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Xu M, Gu B, Zhang J, Xu X, Qiao Y, Hu S, Song S. Differentiation of cancer of unknown primary and lymphoma in head and neck metastatic poorly differentiated cancer using 18 F-FDG PET/CT tumor metabolic heterogeneity index. Nucl Med Commun 2024; 45:148-154. [PMID: 38095143 DOI: 10.1097/mnm.0000000000001797] [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: 01/11/2024]
Abstract
OBJECTIVE To explore the value of 18 F-FDG PET/CT tumor metabolic heterogeneity index (HI) and establish and validate a nomogram model for distinguishing head and neck cancer of unknown primary (HNCUP) from lymphoma with head and neck metastatic poorly differentiated cancer. METHODS This retrospective analysis was conducted on 1242 patients with cervical metastatic poorly differentiated cancer. 108 patients, who were clinically and pathologically confirmed as HNCUP or lymphoma, were finally enrolled. Two independent sample t-tests and χ 2 test were used to compare the clinical and imaging features. Binary logistic regression was used to screen for independent predictive factors. RESULTS Among the 108 patients), 65 patients were diagnosed with HNCUP and 43 were lymphoma. Gender ( P = 0.001), SUV max ( P < 0.001), SUV mean ( P < 0.001), TLG ( P = 0.012), and HI ( P < 0.001) had statistical significance in distinguishing HNCUP and lymphoma. Female ( OR = 4.546, P = 0.003) and patients with HI ≥ 2.37 ( OR = 3.461, P = 0.047) were more likely to be diagnosed as lymphoma. CONCLUSION For patients with cervical metastatic poorly differentiated cancer, gender and HI were independent predictors of pathological type. For such patients, clinical attention should be paid to avoid misdiagnosing lymphoma as HNCUP, which may delay treatment.
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Affiliation(s)
- Mingzhen Xu
- Department of Nuclear Medicine, Shanghai Proton and Heavy Ion Center, Fudan University Shanghai Cancer Center
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000)
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Xuhui District, Shanghai, China
| | - Bingxin Gu
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Xuhui District, Shanghai, China
| | - Jianping Zhang
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Xuhui District, Shanghai, China
| | - Xiaoping Xu
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Xuhui District, Shanghai, China
| | - Ying Qiao
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Xuhui District, Shanghai, China
| | - Silong Hu
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Xuhui District, Shanghai, China
| | - Shaoli Song
- Department of Nuclear Medicine, Shanghai Proton and Heavy Ion Center, Fudan University Shanghai Cancer Center
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000)
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Xuhui District, Shanghai, China
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Sabeghi P, Katal S, Chen M, Taravat F, Werner TJ, Saboury B, Gholamrezanezhad A, Alavi A. Update on Positron Emission Tomography/Magnetic Resonance Imaging: Cancer and Inflammation Imaging in the Clinic. Magn Reson Imaging Clin N Am 2023; 31:517-538. [PMID: 37741639 DOI: 10.1016/j.mric.2023.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2023]
Abstract
Hybrid PET/MRI is highly valuable, having made significant strides in overcoming technical challenges and offering unique advantages such as reduced radiation, precise data coregistration, and motion correction. Growing evidence highlights the value of PET/MRI in broad clinical aspects, including inflammatory and oncological imaging in adults, pregnant women, and pediatrics, potentially surpassing PET/CT. This newly integrated solution may be preferred over PET/CT in many clinical conditions. However, further technological advancements are required to facilitate its broader adoption as a routine diagnostic modality.
