Skip to main content
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging 12/2013

01.12.2013 | Original Article

Diagnostic accuracy of 18F-FDG PET/CT for assessing response to radiofrequency ablation treatment in lung metastases: a multicentre prospective study

verfasst von: Françoise Bonichon, Jean Palussière, Yann Godbert, Marina Pulido, Edouard Descat, Anne Devillers, Catherine Meunier, Sophie Leboulleux, Thierry de Baère, Claire Galy-Lacour, Laurent Lagoarde-Segot, Anne-Laure Cazeau

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 12/2013

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To assess diagnostic accuracy of 18F-FDG PET/CT at 3 months for the detection of local recurrence after radiofrequency ablation (RFA) of lung metastases.

Methods

The PET/CT scan at 3 months was compared with a baseline PET/CT scan from a maximum of 2 months before RFA, with the reference standard as recurrence diagnosed by CT during a 12-month follow-up. Local recurrence was diagnosed on the PET/CT scan if lesional uptake was greater than the mediastinal background. Maximum standardized uptake values (SUVmax) were recorded. ROC curve analysis for SUVmax was performed. Overall survival (OS) and time to local relapse were computed from the date of RFA using the Kaplan-Meier method (www.clinicaltrials.gov: NCT 00382252).

Results

Between 2005 and 2009, 89 patients (mean age 65 years) underwent RFA for 115 lung metastases (mean size 16.2 ± 6.9 mm). The median SUVmax before RFA was 5.8 ± 4. PET/CT at 3 months and the reference standard were available in 77 patients and 100 lesions. Accuracy was 66.00 % (95 % CI 55.85–75.18 %), sensitivity 90.91 % (95 % CI 58.72–99.77 %), specificity 62.92 % (95 % CI 52.03–72.93 %), PPV 23.26 % (95 % CI 11.76–38.63 %), and NPV 98.25 % (95 % CI 90.61–99.96 %). One-year OS was 94.2 % (95 % CI 86.6–97.5 %) and the probability of being free of local recurrence 1 year after RFA was 84.6 % (95 % CI 75.0–90.8 %).

