Background And Objective: There is uncertainty regarding the clinical significance of Ga-PSMA-11 positron emission tomography (PET) computed tomography (CT) findings in men with prostate cancer. In this prespecified objective of the proPSMA study, we report the prognostic value of PET-defined nodal involvement.
Methods: Men with intermediate- to high-risk prostate cancer (grade group 3-5, prostate-specific antigen [PSA] ≥20 ng/ml, or clinical stage ≥T3) underwent Ga-PSMA-11 PET-CT or CT and bone scanning as first- or second-line imaging.
Recent advancements in PET technology have culminated in the development of total-body PET (TB-PET) systems, which overcome many limitations of traditional scanners. These TB-PET scanners, while still becoming widely available, represent the forefront of clinical imaging across numerous medical institutions worldwide. Early clinical applications have demonstrated their enhanced image quality, precise lesion quantification, and overall superior performance relative to conventional scanners.
View Article and Find Full Text PDFPositron emission tomography (PET) plays a crucial role in breast cancer management. This review addresses the role of PET imaging in breast cancer care. We focus primarily on the utility of 18F-fluorodeoxyglucose (FDG) PET in staging, recurrence detection, and treatment response evaluation.
View Article and Find Full Text PDFBackground And Objective: Multiparametric magnetic resonance imaging (mpMRI) of the prostate is used for prostate cancer diagnosis. However, mpMRI has lower sensitivity for small tumours. Prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA-PET/CT) offers increased sensitivity over conventional imaging.
View Article and Find Full Text PDFBackground: To determine the utility of diagnostic 18F-DCPyL PSMA-PET/CT to aid management of men with highly suspicious multiparametric MRI prostate (PIRAD 4-5 lesions) and discrepant negative prostate biopsy.
Methods: A multicentre prospective consecutive case series was conducted (2018-2021), recruiting men with prior mpMRI prostate PIRADS 4-5 lesions and negative prostate biopsy. All men had 18F-DCPyL PSMA-PET/CT with subsequent management based on the concordance between MRI and PET: (1) Concordant lesions were biopsied using in-bore MRI targeting; (2) PSMA-PET/CT avidity without MRI correlate were biopsied using cognitive/software targeting with ultrasound guidance and (3) Patients with negative PET/CT were returned to standard of care follow-up.
Advancing age significantly affects the structural and functional characteristics of organs and tissues, including the peripheral nervous system (PNS) and musculoskeletal system. PET molecular imaging systems offer the ability to assess the metabolic and quantitative effects due to nerve and muscle injuries, which has the potential to impact clinical management of aged subjects. Here, we aim to describe some features of molecular imaging PET systems using different tracers and methods of imaging in musculoskeletal disorders and peripheral neuropathies commonly seen in elderly patients.
View Article and Find Full Text PDFIntroduction: Prostate-specific membrane antigen positron emission tomography (PSMA-PET) has emerged as valuable imaging to assessing metastatic disease in prostate malignancy. However, there has been limited studies exploring the utility PSMA-PET as primary imaging assessing for index lesions prior to biopsy. The primary objective of this study is to compare the diagnostic accuracy of 18-fluorine PSMA (18F DCFPyL PSMA) PET scans to multiparametric MRI (mpMRI) to detect primary prostate cancer at prostate biopsy.
View Article and Find Full Text PDFObjectives: To assess the correlation of pathological radical prostatectomy (RP) specimen features and prostate-specific antigen (PSA) characteristics to imaging findings on subsequent F-DCFPyL positron emission tomography/computed tomography (PET/CT) in patients with biochemical failure (BF).
Patients And Methods: Retrospective analysis of combined F-DCFPyL PET/CT database of patients from centres in Australia and New Zealand was performed. A total of 205 patients presenting with BF after RP were included in this study.
Introduction: Clinical and biochemical assessment and biopsies can miss clinically significant prostate cancers (csPCa) in up to 20% of patients and diagnose clinically insignificant tumours leading to overtreatment. This retrospective study analyses the accuracy of F-DCFPyL PET/CT in detecting csPCa as a primary diagnostic tool and directly compares it with mpMRI prostate in treatment-naive patients. The two modalities are then correlated to determine whether they are better in combination, than either alone.
View Article and Find Full Text PDFProstate-specific membrane antigen (PSMA) tracers have increased sensitivity in the detection of prostate cancer, compared with conventional imaging. We assessed the management impact of F-DCFPyL PSMA PET/CT in patients with prostate-specific antigen (PSA) recurrence after radical prostatectomy (RP) and report early biochemical response in patients who underwent radiation treatment. One hundred patients were enrolled into a prospective study, with a prior RP for prostate cancer, a PSA of 0.
