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Volume 7, Issue 3
2010 . 3
pet center of excellence
newsletter
Imaging Evaluation of Prostate Cancer
with FDG-PET/CT
President’s
Report
George M. Segall, MD
Are Two Photons Better
Than One?
Are two photons better than one? That is
the question that went through my mind when
the chair of a well-known academic radiology department recently told me that “bone
scans are dying,” meaning that the number of
bone scans being performed at that institution
was rapidly decreasing. Could that be true?
Maybe. According to Centers for Medicare and
Medicaid Services (CMS) data, the number of
Medicare claims for whole-body bone scans
decreased 10% from 581,384 scans in 2007 to
521,587 scans in 2008. I asked the chair what
was being done instead of bone scans. The
answer, surprisingly, was PET/CT. I say surprisingly because FDG PET/CT is excellent for
overall cancer staging, but Tc-99m MDP bone
scan is excellent for detection of blastic metastases from prostate and other cancers. But the
playing field is changing. CMS announced in
February 2010 that Medicare would pay for
sodium fluoride PET/CT scans for evaluation
of skeletal metastases in patients with cancer,
under the policy of “coverage with evidence
development.” The National Oncologic PET
Registry (NOPR) is developing a new registry
for sodium fluoride PET/CT scans that will be
open before the end of the year. Studies have
shown that sodium fluoride PET/CT scans are
superior to planar Tc-99m MDP bone scans,
and are also better than SPECT/CT bone scans,
for detection of skeletal metastases.
The gamma camera replaced the rectilinear
scanner in the 1960s and 1970s, and PET/CT
is on the verge of replacing the gamma camera.
Oncologic PET/CT scans already account for
the majority of nuclear medicine studies in
(Continued on page 3. See President.)
Prostate cancer is biologically and clinically a heterogeneous disease. The utility
of FDG-PET in prostate cancer should be
considered in the context of the limitations
and challenges associated with other imaging modalities in prostate cancer. The initial
analysis of the National Oncologic PET
Registry (NOPR) data clearly indicates that
FDG-PET can influence the clinical management of men with prostate cancer (from
non-treatment to treatment in 25.3% and
from treatment to non-treatment in 9.7% of
cases), albeit at a lower rate of influence
than for other cancers (1). Nevertheless, the
overall clinical experience with FDG-PET in
prostate cancer suffers from heterogeneity of
published studies with regards to the clinical
phases of disease in a relatively small number of patients, variability and limitations of
the validation criteria, as well as technical
and image processing factors.
Primary Tumor and Staging
The level of FDG accumulation can overlap in normal prostate, BPH and prostate
cancer tissues, which often co-exist (2–4).
FDG-PET might not be useful in the diagnosis or staging of clinically organ-confined
disease or in the detection of locally recurrent disease, owing to the relatively similar
uptake of FDG by the scar tissue and tumor
cells and because the high excreted radiotracer in the adjacent urinary bladder may
mask any lesions in the vicinity (5). False
positive results may occur with prostatitis (6).
However, FDG uptake is higher in poorly differentiated primary tumors (Gleason sum score
above 7) and higher PSA values than those
tumors with lower Gleason scores, more localized clinical stage and lower serum PSA values
(7). In patients with known osseous metastatic
disease, FDG-PET might distinguish the metabolically active lesions from the metabolically
dormant lesions (8–10). Furthermore, data
from our laboratory suggest that the rate of
concordance of FDG-PET to other imaging
studies depends on phase of disease (castrateresistant vs. castrate-sensitive disease), time
of imaging in relation to therapy (before or
during), and type of lesions (lymph nodes and
visceral lesions vs. osseous lesions) (11–13).
Biochemical Failure and Restaging
FDG-PET may be useful in detecting disease in a fraction of the large proportion of
men who present with PSA relapse, in whom,
by definition, there is no standard imaging evidence of disease. In this group of men, detection of disease by “non-standard” imaging can
direct appropriate treatment, such as salvage
radiation therapy for local recurrence in the
prostate bed or systemic therapy for metastatic
disease. In this clinical setting, FDG-PET is
advantageous over 111In-capromab pendetide
scintigraphy in the detection of metastatic disease in patients with high PSA levels or high
PSA velocity (14). In a retrospective study of
91 patients with PSA relapse following prosta(Continued on page 2. See Prostate Cancer.)
