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1. When to perform positron emission tomography/computed tomography or radionuclide bone scan in patients with recently diagnosed prostate cancer

Author

Caldarella C, Treglia G, Giordano A, and Giovanella L

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Carmelo Caldarella,1 Giorgio Treglia,2 Alessandro Giordano,1 Luca Giovanella2 1Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Rome, Italy; 2Department of Nuclear Medicine and PET/CT Centre, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland Abstract: Skeletal metastases are very common in prostate cancer and represent the main metastatic site in about 80% of prostate cancer patients, with a significant impact in patients' prognosis. Early detection of bone metastases is critical in the management of patients with recently diagnosed high-risk prostate cancer: radical treatment is recommended in case of localized disease; systemic therapy should be preferred in patients with distant secondary disease. Bone scintigraphy using radiolabeled bisphosphonates is of great importance in the management of these patients; however, its main drawback is its low overall accuracy, due to the nonspecific uptake in sites of increased bone turnover. Positron-emitting radiopharmaceuticals, such as fluorine-18-fluorodeoxyglucose, choline-derived drugs (fluorine-18-fluorocholine and carbon-11-choline) and sodium fluorine-18-fluoride, are increasingly used in clinical practice to detect metastatic spread, and particularly bone involvement, in patients with prostate cancer, to reinforce or substitute information provided by bone scan. Each radiopharmaceutical has a specific mechanism of uptake; therefore, diagnostic performances may differ from one radiopharmaceutical to another on the same lesions, as demonstrated in the literature, with variable sensitivity, specificity, and overall accuracy values in the same patients. Whether bone scintigraphy can be substituted by these new methods is a matter of debate. However, greater radiobiological burden, higher costs, and the necessity of an in-site cyclotron limit the use of these positron emission tomography methods as first-line investigations in patients with prostate cancer: bone scintigraphy remains the mainstay for the detection of bone metastases in current clinical practice. Keywords: bone metastases, prostate cancer, bisphosphonates, positron emission tomography

Published
2013

10. Charge redistribution at Pd surfaces: ab initio grounds for tight-binding interatomic potentials

Author

Sawaya, S., Goniakowski, J., Mottet, C., Saul, A., and Treglia, G.

Subjects
Condensed Matter
Abstract

A simplified tight-binding description of the electronic structure is often necessary for complex studies of surfaces of transition metal compounds. This requires a self-consistent parametrization of the charge redistribution, which is not obvious for late transition series elements (such as Pd, Cu, Au), for which not only d but also s-p electrons have to be taken into account. We show here, with the help of an ab initio FP-LMTO approach, that for these elements the electronic charge is unchanged from bulk to the surface, not only per site but also per orbital. This implies different level shifts for each orbital in order to achieve this orbital neutrality rule. Our results invalidate any neutrality rule which would allow charge redistribution between orbitals to ensure a common rigid shift for all of them. Moreover, in the case of Pd, the power law which governs the variation of band energy with respect to coordination number, is found to differ significantly from the usual tight-binding square root., Comment: 6 pages, 2 figures, Latex; Phys.Rev. B 56 (1997)

Published
1997
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12. Update on Management of Medullary Thyroid Carcinoma: Focus on Nuclear Medicine

Author

Treglia, G., Rufini, Vittoria, Piccardo, A., Imperiale, A., Rufini V. (ORCID:0000-0002-2052-8078), Treglia, G., Rufini, Vittoria, Piccardo, A., Imperiale, A., and Rufini V. (ORCID:0000-0002-2052-8078)

Abstract

Currently, there is a discrepancy among the available guidelines on the usefulness of nuclear medicine techniques in medullary thyroid cancer (MTC) diagnosis and treatment. Aim of this review is to provide an update on diagnostic and therapeutic nuclear medicine techniques in this setting. Evidence-based data clearly demonstrates the usefulness of PET/CT with different radiopharmaceuticals in recurrent MTC (in particular when serum calcitonin is higher than 150 pg/mL or calcitonin doubling time is shortened) and 18F-FDOPA should be the preferred PET radiopharmaceutical. If 18F-FDOPA PET/CT is negative or unavailable, 18F-FDG PET/CT or 68Ga-DOTA-peptides PET/CT could be performed for MTC restaging. There is currently insufficient evidence to recommend PET/CT with several radiopharmaceuticals for MTC staging. Clinical experience on PET/MRI with different radiopharmaceuticals in MTC is still limited. Several investigational nuclear medicine therapeutic options are currently under evaluation in metastatic MTC. More data are needed to evaluate the efficacy, toxicity, and role of these therapeutic options in the management of MTC patients.

Published
2023

15. A role of FDG PET/CT for Response Assessment in Large Vessel Disease?

Author

Treglia, G., Albano, D., Dondi, F., Bertagna, F., and Gheysens, O.

