18 F-FDG PET/CT versus anatomic imaging for evaluating disease extent and clinical trial eligibility in Erdheim-Chester
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ORIGINAL ARTICLE
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F-FDG PET/CT versus anatomic imaging for evaluating disease extent and clinical trial eligibility in Erdheim-Chester disease: results from 50 patients in a registry study Julian Kirchner 1,2 & Vaios Hatzoglou 1 & Justin B. Buthorn 3 & Dana Bossert 3 & Allison M. Sigler 3 & Anne S. Reiner 4 & Gary A. Ulaner 1,5 & Eli L. Diamond 3 Received: 21 May 2020 / Accepted: 17 September 2020 # The Author(s) 2020
Abstract Objectives The aim of this study was to [1] characterize distribution of Erdheim-Chester Disease (ECD) by 18F-FDG PET/CT and [2] determine the utility of metabolic (18F-FDG PET/CT) imaging versus anatomic imaging (CT or MRI) in evaluating ECD patients for clinical trial eligibility. Methods 18F-FDG PET/CT and corresponding CT or MRI studies for ECD patients enrolled in a prospective registry study were reviewed. Sites of disease were classified as [1] detectable by 18F-FDG PET only, CT/MRI only, or both and as [2] measurable by modified PERCIST (mPERCIST) only, RECIST only, or both. Descriptive analysis was performed and paired t test for betweengroup comparisons. Results Fifty patients were included (mean age 51.5 years; range 18–70 years). Three hundred thirty-three disease sites were detected among all imaging modalities, 188 (56%) by both 18F-FDG PET and CT/MRI, 67 (20%) by 18F-FDG PET only, 75 (23%) by MRI brain only, and 3 (1%) by CT only. Of 178 disease sites measurable by mPERCIST or RECIST, 40 (22%) were measurable by both criteria, 136 (76%) by mPERCIST only, and 2 (1%) by RECIST only. On the patient level, 17 (34%) had mPERCIST and RECIST measurable disease, 30 (60%) had mPERCIST measurable disease only, and 0 had RECIST measurable disease only (p < 0.0001). Conclusion Compared with anatomic imaging, 18F-FDG PET/CT augments evaluation of disease extent in ECD and increases identification of disease sites measurable by formal response criteria and therefore eligibility for clinical trials. Complementary organ-specific anatomic imaging offers the capacity to characterize sites of disease in greater anatomic detail. Trial registration ClinicalTrials.gov Identifier: NCT03329274 Keywords
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F-FDG PET/CT . Erdheim-Chester disease . ECD . RECIST . Modified PERCIST . Trial eligibility
This article is part of the Topical Collection on Oncology - General Gary A. Ulaner and Eli L. Diamond contributed equally to this work. * Gary A. Ulaner [email protected]
3
Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
* Eli L. Diamond [email protected]
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Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10022, USA
5
Molecular Imaging and Therapy, Hoag Family Cancer Institute, Newport Beach, CA, USA
1
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
2
Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, D-40225 Dusseldorf, Germany
Eur J Nucl Med Mol Imaging
Introduction Erdheim-Chester disease (ECD) is a rare and clinically
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