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See detailClinical added-value of 18FDG PET in neuroendocrine-merkel cell carcinoma
Belhocine, Tarik; Pierard, Gérald ULg; Frühling, Janos et al

in Oncology Reports (2006), 16(2), 347-352

Merkel cell carcinoma (MCC) is a rare and highly malignant skin cancer with neuroendocrine differentiation. We studied the potential value of 18FDG PET in the management of MCC. Eleven patients with MCC ... [more ▼]

Merkel cell carcinoma (MCC) is a rare and highly malignant skin cancer with neuroendocrine differentiation. We studied the potential value of 18FDG PET in the management of MCC. Eleven patients with MCC were examined by 18FDG PET and PET-CT for staging purpose (n=4) or for detection of recurrence (n=7). Qualitative and quantitative interpretation of PET studies was performed routinely. 18FDG PET observations were compared to clinical and radiological findings. In 6 patients, PET findings were also compared to histology. In 7 patients, the 18FDG tumor uptake was compared to the MCC proliferative activity expressed by the Ki-67 index. 18FDG PET was contributive in 10/11 MCC patients. In 7 patients, 18FDG PET detected focal lesions or a disseminated stage of the disease including dermal, nodal and visceral metastases. In 3 patients, a normal 18FDG PET confirmed complete remission of disease. Most MCC patients exhibited highly 18FDG-avid sites suggestive of increased glucose metabolism. This imaging pattern was related to a high proliferative activity (Ki-67 index >50%). In 1 patient with a weakly proliferative nodal MCC (Ki-67<10%), a false negative result was yielded by metabolic imaging. In 4/11 patients, 18FDG PET revealed an unsuspected second neoplasm in addition to MCC. It is concluded that whole-body 18FDG PET may be useful in the management of MCC patients. However, a normal 18FDG PET aspect cannot rule out MCC with low proliferative activity. [less ▲]

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See detailWhole-body positron emission tomography using fluorodeoxyglucose in patients with metastases of unknown primary tumours (CUP syndrome)
Alberini, J. L.; Belhocine, Tarik; Hustinx, Roland ULg et al

in Nuclear Medicine Communications (2003), 24(10), 1081-1086

The aim of this study was to evaluate the clinical performances of whole body 2-[F-18]fluorodeoxyglucose positron emission tomography (FDG PET) imaging for the detection of the primary tumour in patients ... [more ▼]

The aim of this study was to evaluate the clinical performances of whole body 2-[F-18]fluorodeoxyglucose positron emission tomography (FDG PET) imaging for the detection of the primary tumour in patients with metastases of unknown origin. Forty-one patients, without previous history of known cancer (18 women and 23 men; average age 64.1 years) with metastasis confirmed by histopathological analysis were included in a retrospective study. Results of PET were compared with those of techniques used in the current conventional diagnostic procedure. All known metastatic lesions were detected by PET. There were 26 true-positive and two false-negative results. Primary tumour remained undetermined in eight patients after conventional investigations and PET. PET was superior to conventional diagnostic procedure in 11 patients and led to modify treatment in 11 patients. Sensitivity of PET was superior than computed tomography in detecting abdominal primary tumours. FDG PET is useful in patients with unknown primary tumour because its sensitivity is good and it could modify the disease management. Otherwise, PET allows the evaluation of the extent of the disease and could be used to monitor treatment efficiency. Its contribution has to be evaluated particularly in patients with primary tumour with a specific treatment. ((C) 2003 Lippincott Williams Wilkins). [less ▲]

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See detailImaging of large vessel vasculitis with (18)FDG PET: illusion or reality? A critical review of the literature data
Belhocine, Tarik; Blockmans, Daniel; Hustinx, Roland ULg et al

in European Journal of Nuclear Medicine and Molecular Imaging (2003), 30(9), 1305-1313

Fluorine-18 fluorodeoxyglucose positron emission tomography ((18)FDG PET) plays a major role in the management of oncology patients. Owing to the singular properties of the glucose tracer, many patients ... [more ▼]