Subjects
Humans, Fluorodeoxyglucose F18, Positron Emission Tomography Computed Tomography/methods, Positron-Emission Tomography, Vasculitis, Radiopharmaceuticals
Abstract

Currently, a large amount of evidence-based data clearly demonstrates the usefulness of [ 18 F]FDG PET/CT in the diagnosis of several infectious and inflammatory diseases, including those related to the large vessels. The aim of this article is to clarify whether, beyond initial diagnosis, [ 18 F]FDG PET/CT may have a role in treatment response assessment in inflammatory or infectious diseases of the large vessels, including large vessel vasculitis, vascular graft infection, retroperitoneal fibrosis/chronic periaortitis and infective native aortic aneurysms. Rapidly accumulating data suggest that [ 18 F]FDG PET/CT could be a valuable imaging method for therapy monitoring in some infectious and inflammatory diseases of large vessels. The available data, albeit preliminary, indicate that [ 18 F]FDG PET/CT could even play a pivotal role in the management of these diseases, leading to better drug dosage, confirmation of the usefulness of the treatment, and early modification of the therapeutic strategy. However, to date, the role of [ 18 F]FDG PET/CT for treatment assessment in large vessel diseases, in particular large vessel vasculitis, is not clearly defined and well-designed prospective studies are needed to confirm its possible role in treatment monitoring and treatment guidance.

Published
2023

16. Neurological complications of rotavirus infection in children: a systematic review and meta-analysis

Author

Meyer, A, Mazzara, C, Lava, S A G, Treglia, G, Bianchetti, M G, Goeggel Simonetti, B, and Simonetti, G D

Subjects
610 Medicine & health
Abstract

AIM To systematically review the clinical features and outcomes of pediatric patients developing neurological complications associated with a rotavirus infection. METHODS A systematic literature review and meta-analysis was performed, including articles published from 1984 to 2020. Neurological complications were classified into four groups: encephalitis, cerebellitis, encephalo-cerebellitis and benign convulsions with mild gastroenteritis (CwG). RESULTS Out of 68 reports that fulfilled the research criteria, 99 cases of CwG, 39 cases of encephalitis, 18 cases of encephalo-cerebellitis and five cases of cerebellitis were collected. Ninety-five patients were from Asia. Median age was 22 (IQR 14-29) months, and the children who developed CwG were significantly younger (19, IQR 12-24 months, p

Published
2023
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19. PET imaging in cardiovascular infections

Author

Macapinlac, H, Treglia , G, Signore, A, Sollini, M, Bartoli, F, Zanca, R, Lazzeri, E, Slart, R, Erba, P, Sollini M., Bartoli F., Zanca R., Lazzeri E., Slart R. H. J. A., Erba P. A., Macapinlac, H, Treglia , G, Signore, A, Sollini, M, Bartoli, F, Zanca, R, Lazzeri, E, Slart, R, Erba, P, Sollini M., Bartoli F., Zanca R., Lazzeri E., Slart R. H. J. A., and Erba P. A.

Abstract

Cardiovascular (CVS) infections are associated with high morbidity and mortality. Early diagnosis is crucial for adequate patient's management, as early treatment improves the prognosis. Hardly they are diagnosed on the basis of a single symptom, sign or diagnostic test, being a multidisciplinary discussion in addition to the integration of clinical signs, microbiology data and imaging data necessary in many cases. The application of multimodality imaging, including molecular imaging techniques has improved the sensitivity to detect infections involving heart valves and vessels and implanted cardiovascular devices while also allowing for early detection of septic emboli and metastatic infections before these become clinically apparent. In this chapter, we describe the role of WBC SPECT/CT and [18F] FDG PET/CT in most clinically relevant CVS infections including dedicated imaging acquisition protocols, specific imaging reading and interpretations criteria, emphasizing the need of a specific reference framework within a Cardiovascular Multidisciplinary Team Approach to select the best test or combination of tests for each specific clinical situation.

Published
2022

20. Prognostic Factors in Patients with Breast Cancer Liver Metastases Undergoing Liver Resection: Systematic Review and Meta-Analysis

Author

Galiandro, F., Agnes, Salvatore, Moschetta, Giovanni, Orlandi, Armando, Clarke, G., Bria, Emilio, Franceschini, Gianluca, Treglia, G., Giovinazzo, F., Agnes S. (ORCID:0000-0002-3341-4221), Moschetta G., Orlandi A. (ORCID:0000-0001-5253-4678), Bria E. (ORCID:0000-0002-2333-704X), Franceschini G. (ORCID:0000-0002-2950-3395), Galiandro, F., Agnes, Salvatore, Moschetta, Giovanni, Orlandi, Armando, Clarke, G., Bria, Emilio, Franceschini, Gianluca, Treglia, G., Giovinazzo, F., Agnes S. (ORCID:0000-0002-3341-4221), Moschetta G., Orlandi A. (ORCID:0000-0001-5253-4678), Bria E. (ORCID:0000-0002-2333-704X), and Franceschini G. (ORCID:0000-0002-2950-3395)

