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Mena E, Yanamadala A, Cheng G, Subramaniam RM. The Current and Evolving Role of PET in Personalized Management of Lung Cancer. PET Clin 2016; 11:243-59. [DOI: 10.1016/j.cpet.2016.02.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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102
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Molina D, Pérez-Beteta J, Luque B, Arregui E, Calvo M, Borrás JM, López C, Martino J, Velasquez C, Asenjo B, Benavides M, Herruzo I, Martínez-González A, Pérez-Romasanta L, Arana E, Pérez-García VM. Tumour heterogeneity in glioblastoma assessed by MRI texture analysis: a potential marker of survival. Br J Radiol 2016; 89:20160242. [PMID: 27319577 DOI: 10.1259/bjr.20160242] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE: The main objective of this retrospective work was the study of three-dimensional (3D) heterogeneity measures of post-contrast pre-operative MR images acquired with T1 weighted sequences of patients with glioblastoma (GBM) as predictors of clinical outcome. METHODS: 79 patients from 3 hospitals were included in the study. 16 3D textural heterogeneity measures were computed including run-length matrix (RLM) features (regional heterogeneity) and co-occurrence matrix (CM) features (local heterogeneity). The significance of the results was studied using Kaplan-Meier curves and Cox proportional hazards analysis. Correlation between the variables of the study was assessed using the Spearman's correlation coefficient. RESULTS: Kaplan-Meyer survival analysis showed that 4 of the 11 RLM features and 4 of the 5 CM features considered were robust predictors of survival. The median survival differences in the most significant cases were of over 6 months. CONCLUSION: Heterogeneity measures computed on the post-contrast pre-operative T1 weighted MR images of patients with GBM are predictors of survival. ADVANCES IN KNOWLEDGE: Texture analysis to assess tumour heterogeneity has been widely studied. However, most works develop a two-dimensional analysis, focusing only on one MRI slice to state tumour heterogeneity. The study of fully 3D heterogeneity textural features as predictors of clinical outcome is more robust and is not dependent on the selected slice of the tumour.
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Affiliation(s)
- David Molina
- 1 Instituto de Matemática Aplicada a la Ciencia y la Ingeniería, Universidad de Castilla-La Mancha, Ciudad Real, Spain
| | - Julián Pérez-Beteta
- 1 Instituto de Matemática Aplicada a la Ciencia y la Ingeniería, Universidad de Castilla-La Mancha, Ciudad Real, Spain
| | - Belén Luque
- 1 Instituto de Matemática Aplicada a la Ciencia y la Ingeniería, Universidad de Castilla-La Mancha, Ciudad Real, Spain
| | - Elena Arregui
- 2 Hospital General de Ciudad Real, Ciudad Real, Spain
| | - Manuel Calvo
- 2 Hospital General de Ciudad Real, Ciudad Real, Spain
| | - José M Borrás
- 2 Hospital General de Ciudad Real, Ciudad Real, Spain
| | - Carlos López
- 2 Hospital General de Ciudad Real, Ciudad Real, Spain
| | - Juan Martino
- 3 Hospital Marqués de Valdecilla, Santander, Spain
| | | | | | | | | | - Alicia Martínez-González
- 1 Instituto de Matemática Aplicada a la Ciencia y la Ingeniería, Universidad de Castilla-La Mancha, Ciudad Real, Spain
| | | | | | - Víctor M Pérez-García
- 1 Instituto de Matemática Aplicada a la Ciencia y la Ingeniería, Universidad de Castilla-La Mancha, Ciudad Real, Spain
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Dong X, Sun X, Sun L, Maxim PG, Xing L, Huang Y, Li W, Wan H, Zhao X, Xing L, Yu J. Early Change in Metabolic Tumor Heterogeneity during Chemoradiotherapy and Its Prognostic Value for Patients with Locally Advanced Non-Small Cell Lung Cancer. PLoS One 2016; 11:e0157836. [PMID: 27322376 PMCID: PMC4913903 DOI: 10.1371/journal.pone.0157836] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 06/06/2016] [Indexed: 12/25/2022] Open
Abstract
Introduction To observe the early change of metabolic tumor heterogeneity during chemoradiotherapy and to determine its prognostic value for patients with locally advanced non-small cell lung cancer (NSCLC). Methods From January 2007 to March 2010, 58 patients with NSCLC were included who were received 18F-fluorodeoxyglucose (18F-FDG) PET/CT before and following 40 Gy radiotherapy with the concurrent cisplatin-based chemotherapy (CCRT). Primary tumor FDG uptake heterogeneity was determined using global and local scale textural features extracted from standardized uptake value (SUV) histogram analysis (coefficient of variation [COV], skewness, kurtosis, area under the curve of the cumulative SUV histogram [AUC-CSH]) and normalized gray-level co-occurrence matrix (contrast, dissimilarity, entropy, homogeneity). SUVmax and metabolic tumor volume (MTV) were also evaluated. Correlations were analyzed between parameters on baseline or during treatments with tumor response, progression-free survival (PFS), and overall survival (OS). Results Compared with non-responders, responders showed significantly greater pre-treatment COV, contrast and MTV (AUC = 0.781, 0.804, 0.686, respectively). Receiver-operating-characteristic curve analysis showed that early change of tumor textural analysis serves as a response predictor with higher sensitivity (73.2%~92.1%) and specificity (80.0%~83.6%) than baseline parameters. Change in AUC-CSH and dissimilarity during CCRT could also predict response with optimal cut-off values (33.0% and 28.7%, respectively). The patients with greater changes in contrast and AUC-CSH had significantly higher 5-year OS (P = 0.008, P = 0.034) and PFS (P = 0.007, P = 0.039). In multivariate analysis, only change in contrast was found as the independent prognostic factor of PFS (HR 0.476, P = 0.021) and OS (HR 0.519, P = 0.015). Conclusions The metabolic tumor heterogeneity change during CCRT characterized by global and local scale textural features may be valuable for predicting treatment response and survival for patients with locally advanced NSCLC.
