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ABSTRACT: This study aimed to define the potential of 1-(11)C-acetate PET, compared with (18)F-FDG, in detecting meningiomas and monitoring the effect of gamma-knife radiosurgery.
Twenty-two patients with the neuroradiologic diagnosis of meningioma were examined by 1-(11)C-acetate and (18)F-FDG PET on the same day. There were 12 cases of histopathologically proven meningioma (8 grade I, 2 grade II, and 2 grade III), 1 of tuberculous granuloma, and 1 of degenerative tissue. 1-(11)C-acetate PET scans of fasting patients were obtained 10 min after intravenous administration of 740 MBq of 1-(11)C-acetate. (18)F-FDG PET was performed at 2 h after 1-(11)C-acetate scanning. The PET images were evaluated by a qualitative method and semiquantitative analysis using standardized uptake value and tumor-to-cortex ratio.
The (18)F-FDG PET study revealed a hypometabolic focus in 17 meningiomas (8 grade I, 1 grade II, and 8 unknown grade) and hypermetabolism in 1 grade II and 2 grade III meningiomas. High uptake of 1-(11)C-acetate was observed in all 20 meningiomas, in contrast to the low uptake in surrounding normal brain tissue, allowing a clearer demarcation of the tumor boundary than that provided by (18)F-FDG. Dissociation of regional accumulation of 1-(11)C-acetate and (18)F-FDG within the tumor was also noted on the coregistered images. The standardized uptake value for 1-(11)C-acetate was not different from that for (18)F-FDG (mean +/- SD, 3.16 +/- 1.75 vs. 3.22 +/- 1.50, P = 0.601), but the tumor-to-cortex ratio for 1-(11)C-acetate was higher than that for (18)F-FDG (3.46 +/- 1.38 vs. 0.93 +/- 1.08, P < 0.005). (18)F-FDG was able to differentiate grade I from grade II-III meningiomas, whereas 1-(11)C-acetate was unable to do so. Tuberculous granuloma had a high 1-(11)C-acetate and (18)F-FDG uptake similar to that of grade II/III meningioma. Five patients received 1-(11)C-acetate and (18)F-FDG PET before and after gamma-knife surgery. 1-(11)C-acetate performed better than did (18)F-FDG in monitoring the response of tumor metabolism to radiosurgery.
1-(11)C-acetate was found to be useful for detecting meningiomas and evaluating the extent of meningiomas and potentially useful for monitoring tumor response to radiosurgery. However, 1-(11)C-acetate was not useful for evaluating the tumor grade. (18)F-FDG was found to be less useful than 1-(11)C-acetate for evaluating the extent of meningiomas and the response to radiosurgical treatment but may be useful for differentiating benign from malignant meningiomas. (18)F-FDG and 1-(11)C-acetate are complementary for assessing diverse cell metabolism of meningioma.
Journal of Nuclear Medicine 06/2010; 51(6):883-91. · 6.38 Impact Factor
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ABSTRACT: This study aimed to develop a novel tumor-specific promoter gene linking sodium iodide symporter (NIS) gene to specifically target hepatocellular carcinoma in a mouse tumor model.
A tumor-specific chimeric promoter for alpha-fetoprotein gene (AFP) was combined with hepatitis B virus (HBV) enhancer II to investigate radioiodine uptake in vitro and in vivo in hepatoma (HepG2) and nonhepatoma (ARO) cell lines after transfer of hNIS gene. A lentiviral vector carrying the hNIS gene was employed in vitro and in vivo. Radionuclide imaging was acquired for 30 min at 60 min after administration of 1241 to monitor hNIS gene expression in vivo using microPET.
The highest radioiodide uptake of ARO and HepG2 clones which stably expressed hNIS gene were 87- and 208-fold higher than that of parental cells, respectively. After infection of lentivirus, hNIS gene controlled by cytomegavirus (CMV) promoter was expressed in both ARO and HepG2 cells, and hNIS gene induction by EIIAPA promoter was higher than by CMV promoter in HepG2 cells but not in ARO cells. A similar result was observed in vivo, hNIS controlled by CMV promoter was highly expressed in both HepG2 and ARO tumors. The HepG2 tumor multi-infected with LV-EIIAPA-hNIS virus specifically, but the ARO tumor did not activate the EIIAPA promoter and further express the hNIS protein.
Transduction of the hNIS gene controlled by the novel EIIAPA chimeric promoter successfully induces iodide transport in hepatoma.
Anticancer research 02/2009; 29(1):211-21. · 1.73 Impact Factor
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Ren-Shyan Liu,
Cheng-Pei Chang,
Lee-Shing Chu,
Yum-Kung Chu,
Hung-Jen Hsieh,
Chi-Wei Chang,
Bang-Hung Yang,
Shan-Hui Yen,
Min-Chao Huang,
Su-Quin Liao, Shin-Hwa Yeh
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ABSTRACT: The purpose of this study was to assess the use of 1-(11)C-acetate (ACE) as a metabolic tracer for the detection and characterisation of astrocytomas.
