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Sun F, Chen Z, Zhou D, Li Z, Wang H, Zhao R, Xian J, Peng J, Peng X, Jiang C, Shi M, Li D. Regularity and correlation analysis of regional lymph node metastasis in nonoperative patients with non-small cell lung cancer based on positron emission tomography/computed tomography images. Radiat Oncol 2024; 19:137. [PMID: 39375779 PMCID: PMC11457444 DOI: 10.1186/s13014-024-02523-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 09/13/2024] [Indexed: 10/09/2024] Open
Abstract
BACKGROUND Definitive concurrent chemoradiotherapy (CCRT) is the standard treatment for locally advanced, inoperable non-small cell lung cancer (NSCLC). Previous studies have mainly focused on examining local failure and recurrence patterns after surgery and the principles of lymph node metastasis (LNM) in surgical candidates with NSCLC. However, these studies were just only able to guide postoperative radiotherapy (PORT) and the patterns of LNM in patients with resected NSCLC was inadequate to represent that in locally advanced inoperable NSCLC patients for guiding target volume delineation of CCRT. In this study, we aimed to analyze the metastasis regularities and establish the correlations between different lymph node levels in NSCLC patients without any intervention using positron emission tomography/computed tomography (PET/CT) images. METHODS Overall, 358 patients with N1-N3 NSCLC admitted in our hospital between 2018 and 2022 were retrospectively analyzed. The diagnosis of metastatic lymph nodes was reviewed and determined using the European Organization for Research and Treatment of Cancer standard and the standardized value of the PET/CT examination. Univariate and multivariate analysis were performed to investigate the correlations between the different levels were evaluated by using of the chi-square test and logistic regression model. RESULTS The lymph nodes with the highest metastasis rates in patients with left lung cancer were in order as follows: 10L, 4L, 5, 4R, and 7; while in those with right lung cancer they were 10R, 4R, 7, 2R, and 1R. Notably, we found left lung patients were more likely to have contralateral hilar, mediastinal and supraclavicular lymph nodes involved, and the right lung group exhibited a higher propensity for ipsilateral mediastinum and supraclavicular lymph node invasion. Furthermore, correlation analysis revealed there were significant correlative patterns in the LNM across different levels. CONCLUSIONS This study elucidated the patterns of primary LNM in patients with NSCLC who had not undergone surgery (without any treatment interventions) and the correlations between lymph node levels. These findings were expected to provide useful reference for target volume delineation in definitive concurrent chemoradiotherapy in locally advanced NSCLC patients.
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Affiliation(s)
- Feifan Sun
- Department of Oncology, The General Hospital of Western Theater Command, Chengdu, Sichuan Province, 610083, PR China
| | - Zhiming Chen
- Department of Nuclear Medicine, The General Hospital of Western Theater Command, Chengdu, PR China
| | - Daijun Zhou
- Department of Oncology, The General Hospital of Western Theater Command, Chengdu, Sichuan Province, 610083, PR China
| | - Zhihui Li
- Department of Oncology, The General Hospital of Western Theater Command, Chengdu, Sichuan Province, 610083, PR China
| | - Haoyang Wang
- Department of Nuclear Medicine, The General Hospital of Western Theater Command, Chengdu, PR China
| | - Rong Zhao
- Department of Nuclear Medicine, The General Hospital of Western Theater Command, Chengdu, PR China
| | - Jing Xian
- Department of Oncology, The General Hospital of Western Theater Command, Chengdu, Sichuan Province, 610083, PR China
| | - Jingjing Peng
- Department of Oncology, The General Hospital of Western Theater Command, Chengdu, Sichuan Province, 610083, PR China
| | - Xingchen Peng
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, PR China.
| | - Chaoyang Jiang
- Department of Oncology, The General Hospital of Western Theater Command, Chengdu, Sichuan Province, 610083, PR China.
| | - Mei Shi
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shanxi Province, 710000, PR China.
| | - Dong Li
- Department of Oncology, The General Hospital of Western Theater Command, Chengdu, Sichuan Province, 610083, PR China.
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2
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Melosky B, Vincent MD, McGuire AL, Brade AM, Chu Q, Cheema P, Martins I, Spicer JD, Snow S, Juergens RA. Modern era systemic therapies: Expanding concepts of cure in early and locally advanced non-small cell lung cancer. Int J Cancer 2024; 155:963-978. [PMID: 38900018 DOI: 10.1002/ijc.35031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/19/2024] [Accepted: 04/17/2024] [Indexed: 06/21/2024]
Abstract
Cure of cancer is a sensitive and multidimensional concept that is challenging to define, difficult to assert at the individual patient level, and often surrounded by controversy. The notion of cure in non-small cell lung cancer (NSCLC) has changed and continues to evolve with improvements in diagnosis and treatment. Targeted and immune therapies have recently entered the treatment landscape of stage I-III NSCLC. While some initial pivotal trials of such agents failed to improve survival, recently approved epidermal growth factor receptor (EGFR) inhibitors (in EGFR-mutated NSCLC) and immune checkpoint inhibitors have shown delays in disease recurrence or progression and unprecedented survival gains compared to previous standards of care. Additional data is now emerging supporting the benefit of treatment strategies based on alternation-matched targeting (anaplastic lymphoma kinase [ALK] inhibition in ALK-altered disease) and immune checkpoint inhibition in stage I-III NSCLC. Similar to previous developments in the treatment of early and locally advanced NSCLC, it is expected that statistically significant and clinically meaningful trial-level benefits will translate into real-world benefits, including improvements in cure measures. Parallel advances in molecular testing (e.g., circulating tumor DNA analyses) are also allowing for a deeper and more comprehensive characterization of disease status and treatment response. Given the impact that curative-intent treatments have on survival, it is critical that various stakeholders, including clinicians and patients, are aware of new opportunities to pursue cure in stage I-III NSCLC.
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Affiliation(s)
- Barbara Melosky
- BCCA Vancouver Centre, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mark D Vincent
- London Regional Cancer Centre, University of Western Ontario, London, Ontario, Canada
| | - Anna L McGuire
- Vancouver Coastal Health Research Institute, University of British Colombia, Vancouver, British Columbia, Canada
| | - Anthony M Brade
- Trillium Health Partners, University of Toronto, Mississauga, Ontario, Canada
| | - Quincy Chu
- Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Parneet Cheema
- William Osler Health System, University of Toronto, Brampton, Ontario, Canada
| | | | - Jonathan D Spicer
- McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Stephanie Snow
- QEII Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Rosalyn A Juergens
- Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada
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3
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Garg P, Singhal S, Kulkarni P, Horne D, Malhotra J, Salgia R, Singhal SS. Advances in Non-Small Cell Lung Cancer: Current Insights and Future Directions. J Clin Med 2024; 13:4189. [PMID: 39064229 PMCID: PMC11278207 DOI: 10.3390/jcm13144189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/11/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024] Open
Abstract
The leading cause of cancer deaths worldwide is attributed to non-small cell lung cancer (NSCLC), necessitating a continual focus on improving the diagnosis and treatment of this disease. In this review, the latest breakthroughs and emerging trends in managing NSCLC are highlighted. Major advancements in diagnostic methods, including better imaging technologies and the utilization of molecular biomarkers, are discussed. These advancements have greatly enhanced early detection and personalized treatment plans. Significant improvements in patient outcomes have been achieved by new targeted therapies and immunotherapies, providing new hope for individuals with advanced NSCLC. This review discusses the persistent challenges in accessing advanced treatments and their associated costs despite recent progress. Promising research into new therapies, such as CAR-T cell therapy and oncolytic viruses, which could further revolutionize NSCLC treatment, is also highlighted. This review aims to inform and inspire continued efforts to improve outcomes for NSCLC patients globally, by offering a comprehensive overview of the current state of NSCLC treatment and future possibilities.
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Affiliation(s)
- Pankaj Garg
- Department of Chemistry, GLA University, Mathura 281406, Uttar Pradesh, India
| | - Sulabh Singhal
- Department of Internal Medicine, Drexel University College of Medicine, Philadelphia, PA 19104, USA
| | - Prakash Kulkarni
- Departments of Medical Oncology & Therapeutics Research, Beckman Research Institute of City of Hope, Comprehensive Cancer Center and National Medical Center, Duarte, CA 91010, USA
| | - David Horne
- Departments of Molecular Medicine, Beckman Research Institute of City of Hope, Comprehensive Cancer Center and National Medical Center, Duarte, CA 91010, USA
| | - Jyoti Malhotra
- Departments of Medical Oncology & Therapeutics Research, Beckman Research Institute of City of Hope, Comprehensive Cancer Center and National Medical Center, Duarte, CA 91010, USA
| | - Ravi Salgia
- Departments of Medical Oncology & Therapeutics Research, Beckman Research Institute of City of Hope, Comprehensive Cancer Center and National Medical Center, Duarte, CA 91010, USA
| | - Sharad S. Singhal
- Departments of Medical Oncology & Therapeutics Research, Beckman Research Institute of City of Hope, Comprehensive Cancer Center and National Medical Center, Duarte, CA 91010, USA
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4
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Hesami M, Blake M, Anderson MA, Asmundo L, Kilcoyne A, Najmi Z, Caravan PD, Catana C, Czawlytko C, Esfahani SA, Kambadakone AR, Samir A, McDermott S, Domachevsky L, Ursprung S, Catalano OA. Diagnostic Anatomic Imaging for Neuroendocrine Neoplasms: Maximizing Strengths and Mitigating Weaknesses. J Comput Assist Tomogr 2024; 48:521-532. [PMID: 38657156 PMCID: PMC11245376 DOI: 10.1097/rct.0000000000001615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
ABSTRACT Neuroendocrine neoplasms are a heterogeneous group of gastrointestinal and lung tumors. Their diverse clinical manifestations, variable locations, and heterogeneity present notable diagnostic challenges. This article delves into the imaging modalities vital for their detection and characterization. Computed tomography is essential for initial assessment and staging. At the same time, magnetic resonance imaging (MRI) is particularly adept for liver, pancreatic, osseous, and rectal imaging, offering superior soft tissue contrast. The article also highlights the limitations of these imaging techniques, such as MRI's inability to effectively evaluate the cortical bone and the questioned cost-effectiveness of computed tomography and MRI for detecting specific gastric lesions. By emphasizing the strengths and weaknesses of these imaging techniques, the review offers insights into optimizing their utilization for improved diagnosis, staging, and therapeutic management of neuroendocrine neoplasms.
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Affiliation(s)
- Mina Hesami
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Michael Blake
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Mark A. Anderson
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Luigi Asmundo
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Milan, Italy
| | - Aoife Kilcoyne
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Zahra Najmi
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Peter D. Caravan
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Ciprian Catana
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Cynthia Czawlytko
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Shadi Abdar Esfahani
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Avinash R. Kambadakone
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Anthony Samir
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Shaunagh McDermott
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Liran Domachevsky
- Department of Nuclear Medicine, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Stephan Ursprung
- Department of Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Onofrio A. Catalano
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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5
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Yan Q, Yan X, Yang X, Li S, Song J. The use of PET/MRI in radiotherapy. Insights Imaging 2024; 15:63. [PMID: 38411742 PMCID: PMC10899128 DOI: 10.1186/s13244-024-01627-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 01/21/2024] [Indexed: 02/28/2024] Open
Abstract
Positron emission tomography/magnetic resonance imaging (PET/MRI) is a hybrid imaging technique that quantitatively combines the metabolic and functional data from positron emission tomography (PET) with anatomical and physiological information from MRI. As PET/MRI technology has advanced, its applications in cancer care have expanded. Recent studies have demonstrated that PET/MRI provides unique advantages in the field of radiotherapy and has become invaluable in guiding precision radiotherapy techniques. This review discusses the rationale and clinical evidence supporting the use of PET/MRI for radiation positioning, target delineation, efficacy evaluation, and patient surveillance.Critical relevance statement This article critically assesses the transformative role of PET/MRI in advancing precision radiotherapy, providing essential insights into improved radiation positioning, target delineation, efficacy evaluation, and patient surveillance in clinical radiology practice.Key points• The emergence of PET/MRI will be a key bridge for precise radiotherapy.• PET/MRI has unique advantages in the whole process of radiotherapy.• New tracers and nanoparticle probes will broaden the use of PET/MRI in radiation.• PET/MRI will be utilized more frequently for radiotherapy.
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Affiliation(s)
- Qi Yan
- Cancer Center, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences Tongji Shanxi Hospital, Taiyuan, China
| | - Xia Yan
- Cancer Center, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
- Shanxi Provincial Key Laboratory for Translational Nuclear Medicine and Precision Protection, Taiyuan, China
| | - Xin Yang
- Cancer Center, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Sijin Li
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, China.
| | - Jianbo Song
- Cancer Center, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences Tongji Shanxi Hospital, Taiyuan, China.
- Shanxi Provincial Key Laboratory for Translational Nuclear Medicine and Precision Protection, Taiyuan, China.
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6
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Bhalla AS, Garg A. Diffusion-Weighted MRI: Potential Tool for Pulmonary Nodule Characterization. Indian J Radiol Imaging 2024; 34:1-2. [PMID: 38106875 PMCID: PMC10723950 DOI: 10.1055/s-0043-1776884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Affiliation(s)
- Ashu Seith Bhalla
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Anisha Garg
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
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7
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Arslan M, Haider A, Khurshid M, Abu Bakar SSU, Jani R, Masood F, Tahir T, Mitchell K, Panchagnula S, Mandair S. From Pixels to Pathology: Employing Computer Vision to Decode Chest Diseases in Medical Images. Cureus 2023; 15:e45587. [PMID: 37868395 PMCID: PMC10587792 DOI: 10.7759/cureus.45587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2023] [Indexed: 10/24/2023] Open
Abstract
Radiology has been a pioneer in the healthcare industry's digital transformation, incorporating digital imaging systems like picture archiving and communication system (PACS) and teleradiology over the past thirty years. This shift has reshaped radiology services, positioning the field at a crucial junction for potential evolution into an integrated diagnostic service through artificial intelligence and machine learning. These technologies offer advanced tools for radiology's transformation. The radiology community has advanced computer-aided diagnosis (CAD) tools using machine learning techniques, notably deep learning convolutional neural networks (CNNs), for medical image pattern recognition. However, the integration of CAD tools into clinical practice has been hindered by challenges in workflow integration, unclear business models, and limited clinical benefits, despite development dating back to the 1990s. This comprehensive review focuses on detecting chest-related diseases through techniques like chest X-rays (CXRs), magnetic resonance imaging (MRI), nuclear medicine, and computed tomography (CT) scans. It examines the utilization of computer-aided programs by researchers for disease detection, addressing key areas: the role of computer-aided programs in disease detection advancement, recent developments in MRI, CXR, radioactive tracers, and CT scans for chest disease identification, research gaps for more effective development, and the incorporation of machine learning programs into diagnostic tools.
