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Article: COVID-19 in an asymptomatic patient undergoing FDG PET/CT.

Johnson, Lisa N / Vesselle, Hubert

2020 Volume 15, Issue 10, Page(s) 1809–1812

Abstract: The 2019 novel coronavirus pneumonia (COVID-19) is an ongoing global pandemic with a worldwide death toll of over 416,000 as of June 10, 2020. Although the first documented cases in Wuhan, China were patients with severe respiratory symptoms including ... ...

Abstract	The 2019 novel coronavirus pneumonia (COVID-19) is an ongoing global pandemic with a worldwide death toll of over 416,000 as of June 10, 2020. Although the first documented cases in Wuhan, China were patients with severe respiratory symptoms including cough, fever, fatigue, and shortness of breath, the disease process can also be asymptomatic. In this case report, an asymptomatic 63-year-old male with Lynch syndrome undergoing a routine staging fluorodeoxyglucose positron-emission tomography/computed tomography was found to have typical radiologic features of COVID-19 with marked pulmonary FDG uptake and was subsequently diagnosed via reverse-transcription polymerase chain reaction. Many studies have described the appearance of COVID-19 on chest radiography and CT with the most common imaging features being bilateral, peripheral, and basilar predominant ground glass opacities and consolidation. Although these findings are typically nonspecific for an atypical lung infection, early recognition of COVID-19 in the setting of a global pandemic (even in the asymptomatic patient) is critical in order to limit the spread of disease.
Keywords	covid19
Language	English
Publishing date	2020-07-13
Publishing country	Netherlands
Document type	Case Reports
ZDB-ID	2406300-9
ISSN	1930-0433
ISSN	1930-0433
DOI	10.1016/j.radcr.2020.07.018
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Utilizing Clinical Trial Data to Assess Timing of Surgical Treatment for Emphysema Patients.

Alimohammadi, Maryam / Chaovalitwongse, W Art / Vesselle, Hubert J / Zhang, Shengfan

Medical decision making : an international journal of the Society for Medical Decision Making

2022 Volume 43, Issue 1, Page(s) 110–124

Abstract: Background: Lung volume reduction surgery (LVRS) and medical therapy are 2 available treatment options in dealing with severe emphysema, which is a chronic lung disease. However, or there are currently limited guidelines on the timing of LVRS for ... ...

Abstract	Background: Lung volume reduction surgery (LVRS) and medical therapy are 2 available treatment options in dealing with severe emphysema, which is a chronic lung disease. However, or there are currently limited guidelines on the timing of LVRS for patients with different characteristics. Objective: The objective of this study is to assess the timing of receiving LVRS in terms of patient outcomes, taking into consideration a patient's characteristics. Methods: A finite-horizon Markov decision process model for patients with severe emphysema was developed to determine the short-term (5 y) and long-term timing of emphysema treatment. Maximizing the expected life expectancy, expected quality-adjusted life-years, and total expected cost of each treatment option were applied as the objective functions of the model. To estimate parameters in the model, the data provided by the National Emphysema Treatment Trial were used. Results: The results indicate that the treatment timing strategy for patients with upper-lobe predominant emphysema is to receive LVRS regardless of their specific characteristics. However, for patients with non-upper-lobe-predominant emphysema, the optimal strategy depends on the age, maximum workload level, and forced expiratory volume in 1 second level. Conclusion: This study demonstrates the utilization of clinical trial data to gain insights into the timing of surgical treatment for patients with emphysema, considering patient age, observable health condition, and location of emphysema. Highlights: Both short-term and long-term Markov decision process models were developed to assess the timing of receiving lung volume reduction surgery in patients with severe emphysema.How clinical trial data can be used to estimate the parameters and obtain short-term results from the Markov decision process model is demonstrated.The results provide insights into the timing of receiving lung volume reduction surgery as a function of a patient's characteristics, including age, emphysema location, maximum workload, and forced expiratory volume in 1 second level.
Language	English
Publishing date	2022-10-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	604497-9
ISSN	1552-681X ; 0272-989X
ISSN (online)	1552-681X
ISSN	0272-989X
DOI	10.1177/0272989X221132256
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Article ; Online: Clinical Impact of FDG PET/CT of the Lower Extremities in Patients With Merkel Cell Carcinoma With Primary Disease Site Outside of the Lower Extremities.

