Impact of baseline and interim quantitative PET parameters on outcomes of classical Hodgkin Lymphoma.

Currently, analysis of interim PET (iPET) according to the Deauville score (DS) is the most important predictive factor in Hodgkin lymphoma (HL); however, there is room for improvement in its prognostic power. This study aimed to evaluate the prognostic value of quantitative PET analysis (maximum standard uptake value [SUV], total metabolic tumor volume [TMTV] and total lesion glicolysis [TLG]) at baseline (PET0) and iPET in a retrospective cohort of newly diagnosed classical HL. For positive iPET (+ iPET), the reduction of quantitative parameters in relation to PET0 (ΔSUV, ΔTMTV and ΔTLG) was calculated.

Survival and Response Outcomes for Gastrointestinal Neuroendocrine Tumor (GEP-NETs) Patients Treated with Lutetium-177-DOTATATE in a Brazilian Reference Center: A Six-Year Follow-Up Experience.

Background: PRRT can be an option for all-grade GEP-NETs, but selecting patients is challenging. In this scenario, clinical-pathological and radiological characteristics, such as pre-treatment Ga-68 DOTA PET/CT, might have the potential to help.

Methods: A retrospective chart review was conducted on advanced GEP-NETs treated with at least one PRRT dose.

General Concepts in Theranostics.

Theranostics describes the pairing of diagnostic biomarkers and therapeutic agents with common specific targets. Nuclear medicine is the greatest theranostics protagonist, relying on radioactive tracers for imaging biologic phenomena and delivering ionizing radiation to the tissues that take up those tracers. The concept has gained importance with the growth of personalized medicine, allowing customized management for diseases, refining patient selection, better predicting responses, reducing toxicity, and estimating prognosis.

Impressive response to dabrafenib, trametinib, and osimertinib in a metastatic EGFR-mutant/BRAF V600E lung adenocarcinoma patient.

The survival outcomes of the FLAURA trial support osimertinib as the new standard of care for untreated patients harboring activating mutations in the epidermal growth factor receptor (EGFR). Despite the initial response, disease progression invariably occurs. Although uncommon, BRAF V600E mutation arises as a unique mechanism of resistance, and thus far, no prospective studies are available to support concurrent EGFR/BRAF blockade.

Prostate-specific Membrane Antigen PET: Therapy Response Assessment in Metastatic Prostate Cancer.

Therapy response assessment is a critical step in cancer management, leading clinicians to optimize the use of therapeutic options during the course of the disease. Imaging is a pivotal biomarker for therapy response evaluation in oncology and has gained wider use through the development of reproducible data-based guidelines, of which the Response Evaluation Criteria in Solid Tumors is the most successful example. Disease-specific criteria have also been proposed, and the Prostate Cancer Working Group 3 criteria are the mainstay for prostate cancer (PC).

Nonprostatic diseases on PSMA PET imaging: a spectrum of benign and malignant findings.

PSMA PET imaging was originally used to assess biochemical recurrence of prostate cancer (PCa), but its clinical use was promptly extended to detection, staging and therapy response assessment. The expanding use of PSMA PET worldwide has also revealed PSMA ligand uptake in diverse nonprostatic diseases, which raised questions about the specificity of this imaging modality. Although not very common initially, a growing number of pathologies presenting PSMA uptake on PET have been reported in the last few years, and a proper interpretation of PSMA PET imaging findings suddenly became challenging and, to some extent, confusing.

Revisiting Prostate Cancer Recurrence with PSMA PET: Atlas of Typical and Atypical Patterns of Spread.

The introduction of prostate-specific membrane antigen (PSMA) in clinical practice has revolutionized evaluation of biochemical recurrence of prostate cancer after curative-intent treatment. The high expression of this glycoprotein in prostate cancer cells makes PSMA imaging superior to the current conventional staging methods, namely bone scanning and CT. The high capability of PSMA imaging for identifying very small previously undetected lesions has been widely demonstrated in the literature, leading to a rethinking of patient management by oncologists, urologists, and radiation oncologists.