In this Issue
By George M. Segall, MD
By Hossein Jadvar, MD, PhD, MPH, MBA, University of Southern California, Los Angeles, California
View You Can Use
PET in the Literature
SNM Speaks Out on PET
3
4
5
(Prostate Cancer. Continued from page 1.)
tectomy and validation of tumor presence by biopsy or clinical and
imaging follow-up, mean serum PSA levels were higher in FDG-PET
positive patients than in FDG-PET-negative patients (9.5 ± 2.2 ng/
ml versus 2.1 ± 3.3 ng/ml)(15). A PSA level of 2.4 ng/mL and PSA
velocity of 1.3 ng/mL/y provided the best compromise between sensitivity (80% for FDG-PET-positive and 71% for FDG-PET-negative
patients) and specificity (73% for FDG-PET-positive and 77% for
FDG-PET-negative patients) in a receiver operating characteristic
curve analysis. Overall, FDG-PET detected local or systemic disease
in 31% of patients with PSA relapse. However, the study was limited
due to heterogeneity and limitation of the validation criteria, which is
an issue with other similar studies.
Therapy Response Assessment
In one report, FDG accumulation in the primary prostate cancer
and metastatic sites decreased over a period of one to five months
after initiation of androgen deprivation therapy, which was consistent
with results from animal xenograft studies (16, 17). However, an
earlier study of prostate cancer in rats showed that the global FDG
SUV was unchanged after treatment with gemcitabine (18). Preliminary results show that tumor FDG uptake decreases with successful
treatment (using androgen deprivation or various chemotherapy regimens), in general concordance with other measures of response, such
as a decline in serum PSA level (19, 20).
Prognostication
The level and extent of FDG accumulation in metastatic lesions
may provide information on prognosis. An increase of over 33% in
the average maximum SUV measurement from up to five lesions, or
the appearance of new lesions, was reported to be able to categorize
castrate-sensitive metastatic prostate cancer patients treated with
antimicrotubule chemotherapy into progressors or nonprogressors
(21). Similarly, another group reported that patients with primary
prostate tumors with high SUVs had a poorer prognosis in comparison to those with low SUVs (22). Moreover, as FDG uptake in
prostate tumors appears to depend on the presence and activity of
androgen, FDG-PET might also be useful in predicting the length of
time to reach the androgen-refractory state (for example, by an early
increase in castrate tumor FDG uptake), which might facilitate earlier
therapeutic modification to avert or delay this clinical state in order to
potentially improve overall outcome.
Acknowledgement: National Institutes of Health – National Cancer Institute
Grants R01-CA111613 and R21-CA142426.
References
1. Hillner, BE et al. relationship between cancer type and impact of PET
and PET/CT on intended management: findings of the National Oncologic PET Registry. J Nucl Med 2008; 49:1928–1935.
2. Salminen E, Hogg A, Binns D, et al. Investigations with FDG-PET
scanning in prostate cancer show limited value for clinical practice.
Acta Oncol 2002; 41:425–429.
3. Effert PJ, Bares R, Handt S, et al. Metabolic imaging of untreated prostate cancer by positron emission tomography with 18fluorine-labeled
deoxyglucose. J Urol 1996; 155:994–998.
2 PET Center of Excellence Newsletter/2010.3
4. Hofer C, Laubenbacher C, Block T, et al. Fluorine-18-fluorodeoxyglucose positron emission tomography is useless for the detection of local
recurrence after radical prostatectomy. Eur Urol 1999; 36:31–5.
5. Liu IJ, Zafar MB, Lai YH, et al. Fluorodeoxyglucose positron emission
tomography studies in diagnosis and staging of clinically organ-confined prostate cancer. Urology 2001; 57:108–111.
6. Kao PF, Chou YH, Lai CW. Diffuse FDG uptake in acute prostatitis.
Clin Nucl Med 2008; 33:308–10.
7. Oyama N, Akino H, Suzuki Y, et al. The increased accumulation of
[18F]fluorodeoxyglucose in untreated prostate cancer. Jpn J Clin Oncol
1999; 29:623–9.
8. Morris NJ, Akhurst T, Osman I, et al. Fluorinated deoxyglucose positron emission tomography imaging in progressive metastatic prostate
cancer. Urology 2002; 59:913–918.
9. Yeh SD, Imbriaco M, Larson SM, et al. Detection of bony metastases of
androgen-independent prostate cancer by PET-FDG. Nucl Med Biol
1996; 23:693–697.