Conclusion

The specificity of PET/CT at 3 months is low because of persistent inflammation, especially when the lesion is close to the pleura. This technique is useful for its negative predictive value, but positive findings need to be confirmed by histology before new treatment is planned.
Literatur
1.
Zurück zum Zitat Ambrogi MC, Fanucchi O, Cioni R, Dini P, De LA, Cappelli C, et al. Long-term results of radiofrequency ablation treatment of stage I non-small cell lung cancer: a prospective intention-to-treat study. J Thorac Oncol. 2011;6(12):2044–51.CrossRefPubMed Ambrogi MC, Fanucchi O, Cioni R, Dini P, De LA, Cappelli C, et al. Long-term results of radiofrequency ablation treatment of stage I non-small cell lung cancer: a prospective intention-to-treat study. J Thorac Oncol. 2011;6(12):2044–51.CrossRefPubMed
2.
Zurück zum Zitat Facey K, Bradbury I, Laking G, Payne E. Overview of the clinical effectiveness of positron emission tomography imaging in selected cancers. Health Technol Assess. 2007;11(44):iii–iv, xi–267.PubMed Facey K, Bradbury I, Laking G, Payne E. Overview of the clinical effectiveness of positron emission tomography imaging in selected cancers. Health Technol Assess. 2007;11(44):iii–iv, xi–267.PubMed
3.
Zurück zum Zitat de Baère T, Palussière J, Aupérin A, Hakime A, Abdel-Rehim M, Kind M, et al. Midterm local efficacy and survival after radiofrequency ablation of lung tumors with minimum follow-up of 1 year: prospective evaluation. Radiology. 2006;240(2):587–96.CrossRefPubMed de Baère T, Palussière J, Aupérin A, Hakime A, Abdel-Rehim M, Kind M, et al. Midterm local efficacy and survival after radiofrequency ablation of lung tumors with minimum follow-up of 1 year: prospective evaluation. Radiology. 2006;240(2):587–96.CrossRefPubMed
4.
Zurück zum Zitat Simon CJ, Dupuy DE, DiPetrillo TA, Safran HP, Grieco CA, Ng T, et al. Pulmonary radiofrequency ablation: long-term safety and efficacy in 153 patients. Radiology. 2007;243(1):268–75.CrossRefPubMed Simon CJ, Dupuy DE, DiPetrillo TA, Safran HP, Grieco CA, Ng T, et al. Pulmonary radiofrequency ablation: long-term safety and efficacy in 153 patients. Radiology. 2007;243(1):268–75.CrossRefPubMed
5.
Zurück zum Zitat Suh R, Reckamp K, Zeidler M, Cameron R. Radiofrequency ablation in lung cancer: promising results in safety and efficacy. Oncology (Williston Park). 2005;19(11 Suppl 4):12–21. Suh R, Reckamp K, Zeidler M, Cameron R. Radiofrequency ablation in lung cancer: promising results in safety and efficacy. Oncology (Williston Park). 2005;19(11 Suppl 4):12–21.
6.
Zurück zum Zitat Yan TD, King J, Sjarif A, Glenn D, Steinke K, Morris DL. Percutaneous radiofrequency ablation of pulmonary metastases from colorectal carcinoma: prognostic determinants for survival. Ann Surg Oncol. 2006;13(11):1529–37.CrossRefPubMed Yan TD, King J, Sjarif A, Glenn D, Steinke K, Morris DL. Percutaneous radiofrequency ablation of pulmonary metastases from colorectal carcinoma: prognostic determinants for survival. Ann Surg Oncol. 2006;13(11):1529–37.CrossRefPubMed
7.
Zurück zum Zitat Yan TD, King J, Sjarif A, Glenn D, Steinke K, Al-Kindy A, et al. Treatment failure after percutaneous radiofrequency ablation for nonsurgical candidates with pulmonary metastases from colorectal carcinoma. Ann Surg Oncol. 2007;14(5):1718–26.CrossRefPubMed Yan TD, King J, Sjarif A, Glenn D, Steinke K, Al-Kindy A, et al. Treatment failure after percutaneous radiofrequency ablation for nonsurgical candidates with pulmonary metastases from colorectal carcinoma. Ann Surg Oncol. 2007;14(5):1718–26.CrossRefPubMed
8.
