Comparison of FDG-PET/CT and MR with diffusion-weighted imaging for assessing peritoneal carcinomatosis from gastrointestinal malignancy

Soussan, Michaël; Guetz, G. Des; Barrau, Vincent; Aflalo-Hazan, V.; Pop, Gabriel; Mehanna, Ziad; Rust, E.; Aparicio, Thomas; Douard, Richard; Bénamouzig, Robert; Wind, Philippe; Eder, Véronique

doi:10.1007/s00330-012-2397-2

Cited by 113 publications

(84 citation statements)

References 19 publications

(27 reference statements)

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“…The sensitivity and specificity of ∼90% achieved here for untreated tumors as small as 30 μm represents a significant improvement over the 86% and 53% tumor sensitivity and specificity reported for always-on verteporfin (32). This level of selectivity also results in a two order-of-magnitude improvement in tumor-imaging resolution compared with current clinical imaging technologies (e.g., positron emission tomography, computed tomography, and magnetic resonance imaging), which have 40-50% sensitivity for subcentimeter tumors (10,11). These developments address the lack of imaging technologies for detecting and monitoring micrometastatic disease (3) and open the door to patient-tailored therapeutic regimens based upon real-time feedback regarding the presence and response of residual disease.…”

Section: Resultsmentioning

confidence: 47%

See 1 more Smart Citation

Selective treatment and monitoring of disseminated cancer micrometastases in vivo using dual-function, activatable immunoconjugates

Spring

Abu-Yousif

Palanisami

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

102

205

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Drug-resistant micrometastases that escape standard therapies often go undetected until the emergence of lethal recurrent disease. Here, we show that it is possible to treat microscopic tumors selectively using an activatable immunoconjugate. The immunoconjugate is composed of self-quenching, near-infrared chromophores loaded onto a cancer cell-targeting antibody. Chromophore phototoxicity and fluorescence are activated by lysosomal proteolysis, and light, after cancer cell internalization, enabling tumor-confined photocytotoxicity and resolution of individual micrometastases. This unique approach not only introduces a therapeutic strategy to help destroy residual drug-resistant cells but also provides a sensitive imaging method to monitor micrometastatic disease in common sites of recurrence. Using fluorescence microendoscopy to monitor immunoconjugate activation and micrometastatic disease, we demonstrate these concepts of “tumor-targeted, activatable photoimmunotherapy” in a mouse model of peritoneal carcinomatosis. By introducing targeted activation to enhance tumor selectively in complex anatomical sites, this study offers prospects for catching early recurrent micrometastases and for treating occult disease.

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Section: Resultsmentioning

confidence: 47%

“…These residual micrometastases are clinically occult until gross recurrence, which is often refractory to standard treatments (1,2,4). Laparotomy, an invasive surgical reassessment, frequently fails to detect residual disease (9) while noninvasive clinical imaging modalities also have poor sensitivity for subcentimeter tumors (10,11).…”

mentioning

confidence: 99%

Selective treatment and monitoring of disseminated cancer micrometastases in vivo using dual-function, activatable immunoconjugates

Spring

Abu-Yousif

Palanisami

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

102

205

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“…The use of integrated PET/CT has become well established within the last decade for whole-body staging in oncologic patients (6). Various studies investigating the diagnostic capacity of DWI or MR imaging and of PET/CT have reported comparable results for detection and characterization of tumors, including gynecologic malignancies (7)(8)(9).…”

mentioning

confidence: 99%

Diagnostic Value of Diffusion-Weighted Imaging in Simultaneous ¹⁸F-FDG PET/MR Imaging for Whole-Body Staging of Women with Pelvic Malignancies

