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Dong M, Liu J, Sun X, Xing L. Prognositc significance of SUVmax
on pretreatment 18
F-FDG PET/CT in early-stage non-small cell lung cancer treated with stereotactic body radiotherapy: A meta-analysis. J Med Imaging Radiat Oncol 2017; 61:652-659. [PMID: 28266166 DOI: 10.1111/1754-9485.12599] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Accepted: 01/27/2017] [Indexed: 12/14/2022]
Affiliation(s)
- Min Dong
- Department of Radiation Oncology, Shandong Key Laboratory of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University; Shandong Academic of Medicine Science; Jinan Shandong China
- Department of Oncology; Pingyi County People's Hospital; Linyi Shandong China
| | - Jing Liu
- Department of Radiation Oncology, Shandong Key Laboratory of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University; Shandong Academic of Medicine Science; Jinan Shandong China
| | - Xiaorong Sun
- Department of Radiology, Shandong Key Laboratory of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University; Shandong Academic of Medicine Science; Jinan Shandong China
| | - Ligang Xing
- Department of Radiation Oncology, Shandong Key Laboratory of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University; Shandong Academic of Medicine Science; Jinan Shandong China
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Eight cases of salvage pulmonary resection for residual disease or isolated local recurrence detected after definitive chemoradiotherapy for N2 Stage-IIIA lung cancer. Asian J Surg 2017; 40:95-99. [DOI: 10.1016/j.asjsur.2015.05.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 04/21/2015] [Accepted: 05/28/2015] [Indexed: 11/20/2022] Open
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Tatcı E, Uslu Biner İ, Emir S, Tanyıldız HG, Özmen Ö, Alagöz E, Gökçek A, Şahin G. The Correlation Between Pre-treatment Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Parameters and Clinical Prognostic Factors in Pediatric Hodgkin Lymphoma. Mol Imaging Radionucl Ther 2017; 26:9-16. [PMID: 28291005 PMCID: PMC5350506 DOI: 10.4274/mirt.94914] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objective: To compare standardized uptake values (SUV) derived from pre-treatment 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging and clinical prognostic factors in pediatric patients with Hodgkin lymphoma (HL). Methods: Pre-treatment FDG PET/CT findings of 28 children with HL were evaluated in this retrospective study. Metabolic tumor volume (MTV), SUVmax normalized by weight (SUVweight), lean body mass (SUVlbm), body surface area (SUVbsa) and plasma glucose levels of tumors (SUVglucose) were calculated using pre-treatment FDG PET/CT scan images. These metabolic parameters were correlated with clinical factors [age, sex, number of lymph node groups, presence of splenic involvement, bulky mediastinal disease, Ann Arbor stage, serum white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), serum albumin and hemoglobin levels]. Results: SUVbsa, SUVlbm, SUVweight, SUVglucose and MTV were higher in patients with stage III-IV disease, bulky tumor and ≥3 lymph node groups (p<0.05). SUVbsa and SUVglucose were higher in patients with splenic involvement (p<0.05). There was no significant correlation between these metabolic parameters and sex, ESR, levels of albumin and WBC (p>0.05). SUVbsa and SUVlbm were higher in patients with anemia (p<0.05). Additionally, significant increases were detected in SUVweight, MTV, and SUVglucose with increasing age (p=0.005, p=0.027, and p=0.009, respectively). SUVbsa and SUVlbm had no significant correlation with age (p>0.05). Conclusion: Metabolic parameters derived from pre-treatment FDG PET/CT may have an important role in predicting high-risk disease in patients with HL. Also, SUVbsa and SUVlbm may be better markers than SUVweight in the quantitative evaluation of FDG PET/CT scans in pediatric patients.
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Affiliation(s)
- Ebru Tatcı
- Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Nuclear Medicine, Ankara, Turkey Phone: +90 505 914 53 61 E-mail:
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Lombardi M, Cascone T, Guenzi E, Stecco A, Buemi F, Krengli M, Carriero A. Predictive value of pre-treatment apparent diffusion coefficient (ADC) in radio-chemiotherapy treated head and neck squamous cell carcinoma. Radiol Med 2017; 122:345-352. [PMID: 28188603 DOI: 10.1007/s11547-017-0733-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 01/24/2017] [Indexed: 01/18/2023]
Abstract
OBJECTIVE This study aimed at evaluating the role of "baseline" apparent diffusion coefficent (ADC), in patients affected by head and neck cancer treated with radio-chemotherapy, as a potential marker of response to therapy. METHODS Fifty-seven patients underwent pretreatment ADC maps. Minimum, maximum, and medium ADC were computed. Age, dose, treatment time, and ADC values were compared between the two groups (Group 1: local control; Group 2: relapse/persistence of disease) using the Student t test two-tailed unpaired. Two-tailed Fischer exact test was used to compare T stage, N stage, grading and type of treatment between two groups. We have analyzed the receiver operating characteristic (ROC) of statistically significant variables. RESULTS In patients with local control, values of pre-treatment medium and minimum ADC were lower than ADC values of patients with persistent or recurrent disease, with values, respectively, of 0.83 ± 0.02 × 10-3 mm2/s and 0.59 ± 0.02 × 10-3 mm2/s (vs 0.94 ± 0.05 × 10-3 mm2/s and 0.70 ± 0.05 × 10-3 mm2/s). ROC curve analysis displayed statistical significance as regarding the medium ADC value, showing a sensitivity of 50% and a specificity of 84.8%. ROC analysis of the values minimum ADC showed a sensitivity of 42.9% and specificity of 87.9%. CONCLUSION The value of the ADC pre-treatment of patients with local control of the disease is lower than that of patients with persistent disease or recurrence.
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Affiliation(s)
- Mariangela Lombardi
- Department of Radiology, Maggiore della Carità University Hospital, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy.
| | - Teresa Cascone
- Department of Radiology, Maggiore della Carità University Hospital, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy
| | - Elena Guenzi
- Department of Radiology, Maggiore della Carità University Hospital, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy
| | - Alessandro Stecco
- Department of Radiology, Maggiore della Carità University Hospital, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy
| | - Francesco Buemi
- Department of Radiology, Maggiore della Carità University Hospital, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy
| | - Marco Krengli
- Department of Radiotherapy, "Maggiore della Carità" University Hospital, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy
| | - Alessandro Carriero
- Department of Radiology, Maggiore della Carità University Hospital, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy
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Ziai P, Hayeri MR, Salei A, Salavati A, Houshmand S, Alavi A, Teytelboym OM. Role of Optimal Quantification of FDG PET Imaging in the Clinical Practice of Radiology. Radiographics 2017; 36:481-96. [PMID: 26963458 DOI: 10.1148/rg.2016150102] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The combination of fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) and computed tomography (CT) for dual-modality imaging (PET/CT) plays a key role in the diagnosis and staging of FDG-avid malignancies. FDG uptake by the tumor cells offers an opportunity to detect cancer in organs that appear normal at anatomic imaging and to differentiate viable tumor from posttreatment effects. Quantification of FDG uptake has multiple clinical applications, including cancer diagnosis and staging. Dedicated FDG PET/CT-based visual and quantitative criteria have been developed to evaluate treatment response. Furthermore, the level of tumor FDG uptake reflects the biologic aggressiveness of the tumor, predicting the risk of metastasis and recurrence. FDG uptake can be measured with qualitative, semiquantitative, and quantitative methods. Qualitative or visual assessment of PET/CT images is the most common clinical approach for describing the level of FDG uptake. Standardized uptake value (SUV) is the most commonly used semiquantitative tool for measuring FDG uptake. SUV can be measured as maximum, mean, or peak SUV and may be normalized by using whole or lean body weight. SUV measurements provide the basis for quantitative response criteria; however, SUVs have not been widely adopted as diagnostic thresholds for discriminating malignant and benign lesions. Volumetric FDG uptake measurements such as metabolic tumor volume and total lesion glycolysis have shown substantial promise in providing accurate tumor assessment. SUV measurement and other quantification techniques can be affected by many technical, physical, and biologic factors. Familiarity with FDG uptake quantification approaches and their pitfalls is essential for clinical practice and research.
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Affiliation(s)
- Pouya Ziai
- From the Department of Radiology, Mercy Catholic Medical Center, 1500 Lansdowne Ave, Darby, PA 19023 (P.Z., M.R.H., A. Salei, O.M.T.); and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (A. Salavati, S.H., A.A.)
| | - Mohammad Reza Hayeri
- From the Department of Radiology, Mercy Catholic Medical Center, 1500 Lansdowne Ave, Darby, PA 19023 (P.Z., M.R.H., A. Salei, O.M.T.); and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (A. Salavati, S.H., A.A.)
| | - Aliaksei Salei
- From the Department of Radiology, Mercy Catholic Medical Center, 1500 Lansdowne Ave, Darby, PA 19023 (P.Z., M.R.H., A. Salei, O.M.T.); and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (A. Salavati, S.H., A.A.)
| | - Ali Salavati
- From the Department of Radiology, Mercy Catholic Medical Center, 1500 Lansdowne Ave, Darby, PA 19023 (P.Z., M.R.H., A. Salei, O.M.T.); and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (A. Salavati, S.H., A.A.)
| | - Sina Houshmand
- From the Department of Radiology, Mercy Catholic Medical Center, 1500 Lansdowne Ave, Darby, PA 19023 (P.Z., M.R.H., A. Salei, O.M.T.); and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (A. Salavati, S.H., A.A.)
| | - Abass Alavi
- From the Department of Radiology, Mercy Catholic Medical Center, 1500 Lansdowne Ave, Darby, PA 19023 (P.Z., M.R.H., A. Salei, O.M.T.); and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (A. Salavati, S.H., A.A.)
| | - Oleg M Teytelboym
- From the Department of Radiology, Mercy Catholic Medical Center, 1500 Lansdowne Ave, Darby, PA 19023 (P.Z., M.R.H., A. Salei, O.M.T.); and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (A. Salavati, S.H., A.A.)
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Bouyeure-Petit AC, Chastan M, Edet-Sanson A, Becker S, Thureau S, Houivet E, Vera P, Hapdey S. Clinical respiratory motion correction software (reconstruct, register and averaged-RRA), for 18F-FDG-PET-CT: phantom validation, practical implications and patient evaluation. Br J Radiol 2017; 90:20160549. [PMID: 27936893 DOI: 10.1259/bjr.20160549] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE On fluorine-18 fludeoxyglucose (18F-FDG) positron emission tomography (PET) CT of pulmonary or hepatic lesions, standard uptake value (SUV) is often underestimated due to patient breathing. The aim of this study is to validate, on phantom and patient data, a motion correction algorithm [reconstruct, register and averaged (RRA)] implemented on a PET-CT system. METHODS Three phantoms containing five spheres filled with 18F-FDG and suspended in a water or Styrofoam®18F-FDG-filled tank to create different contrasts and attenuation environment were acquired on a Discovery GE710. The spheres were animated with a 2-cm longitudinal respiratory-based movement. Respiratory-gated (RRA) and ungated PET images were compared with static reference images (without movement). The optimal acquisition time, number of phases and the best phase within the respiratory cycle were investigated. The impact of irregular motion was also investigated. Quantification impact was computed on each sphere. Quantification improvement on 28 lung lesions was also investigated. RESULTS Phantoms: 4 min was required to obtain a stable quantification with the RRA method. The reference phase and the number of phases used for RRA did not affect the quantification which was similar on static acquisitions but different on ungated images. The results showed that the maximum standard uptake value (SUVmax) restoration is majored for the smallest spheres (≤2.1 ml). PATIENTS SUVmax on RRA and ungated acquisitions were statistically different to the SUVmax on whole-body images (p = 0.05) but not different from each other (mean SUVmax: 7.0 ± 7.8 vs 6.9 ± 7.8, p = 0.23 on RRA and ungated images, respectively). We observed a statistically significant correlation between SUV restoration and lesion displacement, with a real SUV quantitation improvement for lesion with movement >1.2 mm. CONCLUSION According to the results obtained using phantoms, RRA method is promising, showing a real impact on the lesion quantification on phantom data. With regard to the patient study, our results showed a trend towards an increase in the SUVs and a decrease in the volume between the ungated and RRA data. We also noticed a statistically significant correlation between the quantitative restoration obtained with RRA compared with ungated data and lesion displacement, indicating that the RRA approach should be reserved to patients with small lesions or nodes moving with a displacement larger than 1.2 cm. Advances in knowledge: This article investigates the performances of motion correction software recently introduced in PET. The conclusion revealed that such respiratory motion correction approach shows a real impact on the lesion quantification but must be reserved to the patient for whom lesion displacement was confirmed and high enough to clearly impact lesion evaluation.
