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Singnurkar A, Poon R, Metser U. Head-to-Head Comparison of the Diagnostic Performance of FDG PET/CT and FDG PET/MR in Patients With Cancer: A Systematic Review and Meta-Analysis. AJR Am J Roentgenol 2024. [PMID: 39016450 DOI: 10.2214/ajr.24.31519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2024]
Abstract
Background: The available evidence on the use of FDG PET/MRI performed using an integrated system in patients with cancer has grown substantially. Objective: To perform a systematic review and meta-analysis comparing the diagnostic performance of FDG PET/CT and FDG PET/MRI in patients with cancer. Evidence Acquisition: MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews were searched from July 1, 2015 to January 25, 2023 for studies reporting a head-to-head comparison of the diagnostic performance of FDG PET/CT and FDG PET/MRI in patients with cancer. The two modalities' diagnostic performance was summarized, stratified by performance endpoint. For endpoints with sufficient data, meta-analysis was performed using bivariate modeling to produce summary estimates of pooled sensitivity and specificity. For remaining endpoints, reported performance in individual studies was recorded. Evidence Synthesis: The systematic review included 29 studies with a total of 1656 patients. For patient-level detection of regional nodal metastases (5 studies), pooled sensitivity and specificity for PET/MRI were 88% (95% CI, 74-95%) and 92% (95% CI, 71-98%), respectively, and for PET/CT were 86% (95% CI, 70-94%) and 86% (95% CI, 68-95%), respectively. For lesion-level detection of recurrence and/or metastases (5 studies), pooled sensitivity and specificity for PET/MRI were 94% (95% CI, 78-99%) and 83% (95% CI, 76-88%), respectively, and for PET/CT were 91% (95% CI, 77-96%) and 81% (95% CI, 72-88%), respectively. In individual studies not included in meta-analysis, PET/MRI in comparison with PET/CT showed staging accuracy in breast cancer of 98.0% versus 74.5% and in colorectal cancer of 96.2% versus 69.2%, sensitivity for primary tumor detection in cervical cancer of 93.2% versus 66.2%, and sensitivity, specificity, and accuracy for lesion-level liver metastasis detection of 91.1-98.0% versus 42.3-71.1%, 100.0% versus 83.3-98.6%, and 96.5-98.2% versus 44.7-86.7%, respectively. In three studies, management was more commonly impacted by information from PET/MRI (5.2-11.1%) than PET/CT (0.0-2.6%). Conclusions: PET/MRI showed comparable or superior diagnostic performance versus PET/CT across a range of cancers and endpoints. Clinical Impact: The findings help to identify clinical settings where PET/MRI may provide particular clinical benefit for oncologic evaluation.
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Affiliation(s)
- Amit Singnurkar
- Department of Medical Imaging, University of Toronto, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, Canada, M4N 3M5
| | - Raymond Poon
- Department of Oncology, Program in Evidence-Based Care, Ontario Health (Cancer Care Ontario), McMaster University, Juravinski Hospital and Cancer Centre, Hamilton, Ontario, Canada
| | - Ur Metser
- Department of Medical Imaging, University of Toronto, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, Ontario, Canada, M5G 2M9
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van de Weijer T, van der Meer WL, Moonen RPM, van Nijnatten TJA, Gietema HA, Mitea C, van der Pol JAJ, Wildberger JE, Mottaghy FM. Limited Additional Value of a Chest CT in Whole-Body Staging with PET-MRI: A Retrospective Cohort Study. Cancers (Basel) 2024; 16:2265. [PMID: 38927970 PMCID: PMC11201796 DOI: 10.3390/cancers16122265] [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: 05/15/2024] [Revised: 06/04/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
Hybrid PET-MRI systems are being used more frequently. One of the drawbacks of PET-MRI imaging is its inferiority in detecting lung nodules, so it is often combined with a computed tomography (CT) of the chest. However, chest CT often detects additional, indeterminate lung nodules. The objective of this study was to assess the sensitivity of detecting metastatic versus indeterminate nodules with PET-MRI compared to chest CT. A total of 328 patients were included. All patients had a PET/MRI whole-body scan for (re)staging of cancer combined with an unenhanced chest CT performed at our center between 2014 and 2020. Patients had at least a two-year follow-up. Six percent of the patients had lung metastases at initial staging. The sensitivity and specificity of PET-MRI for detecting lung metastases were 85% and 100%, respectively. The incidence of indeterminate lung nodules on chest CT was 30%. The sensitivity of PET-MRI to detect indeterminate lung nodules was poor (23.0%). The average size of the indeterminate lung nodules detected on PET-MRI was 7 ± 4 mm, and the missed indeterminate nodules on PET-MRI were 4 ± 1 mm (p < 0.001). The detection of metastatic lung nodules is fairly good with PET-MRI, whereas the sensitivity of PET-MRI for detecting indeterminate lung nodules is size-dependent. This may be an advantage, limiting unnecessary follow-up of small, indeterminate lung nodules while adequately detecting metastases.
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Affiliation(s)
- Tineke van de Weijer
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P. Debeylaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands; (T.v.d.W.); (W.L.v.d.M.); (R.P.M.M.); (T.J.A.v.N.); (H.A.G.); (J.A.J.v.d.P.); (J.E.W.)
- School of Nutrition and Translational Research in Metabolism (NUTRIM), 6200 MD Maastricht, The Netherlands
| | - Wilhelmina L. van der Meer
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P. Debeylaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands; (T.v.d.W.); (W.L.v.d.M.); (R.P.M.M.); (T.J.A.v.N.); (H.A.G.); (J.A.J.v.d.P.); (J.E.W.)
| | - Rik P. M. Moonen
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P. Debeylaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands; (T.v.d.W.); (W.L.v.d.M.); (R.P.M.M.); (T.J.A.v.N.); (H.A.G.); (J.A.J.v.d.P.); (J.E.W.)
| | - Thiemo J. A. van Nijnatten
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P. Debeylaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands; (T.v.d.W.); (W.L.v.d.M.); (R.P.M.M.); (T.J.A.v.N.); (H.A.G.); (J.A.J.v.d.P.); (J.E.W.)
- School for Oncology and Reproduction (GROW), 6200 MD Maastricht, The Netherlands
| | - Hester A. Gietema
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P. Debeylaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands; (T.v.d.W.); (W.L.v.d.M.); (R.P.M.M.); (T.J.A.v.N.); (H.A.G.); (J.A.J.v.d.P.); (J.E.W.)
- School for Oncology and Reproduction (GROW), 6200 MD Maastricht, The Netherlands
| | - Cristina Mitea
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P. Debeylaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands; (T.v.d.W.); (W.L.v.d.M.); (R.P.M.M.); (T.J.A.v.N.); (H.A.G.); (J.A.J.v.d.P.); (J.E.W.)
- School for Oncology and Reproduction (GROW), 6200 MD Maastricht, The Netherlands
| | - Jochem A. J. van der Pol
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P. Debeylaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands; (T.v.d.W.); (W.L.v.d.M.); (R.P.M.M.); (T.J.A.v.N.); (H.A.G.); (J.A.J.v.d.P.); (J.E.W.)
- School for Cardiovascular Diseases (CARIM), 6202 AZ Maastricht, The Netherlands
| | - Joachim E. Wildberger
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P. Debeylaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands; (T.v.d.W.); (W.L.v.d.M.); (R.P.M.M.); (T.J.A.v.N.); (H.A.G.); (J.A.J.v.d.P.); (J.E.W.)
- School for Oncology and Reproduction (GROW), 6200 MD Maastricht, The Netherlands
| | - Felix M. Mottaghy
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P. Debeylaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands; (T.v.d.W.); (W.L.v.d.M.); (R.P.M.M.); (T.J.A.v.N.); (H.A.G.); (J.A.J.v.d.P.); (J.E.W.)
