Publications by authors named "Stefano Fanti"
Background And Objective: Up to 50% of patients with prostate cancer experience prostate-specific antigen (PSA) relapse following primary radical prostatectomy (RP). Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is increasingly being used for staging after RP owing to its high detection rate. Our aim was to compare outcomes for patients who received salvage radiotherapy (sRT) with versus without PSMA PET guidance.
View Article and Find Full Text PDFBackground/objectives: To evaluate T&N-staging diagnostic performance of [68Ga]Ga-FAPI-46 PET/CT (FAPI) in a suspected/confirmed lung cancer surgical cohort.
Methods: Patients were enrolled in a prospective monocentric trial (EudraCT: 2021-006570-23) to perform FAPI, in addition to conventional-staging-flow-chart (including [18F]F-FDG PET/CT-FDG). For the current purpose, only surgical patients were included.
Somatostatin receptor (SST) positron emission tomography with computed tomography (PET/CT) is the gold standard for functional imaging of neuroendocrine tumors (NETs), but FDG PET/CT is increasingly recognized for its prognostic value, particularly for higher-grade NETs and to detect disease heterogeneity. Despite the established role of pathological grading, clinical heterogeneity within the tumor burden often complicates accurate prognostication. Evidence suggests FDG PET/CT can outperform WHO grading in predicting outcomes by identifying aggressive, undifferentiated tumor clones that influence long-term prognosis and treatment decisions.
View Article and Find Full Text PDFBackground: Approximately 10%-20% of prostate cancers progress to metastatic and castration-resistant forms (mCRPC). Radioligand (RLT) therapy with [Lu]Lu-prostate-specific membrane antigen (PSMA) is an approved treatment for metastasized mCRPC. Moreover, Actinium-225 (Ac), an alpha-emitter isotope, has also been used to label PSMA and, recently, to treat mCRPC patients with encouraging results.
View Article and Find Full Text PDFPositron Emission Tomography (PET) is a crucial imaging modality in oncology, providing functional insights by detecting metabolic activity in tissues. Total-body (TB) PET and large field-of-view PET have emerged as advanced techniques, offering whole-body imaging in a single acquisition. TB PET enables simultaneous imaging from head to toe, providing comprehensive information on tumor distribution, metastasis, and treatment response.
View Article and Find Full Text PDFBackground And Objective: This review aims to provide an overview of novel diagnostic and therapeutic radiopharmaceuticals tested recently or used currently in genitourinary cancers within prospective phase 1-2 clinical trials, summarizing progresses and future directions.
Methods: A systematic search was conducted using the PubMed/MEDLINE and ClinicalTrials.gov databases for original prospective research studies following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.
Objective: To describe the initial experience with PSMA-PET/CT-guided biopsy in European referral centres.
Methods: This multicenter observational cohort study was endorsed by the Young Academic Urologist (YAU) Prostate Cancer Group of the EAU and conducted across 6 tertiary-level European centres. PSMA-guided biopsies were carried out in a cognitive/fusion manner for all the recruited patients with or without MRI-guided biopsies and/or standard biopsy (SB).
Article Synopsis
- Innovations in advanced prostate cancer have improved outcomes, but there's still a lack of high-level evidence in clinical management, prompting the 2024 Advanced Prostate Cancer Consensus Conference to survey experts for insights.
- A panel of 120 international experts developed and voted on 183 consensus questions through a web-based survey prior to the conference, defining consensus as ≥75% agreement.
- The voting results highlight areas of agreement and disagreement that can guide clinical decisions and future research, with a focus on individualizing treatment based on patient characteristics and encouraging participation in clinical trials.
Treatment response assessment in mCRPC: is PSMA-PET/CT going to take the lead?
Ther Adv Med Oncol
October 2024
Article Synopsis
- Scientists are trying to find better ways to see how well treatments work for prostate cancer because current tests aren't very reliable.
- A special type of scan called PSMA PET is showing promise in spotting cancer and how it reacts to different therapies better than older methods.
- The review talks about the evidence supporting the use of PSMA PET scans to evaluate how patients are responding to treatments for prostate cancer.
Article Synopsis
- Salvage radiation therapy (sRT) is crucial for patients who experience biochemical recurrence after prostate surgery, and a new nomogram has been developed to predict their chances of remaining free from this recurrence.
- * This study aims to evaluate the effectiveness of PSMA-PET-based assessments in guiding sRT for cases of prostate-specific antigen (PSA) persistence or recurrence, and it seeks to improve predictive models using random survival forests compared to traditional Cox models.
