Considerations for Imaging of Malignant Pleural Mesothelioma: A Consensus Statement from the International Mesothelioma Interest Group.

Malignant pleural mesothelioma (MPM) is an aggressive primary malignancy of the pleura that presents unique radiologic challenges with regard to accurate and reproducible assessment of disease extent at staging and follow-up imaging. By optimizing and harmonizing technical approaches to imaging MPM, the best quality imaging can be achieved for individual patient care, clinical trials, and imaging research. This consensus statement represents agreement on harmonized, standard practices for routine multimodality imaging of MPM, including radiography, computed tomography, F-2-deoxy-D-glucose positron emission tomography, and magnetic resonance imaging, by an international panel of experts in the field of pleural imaging assembled by the International Mesothelioma Interest Group.

Clinical Applications of Artificial Intelligence in Positron Emission Tomography of Lung Cancer.

The ability of a computer to perform tasks normally requiring human intelligence or artificial intelligence (AI) is not new. However, until recently, practical applications in medical imaging were limited, especially in the clinic. With advances in theory, microelectronic circuits, and computer architecture as well as our ability to acquire and access large amounts of data, AI is becoming increasingly ubiquitous in medical imaging.

Update on Molecular Imaging and Precision Medicine in Lung Cancer.

Precision medicine integrates molecular pathobiology, genetic make-up, and clinical manifestations of disease in order to classify patients into subgroups for the purposes of predicting treatment response and suggesting outcome. By identifying those patients who are most likely to benefit from a given therapy, interventions can be tailored to avoid the expense and toxicity of futile treatment. Ultimately, the goal is to offer the right treatment, to the right patient, at the right time.

F-18 FDG perfusion PET: intraprocedural assessment of the liver tumor ablation margin.

Purpose: To evaluate F-fluorodeoxyglucose (FDG) perfusion PET during FDG PET/CT-guided liver tumor microwave ablation procedures for assessing the ablation margin and correlating minimum margin measurements with local progression.

Methods: This IRB-approved, HIPAA-compliant study included 20 adult patients (11 M, 9 F; mean age 65) undergoing FDG PET/CT-guided liver microwave ablation to treat 31 FDG-avid tumors. Intraprocedural FDG perfusion PET was performed to assess the ablation margin.

Assessing ablation margins of FDG-avid liver tumors during PET/CT-guided thermal ablation procedures: a retrospective study.

Background: To retrospectively assess liver tumor ablation margins using intraprocedural PET/CT images from FDG PET/CT-guided microwave or cryoablation procedures and to correlate minimum margin measurements with local progression outcomes.

Methods: Fifty-six patients (ages 36 to 85, median 62; 32 females) with 77 FDG-avid liver tumors underwent 60 FDG PET/CT guided, percutaneous microwave, or cryoablation procedures. Single breath-hold PET/CT images were used for intraprocedural assessment of the tumor ablation margin: liver tumors remained visible on PET immediately following ablation; microwave ablation zones were visible using contrast-enhanced CT; cryoablation zones (ice balls) were visible using unenhanced CT.

Contribution of FDG-PET/CT to the management of esophageal cancer patients at multidisciplinary tumor board conferences.

Background: A multidisciplinary team approach to the management of esophageal cancer patients leads to better clinical decisions.

Purpose: The contribution of CT, endoscopic and laparoscopic ultrasound to clinical staging and treatment selection by multidisciplinary tumor boards (MTB) in patients with esophageal cancer is well documented. However, there is a paucity of data addressing the role that FDG-PET/CT (PET/CT) plays to inform the clinical decision-making process at MTB conferences.

Liver tumor F-18 FDG-PET before and immediately after microwave ablation enables imaging and quantification of tumor tissue contraction.

Purpose: Poor liver tumor visibility after microwave ablation (MWA) limits direct tumor ablation margin assessments using contrast-enhanced CT or ultrasound (US). Positron emission tomography (PET) or PET/CT may offer improved intraprocedural assessment of liver tumor ablation margins versus current imaging techniques, as F-fluorodeoxyglucose (F-FDG)-avid tumors remain visible on PET immediately following ablation. The purpose of this study was to assess intraprocedural F-FDG PET scans before and immediately after PET/CT-guided MWA for visualization and quantification of metabolic liver tumor tissue contraction resulting from MWA.

Tc-Methyl-Diphosphonate Binding to Mineral Deposits in Cultures of Marrow-Derived Mesenchymal Stem Cells in Osteogenic Medium.