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Affiliation(s)
- Xinzhe Dong
- Department of Radiation Oncology, Shandong Cancer Hospital, Shandong University, Jinan, Shandong, China
- Key Laboratory of Radiation Oncology of Shandong Province, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
| | - Xiaorong Sun
- Department of Radiology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
| | - Lu Sun
- Jinan University, Jinan, Shandong, China
| | - Peter G. Maxim
- Department of Radiation Oncology and Cancer Institute, Stanford University School of Medicine, Stanford, California, United States of America
| | - Lei Xing
- Department of Radiation Oncology and Cancer Institute, Stanford University School of Medicine, Stanford, California, United States of America
| | - Yong Huang
- Department of Radiology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
| | - Wenwu Li
- Department of Radiology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
| | - Honglin Wan
- College of Physics and Electronic Science, Shandong Normal University, Jinan, Shandong, China
| | - Xianguang Zhao
- Department of Radiation Oncology, Shandong Cancer Hospital, Shandong University, Jinan, Shandong, China
- Key Laboratory of Radiation Oncology of Shandong Province, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
- * E-mail: (XZ); (LX)
| | - Ligang Xing
- Department of Radiation Oncology, Shandong Cancer Hospital, Shandong University, Jinan, Shandong, China
- Key Laboratory of Radiation Oncology of Shandong Province, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
- * E-mail: (XZ); (LX)
| | - Jinming Yu
- Department of Radiation Oncology, Shandong Cancer Hospital, Shandong University, Jinan, Shandong, China
- Key Laboratory of Radiation Oncology of Shandong Province, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
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104
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Orlhac F, Thézé B, Soussan M, Boisgard R, Buvat I. Multiscale Texture Analysis: From 18F-FDG PET Images to Histologic Images. J Nucl Med 2016; 57:1823-1828. [DOI: 10.2967/jnumed.116.173708] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 04/28/2016] [Indexed: 12/17/2022] Open
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Pham TD. The Semi-Variogram and Spectral Distortion Measures for Image Texture Retrieval. IEEE TRANSACTIONS ON IMAGE PROCESSING : A PUBLICATION OF THE IEEE SIGNAL PROCESSING SOCIETY 2016; 25:1556-1565. [PMID: 26886989 DOI: 10.1109/tip.2016.2526902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Semi-variogram estimators and distortion measures of signal spectra are utilized in this paper for image texture retrieval. On the use of the complete Brodatz database, most high retrieval rates are reportedly based on multiple features and the combinations of multiple algorithms, while the classification using single features is still a challenge to the retrieval of diverse texture images. The semi-variogram, which is theoretically sound and the cornerstone of spatial statistics, has the characteristics shared between true randomness and complete determinism and, therefore, can be used as a useful tool for both the structural and statistical analysis of texture images. Meanwhile, spectral distortion measures derived from the theory of linear predictive coding provide a rigorously mathematical model for signal-based similarity matching and have been proven useful for many practical pattern classification systems. Experimental results obtained from testing the proposed approach using the complete Brodatz database, and the the University of Illinois at Urbana-Champaign texture database suggests the effectiveness of the proposed approach as a single-feature-based dissimilarity measure for real-time texture retrieval.
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106
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Haeck JC, Bol K, de Ridder CMA, Brunel L, Fehrentz JA, Martinez J, van Weerden WM, Bernsen MR, de Jong M, Veenland JF. Imaging heterogeneity of peptide delivery and binding in solid tumors using SPECT imaging and MRI. EJNMMI Res 2016; 6:3. [PMID: 26769345 PMCID: PMC4713394 DOI: 10.1186/s13550-016-0160-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 01/05/2016] [Indexed: 01/03/2023] Open
Abstract
Background As model system, a solid-tumor patient-derived xenograft (PDX) model characterized by high peptide receptor expression and histological tissue homogeneity was used to study radiopeptide targeting. In this solid-tumor model, high tumor uptake of targeting peptides was expected. However, in vivo SPECT images showed substantial heterogeneous radioactivity accumulation despite homogenous receptor distribution in the tumor xenografts as assessed by in vitro autoradiography. We hypothesized that delivery of peptide to the tumor cells is dictated by adequate local tumor perfusion. To study this relationship, sequential SPECT/CT and MRI were performed to assess the role of vascular functionality in radiopeptide accumulation. Methods High-resolution SPECT and dynamic contrast-enhanced (DCE)-MRI were acquired in six mice bearing PC295 PDX tumors expressing the gastrin-releasing peptide (GRP) receptor. Two hours prior to SPECT imaging, animals received 25 MBq 111In(DOTA-(βAla)2-JMV594) (25 pmol). Images were acquired using multipinhole SPECT/CT. Directly after SPECT imaging, MR images were acquired on a 7.0-T dedicated animal scanner. DCE-MR images were quantified using semi-quantitative and quantitative models. The DCE-MR and SPECT images were spatially aligned to compute the correlations between radioactivity and DCE-MRI-derived parameters over the tumor. Results Whereas histology, in vitro autoradiography, and multiple-weighted MRI scans all showed homogenous tissue characteristics, both SPECT and DCE-MRI showed heterogeneous distribution patterns throughout the tumor. The average Spearman’s correlation coefficient between SPECT and DCE-MRI ranged from 0.57 to 0.63 for the “exchange-related” DCE-MRI perfusion parameters. Conclusions A positive correlation was shown between exchange-related DCE-MRI perfusion parameters and the amount of radioactivity accumulated as measured by SPECT, demonstrating that vascular function was an important aspect of radiopeptide distribution in solid tumors. The combined use of SPECT and MRI added crucial information on the perfusion efficiency versus radiopeptide uptake in solid tumors and showed that functional tumor characteristics varied locally even when the tissue appeared homogenous on current standard assessment techniques. Electronic supplementary material The online version of this article (doi:10.1186/s13550-016-0160-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- J C Haeck
- Department of Radiology, Erasmus MC, Rotterdam, the Netherlands. .,Department of Medical Informatics, Erasmus MC, Rotterdam, the Netherlands. .,Department of Nuclear Medicine, Erasmus MC, Dr. Molewaterplein 50, 3015 GE, Rotterdam, the Netherlands.
