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Ma W, Chen B, Zhu F, Yang C, Yang J. Diagnostic role of F-18 FDG PET/CT in determining preoperative Lymph node status of patients with rectal cancer: a meta-analysis. Abdom Radiol (NY) 2024; 49:2125-2134. [PMID: 38281158 DOI: 10.1007/s00261-023-04140-4] [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: 09/29/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 01/30/2024]
Abstract
PURPOSE To obtain performance values of PET/CT for determining the nodal status of rectal cancer. MATERIALS A comprehensive literature search was performed on PubMed and Embase for original diagnostic accuracy studies on the diagnostic performance of PET-CT for detection of LN metastasis in rectal cancer. The QUADAS-2 was used to evaluate the methodological quality of each study. Pooled sensitivity, specificity, and AUC were calculated to estimate the diagnostic role of PET/CT using a random-effects model. A subgroup analysis was performed to investigate the influence of different parameters on diagnostic performance. RESULTS A total of 15 studies and 1209 patients were included. A publication bias was observed. The pooled sensitivity, specificity, and AUC for PET/CT was 0.62 (95% CI 0.49, 0.74), 0.94 (95% CI 0.87, 0.97), and 0.87 (95% CI 0.83-0.89), respectively. Per-node basis yields higher accuracy than per-patient basis, with pooled sensitivities of 0.65 (95% CI 0.50-0.79) vs. 0.56 (95% CI 0.36-0.77) and specificities of 0.96 (95% CI 0.92-1.00) vs. 0.88 (95% CI 0.76-1.00), but there were no significant differences in diagnostic accuracy. CONCLUSION PET/CT has high specificity but moderate sensitivity for the detection of LN metastasis in rectal cancer. The current data suggests that the diagnostic capabilities of this method is limited due to its moderate sensitivity.
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Affiliation(s)
- Weili Ma
- Department of Radiology, Key Laboratory of Functional Molecular Imaging of Tumor and Interventional Diagnosis and Treatment of Shaoxing City, Shaoxing People's Hospital, Shaoxing, 312000, China
| | - Bo Chen
- Department of Radiology, Key Laboratory of Functional Molecular Imaging of Tumor and Interventional Diagnosis and Treatment of Shaoxing City, Shaoxing People's Hospital, Shaoxing, 312000, China
| | - Fandong Zhu
- Department of Radiology, Key Laboratory of Functional Molecular Imaging of Tumor and Interventional Diagnosis and Treatment of Shaoxing City, Shaoxing People's Hospital, Shaoxing, 312000, China
| | - Chen Yang
- Department of Radiology, Key Laboratory of Functional Molecular Imaging of Tumor and Interventional Diagnosis and Treatment of Shaoxing City, Shaoxing People's Hospital, Shaoxing, 312000, China
| | - Jianfeng Yang
- Department of Radiology, Key Laboratory of Functional Molecular Imaging of Tumor and Interventional Diagnosis and Treatment of Shaoxing City, Shaoxing People's Hospital, Shaoxing, 312000, China.
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Ji M, Ma G, Liu C, Gu B, Du X, Ou X, Xu X, Song S, Yang Z. Head-to-head comparison of [ 68Ga]Ga-DOTA-FAPI-04 and [ 18F]FDG PET/CT for the evaluation of tonsil cancer and lymph node metastases: a single-centre retrospective study. Cancer Imaging 2024; 24:56. [PMID: 38702821 PMCID: PMC11069139 DOI: 10.1186/s40644-024-00699-3] [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: 01/14/2024] [Accepted: 04/25/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND This study aimed to compare the diagnostic value of [68 Ga]Ga-DOTA-FAPI-04 and [18F]FDG PET/CT imaging for primary lesions and metastatic lymph nodes in patients with tonsil cancer. METHOD Twenty-one tonsil cancer patients who underwent [68 Ga]Ga-DOTA-FAPI-04 and [18F]FDG PET/CT scans within two weeks in our centre were retrospectively enrolled. The maximum standardized uptake value (SUVmax) and tumor-to-background ratio (TBR) of the two tracers were compared by using the Mann‒Whitney U test. In addition, the sensitivity, specificity, and accuracy of the two methods for diagnosing metastatic lymph nodes were analysed. RESULTS In detecting primary lesions, the efficiency was higher for [68 Ga]Ga-DOTA-FAPI-04 PET/CT (20/22) than for [18F]FDG PET/CT (9/22). Although [68 Ga]Ga-DOTA-FAPI-04 uptake (SUVmax, 5.03 ± 4.06) was lower than [18F]FDG uptake (SUVmax, 7.90 ± 4.84, P = 0.006), [68 Ga]Ga-DOTA-FAPI-04 improved the distinction between the primary tumor and contralateral normal tonsillar tissue. The TBR was significantly higher for [68 Ga]Ga-DOTA-FAPI-04 PET/CT (3.19 ± 2.06) than for [18F]FDG PET/CT (1.89 ± 1.80) (p < 0.001). In lymph node analysis, SUVmax and TBR were not significantly different between [68 Ga]Ga-DOTA-FAPI-04 and [18F]FDG PET/CT (7.67 ± 5.88 vs. 8.36 ± 6.15, P = 0.498 and 5.56 ± 4.02 vs. 4.26 ± 3.16, P = 0.123, respectively). The specificity and accuracy of [68 Ga]Ga-DOTA-FAPI-04 PET/CT were higher than those of [18F]FDG PET/CT in diagnosing metastatic cervical lymph nodes (all P < 0.05). CONCLUSION The availability of [68 Ga]Ga-DOTA-FAPI-04 complements the diagnostic results of [18F]FDG by improving the detection rate of primary lesions and the diagnostic accuracy of cervical metastatic lymph nodes in tonsil cancer compared to [18F]FDG.
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Affiliation(s)
- Mengjing Ji
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
- Center for Biomedical Imaging, Fudan University, Shanghai, 200032, China
- Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, 200032, China
| | - Guang Ma
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
- Center for Biomedical Imaging, Fudan University, Shanghai, 200032, China
- Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, 200032, China
| | - Cheng Liu
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
- Center for Biomedical Imaging, Fudan University, Shanghai, 200032, China
- Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, 200032, China
| | - Bingxin Gu
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
- Center for Biomedical Imaging, Fudan University, Shanghai, 200032, China
- Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, 200032, China
| | - Xinyue Du
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
- Center for Biomedical Imaging, Fudan University, Shanghai, 200032, China
- Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, 200032, China
| | - Xiaomin Ou
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
| | - Xiaoping Xu
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
- Center for Biomedical Imaging, Fudan University, Shanghai, 200032, China
- Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, 200032, China
| | - Shaoli Song
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
- Center for Biomedical Imaging, Fudan University, Shanghai, 200032, China.
- Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, 200032, China.
| | - Zhongyi Yang
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
- Center for Biomedical Imaging, Fudan University, Shanghai, 200032, China.
- Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, 200032, China.
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Meynen J, Adriaensens P, Criel M, Louis E, Vanhove K, Thomeer M, Mesotten L, Derveaux E. Plasma Metabolite Profiling in the Search for Early-Stage Biomarkers for Lung Cancer: Some Important Breakthroughs. Int J Mol Sci 2024; 25:4690. [PMID: 38731909 PMCID: PMC11083579 DOI: 10.3390/ijms25094690] [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: 03/21/2024] [Revised: 04/19/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
Lung cancer is the leading cause of cancer-related mortality worldwide. In order to improve its overall survival, early diagnosis is required. Since current screening methods still face some pitfalls, such as high false positive rates for low-dose computed tomography, researchers are still looking for early biomarkers to complement existing screening techniques in order to provide a safe, faster, and more accurate diagnosis. Biomarkers are biological molecules found in body fluids, such as plasma, that can be used to diagnose a condition or disease. Metabolomics has already been shown to be a powerful tool in the search for cancer biomarkers since cancer cells are characterized by impaired metabolism, resulting in an adapted plasma metabolite profile. The metabolite profile can be determined using nuclear magnetic resonance, or NMR. Although metabolomics and NMR metabolite profiling of blood plasma are still under investigation, there is already evidence for its potential for early-stage lung cancer diagnosis, therapy response, and follow-up monitoring. This review highlights some key breakthroughs in this research field, where the most significant biomarkers will be discussed in relation to their metabolic pathways and in light of the altered cancer metabolism.
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Affiliation(s)
- Jill Meynen
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, B-3500 Hasselt, Belgium; (J.M.); (M.C.); (K.V.); (L.M.)
| | - Peter Adriaensens
- Applied and Analytical Chemistry, NMR Group, Institute for Materials Research (Imo-Imomec), Hasselt University, Agoralaan 1, B-3590 Diepenbeek, Belgium;
| | - Maarten Criel
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, B-3500 Hasselt, Belgium; (J.M.); (M.C.); (K.V.); (L.M.)
- Department of Respiratory Medicine, Ziekenhuis Oost-Limburg, Synaps Park 1, B-3600 Genk, Belgium;
| | - Evelyne Louis
- Department of Respiratory Medicine, University Hospital Leuven, Herestraat 49, B-3000 Leuven, Belgium;
| | - Karolien Vanhove
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, B-3500 Hasselt, Belgium; (J.M.); (M.C.); (K.V.); (L.M.)
- Department of Respiratory Medicine, University Hospital Leuven, Herestraat 49, B-3000 Leuven, Belgium;
- Department of Respiratory Medicine, Algemeen Ziekenhuis Vesalius, Hazelereik 51, B-3700 Tongeren, Belgium
| | - Michiel Thomeer
- Department of Respiratory Medicine, Ziekenhuis Oost-Limburg, Synaps Park 1, B-3600 Genk, Belgium;
| | - Liesbet Mesotten
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, B-3500 Hasselt, Belgium; (J.M.); (M.C.); (K.V.); (L.M.)
- Department of Nuclear Medicine, Ziekenhuis Oost-Limburg, Synaps Park 1, B-3600 Genk, Belgium
| | - Elien Derveaux
- Applied and Analytical Chemistry, NMR Group, Institute for Materials Research (Imo-Imomec), Hasselt University, Agoralaan 1, B-3590 Diepenbeek, Belgium;
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González MI, González-Arjona M, Cussó L, Morcillo MÁ, Aguilera-Correa JJ, Esteban J, Kestler M, Calle D, Cerón C, Cortes-Canteli M, Muñoz P, Bouza E, Desco M, Salinas B. In Vivo Detection of Staphylococcus aureus Infections Using Radiolabeled Antibodies Specific for Bacterial Toxins. Int J Biomed Imaging 2024; 2024:3655327. [PMID: 38665417 PMCID: PMC11045290 DOI: 10.1155/2024/3655327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/02/2024] [Accepted: 01/13/2024] [Indexed: 04/28/2024] Open
Abstract
Purpose The Gram-positive Staphylococcus aureus bacterium is one of the leading causes of infection in humans. The lack of specific noninvasive techniques for diagnosis of staphylococcal infection together with the severity of its associated complications support the need for new specific and selective diagnostic tools. This work presents the successful synthesis of an immunotracer that targets the α-toxin released by S. aureus. Methods [89Zr]Zr-DFO-ToxAb was synthesized based on radiolabeling an anti-α-toxin antibody with zirconium-89. The physicochemical characterization of the immunotracer was performed by high-performance liquid chromatography (HPLC), radio-thin layer chromatography (radio-TLC), and electrophoretic analysis. Its diagnostic ability was evaluated in vivo by positron emission tomography/computed tomography (PET/CT) imaging in an animal model of local infection-inflammation (active S. aureus vs. heat-killed S. aureus) and infective osteoarthritis. Results Chemical characterization of the tracer established the high radiochemical yield and purity of the tracer while maintaining antibody integrity. In vivo PET/CT image confirmed the ability of the tracer to detect active foci of S. aureus. Those results were supported by ex vivo biodistribution studies, autoradiography, and histology, which confirmed the ability of [89Zr]Zr-DFO-ToxAb to detect staphylococcal infectious foci, avoiding false-positives derived from inflammatory processes. Conclusions We have developed an immuno-PET tracer capable of detecting S. aureus infections based on a radiolabeled antibody specific for the staphylococcal alpha toxins. The in vivo assessment of [89Zr]Zr-DFO-ToxAb confirmed its ability to selectively detect staphylococcal infectious foci, allowing us to discern between infectious and inflammatory processes.
