Nuclear imaging, also called molecular imaging, includes positron emission computed tomography (PET) and single photon emission computed tomography (SPECT) imaging. This section includes radiopharmaceuticals and tracers, PET-CT, SPECT-CT, and PET-MRI. Molecular imaging includes the field of nuclear medicine, which uses very small amounts of radioactive materials, or radiopharmaceuticals, to diagnose and treat disease.
Staging F18FDG PET/CT images of adenocarcinoma in the RUL (right upper lobe) of the lung illustrates the value of Vereos. The primary lesion in the right upper lobe appears in the upper row (PET image is left, CT image is right). A 3 mm synchronous primary or metastatic lesion in the RUL is apparent in the lower row. The precision afforded by Vereos' images provided the basis for the patient to undergo RUL lobectomy instead of thermal ablation of the primary lesion. (Images courtesy of Dr. Jay Kikut and UVMC)
Transaxial 11Csarcosine hybrid PET/CT showed a (triangulated) adenocarcinoma in the transition zone of the anterior right prostate gland on PET (A), CT (B), and a separately obtained T2?weighted MR sequence (C) with resulting PET/MRI registration (D). Image courtesy of M. Piert et al., University of Michigan, Ann Arbor, Mich.
Example of a patient with an upper left lung NSCLC: A: FDG; B: FDG PET/CT; C: Planning radiotherapy based on FDG (66Gy) with BTVm (GTV), CTV and PTV; D: PET FMISO E: FMISO PET/CT; F: boost based on the FMISO PET (76Gy) with BTVh (biological hypoxic target volume) and PTV boost. Credit: QuantIF – LITIS EA 4108 – FR CNRS 3638, Henri Becquerel Cancer Center, Rouen, France
PET images (MIP 0-60 min) of three Cynomolgus monkeys. Strong signals are detected at the sites where inserted catheters had roughened surfaces. Almost no other background signal is visible. Only accumulation in the gallbladder becomes visible at the bottom of the image. Credit: Piramal Imaging GmbH, Berlin Germany.
WLE specimen from a patient with a grade 3, ER-/HER2-, no special type (NST) carcinoma. (A) Cerenkov image; (B) Grey-scale photographic image overlaid with Cerenkov signal. An increased signal from the tumor is visible (white arrows); mean radiance is 871 ± 131 photons/s/cm2/sr, mean TBR is 3.22. Both surgeons measured the posterior margin (outlined in blue) as 2 mm (small arrow); a cavity shaving would have been performed if the image had been available intraoperatively. The medial margin (outlined in green) measured >5 mm by both surgeons. Pathology ink prevented assessing the lateral margin; a phosphorescent signal is visible (open arrows). (C) Specimen radiography image. The absence of one surgical clip to mark the anterior margin, and the odd position of the superior margin clip (white arrow) prevented reliable margin assessment. (D) Combined histopathology image from two adjacent pathology slides on which the posterior margin (bottom of image) and part of the primary tumor are visible (open arrows). The distance from the posterior margin measured 3 mm microscopically (double arrow). The medial margin is > 5 mm (not present in image). Credit: A. D. Purushotham, M.D., King’s College London, UK
IMAGE OF THE YEAR: Dual-labeled PSMA-inhibitors for the diagnosis and therapy of prostate cancer. Technology of dual-labeled PSMA-inhibitors for PET/CT imaging and fluorescence-guided intraoperative identification of metastases. This work might help to establish a new treatment regimen for more precise and sensitive pre-, intra- and post-therapeutic detection of prostate cancer.
Credit: Courtesy of A. Baranski, M. Schäfer, U. Bauder-Wüst, M. Roscher, J. Schmidt, E. Stenau, L. Maier-Hein, M. Eder, K. Kopka, German Cancer Research Center, Heidelberg, Germany; T. Simpfendörfer, B. Hadaschik, U. Haberkorn, Heidelberg University Hospital, Heidelberg, Germany; PET-image: Afshar-Oromieh et al., EJNMMI 2013; 40(4); STED-image: J. Matthias, German Cancer Research Center.
This study was supported by the VIP+ fund, Federal Ministry of Education & Research (BMBF), Germany.
Scientific Paper 531: “Preclinical evaluation of dual-labeled PSMA-inhibitors for the diagnosis and therapy of prostate cancer.” A. Baranski, M. Schäfer, U. Bauder-Wüst, M. Roscher, J. Schmidt, E. Stenau, L. Maier-Hein, M. Eder, K. Kopka, German Cancer Research Center (DKFZ), Heidelberg, Germany; T. Simpfendörfer, B. Hadaschik, U. Haberkorn, University Hospital, Heidelberg, Germany. Presented at SNMMI’s 64th Annual Meeting, June 10-14, 2017, Denver, Colo.
Axial fused 89Zr-5B1 antibody PET/CT image demonstrates focus of uptake in the liver (arrow). Focus of uptake correlates with increased liver metastasis seen on diagnostic CT (red arrow) performed 2 weeks prior. Image courtesy of Christian Lohrmann, Jason Lewis, Wolfgang Weber, Memorial Sloan Kettering Cancer Center; MabVax Therapeutics