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Spectrum of Physiologic and Pathologic Skeletal Muscle18F-FDG Uptake on PET/CT. AJR Am J Roentgenol 2015; 205:W141-9. [DOI: 10.2214/ajr.14.13457] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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102
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Nguyen NC, Vercher-Conejero JL, Sattar A, Miller MA, Maniawski PJ, Jordan DW, Muzic RF, Su KH, O’Donnell JK, Faulhaber PF. Image Quality and Diagnostic Performance of a Digital PET Prototype in Patients with Oncologic Diseases: Initial Experience and Comparison with Analog PET. J Nucl Med 2015; 56:1378-85. [DOI: 10.2967/jnumed.114.148338] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 06/29/2015] [Indexed: 11/16/2022] Open
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Chang CY, Chang CP, Shih CC, Yang BH, Cheng CY, Chang CW, Chu LS, Wang SJ, Liu RS. Added Value of Dual-Time-Point 18F-FDG PET/CT With Delayed Imaging for Detecting Aortic Graft Infection: An Observational Study. Medicine (Baltimore) 2015; 94:e1124. [PMID: 26166113 PMCID: PMC4504531 DOI: 10.1097/md.0000000000001124] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
F-FDG PET/CT is a promising tool in detecting aortic graft infection. Present study investigated the value of dual-time-point F-FDG PET/CT imaging (DTPI) with delayed imaging in assessing aortic graft infection.Twenty-nine patients with suspected aortic graft infection were prospectively enrolled in this DTPI study. Two nuclear medicine physicians read all the images and achieved consensus about the measurement of maximal standardized uptake value (SUVmax) and grading of image quality. The percentages of SUVmax change between initial and delayed images were recorded as retention index (RI); sensitivity, specificity, and accuracy were calculated based on reference standard.All the 5 infected aortic grafts had positive RIs, which were generally higher than that of noninfected grafts. Those noninfected grafts had variable RIs. Seven patients had improved image quality in delayed imaging. DTPI with delayed image detected all the infected grafts with improved specificity (88%) and accuracy (90%), providing conspicuous delineation of the infected graft extent.In conclusion, noninfected aortic grafts had more variable RIs than infected ones. DTPI might be useful for detecting aortic graft infection, improving image quality, and enhancing delineation of the infected aortic grafts.
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Affiliation(s)
- Chih-Yung Chang
- From the School of Medicine, National Defense Medical Center, Taipei, Taiwan (C-YC, C-YiC, R-SL); Department of Nuclear Medicine, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan (C-YC, C-PC, B-HY, C-WC, L-SC, S-JW, R-SL); Division of Cardiovascular Surgery, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan (C-CS); Department of Nuclear Medicine, Tri-Service General Hospital, Taipei, Taiwan (C-YiC); and Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan (C-YC, R-SL)
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104
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Onishi R, Noguchi M, Kaida H, Moriya F, Chikui K, Kurata S, Kawahara A, Kage M, Ishibashi M, Matsuoka K. Assessment of cell proliferation in renal cell carcinoma using dual-phase 18F-fluorodeoxyglucose PET/CT. Oncol Lett 2015; 10:822-828. [PMID: 26622577 DOI: 10.3892/ol.2015.3372] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 04/08/2015] [Indexed: 11/06/2022] Open
Abstract
The present study aimed to examine the association between 18F-fluorodeoxyglucose (18F-FDG) uptake and cell proliferation markers; in addition, the correlation between 18F-FDG uptake and biological characteristic in patients with renal cell carcinoma (RCC) was investigated using dual-phase 18F-FDG-positron emission tomography/computed tomography (PET/CT). Dual-phase 18F-FDG PET/CT was performed on 31 RCC patients and the maximum standardized uptake values at 1 h (SUV1) and 2 h (SUV2) as well as the retention index (RI; %) in the primary tumors were calculated. Monoclonal antibodies for Ki-67, minichromosome maintenance 2 (MCM2) and topoisomerase II α (topo II α) were used to assess the expression levels of their respective proteins in excised tumor tissue using immunohistochemistry. The results demonstrated that RI and SUV2 in patients with Stage I/II + grade 1 (G1) RCC were significantly decreased compared with all patients with other stages/grades (RI, P=0.0065; SUV2, P=0.043); in addition, significantly increased uptake and RI were detected in patients with metastases compared with patients without metastases (SUV1, P=0.029; SUV2, P=0.0003; RI, P<0.001). All proliferation markers significantly correlated with RI (Ki-67, r=0.501, P=0.004; MCM2, r=0.359, P=0.047; topo II α, r=0.402, P=0.024), while SUV1 and SUV2 correlated with Ki-67 only. In conclusion, the results of the present study demonstrated that dual-phase 18F-FDG-PET/CT was more useful for predicting cell proliferation in RCC compared with single-phase imaging alone. However, follow-ups are required in order to determine whether dual-phase 18F-FDG-PET/CT provides independent prognostic information.
