scholarly journals Early Monitoring Response to Therapy in Patients with Brain Lesions Using the Cumulative SUV Histogram

2021 ◽  
Vol 11 (7) ◽  
pp. 2999
Author(s):  
Alessandro Stefano ◽  
Pietro Pisciotta ◽  
Marco Pometti ◽  
Albert Comelli ◽  
Sebastiano Cosentino ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Treatment Response ◽  
Gamma Knife ◽  
Area Under The Curve ◽  
Positron Emission Tomography Imaging ◽  
Standardized Uptake Value ◽  
Response To Therapy ◽  
Statistical Fluctuation ◽  
Early Assessment ◽  
Absolute Level

Gamma Knife treatment is an alternative to traditional brain surgery and whole-brain radiation therapy for treating cancers that are inaccessible via conventional treatments. To assess the effectiveness of Gamma Knife treatments, functional imaging can play a crucial role. The aim of this study is to evaluate new prognostic indices to perform an early assessment of treatment response to therapy using positron emission tomography imaging. The parameters currently used in nuclear medicine assessments can be affected by statistical fluctuation errors and/or cannot provide information on tumor extension and heterogeneity. To overcome these limitations, the Cumulative standardized uptake value (SUV) Histogram (CSH) and Area Under the Curve (AUC) indices were evaluated to obtain additional information on treatment response. For this purpose, the absolute level of [11C]-Methionine (MET) uptake was measured and its heterogeneity distribution within lesions was evaluated by calculating the CSH and AUC indices. CSH and AUC parameters show good agreement with patient outcomes after Gamma Knife treatments. Furthermore, no relevant correlations were found between CSH and AUC indices and those usually used in the nuclear medicine environment. CSH and AUC indices could be a useful tool for assessing patient responses to therapy.

scholarly journals The role of FDG PET/CT or PET/MRI in assessing response to neoadjuvant therapy for patients with borderline or resectable pancreatic cancer: a systematic literature review

2021 ◽  
Author(s):  
Laura Evangelista ◽  
Pietro Zucchetta ◽  
Lucia Moletta ◽  
Simone Serafini ◽  
Gianluca Cassarino ◽  
...  
Keyword(s):  
Neoadjuvant Therapy ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Response To Therapy ◽  
Ductal Adenocarcinoma ◽  
Resectable Pancreatic Cancer ◽  
Number Of Patients ◽  
Pet Ct ◽  
Fdg Pet Ct

AbstractThe aim of the present systematic review is to examine the role of fluorodeoxyglucose (FDG) positron emission tomography (PET) associated with computed tomography (CT) or magnetic resonance imaging (MRI) in assessing response to preoperative chemotherapy or chemoradiotherapy (CRT) for patients with borderline and resectable pancreatic ductal adenocarcinoma (PDAC). Three researchers ran a database query in PubMed, Web of Science and EMBASE. The total number of patients considered was 488. The most often used parameters of response to therapy were the reductions in the maximum standardized uptake value (SUVmax) or the peak standardized uptake lean mass (SULpeak). Patients whose SUVs were higher at the baseline (before CRT) were associated with a better response to therapy and a better overall survival. SUVs remaining high after neoadjuvant therapy correlated with a poor prognosis. Available data indicate that FDG PET/CT or PET/MRI can be useful for predicting and assessing response to CRT in patients with resectable or borderline PDAC.

Pure and Hybrid Deep Learning Models can Predict Pathologic Tumor Response to Neoadjuvant Therapy in Pancreatic Adenocarcinoma: A Pilot Study

2020 ◽  
pp. 000313482098255
Author(s):  
Michael D. Watson ◽  
Maria R. Baimas-George ◽  
Keith J. Murphy ◽  
Ryan C. Pickens ◽  
David A. Iannitti ◽  
...  
Keyword(s):  
Deep Learning ◽  
Neoadjuvant Therapy ◽  
Pancreatic Adenocarcinoma ◽  
Hybrid Model ◽  
Tumor Response ◽  
Tumor Regression ◽  
Area Under The Curve ◽  
Learning Model ◽  
Response To Therapy ◽  
Deep Learning Model

