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Zirakchian Zadeh M. PET/CT in assessment of colorectal liver metastases: a comprehensive review with emphasis on 18F-FDG. Clin Exp Metastasis 2023; 40:465-491. [PMID: 37682423 DOI: 10.1007/s10585-023-10231-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/21/2023] [Indexed: 09/09/2023]
Abstract
Approximately 25% of those who are diagnosed with colorectal cancer will develop colorectal liver metastases (CRLM) as their illness advances. Despite major improvements in both diagnostic and treatment methods, the prognosis for patients with CRLM is still poor, with low survival rates. Accurate employment of imaging methods is critical in identifying the most effective treatment approach for CRLM. Different imaging modalities are used to evaluate CRLM, including positron emission tomography (PET)/computed tomography (CT). Among the PET radiotracers, fluoro-18-deoxyglucose (18F-FDG), a glucose analog, is commonly used as the primary radiotracer in assessment of CRLM. As the importance of 18F-FDG-PET/CT continues to grow in assessment of CRLM, developing a comprehensive understanding of this subject becomes imperative for healthcare professionals from diverse disciplines. The primary aim of this article is to offer a simplified and comprehensive explanation of PET/CT in the evaluation of CRLM, with a deliberate effort to minimize the use of technical nuclear medicine terminology. This approach intends to provide various healthcare professionals and researchers with a thorough understanding of the subject matter.
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Affiliation(s)
- Mahdi Zirakchian Zadeh
- Molecular Imaging and Therapy and Interventional Radiology Services, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
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Zhou S, Sun D, Mao W, Liu Y, Cen W, Ye L, Liang F, Xu J, Shi H, Ji Y, Wang L, Chang W. Deep radiomics-based fusion model for prediction of bevacizumab treatment response and outcome in patients with colorectal cancer liver metastases: a multicentre cohort study. EClinicalMedicine 2023; 65:102271. [PMID: 37869523 PMCID: PMC10589780 DOI: 10.1016/j.eclinm.2023.102271] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 10/24/2023] Open
Abstract
Background Accurate tumour response prediction to targeted therapy allows for personalised conversion therapy for patients with unresectable colorectal cancer liver metastases (CRLM). In this study, we aimed to develop and validate a multi-modal deep learning model to predict the efficacy of bevacizumab in patients with initially unresectable CRLM using baseline PET/CT, clinical data, and colonoscopy biopsy specimens. Methods In this multicentre cohort study, we retrospectively collected data of 307 patients with CRLM from the BECOME study (NCT01972490) (Zhongshan Hospital of Fudan University, Shanghai) and two independent Chinese cohorts (internal validation cohort from January 1, 2018 to December 31, 2018 at Zhongshan Hospital of Fudan University; external validation cohort from January 1, 2020 to December 31, 2020 at Zhongshan Hospital-Xiamen, Shanghai, and the First Hospital of Wenzhou Medical University, Wenzhou). The main inclusion criteria were that patients with CRLM had pre-treatment PET/CT images as well as colonoscopy specimens. After extracting PET/CT features with deep neural networks (DNN) and selecting related clinical factors using LASSO analysis, a random forest classifier was built as the Deep Radiomics Bevacizumab efficacy predicting model (DERBY). Furthermore, by combining histopathological biomarkers into DERBY, we established DERBY+. The performance of model was evaluated using area under the curve (AUC), sensitivity, specificity, positive predictive value, and negative predictive value. Findings DERBY achieved promising performance in predicting bevacizumab sensitivity with an AUC of 0.77 and 95% confidence interval (CI) [0.67-0.87]. After combining histopathological features, we developed DERBY+, which had more robust accuracy for predicting tumour response in external validation cohort (AUC 0.83 and 95% CI [0.75-0.92], sensitivity 80.4%, specificity 76.8%). DERBY+ also had prognostic value: the responders had longer progression-free survival (median progression-free survival: 9.6 vs 6.3 months, p = 0.002) and overall survival (median overall survival: 27.6 vs 18.5 months, p = 0.010) than non-responders. Interpretation This multi-modal deep radiomics model, using PET/CT, clinical data and histopathological data, was able to identify patients with bevacizumab-sensitive CRLM, providing a favourable approach for precise patient treatment. To further validate and explore the clinical impact of this work, future prospective studies with larger patient cohorts are warranted. Funding The National Natural Science Foundation of China; Fujian Provincial Health Commission Project; Xiamen Science and Technology Agency Program; Clinical Research Plan of SHDC; Shanghai Science and Technology Committee Project; Clinical Research Plan of SHDC; Zhejiang Provincial Natural Science Foundation of China; and National Science Foundation of Xiamen.