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Affiliation(s)
- María Isabel González
- Unidad de Medicina y Cirugía Experimental, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28007 Madrid, Spain
- Unidad de Imagen Avanzada, Centro Nacional de Investigaciones Cardiovasculares (CNIC), 28029 Madrid, Spain
| | - Mario González-Arjona
- Unidad de Medicina y Cirugía Experimental, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28007 Madrid, Spain
| | - Lorena Cussó
- Unidad de Medicina y Cirugía Experimental, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28007 Madrid, Spain
- Unidad de Imagen Avanzada, Centro Nacional de Investigaciones Cardiovasculares (CNIC), 28029 Madrid, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Miguel Ángel Morcillo
- Unidad de Aplicaciones Médicas de las Radiaciones Ionizantes, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), 28040 Madrid, Spain
| | - John Jairo Aguilera-Correa
- Departamento de Química en Ciencias Farmacéuticas, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Servicio de Microbiología Clínica Instituto de Investigación Sanitaria Fundación Jiménez Díaz, UAM, 28040 Madrid, Spain
- CIBERINFEC-CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Jaime Esteban
- Servicio de Microbiología Clínica Instituto de Investigación Sanitaria Fundación Jiménez Díaz, UAM, 28040 Madrid, Spain
- CIBERINFEC-CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Martha Kestler
- Servicio de Microbiología y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
| | - Daniel Calle
- Unidad de Imagen Avanzada, Centro Nacional de Investigaciones Cardiovasculares (CNIC), 28029 Madrid, Spain
| | - Carlos Cerón
- Cardiovascular Risk Factors and Brain Function Programme, Centro Nacional de Investigaciones Cardiovasculares (CNIC) Carlos III, 28029 Madrid, Spain
| | - Marta Cortes-Canteli
- Cardiovascular Risk Factors and Brain Function Programme, Centro Nacional de Investigaciones Cardiovasculares (CNIC) Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), 28040 Madrid, Spain
| | - Patricia Muñoz
- CIBER de Salud Mental, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Servicio de Microbiología y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
- Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Emilio Bouza
- CIBER de Salud Mental, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Servicio de Microbiología y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
- Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Manuel Desco
- Unidad de Medicina y Cirugía Experimental, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28007 Madrid, Spain
- Unidad de Imagen Avanzada, Centro Nacional de Investigaciones Cardiovasculares (CNIC), 28029 Madrid, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Departamento de Bioingeniería, Universidad Carlos III de Madrid, 28911 Madrid, Spain
| | - Beatriz Salinas
- Unidad de Medicina y Cirugía Experimental, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28007 Madrid, Spain
- Unidad de Imagen Avanzada, Centro Nacional de Investigaciones Cardiovasculares (CNIC), 28029 Madrid, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Departamento de Bioingeniería, Universidad Carlos III de Madrid, 28911 Madrid, Spain
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Wang Y, Lombardo E, Huang L, Avanzo M, Fanetti G, Franchin G, Zschaeck S, Weingärtner J, Belka C, Riboldi M, Kurz C, Landry G. Comparison of deep learning networks for fully automated head and neck tumor delineation on multi-centric PET/CT images. Radiat Oncol 2024; 19:3. [PMID: 38191431 PMCID: PMC10773015 DOI: 10.1186/s13014-023-02388-0] [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: 09/01/2023] [Accepted: 12/12/2023] [Indexed: 01/10/2024] Open
Abstract
OBJECTIVES Deep learning-based auto-segmentation of head and neck cancer (HNC) tumors is expected to have better reproducibility than manual delineation. Positron emission tomography (PET) and computed tomography (CT) are commonly used in tumor segmentation. However, current methods still face challenges in handling whole-body scans where a manual selection of a bounding box may be required. Moreover, different institutions might still apply different guidelines for tumor delineation. This study aimed at exploring the auto-localization and segmentation of HNC tumors from entire PET/CT scans and investigating the transferability of trained baseline models to external real world cohorts. METHODS We employed 2D Retina Unet to find HNC tumors from whole-body PET/CT and utilized a regular Unet to segment the union of the tumor and involved lymph nodes. In comparison, 2D/3D Retina Unets were also implemented to localize and segment the same target in an end-to-end manner. The segmentation performance was evaluated via Dice similarity coefficient (DSC) and Hausdorff distance 95th percentile (HD95). Delineated PET/CT scans from the HECKTOR challenge were used to train the baseline models by 5-fold cross-validation. Another 271 delineated PET/CTs from three different institutions (MAASTRO, CRO, BERLIN) were used for external testing. Finally, facility-specific transfer learning was applied to investigate the improvement of segmentation performance against baseline models. RESULTS Encouraging localization results were observed, achieving a maximum omnidirectional tumor center difference lower than 6.8 cm for external testing. The three baseline models yielded similar averaged cross-validation (CV) results with a DSC in a range of 0.71-0.75, while the averaged CV HD95 was 8.6, 10.7 and 9.8 mm for the regular Unet, 2D and 3D Retina Unets, respectively. More than a 10% drop in DSC and a 40% increase in HD95 were observed if the baseline models were tested on the three external cohorts directly. After the facility-specific training, an improvement in external testing was observed for all models. The regular Unet had the best DSC (0.70) for the MAASTRO cohort, and the best HD95 (7.8 and 7.9 mm) in the MAASTRO and CRO cohorts. The 2D Retina Unet had the best DSC (0.76 and 0.67) for the CRO and BERLIN cohorts, and the best HD95 (12.4 mm) for the BERLIN cohort. CONCLUSION The regular Unet outperformed the other two baseline models in CV and most external testing cohorts. Facility-specific transfer learning can potentially improve HNC segmentation performance for individual institutions, where the 2D Retina Unets could achieve comparable or even better results than the regular Unet.
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Affiliation(s)
- Yiling Wang
- Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Radiation Oncology, Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Elia Lombardo
- Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Lili Huang
- Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Michele Avanzo
- Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Medical Physics, Aviano, Italy
| | - Giuseppe Fanetti
- Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Radiation Oncology, Aviano, Italy
| | - Giovanni Franchin
- Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Radiation Oncology, Aviano, Italy
| | - Sebastian Zschaeck
- Radiation Oncology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Berlin, Germany
| | - Julian Weingärtner
- Radiation Oncology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Berlin, Germany
| | - Claus Belka
- Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - Marco Riboldi
- Department of Medical Physics, Ludwig-Maximilians-Universität München, Garching, Germany
| | - Christopher Kurz
- Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Guillaume Landry
- Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, Germany.
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Bissinger O, Von den Hoff A, Maier E, Obermeier KT, Stimmer H, Kolk A, Wolff KD, Götz C. The Value of Surveillance Imaging of Oral Squamous Cell Carcinoma. Cancers (Basel) 2024; 16:207. [PMID: 38201635 PMCID: PMC10778242 DOI: 10.3390/cancers16010207] [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: 09/18/2023] [Revised: 11/15/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
The evaluation of surveillance imaging of OSCC patients is a difficult task physicians have to face daily. Multiple patients experience a recurrence of this disease, which underlines the importance of regular patient monitoring programs. Our study analysed the value of surveillance imaging, such as computed tomography (CT) and nuclear magnetic resonance imaging (NMRI), as a patient monitoring programme and its effectiveness in achieving improvement in early recurrence detection. The study comprised 125 patients, out of which 56 (n = 56) showed radiological and 69 (n = 69) showed clinical and radiological conspicuous patterns in domestic follow-ups, respectively. The use of CT and NMRI showed a significant dependence on the histological result (p = 0.03). However, the different groups showed no significant dependence on the histological result (p = 0.96). The distribution of the histological biopsies, which were taken due to radiological changes, were prone to wrong positive diagnoses (false positives) in 71 percent. To conclude, imaging modalities should be chosen for each patient individually to reduce false positives, improve the early detection of recurrence, and increase the cure rate.
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Affiliation(s)
- Oliver Bissinger
- Department of Oral and Maxillofacial Surgery, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria (C.G.)
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Str. 22, 81675 Munich, Germany
| | - Anne Von den Hoff
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Str. 22, 81675 Munich, Germany
| | - Elisabeth Maier
- Department of Oral and Maxillofacial Surgery, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria (C.G.)
| | - Katharina Theresa Obermeier
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital LMU Munich, Lindwurmstraße 2A, 80337 Munich, Germany
| | - Herbert Stimmer
- Department of Radiology, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Str. 22, 81675 Munich, Germany
| | - Andreas Kolk
- Department of Oral and Maxillofacial Surgery, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria (C.G.)
| | - Klaus-Dietrich Wolff
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Str. 22, 81675 Munich, Germany
| | - Carolin Götz
- Department of Oral and Maxillofacial Surgery, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria (C.G.)
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Str. 22, 81675 Munich, Germany
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Behar M, Peck KK, Yildirim O, Tisnado J, Saha A, Arevalo-Perez J, Lis E, Yamada Y, Holodny AI, Karimi S. T1-Weighted, Dynamic Contrast-Enhanced MR Perfusion Imaging Can Differentiate between Treatment Success and Failure in Spine Metastases Undergoing Radiation Therapy. AJNR Am J Neuroradiol 2023; 44:1451-1457. [PMID: 38049990 PMCID: PMC10714859 DOI: 10.3174/ajnr.a8057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 10/05/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND AND PURPOSE Current imaging techniques have difficulty differentiating treatment success and failure in spinal metastases undergoing radiation therapy. This study investigated the correlation between changes in dynamic contrast-enhanced MR imaging perfusion parameters and clinical outcomes following radiation therapy for spinal metastases. We hypothesized that perfusion parameters will outperform traditional size measurements in discriminating treatment success and failure. MATERIALS AND METHODS This retrospective study included 49 patients (mean age, 63 [SD, 13] years; 29 men) with metastatic lesions treated with radiation therapy who underwent dynamic contrast-enhanced MR imaging. The median time between radiation therapy and follow-up dynamic contrast-enhanced MR imaging was 62 days. We divided patients into 2 groups: clinical success (n = 38) and failure (n = 11). Failure was defined as PET recurrence (n = 5), biopsy-proved (n = 1) recurrence, or an increase in tumor size (n = 7), while their absence defined clinical success. A Mann-Whitney U test was performed to assess differences between groups. RESULTS The reduction in plasma volume was greater in the success group than in the failure group (-57.3% versus +88.2%, respectively; P < .001). When we assessed the success of treatment, the sensitivity of plasma volume was 91% (10 of 11; 95% CI, 82%-97%) and the specificity was 87% (33 of 38; 95% CI, 73%-94%). The sensitivity of size measurements was 82% (9 of 11; 95% CI, 67%-90%) and the specificity was 47% (18 of 38; 95% CI, 37%-67%). CONCLUSIONS The specificity of plasma volume was higher than that of conventional size measurements, suggesting that dynamic contrast-enhanced MR imaging is a powerful tool to discriminate between treatment success and failure.
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Affiliation(s)
- Mark Behar
- From the Department of Radiology (M.B., K.K.P., O.Y., J.T., A.S., J.A.-P., E.L., A.I.H., S.K.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kyung K Peck
- From the Department of Radiology (M.B., K.K.P., O.Y., J.T., A.S., J.A.-P., E.L., A.I.H., S.K.), Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medical Physics (K.K.P.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - Onur Yildirim
- From the Department of Radiology (M.B., K.K.P., O.Y., J.T., A.S., J.A.-P., E.L., A.I.H., S.K.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jamie Tisnado
- From the Department of Radiology (M.B., K.K.P., O.Y., J.T., A.S., J.A.-P., E.L., A.I.H., S.K.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - Atin Saha
- From the Department of Radiology (M.B., K.K.P., O.Y., J.T., A.S., J.A.-P., E.L., A.I.H., S.K.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - Julio Arevalo-Perez
- From the Department of Radiology (M.B., K.K.P., O.Y., J.T., A.S., J.A.-P., E.L., A.I.H., S.K.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - Eric Lis
- From the Department of Radiology (M.B., K.K.P., O.Y., J.T., A.S., J.A.-P., E.L., A.I.H., S.K.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - Yoshiya Yamada
- Department of Radiation Oncology (Y.Y.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - Andrei I Holodny
- From the Department of Radiology (M.B., K.K.P., O.Y., J.T., A.S., J.A.-P., E.L., A.I.H., S.K.), Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiology (A.I.H.), Weill Medical College of Cornell University, New York, New York
- Department of Neuroscience (A.I.H.), Weill-Cornell Graduate School of the Medical Sciences, New York, New York
| | - Sasan Karimi
- From the Department of Radiology (M.B., K.K.P., O.Y., J.T., A.S., J.A.-P., E.L., A.I.H., S.K.), Memorial Sloan Kettering Cancer Center, New York, New York
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8
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Michaan N, Wenkert A, Even-Sapir E, Kerzhner K, Rabin T, Safra T, Peleg-Hasson S, Baruch Y, Raz Y, Grisaru D, Laskov I. Prognostic significance of delayed complete metabolic response on PET/CT after primary chemoradiation treatment of cervical cancer. Int J Gynecol Cancer 2023; 33:1695-1701. [PMID: 37657818 DOI: 10.1136/ijgc-2023-004703] [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] [Indexed: 09/03/2023] Open
Abstract
OBJECTIVE To investigate the prognostic significance of near-complete metabolic response on initial follow-up PET/CT after primary chemoradiation treatment of cervical cancer. METHODS Survival data were retrospectively compared between patients who had complete metabolic response on first follow-up PET/CT, 3 months after chemoradiation (group 1) with those who had near-complete metabolic response on first PET/CT and later showed complete metabolic response at subsequent PET/CT, 6 months or more after treatment (group 2). RESULTS Of the 108 patients included in the final analysis, 74 (68.5%) showed complete metabolic response on initial PET/CT, 3 months after treatment, and 34 patients (31.5%) showed complete metabolic response on subsequent PET/CT, 6 months after treatment. Tumor characteristics were comparable between groups. Group 1 had higher percent of stage 1 (12% vs 0%) and lower percent of stage 4 disease (3% vs 14%) than those of group 2. Group 2 patients had significantly fewer cases of recurrences and deaths than group 1 patients (6% vs 26%, p=0.018; 0% vs 20%, p=0.003, respectively), with comparable 3-year survival rates (group 1, 90% vs group 2, 100%, p=0.31). Twelve patients had progressive disease on first follow-up PET/CT; these patients had significantly worse overall survival compared with all other patients (log-rank test, p<0.001). Younger age and delayed complete metabolic response were associated with lower chance of recurrence and death on univariate analysis. On multivariate analysis, delayed complete metabolic response remained significantly associated with no recurrence HR=0.14 (95% CI 0.25 to 0.84), p=0.031. CONCLUSIONS Survival outcome of patients with cervical cancer who show residual 18F-fluorodeoxyglucose uptake on initial PET/CT after treatment, but reach complete metabolic response on follow-up PET/CT, is not inferior compared with survival of patients who show complete metabolic response on initial PET/CT 3 months after treatment. Watchful waiting with follow-up PET/CT seems a safe option for these patients.