Fluorine-18 fluorodeoxyglucose positron emission tomography ((18)FDG PET) plays a major role in the management of oncology patients. Owing to the singular properties of the glucose tracer, many patients suffering from non-malignant diseases such as inflammatory or infectious diseases may also derive clinical benefit from the appropriate use of metabolic imaging. Large vessel vasculitides such as giant cell arteritis and Takayasu arteritis are other examples that may potentially extend the field of (18)FDG PET indications. The purpose of the present article is to assess the feasibility of metabolic imaging in vasculitis on the basis of the current literature data. In particular, the clinical context and the (18)FDG imaging patterns seen in patients with large vessel vasculitis are analysed in order to identify potential indications for metabolic imaging. [less ▲]

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See detailStaging of primary cervical cancers: the role of nuclear medicine
Belhocine, Tarik; Kridelka, Frédéric ULg; Thille, Alain ULg et al

in Critical Reviews in Oncology/Hematology (2003), 46(3), 275-284

In nuclear medicine, [F-18]-fluorodeoxyglucose positron emission tomography ((18)FDG PET) and lymphatic mapping and sentinel lymphadenectomy (LM/SL) may significantly improve the staging of primary ... [more ▼]

In nuclear medicine, [F-18]-fluorodeoxyglucose positron emission tomography ((18)FDG PET) and lymphatic mapping and sentinel lymphadenectomy (LM/SL) may significantly improve the staging of primary cervical cancers. Indeed, the disease progresses in a 'level by level' fashion to regional nodes through the lymphatic channels, and also to extra-nodal sites via the hematogenous stream. Additionally, the sub-optimal efficacy of routine radiological protocols, while new combined therapies are proving to be more efficient, stresses the need for alternative staging procedures. Current data suggest that LM/SL accurately reflects the regional lymph node status in early stage cervical cancers, and thus could avoid unnecessary complete lymphadenectomies. Also, whole body (18)FDG PET may provide valuable insights on extra-pelvic and distant tumor spreading, with a significant impact on treatment choices. If these promising results are confirmed on large controlled trials, LM/SL and (18)FDG PET imaging could be incorporated in the routine staging work-up of primary cervical cancers. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved. [less ▲]

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See detailUsefulness of F-18-FDG PET in the post-therapy surveillance of endometrial carcinoma
Belhocine, Tarik; De Barsy, Caroline; Hustinx, Roland ULg et al

in European Journal of Nuclear Medicine and Molecular Imaging (2002), 29(9), 1132-1139

The aim of this study was to assess the usefulness of fluorine-18 tluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) in the post-therapy surveillance of endometrial carcinomas. Forty-one ... [more ▼]

The aim of this study was to assess the usefulness of fluorine-18 tluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) in the post-therapy surveillance of endometrial carcinomas. Forty-one fully corrected whole-body PET studies were performed in 34 women with previously treated endometrial cancers as a part of their follow-up programme. In 28 studies, FDG PET was indicated to localise a recurrence suspected at the control visits on the basis of clinical examination and/or radiological abnormalities (chest X-ray, CT or MRI) and/or elevated tumour marker levels (CA125, CEA). Another 13 studies were performed as a simple surveillance procedure. Overall, in 26 studies PET detected recurrent disease, which was confirmed either by histology (n=7) or by clinical and radiological outcomes (n=19). In 88% of the cases, the PET findings confirmed recurrence suggested by routine follow-up. In the remaining 12% of cases, PET detected asymptomatic recurrences that were unsuspected at the control visits. Whole-body PET accurately localised the site of confirmed recurrences as being above and below the diaphragm in 50%, only below the diaphragm in 35% and only above the diaphragm in 15%. In one patient, however, PET missed microscopic lung metastases shown on thoracic CT, and in three studies, metabolic imaging results were not confirmed. In I I of 12 negative PET studies, no subsequent clinical or radiological recurrences were observed with a median follow-up of 10 months. Overall, the results of PET agreed well with the final diagnosis (Cohen's kappa coefficient =0.78). In 9/26 patients (35%) with confirmed recurrences, the PET findings significantly altered the treatment choice by detecting either clinically or radiologically unsuspected distant metastases. The sensitivity, specificity, diagnostic accuracy and positive and negative predictive values of FDG PET imaging in the post-therapy surveillance of endometrial carcinomas were 96%, 78%, 90%, 89% and 91 %, respectively. Indeed, the high likelihood ratio for a positive test result (4.5) and the low likelihood ratio for a negative test result (0.05) demonstrated the clinical utility of metabolic imaging in "ruling in" disease as well as "ruling out" recurrence. In conclusion, whole-body FDG PET appears useful in the post-therapy surveillance of endometrial cancers, both for the accurate localisation of suspected recurrences and for the detection of asymptomatic recurrent disease. [less ▲]