Positron emission tomography (PET) studies with ACE and 2-(18)F-fluoro-2-deoxy-D-glucose (FDG) were performed sequentially in 26 patients with primary astrocytomas. Images were analysed by visual interpretation and determination of the tumour to cortex ratio (T/C ratio) and standardised uptake value (SUV). The tumour uptake was visually scored into three grades as compared with the contralateral cortex: clearly lower (-), almost equal (+) and clearly higher (++).
There were 85% of astrocytomas with ++ ACE uptake, 15% with + ACE uptake and none with - ACE uptake. Only 19% of astrocytomas had ++ FDG uptake. Thirty-seven percent of high-grade astrocytomas had + FDG uptake and 37% had - FDG uptake. The sensitivity and specificity of the FDG T/C ratio in discriminating high-grade from low-grade astrocytomas were 79% and 100%, respectively, at the cutoff value of 0.75. Using 2.33 as the cutoff value of the ACE T/C ratio, the sensitivity and specificity were 42% and 86%, respectively. FDG was better than ACE in discriminating high-grade from low-grade astrocytomas. T/C ratios and SUVs of FDG uptake of tumours correlated with the histological grades, but those of ACE uptake did not.
ACE appears to be a promising tracer for use in the detection of primary astrocytomas, but is of limited value in the differentiation of high- and low-grade astrocytomas. ACE is complementary to FDG for the diagnosis and characterisation of astrocytoma.
European journal of nuclear medicine and molecular imaging 05/2006; 33(4):420-7. · 4.99 Impact Factor
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ABSTRACT: Odontogenic infections are a potential risk for patients who receive cervicofacial radiotherapy and should be treated before irradiation. Anaerobic microbial infections are the most common causes. This study assessed the value of the hypoxic imaging agent fluorine-18 fluoromisonidazole (FMISO) in detecting anaerobic odontogenic infections. Positron emission tomography (PET) imaging was performed at 2 h after injection of 370 MBq (10 mCi) of FMISO in 26 nasopharyngeal carcinoma patients and six controls with healthy teeth. Tomograms were interpreted visually to identify hypoxic foci in the jaw. All patients received thorough dental examinations as a pre-radiotherapy work-up. Fifty-one sites of periodontitis, 15 periodontal abscesses, 14 sites of dental caries with root canal infection, 23 sites of dental caries without root canal infection, and seven necrotic pulps were found by dental examination. Anaerobic pathogens were isolated from 12 patients. Increased uptake of FMISO was found at 45 out of 51 sites of periodontitis, all 15 sites of periodontal abscess, all 14 sites of dental caries with root canal infection, all seven sites of necrotic pulp and 15 sites of dental caries without obvious evidence of active root canal infection. No abnormal uptake was seen in the healthy teeth of patients or in the six controls. The diagnostic sensitivity, specificity, positive and negative predictive values, and accuracy of FMISO PET scan in detecting odontogenic infections were 93%, 97%, 84%, 99% and 96%, respectively.18F-fluoride ion bone scan done in three patients showed that18F-fluoride ion plays no role in the demonstration of anaerobic odontogenic infection. FMISO PET scan is a sensitive method for the detection of anaerobic odontogenic infections, and may play a complementary role in the evaluation of the dental condition of patients with head and neck tumours prior to radiation therapy.
European journal of nuclear medicine and molecular imaging 09/1996; 23(10):1384-1387. · 4.99 Impact Factor
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ABSTRACT: In vivo demonstration of hypoxia is of significance for tumour patient management. Fluorine-18 fluoromisonidazole ([18F]FMISO) is a proven hypoxie imaging agent. We developed an [18F]FMISO tumour to muscle retention ratio (TMRR) for the detection of tumour hypoxia in nasopharyngeal carcinoma (NPC). Data were acquired by positron emission tomography (PET) of the nasopharynx and neck after intravenous injection of 370 MBq of [18F]FMISO. Two imaging protocols were adopted: a long protocol for comprehensive dynamic information and a short protocol for a simple, clinically convenient imaging procedure. Tomograms were reconstructed and evaluated visually. ROI analysis on the basis of time-activity curve evaluation was performed to calculate the TMRR of NPC or cervical nodal metastases (CNMs) in relation to the suboccipital muscles at 2 h. The calculation of the TMRR was exactly the same for both the long and the short protocol as two 30-min composite frames had been created immediately after intravenous injection and 2 h after injection of [18F]FMISO in the long protocol. The normal tissue to muscle retention ratio (NTMRR) was derived similarly from the normal nasopharynx. The data of 12 controls and 24 patients with NPC were analysed. The long protocol was used in 15 patients, and the short protocol in nine. In controls, the mean NTMRR1 SD was 0.960.14. The mean TMRRs for NPC and CNMs were 2.561.50 and 1.350.51, respectively; these values were significantly higher than the mean NTMRR for normal controls (PP18F]FMISO TMRR is a simple and clinically useful index for detecting tumour hypoxia in NPC.