Abstract

Background: The role of surgical resection of liver metastases in patients with breast cancer liver metastasis (BCLM) remains controversial. A systematic review and meta-analysis of prognostic factors related to survival after BCLM resection was performed. Methods: An electronic search of relevant publications was performed. Pooled outcome measures were expressed as hazard ratios (HRs), including 95% confidence interval values (95% CIs), and calculated through a random-effects model. Heterogeneity was tested through the I2 index. Results: Thirty-five publications reported analyses on prognostic factors and survival. A total of 2782 patients who underwent liver resection for BCLM were included. Positive axillary lymph nodes at breast cancer diagnosis were an unfavorable survival factor (HR 1.74, 95% CI 1.25 to 2.41, I2 = 0%). Cumulative predictive factor HRs (multiple liver metastases, size of the metastases, short interval between primary tumor and onset of liver disease) related to the BCLM pattern were 1.32 (95% CI 1.17 to 1.48, I2 = 71%) and 1.51 (95% CI 1.15 to 1.98, I2 = 76%) for surgical and pathological features (resection margin and presence of extrahepatic disease), respectively. Conclusion: Resection of BCLM may provide a survival benefit for selected patients. For better long-term results, surgical selection should consider both primary tumor and BCLM features such as negative axillary lymph nodes at breast resection, a single hepatic lesion, a time longer than 24 months between breast and hepatic diagnosis, and a realizable R0 liver resection. However, the high heterogeneity among studies suggests the need for an RCT to validate the present findings.

Published
2022

21. Overview of the RGD-Based PET Agents Use in Patients With Cardiovascular Diseases: A Systematic Review

Author

Dietz, M., Kamani, C.H., Dunet, V., Fournier, S., Rubimbura, V., Testart Dardel, N., Schaefer, A., Jreige, M., Boughdad, S., Nicod Lalonde, M., Schaefer, N., Mewton, N., Prior, J.O., and Treglia, G.

Subjects
RGD, angiogenesis, atherosclerosis, cardiovascular diseases, myocardial infarction, positron emission tomography, αvβ3 integrin
Abstract

Studies using arginine-glycine-aspartate (RGD)-PET agents in cardiovascular diseases have been recently published. The aim of this systematic review was to perform an updated, evidence-based summary about the role of RGD-based PET agents in patients with cardiovascular diseases to better address future research in this setting. Original articles within the field of interest reporting the role of RGD-based PET agents in patients with cardiovascular diseases were eligible for inclusion in this systematic review. A systematic literature search of PubMed/MEDLINE and Cochrane library databases was performed until October 26, 2021. Literature shows an increasing role of RGD-based PET agents in patients with cardiovascular diseases. Overall, two main topics emerged: the infarcted myocardium and atherosclerosis. The existing studies support that α v β 3 integrin expression in the infarcted myocardium is well evident in RGD PET/CT scans. RGD-based PET radiotracers accumulate at the site of infarction as early as 3 days and seem to be peaking at 1-3 weeks post myocardial infarction before decreasing, but only 1 study assessed serial changes of myocardial RGD-based PET uptake after ischemic events. RGD-based PET uptake in large vessels showed correlation with CT plaque burden, and increased signal was found in patients with prior cardiovascular events. In human atherosclerotic carotid plaques, increased PET signal was observed in stenotic compared with non-stenotic areas based on MR or CT angiography data. Histopathological analysis found a co-localization between tracer accumulation and areas of α v β 3 expression. Promising applications using RGD-based PET agents are emerging, such as prediction of remodeling processes in the infarcted myocardium or detection of active atherosclerosis, with potentially significant clinical impact.

Published
2022

25. PET with Different Radiopharmaceuticals in Neuroendocrine Neoplasms: An Umbrella Review of Published Meta-Analyses

Author

Treglia, G., Sadeghi, R., Giovinazzo, F., Galiandro, F., Annunziata, S., Muoio, B., and Kroiss, A.S.

Subjects
PET, diagnostic performance, impact, meta-analysis, neuroendocrine, positron emission tomography, prognosis, umbrella review
Abstract

Several meta-analyses have reported quantitative data about the diagnostic performance, the prognostic value, the impact on management and the safety of positron emission tomography (PET) including related hybrid modalities (PET/CT or PET/MRI) using different radiopharmaceuticals in patients with neuroendocrine neoplasms. We performed an umbrella review of published meta-analyses to provide an evidence-based summary. A comprehensive literature search of meta-analyses listed in PubMed/MEDLINE and Cochrane Library databases was carried out (last search date: 30 June 2021). Thirty-four published meta-analyses were selected and summarized. About the diagnostic performance: 68 Ga-SSA PET yields high diagnostic performance in patients with NETs and PGL; 18 F-FDOPA PET yields good diagnostic performance in patients with intestinal NETs, PGL, NB, being the best available PET method in detecting rMTC; 68 Ga-exendin-4 PET has good diagnostic accuracy in detecting insulinomas; 18 F-FDG PET has good diagnostic performance in detecting aggressive neuroendocrine neoplasms. About the prognostic value: 68 Ga-SSA PET has a recognized prognostic value in well-differentiated NETs, whereas 18 F-FDG PET has a recognized prognostic value in aggressive neuroendocrine neoplasms. A significant clinical impact of 68 Ga-SSA PET and related hybrid modalities in patients with NETs was demonstrated. There are no major toxicities or safety issues related to the use of PET radiopharmaceuticals in patients with neuroendocrine neoplasms. Evidence-based data support the use of PET with different radiopharmaceuticals in patients with neuroendocrine neoplasms with specific indications for each radiopharmaceutical.

