ABSTRACT
OBJECTIVE: Hepatocellular carcinoma (HCC) with portal vein thrombosis (PVT) have limited therapeutic options, Re-188 lipiodol transarterial therapy being one of them. We aimed to assess the safety and efficacy of Re-188 lipiodol exclusively in HCC with PVT as well as to compare two chelating agents for the synthesis of Re-188 lipiodol: novel bis-(diethyldithiocarbamato) nitrido (N-DEDC) with existing acetylated 4-hexadecyl 1-2,9,9-tetramethyl-4,7-diaza-1,10-decanethiol [(A)HDD]. METHODS: Patients with radiological diagnosis of HCC with PVT having Eastern Cooperative Oncology Group (ECOG) performance status ≤2 and Child Pugh score (PS) A or B were recruited. Patients received an empirical dose of transarterial Re-188 lipiodol, labelled with (A)HDD or N-DEDC. Radiological response on MRI (modified response evaluation criteria in solid tumors), biochemical response with serum alpha fetoprotein and clinical response with ECOG PS was assessed at three months and survival was estimated at the end of the study. RESULTS: Fifteen therapies were performed in 14 patients with a median age of 62 years (range: 41-70â years). Eight therapies were with Re-188 (A)HDD lipiodol and seven with Re-188 N-DEDC lipiodol. Overall mean injected dose was 2.6â ±â 0.37â GBq. Radiological objective response rate was 31% and disease control rate was 85%. Mean overall survival was 14.21 months and mean progression free survival was 10.23 months. Percentage survival assessed at 3, 6 and 9 months was 93%, 64% and 57%, respectively. Safety parameters, response and survival outcome were comparable for (A)HDD and N-DEDC groups. CONCLUSION: Transarterial Re-188 lipiodol in HCC with PVT is safe and effective in disease control as well as improving survival outcome. Additionally, cost-effective and high-yielding novel agent N-DEDC appears to be a comparable alternative to (A)HDD for the same.
Subject(s)
Carcinoma, Hepatocellular , Chelating Agents , Ethiodized Oil , Liver Neoplasms , Portal Vein , Venous Thrombosis , Humans , Carcinoma, Hepatocellular/complications , Carcinoma, Hepatocellular/diagnostic imaging , Pilot Projects , Liver Neoplasms/complications , Liver Neoplasms/diagnostic imaging , Male , Female , Portal Vein/diagnostic imaging , Middle Aged , Ethiodized Oil/therapeutic use , Aged , Venous Thrombosis/diagnostic imaging , Venous Thrombosis/drug therapy , Chelating Agents/therapeutic use , Chelating Agents/chemistry , Radioisotopes/therapeutic use , Adult , Treatment OutcomeABSTRACT
ABSTRACT: A 38-year-old woman with a 2-month history of per vaginal bleeding and episodes of palpitations, headache, and vomiting underwent 68Ga-DOTANOC PET/CT for evaluation, which revealed a left suprarenal mass and a large uterine mass, both of which were intensely tracer avid. Histopathology of the masses after surgery revealed a left pheochromocytoma and uterine leiomyoma. SSTR-expressing leiomyoma is an uncommon finding and must be kept in mind as a differential diagnosis of DOTANOC-avid uterine mass.
Subject(s)
Adrenal Gland Neoplasms , Leiomyoma , Organometallic Compounds , Pheochromocytoma , Adult , Female , Humans , Leiomyoma/diagnostic imaging , Positron Emission Tomography Computed Tomography , Positron-Emission TomographyABSTRACT
ABSTRACT: We present the case of a 45-year-old woman with known adenoid cystic carcinoma of the right parotid gland, postexcision and postoperative radiation therapy. She was followed up on 18F-FDG PET/CT, which revealed minimal local residual disease and bilateral lung nodules, for which chemotherapy was initiated. Postchemotherapy, 18F-FDG PET/CT showed residual lung metastases. As a part of ongoing project, 68Ga-PSMA PET/CT done revealed additional focal uptake in the right cerebellum, missed on FDG PET/CT. The brain lesion was confirmed upon MRI.
Subject(s)
Brain Neoplasms , Carcinoma, Adenoid Cystic , Organometallic Compounds , Brain Neoplasms/diagnostic imaging , Carcinoma, Adenoid Cystic/diagnostic imaging , Female , Fluorodeoxyglucose F18 , Gallium Isotopes , Gallium Radioisotopes , Humans , Middle Aged , Positron Emission Tomography Computed TomographySubject(s)
Endocarditis/diagnostic imaging , Fluorodeoxyglucose F18 , Heart Valve Prosthesis/adverse effects , Positron Emission Tomography Computed Tomography , Prosthesis-Related Infections/diagnostic imaging , Radiopharmaceuticals , Adult , Endocarditis/etiology , Female , Humans , Prosthesis-Related Infections/etiologyABSTRACT
Ga-PSMA PET/CT is the upcoming imaging modality for staging, restaging and response assessment of prostate cancer. However, due to neuroendocrine differentiation in some of patients with prostate cancer, they express somatostatin receptors instead of prostate specific membrane antigen. This can be exploited and other modalities like Ga-DOTANOC PET/CT and F-FDG PET/CT should be used in such cases for guiding management. We hereby discuss a similar case of 67-year-old man of adenocarcinoma prostate with neuroendocrine differentiation, which shows the potential pitfall of Ga-PSMA PET/CT imaging and benefit of Ga-DOTANOC PET/CT and F-FDG PET/CT in such cases.