Zurück zum Zitat Akeboshi M, Yamakado K, Nakatsuka A, Hataji O, Taguchi O, Takao M, et al. Percutaneous radiofrequency ablation of lung neoplasms: initial therapeutic response. J Vasc Interv Radiol. 2004;15(5):463–70.CrossRefPubMed Akeboshi M, Yamakado K, Nakatsuka A, Hataji O, Taguchi O, Takao M, et al. Percutaneous radiofrequency ablation of lung neoplasms: initial therapeutic response. J Vasc Interv Radiol. 2004;15(5):463–70.CrossRefPubMed
9.
Zurück zum Zitat Palussière J, Marcet B, Descat E, Deschamps F, Rao P, Ravaud A, et al. Lung tumors treated with percutaneous radiofrequency ablation: computed tomography imaging follow-up. Cardiovasc Intervent Radiol. 2011;34(5):989–97.CrossRefPubMed Palussière J, Marcet B, Descat E, Deschamps F, Rao P, Ravaud A, et al. Lung tumors treated with percutaneous radiofrequency ablation: computed tomography imaging follow-up. Cardiovasc Intervent Radiol. 2011;34(5):989–97.CrossRefPubMed
10.
Zurück zum Zitat Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000;92(3):205–16.CrossRefPubMed Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000;92(3):205–16.CrossRefPubMed
11.
Zurück zum Zitat Travaini LL, Trifiro G, Ravasi L, Monfardini L, Della VP, Bonomo G, et al. Role of [18F]FDG-PET/CT after radiofrequency ablation of liver metastases: preliminary results. Eur J Nucl Med Mol Imaging. 2008;35:1316–22.CrossRefPubMed Travaini LL, Trifiro G, Ravasi L, Monfardini L, Della VP, Bonomo G, et al. Role of [18F]FDG-PET/CT after radiofrequency ablation of liver metastases: preliminary results. Eur J Nucl Med Mol Imaging. 2008;35:1316–22.CrossRefPubMed
12.
Zurück zum Zitat Deandreis D, Leboulleux S, Dromain C, Auperin A, Coulot J, Lumbroso J, et al. Role of FDG PET/CT and chest CT in the follow-up of lung lesions treated with radiofrequency ablation. Radiology. 2011;258(1):270–6.CrossRefPubMed Deandreis D, Leboulleux S, Dromain C, Auperin A, Coulot J, Lumbroso J, et al. Role of FDG PET/CT and chest CT in the follow-up of lung lesions treated with radiofrequency ablation. Radiology. 2011;258(1):270–6.CrossRefPubMed
13.
Zurück zum Zitat Singnurkar A, Solomon SB, Gonen M, Larson SM, Schoder H. 18F-FDG PET/CT for the prediction and detection of local recurrence after radiofrequency ablation of malignant lung lesions. J Nucl Med. 2010;51(12):1833–40.CrossRefPubMed Singnurkar A, Solomon SB, Gonen M, Larson SM, Schoder H. 18F-FDG PET/CT for the prediction and detection of local recurrence after radiofrequency ablation of malignant lung lesions. J Nucl Med. 2010;51(12):1833–40.CrossRefPubMed
14.
Zurück zum Zitat Yoo DC, Dupuy DE, Hillman SL, Fernando HC, Rilling WS, Shepard JA, et al. Radiofrequency ablation of medically inoperable stage in non-small cell lung cancer: are early posttreatment PET findings predictive of treatment outcome? AJR Am J Roentgenol. 2011;197(2):334–40.CrossRefPubMed Yoo DC, Dupuy DE, Hillman SL, Fernando HC, Rilling WS, Shepard JA, et al. Radiofrequency ablation of medically inoperable stage in non-small cell lung cancer: are early posttreatment PET findings predictive of treatment outcome? AJR Am J Roentgenol. 2011;197(2):334–40.CrossRefPubMed
15.
Zurück zum Zitat Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, et al. Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative. AJR Am J Roentgenol. 2003;181(1):51–5.CrossRefPubMed Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, et al. Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative. AJR Am J Roentgenol. 2003;181(1):51–5.CrossRefPubMed
16.
Zurück zum Zitat Chua TC, Sarkar A, Saxena A, Glenn D, Zhao J, Morris DL. Long-term outcome of image-guided percutaneous radiofrequency ablation of lung metastases: an open-labeled prospective trial of 148 patients. Ann Oncol. 2010;21:2017–22.CrossRefPubMed Chua TC, Sarkar A, Saxena A, Glenn D, Zhao J, Morris DL. Long-term outcome of image-guided percutaneous radiofrequency ablation of lung metastases: an open-labeled prospective trial of 148 patients. Ann Oncol. 2010;21:2017–22.CrossRefPubMed