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Affiliation(s)
- Nadav Michaan
- Department of Gynecologic Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Atalia Wenkert
- Department of Obstetrics and Gynecology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Einat Even-Sapir
- Department of Nuclear Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Kosta Kerzhner
- Department of Nuclear Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Tatiana Rabin
- Department of Radiation Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Tamar Safra
- Department of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Shira Peleg-Hasson
- Department of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Yoav Baruch
- Department of Gynecologic Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Yael Raz
- Department of Gynecologic Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Dan Grisaru
- Department of Gynecologic Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ido Laskov
- Department of Gynecologic Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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9
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Brincat MR, Mira AR, Lawrence A. Current and Emerging Strategies for Tubo-Ovarian Cancer Diagnostics. Diagnostics (Basel) 2023; 13:3331. [PMID: 37958227 PMCID: PMC10647517 DOI: 10.3390/diagnostics13213331] [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: 09/04/2023] [Revised: 10/22/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
Tubo-ovarian cancer is the most lethal gynaecological cancer. More than 75% of patients are diagnosed at an advanced stage, which is associated with poorer overall survival. Symptoms at presentation are vague and non-specific, contributing to late diagnosis. Multimodal risk models have improved the diagnostic accuracy of adnexal mass assessment based on patient risk factors, coupled with findings on imaging and serum-based biomarker tests. Newly developed ultrasonographic assessment algorithms have standardised documentation and enable stratification of care between local hospitals and cancer centres. So far, no screening test has proven to reduce ovarian cancer mortality in the general population. This review is an update on the evidence behind ovarian cancer diagnostic strategies.
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Affiliation(s)
- Mark R. Brincat
- Department of Gynaecological Oncology, Royal London Hospital, Barts Health NHS Trust, London E1 1FR, UK
| | - Ana Rita Mira
- Department of Gynaecological Oncology, Royal London Hospital, Barts Health NHS Trust, London E1 1FR, UK
- Hospital Garcia de Orta, 2805-267 Almada, Portugal
| | - Alexandra Lawrence
- Department of Gynaecological Oncology, Royal London Hospital, Barts Health NHS Trust, London E1 1FR, UK
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10
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Gühne F, Ndum F, Seifert P, Winkens T, Drescher R, Freesmeyer M. The effect of butylscopolamine on [ 18F]FDG uptake in the gastrointestinal tract is negligible and regionally variable. EJNMMI Res 2023; 13:61. [PMID: 37340145 DOI: 10.1186/s13550-023-01012-2] [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: 04/12/2023] [Accepted: 06/16/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Butylscopolamine (or hyoscine butylbromide, trade name Buscopan®) is occasionally administered as a premedication to reduce non-specific FDG uptake in the gastrointestinal tract based on its antiperistaltic effect. To date, there are no consistent recommendations for its use. The aim of this study was to quantify the reduction in intestinal and non-intestinal uptake by butylscopolamine administration and to derive relevance for clinical evaluation. RESULTS 458 patients (PET/CT for lung cancer) were retrospectively reviewed. 218 patients with butylscopolamine and 240 patients without butylscopolamine had comparable characteristics. While the SUVmean in the gullet/stomach and small intestine was significantly reduced with butylscopolamine, the colon and rectum/anus showed no difference. The liver and salivary glands showed a reduced SUVmean, while skeletal muscle and blood pool were unaffected. An effect of butylscopolamine was particularly evident in men and patients under 65 years of age. There was no difference in the perceived confidence in the assessment of intestinal findings in the subjective evaluation, although in the butylscopolamine group further diagnostics appeared advisable more frequently. CONCLUSIONS Butylscopolamine reduces gastrointestinal FDG accumulation only in selected segments and, despite a significant effect, only to a small extent. A general recommendation for the use of butylscopolamine cannot be derived from these results, its use for specific issues could be considered individually.
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Affiliation(s)
- Falk Gühne
- Clinic of Nuclear Medicine, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Ferdinand Ndum
- Clinic of Nuclear Medicine, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Philipp Seifert
- Clinic of Nuclear Medicine, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Thomas Winkens
- Clinic of Nuclear Medicine, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Robert Drescher
- Clinic of Nuclear Medicine, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Martin Freesmeyer
- Clinic of Nuclear Medicine, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
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11
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Borhani A, Afyouni S, Attari MMA, Mohseni A, Catalano O, Kamel IR. PET/MR enterography in inflammatory bowel disease: A review of applications and technical considerations. Eur J Radiol 2023; 163:110846. [PMID: 37121100 DOI: 10.1016/j.ejrad.2023.110846] [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: 02/08/2023] [Revised: 04/18/2023] [Accepted: 04/20/2023] [Indexed: 05/02/2023]
Abstract
Positron emission tomography (PET) magnetic resonance (MR) enterography is a novel hybrid imaging technique that is gaining popularity in the study of complex inflammatory disorders of the gastrointestinal system, such as inflammatory bowel disease (IBD). This imaging technique combines the metabolic information of PET imaging with the spatial resolution and soft tissue contrast of MR imaging. Several studies have suggested potential roles for PET/MR imaging in determining the activity status of IBD, evaluating treatment response, stratifying risk, and predicting long-term clinical outcomes. However, there are challenges in generalizing findings due to limited studies, technical aspects of hybrid MR/PET imaging, and clinical indications of this imaging modality. This review aims to further elucidate the possible role of PET/MR in IBD, highlight important technical aspects of imaging, and address potential pitfalls and prospects of this modality in IBDs.
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Affiliation(s)
- Ali Borhani
- Russell H. Morgan Department of Radiology and Radiological Sciences, John's Hopkins Medicine, John's Hopkins University, Baltimore, MD, United States
| | - Shadi Afyouni
- Russell H. Morgan Department of Radiology and Radiological Sciences, John's Hopkins Medicine, John's Hopkins University, Baltimore, MD, United States
| | - Mohammad Mirza Aghazadeh Attari
- Russell H. Morgan Department of Radiology and Radiological Sciences, John's Hopkins Medicine, John's Hopkins University, Baltimore, MD, United States
| | - Alireza Mohseni
- Russell H. Morgan Department of Radiology and Radiological Sciences, John's Hopkins Medicine, John's Hopkins University, Baltimore, MD, United States
| | - Onofrio Catalano
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, United States; Harvard Medical School, 25 Shattuck St, Boston, MA 02115, United States
| | - Ihab R Kamel
- Russell H. Morgan Department of Radiology and Radiological Sciences, John's Hopkins Medicine, John's Hopkins University, Baltimore, MD, United States.
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12
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Tamaki N, Hirata K, Kotani T, Nakai Y, Matsushima S, Yamada K. Four-dimensional quantitative analysis using FDG-PET in clinical oncology. Jpn J Radiol 2023:10.1007/s11604-023-01411-4. [PMID: 36947283 PMCID: PMC10366296 DOI: 10.1007/s11604-023-01411-4] [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: 01/17/2023] [Accepted: 03/02/2023] [Indexed: 03/23/2023]
Abstract
Positron emission tomography (PET) with F-18 fluorodeoxyglucose (FDG) has been commonly used in many oncological areas. High-resolution PET permits a three-dimensional analysis of FDG distributions on various lesions in vivo, which can be applied for tissue characterization, risk analysis, and treatment monitoring after chemoradiotherapy and immunotherapy. Metabolic changes can be assessed using the tumor absolute FDG uptake as standardized uptake value (SUV) and metabolic tumor volume (MTV). In addition, tumor heterogeneity assessment can potentially estimate tumor aggressiveness and resistance to chemoradiotherapy. Attempts have been made to quantify intratumoral heterogeneity using radiomics. Recent reports have indicated the clinical feasibility of a dynamic FDG PET-computed tomography (CT) in pilot cohort studies of oncological cases. Dynamic imaging permits the assessment of temporal changes in FDG uptake after administration, which is particularly useful for differentiating pathological from physiological uptakes with high diagnostic accuracy. In addition, several new parameters have been introduced for the in vivo quantitative analysis of FDG metabolic processes. Thus, a four-dimensional FDG PET-CT is available for precise tissue characterization of various lesions. This review introduces various new techniques for the quantitative analysis of FDG distribution and glucose metabolism using a four-dimensional FDG analysis with PET-CT. This elegant study reveals the important role of tissue characterization and treatment strategies in oncology.
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Affiliation(s)
- Nagara Tamaki
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
| | - Kenji Hirata
- Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Tomoya Kotani
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshitomo Nakai
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shigenori Matsushima
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kei Yamada
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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13
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Ong W, Zhu L, Tan YL, Teo EC, Tan JH, Kumar N, Vellayappan BA, Ooi BC, Quek ST, Makmur A, Hallinan JTPD. Application of Machine Learning for Differentiating Bone Malignancy on Imaging: A Systematic Review. Cancers (Basel) 2023; 15:cancers15061837. [PMID: 36980722 PMCID: PMC10047175 DOI: 10.3390/cancers15061837] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/07/2023] [Accepted: 03/16/2023] [Indexed: 03/22/2023] Open
Abstract
An accurate diagnosis of bone tumours on imaging is crucial for appropriate and successful treatment. The advent of Artificial intelligence (AI) and machine learning methods to characterize and assess bone tumours on various imaging modalities may assist in the diagnostic workflow. The purpose of this review article is to summarise the most recent evidence for AI techniques using imaging for differentiating benign from malignant lesions, the characterization of various malignant bone lesions, and their potential clinical application. A systematic search through electronic databases (PubMed, MEDLINE, Web of Science, and clinicaltrials.gov) was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 34 articles were retrieved from the databases and the key findings were compiled and summarised. A total of 34 articles reported the use of AI techniques to distinguish between benign vs. malignant bone lesions, of which 12 (35.3%) focused on radiographs, 12 (35.3%) on MRI, 5 (14.7%) on CT and 5 (14.7%) on PET/CT. The overall reported accuracy, sensitivity, and specificity of AI in distinguishing between benign vs. malignant bone lesions ranges from 0.44–0.99, 0.63–1.00, and 0.73–0.96, respectively, with AUCs of 0.73–0.96. In conclusion, the use of AI to discriminate bone lesions on imaging has achieved a relatively good performance in various imaging modalities, with high sensitivity, specificity, and accuracy for distinguishing between benign vs. malignant lesions in several cohort studies. However, further research is necessary to test the clinical performance of these algorithms before they can be facilitated and integrated into routine clinical practice.
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Affiliation(s)
- Wilson Ong
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore
- Correspondence: ; Tel.: +65-67725207
| | - Lei Zhu
- Department of Computer Science, School of Computing, National University of Singapore, 13 Computing Drive, Singapore 117417, Singapore
| | - Yi Liang Tan
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore
| | - Ee Chin Teo
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore
| | - Jiong Hao Tan
- University Spine Centre, Department of Orthopaedic Surgery, National University Health System, 1E, Lower Kent Ridge Road, Singapore 119228, Singapore
| | - Naresh Kumar
- University Spine Centre, Department of Orthopaedic Surgery, National University Health System, 1E, Lower Kent Ridge Road, Singapore 119228, Singapore
| | - Balamurugan A. Vellayappan
- Department of Radiation Oncology, National University Cancer Institute Singapore, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore
| | - Beng Chin Ooi
- Department of Computer Science, School of Computing, National University of Singapore, 13 Computing Drive, Singapore 117417, Singapore
| | - Swee Tian Quek
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore
- Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore
| | - Andrew Makmur
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore
- Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore
| | - James Thomas Patrick Decourcy Hallinan
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore
- Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore
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14
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Ladbury C, Eustace N, Amini A, Dandapani S, Williams T. Biology-Guided Radiation Therapy. Surg Oncol Clin N Am 2023; 32:553-568. [PMID: 37182992 DOI: 10.1016/j.soc.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Biology-guided radiation therapy is an emerging field whereby delivery of external beam radiotherapy incorporates biological/molecular imaging to inform radiation treatment. At present, there is evidence for the use of functional imaging such as PET to evaluate treatment response in patients both during and after radiation treatment as well as to provide a method of adapting or selecting patient-specific treatments. Examples in thoracic, gastrointestinal, and hematologic malignancies are provided. Improvements in PET metrics, thresholds, and novel radiotracers will further move this novel field forward.
