Timothy Akhurst

Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia

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Publications (79)410.09 Total impact

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    ABSTRACT: Background: Data from clinical trials suggest that changes in the glucose avidity of the primary site of lung cancer during induction therapy, measured by changes in (18)F-fluorodeoxyglucose positron emission tomography, correlate with tumor response. Little information about the utility of changes in positron emission tomography imaging of involved lymph nodes during induction chemotherapy is available. The utility of positron emission tomography imaging of either the primary site or nodal metastases, obtained during routine clinical care outside of a clinical trial setting, to predict response has also not been examined. Methods: A retrospective review of all surgical patients with non-small cell lung cancer at a single institution imaged between 2000 and 2006 with (18)F-fluorodeoxyglucose positron emission tomography before or after induction therapy was performed. Results: An increase in standardized uptake value in the primary site of disease during induction therapy was associated with reduced overall survival after resection. Neither pretreatment standardized uptake value nor percentage change in the primary site was associated with overall survival after resection. A decrease in standardized uptake value of greater than 60% in the involved N2 mediastinal nodes was the best predictor of overall survival, better than changes seen in the primary site of disease. Conclusions: An increase in glucose avidity of non-small cell lung cancers during induction therapy was associated with a worse prognosis compared with stable or any decrease in standardized uptake value. Changes in the glucose avidity of mediastinal nodal metastases may be a stronger predictor of survival than changes in the primary site of disease.
    No preview · Article · Jan 2016 · The Annals of thoracic surgery

  • No preview · Article · Aug 2015 · Cancer Research

  • No preview · Conference Paper · May 2015
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    ABSTRACT: Background:The use of smaller molecular weight antibody constructs (eg diabodies) has great promise for antibody therapeutics for improved penetrance into tumor, faster blood clearance, and enhanced tumor: normal tissue uptake, however renal uptake may impact on imaging and therapeutic effects.We have developed a novel pegylated diabody toTAG-72 (AVP0458) for a Phase I, open label, first-in-human trial of PEG-AVP0458. Methods: The primary study objective was the safety of single dose of 124I-PEG-AVP0458 in patients (pts) with TAG-72 +ve relapsed/metastatic prostate or ovarian cancer. Secondary study objectives were evaluation of the biodistribution, tumor targeting, pharmacokinetics (PK) and immunogenicity of 124I-PEG-AVP0458. Pts were infused with 124I-PEGAVP0458 (3–5 mCi) at one of two dose levels (1 mg/m2 and 10 mg/m2), and imaged sequentially over a oneweek period. Safety,PK,and immunogenicity were assessed up to 30 days post-infusion. Results: Six pts (1F:5M; age range 62–85 yrs; 1 ovarian cancer, 5 prostate cancer) were entered into the study, 3 at each dose level. 124I-PEG-AVP0458 was well tolerated, with no infusion-related adverse events, and no serious adverse events observed. There was consistent biodistribution on PET imaging of 124I-PEG-AVP0458, with no normal tissue uptake. High tumor uptake was evident in metastatic disease in liver and lymph nodes, with lesion uptake seen within 1–2 days post-infusion. PK analysis showed a T1⁄2β of 46.8 ± 12.4 hrs. There was no impact of protein dose on biodistribution, tumor uptake or PK. No immunogenicity to PEG-AVP0458 was evident. Conclusions: 124I-PEG-AVP0458 is safe and demonstrates excellent, rapid targeting of tumor, with no normal organ uptake, and high tumor: blood ratios.This data demonstrates the feasibility of using pegylated diabodies for imaging and for payload delivery of radionuclides or cytotoxic drugs in cancer patients.