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Affiliation(s)
- Shizhao Zhou
- Department of General Surgery, Department of Colorectal Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
- Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Dazhen Sun
- Department of Automation, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Wujian Mao
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Yu Liu
- Department of General Surgery, Department of Colorectal Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
- Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Wei Cen
- Department of Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Lechi Ye
- Department of Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Fei Liang
- Department of Biostatistics, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jianmin Xu
- Department of General Surgery, Department of Colorectal Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
- Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Hongcheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Yuan Ji
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Lisheng Wang
- Department of Automation, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Wenju Chang
- Department of General Surgery, Department of Colorectal Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
- Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
- Department of General Surgery, Zhongshan Hospital (Xiamen Branch), Fudan University, Xiamen, Fujian, 361015, China
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Caruso M, Stanzione A, Prinster A, Pizzuti LM, Brunetti A, Maurea S, Mainenti PP. Role of advanced imaging techniques in the evaluation of oncological therapies in patients with colorectal liver metastases. World J Gastroenterol 2023; 29:521-535. [PMID: 36688023 PMCID: PMC9850941 DOI: 10.3748/wjg.v29.i3.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/25/2022] [Accepted: 01/04/2023] [Indexed: 01/12/2023] Open
Abstract
In patients with colorectal liver metastasis (CRLMs) unsuitable for surgery, oncological treatments, such as chemotherapy and targeted agents, can be performed. Cross-sectional imaging [computed tomography (CT), magnetic resonance imaging (MRI), 18-fluorodexoyglucose positron emission tomography with CT/MRI] evaluates the response of CRLMs to therapy, using post-treatment lesion shrinkage as a qualitative imaging parameter. This point is critical because the risk of toxicity induced by oncological treatments is not always balanced by an effective response to them. Consequently, there is a pressing need to define biomarkers that can predict treatment responses and estimate the likelihood of drug resistance in individual patients. Advanced quantitative imaging (diffusion-weighted imaging, perfusion imaging, molecular imaging) allows the in vivo evaluation of specific biological tissue features described as quantitative parameters. Furthermore, radiomics can represent large amounts of numerical and statistical information buried inside cross-sectional images as quantitative parameters. As a result, parametric analysis (PA) translates the numerical data contained in the voxels of each image into quantitative parameters representative of peculiar neoplastic features such as perfusion, structural heterogeneity, cellularity, oxygenation, and glucose consumption. PA could be a potentially useful imaging marker for predicting CRLMs treatment response. This review describes the role of PA applied to cross-sectional imaging in predicting the response to oncological therapies in patients with CRLMs.
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Affiliation(s)
- Martina Caruso
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Napoli 80131, Italy
| | - Arnaldo Stanzione
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Napoli 80131, Italy
| | - Anna Prinster
- Institute of Biostructures and Bioimaging, National Research Council, Napoli 80131, Italy
| | - Laura Micol Pizzuti
- Institute of Biostructures and Bioimaging, National Research Council, Napoli 80131, Italy
| | - Arturo Brunetti
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Napoli 80131, Italy
| | - Simone Maurea
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Napoli 80131, Italy
| | - Pier Paolo Mainenti
- Institute of Biostructures and Bioimaging, National Research Council, Napoli 80131, Italy
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The Value of 18F-FDG-PET-CT Imaging in Treatment Evaluation of Colorectal Liver Metastases: A Systematic Review. Diagnostics (Basel) 2022; 12:diagnostics12030715. [PMID: 35328267 PMCID: PMC8947194 DOI: 10.3390/diagnostics12030715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/04/2022] [Accepted: 03/05/2022] [Indexed: 02/01/2023] Open
Abstract
(1) Background: Up to 50% of patients with colorectal cancer either have synchronous colorectal liver metastases (CRLM) or develop CRLM over the course of their disease. Surgery and thermal ablation are the most common local treatment options of choice. Despite development and improvement in local treatment options, (local) recurrence remains a significant clinical problem. Many different imaging modalities can be used in the follow-up after treatment of CRLM, lacking evidence-based international consensus on the modality of choice. In this systematic review, we evaluated 18F-FDG-PET-CT performance after surgical resection, thermal ablation, radioembolization, and neoadjuvant and palliative chemotherapy based on current published literature. (2) Methods: A systematic literature search was performed on the PubMed database. (3) Results: A total of 31 original articles were included in the analysis. Only one suitable study was found describing the role of 18F-FDG-PET-CT after surgery, which makes it hard to draw a firm conclusion. 18F-FDG-PET-CT showed to be of additional value in the follow-up after thermal ablation, palliative chemotherapy, and radioembolization. 18F-FDG-PET-CT was found to be a poor to moderate predictor of pathologic response after neoadjuvant chemotherapy. (4) Conclusions: 18F-FDG-PET-CT is superior to conventional morphological imaging modalities in the early detection of residual disease after thermal ablation and in the treatment evaluation and prediction of prognosis during palliative chemotherapy and after radioembolization, and 18F-FDG-PET-CT could be considered in selected cases after neoadjuvant chemotherapy and surgical resection.
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5
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Nemeth Z, Wijker W, Lengyel Z, Hitre E, Borbely K. Metabolic Parameters as Predictors for Progression Free and Overall Survival of Patients with Metastatic Colorectal Cancer. Pathol Oncol Res 2020; 26:2683-2691. [PMID: 32661836 PMCID: PMC7772167 DOI: 10.1007/s12253-020-00865-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 06/23/2020] [Indexed: 01/17/2023]
Abstract
We tested the prognostic relevance of metabolic parameters and their relative changes in patients with metastatic colorectal cancer (mCRC) treated with monoclonal antibody and chemotherapy. SUVmax (standardized uptake volume), SAM (standardized added metabolic activity) and TLG (total lesion glycolysis) are assessed with 18F-fluorodeoxyglucosepositron emission tomography and computed tomography (FDG-PET/CT) to evaluate total metabolic activity of malignant processes. Our purpose was to investigate the change of glucose metabolism in relation to PFS (progression free survival) and OS (overall survival). Fifty-three patients with mCRC with at least one measurable liver metastasis were included in this prospective, multi-center, early exploratory study. All patients were treated with first-line chemotherapy and targeted therapy. Metabolic parameters, like SUVmax, SAM, normalized SAM (NSAM) and TLG were assessed by FDG-PET/CT, carried out at baseline (scan-1) and after two therapeutic cycle (scan-2). Our results suggested neither SUVmax nor TLG have such prognostic value as NSAM in liver metastases of colorectal cancer. The parameters after the two cycles of chemotherapy proved to be better predictors of the clinical outcome. NSAM after two cycles of treatment has a statistically significant predictive value on OS, while SAM was predictive to the PFS. The follow up normalized SAM after 2 cycles of first line oncotherapy was demonstrated to be useful as prognostic biomarkers for OS in metastatic colorectal cancer. We should introduce this measurement in metastatic colorectal cancer if there is at least one metastasis in the liver.
