Primary Results of NRG-RTOG1106/ECOG-ACRIN 6697: A Randomized Phase II Trial of Individualized Adaptive (chemo)Radiotherapy Using Midtreatment F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Stage III Non-Small Cell Lung Cancer.

Purpose: NRG-RTOG0617 demonstrated a detrimental effect of uniform high-dose radiation in stage III non-small cell lung cancer. NRG-RTOG1106/ECOG-ACRIN6697 (ClinicalTrials.gov identifier: NCT01507428), a randomized phase II trial, studied whether midtreatment F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) can guide individualized/adaptive dose-intensified radiotherapy (RT) to improve and predict outcomes in patients with this disease.

Low-count whole-body PET with deep learning in a multicenter and externally validated study.

More widespread use of positron emission tomography (PET) imaging is limited by its high cost and radiation dose. Reductions in PET scan time or radiotracer dosage typically degrade diagnostic image quality (DIQ). Deep-learning-based reconstruction may improve DIQ, but such methods have not been clinically evaluated in a realistic multicenter, multivendor environment.

High quality imaging and dosimetry for yttrium-90 (Y) liver radioembolization using a SiPM-based PET/CT scanner.

Purpose: Transarterial radioembolization (TARE) with yttrium-90 (Y) microspheres is a liver-directed treatment for primary and secondary hepatic malignancies. Personalized dosimetry aims for maximum treatment effect and reduced toxicity. We aimed to compare pre-treatment voxel-based dosimetry from Tc macroaggregated albumin (MAA) SPECT/CT with post-treatment Y PET/CT for absorbed dose values, and to evaluate image quality of Y SiPM-based PET/CT.

Two Patient Studies of a Companion Diagnostic Immuno-Positron Emission Tomography (PET) Tracer for Measuring Human CA6 Expression in Cancer for Antibody Drug Conjugate (ADC) Therapy.

An antigen binding fragment (BFab) derived from a tumor-associated mucin 1-sialoglycotope antigen (CA6) targeting antibody (huDS6) was engineered. We synthesized a companion diagnostic positron emission tomography (PET) tracer by radiolabeling BFab with [Cu] to measure CA6 expression on cancer tissues prior to anti-human CA6 (huDS6-DM4 antibody-drug conjugate) therapy for ovarian and breast cancer patients. After chemotherapy, the ovarian patient received PET scan with F-2-fluoro-2-deoxyglucose ([F]FDG: 10 mCi), followed by [Cu]-DOTA-BFab ([Cu]BFab; 5.

Evaluation of integrin αvβ cystine knot PET tracers to detect cancer and idiopathic pulmonary fibrosis.

Advances in precision molecular imaging promise to transform our ability to detect, diagnose and treat disease. Here, we describe the engineering and validation of a new cystine knot peptide (knottin) that selectively recognizes human integrin αvβ with single-digit nanomolar affinity. We solve its 3D structure by NMR and x-ray crystallography and validate leads with 3 different radiolabels in pre-clinical models of cancer.

Ultra-Low-Dose F-Florbetaben Amyloid PET Imaging Using Deep Learning with Multi-Contrast MRI Inputs.

Purpose To reduce radiotracer requirements for amyloid PET/MRI without sacrificing diagnostic quality by using deep learning methods. Materials and Methods Forty data sets from 39 patients (mean age ± standard deviation [SD], 67 years ± 8), including 16 male patients and 23 female patients (mean age, 66 years ± 6 and 68 years ± 9, respectively), who underwent simultaneous amyloid (fluorine 18 [F]-florbetaben) PET/MRI examinations were acquired from March 2016 through October 2017 and retrospectively analyzed. One hundredth of the raw list-mode PET data were randomly chosen to simulate a low-dose (1%) acquisition.

Independent usefulness of flow phase mTc-red blood cell scintigraphy in predicting the results of angiography in acute gastrointestinal bleeding.

Objective:: In acute gastrointestinal bleeding, despite positive dynamic phase mTc-red blood cell scintigraphy, invasive catheter angiography (CA) is frequently negative. In this study, we investigated the value of flow phase scintigraphy in predicting extravasation on CA.