Ishiyama, Mitsutomi / Behnia, Fatemeh / Vesselle, Hubert

AJR. American journal of roentgenology

2021 Volume 216, Issue 3, Page(s) 776–780

Abstract: OBJECTIVE. ...

Abstract	OBJECTIVE.
MeSH term(s)	Aged ; Carcinoma, Merkel Cell/diagnostic imaging ; Carcinoma, Merkel Cell/secondary ; Female ; Fluorodeoxyglucose F18 ; Humans ; Lower Extremity/diagnostic imaging ; Male ; Neoplasm Staging/methods ; Positron Emission Tomography Computed Tomography/methods ; Radiopharmaceuticals ; Retrospective Studies ; Sensitivity and Specificity ; Skin Neoplasms/diagnostic imaging ; Whole Body Imaging
Chemical Substances	Radiopharmaceuticals ; Fluorodeoxyglucose F18 (0Z5B2CJX4D)
Language	English
Publishing date	2021-01-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	82076-3
ISSN	1546-3141 ; 0361-803X ; 0092-5381
ISSN (online)	1546-3141
ISSN	0361-803X ; 0092-5381
DOI	10.2214/AJR.20.23390
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Article ; Online: Independent association of metabolic tumor response on FDG-PET with pulmonary toxicity following risk-adaptive chemoradiation for unresectable non-small cell lung cancer: Inherent radiosensitivity or immune response?

Gates, Evan D H / Hippe, Daniel S / Vesselle, Hubert J / Zeng, Jing / Bowen, Stephen R

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

2023 Volume 185, Page(s) 109720

Abstract: Background: In the context of a phase II trial of risk-adaptive chemoradiation, we evaluated whether tumor metabolic response could serve as a correlate of treatment sensitivity and toxicity.: Methods: Forty-five patients with AJCCv7 stage IIB-IIIB ... ...

Abstract	Background: In the context of a phase II trial of risk-adaptive chemoradiation, we evaluated whether tumor metabolic response could serve as a correlate of treatment sensitivity and toxicity. Methods: Forty-five patients with AJCCv7 stage IIB-IIIB NSCLC enrolled on the FLARE-RT phase II trial (NCT02773238). [18F]fluorodeoxyglucose (FDG) PET-CT images were acquired prior to treatment and after 24 Gy during week 3. Patients with unfavorable on-treatment tumor response received concomitant boosts to 74 Gy total over 30 fractions rather than standard 60 Gy. Metabolic tumor volume and mean standardized uptake value (SUVmean) were calculated semi-automatically. Risk factors of pulmonary toxicity included concurrent chemotherapy regimen, adjuvant anti-PDL1 immunotherapy, and lung dosimetry. Incidence of CTCAE v4 grade 2+ pneumonitis was analyzed using the Fine-Gray method with competing risks of metastasis or death. Peripheral germline DNA microarray sequencing measured predefined candidate genes from distinct pathways: 96 DNA repair, 53 immunology, 38 oncology, 27 lung biology. Results: Twenty-four patients received proton therapy, 23 received ICI, 26 received carboplatin-paclitaxel, and 17 pneumonitis events were observed. Pneumonitis risk was significantly higher for patients with COPD (HR 3.78 [1.48, 9.60], p = 0.005), those treated with immunotherapy (HR 2.82 [1.03, 7.71], p = 0.043) but not with carboplatin-paclitaxel (HR 1.98 [0.71, 5.54], p = 0.19). Pneumonitis rates were similar among selected patients receiving 74 Gy radiation vs 60 Gy (p = 0.33), proton therapy vs photon (p = 0.60), or with higher lung dosimetric V20 (p = 0.30). Patients in the upper quartile decrease in SUVmean (>39.7%) were at greater risk for pneumonitis (HR 4.00 [1.54, 10.44], p = 0.005) and remained significant in multivariable analysis (HR 3.34 [1.23, 9.10], p = 0.018). Germline DNA gene alterations in immunology pathways were most frequently associated with pneumonitis. Conclusion: Tumor metabolic response as measured by mean SUV is associated with increased pneumonitis risk in a clinical trial cohort of NSCLC patients independent of treatment factors. This may be partially attributed to patient-specific differences in immunogenicity.
MeSH term(s)	Humans ; Carboplatin ; Carcinoma, Non-Small-Cell Lung/pathology ; Fluorodeoxyglucose F18 ; Immunity ; Lung Neoplasms/pathology ; Paclitaxel/adverse effects ; Pneumonia/complications ; Positron Emission Tomography Computed Tomography/methods ; Radiation Pneumonitis/etiology ; Radiation Tolerance
Chemical Substances	Carboplatin (BG3F62OND5) ; Fluorodeoxyglucose F18 (0Z5B2CJX4D) ; Paclitaxel (P88XT4IS4D)
Language	English
Publishing date	2023-05-25
Publishing country	Ireland
Document type	Clinical Trial ; Journal Article
ZDB-ID	605646-5
ISSN	1879-0887 ; 0167-8140
ISSN (online)	1879-0887
ISSN	0167-8140
DOI	10.1016/j.radonc.2023.109720
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Article: COVID-19 in an asymptomatic patient undergoing FDG PET/CT