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Affiliation(s)
- Paniz Sabeghi
- Department of Radiology, Keck School of Medicine of University of Southern California, Health Science Campus, 1500 San Pablo Street, Los Angeles, CA 90033, USA
| | - Sanaz Katal
- Medical Imaging Department of St. Vincent's Hospital, Melbourne, Victoria, Australia
| | - Michelle Chen
- Department of Radiology, Keck School of Medicine of University of Southern California, Health Science Campus, 1500 San Pablo Street, Los Angeles, CA 90033, USA
| | - Farzaneh Taravat
- Department of Radiology, Keck School of Medicine of University of Southern California, Health Science Campus, 1500 San Pablo Street, Los Angeles, CA 90033, USA
| | - Thomas J Werner
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Babak Saboury
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA; Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Ali Gholamrezanezhad
- Department of Radiology, Keck School of Medicine of University of Southern California, Health Science Campus, 1500 San Pablo Street, Los Angeles, CA 90033, USA
| | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
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Mistry V, Scott JR, Wang TY, Mollee P, Miles KA, Law WP, Hapgood G. Diagnostic performance of prospective same-day 18F-FDG PET/MRI and 18F-FDG PET/CT in the staging and response assessment of lymphoma. Cancer Imaging 2023; 23:11. [PMID: 36694244 PMCID: PMC9872391 DOI: 10.1186/s40644-023-00520-7] [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] [Received: 08/22/2022] [Accepted: 01/03/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Accurate staging and response assessment are essential for prognosis and to guide treatment in patients with lymphoma. The aim of this study was to compare the diagnostic performance of FDG PET/MRI versus FDG PET/CT in adult patients with newly diagnosed Hodgkin and Non- Hodgkin lymphoma. METHODS In this single centre study, 50 patients were prospectively recruited. FDG PET/MRI was performed after staging FDG PET/CT using a single injection of 18F-FDG. Patients were invited to complete same-day FDG PET/MRI with FDG PET/CT at interim and end of treatment response assessments. Performance was assessed using PET/CT as the reference standard for disease site identification, staging, response assessment with Deauville score and concordance in metabolic activity. RESULTS Staging assessment showed perfect agreement (κ = 1.0, P = 0) between PET/MRI and PET/CT using Ann Arbor staging. There was excellent intermodality correlation with disease site identification at staging (κ = 0.976, P < 0.001) with FDG PET/MRI sensitivity of 96% (95% CI, 94-98%) and specificity of 100% (95% CI, 99-100%). There was good correlation of disease site identification at interim assessment (κ = 0.819, P < 0.001) and excellent correlation at end-of-treatment assessment (κ = 1.0, P < 0.001). Intermodality agreement for Deauville scores was good at interim assessment (κ = 0.808, P < 0.001) and excellent at end-of-treatment assessment (κ = 1.0, P = 0). There was good-excellent concordance in SUV max and mean between modalities across timepoints. Minimum calculated radiation patient effective dose saving was 54% between the two modalities per scan. CONCLUSION With high concordance in disease site identification, staging and response assessment, PET/MR is a potentially viable alternative to PET/CT in lymphoma that minimises radiation exposure.
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Affiliation(s)
- Vijay Mistry
- grid.412744.00000 0004 0380 2017Department of Medical Imaging, Princess Alexandra Hospital, Brisbane, Australia
| | - Justin R. Scott
- grid.1003.20000 0000 9320 7537QCIF Bioinformatics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Tzu-Yang Wang
- grid.412744.00000 0004 0380 2017Department of Haematology, Princess Alexandra Hospital, Brisbane, Australia
| | - Peter Mollee
- grid.412744.00000 0004 0380 2017Department of Haematology, Princess Alexandra Hospital, Brisbane, Australia ,grid.412744.00000 0004 0380 2017Translational Research Institute, Princess Alexandra Hospital, Brisbane, Australia
| | - Kenneth A. Miles
- grid.412744.00000 0004 0380 2017Department of Medical Imaging, Princess Alexandra Hospital, Brisbane, Australia ,grid.83440.3b0000000121901201Institute of Nuclear Medicine, University College London, University College Hospital, London, UK
| | - W. Phillip Law
- grid.412744.00000 0004 0380 2017Department of Medical Imaging, Princess Alexandra Hospital, Brisbane, Australia ,grid.412744.00000 0004 0380 2017Translational Research Institute, Princess Alexandra Hospital, Brisbane, Australia ,grid.1003.20000 0000 9320 7537School of Medicine, University of Queensland, Brisbane, Australia
| | - Greg Hapgood