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Affiliation(s)
- Zsuzsanna Nemeth
- Chemotherapy B and Clinical Pharmacological Department of National Institute of Oncology, Ráth György utca 7-9, Budapest, 1122 Hungary
- Oncology Department of Szent Margit Hospital, Bécsi út 132, Budapest, H-1032 Hungary
| | - Wouter Wijker
- Auxiliis Pharma Ltd, Bokor utca 17, Budapest, H-1037 Hungary
| | - Zsolt Lengyel
- Pozitron Diagnostic Ltd, Hunyadi ut 9-11, Budapest, 1117 Hungary
| | - Erika Hitre
- Chemotherapy B and Clinical Pharmacological Department of National Institute of Oncology, Ráth György utca 7-9, Budapest, 1122 Hungary
| | - Katalin Borbely
- PET Ambulatory Department of National Institute of Oncology, Rath Gyorgy utca 7-9, Budapest, 1122 Hungary
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Watanabe A, Harimoto N, Araki K, Yoshizumi T, Arima K, Yamashita Y, Baba H, Tetsuya H, Kuwano H, Shirabe K. A new strategy based on fluorodeoxyglucose-positron emission tomography for managing liver metastasis from colorectal cancer. J Surg Oncol 2018; 118:1088-1095. [DOI: 10.1002/jso.25250] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 08/31/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Akira Watanabe
- Department of Hepatobiliary and Pancreatic Surgery; Gunma University Graduate School of Medicine; Maebashi Gunma Japan
| | - Norifumi Harimoto
- Department of Hepatobiliary and Pancreatic Surgery; Gunma University Graduate School of Medicine; Maebashi Gunma Japan
| | - Kenichiro Araki
- Department of Hepatobiliary and Pancreatic Surgery; Gunma University Graduate School of Medicine; Maebashi Gunma Japan
| | - Tomoharu Yoshizumi
- Department of Surgery and Science; Graduate School of Medical Sciences, Kyushu University; Fukuoka Japan
| | - Kota Arima
- Department of Gastroenterological Surgery; Graduate School of Medical Sciences, Kumamoto University; Kumamoto Japan
| | - Yoichi Yamashita
- Department of Gastroenterological Surgery; Graduate School of Medical Sciences, Kumamoto University; Kumamoto Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery; Graduate School of Medical Sciences, Kumamoto University; Kumamoto Japan
| | - Higuchi Tetsuya
- Department of Diagnostic Radiology and Nuclear Medicine; Gunma University Graduate School of Medicine; Maebashi Gunma Japan
| | - Hiroyuki Kuwano
- Department of General Surgical Science; Gunma University Graduate School of Medicine; Maebashi Gunma Japan
| | - Ken Shirabe
- Department of Hepatobiliary and Pancreatic Surgery; Gunma University Graduate School of Medicine; Maebashi Gunma Japan
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Granata V, Fusco R, Avallone A, Catalano O, Piccirillo M, Palaia R, Nasti G, Petrillo A, Izzo F. A radiologist's point of view in the presurgical and intraoperative setting of colorectal liver metastases. Future Oncol 2018; 14:2189-2206. [PMID: 30084273 DOI: 10.2217/fon-2018-0080] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Multidisciplinary management of patients with metastatic colorectal cancer requires in each phase an adequate choice of the most appropriate imaging modality. The first challenging step is liver lesions detection and characterization, using several imaging modality ultrasound, computed tomography, magnetic resonance and positron emission tomography. The criteria to establish the metastases resectability have been modified. Not only the lesions number and site but also the functional volume remnant after surgery and the quality of the nontumoral liver must be taken into account. Radiologists should identify the liver functional volume remnant and during liver surgical procedures should collaborate with the surgeon to identify all lesions, including those that disappeared after the therapy, using intraoperative ultrasound with or without contrast medium.