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See detailIncreased uptake of the apoptosis-imaging agent (99m)Tc recombinant human annexin V in human tumors after one course of chemotherapy as a predictor of tumor response and patient prognosis
Belhocine, Tarik; Steinmetz, Neil; Hustinx, Roland ULg et al

in Clinical Cancer Research : An Official Journal of the American Association for Cancer Research (2002), 8(9), 2766-2774

Purpose: Many anticancer therapies exert their therapeutic effect by inducing apoptosis in target tumors. We evaluated in a Phase I study the safety and the feasibility of Tc-99m-Annexin V for imaging ... [more ▼]

Purpose: Many anticancer therapies exert their therapeutic effect by inducing apoptosis in target tumors. We evaluated in a Phase I study the safety and the feasibility of Tc-99m-Annexin V for imaging chemotherapy-induced apoptosis in human cancers immediately after the first course of chemotherapy. Experimental Design: Fifteen patients presenting with lung cancer (n = 10), lymphoma (n = 3), or breast cancer (n = 2) underwent Tc-99m-Annexin V scintigraphy before and within 3 days after their first course of chemotherapy. Tumor response was evaluated by computed tomography and F-18-fluoro-2-deoxy-D-glucose positron emission tomography scans, 3 months in average after completing the treatment. Median follow-up was 117 days. Results: In all cases, no tracer uptake was observed before treatment. However, 24-48 h after the first course of chemotherapy, 7 patients who showed Tc-99m-Annexin V uptake at tumor sites, suggesting apoptosis, had a complete (n = 4) or a partial response In = 3). Conversely, 6 of the 8 patients who showed no significant posttreatment tumor uptake had a progressive disease. Despite the lack of tracer uptake after treatment, the 2 patients with breast cancer had a partial response. Overall survival and progression-free survival were significantly related to tracer uptake in treated lung cancers and lymphomas (P < 0.05). No serious adverse events were observed. Conclusions: Our preliminary results demonstrated the feasibility and the safety of Tc-99m-Annexin V for imaging apoptosis in human tumors after the first course of chemotherapy. Initial data suggest that early Tc-99m-Annexin V tumor uptake may be a predictor of response to treatment in-patients with late stage lung cancer and lymphoma. [less ▲]

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See detailFluorodeoxyglucose positron emission tomography and somatostatin receptor scintigraphy for diagnosing and staging carcinoid tumours: correlations with the pathological indexes p53 and Ki-67
Belhocine, Tarik; Willems, Jacqueline ULg; Rigo, Pierre ULg et al

in Nuclear Medicine Communications (2002), 23(8), 727-734

We performed this study in order to evaluate the diagnostic accuracy of whole-body fluorodeoxyglucose positron emission tomography (FDG PET) imaging and somatostatin receptor scintigraphy (SRS) for ... [more ▼]