    Full-text · Conference Paper · Apr 2015
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    ABSTRACT: [Background] A phase I first-in-human clinical trial of 124I-PEGAVP0458 in patients with TAG-72 positive ovarian or prostate cancer has been carried out to determine the tumour targeting potential of PEGAVP0458, a diabody containing the modified CC49 antibody sequences. This study aimed to elucidate the biodistribution, estimate the tracer kinetics and assess the internal radiation dose of 124I-PEG-AVP0458 in the patients enrolled. [Methods] A total of 5 of 6 recruited patients had their PET/CT wholebody scans undertaken on Day 0, Day 1, Day 2 or 3, Day 4 or 5, and Day 6 or 7, following the IV administration of a single dose of 124I-PEGAVP0458 (196.99 ± 8.42 MBq).The whole-body clearance rate and uptakes in sixteen major organs and reference tumours were quantitatively assessed from the sequential images using PMOD.The internal radiation doses were derived from the 124I-PEG-AVP0458 kinetic data of two patients using OLINDA 1.0 EXM. [Results] No significant differences of the effective half-life (p = 0.97) and biological half-life (p = 0.89) were observed between the 1 mg/m2 and 10 mg/m2 PEG-AVP0458 dose cohort groups, with mean effective half-life of 57.40 ± 4.73 hr and mean biological half-life of 136.59 ± 25.55 hr. In the three patients whose tumours were clearly evident on 124I-PEG-AVP0458 PET images, there was a mean tumour AUC to serum AUC ratio of 3.33 ± 2.87, and the mean liver AUC to serum AUC ratio of 0.40 ± 0.04. The highest mean dose, 0.096 mGy/MBq,was seen in the stomach, whereas the lowest mean dose, 0.009 mGy/MBq, was seen in the brain.The ED was 0.54 mSv/MBq. [Conclusions] The estimated organ doses for 124I-PEG-AVP0458 are low, and tumour : normal tissue ratios are superior to typical intact humanised IgG antibodies. These dosimetry results indicate that radioimmunotherapy with 124I-PEG-AVP0458 is highly feasible and warrants clinical evaluation.
    Full-text · Conference Paper · Apr 2015

  • No preview · Article · Nov 2014 · ANZ Journal of Surgery
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    ABSTRACT: Purpose: Increased glycolytic activity on FDG PET/CT defines a subgroup of patients with metastatic gastroenteropancreatic neuroendocrine tumour (NET) with a poor prognosis. A limited range of systemic treatment options exist for more aggressive NET. The role of peptide receptor chemoradionuclide therapy (PRCRT) in such patients is, however, unclear. This retrospective study assessed the outcomes of patients with FDG-avid NET treated with PRCRT. Methods: Clinical, biochemical and imaging response was assessed after completion of induction treatment of PRCRT with 5-fluorouracil in 52 patients selected for treatment on the basis of somatostatin-receptor imaging without spatially discordant FDG-avid disease. Of the cohort, 67% had received prior chemotherapy. Overall survival (OS) and progression-free survival (PFS) were also analysed. Results: PRCRT was well tolerated with negligible grade 3/4 toxicities. After a median follow-up period of 36 months, the median OS was not achieved with a median PFS of 48 months. At 3 months after completion of PRCRT 2% of patients showed a complete anatomical response, 28% a partial response, 68% stable disease, and only 2% progression. On FDG PET/CT, 27% achieved a complete metabolic response during the follow-up period. A biochemical response (>25% fall in chromogranin-A levels) was seen in 45%. Conclusion: PRCRT is an effective treatment in patients with FDG-avid NET, even in patients who have failed conventional therapies. Given apparently higher response rates than with alternative therapeutic options and low toxicity, further research is needed to establish whether PRCRT should be used as a first-line treatment modality in this patient population.