The work is notable for describing a highly sensitive, quantitative, and nondestructive method for evaluating the in vitro amount of mineral accompanying different types of osteogenic differentiation of mesenchymal stem cells in a monolayer cell culture. What is so unique and useful about the method is that it has the potential to be used to define the kinetics of the differentiation process, reflected in the mineralization, without destroying the monolayer. Therefore, it remains intact for further experiments.

Intraprocedural Ablation Margin Assessment by Using Ammonia Perfusion PET during FDG PET/CT-guided Liver Tumor Ablation: A Pilot Study.

Purpose To prospectively determine whether nitrogen 13 (N) ammonia perfusion positron emission tomography (PET) during fluorine 18 fluorodeoxyglucose (FDG) PET/computed tomography (CT)-guided liver tumor ablation can be used to intraprocedurally assess ablation margins. Materials and Methods Eight patients (five women and three men; age range, 36-74 years; mean age, 57 years) were enrolled in this pilot study and underwent FDG PET/CT-guided microwave ablation of 11 FDG-avid liver metastases (mean diameter, 22 mm; range, 11-34 mm). All procedures were performed between March 2014 and December 2016.

Pilot study of serial FLT and FDG-PET/CT imaging to monitor response to neoadjuvant chemoradiotherapy of esophageal adenocarcinoma: correlation with histopathologic response.

Objective: The aim of this prospective pilot study was to investigate the potential of serial FLT-PET/CT compared to FDG-PET/CT to provide an early indication of esophageal cancer response to concurrent neoadjuvant chemoradiation therapy.

Methods: Five patients with biopsy-proven esophageal adenocarcinomas underwent neoadjuvant chemoradiation (Tx) prior to minimally invasive esophagectomy. The presence of residual tumor was classified histologically using the Mandard et al.

PET Imaging-Based Phenotyping as a Predictive Biomarker of Response to Tyrosine Kinase Inhibitor Therapy in Non-small Cell Lung Cancer: Are We There Yet?

The increased understanding of the molecular pathology of different malignancies, especially lung cancer, has directed investigational efforts to center on the identification of different molecular targets and on the development of targeted therapies against these targets. A good representative is the epidermal growth factor receptor (EGFR); a major driver of non-small cell lung cancer tumorigenesis. Today, tumor growth inhibition is possible after treating lung tumors expressing somatic mutations of the EGFR gene with tyrosine kinase inhibitors (TKI).

Molecular Imaging and Precision Medicine in Lung Cancer.

Precision medicine allows tailoring of preventive or therapeutic interventions to avoid the expense and toxicity of futile treatment given to those who will not respond. Lung cancer is a heterogeneous disease functionally and morphologically. PET is a sensitive molecular imaging technique with a major role in the precision medicine algorithm of patients with lung cancer.

Lack of Increased FDG Uptake in the Lacrimal and Salivary Glands in Patients With Sarcoidosis and Potential Underlying Mechanism.

Purpose: Increased 67Ga uptake in the mediastinal/hilar lymph nodes ("lambda") and in the lacrimal/parotid/submandibular glands ("panda") often coexists in patients with sarcoidosis (Sarc-Pts). However, we observed that increased lacrimal/salivary uptake is uncommon on 18F-FDG PET/CT (FDG-panda) in many Sarc-Pts who showed increased mediastinal/hilar uptake (FDG-lambda). We evaluated parotid and lacrimal FDG activity in Sarc-Pts who showed FDG-lambda in comparison with a control patient group and attempted to find underlying mechanisms to explain the discrepancy between FDG and Ga uptake in these organs.

FDG PET/CT Appearance of Radiation Nephritis.

It is often challenging to assess renal activity on FDG-PET/CT due to intense physiological activity in the collecting system, thus any unusual intrarenal activity should be evaluated carefully. While increased bone tracer uptake in the irradiated region of the kidneys has been reported in the literature, altered biodistribution of FDG in irradiated renal tissue is not well described. We report a case of FDG PET/CT showing increased FDG activity in small portions of the kidneys that were previously irradiated.

Autophagy Correlates with the Therapeutic Responsiveness of Malignant Pleural Mesothelioma in 3D Models.

Malignant pleural mesothelioma is a highly chemoresistant solid tumor. We have studied this apoptotic resistance using in vitro and ex vivo three-dimensional models, which acquire a high level of chemoresistance that can be reduced by PI3K/mTOR inhibitors. Here, we investigate the activity of GDC-0980, a novel dual PI3K/mTOR inhibitor, which has been proposed to be effective in mesothelioma.

(18)F-FDG-PET/CT and (18)F-NaF-PET/CT in men with castrate-resistant prostate cancer.