Background Neoadjuvant therapy may improve survival of patients with pancreatic adenocarcinoma; however, determining response to therapy is difficult. Artificial intelligence allows for novel analysis of images. We hypothesized that a deep learning model can predict tumor response to NAC. Methods Patients with pancreatic cancer receiving neoadjuvant therapy prior to pancreatoduodenectomy were identified between November 2009 and January 2018. The College of American Pathologists Tumor Regression Grades 0-2 were defined as pathologic response (PR) and grade 3 as no response (NR). Axial images from preoperative computed tomography scans were used to create a 5-layer convolutional neural network and LeNet deep learning model to predict PRs. The hybrid model incorporated decrease in carbohydrate antigen 19-9 (CA19-9) of 10%. Accuracy was determined by area under the curve. Results A total of 81 patients were included in the study. Patients were divided between PR (333 images) and NR (443 images). The pure model had an area under the curve (AUC) of .738 ( P < .001), whereas the hybrid model had an AUC of .785 ( P < .001). CA19-9 decrease alone was a poor predictor of response with an AUC of .564 ( P = .096). Conclusions A deep learning model can predict pathologic tumor response to neoadjuvant therapy for patients with pancreatic adenocarcinoma and the model is improved with the incorporation of decreases in serum CA19-9. Further model development is needed before clinical application.

scholarly journals 68Ga-DOTATOC PET/CT Follow Up after Single or Hypofractionated Gamma Knife ICON Radiosurgery for Meningioma Patients

2021 ◽  
Vol 11 (3) ◽  
pp. 375
Author(s):  
Fabio Barone ◽  
Francesco Inserra ◽  
Gianluca Scalia ◽  
Massimo Ippolito ◽  
Sebastiano Cosentino ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Case Series ◽  
Biological Response ◽  
Standardized Uptake Value ◽  
Emission Tomography ◽  
Tumor Diameter ◽  
Relative Percentage ◽  
Positron Emission ◽  
Pet Ct

68Ga-DOTATOC represents a useful tool in tumor contouring for radiosurgery planning. We present a case series of patients affected by meningiomas on who we performed 68Ga-DOTATOC positron emission tomography (PET)/CT pre-operatively, a subgroup of which also underwent a post-operative 68Ga-DOTATOC PET/CT to evaluate the standardized uptake value (SUV) modification after Gamma Knife ICON treatment in single or hypofractionated fractions. Twenty patients were enrolled/included in this study: ten females and ten males. The median age was 52 years (range 33–80). The median tumor diameter was 3.68 cm (range 0.12–22.26 cm), and the median pre-radiotherapy maximum SUV value was 11 (range 2.3–92). The average of the relative percentage changes between SUVs at baseline and follow up was −6%, ranging from −41% to 56%. The SUV was reduced in seven out of 12 patients (58%), stable in two out of 12 (17%), and increased in three out of 12 (25%), suggesting a biological response of the tumor to the Gamma Knife treatment in most of the cases. 68Ga-DOTATOC-PET represents a valuable tool in assessing the meningioma diagnosis for primary radiosurgery; it is also promising for follow-up assessment.

scholarly journals Texture-Based Analysis of 18F-Labeled Amyloid PET Brain Images

2021 ◽  
Vol 11 (5) ◽  
pp. 1991
Author(s):  
Alexander P. Seiffert ◽  
Adolfo Gómez-Grande ◽  
Eva Milara ◽  
Sara Llamas-Velasco ◽  
Alberto Villarejo-Galende ◽  
...  
Keyword(s):  
Area Under The Curve ◽  
Standardized Uptake Value ◽  
Texture Features ◽  
Roc Curves ◽  
Significant Feature ◽  
Study Cohort ◽  
Amyloid Pet ◽  
Reference Region ◽  
Brain Images ◽  
Positron Emission

Amyloid positron emission tomography (PET) brain imaging with radiotracers like [18F]florbetapir (FBP) or [18F]flutemetamol (FMM) is frequently used for the diagnosis of Alzheimer’s disease. Quantitative analysis is usually performed with standardized uptake value ratios (SUVR), which are calculated by normalizing to a reference region. However, the reference region could present high variability in longitudinal studies. Texture features based on the grey-level co-occurrence matrix, also called Haralick features (HF), are evaluated in this study to discriminate between amyloid-positive and negative cases. A retrospective study cohort of 66 patients with amyloid PET images (30 [18F]FBP and 36 [18F]FMM) was selected and SUVRs and 6 HFs were extracted from 13 cortical volumes of interest. Mann–Whitney U-tests were performed to analyze differences of the features between amyloid positive and negative cases. Receiver operating characteristic (ROC) curves were computed and their area under the curve (AUC) was calculated to study the discriminatory capability of the features. SUVR proved to be the most significant feature among all tests with AUCs between 0.692 and 0.989. All HFs except correlation also showed good performance. AUCs of up to 0.949 were obtained with the HFs. These results suggest the potential use of texture features for the classification of amyloid PET images.