Published
2021

26. Prevalence and Significance of Hypermetabolic Lymph Nodes Detected by 2-[18F]FDG PET/CT after COVID-19 Vaccination: A Systematic Review and a Meta-Analysis

Author

Treglia, G., Cuzzocrea, M., Giovanella, L., Elzi, L., and Muoio, B.

Subjects
COVID-19, FDG, PET, inflammation, lymph nodes, meta-analysis, systematic review, vaccine
Abstract

Recently, several articles reported incidental findings at 2-[ 18 F]FDG PET/CT in patients who have received COVID-19 vaccinations, including hypermetabolic axillary lymph nodes (HALNs) ipsilateral to the COVID-19 vaccine injection site which may cause diagnostic dilemmas. The aim of our work was to calculate the prevalence of this finding. A comprehensive computer literature search of PubMed/MEDLINE, Embase, and Cochrane library databases was performed to identify recently published articles that investigated the prevalence of HALNs detected by 2-[ 18 F]FDG PET/CT after COVID-19 vaccination. Pooled prevalence of this finding was calculated through a meta-analytic approach. Nine recently published articles including 2354 patients undergoing 2-[ 18 F]FDG PET/CT after recent COVID-19 vaccination have been included in the systematic review. Overall, HALNs ipsilateral to the vaccine injection site were frequent findings mainly due to vaccine-related immune response in most of the cases. The pooled prevalence of HALNs after COVID-19 vaccination was 37% (95% confidence interval: 27-47%) but with significant heterogeneity among the included studies. Physicians must be aware and recognize the significant frequency of HALNs at 2-[ 18 F]FDG PET/CT related to immune response to vaccine injection. Larger studies are needed to confirm the findings of this systematic review and meta-analysis.

Published
2021

28. International consensus on initial screening and follow-up of asymptomatic SDHx mutation carriers

Author

Amar, L., Pacak, K., Steichen, O., Akker, S.A., Aylwin, SJB, Baudin, E., Buffet, A., Burnichon, N., Clifton-Bligh, R.J., Dahia, PLM, Fassnacht, M., Grossman, A.B., Herman, P., Hicks, R.J., Januszewicz, A., Jimenez, C., Kunst, HPM, Lewis, D., Mannelli, M., Naruse, M., Robledo, M., Taïeb, D., Taylor, D.R., Timmers, HJLM, Treglia, G., Tufton, N., Young, W.F., Lenders, JWM, Gimenez-Roqueplo, A.P., and Lussey-Lepoutre, C.

Subjects
Adult, Aged, Algorithms, Asymptomatic Diseases, Child, Consensus, Genetic Carrier Screening/methods, Genetic Carrier Screening/standards, Genetic Testing/standards, Germ-Line Mutation, Heterozygote, Humans, Internationality, Mass Screening/methods, Mass Screening/standards, Monitoring, Physiologic/methods, Monitoring, Physiologic/standards, Succinate Dehydrogenase/genetics
Abstract

Approximately 20% of patients diagnosed with a phaeochromocytoma or paraganglioma carry a germline mutation in one of the succinate dehydrogenase (SDHx) genes (SDHA, SDHB, SDHC and SDHD), which encode the four subunits of the SDH enzyme. When a pathogenic SDHx mutation is identified in an affected patient, genetic counselling is proposed for first-degree relatives. Optimal initial evaluation and follow-up of people who are asymptomatic but might carry SDHx mutations have not yet been agreed. Thus, we established an international consensus algorithm of clinical, biochemical and imaging screening at diagnosis and during surveillance for both adults and children. An international panel of 29 experts from 12 countries was assembled, and the Delphi method was used to reach a consensus on 41 statements. This Consensus Statement covers a range of topics, including age of first genetic testing, appropriate biochemical and imaging tests for initial tumour screening and follow-up, screening for rare SDHx-related tumours and management of elderly people who have an SDHx mutation. This Consensus Statement focuses on the management of asymptomatic SDHx mutation carriers and provides clinicians with much-needed guidance. The standardization of practice will enable prospective studies in the near future.

