題名Predominance and homogeneity patterns of physiological FDG accumulation in thoracic and lumbar vertebrae: suspected mechanism of ”bone pseudometastasis” on FDG-PET in Japanese patients with esophageal cancer.
要旨OBJECTIVE:
False-positive bone lesions (bone pseudometastases) have been often reported in patients with esophageal cancer (EsoC).
This study aimed to evaluate the vertebral 2-deoxy-2-[18F] fluoro-D-glucose (FDG) accumulation pattern in patients with newly diagnosed esophageal cancers and other malignancies (OtherT) to elucidate the possible mechanism that causes bone pseudometastasis.
METHODS:
FDG positron emission tomography/computed tomography performed for 90 patients with EsoC, and 112 patients with OtherT was retrospectively evaluated.
The uptake pattern in the thoracic (Th) and lumbar (L) vertebrae was visually assessed regarding predominance (TL, Th ≒ L; Td, Th > L; Ld, L > Th), main intensity compared with the uptake in the blood pool (BP) (Grade 1 < BP, Grade 2 ≒ BP, or Grade 3 > BP), and homogeneity
(homogeneous, heterogeneous, marginal, or spotty). The patterns between EsoC and OtherT and between Th and L were compared.
RESULTS:
TL, Td, and Ld patterns were observed in 51.1%, 48.9%, and 0% in EsoC and 79.7%, 20.3%, and 0% in OtherT.
Though Grade 2 was most frequently observed in both groups, the ratio of Grade 3 in Th and Grade 1 in L was significantly higher in EsoC than in OtherT. Heterogeneous and spotty patterns were more frequently observed in L and in EsoC, and these were strongly associated with Td pattern.
CONCLUSION:
Td pattern was frequently seen, especially in EsoC, and was strongly associated with a heterogeneous or marginal pattern in the L. Heterogeneous marrow distribution with declined lumbar uptake is suspected as the mechanism of bone pseudometastasis.
谷垣専門研究員が第42回日本分子生物学会で発表しました。
発表日2019年12月3日
学会名第42回日本分子生物学会
開催地福岡国際会議場(福岡)
演題Cxcr4 ノックアウトマウスの行動学的解析
演者谷垣健二
要旨The 22q11.2 deletion syndrome is caused by deletion of a 1.5 to 3Mb segment of chromosome 22q11.2. About 35% of patients with this syndrome develop psychiatric disorders, mainly schizophrenia.
Mice with deletion of 22q11-related region (Df1) have deficits in sensorimotor gating, learning and memory, like patients with 22q11.2 deletion syndrome and deficits in migration of cortical interneurons and hippocampal dentate precursor cells.
Previously, we have demonstrated that Dgcr8 heterozygosity caused CXCR4/CXCL12 signaling deficiency, leading to neurodevelopmental abnormalities as Df1/+ mice. However, it remains to be elucidated the functions of CXCR4/CXCL12 signaling in the central nervous system,
We performed behavioral analysis of Cxcr4 Knockout mice and compared their behavioral phenotypes with those of Df1/+ mice. We would like to discuss the possible roles of CXCR4/CXCL12 signaling in the pathophysiology of schizophrenia and related mental conditions.
<sup>18</sup>F -FPYBF-2, a new F-18-labelled amyloid imaging PET tracer: first experience in 61 volunteers and 55 patients with dementiaが、11th久田賞(Annals of Nuclear Medicine 論文賞)金賞を受賞しました。
奥山専門研究員と加川主任研究員が第59回日本核医学会学術総会にて発表しました。
発表日2019年11月1~3日
学会名第59回日本核医学会学術総会
開催地愛媛県松山市
演題1FDGの大唾液腺への生理的集積
演者1奥山智緒
共同演者1石津浩一、東達也、西井 龍一、高橋昌章、草野邦典、加川信也、佐賀恒夫、山内浩
要旨1【Purpose】To evaluate the physiological <SUP>18</SUP>F-FDG uptake in major salivary glands.