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Affiliation(s)
- Rei Onishi
- Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Masanori Noguchi
- Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan ; Clinical Research Division, Research Center for Innovative Cancer Therapy, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Hayato Kaida
- Division of Nuclear Medicine, PET Center and Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Fukuko Moriya
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Katsuaki Chikui
- Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Seiji Kurata
- Division of Nuclear Medicine, PET Center and Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Akihiko Kawahara
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Masayoshi Kage
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Masatoshi Ishibashi
- Division of Nuclear Medicine, PET Center and Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Kei Matsuoka
- Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
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105
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Shen G, Hu S, Deng H, Jia Z. Diagnostic value of dual time-point 18 F-FDG PET/CT versus single time-point imaging for detection of mediastinal nodal metastasis in non-small cell lung cancer patients: a meta-analysis. Acta Radiol 2015; 56:681-7. [PMID: 24917609 DOI: 10.1177/0284185114535210] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Accepted: 04/19/2014] [Indexed: 02/05/2023]
Abstract
BACKGROUND Lymph node staging in non-small cell lung cancer (NSCLC) is challenging and important for determining treatment policy. Conflicting results have been presented to date. PURPOSE To evaluate the diagnostic performance of dual time-point (DTP) 18 F-FDG PET/CT compared with single time-point (STP) imaging for detecting mediastinal nodal metastases in patients with NSCLC. MATERIAL AND METHODS The PubMed, EMBASE, EBSCO, and Web of Knowledge databases were searched for relevant articles. The pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (PLR), and negative likelihood ratio (NLR) were calculated using Meta-Disc software. Summary receiver-operating characteristic (SROC) curves were also constructed. The potential for between-study heterogeneity was explored using subgroup analyses. RESULTS A total of eight studies involving 654 patients fulfilled the inclusion criteria. On a per-patient analysis, the pooled sensitivity and specificity with a 95% confidence interval (CI) for DTP PET/CT were 0.85 (0.78-0.91), 0.75 (0.68-0.82), and for STP imaging, they were 0.79 (0.70-0.85), 0.73 (0.65-0.79), respectively. On a per-lesion basis, the corresponding values for DTP imaging were 0.84 (0.81-0.86), 0.89 (0.87-0.91), and for STP imaging, they were 0.84 (0.80-0.86), 0.83 (0.81-0.85), respectively. CONCLUSION DTP PET/CT performed better than STP imaging in evaluating the lymph node status of NSCLC patients and had the potential to be broadly applied in clinical practice. However, due to the small sample size and large heterogeneity, current evidence does not justify the implementation of DTP imaging in routine PET protocols for mediastinal lymph node staging of NSCLC.
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Affiliation(s)
- Guohua Shen
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, PR China
| | - Shuang Hu
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, PR China
| | - Houfu Deng
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, PR China
| | - Zhiyun Jia
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, PR China
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106
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Catalano OA, Nicolai E, Rosen BR, Luongo A, Catalano M, Iannace C, Guimaraes A, Vangel MG, Mahmood U, Soricelli A, Salvatore M. Comparison of CE-FDG-PET/CT with CE-FDG-PET/MR in the evaluation of osseous metastases in breast cancer patients. Br J Cancer 2015; 112:1452-60. [PMID: 25871331 PMCID: PMC4453670 DOI: 10.1038/bjc.2015.112] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 02/25/2015] [Accepted: 02/27/2015] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Despite improvements in treatments, metastatic breast cancer remains difficult to cure. Bones constitute the most common site of first-time recurrence, occurring in 40-75% of cases. Therefore, evaluation for possible osseous metastases is crucial. Technetium 99 ((99)Tc) bone scintigraphy and fluorodexossyglucose (FDG) positron emission tomography (PET)-computed tomography (PET-CT) are the most commonly used techniques to assess osseous metastasis. PET magnetic resonance (PET-MR) imaging is an innovative technique still under investigation. We compared the capability of PET-MR to that of same-day PET-CT to assess osseous metastases in patients with breast cancer. METHODS One hundred and nine patients with breast cancer, who underwent same-day contrast enhanced (CE)-PET-CT and CE-PET-MR, were evaluated. CE-PET-CT and CE-PET-MR studies were interpreted by consensus by a radiologist and a nuclear medicine physician. Correlations with prior imaging and follow-up studies were used as the reference standard. Binomial confidence intervals and a χ(2) test were used for categorical data, and paired t-test was used for the SUVmax data; a non-informative prior Bayesian approach was used to estimate and compare the specificities. RESULTS Osseous metastases affected 25 out 109 patients. Metastases were demonstrated by CE-PET-CT in 22 out of 25 patients (88%±7%), and by CE-PET-MR in 25 out of 25 patients (100%). CE-PET-CT revealed 90 osseous metastases and CE-PET-MR revealed 141 osseous metastases (P<0.001). The estimated sensitivity of CE-PET-CT and CE-PET-MR were 0.8519 and 0.9630, respectively. The estimated specificity for CE-FDG-PET-MR was 0.9884. The specificity of CE-PET-CT cannot be determined from patient-level data, because CE-PET-CT yielded a false-positive lesion in a patient who also had other, true metastases. CONCLUSIONS CE-PET-MR detected a higher number of osseous metastases than did same-day CE-PET-CT, and was positive for 12% of the patients deemed osseous metastasis-negative on the basis of CE-PET-CT.
