ObjectiveIn this pilot study, we investigated the feasibility of response prediction using digital [F-18]FDG PET/computed tomography (CT) and multiparametric MRI before, during, and after... Show moreObjectiveIn this pilot study, we investigated the feasibility of response prediction using digital [F-18]FDG PET/computed tomography (CT) and multiparametric MRI before, during, and after neoadjuvant chemoradiation therapy in locally advanced rectal cancer (LARC) patients and aimed to select the most promising imaging modalities and timepoints for further investigation in a larger trial. MethodsRectal cancer patients scheduled to undergo neoadjuvant chemoradiation therapy were prospectively included in this trial, and underwent multiparametric MRI and [F-18]FDG PET/CT before, 2 weeks into, and 6-8 weeks after chemoradiation therapy. Two groups were created based on pathological tumor regression grade, that is, good responders (TRG1-2) and poor responders (TRG3-5). Using binary logistic regression analysis with a cutoff value of P <= 0.2, promising predictive features for response were selected. ResultsNineteen patients were included. Of these, 5 were good responders, and 14 were poor responders. Patient characteristics of these groups were similar at baseline. Fifty-seven features were extracted, of which 13 were found to be promising predictors of response. Baseline [T2: volume, diffusion-weighted imaging (DWI): apparent diffusion coefficient (ADC) mean, DWI: difference entropy], early response (T2: volume change, DWI: ADC mean change) and end-of-treatment presurgical evaluation MRI (T2: gray level nonuniformity, DWI: inverse difference normalized, DWI: gray level nonuniformity normalized), as well as baseline (metabolic tumor volume, total lesion glycolysis) and early response PET/CT (Delta maximum standardized uptake value, Delta peak standardized uptake value corrected for lean body mass), were promising features. ConclusionBoth multiparametric MRI and [F-18]FDG PET/CT contain promising imaging features to predict response to neoadjuvant chemoradiotherapy in LARC patients. A future larger trial should investigate baseline, early response, and end-of-treatment presurgical evaluation MRI and baseline and early response PET/CT. Show less
Vuijk, F.A.; Shahbazi, S.F.; Noortman, W.A.; Velden, F.H.P. van; Dibbets-Schneider, P.; Marinelli, A.W.K.S.; ... ; Geus-Oei, L.F. de 2023
Objective In this pilot study, we investigated the feasibility of response prediction using digital [18F]FDG PET/computed tomography (CT) and multiparametric MRI before, during, and after... Show moreObjective In this pilot study, we investigated the feasibility of response prediction using digital [18F]FDG PET/computed tomography (CT) and multiparametric MRI before, during, and after neoadjuvant chemoradiation therapy in locally advanced rectal cancer (LARC) patients and aimed to select the most promising imaging modalities and timepoints for further investigation in a larger trial.Methods Rectal cancer patients scheduled to undergo neoadjuvant chemoradiation therapy were prospectively included in this trial, and underwent multiparametric MRI and [18F]FDG PET/CT before, 2 weeks into, and 6–8 weeks after chemoradiation therapy. Two groups were created based on pathological tumor regression grade, that is, good responders (TRG1-2) and poor responders (TRG3-5). Using binary logistic regression analysis with a cutoff value of P ≤ 0.2, promising predictive features for response were selected.Results Nineteen patients were included. Of these, 5 were good responders, and 14 were poor responders. Patient characteristics of these groups were similar at baseline. Fifty-seven features were extracted, of which 13 were found to be promising predictors of response. Baseline [T2: volume, diffusion-weighted imaging (DWI): apparent diffusion coefficient (ADC) mean, DWI: difference entropy], early response (T2: volume change, DWI: ADC mean change) and end-of-treatment presurgical evaluation MRI (T2: gray level nonuniformity, DWI: inverse difference normalized, DWI: gray level nonuniformity normalized), as well as baseline (metabolic tumor volume, total lesion glycolysis) and early response PET/CT (Δ maximum standardized uptake value, Δ peak standardized uptake value corrected for lean body mass), were promising features.Conclusion Both multiparametric MRI and [18F]FDG PET/CT contain promising imaging features to predict response to neoadjuvant chemoradiotherapy in LARC patients. A future larger trial should investigate baseline, early response, and end-of-treatment presurgical evaluation MRI and baseline and early response PET/CT. Show less
Chen, L.L.; Burgt, A. van de; Smit, F.; Audhoe, R.S.; Boer, S.M. de; Velden, F.H.P. van; Geus-Oei, L.F. de 2023
