free survival (PFS) in patients with mantle cell lymphoma (MCL), and whether they enable outcome prognostication.

Methods: Included in this retrospective study were 107 treatment-naive MCL patients scheduled to receive CD20 antibody-based immuno(chemo)therapy. Standardized uptake values (SUV), total lesion glycolysis, and 16 co-occurrence matrix radiomic features were extracted from metabolic tumour volumes on pretherapy [F]FDG PET/CT scans.

F-FDG PET/CT for Systemic Staging of Newly Diagnosed Breast Cancer in Men.

F-FDG PET/CT has demonstrated substantial value in systemic staging of newly diagnosed breast cancer in women. However, it is not known whether breast cancer in male patients benefits similarly. This study assesses F-FDG PET/CT systemic staging in patients with newly diagnosed male breast cancer and determines detection rates for unsuspected distant metastases stratified by pre-PET/CT stage.

Imaging Phenotypes in Women at High Risk for Breast Cancer on Mammography, Ultrasound, and Magnetic Resonance Imaging Using the Fifth Edition of the Breast Imaging Reporting and Data System.

Objective: To assess imaging phenotypes of familial breast cancer on mammography (MG), ultrasound (US), and magnetic resonance imaging (MRI) using the fifth edition of the BI-RADS; to investigate inter-observer agreement and to correlate imaging phenotypes with risk status, histopathology, and molecular subtypes derived by immunohistochemical surrogate.

Materials And Methods: Forty-nine women (BRCA-1/2 mutation carriers and women with >20% lifetime risk) were diagnosed with breast cancer within our high-risk screening program. BI-RADS MG, US, and MRI imaging descriptors were correlated with risk status, histopathology, and molecular subtypes derived by immunohistochemical surrogate.

Association of PI3K Pathway Mutations with Early Positron-Emission Tomography/CT Imaging Response after Radioembolization for Breast Cancer Liver Metastases: Results of a Single-Center Retrospective Pilot Study.

Purpose: To describe imaging response and survival after radioembolization for metastatic breast cancer and to delineate genetic predictors of imaging responses and outcomes.

Materials And Methods: This retrospective study included 31 women (average age, 52 y) with liver metastasis from invasive ductal carcinoma who underwent resin and glass radioembolization (average cumulative dose, 2.0 GBq ± 1.

Mazabraud's Syndrome Mimicking Metastases on FDG PET/CT in a Patient With Colon Cancer.

Mazabraud's, a syndrome consisting of fibrous dysplasia and soft tissue myxomas, is a rare disorder with less than 100 cases reported in the literature. Appearance of lesions in Mazabraud's syndrome on FDG PET/CT scan in an oncological scenario can be misinterpreted as malignancy. We present the case of a 69-year-old woman, diagnosed with metastatic colon carcinoma and suspected osseous as well as soft tissue metastases, who was later found to have concomitant Mazabraud's syndrome.

Adalimumab-Induced Epstein-Barr Virus-Related Lymphoproliferative Disorder on FDG PET/CT.

Adalimumab is a fully human chimeric tumor necrosis factor inhibitor used to treat immune-mediated disorders such as psoriatic arthritis. We present a 51-year-old woman with psoriatic arthritis on methotrexate and infliximab for 12 years. Adalimumab replaced infliximab because of worsening symptoms.

First-in-Human Human Epidermal Growth Factor Receptor 2-Targeted Imaging Using Zr-Pertuzumab PET/CT: Dosimetry and Clinical Application in Patients with Breast Cancer.

In what we believe to be a first-in-human study, we evaluated the safety and dosimetry of Zr-pertuzumab PET/CT for human epidermal growth factor receptor 2 (HER2)-targeted imaging in patients with HER2-positive breast cancer. Patients with HER2-positive breast cancer and evidence of distant metastases were enrolled in an institutional review board-approved prospective clinical trial. Pertuzumab was conjugated with deferoxamine and radiolabeled with Zr.