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Affiliation(s)
| | - Mathieu Chastan
- 1 Nuclear Department, Becquerel Center, Rouen University Hospital, France
| | - Agathe Edet-Sanson
- 1 Nuclear Department, Becquerel Center, Rouen University Hospital, France
| | - Stephanie Becker
- 1 Nuclear Department, Becquerel Center, Rouen University Hospital, France.,2 QuantIF-LITIS EA4108, Rouen University, France
| | - Sebastien Thureau
- 1 Nuclear Department, Becquerel Center, Rouen University Hospital, France.,2 QuantIF-LITIS EA4108, Rouen University, France
| | - Estelle Houivet
- 3 Biostatistics Department, Rouen University Hospital, France
| | - Pierre Vera
- 1 Nuclear Department, Becquerel Center, Rouen University Hospital, France.,2 QuantIF-LITIS EA4108, Rouen University, France
| | - Sebastien Hapdey
- 1 Nuclear Department, Becquerel Center, Rouen University Hospital, France.,2 QuantIF-LITIS EA4108, Rouen University, France
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157
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Ozderya A, Temizkan S, Gul AE, Ozugur S, Sargin M, Aydin K. Correlation of BRAF mutation and SUV max levels in thyroid cancer patients incidentally detected in 18F-fluorodeoxyglucose positron emission tomography. Endocrine 2017; 55:215-222. [PMID: 27696232 DOI: 10.1007/s12020-016-1128-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 09/15/2016] [Indexed: 01/17/2023]
Abstract
The prognostic importance of 18F-fluorodeoxyglucose avidity in primary thyroid tumor and molecular basis responsible for its mechanism has not yet been well characterized. In this study, we aimed to evaluate the correlation between the maximum standardized uptake levels and B-type Raf kinase mutation positivity in incidentally detected papillary thyroid cancer patients during 18F-fluorodeoxyglucose positron emission tomography examination. We retrospectively evaluated 6873 18F-fluorodeoxyglucose-positron emission tomography scans of consecutive subjects from a database search for tumor staging in 2014 at our hospital Nuclear Medicine Center. In total, 135 patients had focal 18F-fluorodeoxyglucose uptake in the thyroid. Of these, 76 patients had fine-needle aspiration biopsy. 18F-fluorodeoxyglucose-maximum standardized uptake of the positron emission tomography-detected nodules was recorded. B-type Raf kinase (V600E) mutation and p53 protein expression were evaluated in papillary thyroid cancer patients. The incidence of thyroid incidentaloma in 18F-fluorodeoxyglucose-maximum standardized uptake scans was 2 % (135/6873). Of the 76 patients evaluated, 41 % (n = 31) were diagnosed papillary thyroid cancer. B-type Raf kinase mutation was positive in 51 % (17/30) of the papillary thyroid cancer patients. Maximum standardized uptake levels of the nodules (≥1 cm) were significantly higher in B-type Raf kinase-mutated papillary thyroid cancer patients than in non-mutated patients [16.6 (10.4-27.9) vs. 9.7 (6.8-11.1); P = 0.007]. Correlation analysis revealed that maximum standardized uptake was significantly associated with B-type Raf kinase mutation positivity (r = 0.519; P = 0.005). Logistic regression analysis showed an association between maximum standardized uptake and B-type Raf kinase mutation positivity even after adjustment for age and gender (P = 0.01). B-type Raf kinase mutation is closely related to 18F-fluorodeoxyglucose-positron emission tomography maximum standardized uptake levels in patients with incidentally detected papillary thyroid cancer.
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Affiliation(s)
- Aysenur Ozderya
- Department of Endocrinology and Metabolism, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, 34890, Turkey
| | - Sule Temizkan
- Department of Endocrinology and Metabolism, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, 34890, Turkey.
| | - Aylin Ege Gul
- Department of Pathology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, 34890, Turkey
| | - Sule Ozugur
- Department of Nuclear Medicine, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, 34890, Turkey
| | - Mehmet Sargin
- Department of Family Medicine, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, 34890, Turkey
| | - Kadriye Aydin
- Department of Endocrinology and Metabolism, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, 34890, Turkey
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Lim YJ, Chang JH, Kim HJ, Keam B, Kim TM, Kim DW, Paeng JC, Kang KW, Chung JK, Jeon YK, Chung DH, Wu HG. Superior Treatment Response and In-field Tumor Control in Epidermal Growth Factor Receptor-mutant Genotype of Stage III Nonsquamous Non-Small cell Lung Cancer Undergoing Definitive Concurrent Chemoradiotherapy. Clin Lung Cancer 2016; 18:e169-e178. [PMID: 28131636 DOI: 10.1016/j.cllc.2016.12.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 12/20/2016] [Accepted: 12/20/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Although previous in vitro data have suggested a more radio-sensitive nature of epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) cell lines, the clinical behavior according to the EGFR mutational status has not been well-established. In this study, we performed a comparative outcome analysis of EGFR-mutant and wild-type locally advanced NSCLC with chemoradiotherapy (CRT). PATIENTS AND METHODS A total of 102 patients with stage III nonsquamous NSCLC undergoing primary CRT were identified. Clinicopathologic characteristics, including the degree of glucose uptake, were evaluated. Failure patterns considering the radiation field and survival outcomes were compared according to the EGFR mutational status. RESULTS Pre- and post-CRT maximum standardized uptake values were significantly lower in EGFR-mutant tumors (P = .010 and .018, respectively). The overall response rate was higher in the EGFR-mutant group compared with the wild-type (89% vs. 64%, respectively; P = .023). The 3-year overall survival rate was better with the genetic alteration (68.0% vs. 47.4%, P = .046), but the statistical significance did not remain in multivariate analysis (hazard ratio, 0.68; 95% confidence interval, 0.30-1.55). Considering the tumor progression inside or outside the radiation field, the EGFR-mutant group showed longer in-field time to progression (P = .002), even after adjusting for other related baseline variables (hazard ratio, 0.27; 95% confidence interval, 0.11-0.71). CONCLUSION The differential metabolic activity, failure patterns, and prognosis suggest the distinct nature of the EGFR-mutant tumors. EGFR mutational status needs to be considered for more precise curative-intent treatment strategies of locally advanced nonsquamous NSCLC.
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Affiliation(s)
- Yu Jin Lim
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Hyun Chang
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea
| | - Hak-Jae Kim
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea
| | - Bhumsuk Keam
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Tae Min Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Dong-Wan Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Chul Paeng
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Keon Wook Kang
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea; Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Korea
| | - June-Key Chung
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea; Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Korea
| | - Yoon Kyung Jeon
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Doo Hyun Chung
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Hong-Gyun Wu
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Korea.
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Prognostic Value of Volumetric Parameters on Staging and Posttreatment FDG PET/CT in Patients With Stage IV Non-Small Cell Lung Cancer. Clin Nucl Med 2016; 41:347-53. [PMID: 26825204 DOI: 10.1097/rlu.0000000000001126] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE This study aimed to evaluate the prognostic value of metabolic tumor burden as measured with metabolic tumor volume (MTV) and total lesion glycolysis (TLG), as well as SUVmax on initial staging and posttreatment F-FDG PET/CT in patients with stage IV non-small cell lung cancer (NSCLC). METHODS Sixty-three NSCLC patients with stage IV who underwent staging and posttreatment FDG PET/CT after completion of the first-line chemotherapy were retrospectively enrolled. SUVmax, MTV, and TLG of primary cancer and all metastatic lesions (lymph node and distant metastases) on both PET/CT images were measured and their association with progression-free survival (PFS) and overall survival (OS) analyzed. RESULTS Median PFS and OS in the patient population were 5.9 and 23.1 months, respectively. Among the PET/CT parameters, MTV and TLG of primary cancer lesions on initial PET/CT and MTV and TLG of metastatic lesions on posttreatment PET/CT were independent prognostic factors for both PFS and OS (P < 0.05). The median OS in patients who showed low values of those PET/CT parameters was more than 26.0 months, whereas patients with high values of those parameters had a median OS of less than 15.0 months. CONCLUSIONS Metabolic tumor burdens of primary cancer lesions on staging PET/CT and metastatic lesions on posttreatment PET/CT were independent prognostic factors in patients with stage IV NSCLC. Volume-based PET parameters could further stratify the prognosis of stage IV NSCLC patients.
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Imaging Phenotyping Using Radiomics to Predict Micropapillary Pattern within Lung Adenocarcinoma. J Thorac Oncol 2016; 12:624-632. [PMID: 27923715 DOI: 10.1016/j.jtho.2016.11.2230] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Revised: 11/22/2016] [Accepted: 11/24/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Lung adenocarcinomas (ADCs) with a micropapillary pattern have been reported to have a poor prognosis. However, few studies have reported on the imaging-based identification of a micropapillary component, and all of them have been subjective studies dealing with qualitative computed tomography variables. We aimed to explore imaging phenotyping using a radiomics approach for predicting a micropapillary pattern within lung ADC. METHODS We enrolled 339 patients who underwent complete resection for lung ADC. Histologic subtypes and grades of the ADC were classified. The amount of micropapillary component was determined. Clinical features and conventional imaging variables such as tumor disappearance rate and maximum standardized uptake value on positron emission tomography were assessed. Quantitative computed tomography analysis was performed on the basis of histogram, size and shape, Gray level co-occurrence matrix-based features, and intensity variance and size zone variance-based features. RESULTS Higher tumor stage (OR = 3.270, 95% confidence interval [CI]: 1.483-7.212), intermediate grade (OR = 2.977, 95% CI: 1.066-8.316), lower value of the minimum of the whole pixel value (OR = 0.725, 95% CI: 0.527-0.98800), and lower value of the variance of the positive pixel value (OR = 0.961, 95% CI: 0.927-0.997) were identified as being predictive of a micropapillary component within lung ADC. On the other hand, maximum standardized uptake value and tumor disappearance rate were not significantly different in groups with a micropapillary pattern constituting at least 5% or less than 5% of the entire tumor. CONCLUSION A radiomics approach can be used to interrogate an entire tumor in a noninvasive manner. Combining imaging parameters with clinical features can provide added diagnostic value to identify the presence of a micropapillary component and thus, can influence proper treatment planning.