Johnson, Lisa N / Vesselle, Hubert

Radiol Case Rep

Abstract	The 2019 novel coronavirus pneumonia (COVID-19) is an ongoing global pandemic with a worldwide death toll of over 416,000 as of June 10, 2020. Although the first documented cases in Wuhan, China were patients with severe respiratory symptoms including cough, fever, fatigue, and shortness of breath, the disease process can also be asymptomatic. In this case report, an asymptomatic 63-year-old male with Lynch syndrome undergoing a routine staging fluorodeoxyglucose positron-emission tomography/computed tomography was found to have typical radiologic features of COVID-19 with marked pulmonary FDG uptake and was subsequently diagnosed via reverse-transcription polymerase chain reaction. Many studies have described the appearance of COVID-19 on chest radiography and CT with the most common imaging features being bilateral, peripheral, and basilar predominant ground glass opacities and consolidation. Although these findings are typically nonspecific for an atypical lung infection, early recognition of COVID-19 in the setting of a global pandemic (even in the asymptomatic patient) is critical in order to limit the spread of disease.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #640836
Database	COVID19

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Article ; Online: COVID-19 in an asymptomatic patient undergoing FDG PET/CT

Johnson, Lisa N. / Vesselle, Hubert

Radiology Case Reports

2020 Volume 15, Issue 10, Page(s) 1809–1812

Keywords	Radiology Nuclear Medicine and imaging ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
ZDB-ID	2406300-9
ISSN	1930-0433
ISSN	1930-0433
DOI	10.1016/j.radcr.2020.07.018
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: 68Ga DOTATATE PET/CT Imaging of Elastofibroma Dorsi.

Ishiyama, Mitsutomi / Vesselle, Hubert

Clinical nuclear medicine

2018 Volume 43, Issue 5, Page(s) e154–e155

Abstract: Sixty six-year-old woman status post ileocecal resection for well-differentiated neuroendocrine tumor in the terminal ileum 7 years ago, who is on octreotide therapy for liver metastases. Ga DOTATATE PET/CT showed soft tissue masses with mildly increased ...