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Affiliation(s)
- O A Catalano
- Department of Radiology, University of Naples Parthenope -SDN IRCCS, Via F. Acton 38, Napoli, Na 80143, Italy
| | - E Nicolai
- Department of Nuclear Medicine, SDN IRCCS, Via Gianturco 113, Napoli, Na 80143, Italy
| | - B R Rosen
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard University Medical School, 149 Thirteenth Street, Charlestown, MA 02129, USA
| | - A Luongo
- Department of Radiology, University of Naples 'Federico II', Naples, NA 80131, Italy
| | - M Catalano
- Department of Radiology, University of Naples 'Federico II', Naples, NA 80131, Italy
| | - C Iannace
- Department of Surgery, Breast Unit, G. Moscati Hospital, Avellino, AV 83100, Italy
| | - A Guimaraes
- Department of Radiology, Oregon Health and Sciences University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA
| | - M G Vangel
- Department of Radiology, MGH Biostatistics Center and MGH Martinos Center, Harvard University Medical School, 149 Thirteenth Street, Charlestown, MA 02129, USA
| | - U Mahmood
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard University Medical School, 149 Thirteenth Street, Charlestown, MA 02129, USA
| | - A Soricelli
- Department of Radiology, University of Naples Parthenope -SDN IRCCS, Via F. Acton 38, Napoli, Na 80143, Italy
| | - M Salvatore
- Department of Radiology and of Nuclear Medicine, SDN IRCCS, Via Gianturco 113, Napoli, Na 80143, Italy
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107
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Wu J, Zhu H, Li K, Yuan CY, Wang YF, Lu GM. Imaging observations of pulmonary inflammatory myofibroblastic tumors in patients over 40 years old. Oncol Lett 2015; 9:1877-1884. [PMID: 25789060 PMCID: PMC4356430 DOI: 10.3892/ol.2015.2923] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 01/16/2015] [Indexed: 12/18/2022] Open
Abstract
Pulmonary inflammatory myofibroblastic tumors (PIMTs) are extremely rare in adults. If occurring in patients >40 years old, PIMT should be rapidly distinguished from lung cancer. The present study aimed to characterize the imaging features of PIMT in patients >40 years old in order to improve the diagnosis of PIMT. The imaging data of 10 patients with PIMT were reviewed retrospectively. Of the patients, eight underwent computed tomography (CT), two underwent positron emission tomography (PET)/CT and four underwent single-photon emission computed tomography (SPECT). Unenhanced CT revealed 10 lesions with a maximum diameter ranging between 5 and 57 mm located in the lower (n=6) or upper (n=4) lobe, in a peripheral (n=9) or central (n=1) region, and that were well- (n=4) or ill-defined (n=6), and round to oval (n=5) or irregular (n=5) in shape. Calcification (n=3), necrosis (n=6), cavity (n=4), air bronchogram (n=6) and obstructive pneumonia (n=1) were also observed in the patients. Contrast-enhanced CT revealed six lesions with moderate to high contrast enhancement in the arterial and venous phases, including four lesions with delayed enhancement. PET/CT identified two lesions with increased tracer uptake that were homogeneous and heterogeneous and each exhibited a maximal standard uptake value (SUVmax) of 6.0 and 5.4, respectively. The delayed PET/CT revealed foci that each exhibited an increased SUVmax of 6.9 and 5.9, respectively. SPECT demonstrated no definitive bone metastases, but did reveal atypical hypertrophic pulmonary osteoarthropathy in one patient. The combined imaging methods may lead to a more precise evaluation of PIMT in patients >40 years old.