- Department of Nuclear Medicine, University Hospital, RWTH Aachen University, 52074 Aachen, Germany
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Kohan A, Hanneman K, Mirshahvalad SA, Afaq A, Mallak N, Metser U, Veit-Haibach P. Current Applications of PET/MR: Part II: Clinical Applications II. Can Assoc Radiol J 2024:8465371241255904. [PMID: 38836428 DOI: 10.1177/08465371241255904] [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: 06/06/2024] Open
Abstract
Due to the major improvements in the hardware and image reconstruction algorithms, positron emission tomography/magnetic resonance imaging (PET/MR) is now a reliable state-of-the-art hybrid modality in medical practice. Currently, it can provide a broad range of advantages in preclinical and clinical imaging compared to single-modality imaging. In the second part of this review, we discussed the further clinical applications of PET/MR. In the chest, PET/MR has particular potential in the oncology setting, especially when utilizing ultrashort/zero echo time MR sequences. Furthermore, cardiac PET/MR can provide reliable information in evaluating myocardial inflammation, cardiac amyloidosis, myocardial perfusion, myocardial viability, atherosclerotic plaque, and cardiac masses. In gastrointestinal and hepato-pancreato-biliary malignancies, PET/MR is able to precisely detect metastases to the liver, being superior over the other imaging modalities. In genitourinary and gynaecology applications, PET/MR is a comprehensive diagnostic method, especially in prostate, endometrial, and cervical cancers. Its simultaneous acquisition has been shown to outperform other imaging techniques for the detection of pelvic nodal metastases and is also a reliable modality in radiation planning. Lastly, in haematologic malignancies, PET/MR can significantly enhance lymphoma diagnosis, particularly in detecting extra-nodal involvement. It can also comprehensively assess treatment-induced changes. Furthermore, PET/MR may soon become a routine in multiple myeloma management, being a one-stop shop for evaluating bone, bone marrow, and soft tissues.
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Affiliation(s)
- Andres Kohan
- University Medical Imaging Toronto, Toronto Joint Department Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, Toronto, ON, Canada
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Kate Hanneman
- University Medical Imaging Toronto, Toronto Joint Department Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, Toronto, ON, Canada
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Seyed Ali Mirshahvalad
- University Medical Imaging Toronto, Toronto Joint Department Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, Toronto, ON, Canada
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Asim Afaq
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Nadine Mallak
- Department of Diagnostic Radiology, Oregon Health and Science University, Portland, OR, USA
| | - Ur Metser
- University Medical Imaging Toronto, Toronto Joint Department Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, Toronto, ON, Canada
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Patrick Veit-Haibach
- University Medical Imaging Toronto, Toronto Joint Department Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, University of Toronto, Toronto, ON, Canada
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
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State of the Art MR Imaging for Lung Cancer TNM Stage Evaluation. Cancers (Basel) 2023; 15:cancers15030950. [PMID: 36765907 PMCID: PMC9913625 DOI: 10.3390/cancers15030950] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/20/2023] [Accepted: 01/28/2023] [Indexed: 02/05/2023] Open
Abstract
Since the Radiology Diagnostic Oncology Group (RDOG) report had been published in 1991, magnetic resonance (MR) imaging had limited clinical availability for thoracic malignancy, as well as pulmonary diseases. However, technical advancements in MR systems, such as sequence and reconstruction methods, and adjustments in the clinical protocol for gadolinium contrast media administration have provided fruitful results and validated the utility of MR imaging (MRI) for lung cancer evaluations. These techniques include: (1) contrast-enhanced MR angiography for T-factor evaluation, (2) short-time inversion recovery turbo spin-echo sequences as well as diffusion-weighted imaging (DWI) for N-factor assessment, and (3) whole-body MRI with and without DWI and with positron emission tomography fused with MRI for M-factor or TNM stage evaluation as well as for postoperative recurrence assessment of lung cancer or other thoracic tumors using 1.5 tesla (T) or 3T systems. According to these fruitful results, the Fleischner Society has changed its position to approve of MRI for lung or thoracic diseases. The purpose of this review is to analyze recent advances in lung MRI with a particular focus on lung cancer evaluation, clinical staging, and recurrence assessment evaluation.
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Wang ML, Zhang H, Yu HJ, Tan H, Hu LZ, Kong HJ, Mao WJ, Xiao J, Shi HC. An initial study on the comparison of diagnostic performance of 18F-FDG PET/MR and 18F-FDG PET/CT for thoracic staging of non-small cell lung cancer: Focus on pleural invasion. Rev Esp Med Nucl Imagen Mol 2023; 42:16-23. [PMID: 36243657 DOI: 10.1016/j.remnie.2021.12.007] [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: 09/03/2021] [Accepted: 12/16/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To compare the diagnostic performance of 18F-FDG PET/MR and PET/CT preliminarily for the thoracic staging of non-small cell lung cancer (NSCLC) with a special focus on pleural invasion evaluation. METHODS 52 patients with pathologically confirmed NSCLC were included and followed for another year. Whole-body 18F-FDG PET/CT and subsequent thoracic PET/MR were performed for initial thoracic staging. Thoracic (simultaneous) PET/MR acquired PET images and MRI sequences including T2 weighted imaging, with and without fat saturation, T1 weighted imaging, and diffusion weighted imaging (DWI). Two radiologists independently assessed the thoracic T, N staging and pleural involvement. The McNemar Chi-square test was used to compare the differences between PET/CT and PET/MR in the criteria. The area under the receiver-operating-characteristic curves (AUC) was calculated. RESULTS Compared to PET/CT, PET/MR exhibited higher sensitivity, specificity in the detection of pleural invasion; 82 % vs. 64% (p = 0.625), 98 % vs. 95% (p = 1.000), PET/MR to PET/CT respectively. The receiver-operating-characteristic analysis results of PET/CT vs PET/MR for the pleural invasion were as follow: AUCPET/CT = 0.79, AUCPET/MR = 0.90, p = 0.21. Both T staging results and N staging results were approximately identical in PET/CT and PET/MR. Differences between PET/CT and PET/MR in T staging, N staging as well as pleural invasion accuracy were not statistically significant (p > 0.05, each). CONCLUSION PET/MR and PET/CT demonstrated equivalent performance about the evaluation of preoperative thoracic staging of NSCLC patients. PET/MR may have greater potential in pleural invasion evaluation for NSCLC, especially for solid nodules, crucial to clinical decision-making, though our results did not demonstrate statistical significance.
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Affiliation(s)
- Ma-Li Wang
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Nuclear Medicine Institute of Fudan University, Shanghai, China; Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - He Zhang
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Nuclear Medicine Institute of Fudan University, Shanghai, China; Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Hao-Jun Yu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Nuclear Medicine Institute of Fudan University, Shanghai, China; Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Hui Tan
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Nuclear Medicine Institute of Fudan University, Shanghai, China; Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | | | - Han-Jing Kong
- Central Research Institute, UIH Group, Beijing, China
| | - Wu-Jian Mao
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Nuclear Medicine Institute of Fudan University, Shanghai, China; Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jie Xiao
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Nuclear Medicine Institute of Fudan University, Shanghai, China; Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Hong-Cheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Nuclear Medicine Institute of Fudan University, Shanghai, China; Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China.
