Impact of hybrid molecular imaging in retroperitoneal fibrosis: a systematic review
Isidora T Grozdic Milojevic1,2, Bogomir Milojevic3, Dragana P Sobic-Saranovic4,5
1Center for Nuclear Medicine, Clinical Center of Serbia, University of Belgrade, Visegradska 26, Belgrade, 11000, Serbia. drisidora.grozdic@yahoo.com.
Abstract:
The aim of this article was to critically assess the usefulness of hybrid molecular imaging (FDG PET/CT and FDG PET/MR) procedures in the evaluation of inflammatory activity in retroperitoneal fibrosis (RPF). A systematic review of the literature was performed using PubMed without timeline restriction and using the following keywords: retroperitoneal fibrosis, disease activity, diagnostic techniques, PET/CT, PET/MR. We evaluated full text articles written in the English language. Case reports, review articles or editorials and articles not in the field of interest of this review were excluded. Nine articles comprising a total of 186 patients met the inclusion criteria and were included and described in this systematic review. The new hybrid molecular imaging methods give promising results in the evaluation of the activity of the disease, quantification and prediction of therapeutic response and in tailoring medical therapy in RPF. FDG PET/CT can be a valuable tool in detecting disease activity, particularly in asymptomatic patients with RPF with acute phase reactant increase. Hybrid imaging can predict therapy response outcome and the best time for stent removal. Although PET/MR has potential advantage in small lesions and has reduced radiation exposure in comparison to PET/CT, PET quantification parameters have potentially higher diagnostic value over MR parameters in the evaluation of RPF. Acute phase reactants alone may not be reliable for the management and follow-up assessment of the disease. Hybrid imaging in RFP could be more comfortable, more accurate, with less radiation burden than different separate imaging studies acquired at different points in time.
Insights
Hybrid molecular imaging, including FDG PET/CT and FDG PET/MR, shows promise for evaluating retroperitoneal fibrosis (RPF) activity. These techniques aid in assessing disease progression and predicting treatment response, offering a more accurate and comfortable alternative to separate imaging studies.
Area of Science:
- Nuclear medicine
- Radiology
- Oncology
Background:
- Retroperitoneal fibrosis (RPF) is a rare condition characterized by inflammation and fibrosis in the retroperitoneum.
- Accurate assessment of RPF inflammatory activity is crucial for effective management and treatment monitoring.
Purpose of the Study:
- To critically evaluate the utility of hybrid molecular imaging techniques, specifically FDG PET/CT and FDG PET/MR, in assessing inflammatory activity in RPF.
- To determine the role of these advanced imaging modalities in disease evaluation, therapeutic response prediction, and treatment personalization.
Main Methods:
- A systematic literature review was conducted using PubMed, searching for studies on RPF, disease activity, and hybrid imaging (PET/CT, PET/MR).
- Inclusion criteria focused on full-text English articles, excluding case reports and reviews. Nine articles involving 186 patients were included.
Main Results:
- Hybrid molecular imaging demonstrates promising results for evaluating RPF activity, disease quantification, and predicting therapeutic response.
- FDG PET/CT is valuable for detecting disease activity, especially in asymptomatic patients with elevated acute phase reactants.
- While PET/MR offers reduced radiation exposure, PET quantification parameters may provide higher diagnostic value for RPF compared to MR parameters.
Conclusions:
- Hybrid imaging, including FDG PET/CT and FDG PET/MR, offers a more comfortable, accurate, and less burdensome approach compared to separate imaging studies for RPF evaluation.
- These techniques can guide medical therapy, predict treatment outcomes, and inform decisions like stent removal.
- Acute phase reactants alone are insufficient for reliable RPF management and follow-up.
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