Showing papers by "David A. Mankoff published in 2001"
TL;DR: FDG PET may uncover disease in these nodal regions not recognized by conventional staging methods in patients with recurrent or metastatic breast cancer, according to a retrospective evaluation of intrathoracic lymph nodes.
Abstract: PURPOSE: To determine the prevalence of suspected disease in the mediastinum and internal mammary (IM) node chain by 18fluorodeoxyglucose (FDG) positron emission tomography (PET), compared with conventional staging by computed tomography (CT) in patients with recurrent or metastatic breast cancer. PATIENTS AND METHODS: We retrospectively evaluated intrathoracic lymph nodes using FDG PET and CT data in 73 consecutive patients with recurrent or metastatic breast cancer who had both CT and FDG PET within 30 days of each other. In reviews of CT scans, mediastinal nodes measuring 1 cm or greater in the short axis were considered positive. PET was considered positive when there were one or more mediastinal foci of FDG uptake greater than the mediastinal blood pool. RESULTS: Overall, 40% of patients had abnormal mediastinal or IM FDG uptake consistent with metastases, compared with 23% of patients who had suspiciously enlarged mediastinal or IM nodes by CT. Both FDG PET and CT were positive in 22%. In the subset...
188 citations
TL;DR: Internal mammary lymph node drainage shown by breast lymphoscintigraphy is common, although drainage is significantly more common from quadrants other than the UOQ.
Abstract: Background: Metastases to internal mammary lymph nodes (IMN) may occur in patients with breast cancer and may alter treatment recommendations. The purpose of this study was to identify the frequency of IMN drainage in patients undergoing breast lymphoscintigraphy and sentinel lymph node dissection (SLND).
113 citations
Journal Article•
TL;DR: The organ doses received by FES are comparable to those associated with other commonly performed nuclear medicine tests, and the potential radiation risks associated with this study are well within accepted limits.
Abstract: [18F]16α-fluoroestradiol (FES) is a PET imaging agent useful for the study of estrogen receptors in breast cancer. We estimated the radiation dosimetry for this tracer using data obtained in patient studies. Methods: Time-dependent tissue concentrations of radioactivity were determined from blood samples and PET images in 49 patients (52 studies) after intravenous injection of FES. Radiation absorbed doses were calculated using the procedures of the MIRD committee, taking into account the variation in dose based on the distribution of activities observed in the individual patients. Effective dose equivalent was calculated using International Commission on Radiological Protection Publication 60 weights for the standard woman. Results: The effective dose equivalent was 0.022 mSv/MBq (80 mrem/mCi). The organ that received the highest dose was the liver (0.13 mGy/MBq [470 mrad/mCi]), followed by the gallbladder (0.10 mGy/MBq [380 mrad/mCi]) and the urinary bladder (0.05 mGy/MBq [190 mrad/mCi]). Conclusion: The organ doses are comparable to those associated with other commonly performed nuclear medicine tests. FES is a useful estrogen receptor-imaging agent, and the potential radiation risks associated with this study are well within accepted limits.
74 citations
TL;DR: Clinical studies using [11C]-thymidine have demonstrated the power of cellular proliferation imaging to characterize tumors and monitor response early in the course of therapy, and patient imaging using the PET thymidine analogs is at an earlier stage but appears promising as a clinically feasible approach to cellular proliferation Imaging.
Abstract: Cell proliferation imaging is based on extensive laboratory investigations of labeled thymidine being selectively incorporated into DNA. [11C]-Thymidine labeled in the ring-2 or the methyl position is the natural extension of earlier work using tritiated thymidine. Proliferation imaging using [11C]-thymidine requires correction for labeled metabolites; however, quantitative approaches can provide reliable estimates of cellular proliferation by measuring thymidine flux from the blood into DNA in tumors. 18F-labeled thymidine analogs that are resistant to catabolism in vivo, [18F]-FLT and [18F]-FMAU, may simplify quantitative analysis and may be more suitable for clinical studies but will require careful validation to determine how their uptake is quantitatively related to cell growth. Clinical studies using [11C]-thymidine have demonstrated the power of cellular proliferation imaging to characterize tumors and monitor response early in the course of therapy. Patient imaging using the PET thymidine analogs is at an earlier stage but appears promising as a clinically feasible approach to cellular proliferation imaging.
72 citations
TL;DR: The principles underlying the use of [(18)F]-fluorodeoxyglucose (FDG) are described, and the clinical experience with FDG pertinent to radiation oncology is reviewed, and preliminary studies using PET tracers with greater specificity than FDG for tumor imaging are discussed.
55 citations