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Shin S, Pak K, Kim IJ, Kim BS, Kim SJ. Prognostic Value of Tumor-to-Blood Standardized Uptake Ratio in Patients with Resectable Non-Small-Cell Lung Cancer. Nucl Med Mol Imaging 2016; 51:233-239. [PMID: 28878849 DOI: 10.1007/s13139-016-0456-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Revised: 09/17/2016] [Accepted: 10/14/2016] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES Previously published studies showed that the standard tumor-to-blood standardized uptake value (SUV) ratio (SUR) was a more accurate prognostic method than tumor maximum standardized uptake value (SUVmax). This study evaluated and compared prognostic value of positron emission tomography (PET) parameters and normalized value of PET parameters by blood pool SUV in non-small-cell lung cancer (NSCLC) patients who received curative surgery. METHODS Seventy-seven patients who underwent curative resection for NSCLC between January 2010 to December 2013 were enrolled in this study. 18Fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) was performed before surgery. The mean standardized uptake value (SUVmean), SUVmax, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of each lesion was measured, on the workstation. SURmean, SURmax, and TLGSUR were calculated by dividing each of them by descending aorta SUVmean. Cox proportional hazards regression was used to analyze the effect of age, sex, pathological parameters, and PET parameters on recurrence and death. RESULTS In Cox regression analysis, N stage predicted for both recurrence (p < 0.0001) and death (p < 0.0001). SURmax predicted recurrence (p = 0.0014), not death. Area under the receiver operating characteristic curve of SURmax was 0.759 with cutoff value 4.004. However, SUVmax, SUVmean, MTV, TLG, SURmean, and TLGSUR predicted neither recurrence nor death. CONCLUSIONS Among PET parameters, SURmax was the independent predictor of recurrence in NSCLC patients who received curative surgery. N stage was the independent prognostic factor for both recurrence and death. Both parameters could be used to stratify the risk of NSCLC patients.
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Affiliation(s)
- Seunghyeon Shin
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Kyoungjune Pak
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - In Joo Kim
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Bum Soo Kim
- Department of Nuclear Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seong Jang Kim
- Department of Nuclear Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
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Role of CT and PET Imaging in Predicting Tumor Recurrence and Survival in Patients with Lung Adenocarcinoma: A Comparison with the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society Classification of Lung Adenocarcinoma. J Thorac Oncol 2016; 10:1785-94. [PMID: 26473646 DOI: 10.1097/jto.0000000000000689] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Recently, a new lung adenocarcinoma classification scheme was published. The prognostic value of this new classification has not been elaborated together with the value of imaging biomarkers including computed tomography (CT) and positron emission tomography (PET). METHODS We reviewed pathologic specimens and imaging characteristics of primary tumors from 723 consecutive patients who underwent surgical resection for lung adenocarcinoma. On pathology, the predominant histologic subtype and pattern group were quantified. Tumor-shadow disappearance ratio (TDR) on CT and maximum standardized uptake value (SUVmax) on PET were assessed. The relationships between those variables and survival (overall survival [OS] and disease-free survival) were analyzed by using Kaplan-Meier curves and Cox regression analyses. RESULTS The median follow-up period was 3.8 years. There were 137 patients (19%) with recurrence and 167 patients (23%) with metastasis after surgical resection. Among 723 patients, 35 patients (4.8%) had adenocarcinoma in situ, 34 patients (4.7%) had minimally invasive adenocarcinoma, 125 patients (17.3%) had lepidic predominant, 314 patients (43.4%) had acinar predominant, 65 patients (9.0%) had papillary predominant, 23 patients (3.2%) had micropapillary predominant, 113 patients (15.6%) had solid predominant, and 14 patients (1.9%) had variant adenocarcinomas. OS and disease-free survival rates were significantly different according to TDR on CT and SUVmax on PET, predominant subtypes, and pattern groups. On multivariate analysis, the SUVmax (p < 0.001), TDR (p = 0.038), and pattern group (p = 0.015) were independent predictors of OS. CONCLUSIONS TDR on CT, SUVmax on PET, and the new histologic classification schemes appear to be promising parameters for the prognostic stratification of patients with lung adenocarcinomas, allowing for the triage of patients who necessitate further staging workup and adjuvant therapy.
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Pharmacogenetic analysis of advanced non-small-cell lung cancer patients treated with first-line paclitaxel and carboplatin chemotherapy. Pharmacogenet Genomics 2016; 26:116-25. [PMID: 26641474 DOI: 10.1097/fpc.0000000000000196] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Genetic polymorphisms contribute toward interindividual variations in drug response. We investigated the effects of genetic polymorphisms on the clinical outcome of advanced non-small-cell lung cancer patients with first-line paclitaxel and carboplatin. MATERIALS AND METHODS A total of 194 non-small-cell lung cancer patients were prospectively enrolled from January 2010 to January 2013. We genotyped 11 polymorphisms in seven genes involved in the glycolysis pathway and the related pharmacokinetic/pharmacodynamic pathway. Genetic associations with PET-SUV, survival outcome, and toxicity were analyzed, and in-vitro drug transport activity was measured in the oocyte system. RESULTS Patients with the c.334 T>G and c.699 G>A homozygous variant in SLCO1B3 showed a higher incidence of grade 3/4 anemia (P=0.002). Transport activities of oocyte that overexpress the SLCO1B3 c.699 G>A variant showed a significantly decreased uptake of paclitaxel compared with the wild-type expressing oocytes. In addition, patients with GG/GA/AA genotypes of ABCB1, c.2677 T>G/A locus showed inferior progression-free survival (hazard ratio=1.49, P=0.017) compared with other genotypes. The GA genotype of HIF1A, c.1834 G>A locus was associated with inferior progression-free survival compared with the GG genotype (hazard ratio=2.47, P=0.008). CONCLUSION This study showed that the SLCO1B3 c.699 G>A polymorphism may predict anemia and ABCB1, HIF1A polymorphism are highly predictive for worse survival in advanced NSCLC with first-line paclitaxel and carboplatin.
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Harmon SA, Tuite MJ, Jeraj R. Molecular image-directed biopsies: improving clinical biopsy selection in patients with multiple tumors. Phys Med Biol 2016; 61:7282-7299. [PMID: 27694707 DOI: 10.1088/0031-9155/61/20/7282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Site selection for image-guided biopsies in patients with multiple lesions is typically based on clinical feasibility and physician preference. This study outlines the development of a selection algorithm that, in addition to clinical requirements, incorporates quantitative imaging data for automatic identification of candidate lesions for biopsy. The algorithm is designed to rank potential targets by maximizing a lesion-specific score, incorporating various criteria separated into two categories: (1) physician-feasibility category including physician-preferred lesion location and absolute volume scores, and (2) imaging-based category including various modality and application-specific metrics. This platform was benchmarked in two clinical scenarios, a pre-treatment setting and response-based setting using imaging from metastatic prostate cancer patients with high disease burden (multiple lesions) undergoing conventional treatment and receiving whole-body [18F]NaF PET/CT scans pre- and mid-treatment. Targeting of metastatic lesions was robust to different weighting ratios and candidacy for biopsy was physician confirmed. Lesion ranked as top targets for biopsy remained so for all patients in pre-treatment and post-treatment biopsy selection after sensitivity testing was completed for physician-biased or imaging-biased scenarios. After identifying candidates, biopsy feasibility was evaluated by a physician and confirmed for 90% (32/36) of high-ranking lesions, of which all top choices were confirmed. The remaining cases represented lesions with high anatomical difficulty for targeting, such as proximity to sciatic nerve. This newly developed selection method was successfully used to quantitatively identify candidate lesions for biopsies in patients with multiple lesions. In a prospective study, we were able to successfully plan, develop, and implement this technique for the selection of a pre-treatment biopsy location.
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Affiliation(s)
- Stephanie A Harmon
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 7033 Wisconsin Institutes for Medical Research, 1111 Highland Avenue, Madison, WI 53705, USA
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Putora PM, Szentesi K, Glatzer M, Rodriguez R, Müller J, Baty F, Früh M. SUVmax and Tumour Location in PET-CT Predict Oncogene Status in Lung Cancer. Oncol Res Treat 2016; 39:681-686. [PMID: 27855379 DOI: 10.1159/000450622] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 08/25/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND In non-small cell lung cancer, anaplastic lymphoma kinase gene rearrangement (ALK+) and epidermal growth factor receptor mutations (EGFR+) are targetable with tyrosine kinase inhibitors. PATIENTS AND METHODS 27 patients with ALK+ tumours, who underwent positron emission tomography-computed tomography (PET-CT) prior to any treatment, were identified. 2 equally sized control groups based on consecutive patients with EGFR+ and EGFR/ALK wild-type (wt) were identified. The maximum standardized uptake value (SUVmax), tumour location (central vs. peripheral), as well as patient- and disease-specific characteristics were collected. RESULTS Mutation status was significantly associated with SUVmax (p < 0.008). The median SUVmax of the primary tumour in the lung for ALK+ patients (SUVmax 13) was significantly higher compared to that of the EGFR+ (SUVmax 9.8, p = 0.010) and the EGFR/ALKwt group (SUVmax 9.6, p = 0.022). No difference was observed between the EGFR+ and the EGFR/ALKwt group (p = 0.961). Mutation status was also associated with primary tumour location (p = 0.001). There was a significantly lower rate of central tumours in the EGFR+ group when compared to ALK+ tumours (15%, p = 0.002). Among EGFR/ALKwt tumours, 41% were central compared to 63% of ALK+ tumours (p = 0.235). CONCLUSION On initial PET-CT, ALK+ primary lung tumours showed a higher SUVmax and were more frequently centrally located while peripheral tumours were more likely to be EGFR+.
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Affiliation(s)
- Paul M Putora
- Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland
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Bai L, Guo C, Wang J, Liu X, Li Y, Li M, Guo Y, Duan X. 18F-fludrodeoxyglucose maximal standardized uptake value and metabolic tumor burden are associated with major chemotherapy-related tumor markers in NSCLC patients. Onco Targets Ther 2016; 9:6315-6324. [PMID: 27789962 PMCID: PMC5072511 DOI: 10.2147/ott.s113832] [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] [Indexed: 12/22/2022] Open
Abstract
Objective Metabolic activity and tumor burden are significant for prognosis and metastasis of non-small cell lung cancer (NSCLC), including maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG). Chemotherapy resistance is a great challenge for treating NSCLC patients and is also closely related with several biomarkers such as epidermal growth factor receptor (EGFR), p53, and excision repair cross-complementing group 1 protein (ERCC1). Our purpose was to determine the correlation between positron emission tomography/computed tomography (PET/CT) parameters and tumor markers-related chemotherapy resistance in NSCLC. Methods Forty-six NSCLC chemotherapy-naïve patients were enrolled. The SUVmax, MTV, and TLG were calculated by PET/CT imaging, and expression of EGFR, p53, and ERCC1 were analyzed by immunohistochemistry on tissues. SUVmax, MTV, and TLG compared for their performance in predicting the expression of EGFR, p53, and ERCC1 were illustrated with statistical analysis. Results SUVmax was significantly correlated with p53 expression (P=0.001), and MTV and TLG were significantly associated with ERCC1 (P=0.000; P=0.000). Furthermore, multiple stepwise regression analysis revealed that SUVmax was the primary predictor for p53, MTV and TLG was the primary predictor for ERCC1. SUVmax had a sensitivity of 91% and specificity of 50% for the detection of p53 positive. The sensitivities of MTV and TLG were 83% and 80%, and specificities were 69% and 75% for the detection of ERCC1 positive, respectively. When we suggested p53 or ERCC1 positive, the cutoff value of SUVmax, MTV, and TLG were 7.68, 23.62, and 129.65 cm3, respectively. Conclusion SUVmax, MTV, and TLG were closely associated with p53 and ERCC1’ expressions. Therefore, 18F-fludrodeoxyglucose PET/CT could be a new way of predicting p53 or ERCC1-related chemotherapy effect in NSCLC patients with more convenience.