We performed this study in order to evaluate the diagnostic accuracy of whole-body fluorodeoxyglucose positron emission tomography (FDG PET) imaging and somatostatin receptor scintigraphy (SRS) for localizing primary carcinoid tumours and evaluating the extent of the disease. A secondary aim was to correlate those findings with the histological characteristics of the lesions. FDG PET was performed in 17 patients and SRS in 16. All patients had pathologically proven carcinoids. All lesions were verified by histopathological analysis or by follow-up. Ki-67 and p53 expression were assessed as an indicator of the tumours' aggressiveness. FDG PET correctly identified 4/7 primary tumours and 8/11 metastatic spreads, as compared to six and 10 respectively, for SRS. Most tumours were typical carcinoids with low Ki-67 expression. No correlation was found between the histological features and the tracer's uptake. We conclude that SRS remains the modality of choice for evaluating patients with carcinoid tumours, regardless of their proliferative activity. FDG PET should be reserved to patients with negative results on SRS. ((C) 2002 Lippincott Williams Wilkins). [less ▲]

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See detailMaladie de Horton et atteintes arterielles extratemporales: utilite de la tomographie par emission de positons au 18FDG. A propos de trois observations et d'une revue de la litterature
Belhocine, Tarik; Kaye, Olivier; Delanaye, Pierre ULg et al

in Revue de Médecine Interne (2002), 23(7), 584-91

PURPOSE: We report three cases of Horton's disease, in which F18-Fluorine-2-Deoxy-D-Glucose (18FDG) positron emission tomography (PET) demonstrated a clinically unsuspected extra-cranial vessels ... [more ▼]

PURPOSE: We report three cases of Horton's disease, in which F18-Fluorine-2-Deoxy-D-Glucose (18FDG) positron emission tomography (PET) demonstrated a clinically unsuspected extra-cranial vessels hypermetabolism. METHODS: Fully corrected whole-body PET was performed in three patients (two women, one man) for exploring a marked inflammatory syndrome. Scanning was acquired 60 min after i.v. injection of 222 MBq of 18FDG in average. RESULTS: In two patients with histologically proven Horton's disease, PET alone showed increased glucose metabolism involving the carotid and sub-clavian arteries as well as the ascending aorta, aortic arch, thoracic and abdominal aorta, and the iliac and femoral arteries. In the third patient, by detecting cervical, thoracic and abdominal vessel hypermetabolism, PET non-invasively contributed to the diagnosis of giant cell arteritis. All patients had complete clinical and biological response to corticoids. PET controls performed 3- to 6-months post-treatment, confirmed the disappearance of the metabolic stigma. CONCLUSION: 18FDG PET may show an increased glucose metabolism in asymptomatic extracranial vessels locations of Horton's arterities. If these observations are confirmed on controlled trials, PET could be particularly useful for non-invasive diagnosing, staging and monitoring atypical clinical forms of Horton's disease. The metabolic imaging could also contribute to a better understanding of the pathogenesis of GCA. [less ▲]

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See detailStaging of regional nodes in AJCC stage I and II melanoma: 18FDG PET imaging versus sentinel node detection.
Belhocine, Tarik; Pierard, Gérald ULg; De Labrassinne, Michel et al

in Oncologist (2002), 7(4), 271-8

PRIMARY PURPOSE: The staging of regional nodes by means of sentinel node detection has been shown to accurately detect subclinical nodal metastases from cutaneous melanoma. On the other hand, the ... [more ▼]