- grid.412744.00000 0004 0380 2017Department of Haematology, Princess Alexandra Hospital, Brisbane, Australia ,grid.412744.00000 0004 0380 2017Translational Research Institute, Princess Alexandra Hospital, Brisbane, Australia
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Husby T, Johansen H, Bogsrud TV, Hustad KV, Evensen BV, Boellaard R, Giskeødegård GF, Fagerli UM, Eikenes L. Prognostic value of combined MTV and ADC derived from baseline FDG PET/MRI in aggressive non-Hodgkins lymphoma. BMC Cancer 2022; 22:1117. [PMID: 36319985 PMCID: PMC9623965 DOI: 10.1186/s12885-022-10194-2] [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: 06/26/2022] [Accepted: 10/18/2022] [Indexed: 01/24/2023] Open
Abstract
PURPOSE The aim of this prospective study was to investigate the prognostic value of metabolic tumor volume (MTV) and apparent diffusion coefficient (ADC) from baseline FDG PET/MRI compared to established clinical risk factors in terms of progression free survival (PFS) at 2 years in a cohort of diffuse large B-cell Lymphoma (DLBCL) and high-grade-B-cell lymphoma (HGBCL). METHODS Thirty-three patients and their baseline PET/MRI examinations were included. Images were read by two pairs of nuclear medicine physicians and radiologists for defining lymphoma lesions. MTV was computed on PET, and up to six lymphoma target lesions with restricted diffusion was defined for each PET/MRI examination. Minimum ADC (ADCmin) and the corresponding mean ADC (ADCmean) from the target lesion with the lowest ADCmin were included in the analyses. For the combined PET/MRI parameters, the ratio between MTV and the target lesion with the lowest ADCmin (MTV/ADCmin) and the corresponding ADCmean (MTV/ADCmean) was calculated for each patient. Clinical, histological, and PET/MRI parameters were compared between the treatment failure and treatment response group, while survival analyses for each variable was performed by using univariate Cox regression. In case of significant variables in the Cox regression analyses, Kaplan-Meier survival analyses with log-rank test was used to study the effect of the variables on PFS. RESULTS ECOC PS scale ≥2 (p = 0.05) and ADCmean (p = 0.05) were significantly different between the treatment failure group (n = 6) and those with treatment response (n = 27). Survival analyses showed that ADCmean was associated with PFS (p = 0.02, [HR 2.3 for 1 SD increase]), while combining MTV and ADC did not predict outcome. In addition, ECOG PS ≥2 (p = 0.01, [HR 13.3]) and histology of HGBCL (p = 0.02 [HR 7.6]) was significantly associated with PFS. CONCLUSIONS ADCmean derived from baseline MRI could be a prognostic imaging biomarker for DLBCL and HGBCL. Baseline staging with PET/MRI could therefore give supplementary prognostic information compared to today's standard PET/CT.
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Affiliation(s)
- Trine Husby
- grid.5947.f0000 0001 1516 2393Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks, 8905 Trondheim, Norway ,grid.52522.320000 0004 0627 3560Department of Oncology, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway
| | - Håkon Johansen
- grid.52522.320000 0004 0627 3560Department of Radiology and Nuclear Medicine, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway
| | - Trond Velde Bogsrud
- grid.412244.50000 0004 4689 5540PET-Centre, University Hospital of North Norway, Tromsø, Norway ,grid.154185.c0000 0004 0512 597XPET-Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Kari Vekseth Hustad
- grid.52522.320000 0004 0627 3560Department of Radiology and Nuclear Medicine, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway
| | - Birte Veslemøy Evensen
- grid.52522.320000 0004 0627 3560Department of Radiology and Nuclear Medicine, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway
| | - Ronald Boellaard
- grid.4494.d0000 0000 9558 4598Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands ,grid.16872.3a0000 0004 0435 165XDepartment of Radiology and Nuclear Medicine, Cancer Center Amsterdam, University Medical Centers Amsterdam, VUMC, Amsterdam, The Netherlands
| | - Guro F. Giskeødegård
- grid.5947.f0000 0001 1516 2393Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Unn-Merete Fagerli
- grid.52522.320000 0004 0627 3560Department of Oncology, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway ,grid.5947.f0000 0001 1516 2393Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Live Eikenes
- grid.5947.f0000 0001 1516 2393Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks, 8905 Trondheim, Norway
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Guja KE, Nadel H, Iagaru A. Overview and Recent Advances in 18F-FDG PET/CT for Evaluation of Pediatric Lymphoma. Semin Nucl Med 2022. [DOI: 10.1053/j.semnuclmed.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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