Usefulness of <sup>18</sup>F-Fluorodeoxyglucose PET for Radiosurgery Planning and Response Monitoring in Patients with Recurrent Spinal Metastasis

Gwak, Ho-Shin; Youn, Sang Min; Chang, Ung-Kyu; Lee, D. H.; Cheon, Gi Jeong; Rhee, Chang Hun; Kim, K.; Kim, H.-J.

doi:10.1055/s-2006-932181

Cited by 21 publications

(9 citation statements)

References 23 publications

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“…SUV max in this context is the value limited to the most active voxel and is highly reproducible across observers. In breast cancer patients with disseminated bone metastases the change in pre- to posttreatment SUV values correlated strongly with both clinical response and percentage change in tumour marker value [97] , with 30–54% decreased values in responding sites versus marginally or unchanged values in nonresponding lesions [98] . The parameter K i indicates regional clearance of [ 18 F] fluoride from blood plasma to bone mineral and was shown to be three times higher in metastatic lesions compared with adjacent unaffected bone [78] .…”

Section: Clinical Imagingmentioning

confidence: 93%

Multimodal imaging of bone metastases: From preclinical to clinical applications

Ellmann

Beck

Kuwert

et al. 2015

Journal of Orthopaedic Translation

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SummaryMetastases to the skeletal system are commonly observed in cancer patients, highly affecting the patients' quality of life. Imaging plays a major role in detection, follow-up, and molecular characterisation of metastatic disease. Thus, imaging techniques have been optimised and combined in a multimodal and multiparametric manner for assessment of complementary aspects in osseous metastases. This review summarises both application of the most relevant imaging techniques for bone metastasis in preclinical models and the clinical setting.

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Section: Clinical Imagingmentioning

confidence: 93%

Multimodal imaging of bone metastases: From preclinical to clinical applications

Ellmann

Beck

Kuwert

et al. 2015

Journal of Orthopaedic Translation

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“…In the first instance, we have looked for a better characterization of the CTV with the assistance of functional imaging with FDG-PET/CT and F-DOPA-PET/CT. The literature suggests that the sensitivity of FDG-PET in detecting spinal metastases is high [14], but only one study evaluated the usefulness of FDG-PET/CT for radiosurgery planning in patients with recurrent spinal metastasis [15]. In our study, numerous vertebrae, judged pathological by MRI, were not detected by these techniques.…”

Section: Discussionmentioning

confidence: 59%

Targeting Stereotactic Body Radiotherapy on Metabolic PET- and Immuno-PET-Positive Vertebral Metastases

et al. 2020

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(1) Background: Stereotactic body radiotherapy (SBRT) for vertebral metastases (VM) allows the delivery of high radiation doses to tumors while sparing the spinal cord. We report a new approach to clinical target volume (CTV) delineation based on anti-carcinoembryonic antigen (CEA) positron emission tomography (pretargeted immuno-PET; “iPET”) in patients with metastatic breast cancer (BC) or medullary thyroid cancer (MTC). (2) Methods: All patients underwent iPET, spine magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET-CT) using 18F-deoxyglucose (FDG) for BC or 18F-dihydroxy-phenylalanine (F-DOPA) for MTC. Vertebrae locations and vertebral segments of lesions were recorded and the impact on CTV delineation was evaluated. (3) Results: Forty-six VM eligible for SBRT following iPET were evaluated in eight patients (five BC, three MTC). Eighty-one vertebral segments were detected using MRI, 26 with FDG or F-DOPA PET/CT, and 70 using iPET. iPET was able to detect more lesions than MRI for vertebral bodies (44 vs. 34). iPET-based delineation modified MRI-based CTV in 70% (32/46) of cases. (4) Conclusion: iPET allows a precise mapping of affected VM segments, and adds complementary information to MRI in the definition of candidate volumes for VM SBRT. iPET may facilitate determining target volumes for treatment with stereotactic body radiotherapy in metastatic vertebral disease.