17.
Zurück zum Zitat Yamakado K, Hase S, Matsuoka T, Tanigawa N, Nakatsuka A, Takaki H, et al. Radiofrequency ablation for the treatment of unresectable lung metastases in patients with colorectal cancer: a multicenter study in Japan. J Vasc Interv Radiol. 2007;18(3):393–8.CrossRefPubMed Yamakado K, Hase S, Matsuoka T, Tanigawa N, Nakatsuka A, Takaki H, et al. Radiofrequency ablation for the treatment of unresectable lung metastases in patients with colorectal cancer: a multicenter study in Japan. J Vasc Interv Radiol. 2007;18(3):393–8.CrossRefPubMed
18.
Zurück zum Zitat Antoch G, Vogt FM, Veit P, Freudenberg LS, Blechschmid N, Dirsch O, et al. Assessment of liver tissue after radiofrequency ablation: findings with different imaging procedures. J Nucl Med. 2005;46(3):520–5.PubMed Antoch G, Vogt FM, Veit P, Freudenberg LS, Blechschmid N, Dirsch O, et al. Assessment of liver tissue after radiofrequency ablation: findings with different imaging procedures. J Nucl Med. 2005;46(3):520–5.PubMed
19.
Zurück zum Zitat Barker DW, Zagoria RJ, Morton KA, Kavanagh PV, Shen P. Evaluation of liver metastases after radiofrequency ablation: utility of 18F-FDG PET and PET/CT. AJR Am J Roentgenol. 2005;184(4):1096–102.CrossRefPubMed Barker DW, Zagoria RJ, Morton KA, Kavanagh PV, Shen P. Evaluation of liver metastases after radiofrequency ablation: utility of 18F-FDG PET and PET/CT. AJR Am J Roentgenol. 2005;184(4):1096–102.CrossRefPubMed
20.
Zurück zum Zitat Dierckx R, Maes A, Peeters M, Van de Wiele C. FDG PET for monitoring response to local and locoregional therapy in HCC and liver metastases. Q J Nucl Med Mol Imaging. 2009;53(3):336–42.PubMed Dierckx R, Maes A, Peeters M, Van de Wiele C. FDG PET for monitoring response to local and locoregional therapy in HCC and liver metastases. Q J Nucl Med Mol Imaging. 2009;53(3):336–42.PubMed
21.
Zurück zum Zitat Kele PG, de Jong KP, van der Jagt EJ. Increase in volume of ablation zones during follow-up is highly suggestive of ablation site recurrence in colorectal liver metastases treated with radiofrequency ablation. J Vasc Interv Radiol. 2012;23(4):537–44.CrossRefPubMed Kele PG, de Jong KP, van der Jagt EJ. Increase in volume of ablation zones during follow-up is highly suggestive of ablation site recurrence in colorectal liver metastases treated with radiofrequency ablation. J Vasc Interv Radiol. 2012;23(4):537–44.CrossRefPubMed
22.
Zurück zum Zitat Kuehl H, Antoch G, Stergar H, Veit-Haibach P, Rosenbaum-Krumme S, Vogt F, et al. Comparison of FDG-PET, PET/CT and MRI for follow-up of colorectal liver metastases treated with radiofrequency ablation: initial results. Eur J Radiol. 2008;67(2):362–71.CrossRefPubMed Kuehl H, Antoch G, Stergar H, Veit-Haibach P, Rosenbaum-Krumme S, Vogt F, et al. Comparison of FDG-PET, PET/CT and MRI for follow-up of colorectal liver metastases treated with radiofrequency ablation: initial results. Eur J Radiol. 2008;67(2):362–71.CrossRefPubMed
23.
Zurück zum Zitat Langenhoff BS, Oyen WJ, Jager GJ, Strijk SP, Wobbes T, Corstens FH, et al. Efficacy of fluorine-18-deoxyglucose positron emission tomography in detecting tumor recurrence after local ablative therapy for liver metastases: a prospective study. J Clin Oncol. 2002;20(22):4453–8.CrossRefPubMed Langenhoff BS, Oyen WJ, Jager GJ, Strijk SP, Wobbes T, Corstens FH, et al. Efficacy of fluorine-18-deoxyglucose positron emission tomography in detecting tumor recurrence after local ablative therapy for liver metastases: a prospective study. J Clin Oncol. 2002;20(22):4453–8.CrossRefPubMed