Published
2021

30. Prevalence of thyroid dysfunction in patients with COVID-19: a systematic review

Author

Giovanella, L., Ruggeri, R. M., Ovcaricek, P. P., Campenni, A., Treglia, G., Deandreis, D., and Ruggeri, Rosaria Maddalena

Subjects
endocrine system, medicine.medical_specialty, endocrine system diseases, Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, MEDLINE, Thyroid function tests, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Radiology, Nuclear Medicine and imaging, Euthyroid, Thyroid, medicine.diagnostic_test, business.industry, SARS-CoV-2, TSH, COVID-19, Thyroid dysfunction, Interventional radiology, Radiation therapy, medicine.anatomical_structure, thyroid, thyroid dysfunction, systematic review, 030220 oncology & carcinogenesis, Systematic review, Thyroid function, business
Abstract

Purpose Currently, there is an increasing interest regarding the impact of COVID-19 on the thyroid function. As several recent reports have described the onset of thyroid dysfunction in patients diagnosed with COVID-19, we performed a systematic review to assess the prevalence of thyroid dysfunction in patients with COVID-19 as this information could be clinically relevant for the management of these patients. Methods A comprehensive computer literature search using PubMed/Medline and Cochrane databases was performed until November 14, 2020 to search original articles evaluating thyroid dysfunction in COVID-19 patients. Information about thyroid dysfunction assessed by thyroid function test was retrieved by the eligible articles. Qualitative analysis (systematic review) only was performed whether a significant heterogeneity of data was detected. Results Seven studies including 1237 patients with COVID- 19 were included. A significant heterogeneity across the studies was found. Most COVID-19 patients were euthyroid with TSH levels in the normal range (from 44 to 94% of the COVID-19 patients assessed in the included studies). The prevalence of thyroid dysfunction in COVID-19 patients (defined as abnormal thyroid function tests) largely varies among the included studies between 13 and 64% of COVID-19 patients as well as clinical presentation. A positive correlation between thyroid dysfunction and clinical severity of COVID-19 was reported. Conclusion Literature data show that thyroid dysfunction is present in a significant percentage of patients with COVID-19. Assessment of thyroid function may be considered in symptomatic COVID-19 patients to have a baseline before introducing thyroid- interfering drugs and those requiring high- intensity care. Further, well-designed studies are needed to better elucidate the impact of COVID-19 on thyroid function and inform thyroid function testing and thyroid dysfunction management in COVID-19 patients.

Published
2021

31. The value of F-FDG PET/CT for the diagnosis of device-related infections in patients with a left ventricular assist device: a systematic review and meta-analysis

Author

Ten Hove, D, Treglia, G, Slart, R H J A, Damman, K, Wouthuyzen-Bakker, M, Postma, D F, Gheysens, O, Borra, R J H, Mecozzi, G, van Geel, P P, Sinha, B, Glaudemans, A W J M, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Centre du cancer, and UCL - (SLuc) Service de médecine nucléaire

Subjects
LVAD infection, Meta-analysis, Prosthesis-Related Infections, Fluorodeoxyglucose F18, Positron Emission Tomography Computed Tomography, Positron-Emission Tomography, 18F-FDG PET/CT, Quality of Life, Systematic review, Humans, Heart-Assist Devices, Radiopharmaceuticals, Sensitivity and Specificity
Abstract

Left ventricular assist devices (LVADs) are increasingly used for the treatment of advanced heart failure. LVADs improve quality of life and decrease mortality, but the driveline carries substantial risk for major infections. These device-related LVAD and driveline infections are difficult to diagnose with conventional imaging. We reviewed and analysed the current literature on the additive value of F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) imaging for the diagnosis of LVAD-related infections." We performed a systematic literature review using several databases from their inception until the 31st of December, 2019. Studies investigating the diagnostic performance of FDG-PET/CT in patients with suspected LVAD infection were retrieved. After a bias risk assessment using QUADAS-2, a study-aggregate meta-analysis was performed on a per examination-based analysis. A total of 10 studies were included in the systematic review, eight of which were also eligible for study-aggregate meta-analysis. For the meta-analysis, a total of 256 FDG-PET/CT scans, examining pump/pocket and/or driveline infection, were acquired in 230 patients. Pooled sensitivity of FDG-PET/CT was 0.95 (95% confidence interval (CI) 0.89-0.97) and pooled specificity was 0.91 (95% CI 0.54-0.99) for the diagnosis of device-related infection. For pump/pocket infection, sensitivity and specificity of FDG-PET/CT were 0.97 (95%CI 0.69-1.00) and 0.93 (95%CI 0.64-0.99), respectively. For driveline infection, sensitivity and specificity were 0.96 (95%CI 0.88-0.99) and 0.99 (95%CI 0.13-1.00) respectively. Significant heterogeneity existed across studies for specificity, mostly caused by differences in scan procedures. Predefined criteria for suspicion of LVAD and/or driveline infection were lacking in all included studies. FDG-PET/CT is a valuable tool for assessment of device-related infection in LVAD patients, with high sensitivity and high, albeit variable, specificity. Standardization of FDG-PET/CT procedures and criteria for suspected device-related LVAD infections are needed for consistent reporting of FDG-PET/CT scans.

Published
2021

32. The value of F-FDG PET/CT for the diagnosis of device-related infections in patients with a left ventricular assist device: a systematic review and meta-analysis.