et al. 2014

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The aim of this study was to assess the diagnostic benefit of diffusion-weighted imaging (DWI) in an 18 F-FDG PET/MR imaging protocol for whole-body staging of women with primary or recurrent malignancies of the pelvis. Methods: Forty-eight patients with a primary pelvic malignancy or suspected recurrence of a pelvic malignancy were included in our study. All patients underwent a whole-body 18 F-FDG PET/MR imaging examination that included DWI. Two radiologists separately evaluated the PET/MR imaging datasets without DWI followed by a second interpretation with DWI. First, both readers identified all primary tumors, as well as lymph node and distant metastases. In a second session, PET and DWI data were assessed qualitatively. Image interpretation comprised lesion conspicuity defined as visual lesion-to-background contrast (4-point ordinal scale) and diagnostic confidence (3-point ordinal scale) for all tumors. The results from histopathologic examination and cross-sectional imaging follow-up ($6 mo) were used as the reference standard. Statistical analysis was performed to assess the significance of differences between obtained values. Results: Among the 122 suspected lesions seen, 98 (80.3%) were considered malignant. PET/MR imaging without DWI had a sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of 92.9%, 87.5%, 96.8%, 75.0%, and 91.8%, respectively, for the detection of malignant lesions. PET/MR imaging with DWI had slightly higher values (94.9%, 83.3%, 95.9%, 80.0%, and 92.6%, respectively), but the difference was not significant (P . 0.05). In the qualitative assessment of lesion-to-background contrast, PET had significantly (P , 0.05) higher values (3.79 ± 0.58) than DWI (3.63 ± 0.77). Furthermore, significantly (P , 0.05) higher scores were found for diagnostic confidence using PET (2.68 ± 0.64) for the determination of malignant lesions, when compared with DWI (2.53 ± 0.69). Conclusion: DWI in PET/MR imaging has no diagnostic benefit for whole-body staging of women with pelvic malignancies. The omission of DWI for staging or restaging gynecologic cancer may significantly reduce examination times, thus increasing patient comfort without a relevant decrease in diagnostic competence.

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“…MRI ve PET/BT'nin birlikte kullanılması ile tanısal doğruluğun ve özellikle de negatif prediktif değerin yükseldiği bildirilmektedir (12). Ancak 1 cm altındaki peritoneal lezyonların saptanmasında her iki tetkik de yetersizdir (13,14). Bizim çalışmamızda 8 hastaya uygulanan PET/BT'nin 4 ü şüpheli olarak yorumlanmış ancak PC varlığını dışlayacak kadar güçlü bulgulara rastlanmamıştır.…”

Section: Yöntemunclassified

To What Extent Peritonitis Carcinomatosa Can Foreseeable in Digestive System Tumors?

Aksel¹,

Karaman²,

Yüksel³

et al. 2017

Acta Oncol Tur.

