ABSTRACT
A 74-year-old man presented with rapid rising prostate-specific antigen (PSA) 2 years after treatment of prostate cancer with prostatectomy and salvage radiation therapy. PSA increased from 923 to 4349 ng/mL within 2 months. No osseous metastatic lesions of prostate cancer were detected by 18F-sodium fluoride PET/CT imaging at an outside facility. 18F-fluciclovine PET/CT imaging was performed to evaluate local recurrence of prostate cancer at surgical bed of prostatectomy and distant metastasis. One small focus of low-level 18F-fluciclovine radiotracer uptake was noted in the surgical bed of prostatectomy without corresponding soft tissue mass on CT. No fluciclovine-avid lymph nodes or osseous metastatic lesions were detected, but multiple hypodense lesions of variable 18F-fluciclovine radiotracer uptake were noted in the liver, concerning for isolated liver metastasis of prostate cancer. The patient underwent docetaxel chemotherapy for treatment of prostate cancer liver metastasis and showed a favorable response to treatment by significant decreased size of the hypodense lesions in the liver on post treatment abdominal CT, along with dramatic reduction of PSA level and improvement of liver function. The findings from this case highlight the importance of checking hypoattenuating lesions in the liver for the presence of prostate cancer metastatic lesions that might appear similar to other benign hypoattenuating lesions of low fluciclovine uptake relative to physiological 18F-fluciclovine uptake in the normal liver tissues, a potential pitfall at interpretation of 18F-fluociclovine PET/CT imaging.
ABSTRACT
Development of new radiopharmaceuticals is crucial for the advance of nuclear medicine and molecular imaging.In recent years,significant progress has been made in the development of radiopharmaceuticals based on radioactive metal nuclides such as 64Cu.Copper is a transition metal element necessary for human physiology.Disorders of copper metabolism not only cause hereditary Wilson disease and Menkes disease,but also play an important role in the development of malignant tumors.In addition to radiolabeling for probes,64Cu can be used for PET diagnostic imaging of copper metabolism disorders.64CuCl2 is a useful radiotracer that can be used to track the dynamic flow of copper ions in human body copper metabolism by PET imaging.In recent years,many preclinical and clinical studies of 64CuCl2 radiotracer have achieved good results,and have attracted a lot of attention in the field of nuclear medicine and molecular imaging.In this article,the progress in the development of 64CuCl2 as a radiotracer for PET diagnostic imaging of hereditary copper metabolism disorders and copper hypermetabolic tumors is reviewed,and further research studies and potential clinical application of 64CuCl2 PET/CT imaging is prospected.
ABSTRACT
Development of new radiopharmaceuticals is crucial for the advance of nuclear medicine and molecular imaging. In recent years, significant progress has been made in the development of radiopharmaceuticals based on radioactive metal nuclides such as 64Cu. Copper is a transition metal element necessary for human physiology. Disorders of copper metabolism not only cause hereditary Wilson disease and Menkes disease, but also play an important role in the development of malignant tumors. In addition to radiolabeling for probes, 64Cu can be used for PET diagnostic imaging of copper metabolism disorders. 64CuCl2 is a useful radiotracer that can be used to track the dynamic flow of copper ions in human body copper metabolism by PET imaging. In recent years, many preclinical and clinical studies of 64CuCl2 radiotracer have achieved good results, and have attracted a lot of attention in the field of nuclear medicine and molecular imaging. In this article, the progress in the development of 64CuCl2 as a radiotracer for PET diagnostic imaging of hereditary copper metabolism disorders and copper hypermetabolic tumors is reviewed, and further research studies and potential clinical application of 64CuCl2 PET/CT imaging is prospected.
ABSTRACT
OBJECTIVE: To investigate the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG), measured by preoperative ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT), in risk stratification of patients with endometrial carcinoma (EC). METHODS: The patients with pathological diagnosis of EC who underwent preoperative ¹⁸F-FDG PET/CT imaging were retrospectively selected for analysis of the prognostic values of PET parameters in risk classification and lymph node metastases (LNMs). Receiver-operating-characteristic analysis was used to analyze the correlation of PET parameters cutoff values with deep myometrial invasion (MI), lymphovascular space involvement and LNM for prognostic values in risk stratification. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for detection of LNM are 83.3%, 99.7%, 90.9%, 99.5% and 99.2%, respectively. The MTV and TLG of primary lesion of EC in the patients with LNM are notably higher than those in patients without LNM, p<0.010. The MTV and TLG of the EC primary lesions in high-risk patients are significantly higher than those in low-risk patients (p<0.010), but the maximum standardized uptake value (SUVmax) is not. The MTV and TLG of primary lesions were superior to SUVmax for predicting of deep MI, LNM and high-risk of EC (p<0.005). CONCLUSION: MTV and TLG of primary lesions are more valuable in predicting risk stratification of EC patients. Preoperative ¹⁸F-FDG PET/CT imaging is useful in predicting the LNM of EC and may help guide pelvic lymphadenectomy to avoid unnecessary pelvic lymphadenectomy in EC patients with low-risk stratification.