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Affiliation(s)
- Muhammad Arslan
- Department of Emergency Medicine, Royal Infirmary of Edinburgh, National Health Service (NHS) Lothian, Edinburgh, GBR
| | - Ali Haider
- Department of Allied Health Sciences, The University of Lahore, Gujrat Campus, Gujrat, PAK
| | - Mohsin Khurshid
- Department of Microbiology, Government College University Faisalabad, Faisalabad, PAK
| | | | - Rutva Jani
- Department of Internal Medicine, C. U. Shah Medical College and Hospital, Gujarat, IND
| | - Fatima Masood
- Department of Internal Medicine, Gulf Medical University, Ajman, ARE
| | - Tuba Tahir
- Department of Business Administration, Iqra University, Karachi, PAK
| | - Kyle Mitchell
- Department of Internal Medicine, University of Science, Arts and Technology, Olveston, MSR
| | - Smruthi Panchagnula
- Department of Internal Medicine, Ganni Subbalakshmi Lakshmi (GSL) Medical College, Hyderabad, IND
| | - Satpreet Mandair
- Department of Internal Medicine, Medical University of the Americas, Charlestown, KNA
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8
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Broncano J, Steinbrecher K, Marquis KM, Raptis CA, Royuela Del Val J, Vollmer I, Bhalla S, Luna A. Diffusion-weighted Imaging of the Chest: A Primer for Radiologists. Radiographics 2023; 43:e220138. [PMID: 37347699 DOI: 10.1148/rg.220138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
Diffusion-weighted imaging (DWI) is a fundamental sequence not only in neuroimaging but also in oncologic imaging and has emerging applications for MRI evaluation of the chest. DWI can be used in clinical practice to enhance lesion conspicuity, tissue characterization, and treatment response. While the spatial resolution of DWI is in the order of millimeters, changes in diffusion can be measured on the micrometer scale. As such, DWI sequences can provide important functional information to MRI evaluation of the chest but require careful optimization of acquisition parameters, notably selection of b values, application of parallel imaging, fat saturation, and motion correction techniques. Along with assessment of morphologic and other functional features, evaluation of DWI signal attenuation and apparent diffusion coefficient maps can aid in tissue characterization. DWI is a noninvasive noncontrast acquisition with an inherent quantitative nature and excellent reproducibility. The outstanding contrast-to-noise ratio provided by DWI can be used to improve detection of pulmonary, mediastinal, and pleural lesions, to identify the benign nature of complex cysts, to characterize the solid portions of cystic lesions, and to classify chest lesions as benign or malignant. DWI has several advantages over fluorine 18 (18F)-fluorodeoxyglucose PET/CT in the assessment, TNM staging, and treatment monitoring of lung cancer and other thoracic neoplasms with conventional or more recently developed therapies. © RSNA, 2023 Quiz questions for this article are available in the supplemental material. Supplemental material and the slide presentation from the RSNA Annual Meeting are available for this article.
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Affiliation(s)
- Jordi Broncano
- From the Cardiothoracic Imaging Unit (J.B.) and Department of Radiology (J.B., J.R.d.V.), Hospital San Juan de Dios, HT-RESSALTA, HT Médica, Avenida el Brillante No. 36, 14012 Córdoba, Spain; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (K.S., K.M.M., C.A.R., S.B.); Cardiothoracic Imaging Section, Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain (I.V.); and MRI Section, Department of Radiology, Clínica Las Nieves, HT-SERCOSA, HT Médica, Jaén, Spain (A.L.)
| | - Kacie Steinbrecher
- From the Cardiothoracic Imaging Unit (J.B.) and Department of Radiology (J.B., J.R.d.V.), Hospital San Juan de Dios, HT-RESSALTA, HT Médica, Avenida el Brillante No. 36, 14012 Córdoba, Spain; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (K.S., K.M.M., C.A.R., S.B.); Cardiothoracic Imaging Section, Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain (I.V.); and MRI Section, Department of Radiology, Clínica Las Nieves, HT-SERCOSA, HT Médica, Jaén, Spain (A.L.)
| | - Kaitlin M Marquis
- From the Cardiothoracic Imaging Unit (J.B.) and Department of Radiology (J.B., J.R.d.V.), Hospital San Juan de Dios, HT-RESSALTA, HT Médica, Avenida el Brillante No. 36, 14012 Córdoba, Spain; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (K.S., K.M.M., C.A.R., S.B.); Cardiothoracic Imaging Section, Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain (I.V.); and MRI Section, Department of Radiology, Clínica Las Nieves, HT-SERCOSA, HT Médica, Jaén, Spain (A.L.)
| | - Constantin A Raptis
- From the Cardiothoracic Imaging Unit (J.B.) and Department of Radiology (J.B., J.R.d.V.), Hospital San Juan de Dios, HT-RESSALTA, HT Médica, Avenida el Brillante No. 36, 14012 Córdoba, Spain; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (K.S., K.M.M., C.A.R., S.B.); Cardiothoracic Imaging Section, Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain (I.V.); and MRI Section, Department of Radiology, Clínica Las Nieves, HT-SERCOSA, HT Médica, Jaén, Spain (A.L.)
| | - Javier Royuela Del Val
- From the Cardiothoracic Imaging Unit (J.B.) and Department of Radiology (J.B., J.R.d.V.), Hospital San Juan de Dios, HT-RESSALTA, HT Médica, Avenida el Brillante No. 36, 14012 Córdoba, Spain; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (K.S., K.M.M., C.A.R., S.B.); Cardiothoracic Imaging Section, Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain (I.V.); and MRI Section, Department of Radiology, Clínica Las Nieves, HT-SERCOSA, HT Médica, Jaén, Spain (A.L.)
| | - Ivan Vollmer
- From the Cardiothoracic Imaging Unit (J.B.) and Department of Radiology (J.B., J.R.d.V.), Hospital San Juan de Dios, HT-RESSALTA, HT Médica, Avenida el Brillante No. 36, 14012 Córdoba, Spain; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (K.S., K.M.M., C.A.R., S.B.); Cardiothoracic Imaging Section, Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain (I.V.); and MRI Section, Department of Radiology, Clínica Las Nieves, HT-SERCOSA, HT Médica, Jaén, Spain (A.L.)
| | - Sanjeev Bhalla
- From the Cardiothoracic Imaging Unit (J.B.) and Department of Radiology (J.B., J.R.d.V.), Hospital San Juan de Dios, HT-RESSALTA, HT Médica, Avenida el Brillante No. 36, 14012 Córdoba, Spain; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (K.S., K.M.M., C.A.R., S.B.); Cardiothoracic Imaging Section, Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain (I.V.); and MRI Section, Department of Radiology, Clínica Las Nieves, HT-SERCOSA, HT Médica, Jaén, Spain (A.L.)
| | - Antonio Luna
- From the Cardiothoracic Imaging Unit (J.B.) and Department of Radiology (J.B., J.R.d.V.), Hospital San Juan de Dios, HT-RESSALTA, HT Médica, Avenida el Brillante No. 36, 14012 Córdoba, Spain; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (K.S., K.M.M., C.A.R., S.B.); Cardiothoracic Imaging Section, Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain (I.V.); and MRI Section, Department of Radiology, Clínica Las Nieves, HT-SERCOSA, HT Médica, Jaén, Spain (A.L.)
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9
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Paudyal R, Shah AD, Akin O, Do RKG, Konar AS, Hatzoglou V, Mahmood U, Lee N, Wong RJ, Banerjee S, Shin J, Veeraraghavan H, Shukla-Dave A. Artificial Intelligence in CT and MR Imaging for Oncological Applications. Cancers (Basel) 2023; 15:cancers15092573. [PMID: 37174039 PMCID: PMC10177423 DOI: 10.3390/cancers15092573] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 05/15/2023] Open
Abstract
Cancer care increasingly relies on imaging for patient management. The two most common cross-sectional imaging modalities in oncology are computed tomography (CT) and magnetic resonance imaging (MRI), which provide high-resolution anatomic and physiological imaging. Herewith is a summary of recent applications of rapidly advancing artificial intelligence (AI) in CT and MRI oncological imaging that addresses the benefits and challenges of the resultant opportunities with examples. Major challenges remain, such as how best to integrate AI developments into clinical radiology practice, the vigorous assessment of quantitative CT and MR imaging data accuracy, and reliability for clinical utility and research integrity in oncology. Such challenges necessitate an evaluation of the robustness of imaging biomarkers to be included in AI developments, a culture of data sharing, and the cooperation of knowledgeable academics with vendor scientists and companies operating in radiology and oncology fields. Herein, we will illustrate a few challenges and solutions of these efforts using novel methods for synthesizing different contrast modality images, auto-segmentation, and image reconstruction with examples from lung CT as well as abdome, pelvis, and head and neck MRI. The imaging community must embrace the need for quantitative CT and MRI metrics beyond lesion size measurement. AI methods for the extraction and longitudinal tracking of imaging metrics from registered lesions and understanding the tumor environment will be invaluable for interpreting disease status and treatment efficacy. This is an exciting time to work together to move the imaging field forward with narrow AI-specific tasks. New AI developments using CT and MRI datasets will be used to improve the personalized management of cancer patients.
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Affiliation(s)
- Ramesh Paudyal
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
| | - Akash D Shah
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
| | - Oguz Akin
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
| | - Richard K G Do
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
| | - Amaresha Shridhar Konar
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
| | - Vaios Hatzoglou
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
| | - Usman Mahmood
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
| | - Nancy Lee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
| | - Richard J Wong
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
| | | | | | - Harini Veeraraghavan
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
| | - Amita Shukla-Dave
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, NY 10065, USA
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10
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Samir A, Elmenem HAEA, Rizk A, Elnekeidy A, Baess AI, Altarawy D. Suspicious lung lesions for malignancy: the lesion-to-spinal cord signal intensity ratio in T2WI and DWI–MRI versus PET/CT; a prospective pathologic correlated study with accuracy and ROC analyses. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2023; 54:67. [DOI: 10.1186/s43055-023-01017-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/01/2023] [Indexed: 09/01/2023] Open
Abstract
Abstract
Background
The multi-detector computed tomography (MDCT) and tissue biopsy are the gold standards for the evaluation of lung malignancies. However, there is a wide range of pulmonary indeterminate lesions that could mimic lung cancer. Furthermore, the diagnosis of malignancy could be challenging if the lesion is small and early presenting by a part-solid or ground-glass nodule or if surrounded by parenchymal lung reaction with consolidation and atelectasis. The previous literature focused on the role of diffusion-weighted image–magnetic resonance imaging (DWI) and the apparent diffusion coefficient (ADC) mapping in the evaluation of lung malignancy. A novel quantitative T2 assessment is provided and tested in this study. Aim of the work: To evaluate the accuracy of specific non-invasive quantitative magnetic resonance imaging (MRI) parameters in the characterization of suspicious lung lesions and the discrimination between the malignant and benign nature. They included the lesion-to-spinal cord signal intensity ratio in T2-WI and DWI as well as the mean and minimum apparent diffusion coefficient (ADC) values. This is performed using a prospective pathologic correlated study with receiver-operating characteristics (ROC) analysis and comparison with positron emission tomography (PET-CT) accuracy results.
Results
This study was prospectively performed during the period between June/2021 and June/2022. It was conducted on 43 suspicious lung lesions detected by MDCT. MRI and PET/CT examinations were performed for all patients, and the results were compared to the final diagnosis obtained after biopsy and pathological assessment, using the statistical tests of significance and P-value. Cutoff values were automatically calculated, and then, accuracy tests and ROC analyses were performed. Five expert radiologists and a single consulting pulmonologist participated in this study. The inter-rater reliability ranges between good and excellent with the intra-class correlation coefficient (ICC) ranging between 0.85 and 0.94. In T2-WI: The lesion-to-spinal cord signal intensity ratio was higher in the malignant group (1.35 ± 0.29) than in the benign group (0.88 ± 0.40), (P < 0.001). At the estimated cutoff value (> 1), the sensitivity was 96.43%, the specificity was 80.00%, and AUC = 0.86. In b500-DWI: The lesion-to-spinal cord signal intensity ratio was higher in the malignant group (0.70–1.35) than in the benign group (0.20–0.70) (P < 0.001). At the estimated cutoff value (> 0.7), the sensitivity was 71.43%, the specificity was 86.67%, and AUC = 0.86. The mean and minimum ADC values were lower in the malignant group (0.6–1.3 and 0.3–1.1 × 10–3 mm2/s) than the benign group (1–1.6 and 0.7–1.4 × 10–3 mm2/s), (P < 0.01 and < 0.001, respectively). At their estimated cutoff values (≤ 1.2 and ≤ 0.9 × 10–3 mm2/s, respectively), the sensitivity was (71.4 and 85.7%), specificity was (83.3 and 66.7%), respectively, and AUC = 0.77 for both. PET/CT had 96.4% sensitivity, 92.3% specificity, and AUC = 0.94.
Conclusions
PET-CT remains the most specific and sensitive tool for the differentiation between benign and malignant lesions. The lesion-to-cord signal intensity ratios in T2WI and DWI-MRI and to a minor extent the mean and minimum ADC values are also considered good parameters for this differentiation based on their accurate statistical results, particularly if PET/CT was not available or feasible. The study added to the previous literature a novel quantitative T2WI assessment which proved a high sensitivity equal to PET/CT with a lower but a good specificity. The availability, expertise, time factor, and patients' tolerance remain challenging factors for MRI.
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Liu J, Xia X, Zou Q, Xie X, Lei Y, Wan Q, Li X. Diagnostic performance of diffusion-weighted imaging versus 18F-FDG PET/CT in differentiating pulmonary lesions: an updated meta-analysis of comparative studies. BMC Med Imaging 2023; 23:37. [PMID: 36899303 PMCID: PMC10007793 DOI: 10.1186/s12880-023-00990-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 02/23/2023] [Indexed: 03/12/2023] Open
Abstract
OBJECTIVE To compare the diagnostic accuracy of diffusion-weighted imaging (DWI) and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for differentiating pulmonary nodules and masses. METHODS We systematically searched six databases, including PubMed, EMBASE, the Cochrane Library, and three Chinese databases, to identify studies that used both DWI and PET/CT to differentiate pulmonary nodules. The diagnostic performance of DWI and PET/CT was compared and pooled sensitivity and specificity were calculated along with 95% confidence intervals (CIs). The Quality Assessment of Diagnostic Accuracy Studies 2 was used to assess the quality of the included studies, and STATA 16.0 software was utilized to perform statistical analysis. RESULTS Overall, 10 studies that enrolled a total of 871 patients with 948 pulmonary nodules were included in this meta-analysis. DWI had greater pooled sensitivity (0.85 [95% CI 0.77-0.90]) and specificity (0.91 [95% CI 0.82-0.96]) than PET/CT (sensitivity, 0.82 [95% CI 0.70-0.90]); specificity, (0.81, [95% CI 0.72-0.87]). The area under the curve of DWI and PET/CT were 0.94 (95% CI 0.91-0.96) and 0.87 (95% CI 0.84-0.90) (Z = 1.58, P > 0.05), respectively. The diagnostic odds ratio of DWI (54.46, [95% CI 17.98-164.99]) was superior to that of PET/CT (15.77, [95% CI 8.19-30.37]). The Deeks' funnel plot asymmetry test showed no publication bias. The Spearman correlation coefficient test revealed no significant threshold effect. Lesion diameter and reference standard could be potential causes for the heterogeneity of both DWI and PET/CT studies, and quantitative or semi-quantitative parameters used would be a potential source of bias for PET/CT studies. CONCLUSION As a radiation-free technique, DWI may have similar performance compare with PET/CT in differentiating malignant pulmonary nodules or masses from benign ones.
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Affiliation(s)
- Jieqiong Liu
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Yanjiangxilu No 151, Guangzhou, 510120, China
| | - Xiaoying Xia
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Yanjiangxilu No 151, Guangzhou, 510120, China
| | - Qiao Zou
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Yanjiangxilu No 151, Guangzhou, 510120, China
| | - Xiaobin Xie
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Yanjiangxilu No 151, Guangzhou, 510120, China
| | - Yongxia Lei
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Yanjiangxilu No 151, Guangzhou, 510120, China
| | - Qi Wan
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Yanjiangxilu No 151, Guangzhou, 510120, China.
| | - Xinchun Li
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Yanjiangxilu No 151, Guangzhou, 510120, China.