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Affiliation(s)
- Vincenza Granata
- Radiology Division, Istitutonazionale Tumori - IRCCS - Fondazione G Pascale, Napoli, Italia
| | - Roberta Fusco
- Radiology Division, Istitutonazionale Tumori - IRCCS - Fondazione G Pascale, Napoli, Italia
| | - Antonio Avallone
- Abdominal Oncology Division, Istitutonazionale Tumori - IRCSS - Fondazione G Pascale, Napoli, Italia
| | - Orlando Catalano
- Radiology Division, Istitutonazionale Tumori - IRCCS - Fondazione G Pascale, Napoli, Italia
| | - Mauro Piccirillo
- Hepatobiliary Surgical Oncology Division, Istitutonazionale Tumori - IRCCS - Fondazione G Pascale, Napoli, Italia
| | - Raffaele Palaia
- Hepatobiliary Surgical Oncology Division, Istitutonazionale Tumori - IRCCS - Fondazione G Pascale, Napoli, Italia
| | - Guglielmo Nasti
- Abdominal Oncology Division, Istitutonazionale Tumori - IRCSS - Fondazione G Pascale, Napoli, Italia
| | - Antonella Petrillo
- Radiology Division, Istitutonazionale Tumori - IRCCS - Fondazione G Pascale, Napoli, Italia
| | - Francesco Izzo
- Hepatobiliary Surgical Oncology Division, Istitutonazionale Tumori - IRCCS - Fondazione G Pascale, Napoli, Italia
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Smith BH, Gazda LS, Fahey TJ, Nazarian A, Laramore MA, Martis P, Andrada ZP, Thomas J, Parikh T, Sureshbabu S, Berman N, Ocean AJ, Hall RD, Wolf DJ. Clinical laboratory and imaging evidence for effectiveness of agarose-agarose macrobeads containing stem-like cells derived from a mouse renal adenocarcinoma cell population (RMBs) in treatment-resistant, advanced metastatic colorectal cancer: Evaluation of a biological-systems approach to cancer therapy (U.S. FDA IND-BB 10091; NCT 02046174, NCT 01053013). Chin J Cancer Res 2018; 30:72-83. [PMID: 29545721 DOI: 10.21147/j.issn.1000-9604.2018.01.08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Objective The complexity, heterogeneity and capacity of malignant neoplastic cells and tumors for rapid change and evolution suggest that living-cell-based biological-systems approaches to cancer treatment are merited. Testing this hypothesis, the tumor marker, metabolic activity, and overall survival (OS) responses, to the use of one such system, implantable macrobeads [RENCA macrobeads (RMBs)], in phase I and IIa clinical trials in advanced, treatment-resistant metastatic colorectal cancer (mCRC) are described here. Methods Forty-eight mCRC patients (30 females; 18 males), who had failed all available, approved treatments, underwent RMB implantation (8 RMB/kg body weight) up to 4 times in phase I and phase IIa open-label trials. Physicals, labs [tumor and inflammation markers, lactate dehydrogenase (LDH)] and positron emission tomography-computed tomography (PET-CT) imaging to measure number/volume and metabolic activity of the tumors were performed pre- and 3-month-post-implantation to evaluate safety and initial efficacy (as defined by biological responses). PET-CT maximum standard uptake value (SUVmax) (baseline and d 90; SUVmax ≥2.5), LDH, and carcinoembryonic antigen (CEA) and/or cancer antigen 19-9 (CA 19-9) response (baseline, d 30 and/or d 60) were assessed and compared to OS. Results Responses after implantation were characterized by an at least 20% decrease in CEA and/or CA 19-9 in 75% of patients. Fluorodeoxyglucose (FDG)-positive lesions (phase I, 39; 2a, 82) were detected in 37/48 evaluable patients, with 35% stable volume and stable or decreased SUV (10) plus four with necrosis; 10, increased tumor volume, SUV. LDH levels remained stable and low in Responders (R) (d 0-60, 290.4-333.9), but increased steadily in Non-responders (NR) (d 0-60, 382.8-1,278.5) (d 60, P=0.050). Responders to RMBs, indicated by the changes in the above markers, correlated with OS (R mean OS=10.76 months; NR mean OS=4.9 months; P=0.0006). Conclusions The correlations of the tumor marker, tumor volume and SUV changes on PET-CT, and LDH levels themselves, and with OS, support the concept of a biological response to RMB implantation and the validity of the biological-systems approach to mCRC. A phase III clinical trial is planned.
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Affiliation(s)
- Barry H Smith
- The Rogosin Institute, New York NY 10021, USA.,The Rogosin Institute-Xenia Division, Xenia OH 45385, USA
| | | | | | | | | | | | | | | | | | | | - Nathaniel Berman
- The Rogosin Institute, New York NY 10021, USA.,The Rogosin Institute-Xenia Division, Xenia OH 45385, USA
| | | | | | - David J Wolf
- The Rogosin Institute, New York NY 10021, USA.,The Rogosin Institute-Xenia Division, Xenia OH 45385, USA
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Advanced imaging to predict response to chemotherapy in colorectal liver metastases - a systematic review. HPB (Oxford) 2018; 20:120-127. [PMID: 29196021 DOI: 10.1016/j.hpb.2017.10.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 10/24/2017] [Accepted: 10/27/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND The assessment of colorectal liver metastases (CRLM) after treatment with chemotherapy is challenging due to morphological and/or functional change without changes in size. The aim of this review was to assess the value of FDG-PET, FDG-PET-CT, CT and MRI in predicting response to chemotherapy in CRLM. METHODS A systematic review was undertaken based on PRISMA statement. PubMed and Embase were searched up to October 2016 for studies on the accuracy of PET, PET-CT, CT and MRI in predicting RECIST or metabolic response to chemotherapy and/or survival in patients with CRLM. Articles evaluating the assessment of response after chemotherapy were excluded. RESULTS Sixteen studies met the inclusion criteria and were included for further analysis. Study results were available for 6 studies for FDG-PET(-CT), 6 studies for CT and 9 studies for MRI. Generally, features predicting RECIST or metabolic response often predicted shorter survival. The ADC (apparent diffusion coefficient, on MRI) seems to be the most promising predictor of response and survival. In CT-related studies, few attenuation-related parameters and texture features show promising results. In FDG-PET(-CT), findings were ambiguous. CONCLUSION Radiological data on the prediction of response to chemotherapy for CRLM is relatively sparse and heterogeneous. Despite that, a promising parameter might be ADC. Second, there seems to be a seemingly counterintuitive correlation between parameters that predict a good response and also predict poor survival.
