The predictive role of interim PET after the first chemotherapy cycle and sequential evaluation of response to ABVD in Hodgkin's lymphoma patients-the Polish Lymphoma Research Group (PLRG) Observational Study.

BACKGROUND: Interim PET after two ABVD cycles (iPET2) predicts treatment outcome in classical Hodgkin's lymphoma. To test whether an earlier assessment of chemosensitivity would improve the prediction accuracy, we launched a prospective, multicenter observational study aimed at assessing the predictive value of iPET after one ABVD (iPET1) and the kinetics of response assessed by sequential PET scanning. PATIENTS AND METHODS: Consecutive patients with newly diagnosed classical Hodgkin's lymphoma underwent interim PET scan after one ABVD course (iPET1). PETs were interpreted according to the Deauville score (DS) as negative (-) (DS 1-3) and positive (+) (DS 4, 5). Patients with iPET1 DS 3-5 underwent iPET2. RESULTS: About 106 early (I-IIA) and 204 advanced (IIB-IV) patients were enrolled between January 2008 and October 2014. iPET1 was (-) in 87/106 (82%) or (+) in 19/106 (18%) of early, and (-) in 133/204 (65%) or (+) in 71/204 (35%) of advanced stage patients, respectively. Twenty-four patients were excluded from response analysis due to treatment escalation. After a median follow-up of 38.2 (3.2-90.2) months, 9/102 (9%) early and 43/184 (23%) advanced patients experienced a progression-free survival event. At 36 months, negative and positive predictive value for iPET1 were 94% and 41% (early) and 84% and 43% (advanced), respectively. The kinetics of PET response was assessed in 198 patients with both iPETs. All 116 patients with iPET1(-) remained iPET2(-) (fast responders), 41/82 with IPET1(+) became iPET2(-) (slow responders), and the remaining 41 stayed iPET2(+) (non-responders); progression-free survival at 36 months for fast, slow and non-responders was 0.88, 0.79 and 0.34, respectively. CONCLUSION: The optimal tool to predict ABVD outcome in HL remains iPET2 because it distinguishes responders, whatever their time to response, from non-responders. However, iPET1 identified fast responders with the best outcome and might guide early treatment de-escalation in both early and advanced-stage HL.

WITHDRAWN: PET-CT derived Artificial Neural Network can predict mediastinal lymph nodes metastases in Non-Small Cell Lung Cancer patients. Preliminary report and scoring model.

Ahead of Print article withdrawn by publisher.

Synthesis of novel halo and tosyloxy nortropane derivatives as efficient precursors for the one-step synthesis of the dopamine transporter PET ligand [(18)F]FECNT.

The fluorine-18 labeled nortropane derivative 2ß-carbomethoxy-3ß-(4-chlorophenyl)-8-(2-fluoroethyl)-nortropane (FECNT) is a dopamine transporter (DAT) ligand. Currently, it is considered as reference for positron emission tomography imaging. Herein, the synthesis of novel precursors (N-tosyloxy-, chloro-, and bromo- analogues) for one-step radiosynthesis of [(18)F]FECNT is reported. Using the N-mesyloxy- precursor in a one-step radiosynthesis, the crude [(18)F]FECNT was obtained with the radiolabeling yield of 45 ± 10%, confirming the practical efficiency of this approach in the design of novel precursors for labeling.

The role of positron emission tomography (PET) in diagnostics of gastroenteropancreatic neuroendocrine tumours (GEP NET).

PET is a successful modality to detect cancer and in recent years has demonstrated a great diagnostic value in large series of tumour types. PET combines high sensitivity and reasonable resolution, and offers the ability to perform whole body scans. 18F-deoxyglucose (FDG)-PET has also been used to diagnose tumours of neuroendocrine origin. Even if 18F-FDG has been successfully and widely employed in oncology, it has not demonstrated a significant uptake in well differentiated neuroendocrine tissues. Thus 18F-FDG is not a good tracer for neuroendocrine tumours, as FDG-PET imaging of number of GEP tumours revealed increased glucose metabolism only in less differentiated GEP tumours with high proliferative activity and in metastatising MTC associated with rapidly increasing CEA levels. In such a situation, additional 18F-FDG PET should be performed only if somatostatin receptor scintigraphy (alone or with 99mTc-DMSA) is negative. On the contrary, other positron emitter tracers seem to be more promising. 68Ga-DOTA-NOC (tetraazycyclododecanetetraacetic acid-[1-Nal3]-octreotide) has been used as a positron emitter tracer for the detection of NETs in preliminary studies. A serotonin precursor 5-hydroxytryptophan (5-HTP) labelled with 11C has shown an increased uptake in carcinoids. This uptake seems to be selective and some clinical evidence has demonstrated that it allows the detection of more lesions with PET than with CT or octreotide scintigraphy. Another radiopharmaceutical in the development for PET is 11C-L-DOPA, which seems to be useful in imaging endocrine pancreatic tumours.