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Affiliation(s)
- Lu Bai
- Department of Medical Imaging
| | | | - Jiansheng Wang
- Department of Oncological Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | | | - Yang Li
- Department of Medical Imaging
| | - Miao Li
- Department of Medical Imaging
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Jung J, Lee S, Son SH, Kim C, Lee C, Jeong JH, Jeong SY, Ahn B, Lee J. Clinical impact of
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F‐FDG positron emission tomography/CT on adenoid cystic carcinoma of the head and neck. Head Neck 2016; 39:447-455. [DOI: 10.1002/hed.24605] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 04/20/2016] [Accepted: 08/22/2016] [Indexed: 11/08/2022] Open
Affiliation(s)
- Ji‐hoon Jung
- Department of Nuclear MedicineKyungpook National University Medical Center and School of MedicineDaegu Republic of Korea
| | - Sang‐Woo Lee
- Department of Nuclear MedicineKyungpook National University Medical Center and School of MedicineDaegu Republic of Korea
| | - Seung Hyun Son
- Department of Nuclear MedicineKyungpook National University Medical Center and School of MedicineDaegu Republic of Korea
| | - Choon‐Young Kim
- Department of Nuclear MedicineKyungpook National University Medical Center and School of MedicineDaegu Republic of Korea
| | - Chang‐Hee Lee
- Department of Nuclear MedicineKyungpook National University Medical Center and School of MedicineDaegu Republic of Korea
| | - Ju Hye Jeong
- Department of Nuclear MedicineKyungpook National University Medical Center and School of MedicineDaegu Republic of Korea
| | - Shin Young Jeong
- Department of Nuclear MedicineKyungpook National University Medical Center and School of MedicineDaegu Republic of Korea
| | - Byeong‐Cheol Ahn
- Department of Nuclear MedicineKyungpook National University Medical Center and School of MedicineDaegu Republic of Korea
| | - Jaetae Lee
- Department of Nuclear MedicineKyungpook National University Medical Center and School of MedicineDaegu Republic of Korea
- DGMIFDaegu Republic of Korea
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Schmitt RJ, Kreidler SM, Glueck DH, Amaria RN, Gonzalez R, Lewis K, Bagrosky BM, Kwak JJ, Koo PJ. Correlation between early 18F-FDG PET/CT response to BRAF and MEK inhibition and survival in patients with BRAF-mutant metastatic melanoma. Nucl Med Commun 2016; 37:122-8. [PMID: 26440571 DOI: 10.1097/mnm.0000000000000406] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE Metabolic response to treatment measured by fluorine-18 fluorodeoxyglucose ((18)F-FDG) PET has prognostic implications in many cancers. This study investigated the association between survival and early changes on (18)F-FDG PET/computed tomography (CT) for patients with BRAF-mutant melanoma receiving combined BRAF and MEK inhibition therapy. MATERIALS AND METHODS Overall, 24 patients with advanced BRAF-mutant melanoma were included. Patients were treated with a BRAF inhibitor (vemurafenib or dabrafenib) and a MEK inhibitor (cobimetinib or trametinib), and were imaged at baseline and shortly thereafter with (18)F-FDG PET/CT. Each scan yielded two values of maximum standardized uptake value (SUVmax): one for the most metabolically active focus and one for the least responsive focus. Short-term treatment response was assessed by evaluating the target lesions using the EROTC criteria. A Cox proportional hazards model was used to examine associations between overall survival (OS) and progression-free survival (PFS) and changes in SUVmax. RESULTS The mean time to follow-up (18)F-FDG PET/CT was 26 days. At follow-up, two patients achieved a complete response. For the most metabolically active focus, 22 patients showed a partial response. For the least responsive focus, 18 patients showed a partial response, two had stable disease, and two had progressive disease.A total of 16 patients were alive at the end of the study. For the most metabolically active tumor, no association was observed between changes in SUVmax and OS (P=0.73) or PFS (P=0.17). For the least responsive tumor, change in SUVmax was associated with PFS [hazard ratio (HR)=1.34, 95% confidence interval (CI): 1.06-1.71, P=0.01], but not OS (P=0.52). The ECOG score was associated with OS (HR=11.81, 95% CI: 1.42-97.60, P=0.02) and PFS (HR=24.72, 95% CI: 3.23-189.42, P=0.002). CONCLUSION Change in SUVmax for the least responsive tumor and baseline functional performance may be useful prognostic indicators for PFS in patients with BRAF-mutant melanoma.
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Affiliation(s)
- Ronald J Schmitt
- aDepartment of Radiology bDepartment of Medicine, Division of Medical Oncology, University of Colorado School of Medicine cDepartment of Biostatistics, Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado dThe University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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169
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Moon Y, Sung SW, Lee KY, Park JK. Clinicopathological characteristics and prognosis of non-lepidic invasive adenocarcinoma presenting as ground glass opacity nodule. J Thorac Dis 2016; 8:2562-2570. [PMID: 27747010 DOI: 10.21037/jtd.2016.08.46] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Ground glass opacity (GGO) generally associated with the lepidic component of lung adenocarcinoma. However, in some cases, GGO nodules have been associated with invasive adenocarcinomas, where a lepidic component is minimal or absent. The purpose of this study is to evaluate the clinicopathological characteristics and prognosis of non-lepidic invasive adenocarcinoma presenting as GGO nodules. METHODS We reviewed computed tomography (CT) images from 168 patients diagnosed with non-lepidic invasive adenocarcinoma classified as stage T1N0M0 (≤3 cm) who underwent curative anatomical resection. Tumors were classified according to radiologic features: 31 were GGO predominant (Group A) and 137 were solid predominant (Group B). The clinicopathological findings and recurrence free survival were used as outcome measures. RESULTS The mean percentages of micropapillary and solid component in tumor was higher in Group B than Group A (P<0.001) Pleural invasion and lymphatic invasion were more frequently seen in Group B. The presence of tumors with a micropapillary component was higher in Group B (P=0.040). The 3-year recurrence-free survival was lower in Group B than Group A (80.4% vs. 100%, P=0.019). Risk factors for recurrence such as presence of a micropapillary component and lymphatic invasion were more frequently seen in Group B. CONCLUSIONS Non-lepidic invasive adenocarcinoma presenting as GGO has fewer risk factors and better prognosis when compared with those presenting as solid tumors. Therefore, the presence of GGO on chest CT is a good prognostic indicator for lung cancer irrespective of histomorphologic classification.
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Affiliation(s)
- Youngkyu Moon
- Department of Thoracic & Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sook Whan Sung
- Department of Thoracic & Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyo Young Lee
- Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jae Kil Park
- Department of Thoracic & Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Bashir U, Siddique MM, Mclean E, Goh V, Cook GJ. Imaging Heterogeneity in Lung Cancer: Techniques, Applications, and Challenges. AJR Am J Roentgenol 2016; 207:534-43. [PMID: 27305342 DOI: 10.2214/ajr.15.15864] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Texture analysis involves the mathematic processing of medical images to derive sets of numeric quantities that measure heterogeneity. Studies on lung cancer have shown that texture analysis may have a role in characterizing tumors and predicting patient outcome. This article outlines the mathematic basis of and the most recent literature on texture analysis in lung cancer imaging. We also describe the challenges facing the clinical implementation of texture analysis. CONCLUSION Texture analysis of lung cancer images has been applied successfully to FDG PET and CT scans. Different texture parameters have been shown to be predictive of the nature of disease and of patient outcome. In general, it appears that more heterogeneous tumors on imaging tend to be more aggressive and to be associated with poorer outcomes and that tumor heterogeneity on imaging decreases with treatment. Despite these promising results, there is a large variation in the reported data and strengths of association.
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Affiliation(s)
- Usman Bashir
- 1 Department of Cancer Imaging, Division of Imaging Sciences and Biomedical Engineering, King's College London, London SE1 7EH, UK
| | - Muhammad Musib Siddique
- 1 Department of Cancer Imaging, Division of Imaging Sciences and Biomedical Engineering, King's College London, London SE1 7EH, UK
| | - Emma Mclean
- 2 Department of Histopathology, Guy's and St. Thomas' Hospitals, London, UK
| | - Vicky Goh
- 1 Department of Cancer Imaging, Division of Imaging Sciences and Biomedical Engineering, King's College London, London SE1 7EH, UK
- 3 Department of Radiology, Guy's and St. Thomas' Hospitals, London, UK
| | - Gary J Cook
- 1 Department of Cancer Imaging, Division of Imaging Sciences and Biomedical Engineering, King's College London, London SE1 7EH, UK
- 4 PET Imaging Centre, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
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Wang D, Koh ES, Descallar J, Pramana A, Vinod SK, Ho Shon I. Application of novel quantitative techniques for fluorodeoxyglucose positron emission tomography/computed tomography in patients with non-small-cell lung cancer. Asia Pac J Clin Oncol 2016; 12:349-358. [PMID: 27550522 DOI: 10.1111/ajco.12587] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 11/09/2015] [Accepted: 01/16/2016] [Indexed: 11/28/2022]
Abstract
AIM Flurodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is routinely used in non-small-cell lung cancer. This study aims to assess the prognostic value of quantitative FDG-PET/CT parameters including standard uptake value (SUV), metabolic tumor volume (MTV) and total lesional glycolysis (TLG) in non-small-cell lung cancer. METHODS A retrospective review of 92 nonsurgical patients with pathologically confirmed stage I-III non-small-cell lung cancers treated with radical dose radiotherapy (≥50 Gy) was conducted. Metabolically active tumor regions on FDG-PET/CT scans were contoured manually. SUV, MTV and TLG were calculated for primary, nodal and whole-body disease. Univariate and multivariate (adjusting for age, sex, disease stage and primary tumor size in centimeters) Cox regression modeling were performed to assess the association between these parameters and both overall and progression-free survival (PFS). RESULTS On univariate analysis, overall survival (OS) was significantly associated with primary MTV (P = 0.03), whole-body MTV (P = 0.02), whole-body maximum SUV (P = 0.05) and whole-body TLG (P = 0.03). PFS was significantly associated with primary MTV (P = 0.01), primary TLG (P = 0.04), whole-body MTV (P < 0.01) and whole-body TLG (P = 0.01). On multivariate analysis, OS was significantly associated with whole-body MTV (P = 0.05). PFS was significantly associated with whole-body MTV (P = 0.02) and whole-body TLG (P = 0.05). CONCLUSIONS Whole-body MTV was significantly associated with overall and PFS, and whole-body TLG was significantly associated with PFS on multivariate analysis. These two parameters may be significant prognostic factors independent of other factors such as stage. SUV was not significantly associated with survival on multivariate analysis.