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Baik H, Lee SM, Seo SH, An MS, Kim KH, Bae KB, Oh MK, Hong KH. Prognostic value of positron emission tomography/computed tomography for adjuvant chemotherapy of colon cancer. ANZ J Surg 2017; 88:587-591. [PMID: 28687025 DOI: 10.1111/ans.14098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 05/06/2017] [Accepted: 05/07/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND To assess the prognostic value of preoperative 18 F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with high-risk stage II or stage III colon cancer who underwent FOLFOX chemotherapy. METHODS The study included 166 patients with high-risk stage II or stage III colon cancer who received FOLFOX4 chemotherapy. Retrospective patient data were analysed including pathological stage, histology, disease-free survival (DFS) and the maximum standardized uptake value (SUVmax ) of the primary tumour on 18 F-fluorodeoxyglucose positron emission tomography/computed tomography. The primary end point was DFS. RESULTS There were recurrences in 29 of the 166 patients (17.4%). Measuring the area under the receiver operating characteristic curve, the cut-off value of SUVmax with maximum sensitivity and specificity was 10.95. Using the Kaplan-Meier method, the DFS of the patients categorized by SUVmax tended to differ (P = 0.055). In univariate analyses, the risk factors for DFS were age over 70 years, higher N stage and neural invasion. SUVmax ≤ 10.95 showed a tendency, but was not significant (P = 0.0604). In multivariate analyses, the risk factors for DFS were age over 70 and neural invasion. CONCLUSIONS The results of this study suggest that high fluorodeoxyglucose uptake of the primary mass in high-risk stage II and stage III colon cancer does not significantly correlate with DFS.
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Affiliation(s)
- HyungJoo Baik
- Department of Surgery, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea
| | - Seok Mo Lee
- Department of Nuclear Medicine, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea
| | - Sang Hyuk Seo
- Department of Surgery, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea
| | - Min Sung An
- Department of Surgery, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea
| | - Kwang Hee Kim
- Department of Surgery, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea
| | - Ki Beom Bae
- Department of Surgery, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea
| | - Min Kyung Oh
- Clinical Trial Center in Pharmacology, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea
| | - Kwan Hee Hong
- Department of Surgery, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea
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Detection and Viability of Colorectal Liver Metastases After Neoadjuvant Chemotherapy: A Multiparametric PET/CT-MRI Study. Clin Nucl Med 2017; 42:258-263. [PMID: 28166142 DOI: 10.1097/rlu.0000000000001538] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE The aim of this study was to compare combined gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA)-enhanced and diffusion-weighted (DW) MRI with IV contrast-enhanced F-FDG PET/CT to detect and assess the viability of colorectal liver metastases (CLMs) after neoadjuvant chemotherapy (NAC). PATIENTS AND METHODS After NAC, 45 patients with CLMs were prospectively enrolled and underwent combined Gd-EOB-DTPA-enhanced and DW-MRI and contrast-enhanced F-FDG PET/CT. Forty patients subsequently underwent surgery based on intraoperative ultrasound, which served as the reference standard for the presence of CLMs. The number of metastases detected by each technique was then compared. In 69 resected metastases, the SUVmean and SUVmax, mean and maximum target-to-background ratio (TBR), total lesion glycolysis, metabolic tumor volume, and mean and minimum apparent diffusion coefficient (ADC) were examined to identify correlations with the corresponding tumor viability (TV) determined from histological specimens. RESULTS Intraoperative ultrasound revealed 153 CLMs, 122 of which were resected. The detection rate of MRI and contrast-enhanced F-FDG PET/CT were similar (P = 0.61). The SUVmax and minimum ADC were negatively correlated (r = -0.34, P = 0.005) on preoperative imaging after NAC. However, TV was significantly correlated with the maximum TBR (r = 0.33, P = 0.006) and mean TBR (r = 0.37, P = 0.002), but not with the minimum ADC (r = -0.02, P = 0.9) or mean ADC (r = 0.01, P = 0.9). CONCLUSIONS Combined Gd-EOB-DTPA-enhanced and DW-MRI and contrast-enhanced F-FDG PET/CT allow confident detection of CLMs, but only F-FDG PET metrics are associated with TV after NAC.
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Dimitrova EG, Chaushev BG, Conev NV, Kashlov JK, Zlatarov AK, Petrov DP, Popov HB, Stefanova NT, Klisarova AD, Bratoeva KZ, Donev IS. Role of the pretreatment 18F-fluorodeoxyglucose positron emission tomography maximal standardized uptake value in predicting outcomes of colon liver metastases and that value's association with Beclin-1 expression. Biosci Trends 2017; 11:221-228. [PMID: 28250335 DOI: 10.5582/bst.2016.01205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The current study sought to evaluate the predictive and prognostic performance of the maximum standardized uptake value (SUVmax) prior to treatment in 43 patients with colon cancer and unresectable liver metastases. Patients with colon cancer who underwent 18F-FDG-PET/computed tomography (CT) scans for staging before the start of first-line 5-fluorouracil-based chemotherapy were retrospectively analyzed. Expression of Beclin-1 in cancer cells was evaluated in primary tumors using immunohistochemical staining. The pretreatment SUVmax for liver metastases was not able to predict progression-free survival but was significantly associated with poorer overall survival, with a hazard ratio of 2.05 (95 % CI, 1.016-4.155). Moreover, a negative correlation was noted between SUVmax and expression of a marker of autophagy - Beclin-1 (rho = -0.42, p = 0.006). This suggests that the pretreatment SUVmax in 18F-FDG PET/CT is a useful tool to help predict survival outcome in patients with colon cancer and unresectable liver metastases and may significantly distinguish between patients with low and high levels of Beclin-1 expression (AUC = 0.809, 95% CI: 0.670-0.948, p = 0.001).