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15
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Microbiota in vivo imaging approaches to study host-microbe interactions in preclinical and clinical setting. Heliyon 2022; 8:e12511. [PMID: 36593827 PMCID: PMC9803719 DOI: 10.1016/j.heliyon.2022.e12511] [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: 05/25/2022] [Revised: 10/14/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022] Open
Abstract
In vivo imaging in preclinical and clinical settings can enhance knowledge of the host-microbiome interactions. Imaging techniques are a crucial node between findings at the molecular level and clinical implementation in diagnostics and therapeutics. The purpose of this study was to review existing knowledge on the microbiota in the field of in vivo imaging and provide guidance for future research, emphasizing the critical role that molecular imaging plays in increasing understanding of the host-microbe interaction. Preclinical microbiota animal models lay the foundation for the clinical translatability of novel microbiota-based therapeutics. Adopting animal models in which factors such as host genetic landscape, microbiota profile, and diet can be controlled enables investigating how the microbiota contributes to immunological dysregulation and inflammatory disorders. Current preclinical imaging of gut microbiota relies on models where the bacteria can be isolated, labelled, and re-administered. In vivo, optical imaging, ultrasound and magnetic resonance imaging define the bacteria's biodistribution in preclinical models, whereas nuclear imaging investigates bacterial metabolic activity. For the clinical investigation of microbe-host interactions, molecular nuclear imaging is increasingly becoming a promising approach. Future microbiota research should develop selective imaging probes to investigate in vivo microbiota profiles and individual strains of specific microbes. Preclinical knowledge can be translated into the molecular imaging field with great opportunities for studying the microbiome.
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16
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Zhang X, Zhang B, Deng S, Meng Q, Chen X, Xiang D. Cross modality fusion for modality-specific lung tumor segmentation in PET-CT images. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac994e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 10/11/2022] [Indexed: 11/09/2022]
Abstract
Abstract
Although positron emission tomography-computed tomography (PET-CT) images have been widely used, it is still challenging to accurately segment the lung tumor. The respiration, movement and imaging modality lead to large modality discrepancy of the lung tumors between PET images and CT images. To overcome these difficulties, a novel network is designed to simultaneously obtain the corresponding lung tumors of PET images and CT images. The proposed network can fuse the complementary information and preserve modality-specific features of PET images and CT images. Due to the complementarity between PET images and CT images, the two modality images should be fused for automatic lung tumor segmentation. Therefore, cross modality decoding blocks are designed to extract modality-specific features of PET images and CT images with the constraints of the other modality. The edge consistency loss is also designed to solve the problem of blurred boundaries of PET images and CT images. The proposed method is tested on 126 PET-CT images with non-small cell lung cancer, and Dice similarity coefficient scores of lung tumor segmentation reach 75.66 ± 19.42 in CT images and 79.85 ± 16.76 in PET images, respectively. Extensive comparisons with state-of-the-art lung tumor segmentation methods have also been performed to demonstrate the superiority of the proposed network.
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17
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Hameed BS, Krishnan UM. Artificial Intelligence-Driven Diagnosis of Pancreatic Cancer. Cancers (Basel) 2022; 14:5382. [PMID: 36358800 PMCID: PMC9657087 DOI: 10.3390/cancers14215382] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/28/2022] [Accepted: 10/28/2022] [Indexed: 08/01/2023] Open
Abstract
Pancreatic cancer is among the most challenging forms of cancer to treat, owing to its late diagnosis and aggressive nature that reduces the survival rate drastically. Pancreatic cancer diagnosis has been primarily based on imaging, but the current state-of-the-art imaging provides a poor prognosis, thus limiting clinicians' treatment options. The advancement of a cancer diagnosis has been enhanced through the integration of artificial intelligence and imaging modalities to make better clinical decisions. In this review, we examine how AI models can improve the diagnosis of pancreatic cancer using different imaging modalities along with a discussion on the emerging trends in an AI-driven diagnosis, based on cytopathology and serological markers. Ethical concerns regarding the use of these tools have also been discussed.
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Affiliation(s)
- Bahrudeen Shahul Hameed
- Centre for Nanotechnology & Advanced Biomaterials (CeNTAB), Shanmugha Arts, Science, Technology and Research Academy, Deemed University, Thanjavur 613401, India
- School of Chemical & Biotechnology (SCBT), Shanmugha Arts, Science, Technology and Research Academy, Deemed University, Thanjavur 613401, India
| | - Uma Maheswari Krishnan
- Centre for Nanotechnology & Advanced Biomaterials (CeNTAB), Shanmugha Arts, Science, Technology and Research Academy, Deemed University, Thanjavur 613401, India
- School of Chemical & Biotechnology (SCBT), Shanmugha Arts, Science, Technology and Research Academy, Deemed University, Thanjavur 613401, India
- School of Arts, Sciences, Humanities & Education (SASHE), Shanmugha Arts, Science, Technology and Research Academy, Deemed University, Thanjavur 613401, India
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18
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Radiolabeling and Biological Evaluation of Novel 99mTc-Nitrido and 99mTc-Oxo Complexes with 4-Methoxy- L-Phenylalanine Dithiocarbamate for Tumor Imaging. Pharmaceutics 2022; 14:pharmaceutics14102196. [PMID: 36297631 PMCID: PMC9607073 DOI: 10.3390/pharmaceutics14102196] [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: 09/12/2022] [Revised: 10/11/2022] [Accepted: 10/13/2022] [Indexed: 11/05/2022] Open
Abstract
To develop novel radiolabeled amino acid tumor imaging agents, 4-methoxy-L-phenylalanine dithiocarbamate (MOPADTC) was synthesized successfully, and two kinds of 99mTc-labeled complexes ([99mTc]TcN-MOPADTC and [99mTc]TcO-MOPADTC) with high radiochemical purities (RCP > 95%) were obtained. The in vitro stability and partition coefficient were determined, and the results show that both of these complexes have good in vitro stability; [99mTc]TcO-MOPADTC is hydrophilic, while [99mTc]TcN-MOPADTC is slightly lipophilic. The biodistribution of [99mTc]TcN-MOPADTC and [99mTc]TcO-MOPADTC in mice bearing S180 tumors shows that the tumor uptake and tumor/muscle ratio of [99mTc]TcO-MOPADTC were higher than the tumor uptake and tumor/muscle ratio of [99mTc]TcN-MOPADTC. In addition, the tumor retention of [99mTc]TcO-MOPADTC is better than the tumor retention of [99mTc]TcN-MOPADTC. A competitive inhibition assay was performed, and the results indicate that [99mTc]TcO-MOPADTC may enter cells primarily via the L-alanine/L-serine/L-cysteine (ASC) system. Single-photon emission computed tomography (SPECT) imaging of [99mTc]TcO-MOPADTC shows obvious accumulation in tumor sites, suggesting that [99mTc]TcO-MOPADTC is a novel potential tumor-imaging agent.
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Yoo J, Cheon M. Septic Pulmonary Emboli Detected by 18F-FDG PET/CT in a Patient with Central Venous Catheter-Related Staphylococcus aureus Bacteremia. Diagnostics (Basel) 2022; 12:diagnostics12102479. [PMID: 36292168 PMCID: PMC9600020 DOI: 10.3390/diagnostics12102479] [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: 09/13/2022] [Revised: 10/07/2022] [Accepted: 10/12/2022] [Indexed: 11/16/2022] Open
Abstract
We describe a case of 18F-FDG PET/CT detecting septic pulmonary emboli in a patient with Staphylococcus aureus catheter-related bloodstream infection (CRBSI). The patient, who had an implantable venous access port for chemotherapy, underwent 18F-FDG PET/CT to diagnose unsuspected infectious foci. The PET/CT examination made it possible to offer a suggestive diagnosis and yielded metastatic infectious foci.
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Kouijzer JJP, Noordermeer DJ, van Leeuwen WJ, Verkaik NJ, Lattwein KR. Native valve, prosthetic valve, and cardiac device-related infective endocarditis: A review and update on current innovative diagnostic and therapeutic strategies. Front Cell Dev Biol 2022; 10:995508. [PMID: 36263017 PMCID: PMC9574252 DOI: 10.3389/fcell.2022.995508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
Abstract
Infective endocarditis (IE) is a life-threatening microbial infection of native and prosthetic heart valves, endocardial surface, and/or indwelling cardiac device. Prevalence of IE is increasing and mortality has not significantly improved despite technological advances. This review provides an updated overview using recent literature on the clinical presentation, diagnosis, imaging, causative pathogens, treatment, and outcomes in native valve, prosthetic valve, and cardiac device-related IE. In addition, the experimental approaches used in IE research to improve the understanding of disease mechanisms and the current diagnostic pipelines are discussed, as well as potential innovative diagnostic and therapeutic strategies. This will ultimately help towards deriving better diagnostic tools and treatments to improve IE patient outcomes.
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Affiliation(s)
- Joop J. P. Kouijzer
- Thoraxcenter, Department of Biomedical Engineering, Erasmus MC University Medical Center, Rotterdam, Netherlands
- *Correspondence: Joop J. P. Kouijzer,
| | - Daniëlle J. Noordermeer
- Thoraxcenter, Department of Biomedical Engineering, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Wouter J. van Leeuwen
- Department of Cardiothoracic Surgery, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Nelianne J. Verkaik
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Kirby R. Lattwein
- Thoraxcenter, Department of Biomedical Engineering, Erasmus MC University Medical Center, Rotterdam, Netherlands
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Fluorophore-conjugated 4-1BB antibody enables early detection of T-cell responses in inflammatory arthritis via NIRF imaging. Eur J Nucl Med Mol Imaging 2022; 50:38-47. [PMID: 36069957 DOI: 10.1007/s00259-022-05946-y] [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: 03/22/2022] [Accepted: 08/12/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE We first developed a 4-1BB-targeted optical probe, named IRDye-680RD-4-1BB mAb (monoclonal antibody), and evaluated its value for the detection of 4-1BB+ activated T cells in vivo as well as the diagnosis of rheumatoid arthritis (RA) in an adjuvant-induced arthritis (AIA) mouse model. METHODS The 4-1BB expression pattern was analysed by flow cytometry and immunofluorescence (IF) staining. The 4-1BB mAb was conjugated with IRDye-680RD NHS ester, and characterized via fluorescence spectrum. A cell-binding assay was also performed to assess the interaction of this probe with activated and naïve murine T cells. Longitudinal near-infrared fluorescence (NIRF) imaging of the probe was performed at 6, 24, 48, 72, and 96 h after probe administration. RESULTS 4-1BB expression was highly upregulated during the pathogenesis of RA. Good colocalization was also observed between CD3 and 4-1BB by IF staining and t-SNE (T-distributed stochastic neighbour embedding) analysis, which indicates that 4-1BB was mainly expressed on T cells. Compared to the control group, a significantly higher signal was observed in the right hind paw (RP) of mice with AIA at all time points. The ex vivo biodistribution study results were consistent with the in vivo NIRF imaging results, which validated the accuracy of the region of interest (ROI) measurements. The sensitivity against 100% specificity observed in the receiver operator characteristic (ROC) curve analysis could distinguish the AIA group from the control group at all time points, indicating the value of IRDye-680RD-4-1BB mAb for RA diagnosis. CONCLUSION We successfully developed a novel optical imaging probe, named IRDye-680RD-4-1BB mAb, for tracking 4-1BB+ activated T cells in vivo, and 4-1BB NIRF imaging is a promising strategy for noninvasively detecting the pathogenesis of RA.
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ÇINAR A, ALAGÖZ E, AYAN A, UÇGUN A. Kolorektal kanseri olan hastaların ameliyat sonrası klinik yönetiminde fluorine-18 fluorodeoxyglucose pozitron emisyon tomografisi/bilgisayarlı tomografi’nin tanısal önemi. MUSTAFA KEMAL ÜNIVERSITESI TIP DERGISI 2022. [DOI: 10.17944/mkutfd.969726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Amaç: Kolorektal kanser, erken tespitinde cerrahi kür sağlanabilen yaygın bir kanser türüdür. Bu kanser tipinde tedaviye yanıtın erken belirlenmesi yaşam süresini olumlu etkilemektedir. Çalışmamızda kolorektal kanseri olan hastaların, ameliyat sonrasındaki klinik yönetimlerinde F-18 FDG PET/BT’nin tanısal önemini değerlendirmeyi amaçladık.
Gereç ve Yöntem: Haziran 2016 ve Ocak 2020 tarihleri arasında 168 hasta kolorektal kanser yönetimi amacıyla bölümümüze yönlendirilmiştir. Bu hastaların hepsi primer kolon tümörleri için ameliyat edilmişlerdi. Sistemik tedavi öncesinde ve sonrasında tedavi yanıtının değerlendirilmesi amacıyla bazal ve ardışık F-18 FDG PET/BT incelemesi yapılmıştır. F-18 FDG PET/BT taramaları sırasıyla analiz edilmiştir.
Bulgular: Hastalar primer tümör lokalizasyonlarına göre gruplandırıldı. Toplam 168 hastanın 55’inde sağ kolonda, 33’ünde sol kolonda, 14’ünde transvers kolonda, 61’inde rektosigmoid kolonda ve 5’inde çekumda primer tümör saptandı. Lokal rekürrens 57 hastada saptanmış olup 33’ü erkek (%57.9) ve 24’ü (%42.1) kadındı. Lokal rekürrense ait ortalama SUVmaks 8.97±3.42 g/ml olarak saptandı. Ek olarak çıkan kolon grubunda 2 hastada (%1.20) yeni tümöral odak gözlendi.