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Affiliation(s)
- Jiang Wu
- Department of Nuclear Medicine, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu 210002, P.R. China
| | - Hong Zhu
- Department of Nuclear Medicine, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu 210002, P.R. China
| | - Kai Li
- Department of Pharmacology, Soochow University, Suzhou, Jiangsu 215123, P.R. China
| | - Cai-Yun Yuan
- Department of Medical Imaging, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu 210002, P.R. China
| | - Yan-Fen Wang
- Department of Pathology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu 210002, P.R. China
| | - Guang-Ming Lu
- Department of Medical Imaging, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu 210002, P.R. China
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108
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Zhuang H, Codreanu I. Growing applications of FDG PET-CT imaging in non-oncologic conditions. J Biomed Res 2015; 29:189-202. [PMID: 26060443 PMCID: PMC4449487 DOI: 10.7555/jbr.29.20140081] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Accepted: 12/09/2014] [Indexed: 12/20/2022] Open
Abstract
As the number of clinical applications of 2-[fluorine 18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography/computed tomography (PET-CT) grows, familiarity with the conditions that can be diagnosed by this modality and when relevant pieces of additional information can be obtained becomes increasingly important for both requesting physicians and nuclear medicine physicians or radiologists who interpret the findings. Apart from its heavy use in clinical oncology, FDG PET-CT is widely used in a variety of non-oncologic conditions interconnecting to such disciplines as general internal medicine, infectious diseases, cardiology, neurology, surgery, traumatology, orthopedics, pediatrics, endocrinology, rheumatology, psychiatry, neuropsychology, and cognitive neuroscience. The aim of this review was to summarize the current evidence of FDG PET-CT applications in evaluating non-oncologic pathologies and the relevant information it can add to achieve a final diagnosis.
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Affiliation(s)
- Hongming Zhuang
- Department of Radiology, Division of Nuclear Medicine, Children's Hospital of Philadelphia, Philadelphia, PA 19104, U.S.A
| | - Ion Codreanu
- Department of Radiology, Division of Nuclear Medicine, Children's Hospital of Philadelphia, Philadelphia, PA 19104, U.S.A. ; Department of Radiology, Medpark International Hospital, State University of Medicine and Pharmacy "Nicolae Testemitanu", Chisinau, MD 2024, Republic of Moldova
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Abstract
In view of the trend towards personalized treatment strategies for (cancer) patients, there is an increasing need to noninvasively determine individual patient characteristics. Such information enables physicians to administer to patients accurate therapy with appropriate timing. For the noninvasive visualization of disease-related features, imaging biomarkers are expected to play a crucial role. Next to the chemical development of imaging probes, this requires preclinical studies in animal tumour models. These studies provide proof-of-concept of imaging biomarkers and help determine the pharmacokinetics and target specificity of relevant imaging probes, features that provide the fundamentals for translation to the clinic. In this review we describe biological processes derived from the “hallmarks of cancer” that may serve as imaging biomarkers for diagnostic, prognostic and treatment response monitoring that are currently being studied in the preclinical setting. A number of these biomarkers are also being used for the initial preclinical assessment of new intervention strategies. Uniquely, noninvasive imaging approaches allow longitudinal assessment of changes in biological processes, providing information on the safety, pharmacokinetic profiles and target specificity of new drugs, and on the antitumour effectiveness of therapeutic interventions. Preclinical biomarker imaging can help guide translation to optimize clinical biomarker imaging and personalize (combination) therapies.
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110
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Hildebrandt MG, Kodahl AR, Teilmann-Jørgensen D, Mogensen O, Jensen PT. [18F]Fluorodeoxyglucose PET/Computed Tomography in Breast Cancer and Gynecologic Cancers. PET Clin 2015; 10:89-104. [DOI: 10.1016/j.cpet.2014.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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111
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Yip S, McCall K, Aristophanous M, Chen AB, Aerts HJWL, Berbeco R. Comparison of texture features derived from static and respiratory-gated PET images in non-small cell lung cancer. PLoS One 2014; 9:e115510. [PMID: 25517987 PMCID: PMC4269460 DOI: 10.1371/journal.pone.0115510] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 11/24/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND PET-based texture features have been used to quantify tumor heterogeneity due to their predictive power in treatment outcome. We investigated the sensitivity of texture features to tumor motion by comparing static (3D) and respiratory-gated (4D) PET imaging. METHODS Twenty-six patients (34 lesions) received 3D and 4D [18F]FDG-PET scans before the chemo-radiotherapy. The acquired 4D data were retrospectively binned into five breathing phases to create the 4D image sequence. Texture features, including Maximal correlation coefficient (MCC), Long run low gray (LRLG), Coarseness, Contrast, and Busyness, were computed within the physician-defined tumor volume. The relative difference (δ3D-4D) in each texture between the 3D- and 4D-PET imaging was calculated. Coefficient of variation (CV) was used to determine the variability in the textures between all 4D-PET phases. Correlations between tumor volume, motion amplitude, and δ3D-4D were also assessed. RESULTS 4D-PET increased LRLG ( = 1%-2%, p < 0.02), Busyness ( = 7%-19%, p < 0.01), and decreased MCC ( = 1%-2%, p < 7.5 × 10(-3)), Coarseness ( = 5%-10%, p < 0.05) and Contrast ( = 4%-6%, p > 0.08) compared to 3D-PET. Nearly negligible variability was found between the 4D phase bins with CV < 5% for MCC, LRLG, and Coarseness. For Contrast and Busyness, moderate variability was found with CV = 9% and 10%, respectively. No strong correlation was found between the tumor volume and δ3D-4D for the texture features. Motion amplitude had moderate impact on δ for MCC and Busyness and no impact for LRLG, Coarseness, and Contrast. CONCLUSIONS Significant differences were found in MCC, LRLG, Coarseness, and Busyness between 3D and 4D PET imaging. The variability between phase bins for MCC, LRLG, and Coarseness was negligible, suggesting that similar quantification can be obtained from all phases. Texture features, blurred out by respiratory motion during 3D-PET acquisition, can be better resolved by 4D-PET imaging. 4D-PET textures may have better prognostic value as they are less susceptible to tumor motion.