10. Jadvar H, Pinski JK, Conti PS. FDG PET in suspected recurrent and
metastatic prostate cancer. Oncol Rep 2003; 10:1485–1488.
11. Jadvar, H. Pinski J, Quinn D, et al. Concordance among FDG PET,
CT and bone scan in men with metastatic prostate cancer. Presented at
the 55th Annual Meeting of the Society of Nuclear Medicine, 2008, New
Orleans, LA.
12. Jadvar H, Pinski J, Quinn D, et al. PET/CT with FDG in metastatic
prostate cancer: castrate-sensitive vs. castrate-resistant disease. Proc
SNM 56th Ann Meeting, Toronto, ON, Canada; p. 120P; 2009.
13. Jadvar H, Desai BB, Conti PS, et al. Detection of lymphadenopathy
with FDG PET-CT in men with metastatic prostate cancer,” Proc
SNM 57th Ann Meeting, Salt Lake City, UT, In: J Nucl Med 51(Supp
2):126P; 2010.
14. Seltzer MA, Barbaric Z, Belldegrun A, et al. Comparison of helical
computerized tomography, positron emission tomography and monoclonal antibody scans for evaluation of lymph node metastases in patients
with prostate specific antigen relapse after treatment for localized prostate cancer. J Urol 1999; 162:1322–1328.
15. Schoder H, Herrmann K, Gonen M, et al. 2-[18F]fluoro-2-deoxyglucose positron emission tomography for detection of disease in patients
with prostate-specific antigen relapse after radical prostatectomy. Clin
Cancer Res 2005; 11:4761–9.
16. Oyama N, Akino H, Suzuki Y, et al. FDG PET for evaluating the change
of glucose metabolism in prostate cancer after androgen ablation. Nucl
Med Commun 2001; 22:963–9.
17. Zhang Y, Saylor M, Wen S, et al. Longitudinally quantitative 2-deoxy2-[18F]fluoro-D-glucose micro positron emission tomography imaging
for efficacy of new anticancer drugs: a case study with bortezomib in
prostate cancer murine model. Mol Imaging Biol 2006; 8:300–8.
18. Haberkorn U, Bellemann ME, Altmann A, et al. PET 2-fluoro-2-deoxyglucose uptake in rat prostate adenocarcinoma during chemotherapy
with gemcitabine. J Nucl Med 1997; 38:1215–1221.
19. Jadvar H. Molecular imaging of prostate cancer with [F-18]-fluorodeoxyglucose PET. Nat Rev Urol 2009; 6:317–323.
20. Jadvar H. FDG-PET in prostate cancer. PET Clinics 2009; 4(2):155–
161.
21. Morris MJ, Akhurst T, Larson SM, et al. Fluorodeoxyglucose positron
emission tomography as an outcome measure for castrate metastatic
prostate cancer treated with antimicrotubule chemotherapy. Clin Cancer Res 2005; 11:3210–6.
22. Oyama N, Akino H, Suzuki Y, et al. Prognostic value of 2-deoxy-2[F-18]fluoro-D-glucose positron emission tomography imaging for
patients with prostate cancer. Mol Imaging Biol 2002; 4:99–104.
(President. Continued from page 1.)
some departments. The approval of new molecular imaging agents for
PET in the next few years is expected to significantly boost the use
of PET/CT. Fluoride-labeled myocardial perfusion agents show great
promise for the diagnosis and evaluation of coronary artery disease.
Fluoride-labeled compounds are already in Phase II trials. Approval
of these agents will make cardiac PET more practical and widely
available. Replacement of Tc-99m MDP bone scans with sodium fluoride PET/CT will be the trifecta that will transform nuclear medicine
departments. Even less common procedures performed with singlephoton agents will be replaced by PET/CT. FDG will replace Tc-99m
or In-111 labeled white blood cells for evaluation of infection, and
Ga-68 DOTATOC will replace In-111 pentetreotide for detection of
neuroendocrine tumors (as it already has in Europe).
It would be premature to announce the end of the gamma camera,
but the gamma camera is 50 years old. PET/CT is the future, and we
are on the verge of a huge paradigm shift. Heath care reform, the
backlash against medical imaging and legitimate concern about radiation exposure will delay the broader application of PET/CT, but the
outcome is inevitable. Are we ready? Not yet. We need to make sure
physicians are properly trained in anatomic and molecular imaging,
conduct comparative effectiveness studies and develop appropriateness criteria to ensure we use the technology wisely and appropriately. The sooner we start, the better.