ObjectiveSince the end of 2019, the coronavirus disease 2019 (COVID-19) virus has infected millions of people, of whom a significant group suffers from sequelae from COVID-19, termed long COVID. As... Show moreObjectiveSince the end of 2019, the coronavirus disease 2019 (COVID-19) virus has infected millions of people, of whom a significant group suffers from sequelae from COVID-19, termed long COVID. As more and more patients emerge with long COVID who have symptoms of fatigue, myalgia and joint pain, we must examine potential biomarkers to find quantifiable parameters to define the underlying mechanisms and enable response monitoring. The aim of this study is to investigate the potential added value of [F-18]FDG-PET/computed tomography (CT) for this group of long COVID patients. MethodsFor this proof of concept study, we evaluated [F-18]FDG-PET/CT scans of long COVID patients and controls. Two analyses were performed: semi-quantitative analysis using target-to-background ratios (TBRs) in 24 targets and total vascular score (TVS) assessed by two independent nuclear medicine physicians. Mann-Whitney U-test was performed to find significant differences between the two groups. ResultsThirteen patients were included in the long COVID group and 25 patients were included in the control group. No significant differences (P < 0.05) were found between the long COVID group and the control group in the TBR or TVS assessment. ConclusionAs we found no quantitative difference in the TBR or TVS between long COVID patients and controls, we are unable to prove that [F-18]FDG is of added value for long COVID patients with symptoms of myalgia or joint pain. Prospective cohort studies are necessary to understand the underlying mechanisms of long COVID. Show less
Chen, L.L.; Burgt, A. van de; Smit, F.; Audhoe, R.S.; Boer, S.M. de; Velden, F.H.P. van; Geus-Oei, L.F. de 2023
Objective Since the end of 2019, the coronavirus disease 2019 (COVID-19) virus has infected millions of people, of whom a significant group suffers from sequelae from COVID-19, termed long COVID.... Show moreObjective Since the end of 2019, the coronavirus disease 2019 (COVID-19) virus has infected millions of people, of whom a significant group suffers from sequelae from COVID-19, termed long COVID. As more and more patients emerge with long COVID who have symptoms of fatigue, myalgia and joint pain, we must examine potential biomarkers to find quantifiable parameters to define the underlying mechanisms and enable response monitoring. The aim of this study is to investigate the potential added value of [18F]FDG-PET/computed tomography (CT) for this group of long COVID patients.Methods For this proof of concept study, we evaluated [18F]FDG-PET/CT scans of long COVID patients and controls. Two analyses were performed: semi-quantitative analysis using target-to-background ratios (TBRs) in 24 targets and total vascular score (TVS) assessed by two independent nuclear medicine physicians. Mann–Whitney U-test was performed to find significant differences between the two groups.Results Thirteen patients were included in the long COVID group and 25 patients were included in the control group. No significant differences (P < 0.05) were found between the long COVID group and the control group in the TBR or TVS assessment.Conclusion As we found no quantitative difference in the TBR or TVS between long COVID patients and controls, we are unable to prove that [18F]FDG is of added value for long COVID patients with symptoms of myalgia or joint pain. Prospective cohort studies are necessary to understand the underlying mechanisms of long COVID. Show less
Rietbergen, D.D.D.; Meershoek, P.; Kleinjan, G.H.; Donswijk, M.; Olmos, R.A.V.; Leeuwen, F.W.B. van; ... ; Hage, J.A. van der 2020
Objective The hybrid tracer indocyanine green (ICG)-Tc-99m-nanocolloid has been introduced for sentinel node imaging. However, until now, a comparison of this tracer with other radiocolloids with a... Show moreObjective The hybrid tracer indocyanine green (ICG)-Tc-99m-nanocolloid has been introduced for sentinel node imaging. However, until now, a comparison of this tracer with other radiocolloids with a larger particle size has not been effectuated. Based on a head-to-head evaluation in patients with melanoma, we have compared ICG-Tc-99m-nanocolloid (particle size 5-80 nm) with(99m)Tc-Senti-Scint (particle size 100-600 nm) to establish differences in drainage pattern and sentinel node localization using lymphoscintigraphy and single-photon emission computed tomography combined with computer tomography (SPECT-CT) in melanoma patients scheduled for sentinel node biopsy. Methods Twenty-five patients (mean age: 56.9 years, range: 25-79 years) with