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6
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Estudio inicial sobre la comparación del rendimiento diagnóstico de la PET/RM con [18F]FDG y la PET/TC con [18F]FDG para la estadificación torácica del cáncer de pulmón de células no pequeñas: enfoque en la invasión pleural. Rev Esp Med Nucl Imagen Mol 2022. [DOI: 10.1016/j.remn.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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7
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Consistency and prognostic value of preoperative staging and postoperative pathological staging using 18F-FDG PET/MRI in patients with non-small cell lung cancer. Ann Nucl Med 2022; 36:1059-1072. [PMID: 36264439 DOI: 10.1007/s12149-022-01795-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 10/05/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVE In recent years, positron emission tomography/magnetic resonance imaging (PET/MRI) has been clinically used as a method to diagnose non-small cell lung cancer (NSCLC). This study aimed to evaluate the concordance of staging and prognostic ability of NSCLC patients using thin-slice computed tomography (CT) and 18F-fluorodeoxyglucose (FDG) PET/MRI. METHODS This retrospective study was performed on consecutive NSCLC patients who underwent both diagnostic CT and 18F-FDG PET/MRI before surgery between November 2015 and May 2019. The cTNM staging yielded from PET/MRI was compared with CT and pathological staging, and concordance was investigated, defining pathological findings as reference. To assess the prognostic value of disease-free survival (DFS) and overall survival (OS), we dichotomized the typical prognostic factors and TNM classification staging (Stage I vs. Stage II or higher). Kaplan-Meier curves derived by the log-rank test were generated, and univariate and multivariate analyses were performed to identify the factors associated with DFS and OS. RESULTS A total of 82 subjects were included; PET/MRI staging was more consistent (59 of 82) with pathological staging than with CT staging. There was a total of 21 cases of CT and 11 cases of PET/MRI that were judged as cStage I, but were actually pStage II or pStage III. CT tended to judge pN1 or pN2 as cN0 compared to PET/MRI. There was a significant difference between NSCLC patients with Stage I and Stage II or higher by PET/MRI staging as well as prognosis prediction of DFS by pathological staging (P < 0.001). In univariate analysis, PET/MRI, CT, and pathological staging (Stage I or lower vs. Stage II or higher) all showed significant differences as prognostic factors of recurrence or metastases. In multivariate analysis, pathological staging was the only independent factor for recurrence (P = 0.009), and preoperative PET/MRI staging was a predictor of patient survival (P = 0.013). CONCLUSIONS In NSCLC, pathologic staging was better at predicting recurrence, and preoperative PET/MRI staging was better at predicting survival. Preoperative staging by PET/MRI was superior to CT in diagnosing hilar and mediastinal lymph-node metastases, which contributed to the high concordance with pathologic staging.
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Vaz SC, Adam JA, Bolton RCD, Vera P, van Elmpt W, Herrmann K, Hicks RJ, Lievens Y, Santos A, Schöder H, Dubray B, Visvikis D, Troost EGC, de Geus-Oei LF. Joint EANM/SNMMI/ESTRO practice recommendations for the use of 2-[ 18F]FDG PET/CT external beam radiation treatment planning in lung cancer V1.0. Eur J Nucl Med Mol Imaging 2022; 49:1386-1406. [PMID: 35022844 PMCID: PMC8921015 DOI: 10.1007/s00259-021-05624-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/15/2021] [Indexed: 12/16/2022]
Abstract
Purpose 2-[18F]FDG
PET/CT is of utmost importance for radiation treatment (RT) planning and response monitoring in lung cancer patients, in both non-small and small cell lung cancer (NSCLC and SCLC). This topic has been addressed in guidelines composed by experts within the field of radiation oncology. However, up to present, there is no procedural guideline on this subject, with involvement of the nuclear medicine societies. Methods A literature review was performed, followed by a discussion between a multidisciplinary team of experts in the different fields involved in the RT planning of lung cancer, in order to guide clinical management. The project was led by experts of the two nuclear medicine societies (EANM and SNMMI) and radiation oncology (ESTRO). Results and conclusion This guideline results from a joint and dynamic collaboration between the relevant disciplines for this topic. It provides a worldwide, state of the art, and multidisciplinary guide to 2-[18F]FDG PET/CT RT planning in NSCLC and SCLC. These practical recommendations describe applicable updates for existing clinical practices, highlight potential flaws, and provide solutions to overcome these as well. Finally, the recent developments considered for future application are also reviewed.
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Affiliation(s)
- Sofia C Vaz
- Nuclear Medicine Radiopharmacology, Champalimaud Centre for the Unkown, Champalimaud Foundation, Lisbon, Portugal.,Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Judit A Adam
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Roberto C Delgado Bolton
- Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja (CIBIR), Logroño (La Rioja), Spain
| | - Pierre Vera
- Henri Becquerel Cancer Center, QuantIF-LITIS EA 4108, Université de Rouen, Rouen, France
| | - Wouter van Elmpt
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Ken Herrmann
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany.
| | - Rodney J Hicks
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Yolande Lievens
- Radiation Oncology Department, Ghent University Hospital and Ghent University, Ghent, Belgium
| | - Andrea Santos
- Nuclear Medicine Department, CUF Descobertas Hospital, Lisbon, Portugal
| | - Heiko Schöder
- Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Bernard Dubray
- Department of Radiotherapy and Medical Physics, Centre Henri Becquerel, Rouen, France.,QuantIF-LITIS EA4108, University of Rouen, Rouen, France
| | | | - Esther G C Troost
- Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany.,Helmholtz-Zentrum Dresden - Rossendorf, Institute of Radiooncology - OncoRay, Dresden, Germany.,National Center for Tumor Diseases (NCT), Partner Site Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Helmholtz Association / Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Dresden, Germany.,German Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lioe-Fee de Geus-Oei
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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Vaz SC, Adam JA, Delgado Bolton RC, Vera P, van Elmpt W, Herrmann K, Hicks RJ, Lievens Y, Santos A, Schöder H, Dubray B, Visvikis D, Troost EGC, de Geus-Oei LF. Perspective paper about the joint EANM/SNMMI/ESTRO practice recommendations for the use of 2-[18F]FDG-PET/CT external beam radiation treatment planning in lung cancer. Radiother Oncol 2022; 168:37-39. [PMID: 35066001 PMCID: PMC9277551 DOI: 10.1016/j.radonc.2021.12.048] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 12/31/2021] [Indexed: 12/25/2022]
Abstract
In “Joint EANM/SNMMI/ESTRO Practice Recommendations for the Use of 2-[18F]FDG-PET/CT External Beam Radiation Treatment Planning in Lung Cancer V1.0” clinical indications for PET-CT in (non-)small cell lung cancer are highlighted and selective nodal irradiation is discussed. Additionally, concepts about target definition, target delineation and treatment evaluation are reviewed.
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Affiliation(s)
- Sofia C Vaz
- Nuclear Medicine-Radiopharmacology Champalimaud Foundation and Leiden University Medical Center, Lisbon, Portugal.
| | - Judit A Adam
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands.
| | - Roberto C Delgado Bolton
- Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja (CIBIR), Logroño (La Rioja), Spain
| | - Pierre Vera
- Henri Becquerel Cancer Center, QuantIF-LITIS EA 4108, Université de Rouen, Rouen, France.
| | - Wouter van Elmpt
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology, Maastricht University Medical Centre, Maastricht, The Netherlands.
| | - Ken Herrmann
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany.
| | - Rodney J Hicks
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia.
| | - Yolande Lievens
- Radiation Oncology Department, Ghent University Hospital and Ghent University, Ghent, Belgium.
| | - Andrea Santos
- Nuclear Medicine Department, CUF Descobertas Hospital, Lisbon, Portugal
| | - Heiko Schöder
- Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, USA.
| | - Bernard Dubray
- Department of Radiotherapy and Medical Physics, Centre Henri Becquerel, Rouen, France; QuantIF-LITIS EA4108, University of Rouen, France.