| | - K Bol
- Department of Radiology, Erasmus MC, Rotterdam, the Netherlands.,Department of Medical Informatics, Erasmus MC, Rotterdam, the Netherlands.,Department of Nuclear Medicine, Erasmus MC, Dr. Molewaterplein 50, 3015 GE, Rotterdam, the Netherlands
| | - C M A de Ridder
- Department of Urology, Erasmus MC, Rotterdam, the Netherlands
| | - L Brunel
- IBMM, UMR 5247, CNRS, ENSCM, Faculté de Pharmacie, Université Montpellier, Montpellier, France
| | - J A Fehrentz
- IBMM, UMR 5247, CNRS, ENSCM, Faculté de Pharmacie, Université Montpellier, Montpellier, France
| | - J Martinez
- IBMM, UMR 5247, CNRS, ENSCM, Faculté de Pharmacie, Université Montpellier, Montpellier, France
| | - W M van Weerden
- Department of Urology, Erasmus MC, Rotterdam, the Netherlands
| | - M R Bernsen
- Department of Radiology, Erasmus MC, Rotterdam, the Netherlands.,Department of Nuclear Medicine, Erasmus MC, Dr. Molewaterplein 50, 3015 GE, Rotterdam, the Netherlands
| | - M de Jong
- Department of Radiology, Erasmus MC, Rotterdam, the Netherlands.,Department of Nuclear Medicine, Erasmus MC, Dr. Molewaterplein 50, 3015 GE, Rotterdam, the Netherlands
| | - J F Veenland
- Department of Radiology, Erasmus MC, Rotterdam, the Netherlands.,Department of Medical Informatics, Erasmus MC, Rotterdam, the Netherlands
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107
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Shin S, Pak K, Park DY, Kim SJ. Tumor Heterogeneity Assessed by 18F-FDG PET/CT Is Not Significantly Associated with Nodal Metastasis in Breast Cancer Patients. Oncol Res Treat 2015; 39:61-6. [PMID: 26891048 DOI: 10.1159/000442760] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 11/04/2015] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The purpose of this study was to evaluate the association of tumor heterogeneity as assessed by positron emission tomography/computed tomography (PET/CT) with pathological factors of breast cancer, and the prediction of nodal metastasis through tumor heterogeneity. METHODS From January 2013 to December 2013, 102 patients with invasive ductal carcinoma of the breast were enrolled into this study. [18F]Fluorodeoxyglucose PET/CT was performed before surgery. The metabolic tumor volume (MTV) of each lesion was calculated and a series of standardized uptake value (SUV) thresholds (e.g. 40%, 50%, 60%, 70%, and 80% of SUVmax) was obtained. A threshold-volume (dV/dT) curve was acquired by plotting thresholds to MTV values automatically calculated with these thresholds. Tumor heterogeneity was calculated from the slope of the threshold-volume curve and defined as heterogeneity factor (HF). RESULTS HF differed significantly according to T stage (p < 0.0001), N stage (p = 0.0131) and American Joint Committee on Cancer (AJCC) stage (p = 0.0006). Among the pathological parameters, dermal lymphatic involvement (p = 0.0039) showed the significant correlations with HF. Lymphovascular invasion (p = 0.0005) was the only independent factor for predicting nodal metastasis. CONCLUSIONS Tumor heterogeneity measured by 18F-FDG PET/CT is significantly associated with dermal lymphatic involvement. However, PET might not be able to predict nodal metastasis in breast cancer.
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Affiliation(s)
- Seunghyeon Shin
- Department of Nuclear Medicine, Pusan National University Hospital, Busan, Korea
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108
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Pourmoghaddas A, Wells RG. Quantitatively accurate activity measurements with a dedicated cardiac SPECT camera: Physical phantom experiments. Med Phys 2015; 43:44. [DOI: 10.1118/1.4937601] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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109
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Orlhac F, Soussan M, Chouahnia K, Martinod E, Buvat I. 18F-FDG PET-Derived Textural Indices Reflect Tissue-Specific Uptake Pattern in Non-Small Cell Lung Cancer. PLoS One 2015; 10:e0145063. [PMID: 26669541 PMCID: PMC4682929 DOI: 10.1371/journal.pone.0145063] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 11/29/2015] [Indexed: 01/29/2023] Open
Abstract
Purpose Texture indices (TI) calculated from 18F-FDG PET tumor images show promise for predicting response to therapy and survival. Their calculation involves a resampling of standardized uptake values (SUV) within the tumor. This resampling can be performed differently and significantly impacts the TI values. Our aim was to investigate how the resampling approach affects the ability of TI to reflect tissue-specific pattern of metabolic activity. Methods 18F-FDG PET were acquired for 48 naïve-treatment patients with non-small cell lung cancer and for a uniform phantom. We studied 7 TI, SUVmax and metabolic volume (MV) in the phantom, tumors and healthy tissue using the usual relative resampling (RR) method and an absolute resampling (AR) method. The differences in TI values between tissue types and cancer subtypes were investigated using Wilcoxon’s tests. Results Most RR-based TI were highly correlated with MV for tumors less than 60 mL (Spearman correlation coefficient r between 0.74 and 1), while this correlation was reduced for AR-based TI (r between 0.06 and 0.27 except for RLNU where r = 0.91). Most AR-based TI were significantly different between tumor and healthy tissues (pvalues <0.01 for all 7 TI) and between cancer subtypes (pvalues<0.05 for 6 TI). Healthy tissue and adenocarcinomas exhibited more homogeneous texture than tumor tissue and squamous cell carcinomas respectively. Conclusion TI computed using an AR method vary as a function of the tissue type and cancer subtype more than the TI involving the usual RR method. AR-based TI might be useful for tumor characterization.
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Affiliation(s)
- Fanny Orlhac
- Imagerie Moléculaire In Vivo, IMIV, CEA, Inserm, CNRS, Univ. Paris-Sud, Université Paris Saclay, CEA-SHFJ, Orsay, France
| | - Michaël Soussan
- Imagerie Moléculaire In Vivo, IMIV, CEA, Inserm, CNRS, Univ. Paris-Sud, Université Paris Saclay, CEA-SHFJ, Orsay, France.,Department of Nuclear Medicine, AP-HP, Avicenne Hospital, Bobigny, France
| | - Kader Chouahnia
- Department of Oncology, AP-HP, Avicenne Hospital, Bobigny, France
| | - Emmanuel Martinod
- Department of Thoracic Surgery, AP-HP, Avicenne Hospital, Bobigny, France
| | - Irène Buvat
- Imagerie Moléculaire In Vivo, IMIV, CEA, Inserm, CNRS, Univ. Paris-Sud, Université Paris Saclay, CEA-SHFJ, Orsay, France
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110
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Pu H, Zhang Q, Zhao C, Shi L, Wang Y, Wang J, Zhang M. Overexpression of G6PD is associated with high risks of recurrent metastasis and poor progression-free survival in primary breast carcinoma. World J Surg Oncol 2015; 13:323. [PMID: 26607846 PMCID: PMC4660828 DOI: 10.1186/s12957-015-0733-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 11/10/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The present study aimed to investigate the expression of CYP27A1, CYP7B1, insulin-like growth factor-1 (IGF-1), glucose-6-phosphate-dehydrogenase (G6PD), glutathione S-transferase P1 (GSTP1), and pyruvate kinase isoform M2 (PKM2) in breast carcinoma tissue and evaluate their prognostic value for progression-free survival (PFS) and overall survival (OS). METHODS A total of 20 patients treated with surgery for primary breast carcinoma were enrolled: 10 cases diagnosed with recurrent metastasis (A), along with their corresponding metastases specimen (AM) and 10 cases with no evidence of recurrence or metastasis (B). Baseline characteristics of patients including age, lymph node metastasis, molecular subtypes, tumor staging and size, and pathological classification were all collected. Immunohistochemistry was performed to detect the protein expression in tumor specimens. RESULTS Elevated G6PD protein levels were noted in group A compared with group AM and B (both P < 0.05), and PKM2 expression was also higher in group A when compared to group AM (P = 0.019), but similar with group B (P > 0.05). No association between clinicopathological parameters and the two proteins expression was observed. The G6PD protein expression was strongly associated with PFS of breast carcinoma patients (P = 0.021) but not for OS. According to the Kaplan-Meier analysis, mean PFS time of patients with G6PD-negative and G6PD-positive expression tumor were 71.36 ± 6.53 and 32.25 ± 5.67 months, respectively (P = 0.002). CONCLUSIONS The G6PD protein could be served as a potential prognostic biomarker for primary breast carcinoma, and overexpression of G6PD protein predicted a high risk of recurrent metastasis and poor PFS during follow-up.
