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Subhawong TK, Winn A, Shemesh SS, Pretell-Mazzini J. F-18 FDG PET differentiation of benign from malignant chondroid neoplasms: a systematic review of the literature. Skeletal Radiol 2017; 46:1233-1239. [PMID: 28608242 DOI: 10.1007/s00256-017-2685-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 04/24/2017] [Accepted: 05/24/2017] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Discriminating among benign chondroid tumors, low-grade chondrosarcomas, and grade 2/3 chondrosarcomas is frequently difficult with standard imaging modalities. We systematically reviewed the literature to determine the performance of PET-CT in making this distinction. METHODS A systematic review was performed identifying 811 PubMed- and Embase-indexed articles containing combinations of "chondrosarcoma," "enchondroma," "chondroid," "cartilage" and "PET/CT," "PET," "positron." Eight articles including 166 lesions were included. Age, gender, tumor size, histologic grade, and SUVmax values were extracted for individual lesions when possible and otherwise recorded as aggregated data. Comparisons in SUVmax among benign, low-grade, and intermediate-/high-grade chondroid neoplasms were made. RESULTS Individual SUVs were available for 101 lesions; 65 additional lesions were reported as aggregated data. There were 101 malignant and 65 benign tumors. Benign tumors were seen more frequently in females (p = 0.04, Fischer's exact test), but malignancy was not associated with age or lesion size. SUVmax was lower for benign (1.6 ± 0.7) than malignant tumors (4.4 ± 2.5) (p < 0.0001, t-test). SUVmax was lower for grade 0/1 (2.0 ± 0.7) than grade 2/3 (6.0 ± 3.2) (p < 0.0001, t-test). Increasing SUVmax correlated with higher grade chondroid tumors (Spearman's rank, ρ = 0.78). SUVmax ≥4.4 was 99% specific for grade 2/3 chondrosarcoma. CONCLUSIONS SUVmax correlates with histologic grade in intraosseous chondroid neoplasms; very low SUVmax supports a diagnosis of benign tumor, while elevated SUVmax is suggestive of higher grade chondrosarcoma.
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Affiliation(s)
- Ty K Subhawong
- Department of Radiology, University of Miami Miller School of Medicine/Jackson Memorial Hospital, 1611 NW 12th Ave., JMH WW 279, Miami, FL, 33136, USA.
| | - Aaron Winn
- Department of Radiology, University of Miami Miller School of Medicine/Jackson Memorial Hospital, 1611 NW 12th Ave., JMH WW 279, Miami, FL, 33136, USA
| | - Shai S Shemesh
- Department of Orthopaedics, University of Miami Miller School of Medicine, 1400 NW 12th Ave, East Bldg, Ste 2, Miami, FL, 33136, USA
| | - Juan Pretell-Mazzini
- Department of Orthopaedics, University of Miami Miller School of Medicine, 1400 NW 12th Ave, East Bldg, Ste 2, Miami, FL, 33136, USA
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Hu M, Che P, Han X, Cai GQ, Liu G, Antony V, Luckhardt T, Siegal GP, Zhou Y, Liu RM, Desai LP, O'Reilly PJ, Thannickal VJ, Ding Q. Therapeutic targeting of SRC kinase in myofibroblast differentiation and pulmonary fibrosis. J Pharmacol Exp Ther 2014; 351:87-95. [PMID: 25047515 DOI: 10.1124/jpet.114.216044] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Myofibroblasts are effector cells in fibrotic disorders that synthesize and remodel the extracellular matrix (ECM). This study investigated the role of the Src kinase pathway in myofibroblast activation in vitro and fibrogenesis in vivo. The profibrotic cytokine, transforming growth factor β1 (TGF-β1), induced rapid activation of Src kinase, which led to myofibroblast differentiation of human lung fibroblasts. The Src kinase inhibitor AZD0530 (saracatinib) blocked TGF-β1-induced Src kinase activation in a dose-dependent manner. Inhibition of Src kinase significantly reduced α-smooth muscle actin (α-SMA) expression, a marker of myofibroblast differentiation, in TGF-β1-treated lung fibroblasts. In addition, the induced expression of collagen and fibronectin and three-dimensional collagen gel contraction were also significantly inhibited in AZD0530-treated fibroblasts. The therapeutic efficiency of Src kinase inhibition in vivo was tested in the bleomycin murine lung fibrosis model. Src kinase activation and collagen accumulation were significantly reduced in the lungs of AZD0530-treated mice when compared with controls. Furthermore, the total fibrotic area and expression of α-SMA and ECM proteins were significantly decreased in lungs of AZD0530-treated mice. These results indicate that Src kinase promotes myofibroblast differentiation and activation of lung fibroblasts. Additionally, these studies provide proof-of-concept for targeting the noncanonical TGF-β signaling pathway involving Src kinase as an effective therapeutic strategy for lung fibrosis.