| | | | - Esther G C Troost
- Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany; Helmholtz-Zentrum Dresden - Rossendorf, Institute of Radiooncology - OncoRay, Dresden, Germany; National Center for Tumor Diseases (NCT), Partner Site Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany, and Helmholtz Association/Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Dresden, Germany; German Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Lioe-Fee de Geus-Oei
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
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10
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Fang T, Meng N, Feng P, Huang Z, Li Z, Fu F, Yuan J, Yang Y, Liu H, Roberts N, Wang M. A Comparative Study of Amide Proton Transfer Weighted Imaging and Intravoxel Incoherent Motion MRI Techniques Versus (18) F-FDG PET to Distinguish Solitary Pulmonary Lesions and Their Subtypes. J Magn Reson Imaging 2021; 55:1376-1390. [PMID: 34723413 DOI: 10.1002/jmri.27977] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Amide proton transfer weighted imaging (APTw), intravoxel incoherent motion (IVIM), and positron emission tomography (PET) imaging all have the potential to characterize solitary pulmonary lesions (SPLs). PURPOSE To compare APTw and IVIM with PET imaging for distinguishing between benign and malignant SPLs and their subtypes. STUDY TYPE Prospective. POPULATION Ninety-five patients, 78 with malignant SPLs (including 48 with adenocarcinoma [AC] and 17 with squamous cell carcinoma [SCC]), and 17 with benign SPLs. FIELD STRENGTH/SEQUENCE Fast spin-echo (FSE) T2WI, FSE APTw and echo-planar imaging IVIM, MR-base attenuation correction (MRAC), and PET imaging on a 3-T whole-body PET/MR system. ASSESSMENT The magnetization transfer ratio asymmetry (MTRasym) at 3.5 ppm, diffusion coefficient (D), pseudo diffusion coefficient (D*), perfusion fraction (f), and the maximum standardized uptake value (SUVmax) were analyzed. STATISTICAL TESTS Individual sample t-test, Delong test, Pearson's correlation analysis, and area under the receiver operating characteristic curve (AUC). P < 0.05 indicated statistical significance. RESULTS The MTRasym and SUVmax were significantly higher, and D was significantly lower in the malignant group (3.3 ± 2.6 [%], 7.8 ± 5, and 1.2 ± 0.3 [×10-3 mm2 /second]) compared to the benign group (-0.3 ± 1.6 [%], 3.1 ± 3.8, and 1.6 ± 0.3 [×10-3 mm2 /second]). The MTRasym and D were significantly lower, and SUVmax was significantly higher in the SCC group (0.8 ± 1.0 [%], 1.0 ± 0.2 [×10-3 mm2 /second] than in the AC group (4.1 ± 2.6 [%], 1.3 ± 0.3 [×10-3 mm2 /second], 6.7 ± 4.6). Besides, the combination (AUC = 0.964) of these three methods showed higher diagnostic efficacy than any individual method (AUC = 0.917, 0.851, 0.82, respectively) in identifying malignant and benign SPLs. However, APTw showed better diagnostic efficacy than the combination of three methods or PET imaging alone in distinguishing SCC and AC groups (AUC = 0.934, 0.781, 0.725, respectively). DATA CONCLUSION APTw, IVIM, and PET imaging are all effective methods to distinguish benign and malignant SPLs and their subtypes. APTw is potentially more capable than PET imaging of distinguishing lung SCC from AC. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Ting Fang
- Department of Medical Imaging, Zhengzhou University People's Hospital, Zhengzhou, China.,Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Nan Meng
- Department of Medical Imaging, Zhengzhou University People's Hospital, Zhengzhou, China.,Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Pengyang Feng
- Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China.,Department of Medical Imaging, Henan University People's Hospital, Zhengzhou, China
| | - Zhun Huang
- Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China.,Department of Medical Imaging, Henan University People's Hospital, Zhengzhou, China
| | - Ziqiang Li
- Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China.,Department of Medical Imaging, Xinxiang Medical University, Xinxiang, China
| | - Fangfang Fu
- Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Jianmin Yuan
- Central Research Institute, UIH Group, Shanghai, China
| | - Yang Yang
- Beijing United Imaging Research Institute of Intelligent Imaging, UIH Group, Beijing, China
| | - Hui Liu
- UIH America, Inc, Houston, Texas, USA
| | - Neil Roberts
- Clinical Research Imaging Centre, School of Clinical Sciences and Community Health, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
| | - Meiyun Wang
- Department of Medical Imaging, Zhengzhou University People's Hospital, Zhengzhou, China.,Department of Medical Imaging, Henan University People's Hospital, Zhengzhou, China.,Department of Medical Imaging, Xinxiang Medical University, Xinxiang, China
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11
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Zukotynski KA, Hasan OK, Lubanovic M, Gerbaudo VH. Update on Molecular Imaging and Precision Medicine in Lung Cancer. Radiol Clin North Am 2021; 59:693-703. [PMID: 34392913 DOI: 10.1016/j.rcl.2021.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Precision medicine integrates molecular pathobiology, genetic make-up, and clinical manifestations of disease in order to classify patients into subgroups for the purposes of predicting treatment response and suggesting outcome. By identifying those patients who are most likely to benefit from a given therapy, interventions can be tailored to avoid the expense and toxicity of futile treatment. Ultimately, the goal is to offer the right treatment, to the right patient, at the right time. Lung cancer is a heterogeneous disease both functionally and morphologically. Further, over time, clonal proliferations of cells may evolve, becoming resistant to specific therapies. PET is a sensitive imaging technique with an important role in the precision medicine algorithm of lung cancer patients. It provides anatomo-functional insight during diagnosis, staging, and restaging of the disease. It is a prognostic biomarker in lung cancer patients that characterizes tumoral heterogeneity, helps predict early response to therapy, and may direct the selection of appropriate treatment.
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Affiliation(s)
- Katherine A Zukotynski
- Department of Medicine, McMaster University, 1200 Main Street West, Hamilton, Ontario L9G 4X5, Canada; Department of Radiology, McMaster University, 1200 Main Street West, Hamilton, Ontario L9G 4X5, Canada
| | - Olfat Kamel Hasan
- Department of Medicine, McMaster University, 1200 Main Street West, Hamilton, Ontario L9G 4X5, Canada; Department of Radiology, McMaster University, 1200 Main Street West, Hamilton, Ontario L9G 4X5, Canada
| | - Matthew Lubanovic
- Department of Radiology, McMaster University, 1200 Main Street West, Hamilton, Ontario L9G 4X5, Canada
| | - Victor H Gerbaudo
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02492, USA.
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12
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Husseini JS, Amorim BJ, Torrado-Carvajal A, Prabhu V, Groshar D, Umutlu L, Herrmann K, Cañamaque LG, Garzón JRG, Palmer WE, Heidari P, Shih TTF, Sosna J, Matushita C, Cerci J, Queiroz M, Muglia VF, Nogueira-Barbosa MH, Borra RJH, Kwee TC, Glaudemans AWJM, Evangelista L, Salvatore M, Cuocolo A, Soricelli A, Herold C, Laghi A, Mayerhoefer M, Mahmood U, Catana C, Daldrup-Link HE, Rosen B, Catalano OA. An international expert opinion statement on the utility of PET/MR for imaging of skeletal metastases. Eur J Nucl Med Mol Imaging 2021; 48:1522-1537. [PMID: 33619599 PMCID: PMC8240455 DOI: 10.1007/s00259-021-05198-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 01/10/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND MR is an important imaging modality for evaluating musculoskeletal malignancies owing to its high soft tissue contrast and its ability to acquire multiparametric information. PET provides quantitative molecular and physiologic information and is a critical tool in the diagnosis and staging of several malignancies. PET/MR, which can take advantage of its constituent modalities, is uniquely suited for evaluating skeletal metastases. We reviewed the current evidence of PET/MR in assessing for skeletal metastases and provided recommendations for its use. METHODS We searched for the peer reviewed literature related to the usage of PET/MR in the settings of osseous metastases. In addition, expert opinions, practices, and protocols of major research institutions performing research on PET/MR of skeletal metastases were considered. RESULTS Peer-reviewed published literature was included. Nuclear medicine and radiology experts, including those from 13 major PET/MR centers, shared the gained expertise on PET/MR use for evaluating skeletal metastases and contributed to a consensus expert opinion statement. [18F]-FDG and non [18F]-FDG PET/MR may provide key advantages over PET/CT in the evaluation for osseous metastases in several primary malignancies. CONCLUSION PET/MR should be considered for staging of malignancies where there is a high likelihood of osseous metastatic disease based on the characteristics of the primary malignancy, hight clinical suspicious and in case, where the presence of osseous metastases will have an impact on patient management. Appropriate choice of tumor-specific radiopharmaceuticals, as well as stringent adherence to PET and MR protocols, should be employed.