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ÖZET Amaç: Birçok sindirim sistemi ve jinekolojik kansere bağlı olarak peritoneal yayılım gelişebilir. Görüntüleme yöntemlerindeki gelişmelere rağmen sindirim sistemi kaynaklı tümörlere bağlı gelişen peritonitis karsinomatoza'yı (PC) ameliyat öncesi tanımak güçtür. Gereç ve Yöntem: Bu çalışmada ameliyat öncesi tanımlanamayan PC saptanan hastaların evreleme tetkikleri geriye dönük olarak gözden geçirilmiştir. Ocak 2012-Kasım 2015 tarihleri arasında 82 hasta değerlendirilmiştir. Bulgular: Kırkbeş (%54.8) hasta mide, 24 hasta (%29.2) kolorektal, 13 hasta (%15.8) pankreas ve safra yolu kaynaklı tümörler nedeniyle opere edilmişti. Hastaların tümüne evreleme amaçlı Bilgisayarlı Tomografi (BT) çekilmiş, 26 hastaya ayrıca karın ultrasonografisi (USG), 4 hastaya Manyetik Rezonans Görüntüleme (MRG) yapılmıştır. Sekiz hastaya ise Pozitron Emisyon Tomografisi (PET-BT) uygulanmıştır. Kırk (%48,7) hastaya cerrahi bypass ve diğer palyatif işlemler uygulanırken, 42 hastaya ek cerrahi işlem uygulanmamıştır. Tamamına laparotomi uygulanmış hastalardan oluşan bizim serimizde tüm hastalara ameliyat öncesi BT çekilmiş, on hastada bulgular şüpheli ancak laparotomiden vazgeçirecek kadar spesifik olmadığı yönünde yorumlanmıştır. En fazla şüpheli bulguya mide kaynaklı PC'lı hastalarda rastlanmıştır (8/45). Bizim çalışmamızda 8 hastaya uygulanan PET/BT'nin 4'ü şüpheli olarak yorumlanmış ancak PC varlığını dışlayacak kadar güçlü bulgulara rastlanmamıştır. Sonuç: Ameliyat öncesi konvansiyonel radyolojik görüntüleme yöntemleri ile PC'yı saptayabilmek halen güçtür. Farklı görüntüleme yöntemlerinin birlikte kullanılması başarı oranını arttırabilir. Özellikle lokal ileri ve sınırda cerrahi olarak çıkarılabilir hastalarda birlikte tümör belirteç yüksekliği de saptanması halinde PC ihtimalinin yüksek olduğu bilinmelidir. Bu hastalarda palyatif girişimler planlanmıyorsa evreleme laparoskopisi uygun bir alternatif olarak karşımıza çıkmaktadır. Anahtar Kelimeler: Peritonitis karsinomatoza; Bilgisayarlı tomografi; Manyetik rezonans görüntüleme; Ultrasonografi ABSTRACT Introduction: Peritoneal dissemination may develop in many digestive system and gynecological cancers. Despite advances in imaging technologies, it is difficult to diagnose PC induced by digestive system tumors before surgery. Methods: In this study, staging tests used in patients with PC that unidentified preoperatively were reviewed retrospectively. Eighty-two patients were evaluated in between January 2012 and November 2015. Results Forty-five (54.8%) patients had been operated with stomach cancer, 24 patients (29.2%) with colorectal, and 13 patients (15.8%), pancreas and biliary tract cancers. Computerized Tomography (CT) was taken to all patients for staging, 26 patients were also evaluated with abdominal ultrasonography (USG) and 4 patients with magnetic resonance imaging (MRI). Positron Emission Tomography (PET-CT) was applied to eight patients. While 40 (48.7%) patients underwent surgical bypass and other palliative procedures, no additional surgical procedures were performed in...

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Comparison of FDG-PET/CT and MR with diffusion-weighted imaging for assessing peritoneal carcinomatosis from gastrointestinal malignancy

Cited by 113 publications

References 19 publications

Selective treatment and monitoring of disseminated cancer micrometastases in vivo using dual-function, activatable immunoconjugates

Selective treatment and monitoring of disseminated cancer micrometastases in vivo using dual-function, activatable immunoconjugates

Diagnostic Value of Diffusion-Weighted Imaging in Simultaneous ¹⁸F-FDG PET/MR Imaging for Whole-Body Staging of Women with Pelvic Malignancies

To What Extent Peritonitis Carcinomatosa Can Foreseeable in Digestive System Tumors?

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Comparison of FDG-PET/CT and MR with diffusion-weighted imaging for assessing peritoneal carcinomatosis from gastrointestinal malignancy

Cited by 113 publications

References 19 publications

Selective treatment and monitoring of disseminated cancer micrometastases in vivo using dual-function, activatable immunoconjugates

Selective treatment and monitoring of disseminated cancer micrometastases in vivo using dual-function, activatable immunoconjugates

Diagnostic Value of Diffusion-Weighted Imaging in Simultaneous 18F-FDG PET/MR Imaging for Whole-Body Staging of Women with Pelvic Malignancies

To What Extent Peritonitis Carcinomatosa Can Foreseeable in Digestive System Tumors?

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Diagnostic Value of Diffusion-Weighted Imaging in Simultaneous ¹⁸F-FDG PET/MR Imaging for Whole-Body Staging of Women with Pelvic Malignancies