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Affiliation(s)
- Stephen Yip
- Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
| | - Keisha McCall
- Department of Radiology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Michalis Aristophanous
- Department of Radiation Physics, Division of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Aileen B. Chen
- Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Hugo J. W. L. Aerts
- Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Ross Berbeco
- Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, United States of America
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Houshmand S, Salavati A, Hess S, Werner TJ, Alavi A, Zaidi H. An update on novel quantitative techniques in the context of evolving whole-body PET imaging. PET Clin 2014; 10:45-58. [PMID: 25455879 DOI: 10.1016/j.cpet.2014.09.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Since its foundation PET has established itself as one of the standard imaging modalities enabling the quantitative assessment of molecular targets in vivo. In the past two decades, quantitative PET has become a necessity in clinical oncology. Despite introduction of various measures for quantification and correction of PET parameters, there is debate on the selection of the appropriate methodology in specific diseases and conditions. In this review, we have focused on these techniques with special attention to topics such as static and dynamic whole body PET imaging, tracer kinetic modeling, global disease burden, texture analysis and radiomics, dual time point imaging and partial volume correction.
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Affiliation(s)
- Sina Houshmand
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Ali Salavati
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Søren Hess
- Department of Nuclear Medicine, Odense University Hospital, Søndre Boulevard 29, Odense 5000, Denmark
| | - Thomas J Werner
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Habib Zaidi
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, CH-1211, Geneva, Switzerland; Geneva Neuroscience Center, Geneva University, CH-1211 Geneva, Switzerland; Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands.
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113
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Value of (18)F-FDG PET/CT in the Detection of Ovarian Malignancy. Nucl Med Mol Imaging 2014; 49:42-51. [PMID: 25774237 DOI: 10.1007/s13139-014-0303-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 10/14/2014] [Accepted: 10/16/2014] [Indexed: 10/24/2022] Open
Abstract
PURPOSE Ovarian cancer is a leading cause of gynecologic malignancy. As symptoms of ovarian cancer are nonspecific, only 20 % of ovarian cancers are diagnosed while they are still limited to the ovaries. Thus, early and accurate detection of disease is important for an improved prognosis. For the accurate and effective diagnosis of ovarian malignancy on (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT), we analyzed several parameters, including visual assessment. METHOD A total of 51 peritoneal lesions in 19 patients who showed ovarian masses with diffuse peritoneal infiltration were enrolled. Twelve patients were confirmed to have ovarian malignancy and seven patients with benign disease by pathologic examination. All patients were examined by (18)F-FDG PET/CT, and an additional 2-h delayed (18)F-FDG PET/CT was also performed for 15 patients with 42 peritoneal lesions. We measured semiquantitative parameters including maximum and mean standardized uptake values (SUVmax, SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) on a 1-h initial (18)F-FDG PET/CT image (Parameter1) and on a 2-h delayed image (Parameter2). Additionally, retention indices of each parameter were calculated, and each parameter among the malignant and benign lesions was compared by Mann-Whitney U test. We also assessed the visual characteristics of each peritoneal lesion, including metabolic extent, intensity, shape, heterogeneity, and total visual score. Associations between visual grades and malignancy were analyzed using linear by linear association methods. Moreover, a receiver operating characteristic (ROC) curve was analyzed to compare the effectiveness of significant parameters. RESULT In a comparison between the malignant and benign groups in the analysis of 51 total peritoneal lesions, SUVmax1, SUVmean1, and TLG1 showed significant differences. Also, in the analysis of 42 peritoneal lesions that underwent an additional 2-h (18)F-FDG PET/CT examination, SUVmax1,2, SUVmean1,2, TLG2, and the RI of TLG showed significant differences between the malignant and benign groups. MTV did not show significant differences in either the analysis of 51 peritoneal lesions or of 42 lesions. Regarding visual assessments, metabolic intensity, shape, heterogeneity, and total visual score showed an association with malignancy. In the ROC analysis, the AUC of the visual score was larger than the AUC of other parameters in both the analyses of 51 peritoneal lesions and of 42 lesions. CONCLUSION Although further study with a larger patient population is needed, the visual assessment of (18)F-FDG PET/CT imaging has a primary role in the detection of malignancy in ovarian cancer patients with assistance from other semi-quantitative parameters.