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State of the Art MR Imaging for Lung Cancer TNM Stage Evaluation. Cancers (Basel) 2023; 15:cancers15030950. [PMID: 36765907 PMCID: PMC9913625 DOI: 10.3390/cancers15030950] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/20/2023] [Accepted: 01/28/2023] [Indexed: 02/05/2023] Open
Abstract
Since the Radiology Diagnostic Oncology Group (RDOG) report had been published in 1991, magnetic resonance (MR) imaging had limited clinical availability for thoracic malignancy, as well as pulmonary diseases. However, technical advancements in MR systems, such as sequence and reconstruction methods, and adjustments in the clinical protocol for gadolinium contrast media administration have provided fruitful results and validated the utility of MR imaging (MRI) for lung cancer evaluations. These techniques include: (1) contrast-enhanced MR angiography for T-factor evaluation, (2) short-time inversion recovery turbo spin-echo sequences as well as diffusion-weighted imaging (DWI) for N-factor assessment, and (3) whole-body MRI with and without DWI and with positron emission tomography fused with MRI for M-factor or TNM stage evaluation as well as for postoperative recurrence assessment of lung cancer or other thoracic tumors using 1.5 tesla (T) or 3T systems. According to these fruitful results, the Fleischner Society has changed its position to approve of MRI for lung or thoracic diseases. The purpose of this review is to analyze recent advances in lung MRI with a particular focus on lung cancer evaluation, clinical staging, and recurrence assessment evaluation.
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Mirshahvalad SA, Metser U, Basso Dias A, Ortega C, Yeung J, Veit-Haibach P. 18F-FDG PET/MRI in Detection of Pulmonary Malignancies: A Systematic Review and Meta-Analysis. Radiology 2023; 307:e221598. [PMID: 36692397 DOI: 10.1148/radiol.221598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background There have been conflicting results regarding fluorine 18-labeled fluorodeoxyglucose (18F-FDG) PET/MRI diagnostic performance in lung malignant neoplasms. Purpose To evaluate the diagnostic performance of 18F-FDG PET/MRI for the detection of pulmonary malignant neoplasms. Materials and Methods A systematic search was conducted within the Scopus, Web of Science, and PubMed databases until December 31, 2021. Published original articles that met the following criteria were considered eligible for meta-analysis: (a) detecting malignant lesions in the lung, (b) comparing 18F-FDG PET/MRI with a valid reference standard, and (c) providing data for the meta-analytic calculations. A hierarchical method was used to pool the performances. The bivariate model was used to find the summary points and 95% CIs. The hierarchical summary receiver operating characteristic model was used to draw the summary receiver operating characteristic curve and calculate the area under the curve. The Higgins I2 statistic and Cochran Q test were used for heterogeneity assessment. Results A total of 43 studies involving 1278 patients met the inclusion criteria and were included in the meta-analysis. 18F-FDG PET/MRI had a pooled sensitivity and specificity of 96% (95% CI: 84, 99) and 100% (95% CI: 98, 100), respectively. 18F-FDG PET/CT had a pooled sensitivity and specificity of 99% (95% CI: 61, 100) and 99% (95% CI: 94, 100), respectively, which were comparable with those of 18F-FDG PET/MRI. At meta-regression, studies in which contrast media (P = .03) and diffusion-weighted imaging (P = .04) were used as a part of a pulmonary 18F-FDG PET/MRI protocol showed significantly higher sensitivities. Conclusion Fluorine 18-labeled fluorodeoxyglucose (18F-FDG) PET/MRI was found to be accurate and comparable with 18F-FDG PET/CT in the detection of malignant pulmonary lesions, with significantly improved sensitivity when advanced acquisition protocols were used. © RSNA, 2023 Supplemental material is available for this article.
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Affiliation(s)
- Seyed Ali Mirshahvalad
- From the Joint Department of Medical Imaging (S.A.M., U.R., A.B.D., C.O., P.V.H.) and Division of Thoracic Surgery, Department of Surgery (J.Y.), Toronto General Hospital, University Health Network, University of Toronto, 585 University Ave, Toronto, ON, Canada M5G 2N2
| | - Ur Metser
- From the Joint Department of Medical Imaging (S.A.M., U.R., A.B.D., C.O., P.V.H.) and Division of Thoracic Surgery, Department of Surgery (J.Y.), Toronto General Hospital, University Health Network, University of Toronto, 585 University Ave, Toronto, ON, Canada M5G 2N2
| | - Adriano Basso Dias
- From the Joint Department of Medical Imaging (S.A.M., U.R., A.B.D., C.O., P.V.H.) and Division of Thoracic Surgery, Department of Surgery (J.Y.), Toronto General Hospital, University Health Network, University of Toronto, 585 University Ave, Toronto, ON, Canada M5G 2N2
| | - Claudia Ortega
- From the Joint Department of Medical Imaging (S.A.M., U.R., A.B.D., C.O., P.V.H.) and Division of Thoracic Surgery, Department of Surgery (J.Y.), Toronto General Hospital, University Health Network, University of Toronto, 585 University Ave, Toronto, ON, Canada M5G 2N2
| | - Jonathan Yeung
- From the Joint Department of Medical Imaging (S.A.M., U.R., A.B.D., C.O., P.V.H.) and Division of Thoracic Surgery, Department of Surgery (J.Y.), Toronto General Hospital, University Health Network, University of Toronto, 585 University Ave, Toronto, ON, Canada M5G 2N2
| | - Patrick Veit-Haibach
- From the Joint Department of Medical Imaging (S.A.M., U.R., A.B.D., C.O., P.V.H.) and Division of Thoracic Surgery, Department of Surgery (J.Y.), Toronto General Hospital, University Health Network, University of Toronto, 585 University Ave, Toronto, ON, Canada M5G 2N2
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14
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Ohno Y, Yui M, Takenaka D, Yoshikawa T, Koyama H, Kassai Y, Yamamoto K, Oshima Y, Hamabuchi N, Hanamatsu S, Obama Y, Ueda T, Ikeda H, Hattori H, Murayama K, Toyama H. Computed DWI MRI Results in Superior Capability for N-Stage Assessment of Non-Small Cell Lung Cancer Than That of Actual DWI, STIR Imaging, and FDG-PET/CT. J Magn Reson Imaging 2023; 57:259-272. [PMID: 35753082 DOI: 10.1002/jmri.28288] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/31/2022] [Accepted: 05/31/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Computed diffusion-weighted imaging (cDWI) is a mathematical computation technique that generates DWIs for any b-value by using actual DWI (aDWI) data with at least two different b-values and may improve differentiation of metastatic from nonmetastatic lymph nodes. PURPOSE To determine the appropriate b-value for cDWI to achieve a better diagnostic capability for lymph node staging (N-staging) in non-small cell lung cancer (NSCLC) patients compared to aDWI, short inversion time (TI) inversion recovery (STIR) imaging, or positron emission tomography with 2-[fluorine-18] fluoro-2-deoxy-d-glucose combined with computed tomography (FDG-PET/CT). STUDY TYPE Prospective. SUBJECTS A total of 245 (127 males and 118 females; mean age 72 years) consecutive histopathologically confirmed NSCLC patients. FIELD STRENGTH/SEQUENCE A 3 T, half-Fourier single-shot turbo spin-echo sequence, electrocardiogram (ECG)-triggered STIR fast advanced spin-echo (FASE) sequence with black blood and STIR acquisition and DWI obtained by FASE with b-values of 0 and 1000 sec/mm2 . ASSESSMENT From aDWIs with b-values of 0 and 1000 (aDWI1000 ) sec/mm2 , cDWI using 400 (cDWI400 ), 600 (cDWI600 ), 800 (cDWI800 ), and 2000 (cDWI2000 ) sec/mm2 were generated. Then, 114 metastatic and 114 nonmetastatic nodes (mediastinal and hilar lymph nodes) were selected and evaluated with a contrast ratio (CR) for each cDWI and aDWI, apparent diffusion coefficient (ADC), lymph node-to-muscle ratio (LMR) on STIR, and maximum standard uptake value (SUVmax ). STATISTICAL TESTS Receiver operating characteristic curve (ROC) analysis, Youden index, and McNemar's test. RESULTS Area under the curve (AUC) of CR600 was significantly larger than the CR400 , CR800 , CR2000 , aCR1000 , and SUVmax . Comparison of N-staging accuracy showed that CR600 was significantly higher than CR400 , CR2000 , ADC, aCR1000 , and SUVmax , although there were no significant differences with CR800 (P = 0.99) and LMR (P = 0.99). DATA CONCLUSION cDWI with b-value at 600 sec/mm2 may have potential to improve N-staging accuracy as compared with aDWI, STIR, and PET/CT. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Yoshiharu Ohno
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan.,Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan.,Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masao Yui
- Canon Medical Systems Corporation, Otawara, Japan
| | | | - Takeshi Yoshikawa
- Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.,Department of Radiology, Hyogo Cancer Center, Akashi, Japan
| | - Hisanobu Koyama
- Department of Radiology, Osaka Police Hospital, Osaka, Japan
| | | | | | - Yuka Oshima
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Nayu Hamabuchi
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Satomu Hanamatsu
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yuki Obama
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Takahiro Ueda
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hirotaka Ikeda
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hidekazu Hattori
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kazuhiro Murayama
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hiroshi Toyama
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
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15
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Ohno Y, Yoshikawa T, Takenaka D, Koyama H, Aoyagi K, Yui M, Oshima Y, Hamabuchi N, Tanaka Y, Shigemura C, Oota S, Nomura M, Murayama K, Inui Y, Kikukawa K, Toyama H. Small Cell Lung Cancer Staging: Prospective Comparison of Conventional Staging Tests, FDG PET/CT, Whole-Body MRI, and Coregistered FDG PET/MRI. AJR Am J Roentgenol 2022; 218:899-908. [PMID: 34877872 DOI: 10.2214/ajr.21.26868] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND. Whole-body MRI and FDG PET/MRI have shown encouraging results for staging of thoracic malignancy but are poorly studied for staging of small cell lung cancer (SCLC). OBJECTIVE. The purpose of our study was to compare the performance of conventional staging tests, FDG PET/CT, whole-body MRI, and FDG PET/MRI for staging of SCLC. METHODS. This prospective study included 98 patients (64 men, 34 women; median age, 74 years) with SCLC who underwent conventional staging tests (brain MRI; neck, chest, and abdominopelvic CT; and bone scintigraphy), FDG PET/CT, and whole-body MRI within 2 weeks before treatment; coregistered FDG PET/MRI was generated. Two nuclear medicine physicians independently reviewed conventional tests and FDG PET/CT examinations in separate sessions, and two chest radiologists independently reviewed whole-body MRI and FDG PET/MRI examinations in separate sessions. Readers assessed T, N, and M categories; TNM stage; and Veterans Administration Lung Cancer Study Group (VALSG) stage. Reader pairs subsequently reached consensus. Stages determined clinically during tumor board sessions served as the reference standard. RESULTS. Accuracy for T category was higher (p < .05) for whole-body MRI (94.9%) and FDG PET/MRI (94.9%) than for FDG PET/CT (85.7%). Accuracy for N category was higher (p < .05) for whole-body MRI (84.7%), FDG PET/MRI (83.7%), and FDG PET/CT (81.6%) than for conventional staging tests (75.5%). Accuracy for M category was higher (p < .05) for whole-body MRI (94.9%), FDG PET/MRI (94.9%), and FDG PET/CT (94.9%) than for conventional staging tests (84.7%). Accuracy for TNM stage was higher (p < .05) for whole-body MRI (88.8%) and FDG PET/MRI (86.7%) than for FDG PET/CT (77.6%) and conventional staging tests (72.4%). Accuracy for VALSG stage was higher (p < .05) for whole-body MRI (95.9%), FDG PET/MRI (95.9%), and FDG PET/CT (98.0%) than for conventional staging tests (82.7%). Interobserver agreement, expressed as kappa coefficients, ranged from 0.81 to 0.94 across imaging tests and staging endpoints. CONCLUSION. FDG PET/CT, whole-body MRI, and coregistered FDG PET/MRI outperformed conventional tests for various staging endpoints in patients with SCLC. Whole-body MRI and FDG PET/MRI outperformed FDG PET/CT for T category and thus TNM stage, indicating the utility of MRI for assessing extent of local invasion in SCLC. CLINICAL IMPACT. Incorporation of either MRI approach may improve initial staging evaluation in SCLC.
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Affiliation(s)
- Yoshiharu Ohno
- Department of Radiology, Fujita Health University School of Medicine, Graduate School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Graduate School of Medicine, Toyoake, Japan
- Department of Radiology, Division of Functional and Diagnostic Imaging Research, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takeshi Yoshikawa
- Department of Radiology, Division of Functional and Diagnostic Imaging Research, Kobe University Graduate School of Medicine, Kobe, Japan
- Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan
| | - Daisuke Takenaka
- Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hisanobu Koyama
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
- Department of Radiology, Osaka Police Hospital, Osaka, Japan
| | - Kota Aoyagi
- Canon Medical Systems Corporation, Otawara, Japan
| | - Masao Yui
- Canon Medical Systems Corporation, Otawara, Japan
| | - Yuka Oshima
- Department of Radiology, Fujita Health University School of Medicine, Graduate School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Nayu Hamabuchi
- Department of Radiology, Fujita Health University School of Medicine, Graduate School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Yumi Tanaka
- Department of Radiology, Fujita Health University School of Medicine, Graduate School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Chika Shigemura
- Department of Radiology, Fujita Health University School of Medicine, Graduate School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Seiichiro Oota
- Department of Radiology, Fujita Health University School of Medicine, Graduate School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Masahiko Nomura
- Department of Radiology, Fujita Health University School of Medicine, Graduate School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Kazuhiro Murayama
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Graduate School of Medicine, Toyoake, Japan
| | - Yoshitaka Inui
- Department of Radiology, Fujita Health University School of Medicine, Graduate School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Kaoru Kikukawa
- Department of Radiology, Fujita Health University School of Medicine, Graduate School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Hiroshi Toyama
- Department of Radiology, Fujita Health University School of Medicine, Graduate School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
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Bak SH, Kim C, Kim CH, Ohno Y, Lee HY. Magnetic resonance imaging for lung cancer: a state-of-the-art review. PRECISION AND FUTURE MEDICINE 2022. [DOI: 10.23838/pfm.2021.00170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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17
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Wang D, Qiu B, He H, Yin S, Peng K, Hu N, Guo J, Li Q, Chen N, Chu C, Liu F, Xie CM, Liu H. Tumor response evaluation by combined modalities of chest magnetic resonance imaging and computed tomography in locally advanced non-small cell lung cancer after concurrent chemoradiotherapy. Radiother Oncol 2022; 168:211-220. [DOI: 10.1016/j.radonc.2022.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 01/27/2022] [Accepted: 01/31/2022] [Indexed: 11/16/2022]
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Maffei ME. Magnetic Fields and Cancer: Epidemiology, Cellular Biology, and Theranostics. Int J Mol Sci 2022; 23:1339. [PMID: 35163262 PMCID: PMC8835851 DOI: 10.3390/ijms23031339] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/22/2022] [Accepted: 01/22/2022] [Indexed: 02/08/2023] Open
Abstract
Humans are exposed to a complex mix of man-made electric and magnetic fields (MFs) at many different frequencies, at home and at work. Epidemiological studies indicate that there is a positive relationship between residential/domestic and occupational exposure to extremely low frequency electromagnetic fields and some types of cancer, although some other studies indicate no relationship. In this review, after an introduction on the MF definition and a description of natural/anthropogenic sources, the epidemiology of residential/domestic and occupational exposure to MFs and cancer is reviewed, with reference to leukemia, brain, and breast cancer. The in vivo and in vitro effects of MFs on cancer are reviewed considering both human and animal cells, with particular reference to the involvement of reactive oxygen species (ROS). MF application on cancer diagnostic and therapy (theranostic) are also reviewed by describing the use of different magnetic resonance imaging (MRI) applications for the detection of several cancers. Finally, the use of magnetic nanoparticles is described in terms of treatment of cancer by nanomedical applications for the precise delivery of anticancer drugs, nanosurgery by magnetomechanic methods, and selective killing of cancer cells by magnetic hyperthermia. The supplementary tables provide quantitative data and methodologies in epidemiological and cell biology studies. Although scientists do not generally agree that there is a cause-effect relationship between exposure to MF and cancer, MFs might not be the direct cause of cancer but may contribute to produce ROS and generate oxidative stress, which could trigger or enhance the expression of oncogenes.