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Affiliation(s)
- Meng Hu
- Departments of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine (M.H., G.Q.-C., G.L., V.A., T.L., Y.Z., R.L., L.P.D., P.J.O., V.J.T., Q.D.), Cell, Development, and Integrative Biology (P.C.), Neurology (X.H.), and Pathology (G.P.S.), University of Alabama at Birmingham, Birmingham, Alabama
| | - Pulin Che
- Departments of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine (M.H., G.Q.-C., G.L., V.A., T.L., Y.Z., R.L., L.P.D., P.J.O., V.J.T., Q.D.), Cell, Development, and Integrative Biology (P.C.), Neurology (X.H.), and Pathology (G.P.S.), University of Alabama at Birmingham, Birmingham, Alabama
| | - Xiaosi Han
- Departments of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine (M.H., G.Q.-C., G.L., V.A., T.L., Y.Z., R.L., L.P.D., P.J.O., V.J.T., Q.D.), Cell, Development, and Integrative Biology (P.C.), Neurology (X.H.), and Pathology (G.P.S.), University of Alabama at Birmingham, Birmingham, Alabama
| | - Guo-Qiang Cai
- Departments of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine (M.H., G.Q.-C., G.L., V.A., T.L., Y.Z., R.L., L.P.D., P.J.O., V.J.T., Q.D.), Cell, Development, and Integrative Biology (P.C.), Neurology (X.H.), and Pathology (G.P.S.), University of Alabama at Birmingham, Birmingham, Alabama
| | - Gang Liu
- Departments of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine (M.H., G.Q.-C., G.L., V.A., T.L., Y.Z., R.L., L.P.D., P.J.O., V.J.T., Q.D.), Cell, Development, and Integrative Biology (P.C.), Neurology (X.H.), and Pathology (G.P.S.), University of Alabama at Birmingham, Birmingham, Alabama
| | - Veena Antony
- Departments of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine (M.H., G.Q.-C., G.L., V.A., T.L., Y.Z., R.L., L.P.D., P.J.O., V.J.T., Q.D.), Cell, Development, and Integrative Biology (P.C.), Neurology (X.H.), and Pathology (G.P.S.), University of Alabama at Birmingham, Birmingham, Alabama
| | - Tracy Luckhardt
- Departments of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine (M.H., G.Q.-C., G.L., V.A., T.L., Y.Z., R.L., L.P.D., P.J.O., V.J.T., Q.D.), Cell, Development, and Integrative Biology (P.C.), Neurology (X.H.), and Pathology (G.P.S.), University of Alabama at Birmingham, Birmingham, Alabama
| | - Gene P Siegal
- Departments of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine (M.H., G.Q.-C., G.L., V.A., T.L., Y.Z., R.L., L.P.D., P.J.O., V.J.T., Q.D.), Cell, Development, and Integrative Biology (P.C.), Neurology (X.H.), and Pathology (G.P.S.), University of Alabama at Birmingham, Birmingham, Alabama
| | - Yong Zhou
- Departments of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine (M.H., G.Q.-C., G.L., V.A., T.L., Y.Z., R.L., L.P.D., P.J.O., V.J.T., Q.D.), Cell, Development, and Integrative Biology (P.C.), Neurology (X.H.), and Pathology (G.P.S.), University of Alabama at Birmingham, Birmingham, Alabama
| | - Rui-ming Liu
- Departments of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine (M.H., G.Q.-C., G.L., V.A., T.L., Y.Z., R.L., L.P.D., P.J.O., V.J.T., Q.D.), Cell, Development, and Integrative Biology (P.C.), Neurology (X.H.), and Pathology (G.P.S.), University of Alabama at Birmingham, Birmingham, Alabama
| | - Leena P Desai
- Departments of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine (M.H., G.Q.-C., G.L., V.A., T.L., Y.Z., R.L., L.P.D., P.J.O., V.J.T., Q.D.), Cell, Development, and Integrative Biology (P.C.), Neurology (X.H.), and Pathology (G.P.S.), University of Alabama at Birmingham, Birmingham, Alabama
| | - Philip J O'Reilly
- Departments of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine (M.H., G.Q.-C., G.L., V.A., T.L., Y.Z., R.L., L.P.D., P.J.O., V.J.T., Q.D.), Cell, Development, and Integrative Biology (P.C.), Neurology (X.H.), and Pathology (G.P.S.), University of Alabama at Birmingham, Birmingham, Alabama
| | - Victor J Thannickal
- Departments of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine (M.H., G.Q.-C., G.L., V.A., T.L., Y.Z., R.L., L.P.D., P.J.O., V.J.T., Q.D.), Cell, Development, and Integrative Biology (P.C.), Neurology (X.H.), and Pathology (G.P.S.), University of Alabama at Birmingham, Birmingham, Alabama
| | - Qiang Ding
- Departments of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine (M.H., G.Q.-C., G.L., V.A., T.L., Y.Z., R.L., L.P.D., P.J.O., V.J.T., Q.D.), Cell, Development, and Integrative Biology (P.C.), Neurology (X.H.), and Pathology (G.P.S.), University of Alabama at Birmingham, Birmingham, Alabama
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