View Article and Find Full Text PDFAccurate target delineation is an absolute requirement for modern radiotherapy planning. Historically, structural imaging modalities have been used for this purpose, but there is a considerable role for functional imaging with PET/CT to contribute in this area. PET/CT's role in radiotherapy planning is well established and its use is indispensable in the clinical management of the lymphomas, particularly Hodgkin Lymphoma.
View Article and Find Full Text PDFObjective: To develop evidence-based recommendations to guide the surgical management and postoperative follow-up of adults with primary hyperparathyroidism.
Methods: Representatives from relevant Australian and New Zealand Societies used a systematic approach for adaptation of guidelines (ADAPTE) to derive an evidence-informed position statement addressing eight key questions.
Results: Diagnostic imaging does not determine suitability for surgery but can guide the planning of surgery in suitable candidates.
Purpose: Prostate-specific membrane antigen (PSMA) PET/CT is increasingly used in patients with biochemical recurrence post prostatectomy to detect local recurrence and metastatic disease at low PSA levels. The aim of this study was to assess patterns of disease detection, predictive factors and safety using [F]DCFPyL PET/CT versus diagnostic CT in patients being considered for salvage radiotherapy with biochemical recurrence post prostatectomy.
Methods: We conducted a prospective trial recruiting 100 patients with detectable PSA post prostatectomy (PSA 0.
Purpose: The primary aim of this retrospective multicenter analysis was to assess the performance of PSMA PET/CT using [F]DCFPyL in the detection and localization of recurrent prostate cancer post radical prostatectomy (RP). Particular reference is given to low PSA groups < 0.5 ng/mL to aid discussion around the inclusion of this group in PSMA guidelines and funding pathways.
View Article and Find Full Text PDFJ Med Imaging Radiat Oncol
June 2021
Recent advances with specific PET tracer ligands, for example prostate-specific membrane antigen (PSMA)-based PET imaging, have substantially improved the sensitivity and specificity of PET imaging. 18F-Fluoroestradiol (FES) is a novel PET tracer that has been demonstrated to have high specificity for oestrogen receptor (ER) in breast cancer. This case describes the use of FES-PET to further characterise a solitary scapular lesion in a patient with locally advanced ER-positive breast cancer.
View Article and Find Full Text PDFBackground: Conventional imaging using CT and bone scan has insufficient sensitivity when staging men with high-risk localised prostate cancer. We aimed to investigate whether novel imaging using prostate-specific membrane antigen (PSMA) PET-CT might improve accuracy and affect management.
Methods: In this multicentre, two-arm, randomised study, we recruited men with biopsy-proven prostate cancer and high-risk features at ten hospitals in Australia.
J Med Imaging Radiat Oncol
June 2020
Pericardial involvement of multiple myeloma is a rare and late-stage complication, with only a few cases reported in the literature. PET/CT has demonstrated a growing role in the diagnosis and follow-up of patients with multiple myeloma. We present a case of pericardial multiple myeloma in a patient with relapsed/refractory disease, showcasing previously unpublished FDG PET/CT findings.
View Article and Find Full Text PDFAccurate tumor delineation is a priority in radiation therapy (RT). Metabolic imaging has a key and evolving role in target volume selection and delineation. This is especially so for non-small cell lung cancer, squamous cell cancer of the head and neck, and lymphoma, for which positron emission tomography/computed tomography (PET/CT) is complimentary to structural imaging modalities, not only in delineating primary tumors, but also often in revealing previously undiagnosed regional nodal disease.
View Article and Find Full Text PDFIntroduction: The prevalence of incidental F-fluorodeoxyglucose (FDG)-avid findings on positron emission tomography-computed tomography (PET/CT) has been extensively described. Few studies, however, have assessed the prevalence and significance of non-FDG-avid findings; pathology that is identified on review of the low-dose, non-contrast CT. The aim of this study was to determine the overall prevalence of non FDG-avid incidental findings on PET/CT and the prevalence of 'clinically significant' non FDG-avid pathology.
View Article and Find Full Text PDFIntroduction: In nuclear medicine, single-photon-emission computed tomography (SPECT) is often combined with 'simultaneous' low-dose CT (LDCT) to provide complementary anatomical and functional correlation. As a consequence, numerous incidental and unexpected findings may be detected on LDCT. Recognition of these findings and appropriate determination of their relevance can add to the utility of SPECT/CT.
View Article and Find Full Text PDFObjectives: Pre-clinical experiments demonstrated that intravenous (99m)Tc labelled DI-DD-3B6/22-80B3 humanised anti-fibrin-D-dimer Fab' fragments ((99m)Tc-DI-80B3) allowed scintigraphic imaging of acute pulmonary emboli (PE). The aims of this clinical study were to determine the safety of (99m)Tc-DI-80B3 in patients with PE and evaluate the resulting scintigraphic images for the localisation of acute PE.
Materials/patients And Methods: (99m)Tc-DI-80B3 (0.