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Affiliation(s)
- Massimo E Maffei
- Department Life Sciences and Systems Biology, University of Turin, Via Quarello 15/a, 10135 Turin, Italy
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Tang X, Bai G, Wang H, Guo F, Yin H. Elaboration of Multiparametric MRI-Based Radiomics Signature for the Preoperative Quantitative Identification of the Histological Grade in Patients With Non-Small-Cell Lung Cancer. J Magn Reson Imaging 2022; 56:579-589. [PMID: 35040525 DOI: 10.1002/jmri.28051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The histological grading plays an essential role in the treatment decision of lung cancer. Detected tumors are usually biopsied to confirm histologic grade. How to use MRI extracted radiomics features for accurately grading lung cancer is still challenging. PURPOSE To examine the diagnostic utility of multiparametric MRI radiomics and clinical factors for grading non-small-cell lung cancer (NSCLC). STUDY TYPE Retrospective. POPULATION A total of 148 patients (25.7% female) with postoperative pathologically confirmed NSCLC and divided into the training cohort (N = 110) and the validation cohort (N = 38). FIELD STRENGTH/SEQUENCE A 1.5 T; single-shot turbo spin-echo (TSE), T2-weighted imaging (T2WI), and integrated shimming-echo planar imaging (ISHIM-EPI) diffusion-weighted imaging (DWI). ASSESSMENT A total of 2775 radiomics features were extracted from carcinomatous regions of interest on T2WI, DWI, and the apparent diffusion coefficient (ADC) maps. The five optimal features were selected by using the Student' s t-test, the least absolute shrinkage and selection operator (LASSO) and stepwise regression. The Radscore combined with clinical factors, which selected by univariate and multivariate analyses, to develop a radiomics-clinical nomogram. Its performance was evaluated in the training cohort and the validation cohort. The potential clinical usefulness was analyzed by the receiver operating characteristic curve (ROC), area under the curve (AUC), and the Hosmer-Lemeshow test. STATISTICAL TESTS Student's t-test, univariate analyses, multivariate analyses, LASSO, ROC, AUC, and the Hosmer-Lemeshow test. P < 0.05 was considered statistically significant. RESULTS Favorable discrimination performance was obtained for five optimal features (out of the 2775 features), using the training cohorts (AUC 0.761) and validation cohorts (AUC 0.753). In addition, the radiomics-clinical nomogram significantly improved the ability to identify histological grades in the training cohort (AUC 0.814) and the validation cohort (AUC 0.767). DATA CONCLUSIONS The radiomics-clinical nomogram based on multiparametric MRI might have the potential to distinguish the histological grade of NSCLC. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Xing Tang
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Guoyan Bai
- Department of Clinical Laboratory, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, 710032, China
| | - Hong Wang
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Fan Guo
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Hong Yin
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
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20
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Zhang Q, Wang Y, Qiu S, Chen J, Sun L, Li Q. 3D-PulCNN: Pulmonary cancer classification from hyperspectral images using convolution combination unit based CNN. JOURNAL OF BIOPHOTONICS 2021; 14:e202100142. [PMID: 34405557 DOI: 10.1002/jbio.202100142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/07/2021] [Accepted: 08/05/2021] [Indexed: 06/13/2023]
Abstract
Pulmonary cancer is one of the most common malignancies worldwide. Accurate classification of its subtypes is required in differential diagnosis. However, existing algorithms are mostly based on color images, and the improvement of accuracy is quite challenging. In this study, we propose a convolution combination unit (CCU)-based three-dimensional convolutional neural network (3D-PulCNN) for classifying pulmonary cancer presented in microscopic hyperspectral image with both spatial and spectral information. CCU is designed to fuse the features acquired by different convolution scales. Compared with VGGNet, only two fully connected layers are used in this model, reducing the network parameters and model complexity. Experimental results show that 3D-PulCNN achieves overall average (OA) of 0.962 and Precision, Recall, and Kappa of more than 0.920, superior to 2D-VGGNet. Then, 3D-UNet is leveraged to segment cancer cells, and their morphological characteristics are calculated to supply quantitative virtual analysis data for classification results explanation and prognosis assessment.
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Affiliation(s)
- Qing Zhang
- Shanghai Key Laboratory of Multidimensional Information Processing, East China Normal University, Shanghai, China
| | - Yan Wang
- Shanghai Key Laboratory of Multidimensional Information Processing, East China Normal University, Shanghai, China
| | - Song Qiu
- Shanghai Key Laboratory of Multidimensional Information Processing, East China Normal University, Shanghai, China
| | - Jiangang Chen
- Shanghai Key Laboratory of Multidimensional Information Processing, East China Normal University, Shanghai, China
| | - Li Sun
- Shanghai Key Laboratory of Multidimensional Information Processing, East China Normal University, Shanghai, China
| | - Qingli Li
- Shanghai Key Laboratory of Multidimensional Information Processing, East China Normal University, Shanghai, China
- Engineering Center of SHMEC for Space Information and GNSS, East China Normal University, Shanghai, China
- Engineering Research Center of Nanophotonics & Advanced Instrument, Ministry of Education, East China Normal University, Shanghai, China
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21
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Yu H, Kim DJ, Choi HY, Kim SM, Rahaman MI, Kim YH, Kim SW. Prospective pharmacological methodology for establishing and evaluating anti-cancer drug resistant cell lines. BMC Cancer 2021; 21:1049. [PMID: 34560848 PMCID: PMC8464141 DOI: 10.1186/s12885-021-08784-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/15/2021] [Indexed: 11/10/2022] Open
Abstract
Background Cell lines are often used to assess the resistance of anticancer drugs when in vivo analysis is not possible. However, the process for establishing anti-cancer drug resistance in cell cultures in vitro and the subsequent method of then evaluating resistance are not clearly established. Traditionally, the IC50 is the most commonly used indicator of resistance evaluation but it cannot represent the effectiveness of anti-cancer drugs in a clinical setting and lacks reliability because it is heavily affected by the cell doubling time. Hence, new indicators that can evaluate anti-cancer drug resistance are needed. Methods A novel resistance evaluation methodology was validated in this present study by establishing sunitinib resistance in renal cell carcinoma cells and assessing the cross-resistance of five different anti-cancer drugs. Results It was confirmed in this present study that the IC50 does not reflect the cell proliferation rates in a way that represents anti-cancer drug resistance. An alternative indicator that can also be clinically meaningful when using in vitro cell line systems is GI100. Additionally, the GR100 allows different cell populations to be calibrated on the same basis when multiple experimental results are compared. Conclusion Since the GR100 has properties that indicate the efficiency of anti-cancer drugs, both the efficacy and GR100 of a particular anti-cancer drug can be used to effectively assess the resistance. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08784-7.
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Affiliation(s)
- Hoon Yu
- Division of Nephrology, Department of Internal Medicine, GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
| | - Dong-Jin Kim
- Drug Evaluation Department, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Osong, Cheongju, Republic of Korea
| | - Hye-Young Choi
- Department of Pharmacology, Catholic Kwandong University College of Medicine, Gangneung, Republic of Korea
| | - So Myoung Kim
- Department of Pharmacology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea.,Bio-Medical Institute of Technology, University of Ulsan, Seoul, Republic of Korea
| | - Md Intazur Rahaman
- Department of Pharmacology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea.,Bio-Medical Institute of Technology, University of Ulsan, Seoul, Republic of Korea
| | - Young-Hoon Kim
- Department of Pharmacology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea. .,Bio-Medical Institute of Technology, University of Ulsan, Seoul, Republic of Korea.
| | - So Won Kim
- Department of Pharmacology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea. .,Bio-Medical Institute of Technology, University of Ulsan, Seoul, Republic of Korea.
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22
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Updates and Ongoing Challenges in Imaging of Multiple Myeloma: AJR Expert Panel Narrative Review. AJR Am J Roentgenol 2021; 217:775-785. [PMID: 33978464 DOI: 10.2214/ajr.21.25878] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Advances in the understanding and treatment of multiple myeloma have led to the need for more sensitive and accurate imaging of intramedullary and extramedullary disease. This role of imaging is underscored by recently revised imaging recommendations of the International Myeloma Working Group (IMWG). This narrative review discusses these recommendations from the IMWG for different disease stages, focusing on advanced whole-body modalities, and addresses related challenges and controversies. In the recommendations, whole-body low-dose CT is central in initial patient assessment, replacing the conventional skeletal survey. Although the recommendations favor MRI for diagnosis because of its superior sensitivity and utility in identifying myeloma-defining events, FDG PET/CT is recommended as the modality of choice for assessing treatment response. Consensus opinions are offered regarding the role of imaging in multiple myeloma for characterization of disease distribution, determination of prognosis, and response evaluation.
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23
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Tanaka Y, Ohno Y, Hanamatsu S, Obama Y, Ueda T, Ikeda H, Iwase A, Fukuba T, Hattori H, Murayama K, Yoshikawa T, Takenaka D, Koyama H, Toyama H. State-of-the-art MR Imaging for Thoracic Diseases. Magn Reson Med Sci 2021; 21:212-234. [PMID: 33952785 PMCID: PMC9199970 DOI: 10.2463/mrms.rev.2020-0184] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Since thoracic MR imaging was first used in a clinical setting, it has been suggested that MR imaging has limited clinical utility for thoracic diseases, especially lung diseases, in comparison with x-ray CT and positron emission tomography (PET)/CT. However, in many countries and states and for specific indications, MR imaging has recently become practicable. In addition, recently developed pulmonary MR imaging with ultra-short TE (UTE) and zero TE (ZTE) has enhanced the utility of MR imaging for thoracic diseases in routine clinical practice. Furthermore, MR imaging has been introduced as being capable of assessing pulmonary function. It should be borne in mind, however, that these applications have so far been academically and clinically used only for healthy volunteers, but not for patients with various pulmonary diseases in Japan or other countries. In 2020, the Fleischner Society published a new report, which provides consensus expert opinions regarding appropriate clinical indications of pulmonary MR imaging for not only oncologic but also pulmonary diseases. This review article presents a brief history of MR imaging for thoracic diseases regarding its technical aspects and major clinical indications in Japan 1) in terms of what is currently available, 2) promising but requiring further validation or evaluation, and 3) developments warranting research investigations in preclinical or patient studies. State-of-the-art MR imaging can non-invasively visualize lung structural and functional abnormalities without ionizing radiation and thus provide an alternative to CT. MR imaging is considered as a tool for providing unique information. Moreover, prospective, randomized, and multi-center trials should be conducted to directly compare MR imaging with conventional methods to determine whether the former has equal or superior clinical relevance. The results of these trials together with continued improvements are expected to update or modify recommendations for the use of MRI in near future.
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Affiliation(s)
- Yumi Tanaka
- Department of Radiology, Fujita Health University School of Medicine
| | - Yoshiharu Ohno
- Department of Radiology, Fujita Health University School of Medicine.,Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine
| | - Satomu Hanamatsu
- Department of Radiology, Fujita Health University School of Medicine
| | - Yuki Obama
- Department of Radiology, Fujita Health University School of Medicine
| | - Takahiro Ueda
- Department of Radiology, Fujita Health University School of Medicine
| | - Hirotaka Ikeda
- Department of Radiology, Fujita Health University School of Medicine
| | - Akiyoshi Iwase
- Department of Radiology, Fujita Health University Hospital
| | - Takashi Fukuba
- Department of Radiology, Fujita Health University Hospital
| | - Hidekazu Hattori
- Department of Radiology, Fujita Health University School of Medicine
| | - Kazuhiro Murayama
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine
| | | | | | | | - Hiroshi Toyama
- Department of Radiology, Fujita Health University School of Medicine
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24
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Liu D, Mao Y, Ma H. Value of circulating tumor cells in the diagnosis and treatment of solitary pulmonary nodules. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:501. [PMID: 33850898 PMCID: PMC8039692 DOI: 10.21037/atm-21-889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Background Lung cancer has become the most common malignant tumor worldwide, with the highest rates of morbidity and mortality. The detection of circulating tumor cells (CTCs) can be simple, rapid, and minimally invasive, thus endowing them with a high value in the diagnosis of malignant tumors. We aimed to explore the correlation between CTCs in peripheral blood and benign or malignant solitary pulmonary nodules (SPNs). Methods A total of 223 patients with SPNs from January 2018 to May 2020 were recruited. During the same period, 20 healthy volunteers were recruited as controls. Venous blood samples were collected from participants for detecting CTCs using a folate receptor (FR)-positive cell detection kit, as well as tumor biomarkers. Results A significant difference in the level of CTCs were observed between the malignant SPNs group, the benign SPNs group, and the control group, which was markedly higher in the malignant SPNs group (10.48±3.49 FU/3 mL) than both the benign SPNs and control groups (6.38±0.53 and 4.45±1.21 FU/3 mL, respectively) (P<0.001). In addition, the level of CTCs was significantly higher in the benign SPNs group than in the control group (P=0.023). In particular, in the malignant SPNs group, patients older than 60 years (11.45±3.92 FU/3 mL) presented a notably higher level of CTCs than other patients (9.55±2.74 FU/3 mL). The patients were then classified according to the pathological subtypes of lung cancer. There was a significant difference in level of CTCs among patients with squamous cell carcinoma (9.10±1.94 FU/3 mL), adenocarcinoma (10.77±3.71 FU/3 mL), and adenosquamous cell carcinoma (11.78±2.61 FU/3 mL). Binary logistic regression analysis suggested that CTCs were an independent risk factor of malignant SPN (OR =3.698, 95% CI: 1.136–11.035, P=0.030). The sensitivity and specificity of CTCs in diagnosing malignant SPNs was significantly higher than tumor biomarkers (single or combined) [sensitivity =89.1%; specificity =92.3%; area under curve (AUC) (95% CI) =0.907 (0.861–0.942)]. Conclusions Peripheral blood CTCs can be used in the diagnosis of malignant SPNs and are recommended for clinical application.