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Affiliation(s)
- Duo Wang
- The University of New South Wales, Sydney, Australia.,Concord Repatriation General Hospital, Sydney, Australia
| | - Eng-Siew Koh
- The University of New South Wales, Sydney, Australia.,Ingham Institute of Applied Medical Research, Sydney, Australia.,Liverpool and Macarthur Cancer Therapy Centres, Sydney, Australia
| | - Joseph Descallar
- The University of New South Wales, Sydney, Australia.,Ingham Institute of Applied Medical Research, Sydney, Australia
| | | | - Shalini K Vinod
- Liverpool and Macarthur Cancer Therapy Centres, Sydney, Australia.,University of Western Sydney, Sydney, Australia.,Southwestern Sydney Clinical School, UNSW, Sydney, Australia
| | - Ivan Ho Shon
- The University of New South Wales, Sydney, Australia.,Department of Nuclear Medicine and PET, Prince of Wales Hospital, Sydney, Australia
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Mohammadkhani Shali S, Schmitt V, Behrendt FF, Winz OH, Heinzel A, Mottaghy FM, Eble MJ, Verburg FA. Metabolic tumour volume of anal carcinoma on 18FDG PET/CT before combined radiochemotherapy is the only independant determinant of recurrence free survival. Eur J Radiol 2016; 85:1390-4. [DOI: 10.1016/j.ejrad.2016.05.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 05/20/2016] [Indexed: 12/17/2022]
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Lee VH, Chan WW, Lee EY, Choy TS, Ho PP, Leung DK, Lam KO, Kwong DL, Leung TW, Khong PL. Prognostic Significance of Standardized Uptake Value of Lymph Nodes on Survival for Stage III Non-small Cell Lung Cancer Treated With Definitive Concurrent Chemoradiotherapy. Am J Clin Oncol 2016; 39:355-62. [DOI: 10.1097/coc.0000000000000070] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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174
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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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Primary Sarcomatoid Carcinoma of the Lung: Radiometabolic (18F-FDG PET/CT) Findings and Correlation with Clinico-Pathological and Survival Results. Lung 2016; 194:653-7. [DOI: 10.1007/s00408-016-9904-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 05/30/2016] [Indexed: 02/05/2023]
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Exploration of Imaging Biomarkers for Predicting Survival of Patients With Advanced Non–Small Cell Lung Cancer Treated With Antiangiogenic Chemotherapy. AJR Am J Roentgenol 2016; 206:987-93. [DOI: 10.2214/ajr.15.15528] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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177
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Dhandapani RG, Anosike C, Ganguly A. Non-small cell lung carcinoma metastasis to the anus. BMJ Case Rep 2016; 2016:bcr-2016-214653. [PMID: 27130556 DOI: 10.1136/bcr-2016-214653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
A 70-year-old man presenting with a lung mass was investigated and treated with pneumonectomy for adenocarcinoma of the lung. He re-presented 3 months later with a large perianal abscess and mass. Subsequent investigations and biopsies showed disseminated metastases from the lung primary. Immunohistochemical staining confirmed the nature of the anal metastasis from the lung adenocarcinoma. Lung cancer is notorious for metastases, hence it is important to be aware of the uncommon modes of spread, which will help obtain early diagnosis and optimise treatment.
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Affiliation(s)
- Ramya Gowri Dhandapani
- Department of Radiology, Warrington and Halton Hospitals NHS Foundation Trust, Warrington, Warrington, UK
| | - Chinedum Anosike
- Department of Radiology, Warrington and Halton Hospitals NHS Foundation Trust, Warrington, Warrington, UK
| | - Akash Ganguly
- Department of Radiology, Warrington and Halton Hospitals NHS Foundation Trust, Warrington, Warrington, UK
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178
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Lin JT, Yang XN, Zhong WZ, Liao RQ, Dong S, Nie Q, Weng SX, Fang XJ, Zheng JY, Wu YL. Association of maximum standardized uptake value with occult mediastinal lymph node metastases in cN0 non-small cell lung cancer. Eur J Cardiothorac Surg 2016; 50:914-919. [DOI: 10.1093/ejcts/ezw109] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 03/04/2016] [Indexed: 12/25/2022] Open
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179
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Yamamoto S, Huang D, Du L, Korn RL, Jamshidi N, Burnette BL, Kuo MD. Radiogenomic Analysis Demonstrates Associations between (18)F-Fluoro-2-Deoxyglucose PET, Prognosis, and Epithelial-Mesenchymal Transition in Non-Small Cell Lung Cancer. Radiology 2016; 280:261-70. [PMID: 27082783 DOI: 10.1148/radiol.2016160259] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Purpose To investigate whether non-small cell lung cancer (NSCLC) tumors that express high normalized maximum standardized uptake value (SUVmax) are associated with a more epithelial-mesenchymal transition (EMT)-like phenotype. Materials and Methods In this institutional review board-approved study, a public NSCLC data set that contained fluorine 18 ((18)F) fluoro-2-deoxyglucose positron emission tomography (PET) and messenger RNA expression profile data (n = 26) was obtained, and patients were categorized on the basis of measured normalized SUVmax values. Significance analysis of microarrays was then used to create a radiogenomic signature. The prognostic ability of this signature was assessed in a second independent data set that consisted of clinical and messenger RNA expression data (n = 166). Signature concordance with EMT was evaluated by means of validation in a publicly available cell line data set. Finally, by establishing an in vitro EMT lung cancer cell line model, an attempt was made to substantiate the radiogenomic signature with quantitative polymerase chain reaction, and functional assays were performed, including Western blot, cell migration, glucose transporter, and hexokinase assays (paired t test), as well as pharmacologic assays against chemotherapeutic agents (half-maximal effective concentration). Results Differential expression analysis yielded a 14-gene radiogenomic signature (P < .05, false discovery rate [FDR] < 0.20), which was confirmed to have differences in disease-specific survival (log-rank test, P = .01). This signature also significantly overlapped with published EMT cell line gene expression data (P < .05, FDR < 0.20). Finally, an EMT cell line model was established, and cells that had undergone EMT differentially expressed this signature and had significantly different EMT protein expression (P < .05, FDR < 0.20), cell migration, glucose uptake, and hexokinase activity (paired t test, P < .05). Cells that had undergone EMT also had enhanced chemotherapeutic resistance, with a higher half-maximal effective concentration than that of cells that had not undergone EMT (P < .05). Conclusion Integrative radiogenomic analysis demonstrates an association between increased normalized (18)F fluoro-2-deoxyglucose PET SUVmax, outcome, and EMT in NSCLC. (©) RSNA, 2016 Online supplemental material is available for this article.
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Affiliation(s)
- Shota Yamamoto
- From the Department of Radiology, The David Geffen School of Medicine at University of California-Los Angeles (UCLA), 10833 LeConte Ave, Box 951721, CHS 17-135, Los Angeles, CA 90095-1721 (S.Y., D.H., L.D., N.J., B.L.B., M.D.K.); Department of Bioengineering, UCLA, Los Angeles, Calif (M.D.K.); and Scottsdale Medical Imaging, Scottsdale, Ariz (R.L.K.)
| | - Danshan Huang
- From the Department of Radiology, The David Geffen School of Medicine at University of California-Los Angeles (UCLA), 10833 LeConte Ave, Box 951721, CHS 17-135, Los Angeles, CA 90095-1721 (S.Y., D.H., L.D., N.J., B.L.B., M.D.K.); Department of Bioengineering, UCLA, Los Angeles, Calif (M.D.K.); and Scottsdale Medical Imaging, Scottsdale, Ariz (R.L.K.)
| | - Liutao Du
- From the Department of Radiology, The David Geffen School of Medicine at University of California-Los Angeles (UCLA), 10833 LeConte Ave, Box 951721, CHS 17-135, Los Angeles, CA 90095-1721 (S.Y., D.H., L.D., N.J., B.L.B., M.D.K.); Department of Bioengineering, UCLA, Los Angeles, Calif (M.D.K.); and Scottsdale Medical Imaging, Scottsdale, Ariz (R.L.K.)
| | - Ronald L Korn
- From the Department of Radiology, The David Geffen School of Medicine at University of California-Los Angeles (UCLA), 10833 LeConte Ave, Box 951721, CHS 17-135, Los Angeles, CA 90095-1721 (S.Y., D.H., L.D., N.J., B.L.B., M.D.K.); Department of Bioengineering, UCLA, Los Angeles, Calif (M.D.K.); and Scottsdale Medical Imaging, Scottsdale, Ariz (R.L.K.)
| | - Neema Jamshidi
- From the Department of Radiology, The David Geffen School of Medicine at University of California-Los Angeles (UCLA), 10833 LeConte Ave, Box 951721, CHS 17-135, Los Angeles, CA 90095-1721 (S.Y., D.H., L.D., N.J., B.L.B., M.D.K.); Department of Bioengineering, UCLA, Los Angeles, Calif (M.D.K.); and Scottsdale Medical Imaging, Scottsdale, Ariz (R.L.K.)
| | - Barry L Burnette
- From the Department of Radiology, The David Geffen School of Medicine at University of California-Los Angeles (UCLA), 10833 LeConte Ave, Box 951721, CHS 17-135, Los Angeles, CA 90095-1721 (S.Y., D.H., L.D., N.J., B.L.B., M.D.K.); Department of Bioengineering, UCLA, Los Angeles, Calif (M.D.K.); and Scottsdale Medical Imaging, Scottsdale, Ariz (R.L.K.)
| | - Michael D Kuo
- From the Department of Radiology, The David Geffen School of Medicine at University of California-Los Angeles (UCLA), 10833 LeConte Ave, Box 951721, CHS 17-135, Los Angeles, CA 90095-1721 (S.Y., D.H., L.D., N.J., B.L.B., M.D.K.); Department of Bioengineering, UCLA, Los Angeles, Calif (M.D.K.); and Scottsdale Medical Imaging, Scottsdale, Ariz (R.L.K.)
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FDG Uptake on Positron Emission Tomography Correlates with Survival and Time to Recurrence in Patients with Stage I Non-Small-Cell Lung Cancer. J Thorac Oncol 2016; 10:897-902. [PMID: 25811445 DOI: 10.1097/jto.0000000000000534] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Patients with stage I non-small-cell lung cancer (NSCLC) have a wide variation in outcomes, most likely because there are undetected metastases at presentation. We retrospectively reviewed patients with early stage lung cancer to determine if FDG uptake of the primary tumor as measured on positron emission tomography (PET) at the time of diagnosis was associated with overall survival (OS) or time to recurrence (TTR). METHODS We reviewed the Tumor Registry at our institution and identified 336 consecutive patients diagnosed with stage I NSCLC over a 5-year period who underwent an FDG-PET/computed tomography within 90 days before surgery. Kaplan-Meier curves were used to describe the survival and TTR experience within subgroups defined by PET maximum standardized uptake value (SUVmax). Cox proportional hazards model was used to assess the impact of PET SUVmax as a continuous variable on OS and TTR. Logistic regression was used to analyze the effect of SUVmax on dichotomized outcomes. RESULTS Three hundred thirty-six consecutive patients (176 women and 160 men) with stage I NSCLC were retrospectively reviewed. Mean SUVmax was 9.2 ± 6.9 (range 0.6-30.3). The hazard or risk of dying and recurrence increased significantly as SUVmax increased (p = 0.0008 and 0.024, respectively). CONCLUSIONS Preoperative FDG uptake in the primary tumor in patients with stage I disease is associated with OS and TTR. This may be useful in identifying early stage patients who may benefit from more aggressive therapy after surgical resection.
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Yilmaz Demirci N, Yilmaz Ü, Biner Uslu I, Dikmen A, Yılmaz A, Erdoğan Y. Prognostic significance of standardised uptake value (SUV max ) measured on 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with small cell lung cancer. Eur J Cancer Care (Engl) 2016; 26. [PMID: 26988938 DOI: 10.1111/ecc.12485] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2016] [Indexed: 11/29/2022]
Abstract
Certain prognostic factors for small cell lung cancer (SCLC) have been validated, but the prognostic role of 18F-FDG PET/CT still remains unclear. The aim of this study was to evaluate the prognostic significance of 18F-FDG PET/CT in patients with SCLC. We reviewed 142 patients with pathologically proven SCLC who underwent pre-treatment 18F-FDG PET/CT. Standardised uptake value (SUVmax ) and other potential prognostic variables were chosen for analysis. The mean age of the study population was 58.2 ± 10.1 years (range, 25-84), and 124 (87.3%) patients were men. The median SUVmax value was 11.6 (4.0-29.3). Among the variables included in the univariate analysis, performance status (P = 0.001), disease stage (P < 0.001), administration of thoracic radiotherapy (TRT; P < 0.001), albumin level (P = 0.030) and LDH level (P < 0.001) showed prognostic significance. Further, multivariate analysis showed that performance status (P = 0.007), albumin level (P = 0.002), LDH level (P < 0.001) and administration of TRT (P = 0.001) were independent prognostic factors for survival. In conclusion, performance status, TRT, LDH level and albumin level were identified as important prognostic factors, while 18F-FDG PET/CT uptake of the primary lesions did not have any prognostic significance for survival in patients with SCLC.