Methods:: Institutional review board approval with a waiver of informed consent was obtained for this retrospective study.

Initial experience with a SiPM-based PET/CT scanner: influence of acquisition time on image quality.

Background: A newly introduced PET/CT scanner (Discovery Meaningful Insights-DMI, GE Healthcare) includes the silicon photomultiplier (SiPM) with time-of-flight (TOF) technology first used in the GE SIGNA PET/MRI. In this study, we investigated the impact of various acquisition times on image quality using this SiPM-based PET/CT.

Methods: We reviewed data from 58 participants with cancer who were scanned using the DMI PET/CT scanner.

18F-FDG silicon photomultiplier PET/CT: A pilot study comparing semi-quantitative measurements with standard PET/CT.

Purpose: To evaluate if the new Discovery Molecular Insights (DMI) PET/CT scanner provides equivalent results compared to the standard of care PET/CT scanners (GE Discovery 600 or GE Discovery 690) used in our clinic and to explore any possible differences in semi-quantitative measurements.

Methods: The local Institutional Review Board approved the protocol and written informed consent was obtained from each patient. Between September and November 2016, 50 patients underwent a single 18F-FDG injection and two scans: the clinical standard PET/CT followed immediately by the DMI PET/CT scan.

Administered activity and outcomes of glass versus resin (90)Y microsphere radioembolization in patients with colorectal liver metastases.

Background: Given the differences in size, specific activity, and dosing methods for glass yttrium-90 microspheres ((90)Y-glass) and resin (90)Y microspheres ((90)Y-resin), these therapies may expose the liver to different amounts of radiation, thereby affecting their efficacy and tolerability. We aimed to compare the prescribed activity of (90)Y-glass and (90)Y-resin for real-world patients undergoing selective internal radiation therapy (SIRT) for liver-dominant metastatic colorectal cancer (mCRC) and to assess efficacy and safety outcomes in these patients.

Methods: We examined the records of 28 consecutive patients with unresectable colorectal liver metastases treated with SIRT between June 2008 and May 2011 at our institution.

Repeatability of hypoxia PET imaging using [¹⁸F]HX4 in lung and head and neck cancer patients: a prospective multicenter trial.

Purpose: Hypoxia is an important factor influencing tumor progression and treatment efficacy. The aim of this study was to investigate the repeatability of hypoxia PET imaging with [(18)F]HX4 in patients with head and neck and lung cancer.

Methods: Nine patients with lung cancer and ten with head and neck cancer were included in the analysis (NCT01075399).

A Dedicated Breast Positron Emission Tomography Scanner: Proof of Concept.

Purpose: This study developed and tested a novel scanner constructed for dedicated positron emission tomography (PET) of the breast. The breast PET (B-PET) scanner is designed with two opposing detectors using curve plate NaI(Tl) detectors to achieve a combination of high spatial resolution and energy resolution.

Methods: Phantom and clinical studies (n = 20) with F-fluorodeoxyglucose were carried out on the whole-body Philips Allegro scanner and the B-PET scanner.

Determination of Radiation Absorbed Dose to Primary Liver Tumors and Normal Liver Tissue Using Post-Radioembolization (90)Y PET.

Background: Radioembolization with Yttrium-90 ((90) Y) microspheres is becoming a more widely used transcatheter treatment for unresectable hepatocellular carcinoma (HCC). Using post-treatment (90) Y positron emission tomography/computerized tomography (PET/CT) scans, the distribution of microspheres within the liver can be determined and quantitatively assessed. We studied the radiation dose of (90) Y delivered to liver and treated tumors.

Comparative analysis of the safety and efficacy of transcatheter arterial chemoembolization and yttrium-90 radioembolization in patients with unresectable hepatocellular carcinoma.

Purpose: To compare retrospectively the safety and efficacy of yttrium-90 ((90)Y) radioembolization with the safety and efficacy of chemoembolization in patients with unresectable hepatocellular carcinoma (HCC).

Materials And Methods: Survival and complication rates were evaluated for patients with HCC who underwent chemoembolization or radioembolization at a single institution between August 2007 and April 2010. Complications were graded according to a standardized grading system for embolization procedures.