BIOM-10. PRECLINICAL PLATFORM FOR THE IDENTIFICATION OF DEUTERIUM MAGNETIC RESONANCE SPECTROSCOPY-BASED BIOMARKERS OF BRAIN TUMOR METABOLISM

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi12-vi12
Author(s):  
Georgios Batsios ◽  
Meryssa Tran ◽  
Céline Taglang ◽  
Anne Marie Gillespie ◽  
Sabrina Ronen ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Brain Tumors ◽  
Treatment Response ◽  
Lactate Production ◽  
Cell Suspensions ◽  
Response To Therapy ◽  
Resonance Spectroscopy

Abstract Metabolic reprogramming is a fundamental hallmark of cancer, which can be exploited for non-invasive tumor imaging. Deuterium magnetic resonance spectroscopy (2H-MRS) recently emerged as a novel, translational method of interrogating flux from 2H-labeled substrates to metabolic products. However, to date, preclinical studies have been performed in vivo, an endeavor which suffers from low-throughput and potential wastage of animal life, especially when considering studies of treatment response. Developing in vitro assays for monitoring metabolism of 2H-labeled substrates will enhance throughput, lead to the rapid evaluation of new 2H-based probes and enable identification of treatment response biomarkers, thereby allowing the best 2H-based probes to be translated for further in vivo assessment. The goal of this study was to develop a preclinical cell-based platform for quantifying metabolism of 2H-labeled probes in brain tumor models. Since the Warburg effect, which is characterized by elevated glycolytic production of lactate, is a metabolic phenotype of cancer, including brain tumors, we examined metabolism of 2H-glucose or 2H-pyruvate in patient-derived glioblastoma (GBM6) and oligodendroglioma (BT88) cells and compared to normal human astrocytes (NHACONTROL). Following incubation in media containing [6,6’-2H]glucose or [U-2H]pyruvate, 2H-MR spectra obtained from live cell suspensions showed elevated 2H-lactate production in GBM6 and BT88 cells relative to NHACONTROL. Importantly, 2H-lactate production from [6,6’-2H]glucose or from [U-2H]pyruvate was reduced in GBM6 or BT88 cells subjected to irradiation and temozolomide, which is standard of care for glioma patients, pointing to the utility of this method for detecting response to therapy. Collectively, we have, for the first time, demonstrated the ability to quantify metabolism of 2H-MRS probes in live cell suspensions and validated the utility of our assay for differentiating tumor from normal cells and assessing response to therapy. Our studies will expedite the identification of novel 2H-MRS probes for imaging brain tumors and potentially other types of cancer.

scholarly journals 18F-FDOPA PET/MRI for monitoring early response to bevacizumab in children with recurrent brain tumors

2017 ◽  
Vol 5 (1) ◽  
pp. 28-36 ◽  
Author(s):  
Karen Gauvain ◽  
Maria Rosana Ponisio ◽  
Amy Barone ◽  
Michael Grimaldi ◽  
Ephraim Parent ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Antiangiogenic Therapy ◽  
Standardized Uptake Value ◽  
Progression Free Survival ◽  
Early Response ◽  
Metabolic Tumor Volume ◽  
Pediatric Brain Tumors ◽  
Initial Study ◽  
Response To Therapy ◽  
Low Grade

Abstract Background Noninvasively predicting early response to therapy in recurrent pediatric brain tumors provides a challenge. 3,4-dihydroxy-6-[18F]fluoro-L-phenylalanine (18F-FDOPA) PET/MRI has not been previously studied as a tool to evaluate early response to antiangiogenic therapy in children. The purpose of this study was to evaluate the safety and feasibility of using 18F-FDOPA PET/MRI to assess response to bevacizumab in children with relapsed brain tumors. Materials and Methods Six patients with recurrent gliomas (5 low-grade, 1 high-grade) planned to undergo treatment with bevacizumab were enrolled. 18F-FDOPA PET/MRI scans were obtained prior to and 4 weeks following the start of treatment, and these were compared with the clinical response determined at the 3-month MRI. The primary PET measure was metabolic tumor volume (MTV) at 10 to 15 min after 18F-FDOPA injection. For each tumor, the MTV was determined by manually defining initial tumor volumes of interest (VOI) and then applying a 1.5-fold threshold relative to the mean standardized uptake value (SUV) of a VOI in the frontal lobe contralateral to the tumor. Results 18F-FDOPA PET/MRI was well tolerated by all patients. All tumors were well visualized with 18F-FDOPA on the initial study, with peak tumor uptake occurring approximately 10 min after injection. Maximum and mean SUVs as well as tumor-to-brain ratios were not predictors of response at 3 months. Changes in MTVs after therapy ranged from 23% to 98% (n = 5). There is a trend towards the percent MTV change seen on the 4-week scan correlating with progression-free survival. Conclusion 18F-FDOPA PET/MRI was well tolerated in pediatric patients and merits further investigation as an early predictor of response to therapy.