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Affiliation(s)
- N Yilmaz Demirci
- Chest Diseases Clinic, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ü Yilmaz
- Chest Diseases Clinic, Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey
| | - I Biner Uslu
- Department of Nuclear Medicine, Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey
| | - A Dikmen
- Department of Statistics, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - A Yılmaz
- Chest Diseases Clinic, Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey
| | - Y Erdoğan
- Chest Diseases Clinic, Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey
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Prognostic value of pre-operative glucose-corrected maximum standardized uptake value in patients with non-small cell lung cancer after complete surgical resection and 5-year follow-up. Ann Nucl Med 2016; 30:362-8. [DOI: 10.1007/s12149-016-1070-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 02/22/2016] [Indexed: 11/25/2022]
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183
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Efficacy of 18F-fluorodeoxyglucose positron emission tomography/computed tomography as a predictor of response in locally advanced non-small-cell carcinoma of the lung. Nucl Med Commun 2016; 37:129-38. [DOI: 10.1097/mnm.0000000000000422] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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184
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Barron CC, Bilan PJ, Tsakiridis T, Tsiani E. Facilitative glucose transporters: Implications for cancer detection, prognosis and treatment. Metabolism 2016; 65:124-39. [PMID: 26773935 DOI: 10.1016/j.metabol.2015.10.007] [Citation(s) in RCA: 268] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 09/22/2015] [Accepted: 10/01/2015] [Indexed: 12/11/2022]
Abstract
It is long recognized that cancer cells display increased glucose uptake and metabolism. In a rate-limiting step for glucose metabolism, the glucose transporter (GLUT) proteins facilitate glucose uptake across the plasma membrane. Fourteen members of the GLUT protein family have been identified in humans. This review describes the major characteristics of each member of the GLUT family and highlights evidence of abnormal expression in tumors and cancer cells. The regulation of GLUTs by key proliferation and pro-survival pathways including the phosphatidylinositol 3-kinase (PI3K)-Akt, hypoxia-inducible factor-1 (HIF-1), Ras, c-Myc and p53 pathways is discussed. The clinical utility of GLUT expression in cancer has been recognized and evidence regarding the use of GLUTs as prognostic or predictive biomarkers is presented. GLUTs represent attractive targets for cancer therapy and this review summarizes recent studies in which GLUT1, GLUT3, GLUT5 and others are inhibited to decrease cancer growth.
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Affiliation(s)
- Carly C Barron
- Department of Health Sciences, Brock University, St. Catharines, ON, L2S 3A1, Canada
| | - Philip J Bilan
- Program in Cell Biology, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON, M5G 0A4, Canada
| | - Theodoros Tsakiridis
- Department of Oncology, and Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, L8S 4L8, Canada
| | - Evangelia Tsiani
- Department of Health Sciences, Brock University, St. Catharines, ON, L2S 3A1, Canada.
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185
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Risk factors associated with recurrence of surgically resected node-positive non-small cell lung cancer. Surg Today 2016; 46:1196-208. [DOI: 10.1007/s00595-015-1301-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 11/26/2015] [Indexed: 12/20/2022]
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186
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Nobashi T, Koyasu S, Nakamoto Y, Kubo T, Ishimori T, Kim YH, Yoshizawa A, Togashi K. Prognostic value of fluorine-18 fludeoxyglucose positron emission tomography parameters differs according to primary tumour location in small-cell lung cancer. Br J Radiol 2016; 89:20150618. [PMID: 26756811 DOI: 10.1259/bjr.20150618] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To investigate the prognostic value of fluorine-18 fludeoxyglucose (FDG) positron emission tomography (PET) parameters for small-cell lung cancer (SCLC), according to the primary tumour location, adjusted by conventional prognostic factors. METHODS From 2008 to 2013, we enrolled consecutive patients with histologically proven SCLC, who had undergone FDG-PET/CT prior to initial therapy. The primary tumour location was categorized into central or peripheral types. PET parameters and clinical variables were evaluated using univariate and multivariate analysis. RESULTS A total of 69 patients were enrolled in this study; 28 of these patients were categorized as having the central type and 41 patients as having the peripheral type. In univariate analysis, stage, serum neuron-specific enolase, whole-body metabolic tumour volume (WB-MTV) and whole-body total lesion glycolysis (WB-TLG) were found to be significant in both types of patients. In multivariate analysis, the independent prognostic factor was found to be stage in the central type, but WB-MTV and WB-TLG in the peripheral type. Kaplan-Meier analysis demonstrated that patients with peripheral type with limited disease and low WB-MTV or WB-TLG showed significantly better overall survival than all of the other groups (p < 0.0083). CONCLUSION The FDG-PET volumetric parameters were demonstrated to be significant and independent prognostic factors in patients with peripheral type of SCLC, while stage was the only independent prognostic factor in patients with central type of SCLC. ADVANCES IN KNOWLEDGE FDG-PET is a non-invasive method that could potentially be used to estimate the prognosis of patients, especially those with peripheral-type SCLC.
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Affiliation(s)
- Tomomi Nobashi
- 1 Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sho Koyasu
- 1 Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuji Nakamoto
- 1 Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takeshi Kubo
- 1 Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takayoshi Ishimori
- 1 Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Young H Kim
- 2 Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akihiko Yoshizawa
- 3 Department of Diagnostic Pathology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kaori Togashi
- 1 Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
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187
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Liu J, Dong M, Sun X, Li W, Xing L, Yu J. Prognostic Value of 18F-FDG PET/CT in Surgical Non-Small Cell Lung Cancer: A Meta-Analysis. PLoS One 2016; 11:e0146195. [PMID: 26727114 PMCID: PMC4699812 DOI: 10.1371/journal.pone.0146195] [Citation(s) in RCA: 110] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 12/13/2015] [Indexed: 12/14/2022] Open
Abstract
Background The identification of surgical non-small cell lung cancer (NSCLC) patients with poor prognosis is a priority in clinical oncology because of their high 5-year mortality. This meta-analysis explored the prognostic value of maximal standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) on disease-free survival (DFS) and overall survival (OS) in surgical NSCLC patients. Materials and Methods MEDLINE, EMBASE and Cochrane Libraries were systematically searched until August 1, 2015. Prospective or retrospective studies that evaluated the prognostic roles of preoperative 18F-FDG PET/CT with complete DFS and OS data in surgical NSCLC patients were included. The impact of SUVmax, MTV or TLG on survival was measured using hazard ratios (HR). Sub-group analyses were performed based on disease stage, pathological classification, surgery only and cut-off values. Results Thirty-six studies comprised of 5807 patients were included. The combined HRs for DFS were 2.74 (95%CI 2.33–3.24, unadjusted) and 2.43 (95%CI: 1.76–3.36, adjusted) for SUVmax, 2.27 (95%CI 1.77–2.90, unadjusted) and 2.49 (95%CI 1.23–5.04, adjusted) for MTV, and 2.46 (95%CI 1.91–3.17, unadjusted) and 2.97 (95%CI 1.68–5.28, adjusted) for TLG. The pooled HRs for OS were 2.54 (95%CI 1.86–3.49, unadjusted) and 1.52 (95%CI 1.16–2.00, adjusted) for SUVmax, 2.07 (95%CI 1.16–3.69, unadjusted) and 1.91 (95%CI 1.13–3.22, adjusted) for MTV, and 2.47 (95%CI 1.38–4.43, unadjusted) and 1.94 (95%CI 1.12–3.33, adjusted) for TLG. Begg’s test detected publication bias, the trim and fill procedure was performed, and similar HRs were obtained. The prognostic role of SUVmax, MTV and TLG remained similar in the sub-group analyses. Conclusions High values of SUVmax, MTV and TLG predicted a higher risk of recurrence or death in patients with surgical NSCLC. We suggest the use of FDG PET/CT to select patients who are at high risk of disease recurrence or death and may benefit from aggressive treatments.
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Affiliation(s)
- Jing Liu
- Department of Radiation Oncology and Shandong Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
| | - Min Dong
- Department of Oncology, the People’s Hospital of Pingyi County, Pingyi, Shandong, China
| | - Xiaorong Sun
- Department of Radiology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
| | - Wenwu Li
- Department of Radiology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
| | - Ligang Xing
- Department of Radiation Oncology and Shandong Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
- * E-mail:
| | - Jinming Yu
- Department of Radiation Oncology and Shandong Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
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Prognostic Implications of the SUVmax of Primary Tumors and Metastatic Lymph Node Measured by 18F-FDG PET in Patients With Uterine Cervical Cancer. Clin Nucl Med 2016; 41:34-40. [DOI: 10.1097/rlu.0000000000001049] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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189
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Nappi A, Gallicchio R, Simeon V, Nardelli A, Pelagalli A, Zupa A, Vita G, Venetucci A, Di Cosola M, Barbato F, Storto G. [F-18] FDG-PET/CT parameters as predictors of outcome in inoperable NSCLC patients. Radiol Oncol 2015; 49:320-6. [PMID: 26834517 PMCID: PMC4722921 DOI: 10.1515/raon-2015-0043] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 09/11/2015] [Indexed: 12/20/2022] Open
Abstract
Background We evaluated the prognostic significance of standardized uptake value (SUVmax), metabolic tumour volume (MTV), and total lesion glycolysis (TLG) in [F-18] FDG PET/CT findings in patients with inoperable non-small-cell lung cancer (NSCLC). Patients and methods. One hundred and three patients (mean age, 65.6 ± 16 years) underwent [F-18] FDG PET/CT before the chemotherapy. The SUVmax value, the MTV (cm3; 42% threshold) and the TLG (g) were registered. The patients were followed up to 18 months thereafter (range 12–55 months). Failure to respond without progression, progression and/or disease-related death constituted surrogate end-points. The optimal SUVmax, MTV and TLG cut-off to predict the patients’ outcome were estimated. PET/CT results were then related to disease outcome (progression free survival; PFS). Results The Kaplan-Meier survival analysis for SUVmax showed a significant shorter PFS in patients presenting with lower values as compared to those with higher (p < 0.05, log-rank test). MTV and TLG were not suitable for predicting PFS apart from the subset of patients with mediastinal nodal involvement. Conclusions Despite the availability of new tools for the quantitative assessment of disease activity on PET/CT, the SUVmax rather than MTV and TLG remains the only predictor for PFS in NSCLC patients. MTV holds a value only when concomitant nodal involvement occurs.