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Affiliation(s)
- Desen Liu
- Department of Thoracic Surgery, Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine, Suzhou, China
| | - Yiming Mao
- Department of Thoracic Surgery, Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine, Suzhou, China
| | - Haitao Ma
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China.,Department of Thoracic Surgery, The Dushuhu Affiliated Hospital of Soochow University, Suzhou, China
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25
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Lu Y, Huang J, Li F, Wang Y, Ding M, Zhang J, Yin H, Zhang R, Ren X. EGFR-specific single-chain variable fragment antibody-conjugated Fe 3O 4/Au nanoparticles as an active MRI contrast agent for NSCLC. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2021; 34:581-591. [PMID: 33624188 PMCID: PMC7902179 DOI: 10.1007/s10334-021-00916-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 12/24/2022]
Abstract
Overexpression of epidermal growth factor receptor (EGFR) is closely associated with a poor prognosis in non-small cell lung cancer (NSCLC), thus making it a promising biomarker for NSCLC diagnosis. Here, we conjugated a single-chain antibody (scFv) targeting EGFR with Fe3O4/Au nanoparticles to form an EGFR-specific molecular MRI bioprobe (scFv@Fe3O4/Au) to better detect EGFR-positive NSCLC tumors in vivo. In vitro, we demonstrated that the EGFR-specific scFv could specifically deliver Fe3O4/Au to EGFR-positive NSCLC cells. In vivo experiments showed that the accumulation of scFv@Fe3O4/Au in tumor tissue was detectable by magnetic resonance imaging (MRI) at the indicated time points after systemic injection. The T2W signal-to-noise ratio (SNR) of EGFR-positive SPC-A1 tumors was significantly decreased after scFv@Fe3O4/Au injection, which was not observed in the tumors of mice injected with BSA@Fe3O4/Au. Furthermore, transmission electron microscopy (TEM) analysis showed the specific localization of scFv@Fe3O4/Au in the SPC-A1 tumor cell cytoplasm. Collectively, the results of our study demonstrated that scFv@Fe3O4/Au might be a useful probe for the noninvasive diagnosis of EGFP-positive NSCLC.
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Affiliation(s)
- Yuan Lu
- Department of Respiratory and Critical Care Medicine, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, China
| | - Jing Huang
- Department of Respiratory and Critical Care Medicine, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, China
| | - Fakai Li
- Department of Respiratory and Critical Care Medicine, Jinhua Guangfu Hospital, Jinhua, Zhejiang, China
| | - Yuan Wang
- The Second Section of Internal Medicine, Xi'an Thoracic Hospital, Xi'an, Shannxi, China
| | - Ming Ding
- Department of Respiratory and Critical Care Medicine, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, China
| | - Jian Zhang
- Department of Respiratory and Critical Care Medicine, Xijing Hospital, Air Force Medical University of PLA (the Fourth Military Medical University), Xi'an, China
| | - Hong Yin
- Department of Radiology, Xijing Hospital, Air Force Medical University of PLA (the Fourth Military Medical University), Xi'an, Shannxi, China.
| | - Rui Zhang
- The State Key Laboratory of Cancer Biology, Department of Immunology, Air Force Medical University of PLA (the Fourth Military Medical University), Xi'an, Shannxi, China.
| | - Xinling Ren
- Department of Respiratory, Shenzhen University General Hospital, Shenzhen University, Xueyuan Ave. 1098, Shenzhen, 518055, Guangdong, China.
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26
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Jagoda P, Fleckenstein J, Sonnhoff M, Schneider G, Ruebe C, Buecker A, Stroeder J. Diffusion-weighted MRI improves response assessment after definitive radiotherapy in patients with NSCLC. Cancer Imaging 2021; 21:15. [PMID: 33478592 PMCID: PMC7818746 DOI: 10.1186/s40644-021-00384-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 01/08/2021] [Indexed: 01/15/2023] Open
Abstract
Background Computed tomography (CT) is the standard procedure for follow-up of non-small-cell lung cancer (NSCLC) after radiochemotherapy. CT has difficulties differentiating between tumor, atelectasis and radiation induced lung toxicity (RILT). Diffusion-weighted imaging (DWI) may enable a more accurate detection of vital tumor tissue. The aim of this study was to determine the diagnostic value of MRI versus CT in the follow-up of NSCLC. Methods Twelve patients with NSCLC stages I-III scheduled for radiochemotherapy were enrolled in this prospective study. CT with i.v. contrast agent and non enhanced MRI were performed before and 3, 6 and 12 months after treatment. Standardized ROIs were used to determine the apparent diffusion weighted coefficient (ADC) within the tumor. Tumor size was assessed by the longest longitudinal diameter (LD) and tumor volume on DWI and CT. RILT was assessed on a 4-point-score in breath-triggered T2-TSE and CT. Results There was no significant difference regarding LD and tumor volume between MRI and CT (p ≥ 0.6221, respectively p ≥ 0.25). Evaluation of RILT showed a very high correlation between MRI and CT at 3 (r = 0.8750) and 12 months (r = 0.903). Assessment of the ADC values suggested that patients with a good tumor response have higher ADC values than non-responders. Conclusions DWI is equivalent to CT for tumor volume determination in patients with NSCLC during follow up. The extent of RILT can be reliably determined by MRI. DWI could become a beneficial method to assess tumor response more accurately. ADC values may be useful as a prognostic marker.
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Affiliation(s)
- Philippe Jagoda
- Clinic for Diagnostic and Interventional Radiology, Saarland University Medical Center, Kirrberger Str. 1, 66421, Homburg, Saar, Germany.
| | - Jochen Fleckenstein
- Department of Radiotherapy and Radiation Oncology, Saarland University Medical Center, Kirrberger Str. Geb. 6.5, 66421, Homburg, Saar, Germany
| | - Mathias Sonnhoff
- Department of Radiotherapy and Radiation Oncology, Saarland University Medical Center, Kirrberger Str. Geb. 6.5, 66421, Homburg, Saar, Germany
| | - Günther Schneider
- Clinic for Diagnostic and Interventional Radiology, Saarland University Medical Center, Kirrberger Str. 1, 66421, Homburg, Saar, Germany
| | - Christian Ruebe
- Department of Radiotherapy and Radiation Oncology, Saarland University Medical Center, Kirrberger Str. Geb. 6.5, 66421, Homburg, Saar, Germany
| | - Arno Buecker
- Clinic for Diagnostic and Interventional Radiology, Saarland University Medical Center, Kirrberger Str. 1, 66421, Homburg, Saar, Germany
| | - Jonas Stroeder
- Clinic for Diagnostic and Interventional Radiology, Saarland University Medical Center, Kirrberger Str. 1, 66421, Homburg, Saar, Germany
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Usuda K, Iwai S, Yamagata A, Iijima Y, Motono N, Matoba M, Doai M, Yamada S, Ueda Y, Hirata K, Uramoto H. Diffusion-weighted whole-body imaging with background suppression (DWIBS) is effective and economical for detection of metastasis or recurrence of lung cancer. Thorac Cancer 2021; 12:676-684. [PMID: 33476488 PMCID: PMC7919163 DOI: 10.1111/1759-7714.13820] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/16/2020] [Accepted: 12/16/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Diffusion-weighted whole-body imaging with background suppression (DWIBS) is used for the diagnosis and staging of cancers. The medical cost of an MR examination including DWIBS is $123, which is 80% less expensive than the cost ($798) of F18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) examination. METHODS This study examined the efficacy of DWIBS for relapses after lung cancer resection. A total of 55 patients who had pulmonary resection of lung cancer, postoperative computed tomography (CT) every six months, and DWIBS and FDG-PET/CT (every year) were enrolled in this study. If a metastatic lesion was detected on CT scan, DWIBS and FDG-PET/CT were also used. RESULTS A total of 55 patients who underwent pulmonary resections for lung cancer, and had CT, DWIBS and FDG-PET/CT examination during follow-up after pulmonary resection were enrolled in this study. Lung cancer in 32 patients relapsed. Postoperative radiographic examinations revealed pulmonary metastases in 17 patients, bone metastases in seven, liver metastases in five, lymph node metastases in five, pleural metastases in four, metastases to the chest wall in two, brain metastases in two, adrenal gland metastasis in one, and renal metastasis in one. The mean apparent diffusion coefficient (ADC) value of the relapse was 0.9 to 1.70 × 10-3 mm2 /s. The accuracy 0.98 (54/55) of DWIBS for detecting multiple metastatic lesions was likely to be higher than 0.94 (52/55) of CT or 0.94 (52/55) of FDG-PET/CT, but there were no significant differences. CONCLUSIONS DWIBS can detect multiple metastatic lesions throughout the entire body and differentiate malignancy from benignity in only one examination. DWIBS has benefits of diagnostic accuracy and is less expensive in medical costs for the detection of a relapse. DWIBS could potentially replace FDG-PET/CT after lung cancer resection.
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Affiliation(s)
- Katsuo Usuda
- Department of Thoracic Surgery, Kanazawa Medical University, Kahoku-gun, Japan
| | - Shun Iwai
- Department of Thoracic Surgery, Kanazawa Medical University, Kahoku-gun, Japan
| | - Aika Yamagata
- Department of Thoracic Surgery, Kanazawa Medical University, Kahoku-gun, Japan
| | - Yoshihito Iijima
- Department of Thoracic Surgery, Kanazawa Medical University, Kahoku-gun, Japan
| | - Nozomu Motono
- Department of Thoracic Surgery, Kanazawa Medical University, Kahoku-gun, Japan
| | - Munetaka Matoba
- Department of Radiology, Kanazawa Medical University, Kahoku-gun, Japan
| | - Mariko Doai
- Department of Radiology, Kanazawa Medical University, Kahoku-gun, Japan
| | - Sohsuke Yamada
- Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Kahoku-gun, Japan
| | - Yoshimichi Ueda
- Department of Pathophysiological and Experimental Pathology, Kanazawa Medical University, Kahoku-gun, Japan
| | - Keiya Hirata
- MRI Center, Kanazawa Medical University, Kahoku-gun, Japan
| | - Hidetaka Uramoto
- Department of Thoracic Surgery, Kanazawa Medical University, Kahoku-gun, Japan
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Bruckmann NM, Kirchner J, Grueneisen J, Li Y, McCutcheon A, Aigner C, Rischpler C, Sawicki LM, Herrmann K, Umutlu L, Schaarschmidt BM. Correlation of the apparent diffusion coefficient (ADC) and standardized uptake values (SUV) with overall survival in patients with primary non-small cell lung cancer (NSCLC) using 18F-FDG PET/MRI. Eur J Radiol 2020; 134:109422. [PMID: 33271432 DOI: 10.1016/j.ejrad.2020.109422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 10/18/2020] [Accepted: 11/15/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To investigate if the combined analysis of the apparent diffusion coefficient (ADC) and standardized uptake values (SUV) measured in 18F-fluoro-deoxy-glucose-positron emission tomography/magnetic resonance imaging (18F-FDG PET/MRI) examinations correlates with overall survival in non-small cell lung cancer (NSCLC). MATERIAL AND METHODS A total of 92 patients with newly diagnosed, histopathologically proven NSCLC (44 women and 48 men, mean age 63.1 ± 9.9y) underwent a dedicated thoracic 18F-FDG PET/MRI examination. A manually drawn polygonal region of interest (ROI), encompassing the entire primary tumor mass, was placed over the primary tumor on fused PET/MR images to determine the maximum and mean standardized uptake values (SUVmax; SUVmean) as well as on the ADC maps to quantify the mean and minimum ADC values (ADCmean, ADCmin). The impact of these parameters to predict patient's overall survival was tested using hazard ratios (HR). Pearson's correlation coefficients were calculated to assess dependencies between the different values. A p-value < 0.05 indicated statistical significance. RESULTS In all 92 patients (n = 59 dead at time of retrospective data collection, mean time till death: 19 ± 16 month, n = 33 alive, mean time to last follow-up: 56 ± 22 month) the Hazard ratios (HR) as independent predictors for overall survival (OS) of SUVmax were 2.37 (95 % CI: 1.23-4.59, p = 0.008) and for SUVmean 1.85 (95 % CI: 1.05-3.26, p = 0.03) while ADCmin showed a HR of 0.95 (95 % CI: 0.57-1.59, p = 0.842) and ADCmean a HR of 2.01 (95 % CI: 1.2-3.38, p = 0.007). Furthermore, a combined analysis for SUVmax/ADCmean, SUVmax / ADCmin and SUVmean/ADCmean revealed a HR of 2.01 (95 % CI: 1.10-3.67, p = 0.02), 1.75 (95 % CI: 0.97-3.15, p = 0.058) and 1.78 (95 % CI: 1.02-3.10, p = 0.04). CONCLUSION SUVmax and SUVmean of the primary tumor are predictors for OS in therapy-naive NSCLC patients, whereas the combined analysis of SUV and ADC values does not improve these results. Therefore, ADC values do not further enhance the diagnostic value of SUV as a prognostic biomarker in NSCLC.
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Affiliation(s)
- Nils Martin Bruckmann
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany; University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany.
| | - Julian Kirchner
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany
| | - Johannes Grueneisen
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany
| | - Yan Li
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany
| | - Angela McCutcheon
- Department of Medical Oncology, West German Cancer Center, University Hospital of Essen, D-45147 Essen, Germany
| | - Clemens Aigner
- Department of Thoracic Surgery, Ruhrlandklinik, University Duisburg-Essen, D-45239 Essen, Germany
| | - Christoph Rischpler
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany
| | - Lino M Sawicki
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany
| | - Benedikt Michael Schaarschmidt
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany
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Sim AJ, Kaza E, Singer L, Rosenberg SA. A review of the role of MRI in diagnosis and treatment of early stage lung cancer. Clin Transl Radiat Oncol 2020; 24:16-22. [PMID: 32596518 PMCID: PMC7306507 DOI: 10.1016/j.ctro.2020.06.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 05/25/2020] [Accepted: 06/01/2020] [Indexed: 12/14/2022] Open
Abstract
Despite magnetic resonance imaging (MRI) being a mainstay in the oncologic care for many disease sites, it has not routinely been used in early lung cancer diagnosis, staging, and treatment. While MRI provides improved soft tissue contrast compared to computed tomography (CT), an advantage in multiple organs, the physical properties of the lungs and mediastinum create unique challenges for lung MRI. Although multi-detector CT remains the gold standard for lung imaging, advances in MRI technology have led to its increased clinical relevance in evaluating early stage lung cancer. Even though positron emission tomography is used more frequently in this context, functional MR imaging, including diffusion-weighted MRI and dynamic contrast-enhanced MRI, are emerging as useful modalities for both diagnosis and evaluation of treatment response for lung cancer. In parallel with these advances, the development of combined MRI and linear accelerator devices (MR-linacs), has spurred the integration of MRI into radiation treatment delivery in the form of MR-guided radiotherapy (MRgRT). Despite challenges for MRgRT in early stage lung cancer radiotherapy, early data utilizing MR-linacs shows potential for the treatment of early lung cancer. In both diagnosis and treatment, MRI is a promising modality for imaging early lung cancer.
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Affiliation(s)
- Austin J. Sim
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Dr., Tampa, FL, USA
| | - Evangelia Kaza
- Department of Radiation Oncology, Dana Farber Cancer Institute, Brigham & Women’s Hospital & Harvard Medical School, 75 Francis St., Boston, MA, USA
| | - Lisa Singer
- Department of Radiation Oncology, Dana Farber Cancer Institute, Brigham & Women’s Hospital & Harvard Medical School, 75 Francis St., Boston, MA, USA
| | - Stephen A. Rosenberg
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Dr., Tampa, FL, USA
- University of South Florida Morsani College of Medicine, 12901 Bruce B. Downs Blvd., Tampa, FL, USA
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Miles A, Evans REC, Halligan S, Beare S, Bridgewater J, Goh V, Janes SM, Navani N, Oliver A, Morton A, Morris S, Rockall A, Taylor SA. Predictors of patient preference for either whole body magnetic resonance imaging (WB-MRI) or CT/ PET-CT for staging colorectal or lung cancer. J Med Imaging Radiat Oncol 2020; 64:537-545. [PMID: 32410378 PMCID: PMC8425331 DOI: 10.1111/1754-9485.13038] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 03/27/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Whole body magnetic resonance imaging (WB-MRI) may be more efficient in staging cancers, but can be harder for patients to tolerate. We examined predictors of patient preference for WB-MRI vs. CT/ PET-CT for staging colorectal or lung cancer. METHODS Patients recruited prospectively to two multicentre trials comparing diagnostic accuracy of WB-MRI with standard staging scans were sent two questionnaires: the first, administered at trial registration, captured demographics, educational level and comorbidities; the second, administered after staging completion, measured emotional distress (GHQ-12), positive mood (PANAS), perceived scan burden, patients' beliefs about WB-MRI, and preference for either WB-MRI or CT (colorectal trial), WB-MRI or PET-CT (lung trial). Preference for WB-MRI or CT/ PET-CT was analysed using logistic regression. RESULTS Baseline and post-staging questionnaires were completed by 97 and 107 patients, respectively. Overall, 56/107 (52%) preferred WB-MRI over standard scans and were more likely to have no additional comorbidities, higher positive mood, greater awareness of potential benefits of WB-MRI and lower levels of perceived WB-MRI scan burden. In adjusted analyses, only awareness of potential WB-MRI benefits remained a significant predictor (OR: 1.516, 95% CIs 1.006-2.284, P = 0.047). Knowledge that WB-MRI does not use radiation predicted preference (adjusted OR: 3.018, 95% CIs 1.099-8.288, P = 0.032), although only 45/107 (42%) patients were aware of this attribute. CONCLUSIONS A small majority of patients undergoing staging of colorectal or lung cancer prefer WB-MRI to CT/ PET-CT. Raising awareness of the potential benefits of WB-MRI, notably lack of ionizing radiation, could influence preference.