Author

UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Centre du cancer, UCL - (SLuc) Service de médecine nucléaire, Ten Hove, D, Treglia, G, Slart, R H J A, Damman, K, Wouthuyzen-Bakker, M, Postma, D F, Gheysens, O, Borra, R J H, Mecozzi, G, van Geel, P P, Sinha, B, Glaudemans, A W J M, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Centre du cancer, UCL - (SLuc) Service de médecine nucléaire, Ten Hove, D, Treglia, G, Slart, R H J A, Damman, K, Wouthuyzen-Bakker, M, Postma, D F, Gheysens, O, Borra, R J H, Mecozzi, G, van Geel, P P, Sinha, B, and Glaudemans, A W J M

Abstract

Left ventricular assist devices (LVADs) are increasingly used for the treatment of advanced heart failure. LVADs improve quality of life and decrease mortality, but the driveline carries substantial risk for major infections. These device-related LVAD and driveline infections are difficult to diagnose with conventional imaging. We reviewed and analysed the current literature on the additive value of F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) imaging for the diagnosis of LVAD-related infections." We performed a systematic literature review using several databases from their inception until the 31st of December, 2019. Studies investigating the diagnostic performance of FDG-PET/CT in patients with suspected LVAD infection were retrieved. After a bias risk assessment using QUADAS-2, a study-aggregate meta-analysis was performed on a per examination-based analysis. A total of 10 studies were included in the systematic review, eight of which were also eligible for study-aggregate meta-analysis. For the meta-analysis, a total of 256 FDG-PET/CT scans, examining pump/pocket and/or driveline infection, were acquired in 230 patients. Pooled sensitivity of FDG-PET/CT was 0.95 (95% confidence interval (CI) 0.89-0.97) and pooled specificity was 0.91 (95% CI 0.54-0.99) for the diagnosis of device-related infection. For pump/pocket infection, sensitivity and specificity of FDG-PET/CT were 0.97 (95%CI 0.69-1.00) and 0.93 (95%CI 0.64-0.99), respectively. For driveline infection, sensitivity and specificity were 0.96 (95%CI 0.88-0.99) and 0.99 (95%CI 0.13-1.00) respectively. Significant heterogeneity existed across studies for specificity, mostly caused by differences in scan procedures. Predefined criteria for suspicion of LVAD and/or driveline infection were lacking in all included studies. FDG-PET/CT is a valuable tool for assessment of device-related infection in LVAD patients, with high sensitivity and high, albeit variable, s

Published
2021

33. Diagnostic value of [18F]FDG-PET/CT in polymyalgia rheumatica: a systematic review and meta-analysis.

Author

UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Centre du cancer, UCL - (SLuc) Service de médecine nucléaire, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, van der Geest, K S M, Treglia, G, Glaudemans, A W J M, Brouwer, E, Jamar, F, Slart, R H J A, Gheysens, O, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Centre du cancer, UCL - (SLuc) Service de médecine nucléaire, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, van der Geest, K S M, Treglia, G, Glaudemans, A W J M, Brouwer, E, Jamar, F, Slart, R H J A, and Gheysens, O

Abstract

Polymyalgia rheumatica (PMR) can be difficult to diagnose. Whole-body [18F]FDG-PET/CT allows for a comprehensive evaluation of all relevant articular and extra-articular structures affected by PMR. We aimed to summarize current evidence on the diagnostic value of [18F]FDG-PET/CT for a diagnosis of PMR. PubMed/MEDLINE and the Cochrane Library database were searched from inception through May 31, 2020. Studies containing patients with PMR who underwent [18F]FDG-PET/CT were included. Screening and full-text review were performed by 3 investigators and data extraction by 2 investigators. Risk of bias was examined with the QUADAS-2 tool. Diagnostic test meta-analysis was performed with a bivariate model. Twenty studies were included in the systematic review, of which 9 studies (n = 636 patients) were eligible for meta-analysis. [18F]FDG positivity at the following sites was associated with a diagnosis of PMR: interspinous bursae (positive likelihood ratio (LR+) 4.00; 95% CI 1.84-8.71), hips (LR+ 2.91; 95% CI 2.09-4.05), ischial tuberosities (LR+ 2.86; 95% CI 1.91-4.28), shoulders (LR+ 2.57; 95% CI 1.24-5.32) and sternoclavicular joints (LR+ 2.31; 95% CI 1.33-4.02). Negative likelihood ratios (LR-) for these sites, as well as the greater trochanters, were all less than 0.50. Composite [18F]FDG-PET/CT scores, as reported in 3 studies, provided a pooled LR+ of 3.91 (95% CI 2.42-6.32) and LR- of 0.19 (95% CI 0.10-0.36). Moderate to high heterogeneity was observed across the studies, mainly due to differences in patient selection, scanning procedures and/or interpretation criteria. Significant [18F]FDG uptake at a combination of anatomic sites is informative for a diagnosis of PMR. [18F]FDG-PET/CT might be an important diagnostic tool in patients with suspected PMR. This study also highlights the need for adherence to published procedural recommendations and standardized interpretation criteria for the use of [18F]FDG-PET/CT in PMR.