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Affiliation(s)
- Jad S Husseini
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Bárbara Juarez Amorim
- Division of Nuclear Medicine, Department of Radiology, School of Medical Sciences,, State University of Campinas, Campinas, Brazil
| | - Angel Torrado-Carvajal
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
- Medical Image Analysis and Biometry Laboratory, Universidad Rey Juan Carlos, Madrid, Spain
| | - Vinay Prabhu
- Department of Radiology, NYU Langone Health, New York, NY, USA
| | - David Groshar
- Department of Nuclear Medicine, Assuta Medical Center, Tel Aviv, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen, Essen, Germany
| | - Lina García Cañamaque
- Department of Nuclear Medicine, Hospital Universitario Madrid Sanchinarro, Madrid, Spain
| | | | - William E Palmer
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Pedram Heidari
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Tiffany Ting-Fang Shih
- Department of Radiology and Medical Imaging, National Taiwan University College of Medicine and Hospital, Taipei City, Taiwan
| | - Jacob Sosna
- Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Cristina Matushita
- Department of Nuclear Medicine, Hospital São Lucas of Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Juliano Cerci
- Department of Nuclear Medicine, Quanta Diagnóstico Nuclear, Curitiba, Brazil
| | - Marcelo Queiroz
- Department of Radiology and Oncology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Valdair Francisco Muglia
- Department of Medical Images, Radiation Therapy and Oncohematology, Ribeirao Preto Medical School, Hospital Clinicas, University of São Paulo, Ribeirão Prêto, Brazil
| | - Marcello H Nogueira-Barbosa
- Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School. University of São Paulo (USP), Ribeirão Prêto, Brazil
| | - Ronald J H Borra
- Medical Imaging Center, University Medical Center Groningen, Groningen, The Netherlands
| | - Thomas C Kwee
- Medical Imaging Center, University Medical Center Groningen, Groningen, The Netherlands
| | - Andor W J M Glaudemans
- Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands
| | - Laura Evangelista
- Department of Clinical and Experimental Medicine, University of Padova, Padua, Italy
| | - Marco Salvatore
- Department of Radiology and Nuclear Medicine, Università Suor Orsola Benincasa di Napoli, Naples, Italy
- Department of Radiology and Nuclear Medicine, Institute for Hospitalization and Healthcare (IRCCS) SDN, Istituto di Ricerca, Naples, Italy
| | - Alberto Cuocolo
- Department of Radiology and Nuclear Medicine, Institute for Hospitalization and Healthcare (IRCCS) SDN, Istituto di Ricerca, Naples, Italy
- Department of Advanced Biomedical Science, University of Naples Federico II, Naples, Italy
| | - Andrea Soricelli
- Department of Radiology and Nuclear Medicine, Institute for Hospitalization and Healthcare (IRCCS) SDN, Istituto di Ricerca, Naples, Italy
- Department of Movement and Wellness Sciences, Parthenope University of Naples, Naples, Italy
| | - Christian Herold
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Andrea Laghi
- Department of Radiology, University of Rome "La Sapienza", Rome, Italy
| | - Marius Mayerhoefer
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Umar Mahmood
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Ciprian Catana
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | | | - Bruce Rosen
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Onofrio A Catalano
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
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13
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Tanaka Y, Ohno Y, Hanamatsu S, Obama Y, Ueda T, Ikeda H, Iwase A, Fukuba T, Hattori H, Murayama K, Yoshikawa T, Takenaka D, Koyama H, Toyama H. State-of-the-art MR Imaging for Thoracic Diseases. Magn Reson Med Sci 2021; 21:212-234. [PMID: 33952785 PMCID: PMC9199970 DOI: 10.2463/mrms.rev.2020-0184] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Since thoracic MR imaging was first used in a clinical setting, it has been suggested that MR imaging has limited clinical utility for thoracic diseases, especially lung diseases, in comparison with x-ray CT and positron emission tomography (PET)/CT. However, in many countries and states and for specific indications, MR imaging has recently become practicable. In addition, recently developed pulmonary MR imaging with ultra-short TE (UTE) and zero TE (ZTE) has enhanced the utility of MR imaging for thoracic diseases in routine clinical practice. Furthermore, MR imaging has been introduced as being capable of assessing pulmonary function. It should be borne in mind, however, that these applications have so far been academically and clinically used only for healthy volunteers, but not for patients with various pulmonary diseases in Japan or other countries. In 2020, the Fleischner Society published a new report, which provides consensus expert opinions regarding appropriate clinical indications of pulmonary MR imaging for not only oncologic but also pulmonary diseases. This review article presents a brief history of MR imaging for thoracic diseases regarding its technical aspects and major clinical indications in Japan 1) in terms of what is currently available, 2) promising but requiring further validation or evaluation, and 3) developments warranting research investigations in preclinical or patient studies. State-of-the-art MR imaging can non-invasively visualize lung structural and functional abnormalities without ionizing radiation and thus provide an alternative to CT. MR imaging is considered as a tool for providing unique information. Moreover, prospective, randomized, and multi-center trials should be conducted to directly compare MR imaging with conventional methods to determine whether the former has equal or superior clinical relevance. The results of these trials together with continued improvements are expected to update or modify recommendations for the use of MRI in near future.
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Affiliation(s)
- Yumi Tanaka
- Department of Radiology, Fujita Health University School of Medicine
| | - Yoshiharu Ohno
- Department of Radiology, Fujita Health University School of Medicine.,Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine
| | - Satomu Hanamatsu
- Department of Radiology, Fujita Health University School of Medicine
| | - Yuki Obama
- Department of Radiology, Fujita Health University School of Medicine
| | - Takahiro Ueda
- Department of Radiology, Fujita Health University School of Medicine
| | - Hirotaka Ikeda
- Department of Radiology, Fujita Health University School of Medicine
| | - Akiyoshi Iwase
- Department of Radiology, Fujita Health University Hospital
| | - Takashi Fukuba
- Department of Radiology, Fujita Health University Hospital
| | - Hidekazu Hattori
- Department of Radiology, Fujita Health University School of Medicine
| | - Kazuhiro Murayama
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine
| | | | | | | | - Hiroshi Toyama
- Department of Radiology, Fujita Health University School of Medicine
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14
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Bębas E, Borowska M, Derlatka M, Oczeretko E, Hładuński M, Szumowski P, Mojsak M. Machine-learning-based classification of the histological subtype of non-small-cell lung cancer using MRI texture analysis. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102446] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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15
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Bruckmann NM, Kirchner J, Grueneisen J, Li Y, McCutcheon A, Aigner C, Rischpler C, Sawicki LM, Herrmann K, Umutlu L, Schaarschmidt BM. Correlation of the apparent diffusion coefficient (ADC) and standardized uptake values (SUV) with overall survival in patients with primary non-small cell lung cancer (NSCLC) using 18F-FDG PET/MRI. Eur J Radiol 2020; 134:109422. [PMID: 33271432 DOI: 10.1016/j.ejrad.2020.109422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 10/18/2020] [Accepted: 11/15/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To investigate if the combined analysis of the apparent diffusion coefficient (ADC) and standardized uptake values (SUV) measured in 18F-fluoro-deoxy-glucose-positron emission tomography/magnetic resonance imaging (18F-FDG PET/MRI) examinations correlates with overall survival in non-small cell lung cancer (NSCLC). MATERIAL AND METHODS A total of 92 patients with newly diagnosed, histopathologically proven NSCLC (44 women and 48 men, mean age 63.1 ± 9.9y) underwent a dedicated thoracic 18F-FDG PET/MRI examination. A manually drawn polygonal region of interest (ROI), encompassing the entire primary tumor mass, was placed over the primary tumor on fused PET/MR images to determine the maximum and mean standardized uptake values (SUVmax; SUVmean) as well as on the ADC maps to quantify the mean and minimum ADC values (ADCmean, ADCmin). The impact of these parameters to predict patient's overall survival was tested using hazard ratios (HR). Pearson's correlation coefficients were calculated to assess dependencies between the different values. A p-value < 0.05 indicated statistical significance. RESULTS In all 92 patients (n = 59 dead at time of retrospective data collection, mean time till death: 19 ± 16 month, n = 33 alive, mean time to last follow-up: 56 ± 22 month) the Hazard ratios (HR) as independent predictors for overall survival (OS) of SUVmax were 2.37 (95 % CI: 1.23-4.59, p = 0.008) and for SUVmean 1.85 (95 % CI: 1.05-3.26, p = 0.03) while ADCmin showed a HR of 0.95 (95 % CI: 0.57-1.59, p = 0.842) and ADCmean a HR of 2.01 (95 % CI: 1.2-3.38, p = 0.007). Furthermore, a combined analysis for SUVmax/ADCmean, SUVmax / ADCmin and SUVmean/ADCmean revealed a HR of 2.01 (95 % CI: 1.10-3.67, p = 0.02), 1.75 (95 % CI: 0.97-3.15, p = 0.058) and 1.78 (95 % CI: 1.02-3.10, p = 0.04). CONCLUSION SUVmax and SUVmean of the primary tumor are predictors for OS in therapy-naive NSCLC patients, whereas the combined analysis of SUV and ADC values does not improve these results. Therefore, ADC values do not further enhance the diagnostic value of SUV as a prognostic biomarker in NSCLC.