Abstract	Sixty six-year-old woman status post ileocecal resection for well-differentiated neuroendocrine tumor in the terminal ileum 7 years ago, who is on octreotide therapy for liver metastases. Ga DOTATATE PET/CT showed soft tissue masses with mildly increased radiotracer uptake in the bilateral subscapular/infrascapular regions. In retrospective image review, these soft tissue masses were first noted 7 years prior and have gradually increased in size over the years. Given the characteristic location and imaging findings, these masses are consistent with benign elastofibroma dorsi instead of metastasis.
MeSH term(s)	Aged ; Diagnosis, Differential ; Female ; Fibroma/diagnostic imaging ; Humans ; Neuroendocrine Tumors/diagnostic imaging ; Neuroendocrine Tumors/pathology ; Organometallic Compounds ; Positron Emission Tomography Computed Tomography ; Radiopharmaceuticals ; Soft Tissue Neoplasms/diagnostic imaging
Chemical Substances	Organometallic Compounds ; Radiopharmaceuticals ; dotatate gallium ga-68 (9L17Y0H71P)
Language	English
Publishing date	2018-05
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	197628-x
ISSN	1536-0229 ; 0363-9762
ISSN (online)	1536-0229
ISSN	0363-9762
DOI	10.1097/RLU.0000000000002023
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Article ; Online: Neurolymphomatosis; a case report.

Aboueldahab, Noha / Shafik, Mohamed Ahmed / Megahed, Ayah / Vesselle, Hubert

Clinical imaging

2021 Volume 80, Page(s) 329–333

Abstract: We present a case of indolent neurolymphomatosis in a 55-year-old male patient with worsening pain and weakness in his right leg over the past few months. The patient has a past medical history of type II diabetes mellitus, four-year history of worsening ...

Abstract	We present a case of indolent neurolymphomatosis in a 55-year-old male patient with worsening pain and weakness in his right leg over the past few months. The patient has a past medical history of type II diabetes mellitus, four-year history of worsening left foot drop, left lower limb pain and weakness attributed to diabetic amyotrophy, and back pain. The new right-sided symptoms prompted further imaging which revealed a left sciatic nerve mass which was biopsied. Initial biopsy results were inconclusive.
MeSH term(s)	Diabetes Mellitus, Type 2 ; Fluorodeoxyglucose F18 ; Humans ; Male ; Middle Aged ; Neurolymphomatosis ; Positron Emission Tomography Computed Tomography ; Positron-Emission Tomography
Chemical Substances	Fluorodeoxyglucose F18 (0Z5B2CJX4D)
Language	English
Publishing date	2021-08-27
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1028123-x
ISSN	1873-4499 ; 0899-7071
ISSN (online)	1873-4499
ISSN	0899-7071
DOI	10.1016/j.clinimag.2021.08.016
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Article: Semi-quantitative metabolic values on FDG PET/CT including extracardiac sites of disease as a predictor of treatment course in patients with cardiac sarcoidosis.

Ishiyama, Mitsutomi / Soine, Laurie A / Vesselle, Hubert J

EJNMMI research

2017 Volume 7, Issue 1, Page(s) 67

Abstract: Background: Cardiac sarcoidosis is associated with major adverse cardiac events including cardiac arrest, for which anti-inflammatory treatment is indicated. Oral corticosteroid is the mainstay among treatment options; however, adverse effects are a ... ...