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Affiliation(s)
- Eleonora G Dimitrova
- Clinic of Medical Oncology, UMHAT "St. Marina".,Department of Propedeutics of Internal Diseases, Medical University of Varna
| | | | - Nikolay V Conev
- Clinic of Medical Oncology, UMHAT "St. Marina".,Department of Propedeutics of Internal Diseases, Medical University of Varna
| | - Javor K Kashlov
- Department of Propedeutics of Internal Diseases, Medical University of Varna
| | - Aleksandar K Zlatarov
- Clinic of Surgery, UMHAT "St. Marina".,Department of General and Operative Surgery, Medical University of Varna
| | - Dilyan P Petrov
- Clinic of Surgery, UMHAT "St. Marina".,Department of General and Operative Surgery, Medical University of Varna
| | | | | | | | | | - Ivan S Donev
- Clinic of Medical Oncology, UMHAT "St. Marina".,Department of Propedeutics of Internal Diseases, Medical University of Varna
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Standardized Added Metabolic Activity Predicts Survival After Intra-arterial Resin-Based 90Y Radioembolization Therapy in Unresectable Chemorefractory Metastatic Colorectal Cancer to the Liver. Clin Nucl Med 2016; 41:e76-81. [PMID: 26447380 DOI: 10.1097/rlu.0000000000000991] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE Standardized added metabolic (SAM) activity is a functional objective measurement of the total tumoral metabolic activity that avoids partial volume effect and thresholding, which limit conventional PET parameters. The purpose of this study is to investigate the role of SAM in predicting survival in unresectable, chemorefractory colorectal hepatic metastatic disease treated with resin-based Y radioembolization. MATERIALS AND METHODS This is a prospective correlative study of patients with unresectable, chemorefractory colorectal liver metastasis who underwent F-FDG PET/CT and CT/MRI before and after Y. Target RECIST, PERCIST, change in total glycolytic activity (ΔTGA), and ΔSAM treatment response were assessed. Percentage changes in diameter, SUVpeak, TGA, and SAM were calculated pre- and post-Y therapy and objective response was defined as >30% change (responders). Survival analysis by Kaplan-Meier, log-rank, and Cox proportional hazard models were performed and significance was set at <0.05. RESULTS Sixteen patients (mean age of 61.6) were enrolled and performed a total of 20 Y therapies. After Y, target ΔSAM showed an objective response rate of 40% vs. 35%, 30%, and 22.2% based on target ΔTGA, PERCIST, and RECIST criteria, respectively. Median overall survival (OS) of the cohort after Y was 9.2 months (CI 95% 2.2-16.2). Patients demonstrating objective response based on ΔSAM had a median OS of 22.7 months (CI 95% 12.4-33.0) vs. 6.7 (CI 95% 4.2-9.2) in non-responders (P = 0.007). On multivariate analysis, hazard ratios for the objective response group based on target ΔSAM were 0.01 (P = 0.03) vs. 0.05 (P = 0.08), 0.20 (P = 0.29), and 0.91 (P = 0.98) based on target ΔTGA, PERCIST, and RECIST criteria, respectively. CONCLUSIONS In unresectable colorectal liver metastatic disease refractory to standard chemotherapy, ΔSAM predicted OS for assessment of response following Y radioembolization therapy, whereas RECIST, PERCIST, and ΔTGA did not.
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Lu W, Chen W. Positron emission tomography/computerized tomography for tumor response assessment-a review of clinical practices and radiomics studies. Transl Cancer Res 2016; 5:364-370. [PMID: 27904837 DOI: 10.21037/tcr.2016.07.12] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Even with recent advances in cancer diagnosis and therapy, treatment outcomes for many cancers remain dismal. Patients often show different response to the same therapy regimen, supporting the development of personalized medicine. 18F-FDG PET/CT has been used routinely in the assessment of tumor response, in prediction of outcomes, and in guiding personalized treatment. These assessments are mainly based on physician's subjective or semi-quantitative evaluation. Recent development in Radiomics provides a promising objective way for tumor response assessment, which uses computerized tools to extract a large number of image features that capture additional information not currently used in clinic that has prognostic value. In this review, we summarized the clinical use of PET/CT and the PET/CT Radiomics studies for tumor response assessment. Finally, we discussed some challenges and future perspectives.