PRIMARY PURPOSE: The staging of regional nodes by means of sentinel node detection has been shown to accurately detect subclinical nodal metastases from cutaneous melanoma. On the other hand, the oncological applications of 18F-fluoro-2-deoxy-D-glucose positron emission tomography (18FDG PET) are, nowadays, firmly established. However, the sensitivity of such metabolic imaging for staging the regional nodes in primary melanoma remains debatable. We prospectively assessed the actual value of PET for detecting sentinel node metastases in 21 consecutive patients presenting with early-stage melanoma. MATERIALS AND METHODS: Twenty-one melanoma patients scheduled for lymphatic mapping and sentinel lymphadenectomy underwent fully corrected whole-body PET using 18FDG. In all cases, the disease was initially classified as either stage I or II, from the latest version of the American Joint Committee on Cancer staging system. The sentinel node detection was systematically performed within the week following the PET scan. Serial sections of the sentinel nodes were analyzed by both conventional pathology and immunohistochemical staining. Metastatic sentinel nodes were also assessed for the size of tumor deposits and the degree of nodal involvement (focal, partial, or massive). The median follow-up time was 12 months. RESULTS: Six of the 21 patients (28.5%) had an involved sentinel node. PET was positive in only one case with a sentinel node >1 cm. In the five other cases, the sentinel nodes missed by PET were <1 cm with focal and/or partial involvements. One patient, free of regional nodal metastases in both sentinel node detection and PET imaging, had, however, a same-basin recurrence 3 months later. In another case, PET had one false positive result. Overall, the sentinel detection of subclinical nodal metastases had a sensitivity of 86%. PET detected only 14% of sentinel node metastases. CONCLUSIONS: Sentinel node detection remains the procedure of choice for detecting subclinical lymph node involvement from primary cutaneous melanoma. Owing to its limited spatial resolution, PET appears insufficiently sensitive to identify microscopic nodal metastases. As a practical consequence, metabolic imaging is not recommended as a first-line imaging strategy for staging regional lymph nodes in patients with stage I or II melanoma. [less ▲]

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See detailApport de la tomographie par émission de positons pour la détection des tumeurs primitives lors de la découverte de métastases
Albérini, Jean-Louis; Belhocine, Tarik; Daenen, Frédéric ULg et al

in Bulletin du Cancer (2001), 88(5), 518-519

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See detailPlace de la tomographie d'émission de positons dans le suivi thérapeutique du cancer du sein
Jerusalem, Guy ULg; Belhocine, Tarik; Silvestre, Rose-Marie et al

in Médecine Nucléaire : Imagerie Fonctionnelle et Métabolique (2001), 25(6), 341-346

La tomographie à émission de positons (TEP) au 18F-fluorodeoxyglucose (FDG) fait l'objet d'un nombre croissant d'applications cliniques en oncologie surtout dans le bilan d'extension et le bilan de fin de ... [more ▼]

La tomographie à émission de positons (TEP) au 18F-fluorodeoxyglucose (FDG) fait l'objet d'un nombre croissant d'applications cliniques en oncologie surtout dans le bilan d'extension et le bilan de fin de traitement. Un domaine très prometteur mais peu étudié est l'utilisation de la TEP dans l'évaluation thérapeutique précoce. Nous passons en revue les données de la littérature concernant la place de la TEP dans l'évaluation précoce de la réponse thérapeutique chez des patientes atteintes de cancer du sein. La TEP permet d'identifier précocement les patientes qui ont une grande probabilité de présenter une réponse tumorale facorable à une chimiothérapie néoadjuvante (chimiothérapie première). Cependant, non propres travaux chez des patientes atteintes de cancer du sein métastatique sont moins prometteurs. La poursuite des travaux de recherche est indispensable pour mieux connaître le bénéfice réel et les limites d'une évaluation thérapeutique précoce. [less ▲]

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See detailTomographie a emission de positons au 18FDG et adenocarcinome pancreatique
Daenen, Frédéric ULg; Hustinx, Roland ULg; Belhocine, Tarik et al

in Revue Médicale de Liège (2000), 55(2), 89-94

FDG-PET imaging non invasively studies the glucose metabolism which is usually increased in malignant lesions. We evaluated the clinical performance of PET for detecting pancreatic cancer and its ... [more ▼]

FDG-PET imaging non invasively studies the glucose metabolism which is usually increased in malignant lesions. We evaluated the clinical performance of PET for detecting pancreatic cancer and its recurrence. In our series of 24 studies, PET appears to complement other imaging modalities. As compared to CT, in particular, it demonstrated fewer false positive results in the pancreas and it was also more sensitive. Moreover, whole-body FDG-PET allows for the entire staging of the disease. [less ▲]

