Terence Wong

Overview:

1. Anatomic/functional oncologic Imaging: SPECT/CT, PET/CT, novel PET radiotracers

2. Radiotheranostics, Radionuclide therapy of cancer, Radiation Therapy Planning

3. Imaging biomarkers for guiding treatment strategies

4. Multicenter clinical trial development (NCI National Clinical Trials Network)

Positions:

Professor of Radiology

Radiology, Nuclear Medicine
School of Medicine

Professor in Medicine

Medicine, Medical Oncology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1990

Dartmouth College

Ph.D. 1990

Dartmouth College

Residency, Diagnostic Radiology

Beth Israel Deaconess Medical Center

Fellowship, Nuclear Radiology

Beth Israel Deaconess Medical Center

Fellowship, Body Imaging

Beth Israel Deaconess Medical Center

Grants:

Phase II Study of 44Gy from 131I-81C6 for CNS Tumors

Administered By
Neurosurgery, Neuro-Oncology
Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

Radiation-Induced Cardiopulmonary Injury in Humans

Administered By
Radiation Oncology
Awarded By
National Institutes of Health
Role
Investigator
Start Date
End Date

Predicting Human Tumor Response by 31p MRS

Administered By
Radiology, Neuroradiology
Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

Simultaneous Emission and Transmission Mammotomography

Administered By
Radiology
Awarded By
National Institutes of Health
Role
Investigator
Start Date
End Date

ECOG-ACRIN Operations Center Grant

Administered By
Radiology, Nuclear Medicine
Awarded By
American College of Radiology Imaging Network
Role
Principal Investigator
Start Date
End Date

Publications:

A phase II/III study of perioperative nivolumab and ipilimumab in patients (pts) with locoregional esophageal (E) and gastroesophageal junction (GEJ) adenocarcinoma: A trial of the ECOG-ACRIN Cancer Research Group (EA2174).

Authors
Eads, JR; Weitz, M; Gibson, MK; Rajdev, L; Khullar, OV; Lin, SH; Gatsonis, C; Wistuba, II; Sanjeevaiah, A; Benson, AB; Bahary, N; Spencer, KR; Saba, NF; Hamilton, SR; Staley, CA; Chakravarthy, AB; Wong, TZ; O'Dwyer, PJ
URI
https://scholars.duke.edu/individual/pub1476202
Source
wos-lite
Published In
Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Volume
38
Published Date

Quality Improvement Initiatives to Assess and Improve PET/CT Injection Infiltration Rates at Multiple Centers.

PET/CT radiotracer infiltration is not uncommon and is often outside the imaging field of view. Infiltration can negatively affect image quality, image quantification, and patient management. Until recently, there has not been a simple way to routinely practice PET radiopharmaceutical administration quality control and quality assurance. Our objectives were to quantify infiltration rates, determine associative factors for infiltration, and assess whether rates could be reduced at multiple centers and then sustained. Methods: A "design, measure, analyze, improve, and control" quality improvement methodology requiring novel technology was used to try to improve PET/CT injection quality. Teams were educated on the importance of quality injections. Baseline infiltration rates were measured, center-specific associative factors were analyzed, team meetings were held, improvement plans were established and executed, and rates remeasured. To ensure that injection-quality gains were retained, real-time feedback and ongoing monitoring were used. Sustainability was assessed. Results: Seven centers and 56 technologists provided data on 5,541 injections. The centers' aggregated baseline infiltration rate was 6.2% (range, 2%-16%). On the basis of their specific associative factors, 4 centers developed improvement plans and reduced their aggregated infiltration rate from 8.9% to 4.6% (P < 0.0001). Ongoing injection monitoring showed sustainability. Significant variation was found in center- and technologist-level infiltration rates (P < 0.0001 and P = 0.0020, respectively). Conclusion: A quality improvement approach with new technology can help centers measure infiltration rates, determine associative factors, implement interventions, and improve and sustain injection quality. Because PET/CT images help guide patient management, the monitoring and improvement of radiotracer injection quality are important.
Authors
Wong, TZ; Benefield, T; Masters, S; Kiser, JW; Crowley, J; Osborne, D; Mawlawi, O; Barnwell, J; Gupta, P; Mintz, A; Ryan, KA; Perrin, SR; Lattanze, RK; Townsend, DW
MLA Citation
Wong, Terence Z., et al. “Quality Improvement Initiatives to Assess and Improve PET/CT Injection Infiltration Rates at Multiple Centers.J Nucl Med Technol, vol. 47, no. 4, Dec. 2019, pp. 326–31. Pubmed, doi:10.2967/jnmt.119.228098.
URI
https://scholars.duke.edu/individual/pub1393525
PMID
31182666
Source
pubmed
Published In
J Nucl Med Technol
Volume
47
Published Date
Start Page
326
End Page
331
DOI
10.2967/jnmt.119.228098

Tumor protein p53 mutation in archived tumor samples from a 12-year survivor of stage 4 pancreatic ductal adenocarcinoma may predict long-term survival with DeltaRex-G: A case report and literature review.

