Fetal Dose Estimates for <sup>18</sup>F-Fluoro-l-Thymidine Using a Pregnant Monkey Model

Bartlett, Rachel; Nickles, Robert J.; Barnhart, Todd E.; Christian, Bradley T.; Holden, James E.; DeJesus, Onofre T.

doi:10.2967/jnumed.109.068734

Cited by 14 publications

(6 citation statements)

References 24 publications

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“…Previously, the safety of FDG-PET imaging during pregnancy for the fetus has been discussed. In pregnant rhesus monkey models using 18 F-fluorothymidine, there is higher radionuclide uptake and longer retention in the fetal liver than in the maternal liver [ 21 ]. Zanotti-Fregonara et al calculated the fetal radiation dose for administration of 18 F-FDG using mathematic modeling for placental crossover and fetal uptake.…”

Section: Discussionmentioning

confidence: 99%

PET/MR imaging for the evaluation of cervical cancer during pregnancy

Ishiguro

Nishikawa

Ishii

et al. 2021

BMC Pregnancy Childbirth

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Background Malignancy during pregnancy is increasing, and the most common type of malignancy is uterine cervical cancer. When planning the treatment of cervical cancer, it is important to look for signs of metastasis before surgery, especially metastasis to the lymph nodes. In this report, we assessed the diagnostic value of positron emission tomography/magnetic resonance imaging (PET/MRI) for evaluating cervical cancer propagation before surgery, with a focus on pregnant women. Case presentation 18F Fluorodeoxyglucose (FDG)-PET/MRI was performed in seven pregnant cervical cancer patients (28–34 years old) at 9–18 gestational weeks. In case #5, a second PET/MRI was performed at 24 gestational weeks. Of seven FDG-PET/MRI examination series in six cases (cases #1–6), FDG-PET/MR imaging could detect cervical tumors with abnormal FDG accumulation; these tumors were confirmed with a standardized uptake value max (SUV max) titer of 4.5–16. A second PET/MRI examination in case #5 revealed the same SUV max titer as the first examination. In these six imaging series (cases #1–5), there were no signs of cancer metastasis to the parametrium and lymph nodes. However, in case #6, abnormal FDG accumulation in the left parametrial lymph nodes was also detectable. Pathological examination showed lymph node metastasis in case #6. In case #7, PET/MRI could not detect any abnormal FDG accumulation in the cervix and other sites. Cone biopsy demonstrated only micro-invasive squamous cell carcinoma. After treatment for cervical cancer, all seven patients have had no recurrence of disease within the follow-up period (2.8–5.6 years), and their children have developed appropriately. Conclusion PET/MRI is an effective imaging tool to evaluate cervical cancer progression in pregnancy.

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Section: Discussionmentioning

confidence: 99%

PET/MR imaging for the evaluation of cervical cancer during pregnancy

Ishiguro

Nishikawa

Ishii

et al. 2021

BMC Pregnancy Childbirth

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“…Both radiation exposures are potentially fetotoxic. The risk for adverse fetal outcome is negatively correlated with gestational stage, and positively correlated with the radiation dose, with the highest risk occurring during the first trimester of pregnancy and with radiation exposures of over 100 mGy . Abdominal and pelvic CT is associated with an average effective radiation dose of 25 mGy.…”