    Full-text · Article · Sep 2014 · European journal of nuclear medicine and molecular imaging
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    ABSTRACT: Objective. Increased glycolytic activity on FDG PET/CT is an adverse prognostic indicator in metastatic gastro-entero-pancreatic neuroendocrine tumor (GEP-NET). A range of systemic treatment options exist for more aggressive GEP-NET, including chemotherapy and targeted agents such as everolimus and sunitinib, particularly for pancreatic primaries. Peptide receptor radionuclide therapy (PRRT) has mainly been applied in patients with low grade GEP-NET but can also be used in patients with higher grade NET if there is sufficient somatostatin expression (SSTR) to enable targeted therapy. This retrospective study assesses the outcomes of patients with FDG-avid GEP-NET treated with peptide receptor chemo-radionuclide therapy (PRCRT). Materials and Methods: Clinical, biochemical and imaging response was assessed after completion of induction treatment of PRCRT with Lu-177 octreotate and infusional 5-fluorouracil chemotherapy in 52 patients. To be eligible, we required tumour uptake intensity of greater than liver on SSTR SPECT/CT or PET/CT, and no sites of spatially discordant FDG-avid disease. Ki,67 was available in 36 patients, with the 78% having ENETS Grade II or III disease. Prior chemotherapy had been received in 67% of the cohort . Overall survival (OS) and progression free survival (PFS) were analysed. Results: The median induction administered activity was 33 GBq over a median of 4 cycles. PRCRT was well tolerated with negligible Grade 3-4 hematologic toxicity. After a median follow-up period of 36 months, the median OS was not achieved with median PFS of 48 months. At 3 months post completion of PRCRT there was a complete anatomic response in 2%, a partial response in 28%, stable disease in 68%, and progression in only 2%. On FDG PET/CT, 27% achieved a complete metabolic response in the follow-up period. Biochemical response (>25% fall in Chromogranin-A levels) occurred in 45%. Conclusions: PRCRT is a highly effective treatment in patients with FDG-avid GEP-NET, even in patients who have failed conventional therapies. Given apparently higher response rates than alternative therapeutic options and low toxicity, further research is needed to establish whether PRCRT should be used as a first-line treatment modality.
    Full-text · Conference Paper · Aug 2014
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    ABSTRACT: Advances in the management of rectal cancer have resulted in an increased application of multimodal therapy with the aim of tailoring therapy to individual patients. Complete pathological response (pCR) is associated with improved survival and may be potentially managed without radical surgical resection. Over the last decade, there has been increasing interest in the ability of functional imaging to predict complete response to treatment. The aim of this review was to assess the role of (18)F-flurordeoxyglucose positron emission tomography (FDG-PET) in prediction of pCR and prognosis in resectable locally advanced rectal cancer. A search of the MEDLINE and Embase databases was conducted, and a systematic review of the literature investigating positron emission tomography (PET) in the prediction of pCR and survival in rectal cancer was performed. Seventeen series assessing PET prediction of pCR were included in the review. Seven series assessed postchemoradiation SUVmax, which was significantly different between response groups in all six studies that assessed this. Nine series assessed the response index (RI) for SUVmax, which was significantly different between response groups in seven series. Thirteen studies investigated PET response for prediction of survival. Metabolic complete response assessed by SUV2max or visual response and RISUVmax showed strong associations with disease-free survival (DFS) and overall survival (OS). SUV2max and RISUVmax appear to be useful FDG-PET markers for prediction of pCR and these parameters also show strong associations with DFS and OS. FDG-PET may have a role in outcome prediction in patients with advanced rectal cancer.