Abstract	Background: Cardiac sarcoidosis is associated with major adverse cardiac events including cardiac arrest, for which anti-inflammatory treatment is indicated. Oral corticosteroid is the mainstay among treatment options; however, adverse effects are a major concern with long-term use. It would be beneficial for providers to predict treatment response and prognosis for proper management strategy of sarcoidosis, though it remains challenging. Fluorine (F)-18 fluorodeoxyglucose (FDG)-positron emission tomography(PET)/computed tomography(CT) has an advantage over anatomical imaging in providing semi-quantitative functional parameters such as standard uptake value (SUV), metabolic volume, and total lesion glycolysis (TLG), which are well-established biomarkers in oncology. However, the relationship between these parameters and treatment response has not been fully investigated in cardiac sarcoidosis. Also, the prognostic value of extracardiac active inflammation noted on FDG-PET/CT in the setting of cardiac sarcoidosis is unclear. The aim of this retrospective study was to investigate the prognostic value of semi-quantitative values of both cardiac and extracardiac disease sites derived from FDG-PET/CT in predicting treatment course in cardiac sarcoidosis. Methods: Sixteen consecutive patients with suspected cardiac sarcoidosis, who demonstrated abnormal myocardial activity on cardiac-inflammation FDG-PET/CT encompassing the entire chest/upper abdomen and subsequently underwent corticosteroid therapy for diagnosis of active cardiac sarcoidosis, were included. Semi-quantitative values of hypermetabolic lesions were derived from all visualized organ system and were compared to daily corticosteroid dose at 6 months. Results: Of the 16 patients, 81.3% (13/16) of the patients showed extracardiac involvement. The lesion with the greatest SUV was identified in the heart in 11 patients (68.7%), in the liver in 1 patient (6.3%), and in lymph nodes in 4 patients (25%). The maximum SUV across all visualized organ systems including the heart were 8.8 ± 3.1 for the patients with corticosteroid dose ≤ 10 mg and 12.5 ± 3.3 for those with > 10 mg (P = 0.04). Metabolic volume and TLG across all visualized organ systems or any values in the heart alone showed no significant statistical difference between the two groups. Conclusions: Maximum SUV across all involved organ-systems of the chest and upper abdomen, not that of the heart alone, could be a predictor of treatment course of steroid therapy at 6 months in patients with active cardiac sarcoidosis.
Language	English
Publishing date	2017-08-18
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2619892-7
ISSN	2191-219X
ISSN	2191-219X
DOI	10.1186/s13550-017-0315-y
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Article: Adaptive Fluorodeoxyglucose-Positron Emission Tomography Based Chemotherapy Selection for Metastatic Non-small Cell Lung Cancer.

Eaton, Keith D / Romine, Perrin E / Martins, Renato G / Leblond, Antoine / Carr, Laurie L / Vesselle, Hubert J

Cureus

2021 Volume 13, Issue 10, Page(s) e18804

Abstract: Objectives The change in tumor fluorodeoxyglucose (FDG) uptake by positron emission tomography (PET) scan after one cycle of platinum-based chemotherapy has been shown to predict progression-free and overall survival (PFS and OS) among advanced non-small ...

Abstract	Objectives The change in tumor fluorodeoxyglucose (FDG) uptake by positron emission tomography (PET) scan after one cycle of platinum-based chemotherapy has been shown to predict progression-free and overall survival (PFS and OS) among advanced non-small cell lung cancer (NSCLC) patients. Using early FDG-PET response to determine subsequent chemotherapy, we aim to evaluate the role that adaptive chemotherapy regimens have on later CT response, PFS, and OS in patients with advanced NSCLC. Materials and Methods Chemotherapy-naïve patients with metastatic NSCLC received carboplatin and paclitaxel (CP) on day one and repeated FDG-PET on day 18. PET-responding patients continued CP chemotherapy for a total of four cycles. PET non-responders were switched to alternate docetaxel and gemcitabine (DG) for three additional cycles. The primary outcome was the CT Response Evaluation Criteria in Solid Tumors (RECIST 1.0) response. Secondary endpoints included PFS and OS. Results Forty-six patients initiated treatment with chemotherapy on trial and were evaluable by PET/CT. Of these, 19 (41%) met the FDG-PET criteria for the response after a single cycle of CP. Only one non-responding patient had a CT response. Despite the lack of CT response in the DG arm, no trend for worse PFS or OS was seen between the two arms. Conclusions This work demonstrates that changing chemotherapy in the event of non-response by PET did not lead to improved CT RECIST response. However, non-responding patients who switched chemotherapy had similar PFS and OS to those who responded by PET and continued the same regimen.
Language	English
Publishing date	2021-10-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.18804
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