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Affiliation(s)
- Anne Miles
- Department of Psychological SciencesBirkbeckUniversity of LondonLondonUK
| | - Ruth EC Evans
- Department of Psychological SciencesBirkbeckUniversity of LondonLondonUK
| | - Steve Halligan
- Centre for Medical ImagingUniversity College LondonCharles Bell HouseUK
| | - Sandy Beare
- Cancer Research UKUniversity College London Clinical Trials CentreLondonUK
| | | | - Vicky Goh
- Cancer ImagingSchool of Biomedical Engineering and Imaging SciencesKing’s College LondonStrand, LondonUK
| | - Sam M Janes
- Lungs for Living Research CentreUCL RespiratoryDivision of MedicineUniversity College LondonLondonUK
| | - Neal Navani
- Department of Thoracic MedicineUCLH and Lungs for Living Research CentreUCL RespiratoryUniversity College LondonLondonUK
| | - Alfred Oliver
- Cancer patient representativesc/o National Cancer Research InstituteLondonUK
| | - Alison Morton
- Cancer patient representativesc/o National Cancer Research InstituteLondonUK
| | - Steve Morris
- Research Department of Applied Health ResearchUniversity College LondonLondonUK
| | - Andrea Rockall
- Department of Surgery and CancerImperial College LondonKensington, LondonUK
| | - Stuart A Taylor
- Centre for Medical ImagingUniversity College LondonCharles Bell HouseUK
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Luo L, Luo Q, Tang L. Diagnostic value and clinical significance of MRI and CT in detecting lymph node metastasis of early cervical cancer. Oncol Lett 2019; 19:700-706. [PMID: 31897185 PMCID: PMC6924181 DOI: 10.3892/ol.2019.11180] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 11/26/2019] [Indexed: 12/25/2022] Open
Abstract
Diagnostic value and clinical significance of magnetic resonance imaging (MRI) and computed tomography (CT) in detecting lymph node metastasis of early cervical cancer were investigated. From April 2015 to April 2019, 160 patients with lymph node metastasis (stage I–II) of early cervical cancer in Jining No. 1 People's Hospital were retrospectively analyzed. All the patients underwent MRI, CT diagnosis and MRI combined with CT diagnosis before operation. Sensitivity, specificity and diagnostic accordance rate, the diagnostic value and clinical significance of MRI, CT and MRI combined with CT in the diagnosis of lymph node metastasis of early cervical cancer were compared. The sensitivity, specificity and diagnostic accordance rate of MRI in the diagnosis of lymph node metastasis of early cervical cancer in stage Ia-Ib were 75.00, 72.92 and 77.50%, respectively, which were significantly higher than those of PET/CT in the same period (P<0.05). The sensitivity, specificity and diagnostic accordance rate of MRI combined with CT in the diagnosis of early cervical cancer in stage Ia-Ib were 78.13, 87.50 and 83.75%, respectively, which were significantly higher than those of MRI or CT alone (P<0.05). However, the sensitivity, specificity and diagnostic accordance rate of MRI combined with CT in the diagnosis of lymph node metastasis of early cervical cancer in stage IIa-IIb were 91.66, 82.81 and 88.13%, respectively, which were significantly higher than those of MRI or CT alone (P<0.05). MRI is superior to CT in the diagnosis of lymph node metastasis of early cervical cancer. However, the diagnostic efficiency of combined scans of the two is far higher than that of MRI or CT alone, which has more diagnostic value. In clinic, MRI and CT should be combined to improve the diagnostic accuracy of diseases.
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Affiliation(s)
- Lan Luo
- Department of Gynaecology, Jining No. 1 People's Hospital, Jining, Shandong 272000, P.R. China
| | - Qian Luo
- Department of Radiology, Jining No. 1 People's Hospital, Jining, Shandong 272000, P.R. China
| | - Liang Tang
- Department of Oncology, Jining No. 1 People's Hospital, Jining, Shandong 272000, P.R. China
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Zhou S, Wang Y, Ai T, Huang L, Zhu T, Zhu W, Xia L. Diagnosis of solitary pulmonary lesions with intravoxel incoherent motion diffusion-weighted MRI and semi-quantitative dynamic contrast-enhanced MRI. Clin Radiol 2019; 74:409.e7-409.e16. [DOI: 10.1016/j.crad.2018.12.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 12/06/2018] [Indexed: 01/02/2023]
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Hou D, Zhao S, Shi J, Wang L, Wang D, Huang Y, Liao X, Xing X, Du L, Yang L, Liu Y, Zhang Y, Wei D, Liu Y, Zhang K, Li N, Chen W, Qiao Y, He J, Dai M, Wu N. Lung cancer imaging methods in China from 2005 to 2014: A national, multicenter study. Thorac Cancer 2019; 10:708-714. [PMID: 30737899 PMCID: PMC6449240 DOI: 10.1111/1759-7714.12988] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 01/03/2019] [Accepted: 01/04/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The study was conducted to examine changes in diagnostic and staging imaging methods for lung cancer in China over a 10-year period and to determine the relationships between such changes and socioeconomic development. METHODS This was a hospital-based, nationwide, multicenter retrospective study of primary lung cancer cases. The data were extracted from the 10-year primary lung cancer databases at eight tertiary hospitals from various geographic areas in China. The chi-squared test was used to assess the differences and the Cochran-Armitage trend test was used to estimate the trends of changes. RESULTS A total of 7184 lung cancer cases were analyzed. Over the 10-year period, the utilization ratio of diagnostic imaging methods, such as chest computed tomography (CT) and chest magnetic resonance imaging (MRI), increased from 65.79% to 81.42% and from 0.73% to 1.96%, respectively, while the utilization ratio of chest X-ray declined from 50.15% to 30.93%. Staging imaging methods, such as positron emission tomography-CT, neck ultrasound, brain MRI, bone scintigraphy, and bone MRI increased from 0.73% to 9.29%, 22.95% to 47.92%, 8.77% to 40.71%, 42.40% to 62.22%, and 0.88% to 4.65%, respectively; abdominal ultrasound declined from 83.33% to 59.9%. These trends were more notable in less developed areas than in areas with substantial economic development. CONCLUSION Overall, chest CT was the most common radiological diagnostic method for lung cancer in China. Imaging methods for lung cancer tend to be used in a diverse, rational, and regionally balanced manner.
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Affiliation(s)
- Dong‐Hui Hou
- Department of Diagnostic RadiologyNational Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Shi‐Jun Zhao
- Department of Diagnostic RadiologyNational Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Ju‐Fang Shi
- Office of Cancer Screening, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Le Wang
- Office of Cancer Screening, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - De‐Bin Wang
- School of Health Services ManagementAnhui Medical UniversityHefeiChina
| | - Yun‐Chao Huang
- Department of Thoracic SurgeryYunnan Cancer HospitalKunmingChina
| | - Xian‐Zhen Liao
- Hunan Office for Cancer Control and ResearchHunan Cancer HospitalChangshaChina
| | - Xiao‐Jing Xing
- Liaoning Office for Cancer Control and ResearchLiaoning Cancer Hospital & InstituteShenyangChina
| | - Ling‐Bin Du
- Zhejiang Office for Cancer Control and ResearchZhejiang Cancer HospitalHangzhouChina
| | - Li Yang
- School of Public HealthGuangxi Medical UniversityNanningChina
| | - Yu‐Qin Liu
- Cancer Epidemiology Research CenterGansu Provincial Cancer HospitalLanzhouChina
| | - Yong‐Zhen Zhang
- Department of EpidemiologyShanxi Provincial Cancer HospitalTaiyuanChina
| | - Dong‐Hua Wei
- Medical DepartmentAnhui Provincial Cancer HospitalHefeiChina
| | - Yun‐Yong Liu
- Liaoning Office for Cancer Control and ResearchLiaoning Cancer Hospital & InstituteShenyangChina
| | - Kai Zhang
- Department of Cancer PreventionNational Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Ni Li
- Office of Cancer Screening, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Wan‐Qing Chen
- Office of Cancer Screening, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - You‐Lin Qiao
- Department of Cancer EpidemiologyNational Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Jie He
- Department of Thoracic SurgeryNational Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Min Dai
- Office of Cancer Screening, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Ning Wu
- Department of Diagnostic RadiologyNational Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
- PET‐CT CenterNational Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
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Guan HX, Pan YY, Wang YJ, Tang DZ, Zhou SC, Xia LM. Comparison of Various Parameters of DWI in Distinguishing Solitary Pulmonary Nodules. Curr Med Sci 2018; 38:920-924. [PMID: 30341530 DOI: 10.1007/s11596-018-1963-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 09/12/2018] [Indexed: 12/19/2022]
Abstract
In order to prospectively assess various parameters of diffusion weighted imaging (DWI) in differential diagnosis of benign and malignant solitary pulmonary nodules (SPNs), 58 patients (40 men and 18 women, and mean age of 48.1±10.4 years old) with SPNs undergoing conventional MR, DWI using b=500 s/mm2 on a 1.5T MR scanner, were studied. Various DWI parameters [apparent diffusion coefficient (ADC), lesion-tospinal cord signal intensity ratio (LSR), signal intensity (SI) score] were calculated and compared between malignant and benign SPNs groups. A receiver operating characteristic (ROC) curve analysis was employed to compare the diagnostic capabilities of all the parameters for discrimination between benign and malignant SPNs. The results showed that there were 42 malignant and 16 benign SPNs. The ADC was significantly lower in malignant SPNs (1.40±0.44)×10-3 mm2/s than in benign SPNs (1.81±0.58)×10-3 mm2/s. The LSR and SI scores were significantly increased in malignant SPNs (0.90±0.37 and 2.8±1.2) as compared with those in benign SPNs (0.68±0.39 and 2.2±1.2). The area under the ROC curves (AUC) of all parameters was not significantly different between malignant SPNs and benign SPNs. It was suggested that as three reported parameters for DWI, ADC, LSR and SI scores are all feasible for discrimination of malignant and benign SPNs. The three parameters have equal diagnostic performance.
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Affiliation(s)
- Han-Xiong Guan
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yue-Ying Pan
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yu-Jin Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Da-Zong Tang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Shu-Chang Zhou
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Li-Ming Xia
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
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Cheng M, Sun X, Liu G, Cheng K, Lv Z, Sun C, Xiu D, Liu L. Comprehensive analysis of marker gene detection and computed tomography for the diagnosis of human lung cancer. Oncol Lett 2018; 16:4400-4406. [PMID: 30250539 PMCID: PMC6144882 DOI: 10.3892/ol.2018.9211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 03/09/2018] [Indexed: 12/23/2022] Open
Abstract
Non-small cell lung cancer (NSCLC) is one of leading causes of cancer-associated mortality, with a high number of cases caused by metastasis. The early diagnosis of cancer contributes to the successful treatment of patients with lung cancer. The aim of the present study was to analyze the efficacy of marker gene detection and computed tomography (CT) in diagnosing human lung cancer. Lung cancer marker genes, including carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), tissue polypeptide antigen (TPA), pro-gastrin-releasing peptide (ProGRB), cytokeratin fragment 21-1 (Cyfra21-1) and neuron-specific enolase (NSE), were analyzed in patients with lung cancer. The tumor size was evaluated using CT, and the association between lung serum levels of marker gene protein expression and tumor size was investigated. A total of 328 patients with lung cancer were identified, including 204 adenocarcinoma, 75 large cell carcinoma and 49 squamous cell carcinoma cases. All patients were indicated to have a high serum level of CEA, CA125, TPA, ProGRB, Cyfra21-1 and NSE, compared with the normal range. Immunohistochemistry demonstrated higher expression levels of CEA, CA125, TPA, ProGRB, Cyfra21-1 and NSE in lung tumor tissues, compared with the normal range. Results indicated that CT was able to diagnose tumor size for patients with lung cancer. The CEA and CA125 expression levels were associated with CT-diagnosed adenocarcinoma tumor size. Large cell carcinoma tumor size was associated with serum levels of CEA, TPA and ProGRB. Results indicated that Cyfra21-1 and NSE were associated with the squamous cell carcinoma cases, as demonstrated using CT. In conclusion, these results indicated that comprehensive analysis of marker gene detection and CT results may be used to diagnose human lung cancer.
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Affiliation(s)
- Min Cheng
- Department of Radiology, Jilin University, China Japan Union Hospital, Changchun, Jilin 130033, P.R. China
| | - Xiaosong Sun
- Department of Head and Neck Surgery, Jilin Cancer Hospital, Changchun, Jilin 130000, P.R. China
| | - Guifeng Liu
- Department of Radiology, Jilin University, China Japan Union Hospital, Changchun, Jilin 130033, P.R. China
| | - Kailiang Cheng
- Department of Radiology, Jilin University, China Japan Union Hospital, Changchun, Jilin 130033, P.R. China
| | - Zhongwen Lv
- Department of Radiology, Jilin University, China Japan Union Hospital, Changchun, Jilin 130033, P.R. China
| | - Changjiang Sun
- Department of Radiology, Jilin University, China Japan Union Hospital, Changchun, Jilin 130033, P.R. China
| | - Dianhui Xiu
- Department of Radiology, Jilin University, China Japan Union Hospital, Changchun, Jilin 130033, P.R. China
| | - Lin Liu
- Department of Radiology, Jilin University, China Japan Union Hospital, Changchun, Jilin 130033, P.R. China
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Wang H, Zhang S, Wan L, Sun H, Tan J, Su Q. Screening and staging for non-small cell lung cancer by serum laser Raman spectroscopy. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2018; 201:34-38. [PMID: 29729529 DOI: 10.1016/j.saa.2018.04.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 03/26/2018] [Accepted: 04/04/2018] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Lung cancer is the leading cause of cancer-related death worldwide. Current clinical screening methods to detect lung cancer are expensive and associated with many complications. Raman spectroscopy is a spectroscopic technique that offers a convenient method to gain molecular information about biological samples. In this study, we measured the serum Raman spectral intensity of healthy volunteers and patients with different stages of non-small cell lung cancer. The purpose of this study was to evaluate the application of serum laser Raman spectroscopy as a low cost alternative method in the screening and staging of non-small cell lung cancer (NSCLC). METHODS The Raman spectra of the sera of peripheral venous blood were measured with a LabRAM HR 800 confocal Micro Raman spectrometer for individuals from five groups including 14 healthy volunteers (control group), 23 patients with stage I NSCLC (stage I group), 24 patients with stage II NSCLC (stage II group), 19 patients with stage III NSCLC (stage III group), 11 patients with stage IV NSCLC (stage IV group). Each serum sample was measured 3 times at different spots and the average spectra represented the signal of Raman spectra in each case. The Raman spectrum signal data of the five groups were statistically analyzed by analysis of variance (ANOVA), principal component analysis (PCA), linear discriminant analysis (LDA), and cross-validation. RESULTS Raman spectral intensity was sequentially reduced in serum samples from control group, stage I group, stage II group and stage III/IV group. The strongest peak intensity was observed in the control group, and the weakest one was found in the stage III/IV group at bands of 848 cm-1, 999 cm-1, 1152 cm-1, 1446 cm-1 and 1658 cm-1 (P < 0.05). Linear discriminant analysis showed that the sensitivity to identify healthy people, stage I, stage II, and stage III/IV NSCLC was 86%, 65%, 75%, and 87%, respectively; the specificity was 95%, 94%, 88%, and 93%, respectively; and the overall accuracy rate was 92% (71/77). CONCLUSION The laser Raman spectroscopy can effectively identify patients with stage I, stage II or stage III/IV Non-Small Cell Lung cancer using patient serum samples.