24.
Zurück zum Zitat Sahin DA, Agcaoglu O, Chretien C, Siperstein A, Berber E. The utility of PET/CT in the management of patients with colorectal liver metastases undergoing laparascopic radiofrequency thermal ablation. Ann Surg Oncol. 2012;19(3):850–5.CrossRefPubMed Sahin DA, Agcaoglu O, Chretien C, Siperstein A, Berber E. The utility of PET/CT in the management of patients with colorectal liver metastases undergoing laparascopic radiofrequency thermal ablation. Ann Surg Oncol. 2012;19(3):850–5.CrossRefPubMed
25.
Zurück zum Zitat Veit P, Kuhle C, Beyer T, Kuehl H, Herborn CU, Borsch G, et al. Whole body positron emission tomography/computed tomography (PET/CT) tumour staging with integrated PET/CT colonography: technical feasibility and first experiences in patients with colorectal cancer. Gut. 2006;55(1):68–73.CrossRefPubMed Veit P, Kuhle C, Beyer T, Kuehl H, Herborn CU, Borsch G, et al. Whole body positron emission tomography/computed tomography (PET/CT) tumour staging with integrated PET/CT colonography: technical feasibility and first experiences in patients with colorectal cancer. Gut. 2006;55(1):68–73.CrossRefPubMed
26.
Zurück zum Zitat Sharma A, Lanuti M, He W, Palmer EL, Shepard JA, Digumarthy SR. Increase in fluorodeoxyglucose positron emission tomography activity following complete radiofrequency ablation of lung tumors. J Comput Assist Tomogr. 2013;37(1):9–14.CrossRefPubMed Sharma A, Lanuti M, He W, Palmer EL, Shepard JA, Digumarthy SR. Increase in fluorodeoxyglucose positron emission tomography activity following complete radiofrequency ablation of lung tumors. J Comput Assist Tomogr. 2013;37(1):9–14.CrossRefPubMed
27.
Zurück zum Zitat Boellaard R. Standards for PET image acquisition and quantitative data analysis. J Nucl Med 2009;50 Suppl 1:11S–20S.CrossRefPubMed Boellaard R. Standards for PET image acquisition and quantitative data analysis. J Nucl Med 2009;50 Suppl 1:11S–20S.CrossRefPubMed
28.
Zurück zum Zitat Fletcher JW, Djulbegovic B, Soares HP, Siegel BA, Lowe VJ, Lyman GH, et al. Recommendations on the use of 18F-FDG PET in oncology. J Nucl Med. 2008;49(3):480–508.CrossRefPubMed Fletcher JW, Djulbegovic B, Soares HP, Siegel BA, Lowe VJ, Lyman GH, et al. Recommendations on the use of 18F-FDG PET in oncology. J Nucl Med. 2008;49(3):480–508.CrossRefPubMed
29.
Zurück zum Zitat Purandare NC, Rangarajan V, Shah SA, Sharma AR, Kulkarni SS, Kulkarni AV, et al. Therapeutic response to radiofrequency ablation of neoplastic lesions: FDG PET/CT findings. Radiographics. 2011;31(1):201–13.CrossRefPubMed Purandare NC, Rangarajan V, Shah SA, Sharma AR, Kulkarni SS, Kulkarni AV, et al. Therapeutic response to radiofrequency ablation of neoplastic lesions: FDG PET/CT findings. Radiographics. 2011;31(1):201–13.CrossRefPubMed
30.
Zurück zum Zitat Okuma T, Matsuoka T, Okamura T, Wada Y, Yamamoto A, Oyama Y, et al. 18F-FDG small-animal PET for monitoring the therapeutic effect of CT-guided radiofrequency ablation on implanted VX2 lung tumors in rabbits. J Nucl Med. 2006;47(8):1351–8.PubMed Okuma T, Matsuoka T, Okamura T, Wada Y, Yamamoto A, Oyama Y, et al. 18F-FDG small-animal PET for monitoring the therapeutic effect of CT-guided radiofrequency ablation on implanted VX2 lung tumors in rabbits. J Nucl Med. 2006;47(8):1351–8.PubMed
31.
Zurück zum Zitat Itti E, Juweid ME, Haioun C, Yeddes I, Hamza-Maaloul F, El Bez I, et al. Improvement of early 18F-FDG PET interpretation in diffuse large B-cell lymphoma: importance of the reference background. J Nucl Med 2010;51(12):1857–62.CrossRefPubMed Itti E, Juweid ME, Haioun C, Yeddes I, Hamza-Maaloul F, El Bez I, et al. Improvement of early 18F-FDG PET interpretation in diffuse large B-cell lymphoma: importance of the reference background. J Nucl Med 2010;51(12):1857–62.CrossRefPubMed