Sonuç: Kolorektal kanserli hastalarda, yapılabiliyorsa kolon rezeksiyonu tedavide ilk aşamadır. Küratif cerrahi sonrası ilk iki yıl içinde, hastaların yaklaşık %40’ında rekürrens görülebilmektedir. Rekürrensin erken tespiti, hastaların yaşam süresini iyileştirmektedir.
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Affiliation(s)
- Alev ÇINAR
- UNIVERSITY OF HEALTH SCIENCES, ANKARA GÜLHANE HEALTH RESEARCH CENTER, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF NUCLEAR MEDICINE
| | - Engin ALAGÖZ
- UNIVERSITY OF HEALTH SCIENCES, ANKARA GÜLHANE HEALTH RESEARCH CENTER, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF NUCLEAR MEDICINE
| | - Aslı AYAN
- UNIVERSITY OF HEALTH SCIENCES, ANKARA GÜLHANE HEALTH RESEARCH CENTER, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF NUCLEAR MEDICINE
| | - Aybüke UÇGUN
- University of Health Sciences, Gulhane Training & Research Hospital
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Validation of a Saliency Map for Assessing Image Quality in Nuclear Medicine: Experimental Study Outcomes. RADIATION 2022. [DOI: 10.3390/radiation2030018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Recently, the use of saliency maps to evaluate the image quality of nuclear medicine images has been reported. However, that study only compared qualitative visual evaluations and did not perform a quantitative assessment. The study’s aim was to demonstrate the possibility of using saliency maps (calculated from intensity and flicker) to assess nuclear medicine image quality by comparison with the evaluator’s gaze data obtained from an eye-tracking device. We created 972 positron emission tomography images by changing the position of the hot sphere, imaging time, and number of iterations in the iterative reconstructions. Pearson’s correlation coefficient between the saliency map calculated from each image and the evaluator’s gaze data during image presentation was calculated. A strong correlation (r ≥ 0.94) was observed between the saliency map (intensity) and the evaluator’s gaze data. This trend was also observed in images obtained from a clinical device. For short acquisition times, the gaze to the hot sphere position was higher for images with fewer iterations during the iterative reconstruction. However, no differences in iterations were found when the acquisition time increased. Saliency by flicker could be applied to clinical images without preprocessing, although compared with the gaze image, it increased slowly.
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Rai A, Dahuja A, Choudhary R, Sharma A, Sankhla S. Sequential Imaging Characteristics and Potential Role of F18 Fluorodeoxyglucose Positron Emission Tomography/CT in the Evaluation of Treatment Response in Cases of Spinal Tuberculosis Without Neurological Involvement: Results From a Pilot Study. Cureus 2022; 14:e26065. [PMID: 35865423 PMCID: PMC9293271 DOI: 10.7759/cureus.26065] [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] [Accepted: 06/18/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose In this non-randomized study, we prospectively studied the sequential imaging properties of fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) and evaluated the role of FDG PET as a non-invasive imaging modality for identifying non-responders during anti-tubercular treatment (ATT) of spinal tuberculosis (TB). Methods Before starting anti-tubercular treatment, 25 patients with clinically and radiological suspected; pathologically confirmed spinal TB had a pretreatment contrast-enhanced whole-body FDG PET scan, followed by scans at six, 12, and 18 months. The maximum standardized uptake value (SUVmax) was computed, and the mean change in SUVmax was compared. The mean change in SUVmax was correlated with the clinicoradiological improvement. Result In cases of spinal tuberculosis, the FDG PET scan can help identify extra-spinal and non-contagious involvement. In our 25 cases of spinal TB, the baseline peak SUVmax of lesions ranged from 6.3 to 28.5 (mean 14.8). Despite treatment, the condition progressed in two patients, and they had neurological deficits; in both cases, the SUVmax levels increased. The fall in SUVmax during the treatment course was statistically significant (p-value <0.05) and correlated well with the clinical improvement. Conclusion The inflammatory cells show increased uptake of F18 FDG, so uptake of radioactive tracer localizes and quantifies the disease activity; thus, FDG PET/CT holds a promising role as a sensitive non-invasive modality for the detection, staging, assessing disease activity, and monitoring therapy and deciding end point treatment in spinal TB.
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Changes in Metabolism as a Diagnostic Tool for Lung Cancer: Systematic Review. Metabolites 2022; 12:metabo12060545. [PMID: 35736478 PMCID: PMC9229104 DOI: 10.3390/metabo12060545] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 05/28/2022] [Accepted: 06/02/2022] [Indexed: 02/04/2023] Open
Abstract
Lung cancer is the leading cause of cancer-related mortality worldwide, with five-year survival rates varying from 3–62%. Screening aims at early detection, but half of the patients are diagnosed in advanced stages, limiting therapeutic possibilities. Positron emission tomography-computed tomography (PET-CT) is an essential technique in lung cancer detection and staging, with a sensitivity reaching 96%. However, since elevated 18F-fluorodeoxyglucose (18F-FDG) uptake is not cancer-specific, PET-CT often fails to discriminate between malignant and non-malignant PET-positive hypermetabolic lesions, with a specificity of only 23%. Furthermore, discrimination between lung cancer types is still impossible without invasive procedures. High mortality and morbidity, low survival rates, and difficulties in early detection, staging, and typing of lung cancer motivate the search for biomarkers to improve the diagnostic process and life expectancy. Metabolomics has emerged as a valuable technique for these pitfalls. Over 150 metabolites have been associated with lung cancer, and several are consistent in their findings of alterations in specific metabolite concentrations. However, there is still more variability than consistency due to the lack of standardized patient cohorts and measurement protocols. This review summarizes the identified metabolic biomarkers for early diagnosis, staging, and typing and reinforces the need for biomarkers to predict disease progression and survival and to support treatment follow-up.
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Covington MF, Koppula BR, Fine GC, Salem AE, Wiggins RH, Hoffman JM, Morton KA. PET-CT in Clinical Adult Oncology: II. Primary Thoracic and Breast Malignancies. Cancers (Basel) 2022; 14:cancers14112689. [PMID: 35681669 PMCID: PMC9179296 DOI: 10.3390/cancers14112689] [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: 04/27/2022] [Revised: 05/20/2022] [Accepted: 05/26/2022] [Indexed: 12/24/2022] Open
Abstract
Simple Summary Positron emission tomography (PET), typically combined with computed tomography (CT), has become a critical advanced imaging technique in oncology. With PET-CT, a radioactive molecule (radiotracer) is injected in the bloodstream and localizes to sites of tumor because of specific cellular features of the tumor that accumulate the targeting radiotracer. The CT scan, performed at the same time, provides information to facilitate assessment of the amount of radioactivity from deep or dense structures, and to provide detailed anatomic information. PET-CT has a variety of applications in oncology, including staging, therapeutic response assessment, restaging, and surveillance. This series of six review articles provides an overview of the value, applications, and imaging and interpretive strategies of PET-CT in the more common adult malignancies. The second article in this series addresses the use of PET-CT in breast cancer and other primary thoracic malignancies. Abstract Positron emission tomography combined with x-ray computed tomography (PET-CT) is an advanced imaging modality with oncologic applications that include staging, therapy assessment, restaging, and surveillance. This six-part series of review articles provides practical information to providers and imaging professionals regarding the best use of PET-CT for the more common adult malignancies. The second article of this series addresses primary thoracic malignancy and breast cancer. For primary thoracic malignancy, the focus will be on lung cancer, malignant pleural mesothelioma, thymoma, and thymic carcinoma, with an emphasis on the use of FDG PET-CT. For breast cancer, the various histologic subtypes will be addressed, and will include 18F fluorodeoxyglucose (FDG), recently Food and Drug Administration (FDA)-approved 18F-fluoroestradiol (FES), and 18F sodium fluoride (NaF). The pitfalls and nuances of PET-CT in breast and primary thoracic malignancies and the imaging features that distinguish between subcategories of these tumors are addressed. This review will serve as a resource for the appropriate roles and limitations of PET-CT in the clinical management of patients with breast and primary thoracic malignancies for healthcare professionals caring for adult patients with these cancers. It also serves as a practical guide for imaging providers, including radiologists, nuclear medicine physicians, and their trainees.
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Affiliation(s)
- Matthew F. Covington
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (M.F.C.); (B.R.K.); (G.C.F.); (A.E.S.); (R.H.W.); (J.M.H.)
| | - Bhasker R. Koppula
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (M.F.C.); (B.R.K.); (G.C.F.); (A.E.S.); (R.H.W.); (J.M.H.)
| | - Gabriel C. Fine
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (M.F.C.); (B.R.K.); (G.C.F.); (A.E.S.); (R.H.W.); (J.M.H.)
| | - Ahmed Ebada Salem
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (M.F.C.); (B.R.K.); (G.C.F.); (A.E.S.); (R.H.W.); (J.M.H.)
- Department of Radiodiagnosis and Intervention, Faculty of Medicine, Alexandria University, Alexandria 21526, Egypt
| | - Richard H. Wiggins
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (M.F.C.); (B.R.K.); (G.C.F.); (A.E.S.); (R.H.W.); (J.M.H.)
| | - John M. Hoffman
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (M.F.C.); (B.R.K.); (G.C.F.); (A.E.S.); (R.H.W.); (J.M.H.)
| | - Kathryn A. Morton
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84132, USA; (M.F.C.); (B.R.K.); (G.C.F.); (A.E.S.); (R.H.W.); (J.M.H.)
- Intermountain Healthcare Hospitals, Summit Physician Specialists, Murray, UT 84123, USA
- Correspondence: ; Tel.: +1-801-581-7553
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Lebbink CA, de Vries LH, Borel Rinkes IHM, Braat AJAT, van Leeuwaarde RS, Lodewijk L, van Treijen MJC, Vriens MR, Valk GD, van Santen HM, de Keizer B. FDG PET/CT in differentiated thyroid cancer patients with low thyroglobulin levels. Eur J Endocrinol 2022; 187:101-110. [PMID: 35521710 DOI: 10.1530/eje-22-0072] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 04/28/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate the usefulness of [18F]fluorodeoxyglucose (FDG) positron emissive tomography (PET)/CT in patients with low detectable thyroglobulin levels suspicious for persistent or recurrent differentiated thyroid cancer (DTC). METHODS A retrospective case series study evaluating FDG PET/CT in patients with detectable thyroglobulin (Tg) levels (≥0.20 and <10.00 ng/mL) after initial treatment with total thyroidectomy and I-131 thyroid remnant ablation for pT1-3aN0-1bM0 DTC. Sensitivity, specificity, positive (PPV) and negative predictive value (NPV) of FDG PET/CT were calculated. RESULTS Twenty-seven patients underwent FDG PET/CT. Median Tg level at FDG PET/CT was 2.00 ng/mL (range 0.30-9.00). FDG PET/CT was positive in 14 patients (51.9%): lesions suspicious for lymph node metastases were depicted in 12 patients, and lung metastases in 2. DTC was confirmed in 13/14 FDG PET/CT-positive patients. In 9/13 patients with a negative FDG PET/CT, DTC was confirmed ≤3 months after FDG PET/CT. The sensitivity, PPV, specificity and NPV were 59.1, 92.9, 80.0 and 30.8%, respectively. CONCLUSIONS This case series shows that FDG PET/CT might be useful to detect persistent or recurrent DTC in patients with low detectable Tg. However, when FDG PET/CT is negative, this does not rule out DTC and further investigations are necessary.
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Affiliation(s)
- Chantal A Lebbink
- Department of Pediatric Endocrinology, Wilhelmina Children's Hospital (WKZ), University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
- Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Lisa H de Vries
- Department of Surgery, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Inne H M Borel Rinkes
- Department of Surgery, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Arthur J A T Braat
- Department of Nuclear Medicine and Radiology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Rachel S van Leeuwaarde
- Department of Endocrine Oncology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Lutske Lodewijk
- Department of Surgery, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Mark J C van Treijen
- Department of Endocrine Oncology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Menno R Vriens
- Department of Surgery, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Gerlof D Valk
- Department of Endocrine Oncology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Hanneke M van Santen
- Department of Pediatric Endocrinology, Wilhelmina Children's Hospital (WKZ), University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
- Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Bart de Keizer
- Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Nuclear Medicine and Radiology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
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Li Y, Qi Y, Fang Y, Gao H, Zhang H. Design, Synthesis, and Biological Evaluation of 4-Arylamino Pyrimidine Derivatives as FAK Inhibitors and Tumor Radiotracers. Mol Pharm 2022; 19:2471-2482. [PMID: 35481371 DOI: 10.1021/acs.molpharmaceut.2c00180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Focal adhesion kinase (FAK) is considered a promising target for the diagnosis and treatment of cancer. In this work, a series of N,N'-(4-((5-bromo-2-(phenylamino)pyrimidin-4-yl)amino)-1,3-phenylene)diacetamide derivatives were synthesized and evaluated as FAK inhibitors and radiotracers. The studied compounds, possessing the same phenylene-diacetamide chain, exhibited high to moderate enzyme inhibition values (IC50) ranging from 3.7 to 108.0 nM. Compound 13a, which exhibits high FAK enzyme inhibition with an IC50 value of 3.7, could effectively suppress the tumor growth. Furthermore, three compounds were radiolabeled with F-18. Among them, a higher tumor uptake value was observed for [18F]17 (3.73 ± 0.10% ID/g) and [18F]13a (3.66 ± 0.02% ID/g). Compound [18F]18 displayed the highest tumor/blood (35.75) value at 120 min postinjection. In addition, the results from docking studies revealed the binding mechanism of the studied compounds. The findings of this study may provide useful guidance to improve the development of radiotracers and enzyme inhibitors.