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Affiliation(s)
- Hong Wang
- The First Affiliated Hospital of Guangdong Pharmaceutical University, No.19 Nonglinxia Road, Yuexiou District, Guangzhou City, Guangdong Province 510080, PR China.
| | - Shaohong Zhang
- Guangzhou Institute of Energy Conversion, CAS, No.2 Nengyuan Road, Tianhe District, Guangzhou City, Guangdong Province 510640, PR China
| | - Limei Wan
- The First Affiliated Hospital of Guangdong Pharmaceutical University, No.19 Nonglinxia Road, Yuexiou District, Guangzhou City, Guangdong Province 510080, PR China
| | - Hong Sun
- The First Affiliated Hospital of Guangdong Pharmaceutical University, No.19 Nonglinxia Road, Yuexiou District, Guangzhou City, Guangdong Province 510080, PR China
| | - Jie Tan
- The First Affiliated Hospital of Guangdong Pharmaceutical University, No.19 Nonglinxia Road, Yuexiou District, Guangzhou City, Guangdong Province 510080, PR China
| | - Qiucheng Su
- Guangzhou Institute of Energy Conversion, CAS, No.2 Nengyuan Road, Tianhe District, Guangzhou City, Guangdong Province 510640, PR China
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Kirchner J, Sawicki LM, Nensa F, Schaarschmidt BM, Reis H, Ingenwerth M, Bogner S, Aigner C, Buchbender C, Umutlu L, Antoch G, Herrmann K, Heusch P. Prospective comparison of 18F-FDG PET/MRI and 18F-FDG PET/CT for thoracic staging of non-small cell lung cancer. Eur J Nucl Med Mol Imaging 2018; 46:437-445. [PMID: 30074073 DOI: 10.1007/s00259-018-4109-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 07/23/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To compare the diagnostic performance of 18F-FDG PET/MRI and 18F-FDG PET/CT for primary and locoregional lymph node staging in non-small cell lung cancer (NSCLC). METHODS In this prospective study, a total of 84 patients (51 men, 33 women, mean age 62.5 ± 9.1 years) with histopathologically confirmed NSCLC underwent 18F-FDG PET/CT followed by 18F-FDG PET/MRI in a single injection protocol. Two readers independently assessed T and N staging in separate sessions according to the seventh edition of the American Joint Committee on Cancer staging manual for 18F-FDG PET/CT and 18F-FDG PET/MRI, respectively. Histopathology as a reference standard was available for N staging in all 84 patients and for T staging in 39 patients. Differences in staging accuracy were assessed by McNemars chi2 test. The maximum standardized uptake value (SUVmax) and longitudinal diameters of primary tumors were correlated using Pearson's coefficients. RESULTS T stage was categorized concordantly in 18F-FDG PET/MRI and 18F-FDG PET/CT in 38 of 39 (97.4%) patients. Herein, 18F-FDG PET/CT and 18F-FDG PET/MRI correctly determined the T stage in 92.3 and 89.7% of patients, respectively. N stage was categorized concordantly in 83 of 84 patients (98.8%). 18F-FDG PET/CT correctly determined the N stage in 78 of 84 patients (92.9%), while 18F-FDG PET/MRI correctly determined the N stage in 77 of 84 patients (91.7%). Differences between 18F-FDG PET/CT and 18F-FDG PET/MRI in T and N staging accuracy were not statistically significant (p > 0.5, each). Tumor size and SUVmax measurements derived from both imaging modalities exhibited excellent correlation (r = 0.963 and r = 0.901, respectively). CONCLUSION 18F-FDG PET/MRI and 18F-FDG PET/CT show an equivalently high diagnostic performance for T and N staging in patients suffering from NSCLC.
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Affiliation(s)
- Julian Kirchner
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, D-40225, Dusseldorf, Germany.
| | - Lino M Sawicki
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, D-40225, Dusseldorf, Germany
| | - Felix Nensa
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147, Essen, Germany
| | - Benedikt M Schaarschmidt
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, D-40225, Dusseldorf, Germany
| | - Henning Reis
- Institute of Pathology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) Essen, D-45147, Essen, Germany
| | - Marc Ingenwerth
- Institute of Pathology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) Essen, D-45147, Essen, Germany
| | - Simon Bogner
- Department of Medical Oncology, University Hospital Essen, West German Cancer Center, University of Duisburg-Essen, D-45122, Essen, Germany
| | - Clemens Aigner
- Department of Thoracic Surgery and Surgical Endoscopy, University Hospital Essen, Ruhrlandklinik, University of Duisburg-Essen, D-45147, Essen, Germany
| | - Christian Buchbender
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, D-40225, Dusseldorf, Germany
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147, Essen, Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, D-40225, Dusseldorf, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, D-45147, Essen, Germany
| | - Philipp Heusch
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, D-40225, Dusseldorf, Germany
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Gao J, Li L, Liu X, Guo R, Zhao B. Contrast-enhanced magnetic resonance imaging with a novel nano-size contrast agent for the clinical diagnosis of patients with lung cancer. Exp Ther Med 2018; 15:5415-5421. [PMID: 29904421 DOI: 10.3892/etm.2018.6112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 01/08/2018] [Indexed: 01/01/2023] Open
Abstract
Recent studies have indicated that magnetic resonance imaging (MRI) efficiently diagnoses lung cancer. However, the efficacy of MRI in diagnosing lung cancer requires improving for patients in the early stage of the disease. In the present study, a novel nano-sized contrast agent of chistosan/Fe3O4-enclosed bispecific antibodies (BsAbCENS) was introduced, which targeted carcino-embryonic antigen (CEA) and neuron-specific enolase (NSE) in lung cancer cells. The diagnostic efficacy of contrast-enhanced MRI with BsAbCENS (CEMRI-BsAbCENS) was investigated in a total of 182 patients with suspected lung cancer who had high serum levels of CEA and NSE. BsAbCENS was administered by pulmonary inhalation prior to the MRI scan. The results revealed that CEA and NSE were overexpressed in human lung cancer cell lines. BsAbCENS bound with CEA and NSE on the surface of human lung cancer cells and produced a higher signal intensity than MRI alone for the diagnosis of patients with lung cancer. The diagnostic data revealed that CEMRI-BsAbCENS diagnosed 124/182 lung cancer cases, whereas CEMRI only diagnosed 98/182, which was significantly less (P<0.01). In addition, the survival rate of patients with lung cancer diagnosed by CEMRI-BsAbCENS was significantly higher than the mean 5-year survival rate (P<0.01). Furthermore, the pharmacodynamics demonstrated that BsAbCENS was metabolized within 24 h. The results of the present study indicate that the efficacy and accuracy of lung cancer diagnosis are improved by CEMRI-BsAbCENS. In conclusion, these results provide a potential novel protocol for the diagnosis of tumors in patients with suspected early stage lung cancer.
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Affiliation(s)
- Jianwei Gao
- Department of MRI, Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong 250021, P.R. China.,Department of Radiology, Tai'an First People's Hospital, Tai'an, Shandong 271000, P.R. China
| | - Lei Li
- Department of Interventional Radiology, The Second Affiliated Hospital of Qingdao University Medical College (Municipal Central Hospital of Qingdao), Qingdao, Shandong 266042, P.R. China
| | - Xia Liu
- Department of Radiology, Tai'an First People's Hospital, Tai'an, Shandong 271000, P.R. China
| | - Rui Guo
- Department of Gynecology and Obstetrics, Zhangqiu People's Hospital, Zhangqiu, Shandong 250200, P.R. China
| | - Bin Zhao
- Department of MRI, Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong 250021, P.R. China
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Jørgensen SF, Ravn P, Thorsen S, Worm SW. Characteristics and outcome in patients with non-specific symptoms and signs of cancer referred to a fast track cancer patient pathway; a retrospective cohort study. BMC Cancer 2017; 17:809. [PMID: 29197366 PMCID: PMC5712161 DOI: 10.1186/s12885-017-3826-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 11/23/2017] [Indexed: 11/21/2022] Open
Abstract
Background In 2012 a new cancer patient pathway for patients with non-specific symptoms and signs of cancer (NSSC-CPP) was introduced in Denmark. Limited information is available about the patients referred to the NSSC-CPP and the investigational course. The aim was to describe the population and the investigational course, estimate the prevalence of cancer and one-year mortality, and identify factors associated with a subsequent cancer diagnosis in patients referred to the NSSC-CPP. Method This cohort study included patients with at least one visit at the NSSC-CPP at North Zealand Hospital in Denmark (NOH) from October 1st 2013 to September 30th 2014. Data was based on retrospective reviews of the patient files. Logistic regression identified factors associated with a subsequent cancer diagnosis. Multivariate analyses were adjusted by age, gender, smoking status and alcohol consumption. Kaplan-Meier survival plots were made at one-year follow-up. Results Eight hundred twenty-five patients were included with a median age of 67 years, 47.4% were male. Prevalence of cancer within one year was 16.7% (138/825). 70.3% (97/138) were solid cancers and 29.7% (41/138) were haematological cancers. During the investigational course 76.7% went through advanced diagnostic imaging (ultrasound, CT, FDG-PET/CT or MRI). Anaemia (OR1.63 CI1.02–2.60), leucocytosis (OR 2.06 CI 1.34–3.15), thrombocytopenia (OR 4.13 CI 2.02–8.47) and elevated LDH (OR 1.64 CI 1.07–2.52) and CRP (OR 2.56 CI 1.66–3.95) were associated with a cancer diagnosis when adjusting for possible confounders. No single non-specific symptom was significantly associated with a cancer diagnosis. One-year mortality for those diagnosed with cancer was 44.2%. Conclusion The prevalence of cancer matches that of another NSSC-CPP in Denmark. Deviations in basic biochemistry were associated with a higher probability of underlying cancer and could possibly raise the level of suspicion of malignancy among physicians. High one-year mortality was seen amongst patients diagnosed with cancer.
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Affiliation(s)
- Sara Falk Jørgensen
- Department of Pulmonary and Infectious Diseases, University Hospital, North Zealand Hospital, Hillerød, Denmark. .,Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark.
| | - Pernille Ravn
- Department of Pulmonary and Infectious Diseases, University Hospital, North Zealand Hospital, Hillerød, Denmark.,Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
| | - Søren Thorsen
- Department of Pulmonary and Infectious Diseases, University Hospital, North Zealand Hospital, Hillerød, Denmark
| | - Signe Westring Worm
- Department of Infectious Diseases, University Hospital Rigshospitalet, Copenhagen, Denmark
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Bainbridge H, Salem A, Tijssen RHN, Dubec M, Wetscherek A, Van Es C, Belderbos J, Faivre-Finn C, McDonald F. Magnetic resonance imaging in precision radiation therapy for lung cancer. Transl Lung Cancer Res 2017; 6:689-707. [PMID: 29218271 PMCID: PMC5709138 DOI: 10.21037/tlcr.2017.09.02] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 09/08/2017] [Indexed: 12/25/2022]
Abstract
Radiotherapy remains the cornerstone of curative treatment for inoperable locally advanced lung cancer, given concomitantly with platinum-based chemotherapy. With poor overall survival, research efforts continue to explore whether integration of advanced radiation techniques will assist safe treatment intensification with the potential for improving outcomes. One advance is the integration of magnetic resonance imaging (MRI) in the treatment pathway, providing anatomical and functional information with excellent soft tissue contrast without exposure of the patient to radiation. MRI may complement or improve the diagnostic staging accuracy of F-18 fluorodeoxyglucose position emission tomography and computerized tomography imaging, particularly in assessing local tumour invasion and is also effective for identification of nodal and distant metastatic disease. Incorporating anatomical MRI sequences into lung radiotherapy treatment planning is a novel application and may improve target volume and organs at risk delineation reproducibility. Furthermore, functional MRI may facilitate dose painting for heterogeneous target volumes and prediction of normal tissue toxicity to guide adaptive strategies. MRI sequences are rapidly developing and although the issue of intra-thoracic motion has historically hindered the quality of MRI due to the effect of motion, progress is being made in this field. Four-dimensional MRI has the potential to complement or supersede 4D CT and 4D F-18-FDG PET, by providing superior spatial resolution. A number of MR-guided radiotherapy delivery units are now available, combining a radiotherapy delivery machine (linear accelerator or cobalt-60 unit) with MRI at varying magnetic field strengths. This novel hybrid technology is evolving with many technical challenges to overcome. It is anticipated that the clinical benefits of MR-guided radiotherapy will be derived from the ability to adapt treatment on the fly for each fraction and in real-time, using 'beam-on' imaging. The lung tumour site group of the Atlantic MR-Linac consortium is working to generate a challenging MR-guided adaptive workflow for multi-institution treatment intensification trials in this patient group.
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Affiliation(s)
- Hannah Bainbridge
- The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - Ahmed Salem
- The University of Manchester and The Christie NHS Foundation Trust, Manchester, UK
| | | | - Michael Dubec
- The University of Manchester and The Christie NHS Foundation Trust, Manchester, UK
| | - Andreas Wetscherek
- The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - Corinne Van Es
- The University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jose Belderbos
- The Netherlands Cancer Institute and The Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Corinne Faivre-Finn
- The University of Manchester and The Christie NHS Foundation Trust, Manchester, UK
| | - Fiona McDonald
- The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, UK
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A novel stereotactic frame for real PET-guided biopsies: A preclinical proof-of-concept. Phys Med 2017; 41:124-128. [DOI: 10.1016/j.ejmp.2017.05.047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 05/03/2017] [Accepted: 05/04/2017] [Indexed: 12/25/2022] Open
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Zarogoulidis P, Athanasiou E, Tsiouda T, Hatzibougias D, Huang H, Bai C, Trakada G, Veletza L, Kallianos A, Kosmidis C, Barbetakis N, Paliouras D, Rapti A, Drougas D, Hohenforst-Schmidt W. Immunotherapy "Shock" a case series of PD-L1 100% and pembrolizumab first-line treatment. Respir Med Case Rep 2017; 22:197-202. [PMID: 28879076 PMCID: PMC5576975 DOI: 10.1016/j.rmcr.2017.08.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 08/18/2017] [Accepted: 08/19/2017] [Indexed: 01/03/2023] Open
Abstract
In this decade a “bloom” of novel therapies has been observed for non-small cell lung cancer. We have new tools for the diagnosis of lung cancer and also we can re-biospy easier than before in different lesions and obtain tissue samples in order to investigate whether a patient can receive new targeted therapies. Immunotherapy has been well established previously for other forms of cancer, and nowadays it is also available for lung cancer. There are two immunotherapies for now nivolumab and pembrolizumab which can be administered as second line treatment, the second can also be administered as first-line if there is a programmed death-ligand 1 ≥50% expression.