    No preview · Article · May 2014 · Annals of Surgical Oncology
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    ABSTRACT: Ga-1,4,7,10-Tetraazacyclododecane-N,N',N'',N'''-tetraacetic acid (DOTA)-F(ab')2-trastuzumab [Ga-DOTA-F(ab')2-trastuzumab] has been developed at our institution as a positron imaging reagent for assessing human epidermal growth factor receptor 2 (HER2) expression status by in-vivo imaging. Initial studies on animals demonstrated promising results in the monitoring of treatment response to heat shock protein 90-targeted drugs that inhibit the client protein HER2. We report here our initial clinical experience in the assessment of the toxicity, pharmacokinetics, biodistribution, and dosimetry profile of Ga-DOTA-F(ab')2-trastuzumab with PET/computed tomography using a mean of 236 MBq/5 mg administered intravenously. A group of 16 women with breast cancer were enrolled in this study. The one patient who did not receive Ga-DOTA-F(ab')2-trastuzumab was excluded from analysis. Both HER2-negative (n=7) and HER2-positive (n=8) cases were studied. Among the latter, seven had undergone trastuzumab treatment previously and one had not. It was determined that Ga-DOTA-F(ab')2-trastuzumab was well tolerated, with a T ½ of ∼3.6±0.9 h; the critical organ was the kidney, with a mean dose of 0.383 cGy/37 MBq; and tumor targeting was seen in 4/8 patients with HER2-positive disease. The reagent is safe, and assessments through additional studies in a better-defined group of patients, using larger administered masses of antibodies, with a better immunoreactive fraction are needed.
    Full-text · Article · Oct 2013 · Nuclear Medicine Communications
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    ABSTRACT: OBJECTIVE:: To prospectively compare the ability of flourodeoxyglucose-positron emission tomography (FDG-PET) and computed tomography (CT) to identify a pathological complete response (pCR) in patients with rectal cancer treated by chemoradiation. BACKGROUND:: A major obstacle in pursuing nonoperative management in patients with rectal cancer after chemoradiation is the inability to identify a pCR preoperatively. METHODS:: A total of 121 patients with rectal cancer were prospectively enrolled. FDG-PET scans and helical CT scans were obtained before and after neoadjuvant chemoradiation. Consensus readings of PET and CT scans were used to classify certainty of disease (5-point confidence rating scale). The ability of PET and CT scans to accurately distinguish a pCR (ypT0) from an incomplete response (ypT1-4) was estimated using the area under the receiver operating characteristic curve (AUC). RESULTS:: Of the 121 patients, 26 (21%) had a pCR. PET and CT scans were equally inadequate at distinguishing a pCR from an incomplete response (AUC = 0.64 for both, P = 0.97). Among the 26 patients with a pCR, 14 (54%) and 5 (19%) were classified as complete responders on PET and CT scans, respectively. Among the 95 patients with an incomplete pathological response, 63 (66%) and 90 (95%) were classified as incomplete responders on PET and CT scans, respectively. None of the individual PET parameters, including visual response score, mean standard uptake value (SUVmean), maximum SUV (SUVmax), and total lesion glycolysis, accurately distinguished a pCR (AUCs = 0.57-0.73). CONCLUSIONS:: Neither PET nor CT scans have adequate predictive value to be clinically useful in distinguishing a pCR from an incomplete response and, therefore, should not be obtained for the purpose of attempting to predict a pCR after neoadjuvant chemoradiation for rectal cancer.
    No preview · Article · Nov 2012 · Annals of surgery
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    ABSTRACT: BackgroundHSP90 inhibition leads to proteosomal degradation of activated KIT and has in vitro activity against gastrointestinal stromal tumors (GIST). BIIB021 is an oral non-ansamycin HSP90 inhibitor. We carried out a phase II study of BIIB021 in patients with GIST refractory to imatinib and sunitinib.Patients and methodsThe primary end-point was metabolic partial response (mPR) as assessed by fluorodeoxyglucose positron emission tomography (FDG-PET). The secondary end-points were pharmacokinetic assessments of BIIB021 and pharmacodynamic assessments of HSP70. Twenty-three patients were treated on two schedules: 12 pts received 600 mg twice a week (BIW) and 11 patients received 400 mg three times a week (TIW). All had prior imatinib and sunitinib but stopped >14 days before starting BIIB021.ResultsThe median age was 59 years (33-88 years), 61% male, 44% Eastern Cooperative Oncology Group 1 (ECOG1). The best response was PR by FDG-PET for five patients (3/12 at 600 mg BIW and 2/9 at 400 TIW) for an overall response rate of 22%. The response duration was 25-138 days. Adverse events (AEs) were mild to moderate. The mean C(max) was 1.5 µmol and the mean AUC was 2.9 µmol h. C(max) >1.5 µmol was associated with a decrease in standardized uptake value (SUV(max)). HSP70 increased substantially following treatment.Conclusions This study met its primary end-point. BIIB021 leads to objective responses in refractory GIST patients. Pharmacodynamic studies confirmed HSP90 inhibition. Further evaluation of BIIB021 in GIST is warranted.