[The significance of radioisotopic methods in internal diseases diagnosis]. / Znaczenie radioizotopowych metod obrazowania w diagnostyce chorób wewnetrznych.

The present article is an attempt to show the best diagnostic radioisotopic methods which are practically applied in the internal diseases diagnostics. It was shown both the most important indications for performing these examinations and expected advantages. In particular, it was paid attention to achieved progress in the diagnostics of some diseases owing to radioisotopic methods application. In addition, a general availability and non-invasity of these methods advocates in support of using them.

[Correlation between results of transcranial doppler ultrasonography and SPECT in the brain of patients with ischemic cerebral stroke]. / Korelacja wyników badan przezczaszkowej ultrasonografii dopplerowskiej i SPECT-u mózgu u chorych z niedokrwiennym uszkodzeniem mózgu.

Single photon emission computerized tomography /SPECT/ and positron emission tomography /PET/ are used presently for the study of the cerebral blood flow /CBF/. The cost of these procedures limits the possibility of their use and makes them available mainly in large and rich clinical centres. Transcranial Doppler USG has no such drawbacks. The purpose of the present study was analysis of a possible correlation between marker cumulation /in SPECT/ in the vascularization area of the middle cerebral artery /MCA/ and the parameters Vs, Vm, Vd, PI, RI, R of the PUSG-G examination of these arteries in 50 patients aged 48-79 years treated for ischaemic cerebral episodes. Brain SPECT examination was done with Apex-SP-6-HR gamma camera assessing the distribution of 99mTc HMPAO marker in the vascularization area of both MCA. PUSG-D examination was done with Tc-2-64 unit. In both MCA the systolic Vs, the mean velocity Vm, the diastolic velocity Vd, the Gosling pulsation index PI, the Purcelot resistance index RI and the velocity amplitude R were measured. The following conclusions have been reached: 1/ in patients with ischaemic cerebral episodes a significant correlation was found between cerebral SPECT findings and the PUSG-D parameters; 2/ reduced perfusion of the cerebral tissue was correlated with lower values of Vs, Vm, Vd, and R and with higher values of PI and RI; 3/ slight disturbances of perfusion found in SPECT were not reflected in changed PUSG-D parameters; 4/ the results justify the use of PUSG-D for indirect assessment of blood flow in the MCA.

[The significance of scintigraphic, echocardiographic and electrocardiographic left atrial transesophageal pacing in diagnosis of ischemic heart disease]. / Znaczenie scyntygraficznego, echokardiograficznego i elektrokardiograficznego testu stymulacji przezprzelykowej lewego przedsionka w diagnostyce choroby niedokrwiennej serca.

UNLABELLED: The aim of the study was to compare the perfusion scintigraphy (using SPECT method with Tc-99-MIBI) during left atrial transoesophageal pacing test (LAPT) with pacing electrocardiography (ECG), echocardiography (ECHO) and electrocardiography exercise test (ExT) in ischaemic heart disease (IHD) diagnostics. The effect of LATP on heart haemodynamic parameters and the correlation between scintigraphic, echocardiographic and electrocardiographic parameters during LAPT test have been also assessed. Investigations were carried out in 55 subjects (Group I: 36 patients with effort angina pectoris; group II: controls: 19 clinically healthy subjects). Coronarography was performed in 24 patients 6 weeks before or after examinations. LATP test was analyzed with ECG, ECHO and SPECT. Echocardiography did not increase significantly the LATP test diagnostic value. Perfusion scintigraphy enhanced sensitivity and predictive excluding value LATP test. These values were 93.3% v 62.9% and 90% v 59.3% respectively. LATP test assessed with ECG, ECHO and perfusion scintigraphy expressed significantly higher sensitivity and predicting excluding value in comparison to ExT. LATP test analyzed in such way was characterized by 100% sensitivity and 100% predicting excluding value. CONCLUSION: Combination of LATP with electrocardiography, echocardiography and SPECT is a non-invasive high quality method for ischaemic heart disease diagnostics.