Supplementary Figure 2 - PDF file 34K, Kaplan Meier curve (along with number of patients at risk for each group over time) showing the proportion of patients surviving for treatment in the validation data-set

Supplementary Figure 1 - PDF file 49K, The 2-D forms of the LoG filter in the spatial and frequency domain at filter value of 2.0

CCR Translation for This Article from Sequential FDG-PET/CT as a Biomarker of Response to Sunitinib in Metastatic Clear Cell Renal Cancer

Appendix - PDF file 148K, This section contains technical and statistical information regarding textural analysis, as well as supplementary survival analysis

Supplementary Table 1 - PDF file 38K, Data to supplement Kaplan Meier curve in Supplementary Figure2

Discutem-se os mecanismos que presidem a obtenção de imagens por métodos não invasivos (medicina nuclear, ultrassonografia, tomografia computorizada de transmissão e de emissão). Introduzem-se definições para sensibilidade, especificidade, valor de previsão e precisão. Defendem-se estratégias de diagnóstico clínico para lesões ocupantes de espaço e sugerem-se orientações para futuro desenvolvimento.

Institute of Nuclear Medicine, University College London Hospitals NHS Foundation Trust, London, UK Received 26 June 2019 Accepted 27 June 2019 Correspondence to Jamshed B. Bomanji, MBBS, PhD, FRCR, FRCP, Institute of Nuclear Medicine, Tower 5, University College London Hospital, 235 Euston Road, London, NW1 2BU, UK, Tel: +44 20 3447 0528; fax: +44 20 3447 0596; e-mail:[email protected]

There is a lack of prognostic biomarkers in idiopathic pulmonary fibrosis (IPF) patients. The objective of this study is to investigate the potential of 18F-FDG-PET/ CT to predict mortality in IPF.

Ga-68-DOTATATE PET/CT scanning is a widely accepted method for imaging of neuroendocrine tumors. This cross-sectional study was performed to review the first 8 y of patient data from a large Ga-68-DOTATATE PET/CT database in order to establish the impact of the modality on patient treatment and survival. Methods: Demographic data, clinical outcome, survival, and change in management after Ga-68-DOTATATE PET/CT were evaluated. Results: Between May 2005 and August 2013, 1,258 Ga-68-DOTATATE PET/CT scans were obtained in 728 patients with confirmed or suspected neuroendocrine tumors. In most patients, the primary site was located in the midgut (26.4%). Analysis of NET grading in patients with known histopathologic data revealed that 35.7% had NET grade G1, 12.2% G2, and 8.7% G3. The most common indications for Ga-68-DOTATATE PET/CT were follow-up (24.4%) and initial tumor staging (23.4%). Of the 1,258 Ga-68-DOTATATE PET/CT scans completed, 75.7% were positive and 24.3% negative; there were 14 false-positive and 29 false-negative scans. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 97%, 95.1%, 96.6%, 98.5%, and 90.4%, respectively. In 40.9% of patients, the treatment plan was changed after the scans, owing mainly to new, unexpected findings. Statistically significant differences in survival were shown between patients with G1, G2, and G3 grade tumors (P < 0.0001) and also between patients with bone metastasis versus patients with soft-tissue metastasis (P < 0.0001). Conclusion: Ga-68-DOTATATE PET/CT scanning is safe and influences management in a large proportion of patients. Prognosis was dependent on tumor grade, and the presence of bone metastasis was associated with worse overall survival.

In the UK, the institute of Nuclear Medicine in London has played an important role in the development of radionuclide investigation of brain. This chapter summarises the very early days of blood brain barrier imaging with labelled pertechnetate, and the use of 3" and 5" sodium iodide crystal scanners in the 60’s, with added simple data processing in the 70’s, progress was continuous, with the introduction of SPET, lyphophilic Tc99m labelled tracers for blood flow studies, the emergence of dopamine transporter imaging in patients with presumed Parkinson’s disease, followed by PET/CT and assessment of glucose metabolism with labelled FDG, and finally the UK introduction of PET/MR and the investigation of the dementias, with labelled amyloid.

