Contact person: Rosa Fonti,
Actors: Viviana De Rosa, viviana.derosa
ibb.cnr.it, Francesca Iommelli, francesca.iommelliibb.cnr.it, Barbara Salvatore, Silvana Del Vecchio, Rosa Fonti, In last years, newer and more advanced imaging modalities have been
developed in the effort to improve the management of neoplastic patients in a non-invasive
manner. Combined multimodal
imaging, in fact, can be of aid in obtaining a more accurate assessment of cancer
patients in order to improve staging, prognostic stratification and therapeutic
procedures. One of these methods, 18F-FDG-PET/CT is a whole-body imaging
technique, capable to provide both morphological and functional information on
the status of cancer patients and is used in the staging and follow-up of a
number of neoplastic diseases. Our research is focused, therefore, on
multimodal imaging of cancer patients in order to compare 18F-FDG-PET/CT to other
morphologic or functional imaging modalities in the evaluation and prognosis of
solid tumors and lymphoproliferative diseases.
In one of these studies we compared 18F-FDG-PET/CT,
99mTc-MIBI and MRI in the evaluation of patients with multiple myeloma at
diagnosis showing that in the whole-body
analysis, 18F-FDG-PET/CT and 99mTc-MIBI provide complementary information on
the status of these patients by detecting focal and diffuse disease, respectively,
while, in the spinal and pelvic regions, MRI is comparable to 18F-FDG-PET/CT
and 99mTc-MIBI in the detection of focal and diffuse patterns, respectively.
Therefore, MRI should be reserved to the evaluation of bone marrow involvement
of the spine and pelvis, whereas 18F-FDG-PET/CT can significantly contribute to
an accurate whole-body evaluation of myeloma patients. We also compared the
relative contribution on 18F-FDG-PET/CT, 99mTc-MIBI and MRI in the prediction
of prognosis in the same series of myeloma patients showing that
the number of focal lesions detected by 18F-FDG PET/CT or 99mTc-MIBI scan is an
independent predictor of both progression free and overall survival therefore
providing complementary information on the prognosis of these
patients.
In further studies on combined imaging in neuroendocrine tumors, we showed
that 18F-FDG-PET/CT scan allows to differentiate high-risk epithelial tumors
and thymic carcinomas from low-risk thymomas, whereas 111In-octreotide SPECT may
identify neuroendocrine tumors among those showing high 18F-FDG uptake. While in a study on patients with medullary thyroid carcinoma we showed
that 18F-FDG-PET/CT provides a useful contribution mainly in evaluating lymph node
involvement whereas 111In-octreotide SPECT can contribute to the detection and
receptor characterization of bone lesions.
Coronal, sagittal and transaxial, CT, PET and fused images of whole-body 18F-FDG-PET/CT (A), anterior and posterior whole-body 99mTc-MIBI (B) and sagittal T1w and T1w FS with Gd MRI images of the spine (C). The three imaging modalities, performed in the same MM patient, showed a focal+diffuse pattern of distribution. In particular, focal lesions were shown in the skull, humerai, pelvis, left femur and right fibula by whole-body 18F-FDG-PET/CT, in the skull, right humerus, pelvis, left femur and right fibula by whole-body 99mTc-MIBI and in the coccigeal bone by spine and pelvis MRI.
Fonti R, Pace L, Cerchione C, Catalano L,
Salvatore B, De Luca S, Pane F, Salvatore M, Del Vecchio S. 18F-FDG PET/CT,
99mTc-MIBI, and MRI in the prediction of outcome of patients with multiple
myeloma: a comparative study. Clin Nucl Med. 2015;40:303-308.
Pace L, Klain M, Salvatore B, Nicolai E,
Zampella E, Assante R, Pellegrino T, Storto G, Fonti R, Salvatore M. Prognostic
role of 18F-Fluorodeoxyglucose Positron Emission Tomography/CT in the
postoperative evaluation of differentiated thyroid cancer patients. Clin Nucl Med.
2015;40:111-115.
Salvatore B, Caprio MG, Fonti R, D’Amico D, Fraioli F,
Salvatore M, Pace L. Is 2-deoxy-2-18Fluoro-D-glucose PET/CT acquisition from
the upper thigh to the vertex of skull useful in oncological patients? Transl Med UniSa. 2014;11:34-38.
L Camera, R Severino, A
Faggiano, S Masone, G Mansueto, S Maurea, R Fonti, M Salvatore. Contrast enhanced multi-detector CT and MR findings of a
well-differentiated pancreatic vipoma. World J Radiol. 2014; 6:840-845.
De Luca S, Fonti R, Palmieri
G, Federico P, Del Prete G, Pacelli R, Pace L, De Placido S, Salvatore M, Del
Vecchio S. Combined Imaging With 18F-FDG-PET/CT and 111In-Labeled Octreotide
SPECT for Evaluation of Thymic Epithelial Tumors. Clin Nucl Med.
2013;38:354-358.
Pasanisi F, Pace L, Fonti R,
Marra M, Sgambati D, De Caprio C, De Filippo E, Vaccaro A, Salvatore M,
Contaldo F. Evidence of brown fat activity in constitutional leanness. J Clin Endocrinol Metab. 2013;98:1214-1218.
Marotta V, Ramundo V, Camera L, Del Prete M, Fonti R, Esposito R, Palmieri
G, Salvatore M, Vitale M, Colao A, Faggiano A. Sorafenib in advanced
iodine-refractory differentiated thyroid cancer: efficacy, safety and
exploratory analysis of role of serum thyroglobulin and FDG-PET. Clin
Endocrinol. 2013;78:760-767.
Fonti R, Larobina M, Del Vecchio S, De Luca S, Fabbricini R, Catalano L,
Pane F, Salvatore M, Pace L. Metabolic Tumor Volume Assessed by 18F-FDG PET/CT
for the Prediction of Outcome in Patients with Multiple Myeloma. J Nucl Med. 2012;53:1829-1835.
Fonti R, Salvatore B, Quarantelli M, Sirignano C, Segreto S, Petruzziello
F, Catalano L, Liuzzi R, Rotoli B, Del Vecchio S, Pace L, Salvatore M. 18F-FDG-PET/CT, 99mTc-MIBI and MRI in
the evaluation of patients with multiple myeloma. J Nucl Med
2008;49:195-200.
Catalano L, Del Vecchio S, Petruzziello F, Fonti R, Salvatore B, Martorelli C, Califano C, Caparrotti G, Segreto S, Pace L, Rotoli B. Sestamibi and FDG-PET scans to support diagnosis of jaw osteonecrosis. Ann Hematol 2007;86:415-423.
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