Published
2021

34. International consensus on initial screening and follow-up of asymptomatic SDHx mutation carriers

Author

Amar, L, Pacak, K, Steichen, O, Akker, SA, Aylwin, SJB, Baudin, E, Buffet, A, Burnichon, N, Clifton-Bligh, RJ, Dahia, PLM, Fassnacht, M, Grossman, AB, Herman, P, Hicks, RJ, Januszewicz, A, Jimenez, C, Kunst, HPM, Lewis, D, Mannelli, M, Naruse, M, Robledo, M, Taieb, D, Taylor, DR, Timmers, HJLM, Treglia, G, Tufton, N, Young, WF, Lenders, JWM, Gimenez-Roqueplo, A-P, Lussey-Lepoutre, C, Amar, L, Pacak, K, Steichen, O, Akker, SA, Aylwin, SJB, Baudin, E, Buffet, A, Burnichon, N, Clifton-Bligh, RJ, Dahia, PLM, Fassnacht, M, Grossman, AB, Herman, P, Hicks, RJ, Januszewicz, A, Jimenez, C, Kunst, HPM, Lewis, D, Mannelli, M, Naruse, M, Robledo, M, Taieb, D, Taylor, DR, Timmers, HJLM, Treglia, G, Tufton, N, Young, WF, Lenders, JWM, Gimenez-Roqueplo, A-P, and Lussey-Lepoutre, C

Abstract

Approximately 20% of patients diagnosed with a phaeochromocytoma or paraganglioma carry a germline mutation in one of the succinate dehydrogenase (SDHx) genes (SDHA, SDHB, SDHC and SDHD), which encode the four subunits of the SDH enzyme. When a pathogenic SDHx mutation is identified in an affected patient, genetic counselling is proposed for first-degree relatives. Optimal initial evaluation and follow-up of people who are asymptomatic but might carry SDHx mutations have not yet been agreed. Thus, we established an international consensus algorithm of clinical, biochemical and imaging screening at diagnosis and during surveillance for both adults and children. An international panel of 29 experts from 12 countries was assembled, and the Delphi method was used to reach a consensus on 41 statements. This Consensus Statement covers a range of topics, including age of first genetic testing, appropriate biochemical and imaging tests for initial tumour screening and follow-up, screening for rare SDHx-related tumours and management of elderly people who have an SDHx mutation. This Consensus Statement focuses on the management of asymptomatic SDHx mutation carriers and provides clinicians with much-needed guidance. The standardization of practice will enable prospective studies in the near future.

Published
2021

37. Usefulness of Brain Positron Emission Tomography with Different Tracers in the Evaluation of Patients with Idiopathic Normal Pressure Hydrocephalous

Author

Mattoli, M.V., Treglia, G., Calcagni, M.L., Mangiola, A., Anile, C., and Trevisi, G.

Subjects
PET, [18F]FDG, amyloid, biomarker, dopaminergic, hydrocephalous, perfusion, positron emission tomography, ventriculo-peritoneal shunt
Abstract

Idiopathic normal pressure hydrocephalus (iNPH) is the only form of dementia that can be cured by surgery. Its diagnosis relies on clinical and radiological criteria. Identifying patients who can benefit from surgery is challenging, as other neurological diseases can be concomitant or mimic iNPH. We performed a systematic review on the role of positron emission tomography (PET) in iNPH. We retrieved 35 papers evaluating four main functional aspects with different PET radiotracers: (1) PET with amyloid tracers, revealing Alzheimer's disease (AD) pathology in 20-57% of suspected iNPH patients, could be useful in predictions of surgical outcome. (2) PET with radiolabeled water as perfusion tracer showed a global decreased cerebral blood flow (CBF) and regional reduction of CBF in basal ganglia in iNPH; preoperative perfusion parameters could predict surgical outcome. (3) PET with 2-Deoxy-2-[ 18 F]fluoroglucose ([ 18 F]FDG ) showed a global reduction of glucose metabolism without a specific cortical pattern and a hypometabolism in basal ganglia; [ 18 F]FDG PET may identify a coexisting neurodegenerative disease, helping in patient selection for surgery; postsurgery increase in glucose metabolism was associated with clinical improvement. (4) Dopaminergic PET imaging showed a postsynaptic D2 receptor reduction and striatal upregulation of D2 receptor after treatment, associated with clinical improvement. Overall, PET imaging could be a useful tool in iNPH diagnoses and treatment response.

Published
2020

38. Diagnostic Performance of PET or PET/CT with Different Radiotracers in Patients with Suspicious Lung Cancer or Pleural Tumours according to Published Meta-Analyses

Author

Lococo, F., Muoio, B., Chiappetta, M., Nachira, D., Petracca Ciavarella, L., Margaritora, S., and Treglia, G.

