Recurrent pancreatic adenocarcinoma depicted by 18F-Fluciclovine PET/CT imaging

Nguyen, Ba D.; Ocal, Tolgay I.

doi:10.1016/j.remnie.2018.10.016

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The figure shows 68Ga PSMA-11 PET/CT scan prior to treatment, MIP (A), axial PET (B), axial CT (C), and axial fusion (D) images indicate multiple intense pathologic uptakes in lymph nodes (simple arrow), liver (dashed arrow) and bone (arrowhead)." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Fuad Novruzov, Jamil A. Aliyev, Zeynəb Allahverdiyeva, Elnur Mehdi, Francesco Giammarile" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Fuad" "apellidos" => "Novruzov" ] 1 => array:2 [ "nombre" => "Jamil A." 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Nguyen, Tolgay I. Ocal" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Ba D." "apellidos" => "Nguyen" "email" => array:1 [ 0 => "Nguyen.ba@mayo.edu" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Tolgay I." "apellidos" => "Ocal" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Department of Radiology, Nuclear Medicine Division, Mayo Clinic Arizona, Scottsdale, AZ, USA" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Scottsdale, AZ, USA" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Recidiva de adenocarcinoma pancreático detectada mediante PET/TC con 18F-Fluciclovina" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1237 "Ancho" => 2500 "Tamanyo" => 343638 ] ] "descripcion" => array:1 [ "en" => "(A) 18F-Fluciclovine anterior maximum intensity projection PET image with the tracer-avid lesion at mid-abdomen (arrow). (row B) Corresponding axial, sagittal and coronal fused PET/CT and (row C) CT images of the retroperitoneal/mesenteric mass (arrows)." ] ] ] "textoCompleto" => "The authors present a case of recurrent pancreatic adenocarcinoma demonstrated by 18F-Fluciclovine PET/CT during the imaging evaluation of a coexisting prostatic cancer biochemical recurrence. To the best of the authors’ knowledge, this incidental PET/CT finding has not been reported in the literature.A 73-year-old man had a prior history of successive prostatic and pancreatic cancers. The initial Gleason 9 prostatic malignancy was treated with radical prostatectomy and lymph node dissection. The pancreatic moderately differentiated ductal adenocarcinoma was diagnosed 11 months after prostatic surgery and treated with radical pancreaticoduodenectomy with end-block resection of portion of portal vein, and adjuvant chemoradiation. Clinical and imaging monitoring was uneventful for 16 months until a slight rise in PSA serum level suspicious for biochemical recurrence of prostate cancer. An 18F-Fluciclovine PET/CT was obtained showing only a 3.6-cm intensely hypermetabolic mass in the mid-abdomen straddling between the retroperitoneum and root of the mesentery (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Subsequent CT-guided tissue sampling of this tracer-avid lesion reached the diagnosis of recurrent pancreatic adenocarcinoma (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). The patient underwent a combined Gemcitabine and Abraxane therapy with planned future imaging monitoring for the dual malignancy.<elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia>Fluciclovine, is a synthetic leucine amino-acid derivative, channeled to sites of tumor proliferation by the L-type amino-acid transporter 1 (LAT1).<a class="elsevierStyleCrossRef" href="#bib0020">1</a> PET/CT with 18F-Fluciclovine is an established imaging modality for patients with treated prostate cancer exhibiting evidence of biochemical recurrence.<a class="elsevierStyleCrossRef" href="#bib0025">2</a> Research is also on-going using this radiotracer for breast cancer and glioma evaluation. For pancreas cancer, the expression of LAT1 has been reported to be highly associated with the disease stage, tumor size, and tumors markers such as Ki-67, VEGF, CD34, p53 and CD98.<a class="elsevierStyleCrossRef" href="#bib0030">3</a> This strong correlation between LAT1 and pancreas cancer may represent the explanation for the 18F-Fluciclovine incidental finding of recurrent pancreatic malignancy in the presented case. In this patient, the usual PET/CT feature of physiologic tracer uptake by the normal pancreatic parenchyma is absent secondary to the pancreatic head surgical resection and the parenchymal atrophy of the remainder of the gland.Conflict of interestThe authors have no conflict of interest to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Nguyen BD, Tolgay OI. Recidiva de adenocarcinoma pancreático detectada mediante PET/TC con 18F-Fluciclovina. Med Nucl Imagen Mol. 2019;38:258–259." ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1237 "Ancho" => 2500 "Tamanyo" => 343638 ] ] "descripcion" => array:1 [ "en" => "(A) 18F-Fluciclovine anterior maximum intensity projection PET image with the tracer-avid lesion at mid-abdomen (arrow). (row B) Corresponding axial, sagittal and coronal fused PET/CT and (row C) CT images of the retroperitoneal/mesenteric mass (arrows)." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 928 "Ancho" => 2487 "Tamanyo" => 377477 ] ] "descripcion" => array:1 [ "en" => "Tissue sampling with histological diagnosis of recurrent pancreatic adenocarcinoma. (A) Biopsy section of the infiltrative lesion with pleomorphic nuclei (H&E stain, 200× magnification). (B) Aspiration cytology smear with dyscohesive, markedly atypical neoplastic cells (Papanicolaou stain, high power)." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0020" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "L-type amino acid transport and cancer: targeting the mTORC1 pathway to inhibit neoplasia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Q. Wang" 1 => "J. Holst" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Cancer Res" "fecha" => "2015" "volumen" => "5" "paginaInicial" => "1281" "paginaFinal" => "1294" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26101697" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0025" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Imaging of prostate cancer using fluciclovine" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "B. Savir-Baruch" 1 => "L. Zanoni" 2 => "D.M. Schuster" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.cpet.2016.11.005" "Revista" => array:6 [ "tituloSerie" => "PET Clin" "fecha" => "2017" "volumen" => "12" "paginaInicial" => "145" "paginaFinal" => "157" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28267449" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0030" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic significance of L-type amino-acid transporter 1 expression in surgically resected pancreatic cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Kaira" 1 => "Y. Sunose" 2 => "K. Arakawa" 3 => "T. Ogawa" 4 => "N. Sunaga" 5 => "K. Shimizu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/bjc.2012.310" "Revista" => array:6 [ "tituloSerie" => "Br J Cancer" "fecha" => "2012" "volumen" => "107" "paginaInicial" => "632" "paginaFinal" => "638" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22805328" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000003800000004/v1_201907020628/S2253808918301083/v1_201907020628/en/main.assets" "Apartado" => array:4 [ "identificador" => "47121" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Interesting image" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22538089/0000003800000004/v1_201907020628/S2253808918301083/v1_201907020628/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808918301083?idApp=UINPBA00004N"]

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The Revista Española de Medicina Nuclear e Imagen Molecular (Spanish Journal of Nuclear Medicine and Molecular Imaging), was founded in 1982, and is the official journal of the Spanish Society of Nuclear Medicine and Molecular Imaging, which has more than 700 members. The Journal, which publishes 6 regular issues per year, has the promotion of research and continuing education in all fields of Nuclear Medicine as its main aim. For this, its principal sections are Originals, Clinical Notes, Images of Interest, and Special Collaboration articles. The works may be submitted in Spanish or English and are subjected to a peer review process. In 2009, it became the leading Spanish journal in the field of Medical Imaging on having an Impact Factor , awarded by the Journal Citation Reports.

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Vol. 38. Issue 4.

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