The aim of this guideline is to provide standards for the recommendation, performance, interpretation and reporting of Ga-PSMA PET/CT for prostate cancer imaging. These recommendations will help to improve accuracy, precision, and repeatability ofGa-PSMA PET/CT for prostate cancer essentially needed for implementation of this modality in science and routine clinical practice.
In retrospective studies, 68 Ga-PSMA-11 positron emission tomographic (PET) imaging improves detection of biochemically recurrent prostate cancer compared with conventional imaging. OBJECTIVE To assess 68 Ga-PSMA-11 PET accuracy in a prospective multicenter trial.
See an invited perspective on this article on page 466. Prostate-specific membrane antigen (PSMA)-ligand PET imaging provides unprecedented accuracy for whole-body staging of prostate cancer. As PSMA-ligand PET/CT is increasingly adopted in clinical trials and routine practice worldwide, a unified language for image reporting is urgently needed. We propose a molecular imaging TNM system (miTNM, version 1.0) as a standardized reporting framework for PSMA-ligand PET/CT or PET/MRI. miTNM is designed to organize findings in comprehensible categories to promote the exchange of information among physicians and institutions. Additionally, flowcharts integrating findings of PSMA-ligand PET and morphologic imaging have been designed to guide image interpretation. Specific applications, such as assessment of prognosis or impact on management, should be evaluated in future trials. miTNM is a living framework that evolves with clinical experience and scientific data.
Four-dimensional flow MR imaging showed abnormal helical systolic flow in the ascending aorta of patients with a BAV, including those without aneurysm or aortic stenosis. Identification and characterization of eccentric flow jets in these patients may help identify those at risk for development of ascending aortic aneurysm.
This manuscript is the result of the North American Neuroendocrine Tumor Society consensus conference on the surgical management of pancreatic neuroendocrine tumors from July 19-20, 2018. The group reviewed a series of questions of specific interest to surgeons taking care of patients with pancreatic neuroendocrine tumors, and for each the available literature was reviewed. What follows are these reviews for each question followed by recommendations of the panel.
Blood flow imaging with 3-dimensional time-resolved, phase-contrast cardiac magnetic resonance (4-dimensional [4D] Flow) is an innovative and visually appealing method for studying cardiovascular disease that allows quantification of important secondary vascular parameters including wall shear stress. The hypothesis of this pilot study is that 4D Flow will become a powerful tool for characterizing the relationship of aortic valve-related flow dynamics, especially with bicuspid aortic valve (BAV), and progression of ascending aortic (AsAo) dilation. We identified 46 patients previously studied with 4D Flow: tricuspid aortic valve patients without valvular disease (n = 20), and BAV patients with either normal flow (n = 7) or eccentric systolic jets resulting in abnormal right-handed helical AsAo flow (n = 19). The subgroup of patients with BAV and eccentric systolic AsAo blood flow was found to have significantly and asymmetrically elevated wall shear stress. This increased hemodynamic burden may place them at risk for AsAo aneurysm.
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