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Affiliation(s)
- Ye Li
- College of Chemistry, Beijing Normal University, No. 19 Xinjiekouwai Street, Haidian District, Beijing 100875, China
| | - Yueheng Qi
- College of Chemistry, Beijing Normal University, No. 19 Xinjiekouwai Street, Haidian District, Beijing 100875, China
| | - Yu Fang
- College of Chemistry and Chemical Engineering, Anyang Normal University, No. 436 Xian'ge Road, Anyang 455000, Henan Province, China
| | - Hang Gao
- College of Chemistry, Beijing Normal University, No. 19 Xinjiekouwai Street, Haidian District, Beijing 100875, China
| | - Huabei Zhang
- College of Chemistry, Beijing Normal University, No. 19 Xinjiekouwai Street, Haidian District, Beijing 100875, China
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FDG PET/CT Features of Polysaccharide-Based Hemostatic Agent: Chronic Inflammatory Changes Can Mimic Metastatic Lesions. Clin Nucl Med 2022; 47:e475-e480. [PMID: 35452003 DOI: 10.1097/rlu.0000000000004216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To prevent hemorrhagic complications, hemostatic agents (HAs) have been widely used in recent years. The use of HAs can lead to false-positive results on postoperative imaging. There exists only 1 study in the literature evaluating these applications during surgical procedures. Therefore, we aimed to evaluate the postoperative imaging features of polysaccharide-based HAs in thoracic surgery patients who have had 18F-FDG PET/CT scans. PATIENTS AND METHODS Two hundred nine consecutive patients who underwent thoracic surgery were enrolled in this study. A topical polysaccharide-based HA was applied to the surgical bed for all of the patients. The patients diagnosed with cancer were followed up with subsequent thoracic CT scans, and 42 of these patients were also imaged with 18F-FDG PET/CT, which then comprised the main study group. Due to suspicion of metastasis, 19/42 patients were reoperated or rebiopsied. The latest histopathological findings were accepted as criterion standard, and previous FDG PET/CT images were retrospectively reevaluated. RESULTS Polysaccharide-based HAs that appear as amorphous basophilic material were identified in histopathological samples of 11/19 patients. Lymphocytes, plasma cells, and histiocytes, which formed foreign body reaction and/or foreign body granuloma, indicating the presence of chronic inflammation, were seen in all of the samples. 18F-FDG PET/CT showed increased FDG uptake in all of these lesions. CONCLUSIONS Despite the inconsistency of the literature, polysaccharide-based HAs can be demonstrated in human surgical specimens as amorphous basophilic materials even after a long time from the initial surgical procedure. These agents almost always cause chronic inflammatory changes. In addition, these agents may mimic "false-positive" findings on postoperative FDG PET/CT scans.
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Dynamic whole-body FDG-PET imaging for oncology studies. Clin Transl Imaging 2022. [DOI: 10.1007/s40336-022-00479-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Abstract
Introduction
Recent PET/CT systems have improved sensitivity and spatial resolution by smaller PET detectors and improved reconstruction software. In addition, continuous-bed-motion mode is now available in some PET systems for whole-body PET imaging. In this review, we describe the advantages of dynamic whole-body FDG-PET in oncology studies.
Methods
PET–CT imaging was obtained at 60 min after FDG administration. Dynamic whole-body imaging with continuous bed motion in 3 min each with flow motion was obtained over 400 oncology cases. For routine image analysis, these dynamic phases (usually four phases) were summed as early FDG imaging. The image quality of each serial dynamic imaging was visually evaluated. In addition, changes in FDG uptake were analyzed in consecutive dynamic imaging and also in early delayed (90 min after FDG administration) time point imaging (dual-time-point imaging; DTPI). Image interpretation was performed by consensus of two nuclear medicine physicians.
Result
All consecutive dynamic whole-body PET images of 3 min duration had acceptable image quality. Many of the areas with physiologically high FDG uptake had altered uptake on serial images. On the other hand, most of the benign and malignant lesions did not show visual changes on serial images. In the study of 60 patients with suspected colorectal cancer, unchanged uptake was noted in almost all regions with pathologically proved FDG uptake, indicating high sensitivity with high negative predictive value on both serial dynamic imaging and on DTPI. We proposed another application of serial dynamic imaging for minimizing motion artifacts for patients who may be likely to move during PET studies.
Discussion
Dynamic whole-body imaging has several advantages over the static imaging. Serial assessment of changes in FDG uptake over a short period of time is useful for distinguishing pathological from physiological uptake, especially in the abdominal regions. These dynamic PET studies may minimize the need for DPTI. In addition, continuous dynamic imaging has the potential to reduce motion artifacts in patients who are likely to move during PET imaging. Furthermore, kinetic analysis of the FDG distribution in tumor areas has a potential for precise tissue characterization.
Conclusion
Dynamic whole-body FDG-PET imaging permits assessment of serial FDG uptake change which is particularly useful for differentiation of pathological uptake from physiological uptake with high diagnostic accuracy. This imaging can be applied for minimizing motion artifacts. Wide clinical applications of such serial, dynamic whole-body PET imaging is expected in oncological studies in the near future.
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PET imaging in ovarian cancer. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00130-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Feldman HA, Erasmus JJ, Zhou N, Antonoff MB, Mehran RJ, Rajaram R, Rice DC, Sepesi B, Swisher SG, Vaporciyan AA, Walsh GL, Hofstetter WL, Betancourt Cuellar SL. Clinical Significance of FDG-PET/CT Avid Hilar Lymph Nodes in Esophageal Carcinoma Patients. Ann Thorac Surg 2021; 114:1183-1188. [PMID: 34634240 DOI: 10.1016/j.athoracsur.2021.08.080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 07/05/2021] [Accepted: 08/30/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND The assumption that increased [18F] fluoro-2-deoxy-d-glucose (FDG) uptake in hilar nodes on PET/CT imaging is indicative of distant metastasis can result in palliative rather than curative care in patients with esophageal cancer. This study aims to determine the significance of increased FDG uptake in hilar nodes in patients with potentially curable, locally advanced disease at initial staging. METHODS We included patients with biopsy-proven esophageal carcinoma who had pretreatment FDG-PET/CT at initial staging, and follow-up imaging >1 year. We excluded patients with distant hematogeneous metastases. Hilar nodes were considered concerning for metastatic disease when SUV max was >2.5 or FDG uptake was visually > mediastinal background were examined. RESULTS We reviewed FDG-PET CT scans from 806 patients treated for esophageal cancer from 2010-2018 and identified 42 patients with FDG avid hilar adenopathy. Thirteen patients underwent histological assessment and 29 were followed with imaging. None of the 42 patients were found to have distant metastatic disease on initial work up and all were treated curatively. In follow up, 2/42 patients eventually manifested hilar nodal metastases after treatment; one who had a biopsy-negative hilar node at initial staging and another who did not have a biopsy of the hilar node. CONCLUSIONS Increased FDG uptake in hilar nodes in patients with localized esophageal cancer was not indicative of non-regional nodal metastasis. Patients in these situations should be approached with curative intent. The need for biopsy of FDG avid hilar nodes in this cohort should be carefully considered due to the low diagnostic utility.
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Affiliation(s)
- Hope A Feldman
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jeremy J Erasmus
- Thoracic Imaging Department, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Nicolas Zhou
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Mara B Antonoff
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Reza J Mehran
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Ravi Rajaram
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - David C Rice
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Boris Sepesi
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Stephen G Swisher
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Ara A Vaporciyan
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Garrett L Walsh
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Wayne L Hofstetter
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Singh H, Alam A, Tilak TVSVGK, Kinra P, Soni BK. Pitfalls in interpretation of FDG PET/CT: Septic pulmonary emboli mimicking metastases in a case of gastric carcinoma. Indian J Radiol Imaging 2021; 26:524-527. [PMID: 28104952 PMCID: PMC5201088 DOI: 10.4103/0971-3026.195792] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Inflammatory lesions may sometimes show intense tracer uptake and mimic neoplastic lesions on (18) F-fluoro-deoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). We report one such false positive case on FDG PET/CT, where septic pulmonary emboli (SPE) mimicked pulmonary metastases. A 45-year-old man with stomach cancer had an indwelling central venous catheter (CVC) in situ while on neoadjuvant chemotherapy. He underwent FDG PET/CT scan for response assessment and the images revealed multiple, intensely FDG avid, peripheral, lung nodules with feeding vessels, which were suspicious for pulmonary metastases. A day later, the patient developed fever with chills and his blood culture showed bacterial growth (Enterobacter cloacae). A provisional diagnosis of SPE from an infected CVC was made. Chemotherapy was withheld, CVC removed, and the catheter tip was sent for bacterial culture. Following a 4-week course of antibiotic treatment, the patient became afebrile. Culture from the CVC tip grew the same organism, as was seen earlier in the patient's blood culture, thus pin-pointing the source of infection in our case. Diagnosis of SPE was clinched when follow-up CT chest done after completion of antibiotic course showed complete resolution of the lung lesions.
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Affiliation(s)
- Harkirat Singh
- Department of Nuclear Medicine, Command Hospital (AF), Bengaluru, Karnataka, India
| | - Aftab Alam
- Department of Radiology, Command Hospital (AF), Bengaluru, Karnataka, India
| | - T V S V G K Tilak
- Department of Medical Oncology, Command Hospital (AF), Bengaluru, Karnataka, India
| | - Prateek Kinra
- Department of Pathology, Command Hospital (AF), Bengaluru, Karnataka, India
| | - Brijesh K Soni
- Department of Radiology, Command Hospital (AF), Bengaluru, Karnataka, India
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Hoshino Y, Sugiyama M, Hirata K, Honda S, Saito H, Manabe A, Kudo K. Extremely low 18F-fluorodeoxyglucose uptake in the brain of a patient with metastatic neuroblastoma and its recovery after chemotherapy: A case report. Acta Radiol Open 2021; 10:20584601211026810. [PMID: 34377537 PMCID: PMC8330469 DOI: 10.1177/20584601211026810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/01/2021] [Indexed: 11/16/2022] Open
Abstract
Commonly, physiological 18F-fluorodeoxyglucose (FDG) uptake in the brain can be observed in 18F-FDG positron emission tomography. Abnormal uptake of 18F-FDG in the brain suggests disorders of central nervous system. Here, we present a case of extremely low 18F-FDG uptake in the brain of a 4-year-old girl with whole-body metastatic neuroblastoma. Almost missing of physiological 18F-FDG uptake in the brain was ascribed at least partly to the metastatic neuroblastoma. The brain could regain physiological 18F-FDG uptake after chemotherapy.
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Affiliation(s)
- Yutaka Hoshino
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan.,Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Minako Sugiyama
- Department of Pediatrics, Hokkaido University Hospital, Sapporo, Japan
| | - Kenji Hirata
- Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan.,Department of Nuclear Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Shohei Honda
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, Sapporo, Japan
| | - Hitoshi Saito
- Department of Anesthesiology and Critical Care Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Atsushi Manabe
- Department of Pediatrics, Hokkaido University Hospital, Sapporo, Japan
| | - Kohsuke Kudo
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan.,Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan.,Global Center for Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University, Sapporo, Japan
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Kobayashi Y, Otsuki Y, Yamamoto H, Hamano T, Inoue S, Hattori K, Uebayashi A, Sasaki K, Suzuki K. A 77-Year-Old Man with a Pulse Granuloma of the Descending Colon Identified by Fluorodeoxyglucose-Positron Emission Tomography (FDG-PET) Imaging 19 Months Following Surgical Resection for Rectal Carcinoma. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e932153. [PMID: 34321452 PMCID: PMC8329869 DOI: 10.12659/ajcr.932153] [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] [Indexed: 12/03/2022]
Abstract
Patient: Male, 77-year-old Final Diagnosis: Pulse granuloma Symptoms: None Medication:— Clinical Procedure: — Specialty: Gastroenterology and Hepatology • Oncology
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Affiliation(s)
- Yasuyuki Kobayashi
- Department of Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Yoshiro Otsuki
- Department of Pathology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Hirotaka Yamamoto
- Department of Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Takashi Hamano
- Department of Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Seiji Inoue
- Department of Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Kento Hattori
- Department of Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Asuka Uebayashi
- Department of Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Kaito Sasaki
- Department of Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Kazufumi Suzuki
- Department of Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
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Anxiety experienced by oncological patients who undergo 18F-FDG PET CT: A systematic review. Radiography (Lond) 2021; 27:1203-1210. [PMID: 34175212 DOI: 10.1016/j.radi.2021.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 05/18/2021] [Accepted: 06/03/2021] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Anxiety is an emotional reaction often experienced by patients who undergo Positron Emission Tomography/Computed Tomography (PET/CT) with 18F-2-fluoro-2-deoxy-d-glucose (18F-FDG). This systematic review aimed to summarise the evidence currently available considering the anxiety experienced by adult oncological patients concerning pre and post 18F-FDG PET/CT examination and the factors contributing to anxiety. METHODS A systematic review search of CINAHL, PsycINFO, PubMed, Scopus and Web Science databases and other manual search sources, was conducted from November to February 2021. The research included articles published from January 2000 to December 2020. It included quantitative studies, which analysed the anxiety experienced by oncological patients who had undergone 18F-FDG PET/CT. RESULTS Ten articles met the inclusion criteria for this systematic review. The studies selected were published between 2011 and 2020 and carried out in five countries. Anxiety experienced by patients was evaluated at the various stages of the 18F-FDG PET/CT, eight studies assessed it in the pre-examination, seven studies in the post-examination and five studies at both times. Four main anxiety factors were found: patients' clinical situation, first-time patients' examination, scan procedure, and patients concern with the examination result. CONCLUSION Moderate to high levels of anxiety are present in most of the patients who undergo the examination. This review also highlights several factors related to the anxiety levels through different procedure moments. IMPLICATIONS FOR PRACTICE The results of this research will allow health professionals to adjust non-pharmacological strategies to decrease anxiety levels in oncological patients undergoing 18F-FDG PET/CT.