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See detailTEP et tumeurs endocrines
Rigo, Pierre ULg; Belhocine, Tarik; Hustinx, Roland ULg et al

in Médecine Nucléaire : Imagerie Fonctionnelle et Métabolique (2000), 24(5), 275-282

Les auteurs passent en revue les indications de la TEP et en particulier du 18FDG dans l'évaluation des diverses tumeurs endocrines de la thyroïde, des parathyroïdes, des surrénales et de l'hyophyse. Les ... [more ▼]

Les auteurs passent en revue les indications de la TEP et en particulier du 18FDG dans l'évaluation des diverses tumeurs endocrines de la thyroïde, des parathyroïdes, des surrénales et de l'hyophyse. Les tumeurs neuroendocrines, gastroentéropancréatiques et carcinoïdes, sont également analysées. Habituellement, les tumeurs différenciées ayant une faible activité métabolique et proliférative, elles ne fixent que peu le FDG. Dans l'évaluation des tumeurs endocrines, la TEP au FDG n'intervient en général pas en première intention mais elle joue un rôle complémentaire d'autres scintigraphies spécifiques. [less ▲]

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See detailEvaluation thérapeutique précoce par tomographie à émission de positons
Jerusalem, Guy ULg; Beguin, Yves ULg; Fassotte, Marie-France ULg et al

in Médecine et Hygiène (2000), 58

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See detailPET for carcinomas of the genitourinary system
Belhocine, Tarik; Hustinx, Roland ULg; Devillers, Céline ULg et al

in Khakhali, I.; Laublant, J.; Goldsmith, S. J. (Eds.) NUCLEAR ONCOLOGY : DIAGNOSIS AND THERAPY (2000)

This book is intended to provide the state-of-the-art in the present knowledge of the fast growing field of nuclear oncology. The enormous sum of data it gathers is presented by the leading authors in ... [more ▼]