    Preview · Article · Aug 2012 · Annals of Oncology
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    ABSTRACT: The American Society of Clinical Oncology (ASCO) and Society of Surgical Oncology (SSO) sought to provide an evidence-based guideline on the use of lymphatic mapping and sentinel lymph node (SLN) biopsy in staging patients with newly diagnosed melanoma. A comprehensive systematic review of the literature published from January 1990 through August 2011 was completed using MEDLINE and EMBASE. Abstracts from ASCO and SSO annual meetings were included in the evidence review. An Expert Panel was convened to review the evidence and develop guideline recommendations. Seventy-three studies met full eligibility criteria. The evidence review demonstrated that SLN biopsy is an acceptable method for lymph node staging of most patients with newly diagnosed melanoma. SLN biopsy is recommended for patients with intermediate-thickness melanomas (Breslow thickness, 1 to 4 mm) of any anatomic site; use of SLN biopsy in this population provides accurate staging. Although there are few studies focusing on patients with thick melanomas (T4; Breslow thickness, > 4 mm), SLN biopsy may be recommended for staging purposes and to facilitate regional disease control. There is insufficient evidence to support routine SLN biopsy for patients with thin melanomas (T1; Breslow thickness, < 1 mm), although it may be considered in selected patients with high-risk features when staging benefits outweigh risks of the procedure. Completion lymph node dissection (CLND) is recommended for all patients with a positive SLN biopsy and achieves good regional disease control. Whether CLND after a positive SLN biopsy improves survival is the subject of the ongoing Multicenter Selective Lymphadenectomy Trial II.
    Full-text · Article · Jul 2012 · Journal of Clinical Oncology
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    ABSTRACT: Purpose: The American Society of Clinical Oncology (ASCO) and Society of Surgical Oncology (SSO) sought to provide an evidence-based guideline on the use of lymphatic mapping and sentinel lymph node (SLN) biopsy in staging patients with newly diagnosed melanoma. Methods: A comprehensive systematic review of the literature published from January 1990 through August 2011 was completed using MEDLINE and EMBASE. Abstracts from ASCO and SSO annual meetings were included in the evidence review. An Expert Panel was convened to review the evidence and develop guideline recommendations. Results: Seventy-three studies met full eligibility criteria. The evidence review demonstrated that SLN biopsy is an acceptable method for lymph node staging of most patients with newly diagnosed melanoma. Recommendations: SLN biopsy is recommended for patients with intermediate-thickness melanomas (Breslow thickness, 1-4 mm) of any anatomic site; use of SLN biopsy in this population provides accurate staging. Although there are few studies focusing on patients with thick melanomas (T4; Breslow thickness, >4 mm), SLN biopsy may be recommended for staging purposes and to facilitate regional disease control. There is insufficient evidence to support routine SLN biopsy for patients with thin melanomas (T1; Breslow thickness, <1 mm), although it may be considered in selected patients with high-risk features when staging benefits outweigh risks of the procedure. Completion lymph node dissection (CLND) is recommended for all patients with a positive SLN biopsy and achieves good regional disease control. Whether CLND after a positive SLN biopsy improves survival is the subject of the ongoing Multicenter Selective Lymphadenectomy Trial II.