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Affiliation(s)
- Wei Lu
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, USA and Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Wengen Chen
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, USA
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Feasibility of novel PPP1R15A and proposed ANXA11 single nucleotide polymorphisms as predictive markers for bevacizumab regimen in metastatic colorectal cancer. J Cancer Res Clin Oncol 2016; 142:1705-14. [PMID: 27177629 DOI: 10.1007/s00432-016-2177-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 05/02/2016] [Indexed: 12/26/2022]
Abstract
PURPOSE Bevacizumab improves survival in patients with metastatic colorectal cancer (mCRC) under chemotherapy, but few predictive markers have been identified. METHODS To investigate chemosensitive single nucleotide polymorphisms (SNPs) of mCRC, we performed exome sequencing and RNA sequencing in 19 patients. A clinical association analysis was performed with the other 116 patients who had received chemotherapy to bevacizumab regimens. In vivo biodistribution studies and [(18)F]FDG-PET imaging were performed on mice bearing human colorectal cancer (HCT116 and SW480) xenografts after injection of bevacizumab with 5-FU, leucovorin, and irinotecan (FOLFIRI). RESULTS PPP1R15A rs557806 showed the most significant association with FRB-driven tumor IR in exome sequencing and the highest correlation (r = 0.74) with drug responses in RNA sequencing. Patients homozygous for the reference alleles (GG) of PPP1R15A rs557806 exhibited greater disease control rate and a tendency toward greater objective response rate (ORR) than those with homozygous or heterozygous substitution alleles (GC and CC; P = 0.027 and 0.073, respectively). In xenografted mice, HCT116 clones transfected with the G allele at PPP1R15A rs557806 were more sensitive to bevacizumab regimens than those with the C allele. Tumor volume of xenografts with the G allele was significantly lower than that of xenografts with the C allele (P = 0.004, day 13). [(18)F]FDG uptake decreased to 75 % in HCT116 xenograft-bearing mice with the G allele, whereas [(18)F]FDG uptake was 42 % in mice xenografts with the C allele (P = 0.032). ANXA11 rs1049550, a predictive biomarker of SNP described in our previous study, was validated using the xenograft model. Tumor volume and [(18)F]FDG uptake analyses showed that tumors in the SW480 xenografts expressing the substitution allele (T) at ANXA11 rs1049550 were more susceptible to FOLFIRI plus bevacizumab-induced suppression than those expressing the reference allele (C) (P = 0.001 and 0.026, respectively). CONCLUSION ANXA11 rs1049550 and PPP1R15A rs557806 may improve the identification of mCRC patients sensitive to bevacizumab regimens, and further validation is required in large cohorts.
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Goulon D, Necib H, Henaff B, Rousseau C, Carlier T, Kraeber-Bodere F. Quantitative Evaluation of Therapeutic Response by FDG-PET-CT in Metastatic Breast Cancer. Front Med (Lausanne) 2016; 3:19. [PMID: 27243012 PMCID: PMC4861036 DOI: 10.3389/fmed.2016.00019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 04/22/2016] [Indexed: 01/31/2023] Open
Abstract
PURPOSE To assess the therapeutic response for metastatic breast cancer with (18)F-FDG position emission tomography (PET), this retrospective study aims to compare the performance of six different metabolic metrics with PERCIST, PERCIST with optimal thresholds, and an image-based parametric approach. METHODS Thirty-six metastatic breast cancer patients underwent 128 PET scans and 123 lesions were identified. In a per-lesion and per-patient analysis, the performance of six metrics: maximum standardized uptake value (SUVmax), SUVpeak, standardized added metabolic activity (SAM), SUVmean, metabolic volume (MV), total lesion glycolysis (TLG), and a parametric approach (SULTAN) were determined and compared to the gold standard (defined by clinical assessment and biological and conventional imaging according RECIST 1.1). The evaluation was performed using PERCIST thresholds (for per-patient analysis only) and optimal thresholds (determined by the Youden criterion from the receiver operating characteristic curves). RESULTS In the per-lesion analysis, 210 pairs of lesion evolutions were studied. Using the optimal thresholds, SUVmax, SUVpeak, SUVmean, SAM, and TLG were significantly correlated with the gold standard. SUVmax, SUVpeak, and SUVmean reached the best sensitivity (91, 88, and 83%, respectively), specificity (93, 95, and 97%, respectively), and negative predictive value (NPV, 90, 88, and 83%, respectively). For the per--patient analysis, 79 pairs of PET were studied. The optimal thresholds compared to the PERCIST threshold did not improve performance for SUVmax, SUVpeak, and SUVmean. Only SUVmax, SUVpeak, SUVmean, and TLG were correlated with the gold standard. SULTAN also performed equally: 83% sensitivity, 88% specificity, and NPV 86%. CONCLUSION This study showed that SUVmax and SUVpeak were the best parameters for PET evaluation of metastatic breast cancer lesions. Parametric imaging is helpful in evaluating serial studies.