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Affiliation(s)
- Nils Martin Bruckmann
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany; University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany.
| | - Julian Kirchner
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany
| | - Johannes Grueneisen
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany
| | - Yan Li
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany
| | - Angela McCutcheon
- Department of Medical Oncology, West German Cancer Center, University Hospital of Essen, D-45147 Essen, Germany
| | - Clemens Aigner
- Department of Thoracic Surgery, Ruhrlandklinik, University Duisburg-Essen, D-45239 Essen, Germany
| | - Christoph Rischpler
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany
| | - Lino M Sawicki
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany
| | - Benedikt Michael Schaarschmidt
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147 Essen, Germany
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16
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Jaykel TJ, Clark MS, Adamo DA, Welch BT, Thompson SM, Young JR, Ehman EC. Thoracic positron emission tomography: 18F-fluorodeoxyglucose and beyond. J Thorac Dis 2020; 12:6978-6991. [PMID: 33282403 PMCID: PMC7711422 DOI: 10.21037/jtd-2019-cptn-09] [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] [Indexed: 11/11/2022]
Abstract
Ongoing technologic and therapeutic advancements in medicine are now testing the limits of conventional anatomic imaging techniques. The ability to image physiology, rather than simply anatomy, is critical in the management of multiple disease processes, especially in oncology. Nuclear medicine has assumed a leading role in detecting, diagnosing, staging and assessing treatment response of various pathologic entities, and appears well positioned to do so into the future. When combined with computed tomography (CT) or magnetic resonance imaging (MRI), positron emission tomography (PET) has become the sine quo non technique of evaluating most solid tumors especially in the thorax. PET/CT serves as a key imaging modality in the initial evaluation of pulmonary nodules, often obviating the need for more invasive testing. PET/CT is essential to staging and restaging in bronchogenic carcinoma and offers key physiologic information with regard to treatment response. A more recent development, PET/MRI, shows promise in several specific lung cancer applications as well. Additional recent advancements in the field have allowed PET to expand beyond imaging with 18F-flurodeoxyglucose (FDG) alone, now with the ability to specifically image certain types of cell surface receptors. In the thorax this predominantly includes 68Ga-DOTATATE which targets the somatostatin receptors abundantly expressed in neuroendocrine tumors, including bronchial carcinoid. This receptor targeted imaging technique permits targeting these tumors with therapeutic analogues such as 177Lu labeled DOTATATE. Overall, the proper utilization of PET in the thorax has the ability to directly impact and improve patient care.
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Affiliation(s)
| | - Michael S Clark
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Daniel A Adamo
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Brain T Welch
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Jason R Young
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Eric C Ehman
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
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17
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Hatabu H, Ohno Y, Gefter WB, Parraga G, Madore B, Lee KS, Altes TA, Lynch DA, Mayo JR, Seo JB, Wild JM, van Beek EJR, Schiebler ML, Kauczor HU. Expanding Applications of Pulmonary MRI in the Clinical Evaluation of Lung Disorders: Fleischner Society Position Paper. Radiology 2020; 297:286-301. [PMID: 32870136 DOI: 10.1148/radiol.2020201138] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Pulmonary MRI provides structural and quantitative functional images of the lungs without ionizing radiation, but it has had limited clinical use due to low signal intensity from the lung parenchyma. The lack of radiation makes pulmonary MRI an ideal modality for pediatric examinations, pregnant women, and patients requiring serial and longitudinal follow-up. Fortunately, recent MRI techniques, including ultrashort echo time and zero echo time, are expanding clinical opportunities for pulmonary MRI. With the use of multicoil parallel acquisitions and acceleration methods, these techniques make pulmonary MRI practical for evaluating lung parenchymal and pulmonary vascular diseases. The purpose of this Fleischner Society position paper is to familiarize radiologists and other interested clinicians with these advances in pulmonary MRI and to stratify the Society recommendations for the clinical use of pulmonary MRI into three categories: (a) suggested for current clinical use, (b) promising but requiring further validation or regulatory approval, and (c) appropriate for research investigations. This position paper also provides recommendations for vendors and infrastructure, identifies methods for hypothesis-driven research, and suggests opportunities for prospective, randomized multicenter trials to investigate and validate lung MRI methods.
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Affiliation(s)
- Hiroto Hatabu
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Yoshiharu Ohno
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Warren B Gefter
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Grace Parraga
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Bruno Madore
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Kyung Soo Lee
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Talissa A Altes
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - David A Lynch
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - John R Mayo
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Joon Beom Seo
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Jim M Wild
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Edwin J R van Beek
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Mark L Schiebler
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Hans-Ulrich Kauczor
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
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- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
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Recent and Current Advances in FDG-PET Imaging within the Field of Clinical Oncology in NSCLC: A Review of the Literature. Diagnostics (Basel) 2020; 10:diagnostics10080561. [PMID: 32764429 PMCID: PMC7459495 DOI: 10.3390/diagnostics10080561] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/29/2020] [Accepted: 08/03/2020] [Indexed: 02/07/2023] Open
Abstract
Lung cancer is the leading cause of cancer-related deaths around the world, the most common type of which is non-small-cell lung cancer (NSCLC). Computed tomography (CT) is required for patients with NSCLC, but often involves diagnostic issues and large intra- and interobserver variability. The anatomic data obtained using CT can be supplemented by the metabolic data obtained using fluorodeoxyglucose F 18 (FDG) positron emission tomography (PET); therefore, the use of FDG-PET/CT for staging NSCLC is recommended, as it provides more accuracy than either modality alone. Furthermore, FDG-PET/magnetic resonance imaging (MRI) provides useful information on metabolic activity and tumor cellularity, and has become increasingly popular. A number of studies have described FDG-PET/MRI as having a high diagnostic performance in NSCLC staging. Therefore, multidimensional functional imaging using FDG-PET/MRI is promising for evaluating the activity of the intratumoral environment. Radiomics is the quantitative extraction of imaging features from medical scans. The chief advantages of FDG-PET/CT radiomics are the ability to capture information beyond the capabilities of the human eye, non-invasiveness, the (virtually) real-time response, and full-field analysis of the lesion. This review summarizes the recent advances in FDG-PET imaging within the field of clinical oncology in NSCLC, with a focus on surgery and prognostication, and investigates the site-specific strengths and limitations of FDG-PET/CT. Overall, the goal of treatment for NSCLC is to provide the best opportunity for long-term survival; therefore, FDG-PET/CT is expected to play an increasingly important role in deciding the appropriate treatment for such patients.