    No preview · Article · Jul 2012 · Annals of Surgical Oncology
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    ABSTRACT: At present there is no defined role for routine FDG-PET in the preoperative evaluation of nonmetastatic rectal cancer. The primary objective of this study was to evaluate the ability of FDG-PET to predict long-term prognosis based on the response to neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer. This was a prospective study. This study was performed at an academic, tertiary care, comprehensive cancer center. One hundred twenty-seven patients with locally advanced rectal cancer were enrolled between September 1999 and December 2005. All patients underwent FDG-PET scans before and after neoadjuvant chemoradiotherapy. FDG-PET parameters were evaluated by at least 2 study board-certified nuclear medicine physicians, and included mean standard uptake value, maximum standard uptake value, total lesion glycolysis, and visual response score. The main outcome measures were time to recurrence and disease-specific survival. Of 127 patients, 82 (65%) were men, the median age was 60 years (range, 27-82), 110 patients had stage II/III disease, and 17 patients had stage IV disease. Median follow-up among survivors was 77 months (range, 1-115 months). Nine patients had unresectable metastatic disease and were excluded from the time-to-recurrence analysis. At 5 years, 74% (95% CI = 66%-81%) of patients had not had recurrences (locally and/or distantly). The 5-year disease-specific survival was 89% (95% CI = 81%-93%). On univariate analysis, visual response score and time to recurrence came closest to having an association (HR = 0.83, 95% CI = 0.68-1.01, p = 0.06). On multivariate analysis, the visual response score was not significant (p = 0.85). No FDG-PET parameter was associated with disease-specific survival. Assessment of rectal cancer response to neoadjuvant chemoradiotherapy by FDG-PET provides no prognostic information. Therefore, serial FDG-PET before and after neoadjuvant chemoradiotherapy should not be performed for this purpose.
    No preview · Article · Apr 2012 · Diseases of the Colon & Rectum
  • J. Ruby · T. Leibold · E. Riedel · J. Shia · S. Larson · T. Akhurst · W. Wong · J. Guillem

    No preview · Conference Paper · May 2011
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    ABSTRACT: Early identification of inadequate response to preoperative chemoradiotherapy (CRT) may spare rectal cancer patients the toxicity of ineffective treatment. We prospectively evaluated tumor response with (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) early in the course of preoperative CRT. A total of 27 prospectively accrued patients with locally advanced rectal cancer (T(3-4)/N(1)) received preoperative CRT (5040 cGy + 5FU-based chemotherapy). Patients underwent PET scanning before and 8-14 days after commencement of CRT. Scans were interpreted using 3 standard parameters: SUV(max), SUV(avg), and total lesion glycolysis (TLG) as well as an investigational parameter: visual response score (VRS). Percent pathologic response was quantified as a continuous variable. All PET parameters were correlated with pathology. Pathologic complete/near-complete response was defined as ≥95% tumor destruction, suboptimal response as <95%. Statistical analysis was performed using the Wilcoxon rank sum test and receiver operating characteristic (ROC) curve analysis. Of the 27 patients, 11 (41%) had pathologic complete/near-complete response; 16 (59%) had suboptimal response. SUV(max), SUV(avg), and TLG did not discriminate between responders and nonresponders. Visual response score (VRS) was statistically significantly higher for complete/near-complete responders than for suboptimal responders (65 vs. 33%, P = 0.02). Suboptimal responders were identified with 94% sensitivity and 78% accuracy using a VRS cut-off of 50%. In this pilot study, FDG-PET at 8-14 days after the beginning of preoperative CRT was unsuccessful at predicting pathological response with enough accuracy to justify an early change in therapy.