32.
Zurück zum Zitat Lin C, Itti E, Haioun C, Petegnief Y, Luciani A, Dupuis J, et al. Early 18F-FDG PET for prediction of prognosis in patients with diffuse large B-cell lymphoma: SUV-based assessment versus visual analysis. J Nucl Med. 2007;48(10):1626–32.CrossRefPubMed Lin C, Itti E, Haioun C, Petegnief Y, Luciani A, Dupuis J, et al. Early 18F-FDG PET for prediction of prognosis in patients with diffuse large B-cell lymphoma: SUV-based assessment versus visual analysis. J Nucl Med. 2007;48(10):1626–32.CrossRefPubMed
33.
Zurück zum Zitat Graham MM, Badawi RD, Wahl RL. Variations in PET/CT methodology for oncologic imaging at U.S. academic medical centers: an imaging response assessment team survey. J Nucl Med. 2011;52(2):311–7.CrossRefPubMed Graham MM, Badawi RD, Wahl RL. Variations in PET/CT methodology for oncologic imaging at U.S. academic medical centers: an imaging response assessment team survey. J Nucl Med. 2011;52(2):311–7.CrossRefPubMed
34.
Zurück zum Zitat Delbeke D, Coleman RE, Guiberteau MJ, Brown ML, Royal HD, Siegel BA, et al. Procedure guideline for tumor imaging with 18F-FDG PET/CT 1.0. J Nucl Med. 2006;47(5):885–95.PubMed Delbeke D, Coleman RE, Guiberteau MJ, Brown ML, Royal HD, Siegel BA, et al. Procedure guideline for tumor imaging with 18F-FDG PET/CT 1.0. J Nucl Med. 2006;47(5):885–95.PubMed
35.
Zurück zum Zitat Higaki F, Okumura Y, Sato S, Hiraki T, Gobara H, Mimura H, et al. Preliminary retrospective investigation of FDG-PET/CT timing in follow-up of ablated lung tumor. Ann Nucl Med. 2008;22(3):157–63.CrossRefPubMed Higaki F, Okumura Y, Sato S, Hiraki T, Gobara H, Mimura H, et al. Preliminary retrospective investigation of FDG-PET/CT timing in follow-up of ablated lung tumor. Ann Nucl Med. 2008;22(3):157–63.CrossRefPubMed
36.
Zurück zum Zitat Deandreis D, Al GA, Leboulleux S, Lacroix L, Garsi JP, Talbot M, et al. Do histological, immunohistochemical and metabolic (radioiodine and fluorodeoxyglucose uptake) patterns of metastatic thyroid cancer correlate with patient outcome? Endocr Relat Cancer. 2011;18:159–69.CrossRefPubMed Deandreis D, Al GA, Leboulleux S, Lacroix L, Garsi JP, Talbot M, et al. Do histological, immunohistochemical and metabolic (radioiodine and fluorodeoxyglucose uptake) patterns of metastatic thyroid cancer correlate with patient outcome? Endocr Relat Cancer. 2011;18:159–69.CrossRefPubMed
37.
Zurück zum Zitat Suzawa N, Yamakado K, Takao M, Taguchi O, Yamada T, Takeda K. Detection of local tumor progression by 18F-FDG PET/CT following lung radiofrequency ablation: PET versus CT. Clin Nucl Med. 2013;38(4):e166–70. Suzawa N, Yamakado K, Takao M, Taguchi O, Yamada T, Takeda K. Detection of local tumor progression by 18F-FDG PET/CT following lung radiofrequency ablation: PET versus CT. Clin Nucl Med. 2013;38(4):e166–70.
Metadaten
Titel
Diagnostic accuracy of 18F-FDG PET/CT for assessing response to radiofrequency ablation treatment in lung metastases: a multicentre prospective study
verfasst von
Françoise Bonichon
Jean Palussière
Yann Godbert
Marina Pulido
Edouard Descat
Anne Devillers
Catherine Meunier
Sophie Leboulleux
Thierry de Baère
Claire Galy-Lacour
Laurent Lagoarde-Segot
Anne-Laure Cazeau
Publikationsdatum
01.12.2013
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 12/2013
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-013-2521-9

Weitere Artikel der Ausgabe 12/2013

European Journal of Nuclear Medicine and Molecular Imaging 12/2013 Zur Ausgabe