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Besson FL, Fernandez B, Faure S, Mercier O, Seferian A, Mignard X, Mussot S, le Pechoux C, Caramella C, Botticella A, Levy A, Parent F, Bulifon S, Montani D, Mitilian D, Fadel E, Planchard D, Besse B, Ghigna-Bellinzoni MR, Comtat C, Lebon V, Durand E. 18F-FDG PET and DCE kinetic modeling and their correlations in primary NSCLC: first voxel-wise correlative analysis of human simultaneous [18F]FDG PET-MRI data. EJNMMI Res 2020; 10:88. [PMID: 32734484 PMCID: PMC7392998 DOI: 10.1186/s13550-020-00671-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/14/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES To decipher the correlations between PET and DCE kinetic parameters in non-small-cell lung cancer (NSCLC), by using voxel-wise analysis of dynamic simultaneous [18F]FDG PET-MRI. MATERIAL AND METHODS Fourteen treatment-naïve patients with biopsy-proven NSCLC prospectively underwent a 1-h dynamic [18F]FDG thoracic PET-MRI scan including DCE. The PET and DCE data were normalized to their corresponding T1-weighted MR morphological space, and tumors were masked semi-automatically. Voxel-wise parametric maps of PET and DCE kinetic parameters were computed by fitting the dynamic PET and DCE tumor data to the Sokoloff and Extended Tofts models respectively, by using in-house developed procedures. Curve-fitting errors were assessed by computing the relative root mean square error (rRMSE) of the estimated PET and DCE signals at the voxel level. For each tumor, Spearman correlation coefficients (rs) between all the pairs of PET and DCE kinetic parameters were estimated on a voxel-wise basis, along with their respective bootstrapped 95% confidence intervals (n = 1000 iterations). RESULTS Curve-fitting metrics provided fit errors under 20% for almost 90% of the PET voxels (median rRMSE = 10.3, interquartile ranges IQR = 8.1; 14.3), whereas 73.3% of the DCE voxels showed fit errors under 45% (median rRMSE = 31.8%, IQR = 22.4; 46.6). The PET-PET, DCE-DCE, and PET-DCE voxel-wise correlations varied according to individual tumor behaviors. Beyond this wide variability, the PET-PET and DCE-DCE correlations were mainly high (absolute rs values > 0.7), whereas the PET-DCE correlations were mainly low to moderate (absolute rs values < 0.7). Half the tumors showed a hypometabolism with low perfused/vascularized profile, a hallmark of hypoxia, and tumor aggressiveness. CONCLUSION A dynamic "one-stop shop" procedure applied to NSCLC is technically feasible in clinical practice. PET and DCE kinetic parameters assessed simultaneously are not highly correlated in NSCLC, and these correlations showed a wide variability among tumors and patients. These results tend to suggest that PET and DCE kinetic parameters might provide complementary information. In the future, this might make PET-MRI a unique tool to characterize the individual tumor biological behavior in NSCLC.
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Affiliation(s)
- Florent L Besson
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMAPs, 91401, Orsay, France.
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France.
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.
| | | | - Sylvain Faure
- Laboratoire de Mathématiques d'Orsay, CNRS, Université Paris-Saclay, 91405, Orsay, France
| | - Olaf Mercier
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - Andrei Seferian
- Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, 94270, Le Kremlin-Bicêtre, France
- Inserm UMR_S999, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - Xavier Mignard
- Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, 94270, Le Kremlin-Bicêtre, France
| | - Sacha Mussot
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - Cecile le Pechoux
- Department of Radiation Oncology, Institut d'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Caroline Caramella
- Department of Radiology, Institut d'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Angela Botticella
- Department of Radiation Oncology, Institut d'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Antonin Levy
- Department of Radiation Oncology, Institut d'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Florence Parent
- Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, 94270, Le Kremlin-Bicêtre, France
- Inserm UMR_S999, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - Sophie Bulifon
- Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, 94270, Le Kremlin-Bicêtre, France
- Inserm UMR_S999, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - David Montani
- Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, 94270, Le Kremlin-Bicêtre, France
- Inserm UMR_S999, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - Delphine Mitilian
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - Elie Fadel
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, 92350, Le Plessis Robinson, France
| | - David Planchard
- Department of Oncology, Institut d'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Benjamin Besse
- Department of Oncology, Institut d'Oncologie Thoracique (IOT), Gustave Roussy, Université Paris Saclay, Villejuif, France
| | | | - Claude Comtat
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMAPs, 91401, Orsay, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Vincent Lebon
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMAPs, 91401, Orsay, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Emmanuel Durand
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMAPs, 91401, Orsay, France
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
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20
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Hybrid PET/MRI in non-small cell lung cancer (NSCLC) and lung nodules-a literature review. Eur J Nucl Med Mol Imaging 2020; 48:584-591. [PMID: 32719914 DOI: 10.1007/s00259-020-04955-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 07/07/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND The use of hybrid PET/MRI for clinical staging is growing in several cancer forms and, consequently, PET/MRI has also gained interest in the assessment of non-small cell lung cancer (NSCLC) and lung lesions. However, lung evaluation with PET/MRI is associated with challenges related to technical issues and diagnostic image quality. We, therefore, investigated the published literature on PET/MRI for clinical staging in NSCLC or lung nodule detection specifically addressing diagnostic accuracy and technical issues. METHODS The data originates from a systematic search performed in PubMed/MEDLINE, Embase, and Cochrane Library on hybrid PET/MRI in patients with cancer for a scoping review published earlier ( https://doi.org/10.1007/s00259-019-04402-8 ). Studies in English and German evaluating the diagnostic performance of hybrid PET/MRI for NSCLC or lung nodule detection in cancer patients were selected. Data reported in peer-reviewed journals without restrictions to year of publication were included. RESULTS A total of 3138 publications were identified from which 116 published 2012-2018 were included. Of these, nine studies addressed PET/MRI in NSCLC (4) or lung nodule detection (5). Overall, PET/MRI did not provide advantages in preoperative T- and N-staging in NSCLC compared to PET/CT. The data on M-staging were too few for conclusions to be drawn. The lung nodule detection rate of PET/MRI was comparable to that of PET/CT for FDG-avid nodules larger than 10 mm, but the sensitivity of PET/MRI for detection of non-FDG-avid nodules smaller than 5 mm was low. CONCLUSION PET/MRI did not provide advantages in T- and N-staging of NSCLC compared to PET/CT. PET/MRI had a comparable sensitivity for detection of FDG-avid lung nodules and nodules over 10 mm, but PET/CT yielded a higher detection rate in non FDG-avid lung nodules under 5 mm. With PET/MRI, the overall detection rate for lung nodules in various cancer types remains inferior to that of PET/CT due to the lower diagnostic performance of MRI than CT in the lungs.
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Martin O, Bruckmann NM, Kirchner J, Ullrich T, Ingenwerth M, Bogner S, Eze C, Nensa F, Herrmann K, Umutlu L, Antoch G, Sawicki LM. Is there a connection between immunohistochemical markers and grading of lung cancer with apparent diffusion coefficient (ADC) and standardised uptake values (SUV) of hybrid 18F-FDG-PET/MRI? J Med Imaging Radiat Oncol 2020; 64:779-786. [PMID: 32705779 DOI: 10.1111/1754-9485.13087] [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: 03/11/2020] [Revised: 06/21/2020] [Accepted: 06/28/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION To correlate tumour grading and prognostic immunohistochemical markers of lung cancer with simultaneously acquired standardised uptake values (SUV) and apparent diffusion coefficient (ADC) derived from hybrid PET/MRI. METHODS In this retrospective study, 55 consecutive patients (mean age 62.5 ± 9.2 years) with therapy-naïve, histologically proven lung cancer were included. All patients underwent whole-body PET/MRI using 18F-flourdeoxyglucose (18F-FDG) as a radiotracer. Diffusion-weighted imaging of the chest (DWI, b-values: 0, 500, 1000 s/mm2 ) was performed simultaneously with PET acquisition. Histopathological tumour grading was available in 43/55 patients. In 15/55 patients, immunohistochemical markers, that is, phospho-AKT Ser473 (pAKTS473), phosphorylated extracellular signal-regulated kinase (pERK), phosphatase and tensin homolog (PTEN), and human epidermal growth factor receptor 2 (erbB2) were available. RESULTS The average SUVmax, SUVmean, ADCmin and ADCmean in lung cancer primaries were 12.6 ± 5.9, 7.7 ± 4.6, 569.9 ± 96.1 s/mm2 and 825.8 ± 93.2 s/mm2 , respectively. We found a significant inverse correlation between the ADCmin and SUVmax (r = -0.58, P < 0.001) as well as between the ADCmin and SUVmean (r = -0.44, P < 0.001). Tumour grading showed a significant positive correlation with SUVmax and SUVmean (R = 0.34 and R = 0.31, both P < 0.05) and a significant inverse correlation with ADCmin and ADCmean (r = -0.30 and r = -0.40, both P < 0.05). In addition, erbB2 showed a significant inverse correlation with SUVmax and SUVmean (r = -0.50 and r = -0.49, both P < 0.05). The other immunohistochemical markers did not show any significant correlation. CONCLUSION 18F-FDG-PET/MRI showed weak to moderate correlations between SUV, ADC, tumour grading and erbB2-expression of lung cancer. Hence, 18F-FDG-PET/MRI may, to some extent, offer complementary information to the histopathology of lung cancer, for the evaluation of tumour aggressiveness and treatment response.