This book is intended to provide the state-of-the-art in the present knowledge of the fast growing field of nuclear oncology. The enormous sum of data it gathers is presented by the leading authors in their respective fields. Recent breakthrough as well as validated techniques are explained in details. Among the most stimulating issues, it becomes clear that the long awaited era of radioimmunotherapy is finally coming to reality and is close to enter into routine clinical use. Several chapters are devoted to this future important aspect of our practice. They should allow the reader to become quickly and completely informed about the main results of the recent trials and also to comprehend the expected evolutions in this field. Positron emission tomography (PET) also occupies a large place. Numerous illustrations help the reader to appreciate the wide capabilities of this technique. The more usual radiopharmaceuticals labeled by single photons emitters are not forgotten and all the aspects of the daily practice of nuclear oncology are covered, from thyroid and bone imaging to sentinel lymph node detection. The first part of the book covers transversally the field of nuclear oncology. A radiopharmaceuticals chapter provides an in-depth review of the properties and chemistry of the single-photon and positron emitters radionuclides. The various mechanisms of localization are also described at the membrane level as well as for metabolic substrates. The properties of the agents aiming at hormone receptors and tumor antigens are excellently described, as well as the recently introduced gene expression imaging. Multidrug resistance (MDR) is divided in two parts. The breast cancer chapter retraces the history and background of sestamibi in the detection of MDR. It also describes the methodology and clinical results of the most important scintigraphic studies that have demonstrated the possibility to detect the early development of resistance to chemotherapy. An interesting series of other agents with a high potential in this indication, particularly positron emitters, is discussed. The role of technetium and positron agents for MDR detection in other tumor localisations, especially in the lung, is also well covered. An instrumentation chapter goes through the fundamentals of planar and SPECT imaging, and also presents the new reconstruction and correction algorithms. A large section is occupied by positron imaging. The pros and cons of dedicated detector and camera coincidence are very well detailed. This part should definitely help to decide those who are trying to make a choice between these two options. The general principles of radiolabeled monoclonal antibodies imaging and therapy are covered in two very interesting chapters. Then radiotherapy of painful bone metastases compares the capabilities of the various agents available. A large chapter deals with pediatric nuclear oncology, in particular neuroblastoma, bone and central nervous system tumors. Finally, the often forgotten role of nuclear medicine in the detection, and possibly in the prevention, of the cardiotoxicity and nephrotoxicity resulting from cancer therapy are addressed at the end of that first part. The second part of the book goes by organ and begins by addressing brain tumors. A vast chapter is devoted to PET imaging. Besides the tracers and instrumentation issues, patient management occupies a central place, in particular with discussion on the role of nuclear medicine in tissue characterization, treatment planning and assessment of treatment response. Cerebrospinal fluid and shunt imaging are described, with particular attention paid to ventriculoperitoneal shunts. After PET imaging of head and neck carcinoma, a chapter extensively reviews thyroid carcinoma. Iodine therapy and long-term monitoring are covered with great details and useful practical recommendations are provided. Emerging radioimmunotherapy is discussed apart. Parathyroid scintigraphy also occupies a large and well documented chapter. PET imaging of lung carcinoma is particularly well illustrated by several cases. The potential of peptide scintigraphy is presented. Breast cancer occupies five chapters, namely, scintimammography, PET imaging, lymphatic mapping, monoclonal antibody imaging and radionuclide therapy. This provides an extensive review of the present and potential possibilities of nuclear medicine in one of the most frequent tumors. Then the role of PET imaging and the capabilities of radioimmunotherapy for maligancies of the gastrointestinal and genitourinary tracts are presented, in particular in two chapters entirely dedicated to prostate carcinoma and in two others to ovarian carcinoma. Radiolabeled somatostatin analogues and their value in the diagnosis and treatment of the neuroendocrine tumors are reviewed. Hepatic neoplasia are addressed through the utilization of technetium-labeled galactosyl neoglycoalbumin and hepatic artery infusion. For lymphomas, besides gallium and PET imaging, a very complete chapter is devoted to monoclonal antibody therapy. The extremely promising results obtained with several radiolabeled-anti-CD monoclonal antibodies in the treatment of B-cell non-Hodgkin’s lymphomas are reviewed in depth. Additional chapters cover adrenal tumors, melanoma, musculoskeletal tumors, in particular imaging of bone metastases. This comprehensive, didactic, up-to-date, well illustrated review of nuclear oncology should help nuclear medicine physicians as well as oncologists to optimize their practice. This book is intended to provide the state-of-the-art in the present knowledge of the fast growing field of nuclear oncology. The enormous sum of data it gathers is presented by the leading authors in their respective fields. Recent breakthrough as well as validated techniques are explained in details. Among the most stimulating issues, it becomes clear that the long awaited era of radioimmunotherapy is finally coming to reality and is close to enter into routine clinical use. Several chapters are devoted to this future important aspect of our practice. They should allow the reader to become quickly and completely informed about the