Views You Can Use
This 68-year-old man had received radiotherapy for prostate cancer
five years earlier, followed by maintenance hormonal therapy. He
recently was noted to have a rising PSA, and CT of the chest, abdomen and pelvis revealed mediastinal lymphadenopathy. A radionuclide bone scan was negative. He had a long, heavy smoking history,
and lung cancer was a concern. A PET/CT was ordered to assess the
extent of disease. The PET/CT showed abnormal uptake in hilar and
mediastinal lymph nodes (curved arrows, Fig. 1), in multiple pelvic
lymph nodes (white arrows, Figs. 2 & 4), in multiple pulmonary
nodules (gray arrows, Fig. 3), and in the sacrum (black arrow, Fig. 4).
Mediastinal biopsy showed metastatic prostate cancer.
How did the PET/CT help?
The PET/CT scan identified additional metastases in normal size
pelvic lymph nodes and a sacral metastasis that was not seen on bone
scan, as well as a subtle lung metastasis that was not identified on the
CT scan. The recent NCCN (National Comprehensive Cancer Network) task force report on the clinical utility of PET suggests that PET
may be of use in hormonally resistant prostate cancer, and the NOPR
(National Oncologic PET Registry) now covers PET for evaluation of
subsequent treatment strategy for prostate cancer1,2.
References:
(1) J Natl Compr Canc Netw. 2009 Jun;7 Suppl 2:S1–26
(2) http://www.cancerpetregistry.org/indications_facilities.htm
(Continued on page 5. See Views.)
www.snm.org/PET 3
PET in the Literature
The international literature on PET and PET/CT continues to grow at a pace that challenges both
researchers and clinicians. In each issue, the PET CoE Newsletter presents a tomographic slice
of the breadth of PET literature that appears in publications around the world. Weekly lists of all
published PET research are available to logged-in members in the PET Center of Excellence section of the SNM website at www.snm.org/pet in the PET References Archive under NEWS/PUBS.
Articles selected for relevance to clinical oncologists are also featured weekly.
Cardiology
Images in radiology. A bright spot.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&
db=PubMed&dopt=Citation&list_uids=20102990.
Huyge V, Unger P, Goldman S.
Am J Med. 2010;123:37-39. (Jan).
Synthesis of fluorine-18 labeled rhodamine B: A potential PET
myocardial perfusion imaging agent.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db
=PubMed&dopt=Citation&list_uids=19783150.
Heinrich TK, Gottumukkala V, Snay E, et al.
Appl Radiat Isot. 2010;68:96-100. (Jan).
General Clinical Practice
Synthesis and evaluation of (99m)Tc-moxifloxacin, a potential
infection specific imaging agent.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db
=PubMed&dopt=Citation&list_uids=19900818.
Chattopadhyay S, Saha Das S, Chandra S, et al.
Appl Radiat Isot. 2010;68:314-316. (Feb).
Whole-body FDG-PET/CT on rheumatoid arthritis of large joints.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db
=PubMed&dopt=Citation&list_uids=19834653.
Kubota K, Ito K, Morooka M, et al.
Ann Nucl Med. 2009;23:783-791. (Nov).
Instrumentation and Data
Synthesis and evaluation of l-5-(2-[(18)F]fluoroethoxy)tryptophan
as a new PET tracer.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db
=PubMed&dopt=Citation&list_uids=19906535.
Li R, Wu SC, Wang SC, et al.
Appl Radiat Isot. 2010;68:303-308. (Feb).
Synthesis of carbon-11-labeled 4-aryl-4H-chromens as new PET
agents for imaging of apoptosis in cancer.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db
=PubMed&dopt=Citation&list_uids=19818636.
Gao M, Wang M, Miller KD, et al.
Appl Radiat Isot. 2010;68:110-116. (Jan).
Neurology
Increased synaptic dopamine function in associative regions of
the striatum in schizophrenia.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db
=PubMed&dopt=Citation&list_uids=20194823.
4 PET Center of Excellence Newsletter/2010.3
Kegeles LS, Abi-Dargham A, Frankle WG, et al.
Arch Gen Psychiatry. 2010;67:231-239. (Mar).