a melanoma scheduled for SLN biopsy prior to (re)excision of the primary lesion (scar) were prospectively included following a two-day procedure. The first day, after(99m)Tc-Senti-Scint injection in four intradermal depots around the primary lesion or scar, early/delayed lymphoscintigraphy and SPECT-CT images were acquired. The injection sites were marked. The second day, after assessing lymph node radioactivity using planar scintigraphy, ICG-Tc-99m-nanocolloid was injected at the previously marked skin points and imaging was performed. The paired planar and SPECT-CT images of both tracers were evaluated with respect to drainage patterns, SLN visualization and non-SLN appearing. Results Twenty-four out of 25 patients were evaluable. SLN visualization on a patient basis was 100% for ICG-Tc-99m-nanocolloid and 96% for(99m)Tc-Senti-Scint, whereas uptake in non-SLNs was found in, respectively, 71% (17/24) and 61% (14/23). Concordance in drainage to 45 lymph node basins was 91%. Discordant drainage was found for two melanomas in the head-and-neck and one in the clavicular area. Unique lymph node basins were seen in 44/45 (98%) for ICG-Tc-99m-nanocolloid and 42/45 (93%) for(99m)Tc-Senti-Scint. Concerning identified SLNs, the number was similar for both tracers (n = 58); however, more non-SLNs (65 vs 50) were visualized with ICG-Tc-99m-nanocolloid than with(99m)Tc-Senti-Scint. Conclusion A slightly higher SLN visualization accompanied by a tendency to depict more non-SLNs was found for ICG-Tc-99m-nanocolloid. Excepting the head and neck area, an overall high concordance in drainage was found for both radiotracers. With an additional value for the hybrid tracer due to the combination of preoperative imaging and the additional visual signal in the operation room, added by the fluorescent component of the hybrid tracer, there was a preference for ICG-Tc-99m-nanocolloid. Show less
I-123-meta-iodobenzyl-guanidine (I-123-MIBG) scintigraphy is used to visualize and quantify the sympathetic nerve activity. Although it has been used since 1980 to identify myocardial innervation,... Show moreI-123-meta-iodobenzyl-guanidine (I-123-MIBG) scintigraphy is used to visualize and quantify the sympathetic nerve activity. Although it has been used since 1980 to identify myocardial innervation, it is not yet regarded a routine sympathetic imaging agent in this respect. The lack of large multicentre studies and the presence of variations in the protocols that are used for planar MIBG acquisition confines the comparability of study results and application of normal values. Therefore, the aim of this study was to assess the variations in mathematical methods that are currently used to quantify the heart-to-mediastinum ratio and washout rate (WOR). In addition, normal values were evaluated in concordance with these methods. A systematic literature search yielded 169 unique manuscripts, of which 30 contained a complete description of the acquisition protocol for planar MIBG acquisition, image analysis and quantification of the parameters. The results indicate not only large variations in mathematical methods, but also in various aspects of the protocols that are used during acquisition. In many manuscripts method-specific normal values were used; however, these values were generally generated from small, single-centre studies. This study stresses the need to produce guidelines to achieve a standardized method for MIBG acquisition, image analysis and methods to quantify parameters. Nucl Med Commun 31:617-628 (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins. Show less
Aim The aim of this study is to assess the additional value of radioiodine-131 (I-131) single-photon emission computed tomography (SPECT) to whole-body scintigraphy (WBS) in the detection of... Show moreAim The aim of this study is to assess the additional value of radioiodine-131 (I-131) single-photon emission computed tomography (SPECT) to whole-body scintigraphy (WBS) in the detection of recurrent differentiated thyroid cancer. Materials and methods Eighty-seven consecutive patients with differentiated thyroid cancer, who had undergone a diagnostic SPECT WBS study, were included. In all patients, posttreatment scans, computed tomography scanning or ultrasonography were used to assess positive results, whereas follow-up was used in patients with a negative scan result. General data, such as primary tumor, histology and biochemical parameters were also gathered. Results In this study cohort, nine positive diagnostic WBS were found compared with 31 positive SPECT scans. In eight of the nine (89%) positive WBS, recurrent thyroid cancer was found at the same location on the SPECT scan. In 56 patients SPECT and WBS were negative. Moreover, eight patients with a positive SPECT study had a serum thyroglobulin level less than 1 mu g/l, which, in our hospital, was the cut-off level for treatment. On the basis of the serum thyroglobulin measurements and the WBS, 9% of the patients would not have been treated. Conclusion I-131 SPECT of the head and neck region and chest has a complementary role for planar imaging in the follow-up of patients treated for differentiated thyroid cancer. Therefore, its use in addition to WBS is strongly recommended in clinical practice. Nucl Med Commun 31:417-422 (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins. Show less
