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Purpose: In this study, we aimed to evaluate the response of the primary and metastatic liver tumors to radioembolization with 90 Y glass microspheres and investigate its correlations with dosimetric variables calculated with 90 Y PET/MRI., Methods: In this ambispective study, 44 patients treated with 90 Y glass microspheres and imaged with 90 Y PET/MRI were included for analysis. Dosimetric analysis was performed for every perfused lesion using dose-volume histograms. Response was assessed by comparing pre-treatment and follow-up total lesion glycolysis (TLG) values derived from 18 F-FDG PET imaging. The relationship between ΔTLG and log-transformed dosimetric variables was analyzed with linear mixed effects regression models. ROC analyses were performed to compare discriminatory power of the variables in predicting response and complete response., Results: Regression and ROC analyses demonstrated that mean tumor dose and almost all D values were statistically significant predictors of treatment response and complete treatment response. Specifically, D60, D70 and D80 values exhibited significantly higher discriminatory power for predicting treatment response compared to the mean dose (D mean ) delivered to tumor. High specificity cut-off values to predict response were determined as 160.75 Gy for D mean , 95.50 Gy for D60, 89 Gy for D70, and 59.50 Gy for D80. Similarly, high-specificity cut-off values to predict complete response were 262.75 Gy for D mean , 173 Gy for D70, 140.5 Gy for D80, and 100 Gy for D90., Conclusion: In this study, we demonstrated that voxel-based dosimetry with post-treatment 90 Y PET/MRI can predict response to treatment. D60, D70 and D80 variables also did have greater discriminatory power compared to D mean in prediction of response. In addition, we present high-specificity cut-offs to predict response (CR + PR) and complete response (CR) for both D mean and several D variables derived from dose-volume histograms., Competing Interests: Declarations. Conflict of interest: The authors have no relevant financial or non-financial interests to disclose. Ethical approval: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Ankara University (21.04.2022/No. İ04-203–22). Consent to participate: Informed consent was obtained from all individual participants prospectively included in the study., (© 2024. The Author(s) under exclusive licence to The Japanese Society of Nuclear Medicine.)

Purpose: The aim of this study was to investigate the relationship between voxel-based dosimetric variables derived from Y-90 PET/MRI and hypertrophy observed in the left lobe after radioembolization and to investigate if there is any difference in hypertrophy induced by glass versus resin microspheres., Methods: Voxel-based dosimetry-derived variables and their relationship with the change of the standardized future liver remnant (ΔFLR) was investigated with linear regression models. To compare and evaluate the discriminatory power of the dosimetric variables, ROC analyses were utilized. ΔFLR and kinetic growth rate (KGR) induced with glass and resin microspheres were compared using the Mann-Whitney U test., Results: In this retrospective study, data of the 40 patients treated with Y-90 microspheres were evaluated. Among the several dosimetric variables, the mean perfused volume normal tissue dose (pDnorm), perfused normal tissue V90 (pV90), and pV100 values for glass microspheres; and the mean whole liver normal tissue dose (Dnorm), pDnorm, whole liver normal tissue V30 (nV30), nV40, and pV40 for resin microspheres had the highest relationship with ΔFLR. In the ROC analysis for glass microspheres, the optimal cut-offs to predict ΔFLR > 5% were 60.55 Gy for Dnorm, 94.21 Gy for pDnorm, 28.07% for pV90, and 24.98% for pV100. For resin microspheres, corresponding values were 23.20 Gy for Dnorm, 37.40 Gy for pDnorm, 31.50% for nV30, 24.50% for nV40, and 43.60% for pV40. No significant difference was observed between glass and resin microsphere-induced median ΔFLR, KGR values and atrophy of the right lobe., Conclusion: Following Y-90 radioembolization therapy with glass and resin microspheres applied to the right lobe of the liver, ΔFLR is correlated with pDnorm and Dnorm, but is also significantly related to various nV and pV values. In addition, the hypertrophy and kinetic growth rates observed with glass and resin microspheres were largely similar., Competing