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Affiliation(s)
- Paul Zarogoulidis
- Pulmonary-Oncology Unit, "Theageneio" Anticancer Hospital, Thessaloniki, Greece
| | | | - Theodora Tsiouda
- Pulmonary-Oncology Unit, "Theageneio" Anticancer Hospital, Thessaloniki, Greece
| | | | - Haidong Huang
- Department of Respiratory and Critical Care Medicine, Shanghai Hospital, Second Military Medical University, Shanghai, China
| | - Chong Bai
- Department of Respiratory and Critical Care Medicine, Shanghai Hospital, Second Military Medical University, Shanghai, China
| | - Georgia Trakada
- Division of Pulmonology, Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Alexandra Hospital, Athens, Greece
| | - Lemonia Veletza
- Division of Pulmonology, Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Alexandra Hospital, Athens, Greece
| | - Anastasios Kallianos
- Division of Pulmonology, Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Alexandra Hospital, Athens, Greece
| | | | - Nikolaos Barbetakis
- Thoracic Surgery Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece
| | - Dimitrios Paliouras
- Thoracic Surgery Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece
| | - Aggeliki Rapti
- 2nd Pulmonary Department, "Sotiria" Hospital of Chest Diseases, Athens, Greece
| | - Dimitrios Drougas
- Private Scientigraphy Department, "Bioiatriki", Thessaloniki, Greece
| | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology/Pulmonology/Intensive Care/Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany
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Priola AM, Priola SM, Gned D, Giraudo MT, Brundu M, Righi L, Veltri A. Diffusion-weighted quantitative MRI of pleural abnormalities: Intra- and interobserver variability in the apparent diffusion coefficient measurements. J Magn Reson Imaging 2017; 46:769-782. [PMID: 28117923 DOI: 10.1002/jmri.25633] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 12/28/2016] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To assess intra- and interobserver variability in the apparent diffusion coefficient (ADC) measurements of pleural abnormalities. MATERIALS AND METHODS Diffusion-weighted magnetic resonance imaging was performed in 34 patients to characterize pleural abnormalities, with a 1.5T unit at b values of 0/150/500/800 sec/mm2 . In two sessions held 3 months apart, on perfusion-free ADC maps, two independent readers measured the ADC of pleural abnormalities (two readings for each reader in each case) using different methods of region-of-interest (ROI) positioning. In three methods, freehand ROIs were drawn within tumor boundaries to encompass the entire lesion on one or more axial slices (whole tumor volume [WTV], three slices observer-defined [TSOD], single-slice [SS]), while in two methods one or more ROIs were placed on the more restricted areas (multiple small round ROI [MSR], one small round ROI [OSR]). Measurement variability between readings by each reader (intraobserver repeatability) and between readers in first reading (interobserver repeatability) were assessed using intraclass correlation coefficient (ICC) and coefficient of variation (CoV). Analysis of variance (ANOVA) was performed to compare ADC values between the different methods. The measurement time of each case for all methods in first reading was recorded and compared between methods and readers. RESULTS All methods demonstrated good (MSR, OSR) and excellent (WTV, TSOD, SS) intra- and interreader agreement, with best and worst repeatability in WTV (lower ICC, 0.977; higher CoV, 3.5%) and OSR (lower ICC, 0.625; higher CoV, 22.8%), respectively. The lower 95% confidence interval of ICC resulted in fair to moderate agreement for OSR (up to 0.379) and in excellent agreement for WTV, TSV, and SS (up to 0.918). ADC values of OSR and MSR were significantly lower compared to other methods (P < 0.001). The OSR and SS required less measurement time (10 and 21/22 sec, respectively) compared to the others (P < 0.0001), while the WTV required the longest measurement time (132/134 sec) (P < 0.0001). CONCLUSION ADC measurements of pleural abnormalities are repeatable. The SS method has excellent repeatability, similar to WTV, but requires significantly less measurement time. Thus, its use should be preferred in clinical practice. LEVEL OF EVIDENCE 4 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:769-782.
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Affiliation(s)
| | - Sandro Massimo Priola
- Department of Diagnostic Imaging, San Luigi Gonzaga University Hospital, Orbassano (Torino), Italy
| | - Dario Gned
- Department of Diagnostic Imaging, San Luigi Gonzaga University Hospital, Orbassano (Torino), Italy
| | | | - Maria Brundu
- Department of Diagnostic Imaging, San Luigi Gonzaga University Hospital, Orbassano (Torino), Italy
| | - Luisella Righi
- Department of Pathology, San Luigi Gonzaga University Hospital, Orbassano (Torino), Italy
| | - Andrea Veltri
- Department of Diagnostic Imaging, San Luigi Gonzaga University Hospital, Orbassano (Torino), Italy
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Biederer J. General Requirements of MRI of the Lung and Suggested Standard Protocol. MRI OF THE LUNG 2017. [DOI: 10.1007/174_2017_98] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Tan H, Cheng D. Using magnetoferritin nanoprobes for both nuclear and magnetic-resonance imaging. Nanomedicine (Lond) 2017; 12:9-11. [PMID: 27876442 DOI: 10.2217/nnm-2016-0369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Hui Tan
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- Institute of Nuclear Medicine, Fudan University, Shanghai 200032, China
- Shanghai Institute of Medical Imaging, Fenglin Road 180, Shanghai 200032, China
| | - Dengfeng Cheng
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- Institute of Nuclear Medicine, Fudan University, Shanghai 200032, China
- Shanghai Institute of Medical Imaging, Fenglin Road 180, Shanghai 200032, China
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46
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Screening for lung cancer: Does MRI have a role? Eur J Radiol 2017; 86:353-360. [DOI: 10.1016/j.ejrad.2016.09.016] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 09/15/2016] [Indexed: 12/17/2022]
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47
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Ohno Y, Yui M, Koyama H, Yoshikawa T, Seki S, Ueno Y, Miyazaki M, Ouyang C, Sugimura K. Chemical Exchange Saturation Transfer MR Imaging: Preliminary Results for Differentiation of Malignant and Benign Thoracic Lesions. Radiology 2016; 279:578-89. [DOI: 10.1148/radiol.2015151161] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Peerlings J, Troost EGC, Nelemans PJ, Cobben DCP, de Boer JCJ, Hoffmann AL, Beets-Tan RGH. The Diagnostic Value of MR Imaging in Determining the Lymph Node Status of Patients with Non-Small Cell Lung Cancer: A Meta-Analysis. Radiology 2016; 281:86-98. [PMID: 27110732 DOI: 10.1148/radiol.2016151631] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Purpose To summarize existing evidence of thoracic magnetic resonance (MR) imaging in determining the nodal status of non-small cell lung cancer (NSCLC) with the aim of elucidating its diagnostic value on a per-patient basis (eg, in treatment decision making) and a per-node basis (eg, in target volume delineation for radiation therapy), with results of cytologic and/or histologic examination as the reference standard. Materials and Methods A systematic literature search for original diagnostic studies was performed in PubMed, Web of Science, Embase, and MEDLINE. The methodologic quality of each study was evaluated by using the Quality Assessment of Diagnostic Accuracy Studies 2, or QUADAS-2, tool. Hierarchic summary receiver operating characteristic curves were generated to estimate the diagnostic performance of MR imaging. Subgroup analyses, expressed as relative diagnostic odds ratios (DORs) (rDORs), were performed to evaluate whether publication year, methodologic quality, and/or method of evaluation (qualitative [ie, lesion size and/or morphology] vs quantitative [eg, apparent diffusion coefficients in diffusion-weighted images]) affected diagnostic performance. Results Twelve of 2551 initially identified studies were included in this meta-analysis (1122 patients; 4302 lymph nodes). On a per-patient basis, the pooled estimates of MR imaging for sensitivity, specificity, and DOR were 0.87 (95% confidence interval [CI]: 0.78, 0.92), 0.88 (95% CI: 0.77, 0.94), and 48.1 (95% CI: 23.4, 98.9), respectively. On a per-node basis, the respective measures were 0.88 (95% CI: 0.78, 0.94), 0.95 (95% CI: 0.87, 0.98), and 129.5 (95% CI: 49.3, 340.0). Subgroup analyses suggested greater diagnostic performance of quantitative evaluation on both a per-patient and per-node basis (rDOR = 2.76 [95% CI: 0.83, 9.10], P = .09 and rDOR = 7.25 [95% CI: 1.75, 30.09], P = .01, respectively). Conclusion This meta-analysis demonstrated high diagnostic performance of MR imaging in staging hilar and mediastinal lymph nodes in NSCLC on both a per-patient and per-node basis. (©) RSNA, 2016 Online supplemental material is available for this article.
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Affiliation(s)
- Jurgen Peerlings
- From the Department of Radiation Oncology (MAASTRO Clinic), GROW School for Oncology and Developmental Biology (J.P., E.G.C.T., A.L.H.), Department of Radiology (J.P., R.G.H.B.), and Department of Epidemiology (P.J.N.), Maastricht University Medical Centre, Dr. Tanslaan 12, 6229 ET Maastricht, the Netherlands; Department of Radiation Oncology, University Medical Centre, Utrecht, the Netherlands (D.C.P.C., J.C.J.d.B.); and Department of Radiation Oncology, Dr Bernard Verbeeten Institute, Tilburg, the Netherlands (D.C.P.C.)
| | - Esther G C Troost
- From the Department of Radiation Oncology (MAASTRO Clinic), GROW School for Oncology and Developmental Biology (J.P., E.G.C.T., A.L.H.), Department of Radiology (J.P., R.G.H.B.), and Department of Epidemiology (P.J.N.), Maastricht University Medical Centre, Dr. Tanslaan 12, 6229 ET Maastricht, the Netherlands; Department of Radiation Oncology, University Medical Centre, Utrecht, the Netherlands (D.C.P.C., J.C.J.d.B.); and Department of Radiation Oncology, Dr Bernard Verbeeten Institute, Tilburg, the Netherlands (D.C.P.C.)
| | - Patricia J Nelemans
- From the Department of Radiation Oncology (MAASTRO Clinic), GROW School for Oncology and Developmental Biology (J.P., E.G.C.T., A.L.H.), Department of Radiology (J.P., R.G.H.B.), and Department of Epidemiology (P.J.N.), Maastricht University Medical Centre, Dr. Tanslaan 12, 6229 ET Maastricht, the Netherlands; Department of Radiation Oncology, University Medical Centre, Utrecht, the Netherlands (D.C.P.C., J.C.J.d.B.); and Department of Radiation Oncology, Dr Bernard Verbeeten Institute, Tilburg, the Netherlands (D.C.P.C.)
| | - David C P Cobben
- From the Department of Radiation Oncology (MAASTRO Clinic), GROW School for Oncology and Developmental Biology (J.P., E.G.C.T., A.L.H.), Department of Radiology (J.P., R.G.H.B.), and Department of Epidemiology (P.J.N.), Maastricht University Medical Centre, Dr. Tanslaan 12, 6229 ET Maastricht, the Netherlands; Department of Radiation Oncology, University Medical Centre, Utrecht, the Netherlands (D.C.P.C., J.C.J.d.B.); and Department of Radiation Oncology, Dr Bernard Verbeeten Institute, Tilburg, the Netherlands (D.C.P.C.)
| | - Johannes C J de Boer
- From the Department of Radiation Oncology (MAASTRO Clinic), GROW School for Oncology and Developmental Biology (J.P., E.G.C.T., A.L.H.), Department of Radiology (J.P., R.G.H.B.), and Department of Epidemiology (P.J.N.), Maastricht University Medical Centre, Dr. Tanslaan 12, 6229 ET Maastricht, the Netherlands; Department of Radiation Oncology, University Medical Centre, Utrecht, the Netherlands (D.C.P.C., J.C.J.d.B.); and Department of Radiation Oncology, Dr Bernard Verbeeten Institute, Tilburg, the Netherlands (D.C.P.C.)
| | - Aswin L Hoffmann
- From the Department of Radiation Oncology (MAASTRO Clinic), GROW School for Oncology and Developmental Biology (J.P., E.G.C.T., A.L.H.), Department of Radiology (J.P., R.G.H.B.), and Department of Epidemiology (P.J.N.), Maastricht University Medical Centre, Dr. Tanslaan 12, 6229 ET Maastricht, the Netherlands; Department of Radiation Oncology, University Medical Centre, Utrecht, the Netherlands (D.C.P.C., J.C.J.d.B.); and Department of Radiation Oncology, Dr Bernard Verbeeten Institute, Tilburg, the Netherlands (D.C.P.C.)
| | - Regina G H Beets-Tan
- From the Department of Radiation Oncology (MAASTRO Clinic), GROW School for Oncology and Developmental Biology (J.P., E.G.C.T., A.L.H.), Department of Radiology (J.P., R.G.H.B.), and Department of Epidemiology (P.J.N.), Maastricht University Medical Centre, Dr. Tanslaan 12, 6229 ET Maastricht, the Netherlands; Department of Radiation Oncology, University Medical Centre, Utrecht, the Netherlands (D.C.P.C., J.C.J.d.B.); and Department of Radiation Oncology, Dr Bernard Verbeeten Institute, Tilburg, the Netherlands (D.C.P.C.)
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Ayan A, Erdemci B, Orsal E, Bayraktutan Z, Akpinar E, Topcu A, Turkeli M, Seven B. Is there any correlation between levels of serum ostepontin, CEA, and FDG uptake in lung cancer patients with bone metastasis? Rev Esp Med Nucl Imagen Mol 2016. [DOI: 10.1016/j.remnie.2016.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cha MJ, Lee KS, Kim HS, Lee SW, Jeong CJ, Kim EY, Lee HY. Improvement in imaging diagnosis technique and modalities for solitary pulmonary nodules: from ground-glass opacity nodules to part-solid and solid nodules. Expert Rev Respir Med 2016; 10:261-78. [PMID: 26751340 DOI: 10.1586/17476348.2016.1141053] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
With advances in CT technology and the popularity of low-dose CT as a device for lung cancer screening, the detection rate of sub-solid pulmonary nodules as well as solid nodules has been increased. Distinguishing solid from sub-solid features is an essential step in the CT evaluation of solitary pulmonary nodules (SPNs) because strategies for nodule characterization and guidelines for management are different for each category. In addition to conventional CT parameters, numerous novel concepts and modalities have been developed. Although there is currently no single effective method for differentiating malignant from benign nodules, growth rate measurement using volumetry, evaluation of tumor vascularity on dynamic helical CT, dual-energy CT and MRI and physiologic evaluation with PET/CT can all be useful for nodule characterization. New techniques such as tomosynthesis can improve detection over radiography alone. The purpose of this article is to enhance our understanding of the evidence-based strategies involved in diagnosing SPNs.
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Affiliation(s)
- Min Jae Cha
- a Department of Radiology and Center for Imaging Science , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea
| | - Kyung Soo Lee
- a Department of Radiology and Center for Imaging Science , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea
| | - Hyun Su Kim
- a Department of Radiology and Center for Imaging Science , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea
| | - So Won Lee
- a Department of Radiology and Center for Imaging Science , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea
| | - Chae Jin Jeong
- a Department of Radiology and Center for Imaging Science , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea
| | - Eun Young Kim
- a Department of Radiology and Center for Imaging Science , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea
| | - Ho Yun Lee
- a Department of Radiology and Center for Imaging Science , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul , Korea
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