- * Data from 1029 patients across five countries were analyzed to validate these predictive models, utilizing machine learning techniques to better understand outcomes related to biochemical failure after treatment.
Article Synopsis
Standardized template for clinical reporting of PSMA PET/CT scans.
Eur J Nucl Med Mol Imaging
December 2024
Article Synopsis
- * A consensus among medical professionals led to the creation of a standardized PSMA PET/CT reporting template, aimed at streamlining communication between radiologists and referring physicians.
- * The proposed template includes essential details like treatment history, tumor uptake information, and incidental findings, which are intended to improve the clarity and utility of imaging reports in patient management.
Article Synopsis
- * Current guidelines recommend using Tc-Bone Scintigraphy and Contrast-Enhanced CT for staging metastatic prostate cancer, but new imaging techniques like PSMA-PET/CT and whole-body MRI (WB-MRI) show promising advantages.
- * WB-MRI combines high-resolution imaging with functional sequences, allowing for a thorough assessment of the disease without the drawbacks of radiation or contrast agents, and although its research is still developing, it suggests a strong case for inclusion in standard cancer care alongside nuclear medicine techniques.
Article Synopsis
- The study evaluates the effectiveness of the Q.Clear algorithm, specifically the β-level settings, for enhancing image quality in PET/CT scans for patients with neuroendocrine tumors.* -
- Compared to standard reconstruction, the β1600 setting showed superior performance in overall image quality and in detecting small lesions (less than 1 cm).* -
- Results indicated that patients with positive PET findings in discordant lesions were confirmed malignant, highlighting the importance of using β1600 reconstruction for accurate diagnosis.*
Purpose: Despite growing evidence for bilateral pelvic radiotherapy (whole pelvis RT, WPRT) there is almost no data on unilateral RT (hemi pelvis RT, HPRT) in patients with nodal recurrent prostate cancer after prostatectomy. Nevertheless, in clinical practice HPRT is sometimes used with the intention to reduce side effects compared to WPRT. Prostate-specific membrane antigen positron emission tomography / computed tomography (PSMA-PET/CT) is currently the best imaging modality in this clinical situation.
View Article and Find Full Text PDFArticle Synopsis
Neuroendocrine neoplasms (NENs) are a diverse group of tumors with varying clinical behaviors. Their incidence has risen due to increased awareness, improved diagnostics, and aging populations. The 2019 World Health Organization classification emphasizes integrating radiology and histopathology to characterize NENs and create personalized treatment plans.
View Article and Find Full Text PDFArticle Synopsis
- The study focuses on a protein called PSMA found in prostate tissue, which helps doctors use a special scan (PSMA-PET) to check for prostate cancer (PCa).
- Researchers looked at samples from 43 men with high-risk PCa who had these scans to understand how their biopsy results (samples taken from the prostate) matched up with the scan results.
- They found that less than 20% of PSMA-negative areas in the biopsies showed better agreement in results, but overall, different scores showed only a moderate match between the biopsy and final pathology.
Neuroendocrine neoplasms (NENs) are rare neoplasms originating from neuroendocrine cells, with increasing incidence due to enhanced detection methods. These tumors display considerable heterogeneity, necessitating diverse management strategies based on factors like organ of origin and tumor size. This article provides a comprehensive overview of therapeutic approaches for NENs, emphasizing the role of imaging in treatment decisions.
View Article and Find Full Text PDFNeuroendocrine neoplasms (NENs) are a diverse group of tumors that express neuroendocrine markers and primarily affect the lungs and digestive system. The incidence of NENs has increased over time due to advancements in imaging and diagnostic techniques. Effective management of NENs requires a multidisciplinary approach, considering factors such as tumor location, grade, stage, symptoms, and imaging findings.
View Article and Find Full Text PDFPurpose Of Review: This paper aims to address the latest findings in neuroendocrine tumor (NET) theranostics, focusing on new evidence and future directions of combined diagnosis with positron emission tomography (PET) and treatment with peptide receptor radionuclide therapy (PRRT).
Recent Findings: Following NETTER-1 trial, PRRT with [177Lu]Lu-DOTATATE was approved by FDA and EMA and is routinely employed in advanced G1 and G2 SST (somatostatin receptor)-expressing NET. Different approaches have been proposed so far to improve the PRRT therapeutic index, encompassing re-treatment protocols, combinations with other therapies and novel indications.