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Houshmand S, Salavati A, Basu S, Khiewvan B, Alavi A. The role of dual and multiple time point imaging of FDG uptake in both normal and disease states. Clin Transl Imaging 2014. [DOI: 10.1007/s40336-014-0075-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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115
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Nielsen K, Scheffer HJ, Pieters IC, van Tilborg AAJM, van Waesberghe JHTM, Oprea-Lager DE, Meijerink MR, Kazemier G, Hoekstra OS, Schreurs HWH, Sietses C, Meijer S, Comans EFI, van den Tol PMP. The use of PET-MRI in the follow-up after radiofrequency- and microwave ablation of colorectal liver metastases. BMC Med Imaging 2014; 14:27. [PMID: 25103913 PMCID: PMC4141664 DOI: 10.1186/1471-2342-14-27] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Accepted: 08/04/2014] [Indexed: 12/16/2022] Open
Abstract
Background Thermal ablation of colorectal liver metastases (CRLM) may result in local progression, which generally appear within a year of treatment. As the timely diagnosis of this progression allows potentially curative local treatment, an optimal follow-up imaging strategy is essential. PET-MRI is a one potential imaging modality, combining the advantages of PET and MRI. The aim of this study is evaluate fluorine-18 deoxyglucose positron emission tomography (FDG) PET-MRI as a modality for detection of local tumor progression during the first year following thermal ablation, as compared to the current standard, FDG PET-CT. The ability of FDG PET-MRI to detect new intrahepatic lesions, and the extent to which FDG PET-MRI alters clinical management, inter-observer variability and patient preference will also be included as secondary outcomes. Methods/Design Twenty patients undergoing treatment with radiofrequency or microwave ablation for (recurrent) CRLM will be included in this prospective trial. During the first year of follow-up, patients will be scanned at the VU University Medical Center at 3-monthly intervals using a 4-phase liver CT, FDG PET-CT and FDG PET-MRI. Patients treated with chemotherapy <6 weeks prior to scanning or with a contra-indication for MRI will be excluded. MRI will be performed using both whole body imaging (mDixon) and dedicated liver sequences, including diffusion-weighted imaging, T1 in-phase and opposed-phase, T2 and dynamic contrast-enhanced imaging. The results of all modalities will be scored by 4 individual reviewers and inter-observer agreement will be determined. The reference standard will be histology or clinical follow-up. A questionnaire regarding patients’ experience with both modalities will also be completed at the end of the follow-up year. Discussion Improved treatment options for local site recurrences following CRLM ablation mean that accurate post-ablation staging is becoming increasingly important. The combination of the sensitivity of MRI as a detection method for small intrahepatic lesions with the ability of FDG PET to visualize enhanced metabolism at the ablation site suggests that FDG PET-MRI could potentially improve the accuracy of (early) detection of progressive disease, and thus allow swifter and more effective decision-making regarding appropriate treatment. Trial registration Trial registration number:
NCT01895673
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Petrousjka M P van den Tol
- Department of Surgery, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
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Time sensitivity factor of single pulmonary nodule: a new cancer characteristic metabolic parameter by (18) F-FDG PET. BIOMED RESEARCH INTERNATIONAL 2014; 2014:830135. [PMID: 24982908 PMCID: PMC4052123 DOI: 10.1155/2014/830135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 05/05/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To calculate the time sensitivity factor (S) for discriminating the solitary pulmonary nodule (SPN) by FDG PET at different time points. METHODS The multiple time-point FDG PET images from 41 patients for evaluating SPN seen on chest X-ray or CT were prospectively analyzed to calculate and evaluate S against the gold standard of tissue histology (n = 38) or long term clinicoradiographic follow-up (n = 3). The maximal standardized uptake values (SUV) at the 3 hourly time points were measured. The S was calculated using S = d{ln(SUV)}/d{ln(t)} at 3 different time intervals. ROC analysis of the S parameters was performed to evaluate the optimal cut-off value and their accuracy in classifying the SPN. RESULTS The SUV in malignant SPN was higher than the corresponding value in benign lesions at all 3 hourly time points (P < 0.003). The S parameters using 3 different time intervals all significantly separated the two groups (P < 0.0005) with an optimal cut-off point near the theoretical value of zero with a high sensitivity of 100% and specificity of 86%. CONCLUSION. The S can be calculated for SPNs using multiple time-point FDG PET, providing a tumor characteristic metabolic parameter with high discrimination power using a simple positive value representing malignancy.