Role of positron emission tomography in management of sinonasal neoplasms--a single institution's experience.

Objective: The objective of the study is to examine the utility of positron emission tomography (PET) for staging and restaging after treatment of paranasal sinus carcinomas.

Study Design: Retrospective data review was done.

Subjects And Methods: Patients selected underwent PET for sinonasal neoplasms from 2003 to 2008 at a tertiary care referral center.

The Role of Functional Imaging in Radiotherapy Planning and Management for Gynecologic Malignancies.

In addition to allowing much greater technical precision, the modern era allows investigation of target physiology and it is the potential incorporation of physiologic information into the treatment-planning rubric that gives modern PET-CT its allure and promise. Although oncologic PET scanning has been clinically available for more than 10 years, it is only recently that sufficient investigative and retrospective data have become available to confidently assert that future radiotherapy treatment planning will include functional imaging as an obligatory dimension of clinical characterization for most gynecologic tumors. This article explores the role of functional imaging in radiotherapy planning and management of gynecologic malignancies.

Use of lymphoscintigraphy in radiation treatment of primary breast cancer in the context of lymphedema risk reduction.

Purpose: The goal of this study was to determine the feasibility of SPECT/CT scintigraphic method for mapping lymphatic drainage for radiation therapy of breast cancer.

Materials And Methods: Thirty-six patients were enrolled in a SPECT/CT lymphoscintigraphy study. (99m)Tc sulfur colloid (1mCi) was injected intradermally in the ipsilateral arm.

Maximum standardized uptake value from staging FDG-PET/CT does not predict treatment outcome for early-stage non-small-cell lung cancer treated with stereotactic body radiotherapy.

Purpose: To perform a retrospective review to determine whether maximum standardized uptake values (SUV(max)) from staging 2-deoxy-2- [(18)F] fluoro-D-glucose (FDG) positron emission tomography/computed tomography (PET/CT) studies are associated with outcomes for early-stage non-small-cell lung cancer (NSCLC) treated with stereotactic body radiotherapy (SBRT).

Methods And Materials: Seventy-two medically inoperable patients were treated between October 17, 2003 and August 17, 2007 with SBRT for T1-2N0M0 NSCLC. SBRT was administered as 60 Gy in 3 fractions, 50 Gy in 5 fractions, or 50 Gy in 10 fractions using abdominal compression and image-guided SBRT.

Tumor metabolism measured by partial volume corrected standardized uptake value varies considerably in primary and metastatic sites in patients with lung cancer. A new observation.

Fluorine-18 fluorodeoxyglycose -position emission tomography ((18)F-FDG-PET) as an efficient staging tool for lung carcinoma; allows description and characterization of the primary tumor and of local and distant metastases in a single examination. One of the important limiting factors in quantification of metabolic parameters with PET is the partial volume effect. Our aim for this study was to delineate tumor (size) both in the primary and metastatic lesions in patients with lung cancer by using partial volume correction techniques.

A recovery coefficient method for partial volume correction of PET images.

Objectives: Correction of the "partial volume effect" has been an area of great interest in the recent times in quantitative PET imaging and has been mainly studied with count recovery models based upon phantoms that incorporate hot spheres in a cold background. The goal of this research study was to establish a similar model that is closer to a biological imaging environment, namely hot spheres/lesions in a warm background and to apply this model in a small cohort of patients.

Methods: A NEMA phantom with six spheres (diameters 1-3.

A pilot study to assess the utility of SPECT/CT-based lymph node imaging to localize lymph nodes that drain the arm in patients undergoing treatment for breast cancer.

Image-guided treatment planning that minimizes irradiation of critical lymph nodes (LNs) may reduce the incidence and severity of long term complications following breast cancer treatment. This localization cannot be obtained with conventional imaging techniques and we undertook this proof of concept study to determine whether a coordinated use of SPECT and CT has sufficient precision to inform radiation planning and potentially lessen the incidental exposure of critical LNs. Thirty-two consecutive women with breast cancer were injected in the arm ipsilateral to their breast cancers prior to radiation treatment with 0.