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Yuan C, Zhang M, Huang X, Xie W, Lin X, Zhao W, Li B, Qian D. Diffuse large B-cell lymphoma segmentation in PET-CT images via hybrid learning for feature fusion. Med Phys 2021; 48:3665-3678. [PMID: 33735451 DOI: 10.1002/mp.14847] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 02/09/2021] [Accepted: 03/10/2021] [Indexed: 12/27/2022] Open
Abstract
PURPOSE Diffuse large B-cell lymphoma (DLBCL) is an aggressive type of lymphoma with high mortality and poor prognosis that especially has a high incidence in Asia. Accurate segmentation of DLBCL lesions is crucial for clinical radiation therapy. However, manual delineation of DLBCL lesions is tedious and time-consuming. Automatic segmentation provides an alternative solution but is difficult for diffuse lesions without the sufficient utilization of multimodality information. Our work is the first study focusing on positron emission tomography and computed tomography (PET-CT) feature fusion for the DLBCL segmentation issue. We aim to improve the fusion performance of complementary information contained in PET-CT imaging with a hybrid learning module in the supervised convolutional neural network. METHODS First, two encoder branches extract single-modality features, respectively. Next, the hybrid learning component utilizes them to generate spatial fusion maps which can quantify the contribution of complementary information. Such feature fusion maps are then concatenated with specific-modality (i.e., PET and CT) feature maps to obtain a representation of the final fused feature maps in different scales. Finally, the reconstruction part of our network creates a prediction map of DLBCL lesions by integrating and up-sampling the final fused feature maps from encoder blocks in different scales. RESULTS The ability of our method was evaluated to detect foreground and segment lesions in three independent body regions (nasopharynx, chest, and abdomen) of a set of 45 PET-CT scans. Extensive ablation experiments compared our method to four baseline techniques for multimodality fusion (input-level (IL) fusion, multichannel (MC) strategy, multibranch (MB) strategy, and quantitative weighting (QW) fusion). The results showed that our method achieved a high detection accuracy (99.63% in the nasopharynx, 99.51% in the chest, and 99.21% in the abdomen) and had the superiority in segmentation performance with the mean dice similarity coefficient (DSC) of 73.03% and the modified Hausdorff distance (MHD) of 4.39 mm, when compared with the baselines (DSC: IL: 53.08%, MC: 63.59%, MB: 69.98%, and QW: 72.19%; MHD: IL: 12.16 mm, MC: 6.46 mm, MB: 4.83 mm, and QW: 4.89 mm). CONCLUSIONS A promising segmentation method has been proposed for the challenging DLBCL lesions in PET-CT images, which improves the understanding of complementary information by feature fusion and may guide clinical radiotherapy. The statistically significant analysis based on P-value calculation has indicated a degree of significant difference between our proposed method and other baselines (almost metrics: P < 0.05). This is a preliminary research using a small sample size, and we will collect data continually to achieve the larger verification study.
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Affiliation(s)
- Cheng Yuan
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, 200040, China
| | - Miao Zhang
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xinyun Huang
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Wei Xie
- Department of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xiaozhu Lin
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Weili Zhao
- Department of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Biao Li
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Dahong Qian
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, 200040, China
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Jónsdóttir B, Ripoll MA, Bergman A, Silins I, Poromaa IS, Ahlström H, Stålberg K. Validation of 18F-FDG PET/MRI and diffusion-weighted MRI for estimating the extent of peritoneal carcinomatosis in ovarian and endometrial cancer -a pilot study. Cancer Imaging 2021; 21:34. [PMID: 33849649 PMCID: PMC8042953 DOI: 10.1186/s40644-021-00399-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 03/25/2021] [Indexed: 12/25/2022] Open
Abstract
Background The extent of peritoneal carcinomatosis is difficult to estimate preoperatively, but a valid measure would be important in identifying operable patients. The present study set out to validate the usefulness of integrated 18F-FDG PET/MRI, in comparison with diffusion-weighted MRI (DW-MRI), for estimation of the extent of peritoneal carcinomatosis in patients with gynaecological cancer. Methods Whole-body PET/MRI was performed on 34 patients with presumed carcinomatosis of gynaecological origin, all scheduled for surgery. Two radiologists evaluated the peritoneal cancer index (PCI) on PET/MRI and DW-MRI scans in consensus. The surgeon estimated PCI intraoperatively, which was used as the gold standard. Results Median total PCI for PET/MRI (21.5) was closer to surgical PCI (24.5) (p = 0.6), than DW-MRI (median PCI 20.0, p = 0.007). However, both methods were highly correlated with the surgical PCI (PET/MRI: β = 0.94 p < 0.01, DW-MRI: β = 0.86, p < 0.01). PET/MRI was more accurate (p = 0.3) than DW-MRI (p = 0.001) when evaluating patients at primary diagnosis but no difference was noted in patients treated with chemotherapy. PET/MRI was superior in evaluating high tumour burden in inoperable patients. In the small bowel regions, there was a tendency of higher sensitivity but lower specificity in PET/MRI compared to DW-MRI. Conclusions Our results suggest that FDG PET/MRI is superior to DW-MRI in estimating total spread of carcinomatosis in gynaecological cancer. Further, the greatest advantage of PET/MRI seems to be in patients at primary diagnosis and with high tumour burden, which suggest that it could be a useful tool when deciding about operability in gynaecological cancer. Supplementary Information The online version contains supplementary material available at 10.1186/s40644-021-00399-2.
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Affiliation(s)
- Björg Jónsdóttir
- Department of Women's and Children's Health, Uppsala University, 75185, Uppsala, Sweden.
| | | | - Antonina Bergman
- Department of Surgical Sciences, Section of Radiology, Uppsala University, Uppsala, Sweden
| | - Ilvars Silins
- Department of Women's and Children's Health, Uppsala University, 75185, Uppsala, Sweden
| | | | - Håkan Ahlström
- Department of Surgical Sciences, Section of Radiology, Uppsala University, Uppsala, Sweden.,Antaros, Medical AB, Uppsala, Sweden
| | - Karin Stålberg
- Department of Women's and Children's Health, Uppsala University, 75185, Uppsala, Sweden
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Shahzad K, Majid ASA, Khan M, Iqbal MA, Ali A. Recent advances in the synthesis of (99mTechnetium) based radio-pharmaceuticals. REV INORG CHEM 2021. [DOI: 10.1515/revic-2020-0021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Abstract
Technetium radionuclide (99mTc) has excellent extent of disintegration properties and occupies a special place in the field of nuclear medicinal chemistry and other health disciplines. Current review describes recent approaches of synthesis in detailed ways for radio-pharmaceuticals of technetium which have been developed to treat and diagnose the biotic disorders. These technetium labeled radio-pharmaceuticals have been established to apply in the field of diagnostic nuclear medicine especially for imaging of different body parts such as brain, heart, kidney, bones and so on, through single photon emission computed tomography (SPECT) that is thought to be difficult to image such organs by using common X-ray and MRI (Magnetic Resonance Imaging) techniques. This review highlights and accounts an inclusive study on the various synthetic routes of technetium labeled radio-pharmaceuticals using ligands with various donor atoms such as carbon, nitrogen, sulphur, phosphorus etc. These compounds can be utilized as next generation radio-pharmaceuticals.
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Affiliation(s)
- Khurram Shahzad
- Department of Chemistry , University of Agriculture , Faisalabad , 38000 , Pakistan
| | | | - Mumtaz Khan
- Health Physics Division, Pakistan Institute of Nuclear Science and Technology , Islamabad , Pakistan
| | - Muhammad Adnan Iqbal
- Department of Chemistry , University of Agriculture , Faisalabad , 38000 , Pakistan
- Organometallic and Coordination Chemistry Laboratory, University of Agriculture , Faisalabad , 38000 , Pakistan
| | - Asjad Ali
- Department of Chemistry , University of Agriculture , Faisalabad , 38000 , Pakistan
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Utility of PET/CT in the diagnosis and staging of lung cancer after ecobronchoscopy in mining population. Med Clin (Barc) 2021; 158:65-69. [PMID: 33478813 DOI: 10.1016/j.medcli.2020.11.032] [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: 06/15/2020] [Revised: 11/06/2020] [Accepted: 11/11/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Positron emission tomography (PET) with computerized axial tomography (CT) in a single device is known as PET/CT. It has been widely documented and validated, and it is currently a core part of the diagnosis and staging of lung cancer. However, its reliability has not been analysed in specific populations. The objective of this study is to determine the usefulness of PET/CT in patients exposed to mining activities in which an endobronchial ultrasound (EBUS) has been performed for the diagnosis and/or staging of lung cancer. PATIENTS AND METHODS With a prospective and real-time database, all the patients who had undergone an EBUS with suspicion of lung cancer and who had previously undergone a PET/CT were selected. The observation unit was the lymph node and, based on their history of exposure to mining activities, the sample was divided into two categories, group 1: not exposed; and group 2: exposed. In each group, and with the results from anatomical pathology as a dependent variable, logistic models were established to look for independent risk factors for malignancy. RESULTS In group 1, lymph nodes larger than 1 cm and PET/CT uptake with maximum standardized uptake value (SUVmax) over 2.5 were independent risk factors for malignancy. However, in group 2 (exposed patients), none of those factors were predictors for malignancy. DISCUSSION In the population of individuals with occupational exposure to mining, PET/CT is an imaging technique with diagnostic limitations for lung cancer.
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Wang C, Leach BI, Lister D, Adams SR, Xu H, Hoh C, McConville P, Zhang J, Messer K, Ahrens ET. Metallofluorocarbon Nanoemulsion for Inflammatory Macrophage Detection via PET and MRI. J Nucl Med 2020; 62:1146-1153. [DOI: 10.2967/jnumed.120.255273] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/12/2020] [Indexed: 12/14/2022] Open
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Li SJ, Kam NM, Mehta K, Sutherland TR. Enlarging internal mammary silicone lymphadenopathy mimicking breast metastases. J Med Imaging Radiat Oncol 2020; 65:216-218. [PMID: 33179438 DOI: 10.1111/1754-9485.13124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 10/05/2020] [Accepted: 10/12/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Simon J Li
- Medical Imaging Department, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Ning Mao Kam
- Medical Imaging Department, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Kirti Mehta
- Medical Imaging Department, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.,BreastScreen, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Tom R Sutherland
- Medical Imaging Department, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.,Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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Ravikanth R. 18F-fluorodeoxyglucose positron emission tomography/computed tomography imaging review of benign lesions of the thorax. World J Nucl Med 2020; 20:7-16. [PMID: 33850484 PMCID: PMC8034779 DOI: 10.4103/wjnm.wjnm_85_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 06/20/2020] [Accepted: 06/29/2020] [Indexed: 12/02/2022] Open
Abstract
2-deoxy-2-(Fluorine-18) fluoro-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) has been used exclusively to diagnose malignancies. However, increased 18F-FDG uptake is not always limited to malignant lesions. This imaging review demonstrates the physiological 18F-FDG uptake of normal structures in the thorax and illustrates many benign pathological lesions with standardized uptake value >2.5. These various conditions can be broadly categorized into three groups: infective lesions, active granulomatous diseases such as sarcoidosis, noninfectious/inflammatory, or proliferative conditions such as radiation pneumonitis, postlung transplant lymphoproliferative disorders, occupational pleuropulmonary complications, and postsurgical conditions, all of which can demonstrate varying degrees of 18F-FDG uptake on PET/CT based upon the degree of inflammatory activity. Familiarity of false-positive findings improves the PET/CT evaluation accuracy of benign lesions of the thorax. Radiation exposure and surgical history correlation along with imaging cross check evaluation of radiographs and magnetic resonance images for the anatomic location remains the mainstay of PET/CT characterization of positive findings.