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MESH Headings
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/enzymology
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/enzymology
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Ductal, Breast/surgery
- Carrier Proteins/metabolism
- Female
- Follow-Up Studies
- Glucosephosphate Dehydrogenase/metabolism
- Glutathione S-Transferase pi/metabolism
- Humans
- Immunoenzyme Techniques
- Lymphatic Metastasis
- Membrane Proteins/metabolism
- Middle Aged
- Neoplasm Grading
- Neoplasm Invasiveness
- Neoplasm Recurrence, Local/diagnosis
- Neoplasm Recurrence, Local/enzymology
- Neoplasm Recurrence, Local/surgery
- Neoplasm Staging
- Prognosis
- Survival Rate
- Thyroid Hormones/metabolism
- Thyroid Hormone-Binding Proteins
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Affiliation(s)
- Haihong Pu
- Department of Medical Oncology, The Third Affiliated Hospital of Harbin Medical University, Haping Road 150 of Nangang District, Harbin, Heilongjiang Province, 150086, China.
| | - Qingyuan Zhang
- Department of Medical Oncology, The Third Affiliated Hospital of Harbin Medical University, Haping Road 150 of Nangang District, Harbin, Heilongjiang Province, 150086, China.
| | - Chunbo Zhao
- Department of Medical Oncology, The Third Affiliated Hospital of Harbin Medical University, Haping Road 150 of Nangang District, Harbin, Heilongjiang Province, 150086, China.
| | - Lei Shi
- Department of radiation oncology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, 150001, China.
| | - Yan Wang
- Department of Medical Oncology, The Third Affiliated Hospital of Harbin Medical University, Haping Road 150 of Nangang District, Harbin, Heilongjiang Province, 150086, China.
| | - Jingxuan Wang
- Department of Medical Oncology, The Third Affiliated Hospital of Harbin Medical University, Haping Road 150 of Nangang District, Harbin, Heilongjiang Province, 150086, China.
| | - Minghui Zhang
- Department of Medical Oncology, The Third Affiliated Hospital of Harbin Medical University, Haping Road 150 of Nangang District, Harbin, Heilongjiang Province, 150086, China.
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Nyflot MJ, Yang F, Byrd D, Bowen SR, Sandison GA, Kinahan PE. Quantitative radiomics: impact of stochastic effects on textural feature analysis implies the need for standards. J Med Imaging (Bellingham) 2015; 2:041002. [PMID: 26251842 PMCID: PMC4524811 DOI: 10.1117/1.jmi.2.4.041002] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 06/02/2015] [Indexed: 11/14/2022] Open
Abstract
Image heterogeneity metrics such as textural features are an active area of research for evaluating clinical outcomes with positron emission tomography (PET) imaging and other modalities. However, the effects of stochastic image acquisition noise on these metrics are poorly understood. We performed a simulation study by generating 50 statistically independent PET images of the NEMA IQ phantom with realistic noise and resolution properties. Heterogeneity metrics based on gray-level intensity histograms, co-occurrence matrices, neighborhood difference matrices, and zone size matrices were evaluated within regions of interest surrounding the lesions. The impact of stochastic variability was evaluated with percent difference from the mean of the 50 realizations, coefficient of variation and estimated sample size for clinical trials. Additionally, sensitivity studies were performed to simulate the effects of patient size and image reconstruction method on the quantitative performance of these metrics. Complex trends in variability were revealed as a function of textural feature, lesion size, patient size, and reconstruction parameters. In conclusion, the sensitivity of PET textural features to normal stochastic image variation and imaging parameters can be large and is feature-dependent. Standards are needed to ensure that prospective studies that incorporate textural features are properly designed to measure true effects that may impact clinical outcomes.
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Affiliation(s)
- Matthew J. Nyflot
- University of Washington, Department of Radiation Oncology, 1959 NE Pacific Street, Box 356043, Seattle, Washington 98195-6043, United States
| | - Fei Yang
- University of Washington, Department of Radiation Oncology, 1959 NE Pacific Street, Box 356043, Seattle, Washington 98195-6043, United States
| | - Darrin Byrd
- University of Washington, Department of Radiology, 1959 NE Pacific Street, Box 356043, Seattle, Washington 98195-6043, United States
| | - Stephen R. Bowen
- University of Washington, Department of Radiation Oncology, 1959 NE Pacific Street, Box 356043, Seattle, Washington 98195-6043, United States
- University of Washington, Department of Radiology, 1959 NE Pacific Street, Box 356043, Seattle, Washington 98195-6043, United States
| | - George A. Sandison
- University of Washington, Department of Radiation Oncology, 1959 NE Pacific Street, Box 356043, Seattle, Washington 98195-6043, United States
| | - Paul E. Kinahan
- University of Washington, Department of Radiology, 1959 NE Pacific Street, Box 356043, Seattle, Washington 98195-6043, United States
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Yan J, Chu-Shern JL, Loi HY, Khor LK, Sinha AK, Quek ST, Tham IWK, Townsend D. Impact of Image Reconstruction Settings on Texture Features in 18F-FDG PET. J Nucl Med 2015; 56:1667-73. [PMID: 26229145 DOI: 10.2967/jnumed.115.156927] [Citation(s) in RCA: 188] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 07/06/2015] [Indexed: 12/21/2022] Open
Abstract
UNLABELLED Evaluation of tumor heterogeneity based on texture parameters has recently attracted much interest in the PET imaging community. However, the impact of reconstruction settings on texture parameters is unclear, especially relating to time-of-flight and point-spread function modeling. Their effects on 55 texture features (TFs) and 6 features based on first-order statistics (FOS) were investigated. Standardized uptake value (SUV) measures were also evaluated as peak SUV (SUVpeak), maximum SUV, and mean SUV (SUVmean). METHODS This study retrospectively recruited 20 patients with lesions in the lung who underwent whole-body (18)F-FDG PET/CT. The coefficient of variation (COV) of each feature across different reconstructions was calculated. RESULTS SUVpeak, SUVmean, 18 TFs, and 1 FOS were the most robust (COV ≤ 5%) whereas skewness, cluster shade, and zone percentage were the least robust (COV > 20%) with respect to reconstruction algorithms using default settings. Heterogeneity parameters had different sensitivities to iteration number. Twenty-four parameters including SUVpeak and SUVmean exhibited variation with a COV less than 5%; 28 parameters, including maximum SUV, showed variation with a COV in the range of 5%-10%. In addition, skewness, cluster shade, and zone percentage were the most sensitive to iteration number. In terms of sensitivity to full width at half maximum (FWHM), 15 TFs and 1 FOS had the best performance with a COV less than 5%, whereas SUVpeak and SUVmean had a COV between 5% and 10%. Grid size had the largest impact on image features, which was demonstrated by only 11 features, including SUVpeak and SUVmean, having a COV less than 10%. CONCLUSION Different image features have different sensitivities to reconstruction settings. Iteration number and FWHM of the gaussian filter have a similar impact on the image features. Grid size has a larger impact on the features than iteration number and FWHM. The features that exhibited large variations such as skewness in FOS, cluster shade, and zone percentage should be used with caution. The entropy in FOS, difference entropy, inverse difference normalized, inverse difference moment normalized, low gray-level run emphasis, high gray-level run emphasis, and low gray-level zone emphasis are the most robust features.