OBJECTIVE: The aim of this study was to investigate the differences in biological performance between a technetium-99m (Tc)-labelled glucose derivative, the Tc-labelled 1-thio-beta-D-glucose 2,3,4... Show moreOBJECTIVE: The aim of this study was to investigate the differences in biological performance between a technetium-99m (Tc)-labelled glucose derivative, the Tc-labelled 1-thio-beta-D-glucose 2,3,4,6-tetra-acetate analogue (Tc-TG) with F-fluoro-2-deoxy-glucose ([F]FDG). METHODS: Binding of both tracers was performed in vitro to viable tumour cells and bacteria. Both tracers were injected into mice for targeting Staphylococcus aureus thigh muscle infections and subcutaneous rat lymphoma (RMA) tumours by using scintigraphy, or by radioactivity counts in excised tissues to determine the biodistribution. RESULTS: In-vitro binding studies revealed that both tracers bind more effectively to tumour cells expressing the glucose transporter 1 rather than the glucose transporter 2, and this binding was specific for [F]FDG. Tc-TG shows the highest binding to bacteria and, in addition, gives the highest rate of accumulation in infected thigh muscles in mice. Both tracers were rapidly removed from the circulatory system through the kidneys, and the majority of the injected radioactivity accumulated in the urinary bladder. Two hours after the injection radioactivity accumulation in two high-energy-dependent organs, heart, and liver, increased. Within 15 min of the injections, Tc-TG visualized the site of S. aureus infection or the tumour. CONCLUSION: We conclude that the new tracer Tc-TG may have potential use as a SPECT agent for infection and tumour imaging. Show less
Objective The aim of this study was to investigate the differences in biological performance between a technetium-99m (Tc-99m)-labelled glucose derivative, the Tc-99m-labelled 1-thio-beta-D-glucose... Show moreObjective The aim of this study was to investigate the differences in biological performance between a technetium-99m (Tc-99m)-labelled glucose derivative, the Tc-99m-labelled 1-thio-beta-D-glucose 2,3,4,6-tetra-acetate analogue (Tc-99m-TG) with F-18-fluoro-2-deoxy-glucose ([F-18]FDG). Methods Binding of both tracers was performed in vitro to viable tumour cells and bacteria. Both tracers were injected into mice for targeting Staphylococcus aureus thigh muscle infections and subcutaneous rat lymphoma (RMA) tumours by using scintigraphy, or by radioactivity counts in excised tissues to determine the biodistribution. Results In-vitro binding studies revealed that both tracers bind more effectively to tumour cells expressing the glucose transporter 1 rather than the glucose transporter 2, and this binding was specific for [F-18]FDG. (99)mTc-TG shows the highest binding to bacteria and, in addition, gives the highest rate of accumulation in infected thigh muscles in mice. Both tracers were rapidly removed from the circulatory system through the kidneys, and the majority of the injected radioactivity accumulated in the urinary bladder. Two hours after the injection radioactivity accumulation in two high-energy-dependent organs, heart, and liver, increased. Within 15 min of the injections, Tc-99m-TG visualized the site of S. aureus infection or the tumour. Conclusion We conclude that the new tracer Tc-99m-TG may have potential use as a SPECT agent for infection and tumour imaging. Nucl Med Commun 31: 239-248 (C) 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins. Show less
![Performance of a 99mTc-labelled 1-thio-beta-D-glucose 2,3,4,6-tetra-acetate analogue in the detection of infections and tumours in mice: a comparison with [18F]FDG](/sites/all/modules/custom/islandora_solr_search/images/defaultimg.png?solr_nav%5Bid%5D=eb0308c09e7a3762d83c&solr_nav%5Bpage%5D=0&solr_nav%5Boffset%5D=14)
![Performance of a Tc-99m-labelled 1-thio-beta-D-glucose 2,3,4,6-tetra-acetate analogue in the detection of infections and tumours in mice: a comparison with [F-18]FDG](/sites/all/modules/custom/islandora_solr_search/images/defaultimg.png?solr_nav%5Bid%5D=eb0308c09e7a3762d83c&solr_nav%5Bpage%5D=0&solr_nav%5Boffset%5D=15)