【Methods】We retrospectively evaluated 128 FDG-PET/CT studies (26-89 y.o; M:F 68:60). Patients with a history of any treatment for malignant tumors, with head and neck tumors, lymphoma, sarcoidosis, collagen disease, or IgG4RD, or examinations with misregistration were excluded.
ROIs were placed on parotid glands (Pa), submantibular glands(SM) and sublingual glands (SL). The uptake among these glands was compared and the correlations between the uptake and age was evaluated.
【Results】SUV means of Pa, SM, and SL were 1.3 ± 0.3, 2.0 ± 0.4, and 2.6 ± 1.0 (p<0.0001). Negative correlation was seen between uptake of SL and age.
【Conclusion】Physiological FDG uptake differs among three salivary glands.
要旨2【Purpose】To compare the tracer uptake in major salivary glands between <SUP>18</SUP>F-FDG and <SUP>11</SUP>C-MeAIB, and to evaluate the effects of irradiation.
【Methods】Physiological tracer uptake of FDG and MeAIB in parotid glands(P), submandibular glands(SM), and sublingual gland (SL) were evaluated using control cases (N = 38).
For cases with head and neck cancer(N=44), the uptake in these glands were evaluated based on whether each gland received irradiation therapy (RT)or not(NRT).
【Results】SUV means of P, SM, and SL of control cases were 1.5 ± 0.5, 2.3 ± 0.7, and 2.9 ± 1.0, on FDG, and 7.1 ± 2.5, 4.8 ± 1.5, and 2.2 ± 0.6 on MeAIB, respectively.
In head and neck cancer patients, P, SM, and SL in RT glands showed low uptake compared in NRT glands (p < 0.0001) on MeAIB, but there were no significant differences in FDG uptake in P and SM between RT and NRT glands.
Uptake of MeAIB also decreased in some glands whose ductal passage was interrupted by tumors.
【Conclusion】FDG and MeAIB show the different features of the salivary glands.
表題 Significantly increased accumulation of fluorodeoxyglucose throughout the left middle cerebral artery territory corresponding to acute phase infarction.
要旨 A 70-year-old woman had spontaneous resolution of an embolism in her right middle cerebral artery (MCA) (day 1); another embolism occurred in her left MCA (day 3) which was promptly removed.
On day 5,F-18-fluorodeoxyglucose (FDG) positron emission tomography / computed tomography performed for staging mediastinal lymphoma showed marked FDG accumulation in the left MCA territory, while a defect was seen in the right insular region.
Eventually, bilateral lesions developed irreversible infarction. Anaerobic metabolism and / or inflammation in acute phase infarction were the supposed mechanism for the increased accumulation of FDG in her left MCA territory.
生検後に自然消退したリンパ腫症例のPET画像を載せたCase reportをClinical Nuclear Medicine のinteresting imageに掲載されました。
掲載日2019年10月17日
掲載雑誌名Clin Nucl Med. 2019 Oct 17. doi: 10.1097/RLU.0000000000002782. [Epub ahead of print]
著者Nakamoto Y, Okuyama C,Oka S.
表題Complete spontaneous regression of hepatosplenic T-cell lymphoma after surgical biopsy
要旨 F18-FDG PET/CT for a 74-year-old man with elevated serum soluble interleukin 2 receptor showed multiple intense uptake in the liver, spleen, and bone.
A surgical biopsy from 2 of liver tumors confirmed hepatosplenic αβ T-cell lymphoma.
One and a half months after biopsy, FDG PET scan was performed again for staging before starting chemotherapy, and it showed the complete disappearance of all of the lesions.
The excisional biopsy could be a possible trigger of his spontaneous regression.
画像研究部門の郷田看護師が研究発表を行いました。
画像研究部門の郷田看護師が、8月23日から25日までコラッセふくしまで開催された、PETサマーセミナー2019 in 福島で、当研究所で行った病院スタッフのPET検査への理解を高めるための取り組みについて発表しました。
著者Yoshimoto M, Hirata M, Kagawa S, Magata Y, Ohmomo Y, Temma T.