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Affiliation(s)
- Jianhua Yan
- A*STAR-NUS, Clinical Imaging Research Center, Singapore
| | | | - Hoi Yin Loi
- Department of Diagnostic Radiology, National University Hospital, Singapore; and
| | - Lih Kin Khor
- Department of Diagnostic Radiology, National University Hospital, Singapore; and
| | - Arvind K Sinha
- Department of Diagnostic Radiology, National University Hospital, Singapore; and
| | - Swee Tian Quek
- Department of Diagnostic Radiology, National University Hospital, Singapore; and
| | - Ivan W K Tham
- A*STAR-NUS, Clinical Imaging Research Center, Singapore Department of Radiation Oncology, National University Cancer Institute, Singapore
| | - David Townsend
- A*STAR-NUS, Clinical Imaging Research Center, Singapore Department of Diagnostic Radiology, National University Hospital, Singapore; and
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Do clinical, histological or immunohistochemical primary tumour characteristics translate into different (18)F-FDG PET/CT volumetric and heterogeneity features in stage II/III breast cancer? Eur J Nucl Med Mol Imaging 2015; 42:1682-1691. [PMID: 26140849 DOI: 10.1007/s00259-015-3110-x] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 06/03/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE The aim of this retrospective study was to determine if some features of baseline (18)F-FDG PET images, including volume and heterogeneity, reflect clinical, histological or immunohistochemical characteristics in patients with stage II or III breast cancer (BC). METHODS Included in the present retrospective analysis were 171 prospectively recruited patients with stage II/III BC treated consecutively at Saint-Louis hospital. Primary tumour volumes were semiautomatically delineated on pretreatment (18)F-FDG PET images. The parameters extracted included SUVmax, SUVmean, metabolically active tumour volume (MATV), total lesion glycolysis (TLG) and heterogeneity quantified using the area under the curve of the cumulative histogram and textural features. Associations between clinical/histopathological characteristics and (18)F-FDG PET features were assessed using one-way analysis of variance. Areas under the ROC curves (AUC) were used to quantify the discriminative power of the features significantly associated with clinical/histopathological characteristics. RESULTS T3 tumours (>5 cm) exhibited higher textural heterogeneity in (18)F-FDG uptake than T2 tumours (AUC <0.75), whereas there were no significant differences in SUVmax and SUVmean. Invasive ductal carcinoma showed higher SUVmax values than invasive lobular carcinoma (p = 0.008) but MATV, TLG and textural features were not discriminative. Grade 3 tumours had higher FDG uptake (AUC 0.779 for SUVmax and 0.694 for TLG), and exhibited slightly higher regional heterogeneity (AUC 0.624). Hormone receptor-negative tumours had higher SUV values than oestrogen receptor-positive (ER-positive) and progesterone receptor-positive tumours, while heterogeneity patterns showed only low-level variation according to hormone receptor expression. HER-2 status was not associated with any of the image features. Finally, SUVmax, SUVmean and TLG significantly differed among the three phenotype subgroups (HER2-positive, triple-negative and ER-positive/HER2-negative BCs), but MATV and heterogeneity metrics were not discriminative. CONCLUSION SUV parameters, MATV and textural features showed limited correlations with clinical and histopathological features. The three main BC subgroups differed in terms of SUVs and TLG but not in terms of MATV and heterogeneity. None of the PET-derived metrics offered high discriminative power.
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114
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Koo HR, Park JS, Kang KW, Han W, Park IA, Moon WK. Correlation between (18)F-FDG uptake on PET/CT and prognostic factors in triple-negative breast cancer. Eur Radiol 2015; 25:3314-21. [PMID: 25903708 DOI: 10.1007/s00330-015-3734-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 03/18/2015] [Accepted: 03/23/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate whether a correlation exists between (18)F-fluorodeoxyglucose (FDG) uptake and prognostic factors in triple-negative breast cancer (TNBC). METHODS Between January 2009 and December 2013, 103 patients (mean age, 50.6 years) with primary TNBC (mean, 2.6 cm; range, 1.0-6.5 cm) underwent (18)F-FDG PET/CT for initial staging. Correlations between maximum standardized uptake value (SUVmax) on PET/CT and prognostic factors including tumour size, nodal status, histological grade, Ki-67 proliferation index, tumour suppressor p53, and 'basal-like' markers (epidermal growth factor receptor and CK 5/6) were assessed. RESULTS The mean SUVmax of the 103 tumours was 10.94 ± 5.25 (range: 2-32.8). There was a positive correlation between SUVmax and Ki-67 (Spearman's rho = 0.29, P = 0.003) and tumour size (Spearman's rho = 0.27, P = 0.006), whereas this relationship was not observed in the nodal status, histological grade, p53 status and 'basal-like' phenotypes. In a multivariate regression analysis, Ki-67 (P < 0.001) and tumour size (P = 0.009) were significantly associated with SUVmax in TNBCs. CONCLUSIONS Increased (18)F-FDG uptake on PET/CT was correlated with a high Ki-67 proliferation index and larger tumour size in TNBC. These results suggest a potential role of (18)F-FDG PET/CT in identifying TNBC with more aggressive behaviour. KEY POINTS • A wide range of FDG uptake reflected heterogeneity of cancer metabolism. • FDG uptake was correlated with the Ki-67 proliferation index in TNBC. • FDG uptake was correlated with tumour size in TNBC. • FDG uptake was not correlated with 'basal-like' phenotype.