Section: Case I: Advanced Stage Newly Diagnosed Hl In the First Trimementioning

confidence: 99%

The management of hodgkin lymphomas in pregnancies

Moshe

Bentur

Lishner

et al. 2017

European J of Haematology

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Hodgkin lymphoma is the most common hematological malignancy in pregnancy. Its management presents several unique challenges, as decisions have to take both maternal and fetal risks into consideration. Using three hypothetical cases, we review current evidence and guidelines and suggest our recommendations for managing pregnant Hodgkin lymphoma patients. The opportunity for a prompt and accurate diagnosis should not be missed; this may be achieved by vigilance to suggestive symptoms, performance of biopsy which is not contraindicated during pregnancy and use of MRI for staging. Most patients should receive treatment with doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) after completion of the first trimester. Bridging therapy with corticosteroids or vinblastine should be considered during the first trimester.In most cases of early disease, the addition of chemotherapy cycles to the treatment plan seems preferable to radiation therapy. Diagnosis at relapse raises unique dilemmas regarding second-line chemotherapeutic regimens and timing of consolidation with high-dose therapy and autologous stem cell transplantation, an approach which is contraindicated during pregnancy. Considering the excellent outcomes of Hodgkin lymphoma outside pregnancy, every effort should be made to strive toward a curative treatment plan while balancing the multiple issues and dilemmas which arise when treating this malignancy in a pregnant patient.

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“…The diagnosis of both Hodgkin and non-Hodgkin lymphoma has its own set of clinical challenges. Disease staging requires imaging studies, usually computerized tomography (CT) or positron emission tomography (PET) combined with CT; however, these tests should be avoided during pregnancy because of the risks of fetal exposure to radiation (12,23). Chest radiography with abdominal shielding can be performed in pregnant women.…”

Section: Haematological Malignanciesmentioning

confidence: 99%

Haematological malignancies in pregnancy: An overview with an emphasis on thrombotic risks

Horowitz¹,

Lavi²,

Nadir³

et al. 2016

Thromb Haemost

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With increase of maternal age, the incidence of haematological malignancies during pregnancy is rising and posing diagnostic and treatment challenges. Lymphoma is the fourth most common malignancy diagnosed in pregnancy; Hodgkin lymphoma is more frequent in pregnant women than non-Hodgkin lymphoma (NHL). The proportion of highly aggressive lymphomas in pregnant women is significantly higher than in non-pregnant women of reproductive age. Reproductive organ involvement is observed in almost half of pregnant women with NHL. The association of acute leukaemia and pregnancy is infrequent and it is assumed that pregnancy does not accelerate the disease course. Both cancer and pregnancy induce a procoagulant state which can lead to maternal venous thromboembolism (VTE) and placental occlusion. Pregnancy in woman with myeloproliferative neoplasms (MPN) promotes thrombotic environment, associating with an augmented risk of placental thrombosis, intrauterine growth retardation or loss and maternal thrombotic events.Haematological malignancies during pregnancy often require urgent diagnosis and management and are associated with potential adverse fetal outcomes. Most chemotherapeutic agents are teratogenic and should be avoided during the first trimester. Their use during the second and third trimesters may cause intrauterine growth restriction, premature birth and intrauterine fetal death. All chemotherapeutic drugs should be administered only after a detailed discussion with the patient and with close fetal monitoring. Chemotherapy and biological agents might also augment thrombotic risk. Guidelines for VTE prophylaxis in pregnant women with hematologic malignancies, apart from MPN, are currently unavailable, and therefore, clinical judgment should be made in each case.

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Fetal Dose Estimates for ¹⁸F-Fluoro-l-Thymidine Using a Pregnant Monkey Model

Cited by 14 publications

References 24 publications

PET/MR imaging for the evaluation of cervical cancer during pregnancy

PET/MR imaging for the evaluation of cervical cancer during pregnancy

The management of hodgkin lymphomas in pregnancies

Haematological malignancies in pregnancy: An overview with an emphasis on thrombotic risks

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Fetal Dose Estimates for 18F-Fluoro-l-Thymidine Using a Pregnant Monkey Model

Cited by 14 publications

References 24 publications

PET/MR imaging for the evaluation of cervical cancer during pregnancy

PET/MR imaging for the evaluation of cervical cancer during pregnancy

The management of hodgkin lymphomas in pregnancies

Haematological malignancies in pregnancy: An overview with an emphasis on thrombotic risks

Contact Info

Product

Resources

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Fetal Dose Estimates for ¹⁸F-Fluoro-l-Thymidine Using a Pregnant Monkey Model