To evaluate (18)F-labeled-fluorodeoxyglucose ((18)F-FDG-) and (18)F-labeled-sodium fluoride ((18)F-NaF-) positron emission tomography/computed tomography (PET/CT) as biomarkers in metastatic castrate-resistant prostate cancer (mCRPC). Nine men (53-75 years) in a phase 1 trial of abiraterone and cabozantinib had (18)F-FDG-PET/CT, (18)F-NaF-PET/CT and standard imaging ((99m)Tc-labeled-methylene-diphosphonate ((99m)Tc-MDP) bone scan and abdominal/pelvic CT) at baseline and after 8 weeks of therapy. Baseline disease was classified as widespread (18)F-FDG-avid, oligometastatic (18)F-FDG-avid (1 site), or non-(18)F-FDG-avid.

Systemic chemotherapy decreases brain glucose metabolism.

Objective: Cancer patients may experience neurologic adverse effects, such as alterations in neurocognitive function, as a consequence of chemotherapy. The mechanisms underlying such neurotoxic syndromes remain poorly understood. We here describe the temporal and regional effects of systemically administered platinum-based chemotherapy on glucose metabolism in the brain of cancer patients.

Thorax: normal and benign pathologic patterns in FDG-PET/CT imaging.

This article describes the normal patterns of thoracic (18)F-fluorodeoxyglucose (FDG) biodistribution, and expands on the role of FDG-PET/computed tomography (CT) for the evaluation of patients suffering from a spectrum of benign pathologic conditions that affect the chest. The discussion addresses the applications of FDG-PET/CT imaging in a wide variety of chest-related disorders. Familiarity with the normal thoracic biodistribution of FDG, coupled with knowledge of the potential nonmalignant causes of increased FDG uptake in the chest, is essential to minimize the incidence of incorrect interpretation of FDG-PET images in daily clinical practice.

Thymic measurements in pathologically proven normal thymus and thymic hyperplasia: intraobserver and interobserver variabilities.

Rationale And Objectives: To determine the intraobserver and interobserver variabilities of thymic measurements on computed tomography (CT) in patients with pathologic diagnosis of thymic hyperplasia or normal thymus.

Materials And Methods: Thirty-three patients with pathologic diagnosis of thymic hyperplasia (n = 25) or normal thymus (n = 8) who had identifiable thymus gland on CT were retrospectively studied. Two radiologists independently measured thymic size and CT attenuation.

Imaging characteristics of pathologically proven thymic hyperplasia: identifying features that can differentiate true from lymphoid hyperplasia.

Objective: The purpose of this article is to investigate the imaging characteristics of pathologically proven thymic hyperplasia and to identify features that can differentiate true hyperplasia from lymphoid hyperplasia.

Materials And Methods: Thirty-one patients (nine men and 22 women; age range, 20-68 years) with pathologically confirmed thymic hyperplasia (18 true and 13 lymphoid) who underwent preoperative CT (n=27), PET/CT (n=5), or MRI (n=6) were studied. The length and thickness of each thymic lobe and the transverse and anterior-posterior diameters and attenuation of the thymus were measured on CT.

Quantitative simultaneous 111In∕99mTc SPECT-CT of osteomyelitis.

Purpose: A well-established approach for diagnostic imaging of osteomyelitis (OM), a bone infection, is simultaneous SPECT-CT of 99mTc sulfur colloid (SC) and 111In white blood cells (WBC). This method provides essentially perfect spatial registration of the tracers within anatomic sites of interest. Currently, diagnosis is based purely on a visual assessment-where relative discordance between 99mTc and 111In uptake in bone, i.

Effects of PDGF-BB and OP-1 on mesenchymal stem cells in a porous mineral block.

The aim of this study was to evaluate the effects of an osteogenic medium supplemented with platelet-derived growth factor (PDGF) BB and osteogenic protein (OP) 1 on the proliferation and differentiation of mesenchymal stem cells (MSCs) in an anorganic bovine cancellous bone scaffold. At day 7, there was a statistically significant increase in the number of cells in the scaffolds in the group treated with the medium supplemented with both PDGF-BB and OP-1 when compared with the control groups. The highest alkaline phosphate levels, at 14 and 21 days, were recorded for the samples in medium supplemented with OP-1 alone reflecting osteogenic differentiation.

Occupational radiation dosimetry assessment using an automated infusion device for positron-emitting radiotracers.

Unlabelled: Handling and administration of radiopharmaceuticals are a key contributor to staff radiation dose. Shielded automated infusion devices potentially standardize and reduce radiation exposure during procedures. However, loading the devices adds incremental radiation exposure, which may mitigate dose savings.