Brain serotonin and dopamine transporter bindings in adults with
high-functioning autism.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db
=PubMed&dopt=Citation&list_uids=20048223.
Nakamura K, Sekine Y, Ouchi Y, et al.
Arch Gen Psychiatry. 2010;67:59-68. (Jan).
Oncology
Evaluation of O-(2-[18F]-Fluoroethyl)-L-Tyrosine in the Diagnosis of Glioblastoma.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db
=PubMed&dopt=Citation&list_uids=20212242.
Benouaich-Amiel A, Lubrano V, Tafani M, et al.
Arch Neurol. 2010;67:370-372. (Mar).
Positron emission tomography-computed tomography in paraneoplastic neurologic disorders: systematic analysis and review.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db
=PubMed&dopt=Citation&list_uids=20065123.
McKeon A, Apiwattanakul M, Lachance DH, et al.
Arch Neurol. 2010;67:322-329. (Mar).
Radiopharmacology
Impact of early life stress on the reinforcing and behavioral-stimulant effects of psychostimulants in rhesus monkeys.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db
=PubMed&dopt=Citation&list_uids=20016373.
Ewing Corcoran SB, Howell LL.
Behav Pharmacol. 2010;21:69-76. (Feb).
Predicting gemcitabine transport and toxicity in human pancreatic
cancer cell lines with the positron emission tomography tracer
3’-deoxy-3’-fluorothymidine.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db
=PubMed&dopt=Citation&list_uids=19788890.
Paproski RJ, Young JD, Cass CE.
Biochem Pharmacol. 2010;79:587-595. (Feb 15).
Speaks Out
on PET
Optical Imaging Could Create Pathway
for Radiotracers, JNM Study Finds
The next generation of imaging techniques could harness a technology that moves faster than the speed of light
Reston, Va.—A study published in the July issue of The Journal
of Nuclear Medicine (JNM) reports on investigative research of a
novel optical imaging technique called “Cerenkov luminescence
imaging (CLI).” According to the authors, the technique could lead
to the faster and more cost-effective development of radiopharmaceuticals for the diagnosis and treatment of cancer and other
conditions.
“The development of novel multimodality imaging agents and
techniques could represent the frontier of research in the field of
medical imaging science,” said Jan Grimm, M.D., Ph.D., a professor and physician at Memorial Sloan-Kettering Cancer Center and
Weill Cornell Medical Center in New York and corresponding
author for the study. Grimm explained that his group’s work, along
with current work from groups at the University of California
Davis (Simon Cherry, Ph.D.) and Stanford University (Sanjiv Sam
Gambhir, M.D., Ph.D.), may open a new path for optical imaging
to move into the clinic.
When light travels through water, its speed decreases. A particle
that moves faster than light produces a “shock wave” (much like
the sonic boom that broke the sound barrier), which emits a visible
blue light known as “Cerenkov radiation.” The researchers write
that their study is among the first to explore Cerenkov radiation’s
(Continued on page 6. See SNM Speaks Out.)
(Views. Continued from page 3.)
Fig. 6
The mediastinal biopsy showed rare, cohesive groups of atypical epithelial cells (black arrows, Fig. 5) in a background of normal
lymphoid tissue. These epithelial groups demonstrated an immunohistochemical staining profile diagnostic for metastatic prostate cancer, showing immunoreactivity for prostate specific antigen (PSA),
prostate specific acid phosphatase (PSAP), and the epithelial marker
cytokeratin AE1/AE3 (Fig. 6). Staining was negative for cytokeratin
7, cytokeratin 20, and TTF-1 (a lung and thyroid marker), which also
supported the diagnosis (Fig. 6).
Histology courtesy of Jennifer Broussard, M.D.
About “Views You Can Use”
This case was provided by David Seldin, MD, Franklin Square Hospital Center, Baltimore, Md. It was also featured on the Web site of Gabriel Soudry, MD,
at www.petcases.com. In addition to the Web site, Dr. Soudry also mails printed versions of the example cases to referring physicians in Franklin Square
and the surrounding community. Working with Dr. Soudry and other PET specialists, the PET CoE Web site (www.snm.org/PET) features “Views You Can
Use,” single-sheet PDFs that include specific cases, images and references. As a PET CoE member, you can add your own contact information to these
sheets and distribute them electronically or by printed hard copy to referring physicians for education purposes.
www.snm.org/PET 5
(SNM Speaks Out. Continued from page 5.)
applications for medical imaging using optical imaging techniques.