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Affiliation(s)
- Reddy Ravikanth
- Department of Radiology, St. John's Hospital, Kattappana, Kerala, India
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Kurtoğlu E, Göçer M. Clinical Significance of Increased FDG Uptake in the Waldeyer Ring and the Nasopharynx Region Identified by PET-CT in Postchemotherapy Follow-up in Patients With Lymphoma: When Should We Perform Biopsy? CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2020; 20:830-835. [PMID: 32917575 DOI: 10.1016/j.clml.2020.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 01/14/2023]
Abstract
PURPOSE To identify whether fluorodeoxyglucose (FDG) uptake in the Waldeyer ring (WR)/nasopharyngeal (NP) region by positron emission tomography-computed tomography (PET-CT) was physiologic or pathologic in the follow-up of lymphoma patients receiving postchemotherapy treatment. PATIENTS AND METHODS We retrospectively examined FDG uptake in the WR/NP region in 534 patients with lymphoma as assessed by PET-CT used for both diagnosis and follow-up. RESULTS Forty-nine patients had FDG uptake in the WR/NP region by PET-CT performed after completion of a chemotherapy regimen. Biopsy was performed for 11 of these patients in whom the uptake was considered to be pathologic, and results indicated the presence of reactive follicular hyperplasia. It was considered to be physiologic in 38 patients. PET-CT was repeated after 1 year, and no significant difference was identified between the standardized maximum uptake values (SUVmax; P = .107). The initial diagnosis of 20 patients was made via biopsy performed in the WR/NP region. The SUVmax for the FDG uptake in these patients, asymmetry, SUVmax of the coexisting lymphadenopathies in the neck, and FDG uptake with a counterpart finding by CT were significantly higher than other groups (P = .047, .001, and .005). CONCLUSION When deciding whether to resample after treatment completion, it should be taken into account that, in addition to the SUVmax of the lesion, asymmetry, and the SUVmax of the coexisting lymphadenopathy in the neck, a crucial criterion is whether the FDG uptake has a counterpart finding by CT.
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Affiliation(s)
- Erdal Kurtoğlu
- Division of Hematology, Department of Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey.
| | - Mesut Göçer
- Division of Hematology, Department of Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey
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Fatania K, Brown PJ, Xie C, McDermott G, Callister MEJ, Graham R, Subesinghe M, Gleeson FV, Scarsbrook AF. Multi-observer concordance and accuracy of the British Thoracic Society scale and other visual assessment qualitative criteria for solid pulmonary nodule assessment using FDG PET-CT. Clin Radiol 2020; 75:878.e21-878.e28. [PMID: 32709393 DOI: 10.1016/j.crad.2020.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 06/24/2020] [Indexed: 10/23/2022]
Abstract
AIM To compare the interobserver reliability and diagnostic accuracy of the British Thoracic Society (BTS) scale and other visual assessment criteria in the context of 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography (PET)-computed tomography (CT) evaluation of solid pulmonary nodules (SPNs). MATERIALS AND METHODS Fifty patients who underwent FDG PET-CT for assessment of a SPN were identified. Seven reporters with varied experience at four centres graded FDG uptake visually using the British Thoracic Society (BTS) four-point scale. Five reporters also scored SPNs according to three- and five-point visual assessment scales and using semi-quantitative assessment (maximum standardised uptake value [SUVmax]). Interobserver reliability was assessed with the intra-class correlation coefficient (ICC) and weighted Cohen's kappa (κ). Diagnostic performance was evaluated by receiver operator characteristic (ROC) analysis. RESULTS Good interobserver reliability was demonstrated with the BTS scale (ICC=0.78, 95% confidence interval [CI]: 0.69-0.85) and five-point scale (ICC=0.78, 95 CI 0.68-0.86), whilst the three-point scale demonstrated moderate reliability (ICC=0.70, 95% CI: 0.59-0.80). Almost perfect agreement was achieved between two consultants (κ=0.85), and substantial agreement between two other consultants (κ=0.78) using the BTS scale. ROC curves for the BTS and five-point scales demonstrated equivalent accuracy (BTS area under the ROC curve [AUC]=0.768; five-point AUC=0.768). SUVmax was no more accurate compared to the BTS scale (SUVmax AUC=0.794; BTS AUC=0.768, p=0.43). CONCLUSIONS The BTS scale can be applied reliably by reporters with varied levels of PET-CT reporting experience, across different centres and has a diagnostic performance that is not surpassed by alternative scales.
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Affiliation(s)
- K Fatania
- Department of Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
| | - P J Brown
- Department of Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - C Xie
- Department of Radiology, Oxford University Hospitals Foundation Trust, Oxford, UK
| | - G McDermott
- Department of Medical Physics, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - M E J Callister
- Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - R Graham
- Department of Radiology, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - M Subesinghe
- King's College London & Guy's and St. Thomas' PET Centre, St Thomas' Hospital, London, UK; Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - F V Gleeson
- Department of Radiology, Oxford University Hospitals Foundation Trust, Oxford, UK
| | - A F Scarsbrook
- Department of Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK; Leeds Institute of Research at St James', University of Leeds, UK
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Liu C, Ma C, Duan J, Qiu Q, Guo Y, Zhang Z, Yin Y. Using CT texture analysis to differentiate between peripheral lung cancer and pulmonary inflammatory pseudotumor. BMC Med Imaging 2020; 20:75. [PMID: 32631330 PMCID: PMC7339470 DOI: 10.1186/s12880-020-00475-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 06/26/2020] [Indexed: 12/13/2022] Open
Abstract
Background This study is to distinguish peripheral lung cancer and pulmonary inflammatory pseudotumor using CT-radiomics features extracted from PET/CT images. Methods In this study, the standard 18F-fluorodeoxyglucose positron emission tomography/ computed tomography (18 F-FDG PET/CT) images of 21 patients with pulmonary inflammatory pseudotumor (PIPT) and 21 patients with peripheral lung cancer were retrospectively collected. The dataset was used to extract CT-radiomics features from regions of interest (ROI), The intra-class correlation coefficient (ICC) was used to screen the robust feature from all the radiomic features. Using, then, statistical methods to screen CT-radiomics features, which could distinguish peripheral lung cancer and PIPT. And the ability of radiomics features distinguished peripheral lung cancer and PIPT was estimated by receiver operating characteristic (ROC) curve and compared by the Delong test. Results A total of 435 radiomics features were extracted, of which 361 features showed relatively good repeatability (ICC ≥ 0.6). 20 features showed the ability to distinguish peripheral lung cancer from PIPT. these features were seen in 14 of 330 Gray-Level Co-occurrence Matrix features, 1 of 49 Intensity Histogram features, 5 of 18 Shape features. The area under the curves (AUC) of these features were 0.731 ± 0.075, 0.717, 0.748 ± 0.038, respectively. The P values of statistical differences among ROC were 0.0499 (F9, F20), 0.0472 (F10, F11) and 0.0145 (F11, Mean4). The discrimination ability of forming new features (Parent Features) after averaging the features extracted at different angles and distances was moderate compared to the previous features (Child features). Conclusion Radiomics features extracted from non-contrast CT based on PET/CT images can help distinguish peripheral lung cancer and PIPT.
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Affiliation(s)
- Chenlu Liu
- School of Nuclear Science and Technology, University of South China, Hengyang, 421001, China.,Department of Radiotherapy, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong Province, China
| | - Changsheng Ma
- Department of Radiotherapy, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong Province, China
| | - Jinghao Duan
- Department of Radiotherapy, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong Province, China
| | - Qingtao Qiu
- Department of Radiotherapy, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong Province, China
| | - Yanluan Guo
- Department of Medical Imaging, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong Province, China
| | - Zhenhua Zhang
- School of Nuclear Science and Technology, University of South China, Hengyang, 421001, China
| | - Yong Yin
- Department of Radiotherapy, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong Province, China.
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Chiaravalloti A, Filippi L, Ricci M, Cimini A, Schillaci O. Molecular Imaging in Pediatric Brain Tumors. Cancers (Basel) 2019; 11:cancers11121853. [PMID: 31771237 PMCID: PMC6966547 DOI: 10.3390/cancers11121853] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 11/16/2019] [Accepted: 11/19/2019] [Indexed: 02/07/2023] Open
Abstract
In the last decade, several radiopharmaceuticals have been developed and investigated for imaging in vivo of pediatric brain tumors with the aim of exploring peculiar metabolic processes as glucose consumption, amino-acid metabolism, and protein synthesis with nuclear medicine techniques. Although the clinical shreds of evidence are limited, preliminary results are encouraging. In this review, we performed web-based and desktop research summarizing the most relevant findings of the literature published to date on this topic. Particular attention was given to the wide spectrum of nuclear medicine advances and trends in pediatric neurooncology and neurosurgery. Furthermore, the role of somatostatin receptor imaging through single-photon emission computed tomography (SPECT) and positron emission tomography (PET) probes, with reference to their potential therapeutic implications, was examined in the peculiar context. Preliminary results show that functional imaging in pediatric brain tumors might lead to significant improvements in terms of diagnostic accuracy and it could be of help in the management of the disease.
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Affiliation(s)
- Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy (O.S.)
- Nuclear Medicine Section, IRCCS Neuromed, 86077 Pozzilli, Italy
- Correspondence: or ; Tel.: +39-062-090-2457
| | - Luca Filippi
- Nuclear Medicine Section, “Santa Maria Goretti” Hospital, 04100 Latina, Italy;
| | - Maria Ricci
- Department of Radiological, Oncological and Pathological Sciences, Faculty of Medicine and Surgery, La Sapienza University, 00161 Rome, Italy;
| | - Andrea Cimini
- Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy (O.S.)
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy (O.S.)
- Nuclear Medicine Section, IRCCS Neuromed, 86077 Pozzilli, Italy
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Extracellular acidosis differentiates pancreatitis and pancreatic cancer in mouse models using acidoCEST MRI. Neoplasia 2019; 21:1085-1090. [PMID: 31734629 PMCID: PMC6888716 DOI: 10.1016/j.neo.2019.09.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 09/26/2019] [Accepted: 09/30/2019] [Indexed: 01/07/2023] Open
Abstract
Differentiating pancreatitis from pancreatic cancer would improve diagnostic specificity, and prognosticating pancreatitis that progresses to pancreatic cancer would also improve diagnoses of pancreas pathology. The high glycolytic metabolism of pancreatic cancer can cause tumor acidosis, and different levels of pancreatitis may also have different levels of acidosis, so that extracellular acidosis may be a diagnostic biomarker for these pathologies. AcidoCEST MRI can noninvasively measure extracellular pH (pHe) in the pancreas and pancreatic tissue. We used acidoCEST MRI to measure pHe in a KC model treated with caerulein, which causes pancreatitis followed by development of pancreatic cancer. We also evaluated the KC model treated with PBS, and wild-type mice treated with caerulein or PBS as controls. The caerulein-treated KC cohort had lower pHe of 6.85–6.92 before and during the first 48 h after initiating treatment, relative to a pHe of 6.92 to 7.05 pHe units for the other cohorts. The pHe of the caerulein-treated KC cohort decreased to 6.79 units at 5 weeks when pancreatic tumors were detected with anatomical MRI, and sustained a pHe of 6.75 units at the 8-week time point. Histopathology was used to evaluate and validate the presence of tumors and inflammation in each cohort. These results showed that acidoCEST MRI can differentiate pancreatic cancer from pancreatitis in this mouse model, but does not appear to differentiate pancreatitis that progresses to pancreatic cancer vs. pancreatitis that does not progress to cancer.
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Bae MR, Roh JL, Kim JS, Lee JH, Cho KJ, Choi SH, Nam SY, Kim SY. 18F-FDG PET/CT versus CT/MR imaging for detection of neck lymph node metastasis in palpably node-negative oral cavity cancer. J Cancer Res Clin Oncol 2019; 146:237-244. [DOI: 10.1007/s00432-019-03054-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 10/05/2019] [Indexed: 02/06/2023]
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Relationship between sex hormones levels and 18F-FDG uptake by the ovaries in premenopausal woman. Radiol Oncol 2019; 53:293-299. [PMID: 31553705 PMCID: PMC6765169 DOI: 10.2478/raon-2019-0035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 07/17/2019] [Indexed: 12/13/2022] Open
Abstract
Background The study was conducted to evaluate the effect of sex hormones on F-18 fluorodeoxyglucose (18F-FDG) uptake by normal ovaries. Patients and methods A total of 197 premenopausal women were included in this study. Based on 18F-FDG positron emission tomography/computed tomography (PET/CT) images obtained from these subjects, the association of ovarian 18F-FDG uptake with levels of sex hormones, including estradiol, progesterone, testosterone, follicle-stimulating hormone, and luteinizing hormone was investigated. We also analysed the relationship between the menstrual cycle and ovarian 18F-FDG uptake. Results The highest ovarian 18F-FDG uptake occurred at 2 weeks after the onset of menstruation (median maximum standardized uptake value [SUVmax] = 3.40, median mean SUV [SUVmean] = 2.20), and the lowest ovarian 18F-FDG uptake was observed during the first week of the menstrual cycle (median SUVmax = 1.60, median SUVmean = 1.20). Ovarian 18F-FDG uptake was weakly positively correlated with progesterone levels (rho = 0.28, p < 0.001 for SUVmax, rho = 0.30, p < 0.001 for SUVmean), and this pattern was consistently observed in subjects in the follicular-phase group (rho = 0.29, p = 0.003 for both SUVmax and SUVmean) but not in subjects in the luteal-phase group. Conclusions Based on PET images, ovarian glucose metabolism in premenopausal women tended to increase slightly with increasing progesterone concentration.
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