題名Synthesis and characterization of novel radiofluorinated probes for Positron Emission Tomography imaging of monoamine oxidase B.
要旨OBJECTIVE: Monoamine oxidase B (MAO-B), predominantly expressed in glial cells, plays an important role in neurotransmitter regulation, and MAO-B activity relates to several neuronal diseases.
Here, we aimed to develop a radiofluorinated MAO-B imaging probe based on the structure of a selective MAO-B inhibitor, MD-230254. We synthesized and evaluated a series of compounds in vitro and in vivo.
METHODS: A series of fluorinated analogues of MD-230254 were synthesized and evaluated for inhibitory potency and selectivity toward MAO-B.
5-[4-(2-[18F]Fluorobenzyloxy)phenyl]-3-(2-cyanoethyl)-1,3,4-oxadiazol-2(3H)-one (2-[18F]FBPO) was synthesized from a corresponding tributylstannyl precursor and [18F]CH3COOF.
Biodistribution after intravenous injection of 2-[18F]FBPO was evaluated in male ddY mice with or without pretreatment by inhibitors.
RESULTS: Among the compounds synthesized and evaluated, 2-FBPO showed high inhibitory potency and selectivity toward MAO-B comparable to MD-230254. 2-[18F]FBPO was successfully synthesized by an electrophilic reaction with a high radiochemical purity of more than 99%.
2-[18F]FBPO was efficiently taken up by the brain and showed rapid blood clearance, which provided a brain/blood radioactivity ratio of 3.7 at 90 min post injection. The brain radioactivity was significantly decreased by pretreatment with an MAO-B selective inhibitor.
CONCLUSIONS: The great potential of 2-[18F]FBPO as an MAO-B imaging probe, applicable to a variety of diseases, is indicated.
当院放射線診断科の中本隆介医師とともに、研究員らはそのような症例の臨床的特徴を解析し、cancer associated cachexia state との関連を見出した。
掲載日 2019年6月11日(Published online)
掲載雑誌名Clinical Nuclear Medicine. (doi: 10.1097/RLU.0000000000002658. [Epub ahead of print])
著者Nakamoto R, Okuyama C, Ishizu K, Higashi T, Takahashi M, Kusano K, Kagawa S, Yamauchi H.
表題Diffusely Decreased Liver Uptake on FDG PET and Cancer-Associated Cachexia with Reduced Survival
要旨OBJECTIVES: We investigated clinical characteristics of patients with extremely increased or decreased physiologic F-FDG uptake of the liver and their prognosis.
METHODS: One thousand four hundred eighty-seven PET/CT scans of patients with known or suspected malignancy were retrospectively analyzed. A spherical volume of interest (3 cm in diameter) was set on the right lobe of the liver to calculate the SUVmean.
Scans with extremely high (SUVmean >97.5th percentile) and low (SUVmean <2.5th percentile) FDG uptake in the liver were evaluated.
Physical and laboratory data among a control group (n = 30), the extremely high liver uptake group (HG, n = 36), and the extremely low liver uptake group (LG, n = 36) were compared. Overall survival (OS) of the 3 groups was also compared.
RESULTS: Body weight and body mass index in the HG (SUVmean ≥3.04) were significantly higher than those in the control group. The LG cases (SUVmean ≤1.78) had anemia, impaired liver function, and systemic inflammation.
They were also in a poor nutritional state. The characteristics of LG cases had many things in common with those of cachectic patients. Indeed, 36.1% of LG cases met the diagnostic criteria for cachexia.
Moreover, in LG cases with viable and/or recurrent malignant lesions on FDG PET, the proportion of cachexia increased by 52.6%. The OS of LG cases (median, 33 months) was significantly worse than that of controls and HG cases.
CONCLUSIONS: Our data indicate that cancer patients with extremely decreased liver FDG uptake were likely to have cancer cachexia and a lower OS.