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Affiliation(s)
- Hye Ryoung Koo
- Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea.,Department of Radiology, Hanyang University College of Medicine, Seoul, Korea
| | - Jeong Seon Park
- Department of Radiology, Hanyang University College of Medicine, Seoul, Korea
| | - Keon Wook Kang
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Wonshik Han
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - In Ae Park
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Woo Kyung Moon
- Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea.
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Chaudhury B, Zhou M, Goldgof DB, Hall LO, Gatenby RA, Gillies RJ, Patel BK, Weinfurtner RJ, Drukteinis JS. Heterogeneity in intratumoral regions with rapid gadolinium washout correlates with estrogen receptor status and nodal metastasis. J Magn Reson Imaging 2015; 42:1421-30. [PMID: 25884277 DOI: 10.1002/jmri.24921] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 04/03/2015] [Indexed: 12/19/2022] Open
Abstract
PURPOSE To evaluate heterogeneity within tumor subregions or "habitats" via textural kinetic analysis on breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for the classification of two clinical prognostic features; 1) estrogen receptor (ER)-positive from ER-negative tumors, and 2) tumors with four or more viable lymph node metastases after neoadjuvant chemotherapy from tumors without nodal metastases. MATERIALS AND METHODS Two separate volumetric DCE-MRI datasets were obtained at 1.5T, comprised of bilateral axial dynamic 3D T1 -weighted fat suppressed gradient recalled echo-pulse sequences obtained before and after gadolinium-based contrast administration. Representative image slices of breast tumors from 38 and 34 patients were used for ER status and lymph node classification, respectively. Four tumor habitats were defined based on their kinetic contrast enhancement characteristics. The heterogeneity within each habitat was quantified using textural kinetic features, which were evaluated using two feature selectors and three classifiers. RESULTS Textural kinetic features from the habitat with rapid delayed washout yielded classification accuracies of 84.44% (area under the curve [AUC] 0.83) for ER and 88.89% (AUC 0.88) for lymph node status. The texture feature, information measure of correlation, most often chosen in cross-validations, measures heterogeneity and provides accuracy approximately the same as with the best feature set. CONCLUSION Heterogeneity within habitats with rapid washout is highly predictive of molecular tumor characteristics and clinical behavior.
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Affiliation(s)
- Baishali Chaudhury
- Department of Computer Science and Engineering, University of South Florida, Tampa, Florida, USA
| | - Mu Zhou
- Department of Computer Science and Engineering, University of South Florida, Tampa, Florida, USA
| | - Dmitry B Goldgof
- Department of Computer Science and Engineering, University of South Florida, Tampa, Florida, USA
| | - Lawrence O Hall
- Department of Computer Science and Engineering, University of South Florida, Tampa, Florida, USA
| | - Robert A Gatenby
- Department of Radiology, H. Lee Moffitt Cancer and Research Institute, Tampa, Florida, USA
| | - Robert J Gillies
- Department of Radiology, H. Lee Moffitt Cancer and Research Institute, Tampa, Florida, USA
| | - Bhavika K Patel
- Department of Radiology, H. Lee Moffitt Cancer and Research Institute, Tampa, Florida, USA
| | - Robert J Weinfurtner
- Department of Radiology, H. Lee Moffitt Cancer and Research Institute, Tampa, Florida, USA
| | - Jennifer S Drukteinis
- Department of Radiology, H. Lee Moffitt Cancer and Research Institute, Tampa, Florida, USA
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Peng N, Chou C, Pan H, Chang T, Hu C, Chiu Y, Fu T, Chang H. FDG‐PET
/
CT
detection of very early breast cancer in women with breast microcalcification lesions found in mammography screening. J Med Imaging Radiat Oncol 2015; 59:445-452. [DOI: 10.1111/1754-9485.12309] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 02/27/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Nan‐Jing Peng
- Department of Nuclear MedicineKaohsiung Veterans General Hospital Kaohsiung Taiwan
- National Yang‐Ming UniversitySchool of Medicine Taipei Taiwan
| | - Chen‐Pin Chou
- Department of RadiologyKaohsiung Veterans General Hospital Kaohsiung Taiwan
| | - Huay‐Ben Pan
- Department of RadiologyKaohsiung Veterans General Hospital Kaohsiung Taiwan
| | - Tsung‐Hsien Chang
- Department of Medical Education and ResearchKaohsiung Veterans General Hospital Kaohsiung Taiwan
| | - Chin Hu
- Department of Nuclear MedicineKaohsiung Veterans General Hospital Kaohsiung Taiwan
| | - Yu‐Li Chiu
- Department of Nuclear MedicineKaohsiung Veterans General Hospital Kaohsiung Taiwan
| | - Ting‐Ying Fu
- Department of PathologyKaohsiung Veterans General Hospital Kaohsiung Taiwan
| | - Hong‐Tai Chang
- National Yang‐Ming UniversitySchool of Medicine Taipei Taiwan
- Department of SurgeryKaohsiung Veterans General Hospital Kaohsiung Taiwan
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Kim TH, Yoon JK, Kang DK, Lee SJ, Jung YS, Yim H, An YS. Correlation Between F-18 Fluorodeoxyglucose Positron Emission Tomography Metabolic Parameters and Dynamic Contrast-Enhanced MRI-Derived Perfusion Data in Patients with Invasive Ductal Breast Carcinoma. Ann Surg Oncol 2015; 22:3866-72. [PMID: 25805237 DOI: 10.1245/s10434-015-4526-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Indexed: 11/18/2022]
Abstract
PURPOSE The aim of this study was to establish possible relationships among the metabolic and vascular characteristics of breast cancer using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging. METHODS Sixty-seven female patients with invasive ductal breast carcinoma (age 32-79 years) who underwent FDG PET/CT and DCE-MRI prior to cancer treatment were included in the study. The maximum standardized uptake value (SUVmax), metabolic tumor volume, total lesion glycolysis (TLG), and heterogeneity factor (HF) were derived from FDG PET/CT. The DCE-MRI parameters K trans, K ep, and V e were obtained for all tumors, and relationships between the metabolic and perfusion parameters were sought via Spearman's rank correlation analysis. The prognostic significance of clinicopathological and imaging parameters in terms of recurrence-free survival (RFS) was also evaluated. RESULTS No significant correlation between perfusion and metabolic parameters (p > 0.05) was found, except between SUVmax and V e (p = 0.001, rho = -0.391). Recurrence developed in 12 of the 67 patients (17.9 %, follow-up period 8-41 months). Age (p = 0.016) and HF (p = 0.027) were significant independent predictors of recurrence-free survival (RFS) upon multivariate analysis. The RFS of patients under 40 years of age was significantly poorer than that of older patients (p < 0.001). Survival of patients with more heterogeneous tumors (HF less than -0.12) was poorer than those with relatively homogenous tumors (p = 0.033). CONCLUSIONS Tumors with higher levels of glucose metabolism (SUVmax values) exhibited higher tumor cellularities (V e values). Also, of the various metabolic and perfusion parameters available, tumor heterogeneity measured via FDG PET/CT (HF) may be useful in predicting RFS in breast cancer patients.