BACKGROUND:Simultaneous PET-MRI is used to compare patterns of cerebral hypometabolism and atrophy in six different dementia syndromes.OBJECTIVES:The primary objective was to conduct an initial exploratory study regarding the concordance of atrophy and hypometabolism in syndromic variants of Alzheimer's disease (AD) and frontotemporal dementia (FTD). The secondary objective was to determine the effect of image analysis methods on determination of atrophy and hypometabolism.METHOD:PET and MRI data were acquired simultaneously on 24 subjects with six variants of AD and FTD (n = 4 per group). Atrophy was rated visually and also quantified with measures of cortical thickness. Hypometabolism was rated visually and also quantified using atlas- and SPM-based approaches. Concordance was measured using weighted Cohen's kappa.RESULTS:Atrophy-hypometabolism concordance differed markedly between patient groups; kappa scores ranged from 0.13 (nonfluent/agrammatic variant of primary progressive aphasia, nfvPPA) to 0.49 (posterior cortical variant of AD, PCA). Heterogeneity was also observed within groups; the confidence intervals of kappa scores ranging from 0-0.25 for PCA to 0.29-0.61 for nfvPPA. More widespread MRI and PET changes were identified using quantitative methods than on visual rating.CONCLUSION:The marked differences in concordance identified in this initial study may reflect differences in the molecular pathologies underlying AD and FTD syndromic variants but also operational differences in the methods used to diagnose these syndromes. The superior ability of quantitative methodologies to detect changes on PET and MRI, if confirmed on larger cohorts, may favor their usage over qualitative visual inspection in future clinical diagnostic practice.

Patients with idiopathic pulmonary fibrosis (IPF) show increased PET signal at sites of morphological abnormality on high-resolution computed tomography (HRCT). The purpose of this investigation was to investigate the PET signal at sites of normal-appearing lung on HRCT in IPF.

Purpose: To investigate the utility of 18F-fluorodeoxyglucose Positron Emission Tomography (FDG PET) in helping decision making for epilepsy surgery.Methods: All patients with medically refractory focal epilepsy and MRI that was normal or discordant with clinical and EEG data underwent FDG PET. FDG PET scans were reported by two investigators blinded to clinical data using visual assessment aided by the semiquantitative assessment. All clinical, MRI and FDG PET data were reviewed in the multidisciplinary patient management conferences for the localization and further decisions, which were recorded in the electronic database. For this study, we reviewed the charts of all these patients to decide the usefulness of PET in further decision making. FDG PET was considered to be useful if led directly to surgery, helped in planning intracranial EEG or helped in excluding patients from further evaluation.Results: 194 consecutive adult patients (median age, 32.5 years) underwent FDG PET; 158 had normal MRI, 12 had subtle MRI abnormalities and 24 had discordant non-invasive data. Final localization was temporal lobe epilepsy (TLE, n = 64), frontal lobe epilepsy (FLE, n = 66), temporal-plus epilepsy (n = 26) and other extratemporal lobe epilepsies (ETE, n = 38). PET scans were normal in 72 (37%) patients, showed unifocal hypometabolism in 98 (50.5%) and bilateral hypometabolism in 24 (12%) patients. The TLE group had a higher proportion of abnormal PET scans (67%) than FLE (52%) and ETE (61%). PET data were useful in 103 (53%) patients, more in TLE (63%) than FLE (38%) or ETE (50%). It led directly to surgery in 12 (6%) cases, helped in planning intracranial EEG in 67 (35%) patients and excluded 24 (12%) patients from further evaluation. Focal hypometabolism on FDG PET increased the odds of being selected for surgery or intracranial EEG by five fold [odds ratio, 5.1 (2.8-9.4); p < 0.0001].Conclusions: FDG PET scan can help decision making in 53% of presurgical patients with normal or discordant MRI. PET findings need to be evaluated in conjunction with other data. (C) 2014 Elsevier B.V. All rights reserved.