Immunotherapy plays a vital role in the treatment of several types of malignancies. While the molecular targets of immunotherapy differ, the desired goal is to increase the host immune response against neoplastic tissue. This upregulated immune state results in infiltration of the tumor with activated immune cells and may be misinterpreted as disease progression in anatomical and metabolic imaging studies, known as pseudoprogression. We present a case of pseudoprogression demonstrated on a fluoride-18 (F-18) fluciclovine positron emission tomography-computed tomography (PET-CT) scan of an 85-year-old male with metastatic castrate-resistant prostate cancer who underwent treatment with sipuleucel-T. An understanding of the pseudoprogression phenomenon and its manifestations is critical for both treating physicians and imaging specialists to facilitate decision-making regarding treatment.
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http://dx.doi.org/10.7759/cureus.30380 | DOI Listing |
Ann Nucl Med
January 2025
Research Team for Neuroimaging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2, Sakae-Cho, Itabashi-ku, Tokyo, 173-0015, Japan.
Objective: Amino acid positron emission tomography (PET) examinations using anti-1-amino-3-[F]-fluorocyclobutane-1-carboxylic acid ([F]FACBC) were allowed for routine clinical use in July 2024. However, phantom test procedures for [F]FACBC reconstruction parameters have not yet been established. The present study aimed to establish new phantom test procedures for [F]FACBC brain PET imaging to determine optimal reconstruction parameters.
View Article and Find Full Text PDFPract Radiat Oncol
November 2024
Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
Purpose: Whole-pelvis (WP) radiation therapy (radiation) improved biochemical relapse-free survival (bRFS) compared with prostate bed (PB)-only radiation in the Radiation Therapy Oncology Group 0534, but was performed in an era prior to positron emission tomography (PET) staging. Separately, 18F-fluciclovine PET/CT-guided postprostatectomy radiation improved 3-year bRFS versus radiation guided by conventional imaging alone. We hypothesized that patients who were changed from WP to PB-only radiation after PET would have bRFS that was: (a) no higher than patients initially planned for PB-only radiation; and (b) lower than patients planned for WP radiation without PET guidance.
View Article and Find Full Text PDFProstate
October 2024
Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Background: There are no population-level studies assessing F-fluciclovine (fluciclovine) utilization of Positron emission tomography/computed tomography (PET/CT) for biochemically recurrent prostate cancer (PC). We assessed fluciclovine PET/CT in the Veterans Affairs Health Care System.
Methods: Of 1153 men with claims suggesting receipt of fluciclovine PET/CT, we randomly reviewed charts of 300 who indeed underwent fluciclovine PET/CT.
Eur J Nucl Med Mol Imaging
November 2024
Department of Radiology and Imaging Sciences, Emory University, 1364 Clifton Road, NE, Atlanta, GA, 30322, USA.
Purpose: To explore the feasibility of imaging amino-acid transport and PSMA molecular pathways in the detection of metastatic breast invasive lobular carcinoma (ILC) and if there is superior detection compared to standard-of-care imaging [computed tomography (CT)/bone scan, or F-FDG positron-emission-tomography (PET)-CT].
Methods: 20 women with de-novo or suspected metastatic ILC underwent two PET-CT scans with F-fluciclovine and Ga-PSMA-11 on separate days. Uptake per patient and in 3 regions per patient - ipsilateral axillary lymph node (LN), extra-axillary LN (ipsilateral supraclavicular or internal mammary), or distant sites of disease - was compared to standard-of-care imaging (CT/bone scan in 13 patients and F-FDG PET-CT in 7 patients).
ESMO Open
May 2024
Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna.
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