Interests: Declarations. Ethics approval: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Ankara University (28.03.2024/No. İ03-240–24). Competing interests: The authors have no relevant financial or non-financial interests to disclose., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Multiparametric magnetic resonance imaging (mpMRI) is used as a current marker in preoperative staging and surgical decision-making, but current evidence on predicting post-surgical oncological outcomes based on preoperative mpMRI findings is limited. In this study We aimed to develop a risk classification based on mpMRI and mpMRI-derived biopsy findings to predict early biochemical recurrence (BCR) after radical prostatectomy., Methods: Between January 2017 and January 2023, the data of 289 patients who underwent mpMRI, transrectal ultrasound-guided cognitive and fusion targeted biopsies, and subsequent radical prostatectomy (RP) with or without pelvic lymph node dissection in a single center were retrospectively re-evaluated. BCR was defined as a prostate specific-antigen (PSA) ≥ 0.2 ng/mL at least twice after RP. Multivariate logistic regression models tested the predictors of BCR. The regression tree analysis stratified patients into risk groups based on preoperative mpMRI characteristics. Receiver operating characteristic (ROC)-derived area under the curve (AUC) estimates were used to test the accuracy of the regression tree-derived risk stratification tool., Results: BCR was detected in 47 patients (16.2 %) at a median follow-up of 24 months. In mpMRI based multivariate analyses, the maximum diameter of the index lesion (HR 1.081, 95%Cl 1.015-1.151, p = 0.015) the presence of PI-RADS 5 lesions (HR 2.604, 95%Cl 1.043-6.493, p = 0.04), ≥iT3a stage (HR 2.403, 95%Cl 1.013-5.714, p = 0.046) and ISUP grade ≥4 on biopsy (HR 2.440, 95%Cl 1.123-5.301, p = 0.024) were independent predictors of BCR. In regression tree analysis, patients were stratified into three risk groups: maximum diameter of index lesion, biopsy ISUP grade, and clinical stage on mpMRI. The regression tree-derived risk stratification model had moderate-good accuracy in predicting early BCR (AUC 77 %) CONCLUSION: Straightforward mpMRI and mpMRI-derived biopsy-based risk stratification for BCR prediction provide an additional clinical predictive model to the currently available pathological risk tools., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Purpose: To evaluate the diagnostic performance of liver 18F-FDG PET/MRI in addition to whole-body PET/CT and to compare it with MRI in the detection and clinical management of liver metastasis in patients with colorectal cancer (CRC)., Material and Methods: Seventy-eight patients with CRC who underwent whole-body 18F-FDG PET/CT followed by liver PET/MRI were prospectively included. Histopathological confirmation and/or at least 3 months of clinical follow-up after PET/MRI were accepted as gold standard. Lesion and patient-based analyses were performed to evaluate the diagnostics performances of PET/CT, PET/MRI and MRI. In addition, changes of clinical management were evaluated., Results: On lesion-based analysis, for PET/CT, PET/MRI and MRI; sensitivity (Se): 55.6%, 97.2% and 100%; specificity (Sp): 98.5%, 100% and 80.5%; and accuracy (Acc): 70.7%, 98.2% and 93.1% were calculated, respectively. Se and Acc of PET/MRI and MRI were significantly superior than PET/CT (P < 0.001). Se and Acc of PET/MRI and MRI were comparable; however, Sp of PET/MRI was significantly better than MRI (P < 0.001). On patient-based analysis, Se: 75.6%, 100% and 100%; Sp: 97.3%, 100% and 86.5%; and Acc: 85.9%, 100% and 93.5% were calculated, respectively. Se and Acc of PET/MRI were significantly superior than PET/CT (P < 0.001). Also, Se of MRI was significantly superior than PET/CT (P < 0.001). Se of PET/MRI and MRI were comparable, but Sp and Acc of PET/MRI were significantly better than MRI. The additional information obtained from liver PET/MRI changed treatment strategy in 14/78 (18%) patients compared to PET/CT or alone liver MRI., Conclusion: Diagnostic performances of PET/MRI and MRI for detection of CRC liver metastasis is superior to PET/CT. PET/MRI especially helps in the accurate detection of liver metastases that are suspicious on MRI and has the potential to change the clinical management of especially oligometastatic patients by identifying uncertain liver lesions., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)