scholarly journals S100A12 Is Associated with Response to Therapy in Juvenile Idiopathic Arthritis

2018 ◽  
Vol 45 (4) ◽  
pp. 547-554 ◽  
Author(s):  
Faekah Gohar ◽  
Janneke Anink ◽  
Halima Moncrieffe ◽  
Lisette W.A. Van Suijlekom-Smit ◽  
Femke H.M. Prince ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Serum Concentration ◽  
Treatment Response ◽  
Therapy Group ◽  
Univariate Analysis ◽  
S100 Protein ◽  
Response To Therapy ◽  
Inactive Disease ◽  
Baseline Serum ◽  
Potential Biomarker

Objective.Around one-third of patients with juvenile idiopathic arthritis (JIA) fail to respond to first-line methotrexate (MTX) or anti-tumor necrosis factor (TNF) therapy, with even fewer achieving ≥ American College of Rheumatology Pediatric 70% criteria for response (ACRpedi70), though individual responses cannot yet be accurately predicted. Because change in serum S100-protein myeloid-related protein complex 8/14 (MRP8/14) is associated with therapeutic response, we tested granulocyte-specific S100-protein S100A12 as a potential biomarker for treatment response.Methods.S100A12 serum concentration was determined by ELISA in patients treated with MTX (n = 75) and anti-TNF (n = 88) at baseline and followup. Treatment response (≥ ACRpedi50 score), achievement of inactive disease, and improvement in Juvenile Arthritis Disease Activity Score (JADAS)-10 score were recorded.Results.Baseline S100A12 concentration was measured in patients treated with anti-TNF [etanercept n = 81, adalimumab n = 7; median 200, interquartile range (IQR) 133–440 ng/ml] and MTX (median 220, IQR 100–440 ng/ml). Of the patients in the anti-TNF therapy group, 74 (84%) were also receiving MTX. Responders to MTX (n = 57/75) and anti-TNF (n = 66/88) therapy had higher baseline S100A12 concentration compared to nonresponders: median 240 (IQR 125–615) ng/ml versus 150 (IQR 87–233) ng/ml, p = 0.021 for MTX, and median 308 (IQR 150–624) ng/ml versus 151 (IQR 83–201) ng/ml, p = 0.002, for anti-TNF therapy. Followup S100A12 could be measured in 44/75 MTX-treated patients (34/44 responders) and 39/88 anti-TNF-treated patients (26/39 responders). Responders had significantly reduced S100A12 concentration (MTX: p = 0.031, anti-TNF: p < 0.001) at followup versus baseline. Baseline serum S100A12 in both univariate and multivariate regression models for anti-TNF therapy and univariate analysis alone for MTX therapy was significantly associated with change in JADAS-10.Conclusion.Responders to MTX or anti-TNF treatment can be identified by higher pretreatment S100A12 serum concentration levels.

Pneumothorax

2007 ◽  
pp. 161-170
Keyword(s):  
Treatment Response ◽  
Spontaneous Pneumothorax ◽  
Tension Pneumothorax ◽  
Pleural Space ◽  
Response To Therapy ◽  
Primary Spontaneous Pneumothorax ◽  
Acute Presentation ◽  
Secondary Spontaneous Pneumothorax

Definitions 162 Primary spontaneous pneumothorax (PSP) 162 Secondary spontaneous pneumothorax (SSP) 162 Acute presentation 163 Tension pneumothorax 164 Investigations 165 Management 166 Complications 167 Pneumothorax is defined as air in the pleural space. It may occur as a result of trauma or spontaneously, in which case it is further subdivided into primary and secondary. The treatment, response to therapy, and prognosis in these two groups is quite different, and establishing the category is essential....

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