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Affiliation(s)
- Tae Hee Kim
- Department of Radiology, Ajou University School of Medicine, Suwon, Korea
| | - Joon-Kee Yoon
- Department of Nuclear Medicine and Molecular Imaging, School of Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Doo Kyoung Kang
- Department of Radiology, Ajou University School of Medicine, Suwon, Korea
| | - Su Jin Lee
- Department of Nuclear Medicine and Molecular Imaging, School of Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Yong Sik Jung
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Hyunee Yim
- Department of Pathology, Ajou University School of Medicine, Suwon, Korea
| | - Young-Sil An
- Department of Nuclear Medicine and Molecular Imaging, School of Medicine, Ajou University School of Medicine, Suwon, Korea.
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Jung NY, Kim SH, Choi BB, Kim SH, Sung MS. Associations between the standardized uptake value of (18)F-FDG PET/CT and the prognostic factors of invasive lobular carcinoma: in comparison with invasive ductal carcinoma. World J Surg Oncol 2015; 13:113. [PMID: 25889560 PMCID: PMC4371618 DOI: 10.1186/s12957-015-0522-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 02/23/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aims of this study were to evaluate the associations between the maximum standardized uptake value (SUVmax) and prognostic factors in invasive lobular carcinoma (ILC) and to compare these results with those in invasive ductal carcinoma (IDC). METHODS The study included pathologically confirmed ILCs (n = 32) and IDCs (n = 73). We retrospectively evaluated the preoperative (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) and measured the SUVmax. The pathologic results were reviewed regarding the size, histological type, histological grade, estrogen receptor (ER) and progesterone receptor (PR) status, human epidermal growth factor receptor 2 (HER2), epidermal growth factor receptor (EGFR), and Ki-67 of the primary tumor. We also compared the associations between the SUVmax and prognostic factors. RESULTS The mean SUVmax of the ILCs was significantly lower compared with that of the IDCs (P = 0.032). The SUVmax increased with tumor grade (P < 0.001) and was higher with ER negativity compared with ER positivity (P = 0.007) in IDC. The SUVmax was higher with EGFR positivity compared with EGFR negativity (P = 0.013) in IDC and higher with Ki-67 positivity compared with Ki-67 negativity in IDC and ILC (P < 0.001 and P = 0.002, respectively). The SUVmax was not significantly different regarding PR or HER2 for both tumor groups. The correlation between the tumor size and the SUVmax was demonstrated for IDCs (r = 0.57), but not for ILCs (r = 0.25). CONCLUSIONS The SUVmax was significantly different according to the tumor grade, ER, EGFR, and Ki-67 for IDCs. The SUVmax exhibited a positive association with Ki-67 in ILC; however, it was not significantly different with other factors, which suggests that the role of (18)F-FDG PET/CT may be limited in ILC.
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Affiliation(s)
- Na Young Jung
- Department of Radiology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 327 Sosa-ro, Wonmi-gu, Bucheon-si, Gyeonggi-do, 420-717, Republic of Korea.
| | - Sung Hun Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Republic of Korea.
| | - Bo Bae Choi
- Department of Radiology, Chungnam National University Hospital, 282 Muhwha-ro Jung-gu, Daejeon, 301-721, Republic of Korea.
| | - Sung Hoon Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Republic of Korea.
| | - Mi Sook Sung
- Department of Radiology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 327 Sosa-ro, Wonmi-gu, Bucheon-si, Gyeonggi-do, 420-717, Republic of Korea.
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Brooks FJ, Grigsby PW. Low-order non-spatial effects dominate second-order spatial effects in the texture quantifier analysis of 18F-FDG-PET images. PLoS One 2015; 10:e0116574. [PMID: 25714472 PMCID: PMC4340651 DOI: 10.1371/journal.pone.0116574] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 12/09/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND There is increasing interest in applying image texture quantifiers to assess the intra-tumor heterogeneity observed in FDG-PET images of various cancers. Use of these quantifiers as prognostic indicators of disease outcome and/or treatment response has yielded inconsistent results. We study the general applicability of some well-established texture quantifiers to the image data unique to FDG-PET. METHODS We first created computer-simulated test images with statistical properties consistent with clinical image data for cancers of the uterine cervix. We specifically isolated second-order statistical effects from low-order effects and analyzed the resulting variation in common texture quantifiers in response to contrived image variations. We then analyzed the quantifiers computed for FIGOIIb cervical cancers via receiver operating characteristic (ROC) curves and via contingency table analysis of detrended quantifier values. RESULTS We found that image texture quantifiers depend strongly on low-effects such as tumor volume and SUV distribution. When low-order effects are controlled, the image texture quantifiers tested were not able to discern only the second-order effects. Furthermore, the results of clinical tumor heterogeneity studies might be tunable via choice of patient population analyzed. CONCLUSION Some image texture quantifiers are strongly affected by factors distinct from the second-order effects researchers ostensibly seek to assess via those quantifiers.
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Affiliation(s)
- Frank J. Brooks
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis,
Missouri, United States of America
| | - Perry W. Grigsby
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis,
Missouri, United States of America
- Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Saint Louis, Missouri,
United States of America
- Department of Obstetrics and Gynecology, Washington University Medical Center, Saint
Louis, Missouri, United States of America
- Alvin J. Siteman Cancer Center, Washington University Medical Center, Saint Louis,
Missouri, United States of America
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Multiparametric monitoring of early response to antiangiogenic therapy: a sequential perfusion CT and PET/CT study in a rabbit VX2 tumor model. ScientificWorldJournal 2014; 2014:701954. [PMID: 25383376 PMCID: PMC4213998 DOI: 10.1155/2014/701954] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 08/19/2014] [Accepted: 09/01/2014] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES To perform dual analysis of tumor perfusion and glucose metabolism using perfusion CT and FDG-PET/CT for the purpose of monitoring the early response to bevacizumab therapy in rabbit VX2 tumor models and to assess added value of FDG-PET to perfusion CT. METHODS Twenty-four VX2 carcinoma tumors implanted in bilateral back muscles of 12 rabbits were evaluated. Serial concurrent perfusion CT and FDG-PET/CT were performed before and 3, 7, and 14 days after bevacizumab therapy (treatment group) or saline infusion (control group). Perfusion CT was analyzed to calculate blood flow (BF), blood volume (BV), and permeability surface area product (PS); FDG-PET was analyzed to calculate SUVmax, SUVmean, total lesion glycolysis (TLG), entropy, and homogeneity. The flow-metabolic ratio (FMR) was also calculated and immunohistochemical analysis of microvessel density (MVD) was performed. RESULTS On day 14, BF and BV in the treatment group were significantly lower than in the control group. There were no significant differences in all FDG-PET-derived parameters between both groups. In the treatment group, FMR prominently decreased after therapy and was positively correlated with MVD. CONCLUSIONS In VX2 tumors, FMR could provide further insight into the early antiangiogenic effect reflecting a mismatch in intratumor blood flow and metabolism.