18F-Fluoride Uptake in Soft Tissue Metastases of Medullary Thyroid Carcinoma as a Marker of Progressive Calcification.

F-fluoride (F-NaF) uptake in soft tissue metastases of medullary thyroid carcinoma (MTC) has been reported. However, the evolution of these metastatic sites has rarely been assessed. We present a case of F-NaF uptake in multiple liver metastases of MTC initially without macroscopic calcification.

Fluorodeoxyglucose-positron emission tomography staging can replace bone marrow biopsy in Hodgkin's lymphoma. Results from Brazilian Hodgkin's Lymphoma Study Group.

Objective: To investigate, in a large prospective multicenter study, whether 2-[18F]-fluoro-2-deoxy-d-glucose-positron emission tomography is sufficiently accurate to identify clinically important bone marrow involvement by Hodgkin's lymphoma to replace routine bone marrow biopsy in a developing tropical country.

Methods: Patients newly diagnosed with Hodgkin's lymphoma were recruited from six cancer centers in Brazil. All were staged by the results of positron emission tomography/computed tomography that were centrally reviewed and by iliac crest bone marrow biopsy.

Brain Metastasis of Medullary Thyroid Carcinoma Without Macroscopic Calcification Detected First on 68Ga-Dotatate and Then on 18F-Fluoride PET/CT.

We report a case of a medullary thyroid carcinoma noncalcified brain metastasis characterized on Ga-dotatate PET/CT but not on an F-fluoride PET/CT performed 1 month later. Subsequent F-fluoride PET/CT studies performed 7 and 19 months after the Ga-dotatate PET/CT study demonstrated focal uptake in the metastasis. The CT images of the last PET/CT study also depicted a small focus of calcification beginning in the metastatic site.

Iodine/FDG "Flip-Flop" Phenomenon Inside a Large Metastatic Thyroid Cancer Lesion Better Characterized on SPECT/CT and PET/CT Studies.

Iodine/FDG "flip-flop" phenomenon inside large metastatic thyroid cancer lesions has been rarely described. We present a case of this phenomenon better characterized using SPECT/CT and PET/CT studies.

SUV Normalized by Skeletal Volume on 18F-Fluoride PET/CT Studies.

Objective: To propose a technique for SUV normalization on F-fluoride PET/CT (F-NaF) studies based on skeletal volume and to compare the SUVs normalized by this technique with the ones normalized by body weight.

Methods: SUVs were obtained in volumes of interest (VOIs) in proximal diaphyseal regions of the right humerus (HD) and right femur (FD) in 12 selected F-NaF studies. The 12 studies presented both regions considered normal by visual examination on PET and CT and were performed in patients presenting body weight below 50 kg (B50) or above 90 kg (A90) (6 patients in each group).

Visualization of Lymph Nodal and Hepatic Metastases of Medullary Thyroid Carcinoma on 18F-Fluoride PET/CT.

F-fluoride uptake in soft tissue metastases has been previously described. Herein, we report a case of F-fluoride uptake in lymph nodal and hepatic metastases of medullary thyroid carcinoma. Simultaneous CT showed calcified lesions in these regions.

Initial results on the use of mechanical devices for proximal saphenous vein graft anastomoses: a clinical and angiographic evaluation.

Objective: To report on our initial clinical experience of the utilization of a mechanical anastomotic device (MAD) to perform saphenous vein graft to aorta anastomosis.

Method: Between June 2002 and May 2003, 17 patients, including 13 male, with a mean age of 64.4 +/- 9.

Distribution of risk factors in parents and siblings of patients with early coronary artery disease.

Objective: Early coronary artery disease (CAD) is associated with risk factors (RF). Offspring of parents with a RF have a greater prevalence of them. However, the distribution of RF in parents and siblings of patients with early CAD is unknown.