DeltaRex-G is a replication-incompetent amphotropic murine leukemia virus-based retroviral vector that displays a collagen-matrix-targeting decapeptide on its surface envelope protein, gp70, and encodes a cytocidal 'dominant negative', i.e. a truncated construct of the executive cyclin G1 (CCNG1) oncogene. DeltaRex-G inhibits the CCNG1 function of promoting cell competence and survival through the commanding CCNG1/cyclin-dependent kinase (CDK)/Myc/mouse double minute 2 homolog (Mdm2)/p53 axis. In 2009, DeltaRex-G was granted Fast Track designation from the US Food and Drug Administration for the treatment of pancreatic cancer. In 2019, the results of a phase 1/2 study that used DeltaRex-G as monotherapy for stage 4 chemotherapy-resistant pancreatic ductal adenocarcinoma (PDAC) were published. A unique participant of the aforementioned phase 1/2 study is now an 84-year-old Caucasian woman with chemoresistant PDAC who was treated with DeltaRex-G, 3x1011 colony forming units (cfu)/dose, 3 times/week for 4 weeks with a 2-week rest period, for 1.5 years. During the treatment period, the patient's tumors in the liver, lymph node and peritoneum exhibited progressive decreases in size, which were accompanied by a reduction and normalization of serum carbohydrate antigen 19-9 levels, and the patient achieved complete remission after 8 months of DeltaRex-G therapy with minimal side effects (grade 2 fatigue). Henceforth, the patient has been in remission for 12 years with no evidence of disease, no late therapy-related adverse events, and no further cancer therapy following DeltaRex-G treatment. The present study reports a mutation of tumor protein p53 (TP53) (G199V) found retrospectively in the patient's archived tumor samples. TP53 is a well-characterized tumor suppressor gene, and a critical regulatory component of the executive CCNG1/CDK/Myc/Mdm2/p53 axis, which regulates proliferative cell competence, DNA fidelity and survival. Studies are underway to determine whether TP53 mutations in pancreatic cancer can help identify a subset of patients with advanced metastatic cancer with an otherwise poor prognosis who would respond favorably to DeltaRex-G, which would broaden the treatment options for patients with otherwise lethal PDAC.
Authors
Morse, MA; Chawla, SP; Wong, TZ; Bruckner, HW; Hall, FL; Gordon, EM
URI
https://scholars.duke.edu/individual/pub1488888
PMID
34277005
Source
pubmed
Published In
Mol Clin Oncol
Volume
15
Published Date
Start Page
186
DOI
10.3892/mco.2021.2348

Visual and semiquantitative analysis of 82Rb uptake in malignant tumors on PET/CT: first systematic analysis.

OBJECTIVE: The objective of this study was to analyze the uptake of rubidium in malignant tumors. PARTICIPANTS AND METHODS: Sixteen malignant lesions were included. Two radiologists compared each lesion to four references (subcutaneous fat, lung, mediastinal blood pool, and liver) at rest and stress and scored as 1-4. Maximum standardized uptake value (SUV) in each lesion and four references, as well as ratios of lesion SUV to SUV of each of the references, were calculated at rest and stress. We assessed an agreement for scores of reader 1 versus reader 2 (inter-reader) at rest and stress, scores at rest versus stress (intrapatient) for reader 1 and reader 2, and lesion SUV and respective ratios at rest and stress using paired t-test and Bland-Altman analyses. RESULTS: Fifteen (94%) out of 16 lesions had a score of 3 or 4 at rest or stress or both by at least one reviewer. We did not find evidence of inter-reader bias at rest or stress or intrapatient (rest vs. stress) bias for either reader. SUV ranged from 1.0 to 8.1 at rest and from 0.7 to 6.7 at stress. There was an excellent agreement between ratios of lesion SUV to lung SUV at rest versus stress. On the extreme, there was a poor agreement between ratios of lesion SUV to liver SUV at rest versus stress. Otherwise, the agreement was good for the majority of the results, and moderate for a few others. CONCLUSION: Malignant tumors can be readily depicted and quantified on rubidium PET/CT. Further research is needed.
Authors
Khandani, AH; Commander, CW; Desai, H; Oldan, JD; Wong, TZ; Benefield, T; Ivanovic, M
MLA Citation
Khandani, Amir H., et al. “Visual and semiquantitative analysis of 82Rb uptake in malignant tumors on PET/CT: first systematic analysis.Nucl Med Commun, vol. 40, no. 5, May 2019, pp. 532–38. Pubmed, doi:10.1097/MNM.0000000000001011.
URI
https://scholars.duke.edu/individual/pub1431927
PMID
30920430
Source
pubmed
Published In
Nucl Med Commun
Volume
40
Published Date
Start Page
532
End Page
538
DOI
10.1097/MNM.0000000000001011

18F-FDG-PET/CT Imaging for Gastrointestinal Malignancies.

Gastrointestinal malignancies encompass a variety of primary tumor sites, each with different staging criteria and treatment approaches. In this review we discuss technical aspects of 18F-FDG-PET/CT scanning to optimize information from both the PET and computed tomography components. Specific applications for 18F-FDG-PET/CT are summarized for initial staging and follow-up of the major disease sites, including esophagus, stomach, hepatobiliary system, pancreas, colon, rectum, and anus.
Authors
Howard, BA; Wong, TZ
MLA Citation
Howard, Brandon A., and Terence Z. Wong. “18F-FDG-PET/CT Imaging for Gastrointestinal Malignancies.Radiol Clin North Am, vol. 59, no. 5, Sept. 2021, pp. 737–53. Pubmed, doi:10.1016/j.rcl.2021.06.001.
URI
https://scholars.duke.edu/individual/pub1494608
PMID
34392916
Source
pubmed
Published In
Radiol Clin North Am
Volume
59
Published Date
Start Page
737
End Page
753
DOI
10.1016/j.rcl.2021.06.001

Research Areas:

Diagnostic Imaging
Imaging, Three-Dimensional
Molecular Imaging
Radionuclide Imaging