    No preview · Article · Apr 2011 · Annals of Surgical Oncology
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    ABSTRACT: The purpose of this study is to establish and validate a methodology for estimating the standard deviation of voxels with large activity concentrations within a PET image using replicate imaging that is immediately available for use in the clinic. To do this, ensembles of voxels in the averaged replicate images were compared to the corresponding ensembles in images derived from summed sinograms. In addition, the replicate imaging noise estimate was compared to a noise estimate based on an ensemble of voxels within a region. To make this comparison two phantoms were used. The first phantom was a seven-chamber phantom constructed of 1 liter plastic bottles. Each chamber of this phantom was filled with a different activity concentration relative to the lowest activity concentration with ratios of 1:1, 1:1, 2:1, 2:1, 4:1, 8:1 and 16:1. The second phantom was a GE Well-Counter phantom. These phantoms were imaged and reconstructed on a GE DSTE PET/CT scanner with 2D and 3D reprojection filtered backprojection (FBP), and with 2D- and 3D-ordered subset expectation maximization (OSEM). A series of tests were applied to the resulting images that showed that the region and replicate imaging methods for estimating standard deviation were equivalent for backprojection reconstructions. Furthermore, the noise properties of the FBP algorithms allowed scaling the replicate estimates of the standard deviation by a factor of 1/square root N, where N is the number of replicate images, to obtain the standard deviation of the full data image. This was not the case for OSEM image reconstruction. Due to nonlinearity of the OSEM algorithm, the noise is shown to be both position and activity concentration dependent in such a way that no simple scaling factor can be used to extrapolate noise as a function of counts. The use of the Well-Counter phantom contributed to the development of a heuristic extrapolation of the noise as a function of radius in FBP. In addition, the signal-to-noise ratio for high uptake objects was confirmed to be higher with backprojection image reconstruction methods. These techniques were applied to several patient data sets acquired in either 2D or 3D mode, with (18)F (FLT and FDG). Images of the standard deviation and signal-to-noise ratios were constructed and the standard deviations of the tumors' uptake were determined. Finally, a radial noise extrapolation relationship deduced in this paper was applied to patient data.
    No preview · Article · Oct 2010 · Physics in Medicine and Biology
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    ABSTRACT: An asymptomatic 11-week-old male received no treatment after he was classified as having a suspected atypical form of MYCN-nonamplified hyperdiploid stage 4S neuroblastoma (NB), with masses in an adrenal gland, subcutaneous tissues, and the falx cerebri. Within 2 months, however, disease progressed in dura and bone marrow. Two cycles of low-dose chemotherapy achieved a partial response; treatment was discontinued. Complete remission was documented 24 weeks post-cycle 2, and has continued >6 years. The falx cerebri probably does not represent an atypical site for stage 4S NB, but stage 4 NB with favorable biology is sometimes curable with minimal therapy.
    No preview · Article · Dec 2009 · Pediatric Blood & Cancer
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    ABSTRACT: To facilitate future direct correlations between fluorine 18 fluorodeoxyglucose (FDG)-avid colonic lesions and immunohistochemical assay findings, the authors tested the feasibility of ex vivo FDG positron emission tomography (PET) of the colon resected from humans. In this institutional review board-approved, HIPAA-compliant study, the authors, after obtaining informed patient consent, injected FDG intraoperatively in five patients with neoplasms and imaged their resected colons approximately 3 hours later. The colon could be imaged during this fairly limited time interval, and polyps and cancers could be identified. No biologic tissue degradation occurred. The authors concluded that ex vivo FDG PET of the colon is feasible and, when combined with careful histologic and immunohistochemical analyses, may serve as a research tool to determine the mechanisms of the normal colonic uptake of FDG and the localization of FDG in polyps and cancers.
    No preview · Article · Aug 2009 · Radiology

Publication Stats

4k Citations
410.09 Total Impact Points

Institutions

  • 2012-2015
    • Peter MacCallum Cancer Centre
      Melbourne, Victoria, Australia
  • 2014
    • University of Melbourne
      Melbourne, Victoria, Australia
  • 1998-2013
    • Memorial Sloan-Kettering Cancer Center
      • • Molecular Imaging and Therapy Service
      • • Department of Nuclear Medicine
      • • Department of Radiology
      New York, New York, United States
  • 2004-2005
    • Cornell University
      Итак, New York, United States
  • 2000
    • Gracie Square Hospital, New York, NY
      New York City, New York, United States