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Affiliation(s)
- Dorothée Goulon
- Service de médecine nucléaire, ICO Nantes , Saint Herblain Cedex , France
| | - Hatem Necib
- Service de radiologie, CHU Nantes , Nantes , France
| | - Brice Henaff
- Service de médecine nucléaire, CHU Nantes , Nantes , France
| | - Caroline Rousseau
- Service de médecine nucléaire, ICO Nantes, Saint Herblain Cedex, France; INSERM UM R892, Nantes, France
| | - Thomas Carlier
- Service de médecine nucléaire, CHU Nantes, Nantes, France; INSERM UM R892, Nantes, France
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Xia Q, Liu J, Wu C, Song S, Tong L, Huang G, Feng Y, Jiang Y, Liu Y, Yin T, Ni Y. Prognostic significance of (18)FDG PET/CT in colorectal cancer patients with liver metastases: a meta-analysis. Cancer Imaging 2015; 15:19. [PMID: 26589835 PMCID: PMC4654916 DOI: 10.1186/s40644-015-0055-z] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 11/15/2015] [Indexed: 12/19/2022] Open
Abstract
Background The role of 18-fluorodeoxyglucose positron emission tomography CT (18FDG PET/CT), as a prognostic factor for survival in colorectal cancer patients with liver metastases, is still controversial. We sought to perform a meta-analysis of the literature to address this issue. Methods A systematic literature search was performed to identify the studies that associated 18FDG PET/CT to clinical survival outcomes of patients with liver metastases. Methodological qualities of the included studies were also assessed. The summarized hazard ratio (HR) was estimated by using fixed- or random-effect model according to heterogeneity between trails. Results By analyzing a total of 867 patients from 15 studies, we found that PET/CT for metabolic response to the therapy was capable of predicting event-free survival (EFS) and overall survival (OS) with statistical significance, and the HR was 0.45 (95 % confidence interval [CI], 0.26–0.78) and 0.36 (95 % CI, 0.18–0.71), respectively. Furthermore, pre-treatment 18FDG PET/CT with high standardized uptake value (SUV) was also significantly associated with poorer OS HR, 1.24; (95 % CI, 1.06–1.45). However, we did not find a statistically significant effect of post-treatment SUV for predicting OS HR, 1.68; (95 % CI, 0.63–4.52). Conclusions The present meta-analysis confirms that 18FDG PET/CT is a useful tool to help predict survival outcomes in patients with liver metastases. Electronic supplementary material The online version of this article (doi:10.1186/s40644-015-0055-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Qian Xia
- Department of Nuclear Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160, Pu Jian road, Shanghai, 200127, China.
| | - Jianjun Liu
- Department of Nuclear Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160, Pu Jian road, Shanghai, 200127, China.
| | - Cheng Wu
- Department of Health Statistics, Second Military Medical University, No. 800, Xiang Yin road, Shanghai, 200433, China.
| | - Shaoli Song
- Department of Nuclear Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160, Pu Jian road, Shanghai, 200127, China.
| | - Linjun Tong
- Department of Nuclear Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160, Pu Jian road, Shanghai, 200127, China
| | - Gang Huang
- Department of Nuclear Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160, Pu Jian road, Shanghai, 200127, China.
| | - Yuanbo Feng
- Department of Imaging and Pathology, University Hospitals, KU Leuven, Herestraat 49, Leuven, 3000, Belgium.
| | - Yansheng Jiang
- Department of Imaging and Pathology, University Hospitals, KU Leuven, Herestraat 49, Leuven, 3000, Belgium.
| | - Yewei Liu
- Department of Imaging and Pathology, University Hospitals, KU Leuven, Herestraat 49, Leuven, 3000, Belgium.
| | - Ting Yin
- Department of Imaging and Pathology, University Hospitals, KU Leuven, Herestraat 49, Leuven, 3000, Belgium
| | - Yicheng Ni
- Department of Imaging and Pathology, University Hospitals, KU Leuven, Herestraat 49, Leuven, 3000, Belgium.
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Prognostic value of metabolic parameters and clinical impact of 18F-fluorocholine PET/CT in biochemical recurrent prostate cancer. Eur J Nucl Med Mol Imaging 2015; 42:1784-93. [DOI: 10.1007/s00259-015-3123-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 06/29/2015] [Indexed: 01/17/2023]
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Laurens ST, Oyen WJ. Impact of Fluorodeoxyglucose PET/Computed Tomography on the Management of Patients with Colorectal Cancer. PET Clin 2015; 10:345-60. [DOI: 10.1016/j.cpet.2015.03.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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20
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Positron Emission Tomography for the Response Evaluation following Treatment with Chemotherapy in Patients Affected by Colorectal Liver Metastases: A Selected Review. Gastroenterol Res Pract 2015; 2015:706808. [PMID: 26078753 PMCID: PMC4442279 DOI: 10.1155/2015/706808] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 04/20/2015] [Accepted: 04/20/2015] [Indexed: 02/08/2023] Open
Abstract
The aim of the present paper is to review the scientific literature concerning the usefulness of (18)F-FDG PET/CT in the evaluation of response to chemotherapy in patients affected by liver metastases from colorectal cancer. Material and Methods. Studies were identified by searching PubMed electronic databases. Both prospective and retrospective studies were included. Information regarding the figure of merit of PET for the evaluation of therapy response was extracted and analyzed. Results. Existing data suggests that (18)F-FDG PET/CT may have an outstanding role in evaluating the response. The sensitivity of PET in detecting therapy response seems to be greater than conventional imaging (CT and MRI). PET/CT response is strictly related to better overall survival and progression-free survival. Conclusions. PET/CT is more than a promising technique to assess the response to chemotherapy in colorectal and liver metastases. However, to be fully validated, this examination needs further studies by recruiting more patients.
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Lu W, Wang J, Zhang HH. Computerized PET/CT image analysis in the evaluation of tumour response to therapy. Br J Radiol 2015; 88:20140625. [PMID: 25723599 DOI: 10.1259/bjr.20140625] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Current cancer therapy strategy is mostly population based, however, there are large differences in tumour response among patients. It is therefore important for treating physicians to know individual tumour response. In recent years, many studies proposed the use of computerized positron emission tomography/CT image analysis in the evaluation of tumour response. Results showed that computerized analysis overcame some major limitations of current qualitative and semiquantitative analysis and led to improved accuracy. In this review, we summarize these studies in four steps of the analysis: image registration, tumour segmentation, image feature extraction and response evaluation. Future works are proposed and challenges described.
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Affiliation(s)
- W Lu
- Department of Radiation Oncology, University of Maryland, School of Medicine, Baltimore, MD, USA
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