European journal of nuclear medicine and molecular imaging 01/1996; 23(10):1378-1383. · 4.99 Impact Factor
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ABSTRACT: Measurement of the local cerebral metabolic rate of glucose
(LCMRGlc) and the individual rate constant parameters of the [<sup>18
</sup>F]2-fluoro-2-deoxy-D-glucose (FDG) model can provide a clearer
understanding and insight to the physiological processes in the human
brain, and a quicker and more accurate means of diagnosis in clinical
applications. A systematic study using simulated and clinical tissue
time activity data is presented to evaluate several existing and newly
developed major algorithms used for determining LCMRGlc and the
individual rate constants from positron emission tomography dynamic
data. The computational and statistical properties of the
autoradiographic approach, weighted and unweighted nonlinear least
squares methods, Patlak graphic approach, weighted integration method,
linear least squares and generalized linear least squares methods are
investigated and discussed in this paper
IEEE Transactions on Medical Imaging 01/1996; · 3.64 Impact Factor
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ABSTRACT: Thymomas are lacking in malignant cytological features. Their staging is defined by the invasiveness of the tumour. This study aimed to analyse the uptake patterns of fluorine-18 fluorodeoxyglucose (FDG) in thymomas of different stages. FDG positron emission tomography (PET) scan was performed in 12 patients suspected of having thymoma and in nine controls. Qualitative visual interpretation was used to detect the foci with FDG uptake higher than that of normal mediastinum. Tumour/lung ratio (TLR) was calculated from the counts of ROIs over the mass and over comparable normal lung tissue in thymoma patients. Mediastinum/lung ratio (MLR) was calculated from the counts of ROIs over the anterior mediastinum and lung in controls. The PET scan patterns of distribution of foci with FDG uptake and TLRs were correlated with the computed tomography (CT) or magnetic resonance imaging (MRI) findings, and staging of the thymomas. Thymectomy was performed in ten patients and thoracoscopy was done in two patients. The results revealed ten thymomas (two stage I tumours, two stage II, four stage III and two stage IV, according to the Masaoka classification), and two cases of thymic hyperplasia associated with myasthenia gravis. Myasthenia gravis was also noted in four thymoma patients. FDG studies showed (a) diffuse uptake in the widened anterior mediastinum in patients with thymic hyperplasia, (b) confined focal FDG uptake in the non-invasive or less invasive, stage I and II thymomas, and (c) multiple discrete foci of FDG uptake in the mediastinum and thoracic structures in stage III and IV advanced invasive thymomas. The thymomas had the highest TLRs, followed by the TLRs of thymic hyperplasia and the MLRs of control subjects (P
European journal of nuclear medicine and molecular imaging 11/1995; 22(12):1402-1407. · 4.99 Impact Factor
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ABSTRACT: This paper presents a 61-year-old male patient with nephrotic syndrome, hypercoagulability and IVC thrombosis. Increased soft
tissue uptake below the level of the mid chest was seen in his bone scan. The term “Fisherman’s Waders” sign is suggested
for this finding, whose recognition may permit the identification of inferior vena cava obstruction in bone scans. The existence
of a cavoportal shunt was also confirmed by dynamic scintigraphy.
Annals of Nuclear Medicine 04/1995; 9(4):237-241. · 1.50 Impact Factor
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ABSTRACT: Thirty-seven patients with Hrthle cell carcinoma of the thyroid gland underwent total thyroidectomy and then technetium-99m sestamibi (2-methoxyisobutylisonitrile), iodine-131 and thallium-201 wholebody scans. Twenty-two of them had elevated human serum thyroglobulin (HTg) levels. Among these 22 patients, abnormal uptake of 131I was seen in four (18.1%), abnormal uptake of 201Tl chloride in 15 (68.1%), and abnormal 99mTc-sestamibi accumulation in 18 (81.8%). No patients with normal levels had a positive whole-body scan. In comparison with the 1311 and 201T1 chloride images, the 99mTc-sestamibi images were of superior quality and detected significantly more (P < 0.05)="" metastatic="" lesions="" of="" hurthle="" cell="" carcinoma="" of="" the="" thyroid="" gland="" in="" patients="" with="" elevated="" htg="" after="" total="" thyroidectomy.="" a="" mechanism="" is="" proposed="" that="" may="" explain="" these="">
European journal of nuclear medicine and molecular imaging 08/1994; 21(9):980-983. · 4.99 Impact Factor
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ABSTRACT: Of the nine patients included in this study, five with proven unilateral parotitis initially had diffuse high uptake of99mTc-pertechnetate in the affected glands with adequate washout following vitamin C stimulation. Of four patients with proven Warthin's tumor, two had focal high uptake in the parotid masses and two had diffuse high uptake on baseline images. All tumors were clearly delineated after stimulation.99mTc-pertechnetate salivary scintigraphy with vitamin C stimulation may provide a useful tool in differentiating unilateral parotitis from Warthin's tumor.
European journal of nuclear medicine and molecular imaging 07/1990; 16(8):689-691. · 4.99 Impact Factor
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IEEE Engineering in Medicine and Biology Magazine 22(4):141-6. · 2.06 Impact Factor