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“…However, few studies on spinal intramedullary lesions have been reported. 5,6,8,11,13,[15][16][17]18 Although the majority of previously published studies are illustrative case reports, the findings suggest that spinal PET may play a role in the clinical diagnosis of spinal intramedullary lesions by helping to identify diagnostically troublesome lesions based on metabolic activity. Wilmshurst et al conducted a prospective study to investigate the use of FDG-and MET-PET for detection of spinal intramedullary tumors in 14 patients over a 5-year period.…”

Section: Discussionmentioning

confidence: 99%

“…1,2,7,10,20,22,23 However, investigations of spinal intramedullary tumors using PET remain sporadic, with only case reports or case series available to date. 5,6,8,11,13,[15][16][17]18 PET diagnosis of spinal intramedullary tumors can- 18 F]-fluorodeoxyglucose (FDG)-PET/CT was performed in 26 patients with spinal intramedullary lesions. The region of interest (ROI) within the spinal cord parenchyma was placed manually in the axial plane.…”

mentioning

confidence: 99%

Qualitative analysis of spinal intramedullary lesions using PET/CT

Naito

Yamagata

Arima³

et al. 2015

SPI

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OBJECT Although the usefulness of PET for brain lesions has been established, few reports have examined the use of PET for spinal intramedullary lesions. This study investigated the diagnostic utility of PET/CT for spinal intramedullary lesions. METHODS l-[methyl-11C]-methionine (MET)- or [18F]-fluorodeoxyglucose (FDG)-PET/CT was performed in 26 patients with spinal intramedullary lesions. The region of interest (ROI) within the spinal cord parenchyma was placed manually in the axial plane. Maximum pixel counts in the ROIs were normalized to the maximum standardized uptake value (SUVmax) using subject body weight. For FDG-PET the SUVmax was corrected for lean body mass (SULmax) to exclude any influence of the patient’s body shape. Each SUV was analyzed based on histopathological results after surgery. The diagnostic validity of the SUV was further compared with the tumor proliferation index using the MIB-1 monoclonal antibody (MIB-1 index). RESULTS A total of 16 patients underwent both FDG-PET and MET-PET, and the remaining 10 patients underwent either FDG-PET or MET-PET. Pathological diagnoses included high-grade malignancy such as glioblastoma multiforme, anaplastic astrocytoma, or anaplastic ependymoma in 5 patients; low-grade malignancy such as hemangioblastoma, diffuse astrocytoma, or ependymoma in 12 patients; and nonneoplastic lesion including cavernous malformation in 9 patients. Both FDG and MET accumulated significantly in high-grade malignancy, and the SULmax and SUVmax correlated with the tumor proliferation index. Therapeutic response after chemotherapy or radiation in high-grade malignancy was well monitored. However, a significant difference in SULmax and SUVmax for FDG-PET and MET-PET was not evident between low-grade malignancy and nonneoplastic lesions. CONCLUSIONS Spinal PET/CT using FDG or MET for spinal intramedullary lesions appears useful and practical, particularly for tumors with high-grade malignancy. Differentiation of tumors with low-grade malignancy from nonneoplastic lesions may still prove difficult. Further technological refinement, including the selection of radiotracer or analysis evaluation methods, is needed.

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Usefulness of ¹⁸F-Fluorodeoxyglucose PET for Radiosurgery Planning and Response Monitoring in Patients with Recurrent Spinal Metastasis

Abstract: To our knowledge, this is the first report using FDG-PET with radiosurgery in patients with recurrent spinal metastases hidden under metallic artifacts. The mass responses measured by SUV changes in FDG-PET correlated with the clinical results.

Cited by 21 publications

References 23 publications

Multimodal imaging of bone metastases: From preclinical to clinical applications

Multimodal imaging of bone metastases: From preclinical to clinical applications

Targeting Stereotactic Body Radiotherapy on Metabolic PET- and Immuno-PET-Positive Vertebral Metastases

Qualitative analysis of spinal intramedullary lesions using PET/CT

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Usefulness of 18F-Fluorodeoxyglucose PET for Radiosurgery Planning and Response Monitoring in Patients with Recurrent Spinal Metastasis

Abstract: To our knowledge, this is the first report using FDG-PET with radiosurgery in patients with recurrent spinal metastases hidden under metallic artifacts. The mass responses measured by SUV changes in FDG-PET correlated with the clinical results.

Cited by 21 publications

References 23 publications

Multimodal imaging of bone metastases: From preclinical to clinical applications

Multimodal imaging of bone metastases: From preclinical to clinical applications

Targeting Stereotactic Body Radiotherapy on Metabolic PET- and Immuno-PET-Positive Vertebral Metastases

Qualitative analysis of spinal intramedullary lesions using PET/CT

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Usefulness of ¹⁸F-Fluorodeoxyglucose PET for Radiosurgery Planning and Response Monitoring in Patients with Recurrent Spinal Metastasis