Gallbladder adenocarcinoma is an uncommon and serious disease. The primary disease grows rapidly with local invasion into the liver and with distant spread to lymph nodes. It is often detected late, due to which management can be challenging. Despite routine use of computed tomography (CT) and ultrasonography (US) for detection, magnetic resonance imaging (MRI) is often considered for a detailed assessment of the anatomic behavior of these tumors. We share three cases where 18-FDG PET/CT played a role in management thereof.
Multi-Modality Imaging
Diagnostic yield of FDG PET/CT, MRI, and CSF cytology in nonbiopsiable Neurolymphomatosis as a heralding feature of Diffuse B-cell Lymphoma recurrence.
Neurolymphomatosis (NL) is a rare condition associated with lymphomas in which various structures of the nervous system are infiltrated by malignant lymphocytes. Rarely, it may be the presenting feature of recurrence of lymphoma otherwise deemed to be in remission. It is crucial, as is the case with all types of nodal or visceral involvement of lymphoma, to identify the disease early and initiate treatment with chemotherapy and/or radiation therapy. Positron emission tomography-computed tomography (PET-CT) has been shown to be a sensitive modality for staging, restaging, biopsy guidance, therapy response assessment, and surveillance for recurrence of lymphoma. Magnetic resonance imaging (MRI) is another useful imaging modality, which, along with PET/CT, compliment cerebrospinal spinal fluid (CSF) cytology and electromyography (EMG) in the diagnosis of NL. Performing nerve biopsies to confirm neurolymphomatosis can be challenging and with associated morbidity. The case presented herein illustrates the practical usefulness of these tests in detecting NL as a heralding feature of lymphoma recurrence, especially in the absence of histopathologic correlation.
Quantitative Imaging Analysis of FDG PET/CT Imaging for Detection of Central Neurolymphomatosis in a Case of Recurrent Diffuse B-Cell Lymphoma
Neurolymphomatosis (NL) is a rare disease characterized by malignant lymphocytes infiltrating various structures of the nervous system. It typically manifests as a neuropathy involving the peripheral nerves, nerve roots, plexuses, or cranial nerves. It often presents as a complication of lymphoma, but it can be the presenting feature of recurrent lymphoma. It is essential to identify and initiate treatment early with chemotherapy and/or radiation therapy in all cases of nodal or visceral (including neural) involvement with lymphoma. There are various diagnostic tests that can be used for its detection, such as cerebrospinal spinal fluid (CSF) cytology, electromyography (EMG), magnetic resonance imaging (MRI), and positron-emission tomography/computed tomography (PET/CT). FDG-PET/CT is the standard of care in lymphoma staging, restaging, and therapy response assessment, but has an inherent limitation in the detection of disease involvement in the central nervous system. While that is mostly true for visual assessment, there are quantitative methods to measure variation in the metabolic activity in the brain, which in turn helps detect the occurrence of neurolymphomatosis.
IAG announced new partnership in development of novel, targeted T-cell enhancing immuno-oncology therapeutics
Pieris Pharmaceuticals, Inc. and Image Analysis Group Partner to use advanced imaging strategies to develop monoclonal antibody therapeutics against solid tumors.
BOSTON, MA, USA and LONDON, UK – April 16, 2020
IAG has partnered with the Boston-based Pieris Pharmaceuticals, Inc. to use quantitative image analysis methodologies, such as Radiomics to develop their novel asset, which is a monoclonal antibody therapeutic agent against solid tumors.
In this collaboration, IAG will provide expertise on the imaging methodologies, which include Computed tomography (CT) radiomics as a means of early detection of tumor’s response to therapy. This approach is poised to not only provide invigorating scientific endpoints but also offer the means to design and execute trials in a more efficient way.
Dr Olga Kubassova of IAG comments, “We are very excited to partner with Pieris on this project, in which we leverage Radiomics in the development of a very promising immunotherapeutic agent. There is tremendous potential in this methodology, not only as a standalone but even more so when combined with genomics and pathomics.”
Markus Ziettl, the CMO of Pieris shares his thoughts about this project, “Radiomics is a very exciting image analysis approach that provides non-invasive imaging biomarkers that work as surrogate markers for outcomes. When correlated with clinicopathologic outcomes, radiomic signatures can not detect the immunotherapy response earlier but also more accurately.”
ABOUT PARTNERS:
Pieris Pharmaceuticals, Inc. (NASDAQ:PIRS) Pieris is a clinical-stage biotechnology company that combines leading protein engineering capabilities and deep understanding into molecular drivers of disease to develop medicines that drive local biology to produce superior clinical outcomes for patients. Our pipeline is focused on inhalable Anticalin proteins to treat respiratory diseases and locally-activated bispecifics for immuno-oncology. Proprietary to Pieris, Anticalin proteins are a novel class of therapeutics validated in the clinic and by strong partnerships with leading pharmaceutical companies.
IAG, Image Analysis Group is a leadering imaging expert organization that provides cutting-edge advanced imaging methodology-based services in the realm of drug discovery and development. IAG has experts in Immuno-oncology, Neuroradiology, Molecular imaging and Musculoskeletal imaging. IAG has partnered with several major medical centers on one hand, such as University College London and McMaster University, and numerous biopharma/biotech companies in the realm of translational medicine and drug development on the other. IAG is a unique clinical development partner to life sciences companies and has a proprietary cloud-based platform DYNAMIKA for all image analysis needs. We have years of experience in AI and Machine Learning as well as bespoke co-development business models that ensure higher probability for promising therapeutics to reach the patients. Our independent Bio-Partnering division fuses risk-sharing business models and agile culture to accelerate novel drug development.