Subjects
Article Subject
Abstract

Several meta-analyses have reported data about the diagnostic performance of positron emission tomography or positron emission tomography/computed tomography (PET or PET/CT) with different radiotracers in patients with suspicious lung cancer (LC) or pleural tumours (PT). This review article aims at providing an overview on the recent evidence-based data in this setting. A comprehensive literature search of meta-analyses published in PubMed/MEDLINE and Cochrane Library database from January 2010 through March 2020 about the diagnostic performance of PET or PET/CT with different radiotracers in patients with suspicious LC or PT was performed. This combination of keywords was used: (A) "PET" OR "positron emission tomography" AND (B) "lung" OR "pulmonary" OR "pleur ∗ " AND (C) meta-analysis. Only meta-analyses on PET or PET/CT in patients with suspicious LC or PT were selected. We have summarized the diagnostic performance of PET or PET/CT with fluorine-18 fluorodeoxyglucose ( 18 F-FDG) and other radiotracers taking into account 17 meta-analyses. Evidence-based data demonstrated a good diagnostic performance of 18 F-FDG PET or PET/CT for the characterization of solitary pulmonary nodules (SPNs) or pleural lesions with overall higher sensitivity than specificity. Evidence-based data do not support the routine use of dual time point (DTP) 18 F-FDG PET/CT or fluorine-18 fluorothymidine ( 18 F-FLT) PET/CT in the differential diagnosis of SPNs. Even if 18 F-FDG PET/CT has high sensitivity and specificity as a selective screening modality for LC, its role in this setting remains unknown. Evidence-based data about the diagnostic performance of PET/CT with different radiotracers for suspicious LC or PT are increasing, with good diagnostic performance of 18 F-FDG PET/CT. More prospective multicenter studies and cost-effectiveness analyses are warranted.

Published
2020
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39. Correlation between 18F-FDG PET/computer tomography findings and histology in thymic epithelial tumors: Current evidences and clinical implications

Author

Lococo, Filippo, Sassorossi, Carolina, Chiappetta, M., Cesario, Alfredo, Treglia, G., Margaritora, Stefano, Lococo F. (ORCID:0000-0002-9383-5554), Sassorossi C., Cesario A. (ORCID:0000-0003-4687-0709), Margaritora S. (ORCID:0000-0002-9796-760X), Lococo, Filippo, Sassorossi, Carolina, Chiappetta, M., Cesario, Alfredo, Treglia, G., Margaritora, Stefano, Lococo F. (ORCID:0000-0002-9383-5554), Sassorossi C., Cesario A. (ORCID:0000-0003-4687-0709), and Margaritora S. (ORCID:0000-0002-9796-760X)

Abstract

N/A

Published
2020

40. Usefulness of brain positron emission tomography with different tracers in the evaluation of patients with idiopathic normal pressure hydrocephalous

Author

Mattoli, M. V., Treglia, G., Calcagni, Maria Lucia, Mangiola, Annunziato, Anile, Carmelo, Trevisi, Giuseppe, Calcagni M. L. (ORCID:0000-0002-0805-8245), Mangiola A. (ORCID:0000-0002-1378-4524), Anile C. (ORCID:0000-0002-0481-9713), Trevisi G., Mattoli, M. V., Treglia, G., Calcagni, Maria Lucia, Mangiola, Annunziato, Anile, Carmelo, Trevisi, Giuseppe, Calcagni M. L. (ORCID:0000-0002-0805-8245), Mangiola A. (ORCID:0000-0002-1378-4524), Anile C. (ORCID:0000-0002-0481-9713), and Trevisi G.

Abstract

Idiopathic normal pressure hydrocephalus (iNPH) is the only form of dementia that can be cured by surgery. Its diagnosis relies on clinical and radiological criteria. Identifying patients who can benefit from surgery is challenging, as other neurological diseases can be concomitant or mimic iNPH. We performed a systematic review on the role of positron emission tomography (PET) in iNPH. We retrieved 35 papers evaluating four main functional aspects with different PET radiotracers: (1) PET with amyloid tracers, revealing Alzheimer’s disease (AD) pathology in 20–57% of suspected iNPH patients, could be useful in predictions of surgical outcome. (2) PET with radiolabeled water as perfusion tracer showed a global decreased cerebral blood flow (CBF) and regional reduction of CBF in basal ganglia in iNPH; preoperative perfusion parameters could predict surgical outcome. (3) PET with 2-Deoxy-2-[18F]fluoroglucose ([18F]FDG ) showed a global reduction of glucose metabolism without a specific cortical pattern and a hypometabolism in basal ganglia; [18F]FDG PET may identify a coexisting neurodegenerative disease, helping in patient selection for surgery; postsurgery increase in glucose metabolism was associated with clinical improvement. (4) Dopaminergic PET imaging showed a postsynaptic D2 receptor reduction and striatal upregulation of D2 receptor after treatment, associated with clinical improvement. Overall, PET imaging could be a useful tool in iNPH diagnoses and treatment response.

Published
2020

47. The value of 18F-FDG PET/CT for the diagnosis of device-related infections in patients with a left ventricular assist device: a systematic review and meta-analysis

Author

ten Hove, D., primary, Treglia, G., additional, Slart, R. H. J. A., additional, Damman, K., additional, Wouthuyzen-Bakker, M., additional, Postma, D. F., additional, Gheysens, O., additional, Borra, R. J. H., additional, Mecozzi, G., additional, van Geel, P. P., additional, Sinha, B., additional, and Glaudemans, A. W. J. M., additional

Published
2020
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