Optical imaging is a molecular imaging procedure in which lightproducing molecules designed to attach to specific cells or molecules are
injected into the bloodstream and then detected by an optical imaging
device. It usually requires either excitation by an external light source or
by a biological process. Cerenkov imaging produces the light from the
radioactivity, so no external illumination is needed. Combining optical
imaging with nuclear medicine presents a new path for imaging medical isotopes, Grimm said. “It provides optical imaging with an array of
approved nuclear tracers already in clinical use today, which can be used
immediately, as opposed to fluorescent dyes,” he added.
For the study, researchers evaluated several radionuclides for potential
use with CLI. Researchers used CLI and positron-emission tomography
(PET) imaging to visualize tumor-bearing mice. The results show that
CLI visualizes radiotracer uptake in vivo. The resulting decrease of light
over time correlates with the radioactive decay of the injected tracer.
An added value of this technique is its ability to image radionuclides
that do not emit either positrons or gamma rays—a current limitation for
nuclear imaging modalities. CLI brings to light isotopes that could not
be visualized previously. Additionally, optical imaging techniques show
promise for endoscopy and surgery because of the ability to visualize
tumor lesions, which could provide real-time information to surgeons and
help guide operations.
“The benefits of optical imaging are numerous, and we’re on a path
to realizing them,” said Grimm. “We are optimistic that these new techniques will one day be available to physicians as another tool for the
diagnosis and treatment of disease.”
Authors of “Cerenkov Luminescence Imaging of Medical Isotopes”
include: Alessandro Ruggiero, Jan Grimm, Nuclear Medicine Service,
Department of Radiology, Memorial Sloan-Kettering Cancer Center,
New York, New York; Jason P. Holland, Jason S. Lewis, Radiochemistry
Service, Department of Radiology, Memorial Sloan-Kettering Cancer
Center, New York, New York; Jason S. Lewis, Jan Grimm, Molecular
Pharmacology and Chemistry Program, Memorial Sloan-Kettering Cancer Center, New York, New York.
The Commission on Cancer (CoC), partnered
with the Society of Nuclear Medicine (SNM),
is pleased to host the October 27 Webinar:
“Molecular Imaging to Direct
Locoregional Cancer Treatment”
Eric M. Rohren, MD, PhD, associate professor, nuclear medicine,
University of Texas M.D. Anderson Cancer Center, Houston, TX, and Ehab
Y. Hanna, MD, FACS, professor and vice chair for clinical affairs, Department of Head and Neck Surgery, University of Texas M.D. Anderson Cancer
Center, Houston, TX, will present this webinar covering the current state of
the art and future directions for the application of molecular imaging to guide
cancer therapy, with an emphasis on locoregional treatments (surgery and
radiation oncology). Important imaging modalities will also be reviewed.
Learn more about current challenges faced by cancer practitioners in the
choice of locoregional treatment.
The cost is $50 for this one hour program.
To register and for more information, please visit:
http://eo2.commpartners.com/users/acs/session.php?id=5006
6 PET Center of Excellence Newsletter/2010.3
pet center of excellence newsletter
The PET Center of Excellence Newsletter is a quarterly
member information service published under the
direction of the PET CoE leadership and SNM.
PCOE Newsletter Editorial Board
François Bénard, MD
[email protected]
Hossein Jadvar, MD, PhD, MPH, MBA, Editor
[email protected]
Gabriel Soudry, MD
[email protected]
Jian (Michael) Yu, MD
[email protected]
PCOE Board of Directors
George M. Segall, MD
President
Eric M. Rohren, MD, PhD
Vice President
Paul D. Shreve, MD
Secretary/Treasurer
Homer A. Macapinlac, MD
Immediate Past President
Robert W. Atcher, PhD, MBA
Jacqueline C. Brunetti, MD
Dominique Delbeke, MD, PhD
Lisa S. Gobar, MD
Michael M. Graham, PhD, MD
Rodney J. Hicks, MD
Hossein Jadvar, MD, PhD, MPH, MBA
Marc Seltzer, MD
Anthony F. Shields, MD, PhD
Daniel H. Silverman, MD, PhD
Terence Wong, MD
Ryan Niederkohr, MD, Intern
SNM Chief Executive Officer
Virginia Pappas, CAE
Managing Editor
Jane Kollmer
Graphic Designer
Laura Mahoney