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Povoski SP, Murrey DA, Smith SM, Martin EW, Hall NC. 18F-FDG PET/CT oncologic imaging at extended injection-to-scan acquisition time intervals derived from a single-institution 18F-FDG-directed surgery experience: feasibility and quantification of 18F-FDG accumulation within 18F-FDG-avid lesions and background tissues. BMC Cancer 2014; 14:453. [PMID: 24942656 PMCID: PMC4075626 DOI: 10.1186/1471-2407-14-453] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 06/13/2014] [Indexed: 12/31/2022] Open
Abstract
Background 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) is a well-established imaging modality for a wide variety of solid malignancies. Currently, only limited data exists regarding the utility of PET/CT imaging at very extended injection-to-scan acquisition times. The current retrospective data analysis assessed the feasibility and quantification of diagnostic 18F-FDG PET/CT oncologic imaging at extended injection-to-scan acquisition time intervals. Methods 18F-FDG-avid lesions (not surgically manipulated or altered during 18F-FDG-directed surgery, and visualized both on preoperative and postoperative 18F-FDG PET/CT imaging) and corresponding background tissues were assessed for 18F-FDG accumulation on same-day preoperative and postoperative 18F-FDG PET/CT imaging. Multiple patient variables and 18F-FDG-avid lesion variables were examined. Results For the 32 18F-FDG-avid lesions making up the final 18F-FDG-avid lesion data set (from among 7 patients), the mean injection-to-scan times of the preoperative and postoperative 18F-FDG PET/CT scans were 73 (±3, 70-78) and 530 (±79, 413-739) minutes, respectively (P < 0.001). The preoperative and postoperative mean 18F-FDG-avid lesion SUVmax values were 7.7 (±4.0, 3.6-19.5) and 11.3 (±6.0, 4.1-29.2), respectively (P < 0.001). The preoperative and postoperative mean background SUVmax values were 2.3 (±0.6, 1.0-3.2) and 2.1 (±0.6, 1.0-3.3), respectively (P = 0.017). The preoperative and postoperative mean lesion-to-background SUVmax ratios were 3.7 (±2.3, 1.5-9.8) and 5.8 (±3.6, 1.6-16.2), respectively, (P < 0.001). Conclusions 18F-FDG PET/CT oncologic imaging can be successfully performed at extended injection-to-scan acquisition time intervals of up to approximately 5 half-lives for 18F-FDG while maintaining good/adequate diagnostic image quality. The resultant increase in the 18F-FDG-avid lesion SUVmax values, decreased background SUVmax values, and increased lesion-to-background SUVmax ratios seen from preoperative to postoperative 18F-FDG PET/CT imaging have great potential for allowing for the integrated, real-time use of 18F-FDG PET/CT imaging in conjunction with 18F-FDG-directed interventional radiology biopsy and ablation procedures and 18F-FDG-directed surgical procedures, as well as have far-reaching impact on potentially re-shaping future thinking regarding the “most optimal” injection-to-scan acquisition time interval for all routine diagnostic 18F-FDG PET/CT oncologic imaging.
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Affiliation(s)
- Stephen P Povoski
- Division of Surgical Oncology, Department of Surgery, Arthur G, James Cancer Hospital and Richard J, Solove Research Institute and Comprehensive Cancer Center, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA.
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Kwee TC, Cheng G, Lam MGEH, Basu S, Alavi A. SUVmax of 2.5 should not be embraced as a magic threshold for separating benign from malignant lesions. Eur J Nucl Med Mol Imaging 2014; 40:1475-7. [PMID: 23801170 DOI: 10.1007/s00259-013-2484-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Thomas C Kwee
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
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Cheng G, Alavi A, Lee NJ, Akers SR. Differential Background Clearance of Fluorodeoxyglucose Activity in Normal Tissues and its Clinical Significance. PET Clin 2014; 9:209-16. [DOI: 10.1016/j.cpet.2013.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Hess S, Blomberg BA, Zhu HJ, Høilund-Carlsen PF, Alavi A. The pivotal role of FDG-PET/CT in modern medicine. Acad Radiol 2014; 21:232-49. [PMID: 24439337 DOI: 10.1016/j.acra.2013.11.002] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 10/30/2013] [Accepted: 11/01/2013] [Indexed: 12/21/2022]
Abstract
The technology behind positron emission tomography (PET) and the most widely used tracer, 2-deoxy-2-[18F]fluoro-D-glucose (FDG), were both conceived in the 1970s, but the latest decade has witnessed a rapid emergence of FDG-PET as an effective imaging technique. This is not least due to the emergence of hybrid scanners combining PET with computed tomography (PET/CT). Molecular imaging has enormous potential for advancing biological research and patient care, and FDG-PET/CT is currently the most widely used technology in this domain. In this review, we discuss contemporary applications of FDG-PET and FDG-PET/CT as well as novel developments in quantification and potential future indications including the emerging new modality PET/magnetic resonance imaging.