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Affiliation(s)
- Antonio Nappi
- Nuclear Medicine Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Centro di Riferimento Oncologico di Basilicata (CROB), Rionero in Vulture, Italy
| | - Rosj Gallicchio
- Nuclear Medicine Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Centro di Riferimento Oncologico di Basilicata (CROB), Rionero in Vulture, Italy
| | - Vittorio Simeon
- Research Laboratories, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Centro di Riferimento Oncologico di Basilicata (CROB), Rionero in Vulture, Italy
| | - Anna Nardelli
- Istituto di Biostrutture e Bioimmagini, Consiglio Nazionale delle Ricerche, Napoli, Italy
| | - Alessandra Pelagalli
- Istituto di Biostrutture e Bioimmagini, Consiglio Nazionale delle Ricerche, Napoli, Italy
| | - Angela Zupa
- Research Laboratories, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Centro di Riferimento Oncologico di Basilicata (CROB), Rionero in Vulture, Italy
| | - Giulia Vita
- Research Laboratories, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Centro di Riferimento Oncologico di Basilicata (CROB), Rionero in Vulture, Italy
| | - Angela Venetucci
- Nuclear Medicine Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Centro di Riferimento Oncologico di Basilicata (CROB), Rionero in Vulture, Italy
| | | | | | - Giovanni Storto
- Nuclear Medicine Department, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Centro di Riferimento Oncologico di Basilicata (CROB), Rionero in Vulture, Italy
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190
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Xia Q, Liu J, Wu C, Song S, Tong L, Huang G, Feng Y, Jiang Y, Liu Y, Yin T, Ni Y. Prognostic significance of (18)FDG PET/CT in colorectal cancer patients with liver metastases: a meta-analysis. Cancer Imaging 2015; 15:19. [PMID: 26589835 PMCID: PMC4654916 DOI: 10.1186/s40644-015-0055-z] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 11/15/2015] [Indexed: 12/19/2022] Open
Abstract
Background The role of 18-fluorodeoxyglucose positron emission tomography CT (18FDG PET/CT), as a prognostic factor for survival in colorectal cancer patients with liver metastases, is still controversial. We sought to perform a meta-analysis of the literature to address this issue. Methods A systematic literature search was performed to identify the studies that associated 18FDG PET/CT to clinical survival outcomes of patients with liver metastases. Methodological qualities of the included studies were also assessed. The summarized hazard ratio (HR) was estimated by using fixed- or random-effect model according to heterogeneity between trails. Results By analyzing a total of 867 patients from 15 studies, we found that PET/CT for metabolic response to the therapy was capable of predicting event-free survival (EFS) and overall survival (OS) with statistical significance, and the HR was 0.45 (95 % confidence interval [CI], 0.26–0.78) and 0.36 (95 % CI, 0.18–0.71), respectively. Furthermore, pre-treatment 18FDG PET/CT with high standardized uptake value (SUV) was also significantly associated with poorer OS HR, 1.24; (95 % CI, 1.06–1.45). However, we did not find a statistically significant effect of post-treatment SUV for predicting OS HR, 1.68; (95 % CI, 0.63–4.52). Conclusions The present meta-analysis confirms that 18FDG PET/CT is a useful tool to help predict survival outcomes in patients with liver metastases. Electronic supplementary material The online version of this article (doi:10.1186/s40644-015-0055-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Qian Xia
- Department of Nuclear Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160, Pu Jian road, Shanghai, 200127, China.
| | - Jianjun Liu
- Department of Nuclear Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160, Pu Jian road, Shanghai, 200127, China.
| | - Cheng Wu
- Department of Health Statistics, Second Military Medical University, No. 800, Xiang Yin road, Shanghai, 200433, China.
| | - Shaoli Song
- Department of Nuclear Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160, Pu Jian road, Shanghai, 200127, China.
| | - Linjun Tong
- Department of Nuclear Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160, Pu Jian road, Shanghai, 200127, China
| | - Gang Huang
- Department of Nuclear Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160, Pu Jian road, Shanghai, 200127, China.
| | - Yuanbo Feng
- Department of Imaging and Pathology, University Hospitals, KU Leuven, Herestraat 49, Leuven, 3000, Belgium.
| | - Yansheng Jiang
- Department of Imaging and Pathology, University Hospitals, KU Leuven, Herestraat 49, Leuven, 3000, Belgium.
| | - Yewei Liu
- Department of Imaging and Pathology, University Hospitals, KU Leuven, Herestraat 49, Leuven, 3000, Belgium.
| | - Ting Yin
- Department of Imaging and Pathology, University Hospitals, KU Leuven, Herestraat 49, Leuven, 3000, Belgium
| | - Yicheng Ni
- Department of Imaging and Pathology, University Hospitals, KU Leuven, Herestraat 49, Leuven, 3000, Belgium.
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Paesmans M, Garcia C, Wong CYO, Patz EF, Komaki R, Eschmann S, Govindan R, Vansteenkiste J, Meert AP, de Jong WK, Altorki NK, Higashi K, Van Baardwijk A, Borst GR, Ameye L, Lafitte JJ, Berghmans T, Flamen P, Rami-Porta R, Sculier JP. Primary tumour standardised uptake value is prognostic in nonsmall cell lung cancer: a multivariate pooled analysis of individual data. Eur Respir J 2015; 46:1751-61. [PMID: 26405289 DOI: 10.1183/13993003.00099-2015] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 07/05/2015] [Indexed: 01/09/2023]
Abstract
(18)F-fluoro-2-deoxy-d-glucose positron emission tomography (PET) complements conventional imaging for diagnosing and staging lung cancer. Two literature-based meta-analyses suggest that maximum standardised uptake value (SUVmax) on PET has univariate prognostic value in nonsmall cell lung cancer (NSCLC). We analysed individual data pooled from 12 studies to assess the independent prognostic value of binary SUVmax for overall survival.After searching the published literature and identifying unpublished data, study coordinators were contacted and requested to provide data on individual patients. Cox regression models stratified for study were used.Data were collected for 1526 patients (median age 64 years, 60% male, 34% squamous cell carcinoma, 47% adenocarcinoma, 58% stage I-II). The combined univariate hazard ratio for SUVmax was 1.43 (95% CI 1.22-1.66) and nearly identical if the SUV threshold was calculated stratifying for histology. Multivariate analysis of patients with stage I-III disease identified age, stage, tumour size and receipt of surgery as independent prognostic factors; adding SUV (HR 1.58, 95% CI 1.27-1.96) improved the model significantly. The only detected interaction was between SUV and stage IV disease.SUV seems to have independent prognostic value in stage I-III NSCLC, for squamous cell carcinoma and for adenocarcinoma.
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Affiliation(s)
- Marianne Paesmans
- Data Centre, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium Both authors contributed equally
| | - Camilo Garcia
- Nuclear Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium Both authors contributed equally
| | - Ching-Yee Oliver Wong
- Diagnostic Radiology and Molecular Imaging, Oakland University William Beaumont School of Medicine, William Beaumont Hospital, Royal Oak, MI, USA
| | - Edward F Patz
- Radiology, Duke University Medical Center, Durham, NC, USA
| | - Ritsuko Komaki
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Ramaswamy Govindan
- Division of Medical Oncology, Washington University School of Medicine, St. Louis, MI, USA
| | - Johan Vansteenkiste
- Pneumology, Respiratory Oncology Unit, University Hospitals KU Leuven, Leuven, Belgium
| | - Anne-Pascale Meert
- Intensive Care and Thoracic Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | | | | | | | - Angela Van Baardwijk
- Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Gerben R Borst
- Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Lieveke Ameye
- Data Centre, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Thierry Berghmans
- Intensive Care and Thoracic Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Patrick Flamen
- Nuclear Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Ramon Rami-Porta
- Thoracic Surgery, Hospital Universitari Mutua Terrassa and CIBERES Lung Cancer Group, Terrassa, Spain
| | - Jean-Paul Sculier
- Intensive Care and Thoracic Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
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192
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van der Vos CS, Grootjans W, Osborne DR, Meeuwis AP, Hamill JJ, Acuff S, de Geus-Oei LF, Visser EP. Improving the Spatial Alignment in PET/CT Using Amplitude-Based Respiration-Gated PET and Respiration-Triggered CT. J Nucl Med 2015; 56:1817-22. [DOI: 10.2967/jnumed.115.163055] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 09/03/2015] [Indexed: 11/16/2022] Open
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193
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Ozmen O, Yilmaz U, Dadali Y, Tatci E, Gokcek A, Aydin E, Okuyucu K, Arslan N. Use of FDG PET/CT in Patients with Pancoast Tumors: Does It Add Any Contribution to Patient Management? Cancer Biother Radiopharm 2015; 30:359-67. [PMID: 26367245 DOI: 10.1089/cbr.2014.1809] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To evaluate any potential value of 2-deoxy-2-[18F] fluoro-D-glucose with positron emission tomography/computerized tomography (FDG PET/CT) in staging of patients with Pancoast tumors and to investigate the relationship between volume-based quantitative PET parameters and prognosis. MATERIALS AND METHODS The authors retrospectively reviewed data of the 47 patients with Pancoast tumors who underwent initial staging by conventional imaging methods and FDG PET/CT. FDG-PET images were visually and quantitatively evaluated, and metabolic tumor volume (MTV), total lesion glycolysis, and maximum standardized uptake values of primary tumors were calculated. The correlations between quantitative PET parameters and tumor stages, as well as overall survival, were analyzed. RESULTS By detecting unknown distant metastasis, PET/CT upstaged 21% of patients. The sensitivity and specificity for detection of lymphatic involvement were 100% and 83.75%, respectively. Having surgery (p = 0.01) and being at an early stage (p = 0.004) were the most predictive factors for overall survival. Although there was no significant correlation between quantitative PET parameters and overall survival, MTV was the most powerful discriminator for operability and preoperative staging (p < 0.05). CONCLUSIONS FDG-PET imaging was found to be a valuable method for an accurate staging in the management of patients with Pancoast tumor. Having surgery and being at an early stage at presentation were found to be significant predictors for survival. Quantitative metabolic parameters may contribute to clarification of operable patient subgroups having an early disease stage with low MTV.
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Affiliation(s)
- Ozlem Ozmen
- 1 Department of Nuclear Medicine, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital , Ankara, Turkey
| | - Ulku Yilmaz
- 2 Department of Chest Diseases, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital , Ankara, Turkey
| | - Yeliz Dadali
- 3 Department of Radiology, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital , Ankara, Turkey
| | - Ebru Tatci
- 1 Department of Nuclear Medicine, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital , Ankara, Turkey
| | - Atila Gokcek
- 3 Department of Radiology, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital , Ankara, Turkey
| | - Ertan Aydin
- 4 Department of Chest Surgery, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital , Ankara, Turkey
| | - Kursat Okuyucu
- 5 Department of Nuclear Medicine, Gulhane Military Medical Academy and Medical Faculty , Ankara, Turkey
| | - Nuri Arslan
- 5 Department of Nuclear Medicine, Gulhane Military Medical Academy and Medical Faculty , Ankara, Turkey
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194
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(18)F-Fluorodeoxyglucose positron emission tomography and serum cytokines and matrix metalloproteinases in the assessment of disease activity in Takayasu's arteritis. REVISTA BRASILEIRA DE REUMATOLOGIA 2015; 56:299-308. [PMID: 27476622 DOI: 10.1016/j.rbre.2015.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 03/01/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate (18)F-fluorodeoxyglucose ((18)F-FDG) uptake on positron emission tomography-computed tomography (PET-CT) and serum levels of different cytokines and matrix metalloproteinases (MMPs) in patients with Takayasu arteritis (TA) and associations with disease activity. METHODS Serum levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-2, IL-6, IL-8, IL-12, IL-18, MMP-3 and MMP-9 were measured in 36 TA patients and 36 controls. Maximum standard uptake value (SUVmax) of (18)F-FDG in arterial walls was determined by PET-CT scans. TA patients were classified as active disease, inactive disease and possible active disease. RESULTS Serum IL-6 and MMP-3 levels were higher in TA patients than in controls (p<0.001). Serum IL-6 was higher in patients with active disease and in patients with possible active disease than in inactive disease (p<0.0001). Patients with active disease had higher serum TNFα levels than patients with inactive disease (p=0.049) while patients with possible active disease presented higher IL-18 levels than patients with inactive disease (p=0.046). Patients with active disease had higher SUVmax values than those with inactive disease (p=0.042). By receiver operating characteristic (ROC) curve SUVmax was predictive of active disease in TA and values ≥1.3 were associated with disease activity (p=0.039). Serum TNF-α levels were higher in patients with SUVmax≥1.3 than <1.3 (p=0.045) and controls (p=0.012). Serum IL-6 levels were higher in patients with SUVmax≥1.3 than in controls (p<0.001). No differences regarding other biomarkers were found between TA patients and controls. CONCLUSIONS Higher serum IL-6 and TNFα levels as well as higher (18)F-FDG uptake in arterial wall are associated with active TA.