著者 Kimura H, Yagi Y, Mikamo M, Kazuya M, Kagawa S, Arimitsu K, Higashi T, Nishii R, Ono M, Nakamoto Y, Togashi K, Kusuhara H, Saji H.
題名Evaluation of transporter-mediated hepatobiliary transport of newly developed 18F-labeled pitavastatin derivative, PTV-F1, in rats by PET imaging.
要旨Quantitative evaluations of the functions of uptake and efflux transporters directly in vivo is desired to understand an efficient hepatobiliary transport of substrate drugs.
Pitavastatin is a substrate of organic anion transporting polypeptides (OATPs) and canalicular efflux transporters; thus, it can be a suitable probe for positron-emission tomography (PET) imaging of hepatic transporter functions.
To characterize the performance of [18F]PTV-F1, an analogue of pitavastatin, we investigated the impact of rifampicin (a typical OATP inhibitor) coadministration or Bcrp (breast cancer resistance protein) knockout on [18F]PTV-F1 hepatic uptake and efflux in rats by PET imaging.
After intravenous administration, [18F]PTV-F1 selectively accumulated in the liver, and the radioactivity detected in plasma, liver, and bile mainly derived from the parent PTV-F1 during the PET study (∼40 min).
Coadministration of rifampicin largely decreased the hepatic uptake of [18F]PTV-F1 by 73%. Because of its lower clearance in rats, [18F]PTV-F1 is more sensitive for monitoring changes in hepatic OATP1B function that other previously reported OATP1B PET probes.
Rifampicin coadministration also significantly decreased the biliary excretion of radioactivity by 65%. Bcrp knockout did not show a significant impact on its biliary excretion. [18F]PTV-F1 enables quantitative analysis of the hepatobiliary transport system for organic anions.
山内副所長らが執筆した論文がJournal of Neurology, Neurosurgery and Psychiatry 誌にonline掲載されました。
表題 Selective neuronal damage and blood pressure in atherosclerotic major cerebral artery disease
要旨Objective In patients with atherosclerotic major cerebral artery disease, low blood pressure might impair cerebral perfusion, thereby exacerbate the risk of selective neuronal damage.
The purpose of this retrospective study was to determine whether low blood pressure at follow-up is associated with increased selective neuronal damage.
Methods We retrospectively analysed data from 76 medically treated patients with atherosclerotic internal carotid artery or middle cerebral artery disease with no ischaemic episodes on a follow-up of 6 months or more.
All patients had measurements of the distribution of central benzodiazepine receptors twice using positron emission tomography and 11C-flumazenil.
Using three-dimensional stereotactic surface projections,
we quantified abnormal decreases in the benzodiazepine receptors of the cerebral cortex within the middle cerebral artery distribution and correlated these changes in the benzodiazepine receptors index with blood pressure values at follow-up examinations.
Results The changes in the benzodiazepine receptor index during follow-up (mean 27±21 months) were negatively correlated with systolic blood pressure at follow-up.
The relationship between changes in benzodiazepine receptor index and systolic blood pressure was different among patients with and without decreased cerebral blood flow at baseline (interaction, p<0.005).
Larger increases in benzodiazepine receptor index (neuronal damage) were observed at lower systolic blood pressure levels in patients with decreased cerebral blood flow than in patients without such decreases.
Conclusion In patients without ischaemic stroke episodes at follow-up but with decreased cerebral blood flow due to arterial disease, low systolic blood pressure at follow-up may be associated with increased selective neuronal damage.
掲載雑誌名Clinical Nuclear Medicine. (doi: 10.1097/RLU.0000000000002625. [Epub ahead of print])
著者 Okuyama C, Higashi T, Ishizu K, Nakamoto R, Takahashi M, Kusano K, Kagawa S, Yamauchi H
表題 Bone Pseudometastasis on 18F-FDG PET in Japanese Patients with Esophageal Cancer
要旨PURPOSE OF THE REPORT: False-positive bone lesions mimicking bone metastases (bone pseudometastasis) on F-FDG PET/CT have often been reported in patients with esophageal cancer.