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Catalano OA, Rosen BR, Sahani DV, Hahn PF, Guimaraes AR, Vangel MG, Nicolai E, Soricelli A, Salvatore M. Clinical impact of PET/MR imaging in patients with cancer undergoing same-day PET/CT: initial experience in 134 patients--a hypothesis-generating exploratory study. Radiology 2013; 269:857-69. [PMID: 24009348 DOI: 10.1148/radiol.13131306] [Citation(s) in RCA: 127] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE To compare the clinical impact of combined positron emission tomography (PET) and magnetic resonance (MR) imaging to that of combined PET and computed tomography (CT) performed on the same day in patients with cancer. MATERIALS AND METHODS This HIPAA-compliant retrospective study was approved by the institutional review board. Patients gave written informed consent for study enrollment, including the possibility to use their imaging and clinical data in future evaluations. A total of 134 patients with cancer with a non-central nervous system primary neoplasm underwent same-day fluorodeoxyglucose (FDG) PET/CT and FDG PET/MR imaging. PET/CT and PET/MR studies were independently interpreted by teams of radiologists and nuclear medicine physicians. Four readers, divided into two teams composed of one radiologist and one nuclear medicine physician each, read all 134 studies. The referring physician classified discordance between PET/CT and PET/MR observations either as findings affecting clinical management or as findings not affecting clinical management. Data were compared with the χ(2) test. RESULTS Findings affecting clinical management were noted for PET/CT studies but not for PET/MR studies in two (1.5%) of 134 patients and for PET/MR studies but not for PET/CT studies in 24 (17.9%) of 134 patients. The discrepancies between findings affecting clinical management detected with PET/MR imaging over those detected with PET/CT were significant (P < .001). CONCLUSION In these patients, PET/MR imaging alone contributed to clinical management more often than did PET/CT alone. PET/MR imaging provides information that affects the care of patients with cancer and is unavailable from PET/CT. Online supplemental material is available for this article.
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Affiliation(s)
- Onofrio A Catalano
- From the Departments of Radiology (O.A.C.) and Nuclear Medicine (E.N., A.S.), SDN Istituto Ricerca Diagnostica Nucleare, Via Gianturco 113, Naples 80143, Italy; Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging (B.R.R., A.R.G., M.G.V.), and Biostatistics Center (M.G.V.), Massachusetts General Hospital, Harvard University Medical School, Charlestown, Mass; Department of Radiology, Massachusetts General Hospital, Harvard University Medical School, Boston, Mass (D.V.S., P.F.H.); and Department of Radiology, University of Naples Federico II, Naples, Italy (M.S.)
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Gharavi MH, Wu HH, Toms SA. High fluorodeoxyglucose ((18)F)PET-uptake lymph nodes in a patient with chordoma: Tumor metastasis or sarcoidosis? AMERICAN JOURNAL OF CASE REPORTS 2013; 14:373-5. [PMID: 24086794 PMCID: PMC3783480 DOI: 10.12659/ajcr.889329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Accepted: 05/17/2013] [Indexed: 02/02/2023]
Abstract
Patient: Male, 48 Final Diagnosis: Chordoma Symptoms: — Medication: — Clinical Procedure: — Specialty: Neurology
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Chandarana H, Heacock L, Rakheja R, DeMello LR, Bonavita J, Block TK, Geppert C, Babb JS, Friedman KP. Pulmonary Nodules in Patients with Primary Malignancy: Comparison of Hybrid PET/MR and PET/CT Imaging. Radiology 2013; 268:874-81. [DOI: 10.1148/radiol.13130620] [Citation(s) in RCA: 118] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Lam MG, Kwee TC, Basu S, Alavi A. Underestimated Role of 18F-FDG PET for HCC Evaluation and Promise of 18F-FDG PET/MR Imaging in This Setting. J Nucl Med 2013; 54:1510-1. [DOI: 10.2967/jnumed.113.123273] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Ito K, Morooka M, Minamimoto R, Miyata Y, Okasaki M, Kubota K. Imaging spectrum and pitfalls of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with tuberculosis. Jpn J Radiol 2013; 31:511-20. [DOI: 10.1007/s11604-013-0218-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 05/13/2013] [Indexed: 11/30/2022]
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