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195
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Noda Y, Goshima S, Kanematsu M, Watanabe H, Kawada H, Kawai N, Ono H, Bae KT. F-18 FDG uptake on positron emission tomography as a predictor for lymphovascular invasion in patients with lung adenocarcinoma. Ann Nucl Med 2015; 30:11-7. [PMID: 26337532 DOI: 10.1007/s12149-015-1023-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 08/25/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the contributory value of Fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT) in the prediction of lymphovascular tumor invasion in patients with lung adenocarcinoma. MATERIALS AND METHODS We evaluated F-18 FDG-PET/CT images in 84 patients with histopathologically proven lung adenocarcinoma (37 men and 47 women, age range 39-83 years, mean age 67.0 ± 8.9 years). The maximum standardized uptake values (SUVmax) of the carcinomas were measured from the PET images. The Mann-Whitney U test was conducted to compare the median SUVmax between the tumor groups with and without lymphovascular invasion. In the subgroup patients with no lymph-node metastasis, we also compared the median SUVmax between the tumor groups with and without lymphatic invasion. RESULTS The tumors with lymphovascular invasion had a significantly (P < 0.0001) greater median SUVmax than those without invasion. In the subgroup patients with no lymph-node metastasis, the median SUVmax was higher in tumors with lymphatic invasion than those without (P = 0.0004). The sensitivity, specificity, and area under the receiver operating characteristic curve for the detection of tumors with lymphovascular invasion were 89, 75 %, and 0.82, respectively, with a cutoff SUVmax value of 2.32. CONCLUSION The SUVmax of lung adenocarcinoma is a potential imaging biomarker for predicting tumor lymphovascular invasion.
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Affiliation(s)
- Yoshifumi Noda
- Departments of Radiology, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Satoshi Goshima
- Departments of Radiology, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.
| | - Masayuki Kanematsu
- Departments of Radiology, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.,Departments of Radiology Services, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Haruo Watanabe
- Departments of Radiology, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Hiroshi Kawada
- Departments of Radiology, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Nobuyuki Kawai
- Departments of Radiology, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Hiromi Ono
- Departments of Radiology, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Kyongtae T Bae
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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196
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Iwano S, Ito R, Umakoshi H, Ito S, Naganawa S. Evaluation of lung cancer by enhanced dual-energy CT: association between three-dimensional iodine concentration and tumour differentiation. Br J Radiol 2015; 88:20150224. [PMID: 26329466 DOI: 10.1259/bjr.20150224] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To investigate the correlation between iodine concentration of dual-energy CT (DECT) and histopathology of surgically resected primary lung cancers. METHODS We reviewed the medical records, post-operative pathological records and pre-operative DECT images of patients who underwent surgical lung resection for primary lung cancer. After injection of iodinated contrast media, arterial and delayed phases were scanned using 140- and 80-kV tube voltages. Three-dimensional iodine concentration (iodine volume) of primary tumours was calculated using lung nodule application software. RESULTS A total of 60 patients (37 males and 23 females; age range, 39-84 years; mean age, 69 years) with 62 lung cancers were analysed. The resected tumours were histopathologically classified into well-differentiated (G1; n = 20), moderately differentiated (G2; n = 29), poorly differentiated (G3; n = 9) and undifferentiated (G4; n = 4) groups by degree of tumour differentiation (DTD). The mean ± standard deviation of iodine volume at the delayed phase was 59.6 ± 18.6 HU in G1 tumours, 46.5 ± 11.3 HU in G2 tumours, 34.3 ± 15.0 HU in G3 tumours and 28.8 ± 6.4 HU in G4 tumours; significant differences were observed between groups (p < 0.001). Univariate logistic regression analysis showed that iodine volumes both at the early and delayed phases were significantly correlated with DTD (p = 0.006 and p = 0.001, respectively), whereas gender, body weight and tumour size were not (p = 0.084, p = 0.062 and p = 0.391, respectively). CONCLUSION The iodine volume of lung cancers was significantly associated with their DTD. High-grade tumours tended to have lower iodine volumes than low-grade tumours. ADVANCES IN KNOWLEDGE Iodine volume measured by DECT could be a valuable functional imaging method to estimate differentiation of primary lung cancer.
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Affiliation(s)
- Shingo Iwano
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Rintaro Ito
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroyasu Umakoshi
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shinji Ito
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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197
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Pan Y, Yao Y, Ma Y. Standardized Uptake Value on F-FDG PET/CT as a Prognostic Factor for Survival of Women with Malignant Uterine Tumors: A Meta-Analysis. Gynecol Obstet Invest 2015; 81:000433598. [PMID: 26337494 DOI: 10.1159/000433598] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Malignant uterine tumors are crucial in the evaluation of prognosis and the determination of therapeutic strategy. AIM This meta-analysis of the available literature aimed to investigate the prognostic value of standardized uptake value (SUV) on fluorine-18-fluorodeoxyglucose positron emission tomography with computed tomography (18F-FDG PET/CT) in uterine malignancies before treatment. METHODS The PubMed, MEDLINE and EMBASE databases (1990 to February 2014) were searched to identify studies evaluating SUV on 18F-FDG PET/CT as a prognostic tool for predicting long-term survival in patients with carcinomas of the uterus. The χ2 test and the I2 index were used to estimate heterogeneity among the trials selected in the meta-analysis. The combined hazard ratio was calculated by using a fixed- or random-effects model according to heterogeneity. RESULTS Thirteen studies with a total of 1,196 patients were eligible for analysis. High pretreatment SUVmax was significantly associated with poorer event-free survival and overall survival, and the summarized hazard ratio was 3.33 (95% confidence interval 2.34-4.74) and 1.31 (95% confidence interval 1.03-1.67), respectively. CONCLUSION The present evidence indicates that SUV on 18F-FDG PET/CT seems to be a valuable prognostic indicator for survival of patients with malignant uterine tumors. Given that 18F-FDG PET/CT can provide both morphologic and functional information, we suggest utilizing PET/CT and its quantitative marker in uterine malignancies before treatment. © 2015 S. Karger AG, Basel.
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Affiliation(s)
- Yifan Pan
- Department of Nuclear Medicine, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China
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198
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Total Lesion Glycolysis in Positron Emission Tomography Can Predict Gefitinib Outcomes in Non–Small-Cell Lung Cancer with Activating EGFR Mutation. J Thorac Oncol 2015. [DOI: 10.1097/jto.0000000000000569] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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199
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Lee DS, Kim SJ, Jang HS, Yoo IR, Park KR, Na SJ, Lee KY, Hong SH, Kang JH, Kim YK, Kim YS. Clinical Correlation Between Tumor Maximal Standardized Uptake Value in Metabolic Imaging and Metastatic Tumor Characteristics in Advanced Non-small Cell Lung Cancer. Medicine (Baltimore) 2015; 94:e1304. [PMID: 26266371 PMCID: PMC4616678 DOI: 10.1097/md.0000000000001304] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
This study aimed to elucidate whether the maximal standardized uptake value (SUVmax) of primary tumors in metabolic imaging correlated with pathological or metastatic characteristics and whether it was prognostic in stage IV nonsmall cell lung cancer (NSCLC).We retrospectively reviewed the medical records of 412 eligible patients between June 2007 and January 2013. All enrolled patients fulfilled the following criteria: they were newly diagnosed with stage IV NSCLC without any previous treatment and had undergone a systemic evaluation, including 18(F)-Fluoro-2-deoxyglucose positron emission tomography/computed tomography, to assess synchronous metastatic sites. Patient and tumor characteristics were analyzed, and clinical correlations between SUVmax and metastatic features were investigated.The median age of the study population was 65 years (range, 30-94), and 259 (62.9%) patients were male. The median SUVmax was statistically higher in males, in tumors with squamous cell histology, and in poorly differentiated tumors. Multivariate logistic regression analysis revealed that SUVmax ≥ 11.4 (top 30 percentiles) were significantly correlated with positive lymph node status (odds ratio [OR] 3.473), abdomen/pelvis metastasis (OR 1.949), and the absence of bone metastasis (OR 0.399) in the subgroup of nonsquamous NSCLC (n = 343). In Kaplan-Meier survival analysis, overall survival was significantly lower among cohorts with high SUVmax (≥11.4) than with low SUVmax (<11.4) (P < 0.001, median 7.4 months vs 12.1 months).The tumors with different SUVmax have distinctive metastatic and biological features in stage IV NSCLC. The underlying mechanisms of this unique metabolic biology need to be resolved in future studies.
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Affiliation(s)
- Dong Soo Lee
- From the Department of Radiation Oncology (DSL, HSJ, YSK), College of Medicine, The Catholic University of Korea; Division of Pulmonology (SJK, YKK), Department of Internal Medicine, College of Medicine, The Catholic University of Korea; Department of Radiation Oncology (KRP), School of Medicine, Ewha Womans University; Department of Nuclear Medicine (IRY, SJN), College of Medicine, The Catholic University of Korea; Department of Hospital Pathology (KYL), College of Medicine, The Catholic University of Korea; and Department of Medical Oncology (SHH, JHK), College of Medicine, The Catholic University of Korea, Seoul, South Korea
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200
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Arraes AED, de Souza AWS, Mariz HA, Silva NP, Torres ICG, Pinto PNV, Lima ENP, Sato EI. [ 18F-Fluorodeoxyglucose positron emission tomography and serum cytokines and matrix metalloproteinases in the assessment of disease activity in Takayasu's arteritis]. REVISTA BRASILEIRA DE REUMATOLOGIA 2015; 56:S0482-5004(15)00093-5. [PMID: 26304781 DOI: 10.1016/j.rbr.2015.03.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 01/05/2015] [Accepted: 03/01/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To evaluate 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography-computed tomography (PET-CT)-and serum levels of different cytokines and matrix metalloproteinases (MMPs) in patients with Takayasu's arteritis (TA) and associations with disease activity. METHODS Serum levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-2, IL-6, IL-8, IL-12, IL-18, MMP-3 and MMP-9 were measured in 36 TA patients and 36 controls. Maximum standard uptake value (SUVmax) of 18F-FDG in arterial walls was determined by PET-CT scans. TA patients were classified as active disease, inactive disease and possible active disease. RESULTS Serum IL-6 and MMP-3 levels were higher in TA patients than in controls (p<0.001). Serum IL-6 was higher in patients with active disease and in patients with possible active disease than in inactive disease (p<0.0001). Patients with active disease had higher serum TNFα levels than patients with inactive disease (p=0.049) while patients with possible active disease presented higher IL-18 levels than patients with inactive disease (p=0.046). Patients with active disease had higher SUVmax values than those with inactive disease (p=0.042). By ROC curve SUVmax was predictive of active disease in TA and values ≥1.3 were associated with disease activity (p=0.039). Serum TNF-α levels were higher in patients with SUVmax ≥1.3 than<1.3 (p=0.045) and controls (p=0.012). Serum IL-6 levels were higher in patients with SUVmax ≥1.3 than in controls (p<0.001). No differences regarding other biomarkers were found between TA patients and controls. CONCLUSIONS Higher serum IL-6 and TNFα levels as well as higher arterial 18F-FDG uptake are associated with active TA.
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Affiliation(s)
- Anne E D Arraes
- Disciplina de Reumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
| | - Alexandre W S de Souza
- Disciplina de Reumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
| | - Henrique A Mariz
- Disciplina de Reumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
| | - Neusa P Silva
- Disciplina de Reumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
| | - Ivone C G Torres
- Divisão de Radiologia, Hospital A.C. Camargo, São Paulo, SP, Brasil
| | - Paula N V Pinto
- Divisão de Radiologia, Hospital A.C. Camargo, São Paulo, SP, Brasil
| | - Eduardo N P Lima
- Divisão de Radiologia, Hospital A.C. Camargo, São Paulo, SP, Brasil
| | - Emilia I Sato
- Disciplina de Reumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil.
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