We aimed to evaluate the prevalence and features of these lesions in Japanese patients with esophageal cancer.
METHODS: In this retrospective study, we analyzed 83 FDG PET/CT studies for initial staging of esophageal cancer, and extracted patients with 1 or more localized high uptake sites with no subsequent progression, which were therefore judged to be bone pseudometastasis.
The FDG PET/CT imaging features of the bone pseudometastasis were evaluated, and other available imaging and clinical features reviewed.
RESULTS: Of the 83 patients, 7 had bone pseudometastasis. All 7 were males diagnosed with squamous cell cancer, of which 5 had T1a tumors.
Bone pseudometastasis showed normal or ill-defined hyperdense (nonosteolytic) sites compared with the surrounding area on the CT.
Additionally, accumulation in the upper vertebral levels of each case was contiguously high compared with the lumbar spines (we named this finding ”contiguous accumulation”).
On MRI, these findings were visualized as low signals on T1-weighted imaging (T1WI) and T2WI images but were unclear on fat-suppressed T2WI images.
CONCLUSIONS: Among all PET/CT performed for staging of esophageal cancer, 8.3% demonstrated bone pseudometastasis characterized by heterogeneous distribution with severe fatty degeneration of bone marrow accompanied by contiguous accumulation.
Caution is required during diagnoses of bone lesions in esophageal cancer patients in Japan to prevent inappropriate therapeutic choices.
奥山専門研究員が執筆した論文がに英文医学誌 Annals of Nuclear Medicine に Online 掲載されました。
表題The difference of risk factors predicting cardiac events in patients with chronic kidney disease between with and without diabetes
要旨Objective Chronic kidney disease (CKD) and diabetes are both associated with cardiovascular disease, but the effects of diabetes in patients with CKD remain unknown.
This study aimed to compare the risk factors of cardiac events between patients with CKD accompanied and not by diabetes using myocardial perfusion imaging.
Methods We initially classifed 529 patients with CKD from the Japanese Assessment of Cardiac Events and Survival Study-3 (J-ACCESS-3)
study who had been assessed by gated single-photon emission-computed tomography based on whether they had diabetes (n=220) or not (n=309) and then separated them into four subgroups based on the ejection fraction (EF) calculated by quantitative gated SPECT.
After 3-year follow-up, the incidence of major cardiac events (cardiac death, sudden death, non-fatal myocardial infarction, and heart failure requiring hospitalization), risk factors among each group, and the ability of myocardial perfusion image to predict prognosis were evaluated.
Results Major cardiac events occurred in 12.7% and 10.3% of patients with and without diabetes (not signifcant), and heart failure requiring hospitalization was the most frequent (75% and 78%, respectively)
in both groups. Event-free survival rates were lower in the subgroups with low EF and high summed stress scores (SSS).
Event-free survival rates were lower in the subgroups with low EF and high summed stress scores (SSS).
Independent risk factors comprised currently smoking and a higher SSS, among patients with diabetes, while higher left ventricular end diastolic volumes and serum C-reactive protein values among those without diabetes.
Conclusions In patients with CKD, while the risk factors of major cardiac events difer between in patients with and without diabetes, quantitation with gated MPI could be used efectively in both groups.
表題Splenic Marginal Zone B-Cell Lymphoma with Splenic Infarction in a Patient with Cold Agglutinin Disease.
要旨We report a case of splenic marginal zone B-cell lymphoma discovered in a 73-year-old man with cold agglutinin disease.
PET/CT revealed splenomegaly with focally intense uptake of F-FDG and diffusely increased bone marrow uptake, which was considered to be secondary to hemolytic anemia.
Splenectomy was performed. The histopathology of the spleen showed splenic marginal zone B-cell lymphoma with partial splenic infarction,
which correlated with the area of focal intense FDG uptake. Depending on the time since onset, splenic infarctions can present as focal FDG accumulation.