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The usefulness of standardized uptake value in differentiation between benign and malignant thyroid lesions detected incidentally in 18F-FDG PET/CT examination. PLoS One 2014; 9:e109612. [PMID: 25296297 PMCID: PMC4190406 DOI: 10.1371/journal.pone.0109612] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Accepted: 09/01/2014] [Indexed: 11/19/2022] Open
Abstract
Introduction In the last decade, (18)F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET and PET/CT) has become one of the major diagnostic tools used in oncology. A significant number of patients who undergo this procedure, due to non-thyroidal reasons, present incidental uptake of (18F-FDG) in the thyroid. The aim of the study was to compare the SUVmax (standardized uptake value) of thyroid focal lesions, which were incidentally found on PET/CT, in relation to the results of thyroid fine-needle aspiration biopsy (FNAB) and/or histopathological evaluation. Materials and Methods Patients referred for PET/CT examination, due to non-thyroidal illness, presented focal 18F-FDG uptake in the thyroid and were advised to undergo ultrasonography (US), hormonal evaluation, FNAB and/or total thyroidectomy at our institution. Results 6614 PET/CT examinations performed in 5520 patients were analyzed. Of the 122 patients with focal thyroid 18F-FDG activity, 82 patients (67.2%) underwent further thyroid evaluation using FNAB. Benign lesions were diagnosed in 46 patients, malignant - in 19 patients (confirmed by post-surgical histopathology), while 17 patients had inconclusive results of cytological assessment. Mean SUVmax of benign lesions was 3.2±2.8 (median = 2.4), while the mean SUVmax value for malignant lesions was 7.1±8.2 (median = 3.5). The risk of malignancy was 16.7% for lesions with a SUVmax under 3, 43.8% for lesions with a SUVmax between 3 and 6, and 54.6% for lesions with a SUVmax over 6. In the group of malignant lesions, a positive correlation between the lesion’s diameter and SUVmax was observed (p = 0.03, r = 0.57). Conclusions Subjects with incidental focal uptake of 18F-FDG in thyroid are at a high risk of thyroid malignancy. A high value of SUVmax further increases the risk of malignancy, indicating the necessity for further cytological or histological evaluation. However, as SUVmax correlated with the diameter of malignant lesions, small lesions with focal uptake of 18F-FDG should be interpreted cautiously.
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Ma Q, Chen B, Gao S, Ji T, Wen Q, Song Y, Zhu L, Xu Z, Liu L. 99mTc-3P4-RGD2 scintimammography in the assessment of breast lesions: comparative study with 99mTc-MIBI. PLoS One 2014; 9:e108349. [PMID: 25250628 PMCID: PMC4176966 DOI: 10.1371/journal.pone.0108349] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 08/19/2014] [Indexed: 12/03/2022] Open
Abstract
Purpose To compare the potential application of 99mTc-3P-Arg-Gly-Asp (99mTc-3P4-RGD2) scintimammography (SMM) and 99mTc-methoxyisobutylisonitrile (99mTc-MIBI) SMM for the differentiation of malignant from benign breast lesions. Method Thirty-six patients with breast masses on physical examination and/or suspicious mammography results that required fine needle aspiration cytology biopsy (FNAB) were included in the study. 99mTc-3P4-RGD2 and 99mTc-MIBI SMM were performed with single photon emission computed tomography (SPECT) at 60 min and 20 min respectively after intravenous injection of 738±86 MBq radiotracers on a separate day. Images were evaluated by the tumor to non-tumor localization ratios (T/NT). Receiver operating characteristic (ROC) curve analysis was performed on each radiotracer to calculate the cut-off values of quantitative indices and to compare the diagnostic performance for the ability to differentiate malignant from benign diseases. Results The mean T/NT ratio of 99mTc-3P4-RGD2 in malignant lesions was significantly higher than that in benign lesions (3.54±1.51 vs. 1.83±0.98, p<0.001). The sensitivity, specificity, and accuracy of 99mTc-3P4-RGD2 SMM were 89.3%, 90.9% and 89.7%, respectively, with a T/NT cut-off value of 2.40. The mean T/NT ratio of 99mTc-MIBI in malignant lesions was also significantly higher than that in benign lesions (2.86±0.99 vs. 1.51±0.61, p<0.001). The sensitivity, specificity and accuracy of 99mTc-MIBI SMM were 87.5%, 72.7% and 82.1%, respectively, with a T/NT cut-off value of 1.45. According to the ROC analysis, the area under the curve for 99mTc-3P4-RGD2 SMM (area = 0.851) was higher than that for 99mTc-MIBI SMM (area = 0.781), but the statistical difference was not significant. Conclusion 99mTc-3P4-RGD2 SMM does not provide any significant advantage over the established 99mTc-MIBI SMM for the detection of primary breast cancer. The T/NT ratio of 99mTc-3P4-RGD2 SMM was significantly higher than that of 99mTc-MIBI SMM. Both tracers could offer an alternative method for elucidating non-diagnostic mammograms.
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Affiliation(s)
- Qingjie Ma
- China-Japan Union Hospital, Jilin University, Changchun, China
| | - Bin Chen
- China-Japan Union Hospital, Jilin University, Changchun, China
| | - Shi Gao
- China-Japan Union Hospital, Jilin University, Changchun, China
| | - Tiefeng Ji
- China-Japan Union Hospital, Jilin University, Changchun, China
| | - Qiang Wen
- China-Japan Union Hospital, Jilin University, Changchun, China
| | - Yan Song
- China-Japan Union Hospital, Jilin University, Changchun, China
| | - Lei Zhu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen, China
| | - Zheli Xu
- China-Japan Union Hospital, Jilin University, Changchun, China
| | - Lin Liu
- China-Japan Union Hospital, Jilin University, Changchun, China
- * E-mail:
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