main results of the recent trials and also to comprehend the expected evolutions in this field. Positron emission tomography (PET) also occupies a large place. Numerous illustrations help the reader to appreciate the wide capabilities of this technique. The more usual radiopharmaceuticals labeled by single photons emitters are not forgotten and all the aspects of the daily practice of nuclear oncology are covered, from thyroid and bone imaging to sentinel lymph node detection. The first part of the book covers transversally the field of nuclear oncology. A radiopharmaceuticals chapter provides an in-depth review of the properties and chemistry of the single-photon and positron emitters radionuclides. The various mechanisms of localization are also described at the membrane level as well as for metabolic substrates. The properties of the agents aiming at hormone receptors and tumor antigens are excellently described, as well as the recently introduced gene expression imaging. Multidrug resistance (MDR) is divided in two parts. The breast cancer chapter retraces the history and background of sestamibi in the detection of MDR. It also describes the methodology and clinical results of the most important scintigraphic studies that have demonstrated the possibility to detect the early development of resistance to chemotherapy. An interesting series of other agents with a high potential in this indication, particularly positron emitters, is discussed. The role of technetium and positron agents for MDR detection in other tumor localisations, especially in the lung, is also well covered. An instrumentation chapter goes through the fundamentals of planar and SPECT imaging, and also presents the new reconstruction and correction algorithms. A large section is occupied by positron imaging. The pros and cons of dedicated detector and camera coincidence are very well detailed. This part should definitely help to decide those who are trying to make a choice between these two options. The general principles of radiolabeled monoclonal antibodies imaging and therapy are covered in two very interesting chapters. Then radiotherapy of painful bone metastases compares the capabilities of the various agents available. A large chapter deals with pediatric nuclear oncology, in particular neuroblastoma, bone and central nervous system tumors. Finally, the often forgotten role of nuclear medicine in the detection, and possibly in the prevention, of the cardiotoxicity and nephrotoxicity resulting from cancer therapy are addressed at the end of that first part. The second part of the book goes by organ and begins by addressing brain tumors. A vast chapter is devoted to PET imaging. Besides the tracers and instrumentation issues, patient management occupies a central place, in particular with discussion on the role of nuclear medicine in tissue characterization, treatment planning and assessment of treatment response. Cerebrospinal fluid and shunt imaging are described, with particular attention paid to ventriculoperitoneal shunts. After PET imaging of head and neck carcinoma, a chapter extensively reviews thyroid carcinoma. Iodine therapy and long-term monitoring are covered with great details and useful practical recommendations are provided. Emerging radioimmunotherapy is discussed apart. Parathyroid scintigraphy also occupies a large and well documented chapter. PET imaging of lung carcinoma is particularly well illustrated by several cases. The potential of peptide scintigraphy is presented. Breast cancer occupies five chapters, namely, scintimammography, PET imaging, lymphatic mapping, monoclonal antibody imaging and radionuclide therapy. This provides an extensive review of the present and potential possibilities of nuclear medicine in one of the most frequent tumors. Then the role of PET imaging and the capabilities of radioimmunotherapy for maligancies of the gastrointestinal and genitourinary tracts are presented, in particular in two chapters entirely dedicated to prostate carcinoma and in two others to ovarian carcinoma. Radiolabeled somatostatin analogues and their value in the diagnosis and treatment of the neuroendocrine tumors are reviewed. Hepatic neoplasia are addressed through the utilization of technetium-labeled galactosyl neoglycoalbumin and hepatic artery infusion. For lymphomas, besides gallium and PET imaging, a very complete chapter is devoted to monoclonal antibody therapy. The extremely promising results obtained with several radiolabeled-anti-CD monoclonal antibodies in the treatment of B-cell non-Hodgkin’s lymphomas are reviewed in depth. Additional chapters cover adrenal tumors, melanoma, musculoskeletal tumors, in particular imaging of bone metastases. This comprehensive, didactic, up-to-date, well illustrated review of nuclear oncology should help nuclear medicine physicians as well as oncologists to optimize their practice. [less ▲]

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See detailAn Appraisal of 18-Fluorodeoxyglucose Positron Emission Tomography for Melanoma Staging
Paquet, Philippe ULg; Henry, Frédérique ULg; Belhocine, Tarik et al

in Dermatology : International Journal for Clinical & Investigative Dermatology (2000), 200(2), 167-9

BACKGROUND: Positron emission tomography (PET scan) using fluorodeoxyglucose (FDG) is increasingly recognized as a reliable diagnostic method to detect metastases of malignant melanoma (MM). OBJECTIVE: To ... [more ▼]

BACKGROUND: Positron emission tomography (PET scan) using fluorodeoxyglucose (FDG) is increasingly recognized as a reliable diagnostic method to detect metastases of malignant melanoma (MM). OBJECTIVE: To compare the diagnostic performance of 18-FDG PET scan to that of conventional imaging. METHODS: A total of 28 assessments were conducted in 24 patients at risk of metastatic MM. Results: The diagnostic accuracy was over 80% and similar for PET scan and conventional imaging. CONCLUSION: Both the specificity and sensitivity of PET scan are high although not perfect. Confrontation of data with anatomical location and clinicopathological findings remains mandatory. [less ▲]

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