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Affiliation(s)
- Ole Martin
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany
| | - Nils-Martin Bruckmann
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany
| | - Julian Kirchner
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany
| | - Tim Ullrich
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany
| | - Marc Ingenwerth
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Simon Bogner
- Department of Medical Oncology, University Hospital Essen, West German Cancer Center, University of Duisburg-Essen, Essen, Germany
| | - Chukwuka Eze
- Department of Radiation Oncology, LMU Munich, Munich, Germany
| | - Felix Nensa
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany
| | - Lino M Sawicki
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany
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Abstract
Purpose of Review The main goal of the article is to familiarize the reader with commonly and uncommonly used nuclear medicine procedures that can significantly contribute to improved patient care. The article presents examples of specific modality utilization in the chest including assessment of lung ventilation and perfusion, imaging options for broad range of infectious and inflammatory processes, and selected aspects of oncologic imaging. In addition, rapidly developing new techniques utilizing molecular imaging are discussed. Recent Findings The article describes nuclear medicine imaging modalities including gamma camera, SPECT, PET, and hybrid imaging (SPECT/CT, PET/CT, and PET/MR) in the context of established and emerging clinical applications. Areas of potential future development in nuclear medicine are discussed with emphasis on molecular imaging and implementation of new targeted tracers used in diagnostics and therapeutics (theranostics). Summary Nuclear medicine and molecular imaging provide many unique and novel options for the diagnosis and treatment of pulmonary diseases. This article reviews current applications for nuclear medicine and molecular imaging and selected future applications for radiopharmaceuticals and targeted molecular imaging techniques.
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Sanz-Santos J, Call S. Preoperative staging of the mediastinum is an essential and multidisciplinary task. Respirology 2020; 25 Suppl 2:37-48. [PMID: 32656946 DOI: 10.1111/resp.13901] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/26/2020] [Accepted: 06/03/2020] [Indexed: 12/20/2022]
Abstract
Mediastinal staging is a crucial step in the management of patients with NSCLC. With the recent development of novel techniques, mediastinal staging has evolved from an activity of interest mainly for thoracic surgeons to a joint effort carried out by many specialists. In this regard, the debate of cases in MDT sessions is crucial for optimal management of patients. Current evidence-based clinical guidelines for preoperative NSCLC staging recommend that mediastinal staging should be performed with increasing invasiveness. Image-based techniques are the first approach, although they have limited accuracy and findings must be confirmed by pathology in almost all cases. In this setting, the advent of radiomics is promising. Invasive staging depends on procedural factors rather than diagnostic performance. The choice between endoscopy-based or surgical procedures should depend on the local expertise of each centre. As the extension of mediastinal disease in terms of number of involved lymph nodes and nodal stations affects prognosis and the choice of treatment, systematic samplings are preferred over random targeted samplings. Following this approach, a diagnosis of single mediastinal nodal involvement can be unreliable if all reachable mediastinal nodal stations have not been assessed. The performance of confirmatory mediastinoscopy after a negative endoscopy-based procedure is controversial but currently recommended. Current indications of invasive staging in patients with radiologically normal mediastinum have to be re-evaluated, especially for central tumour location.
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Affiliation(s)
- José Sanz-Santos
- Department of Pulmonology, Hospital Universitari Mútua Terrassa, University of Barcelona, Terrassa, Spain.,Department of Medicine, Medical School, University of Barcelona, Barcelona, Spain.,Network of Centres for Biomedical Research in Respiratory Diseases (CIBERES) Lung Cancer Group, Terrassa, Spain
| | - Sergi Call
- Department of Thoracic Surgery, Hospital Universitari Mútua Terrassa, University of Barcelona, Terrassa, Spain.,Department of Morphological Sciences, Medical School, Autonomous University of Barcelona, Cerdanyola, Spain
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Use of Magnetic Resonance Imaging in the Evaluation of Mediastinal and Systemic Disease in Lymphoma. A Systematic Review. OPEN RESPIRATORY ARCHIVES 2020. [DOI: 10.1016/j.opresp.2020.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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25
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Unterrainer M, Eze C, Ilhan H, Marschner S, Roengvoraphoj O, Schmidt-Hegemann NS, Walter F, Kunz WG, Rosenschöld PMA, Jeraj R, Albert NL, Grosu AL, Niyazi M, Bartenstein P, Belka C. Recent advances of PET imaging in clinical radiation oncology. Radiat Oncol 2020; 15:88. [PMID: 32317029 PMCID: PMC7171749 DOI: 10.1186/s13014-020-01519-1] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 03/19/2020] [Indexed: 12/25/2022] Open
Abstract
Radiotherapy and radiation oncology play a key role in the clinical management of patients suffering from oncological diseases. In clinical routine, anatomic imaging such as contrast-enhanced CT and MRI are widely available and are usually used to improve the target volume delineation for subsequent radiotherapy. Moreover, these modalities are also used for treatment monitoring after radiotherapy. However, some diagnostic questions cannot be sufficiently addressed by the mere use standard morphological imaging. Therefore, positron emission tomography (PET) imaging gains increasing clinical significance in the management of oncological patients undergoing radiotherapy, as PET allows the visualization and quantification of tumoral features on a molecular level beyond the mere morphological extent shown by conventional imaging, such as tumor metabolism or receptor expression. The tumor metabolism or receptor expression information derived from PET can be used as tool for visualization of tumor extent, for assessing response during and after therapy, for prediction of patterns of failure and for definition of the volume in need of dose-escalation. This review focuses on recent and current advances of PET imaging within the field of clinical radiotherapy / radiation oncology in several oncological entities (neuro-oncology, head & neck cancer, lung cancer, gastrointestinal tumors and prostate cancer) with particular emphasis on radiotherapy planning, response assessment after radiotherapy and prognostication.
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Affiliation(s)
- M Unterrainer
- Department of Nuclear Medicine, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany. .,Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany. .,German Cancer Consortium (DKTK), partner site Munich; and German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - C Eze
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - H Ilhan
- Department of Nuclear Medicine, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - S Marschner
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - O Roengvoraphoj
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - N S Schmidt-Hegemann
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - F Walter
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - W G Kunz
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - P Munck Af Rosenschöld
- Radiation Physics, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, and Lund University, Lund, Sweden
| | - R Jeraj
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, USA
| | - N L Albert
- Department of Nuclear Medicine, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.,German Cancer Consortium (DKTK), partner site Munich; and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A L Grosu
- Department of Radiation Oncology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,German Cancer Consortium (DKTK), partner Site Freiburg, Freiburg, Germany
| | - M Niyazi
- German Cancer Consortium (DKTK), partner site Munich; and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - P Bartenstein
- Department of Nuclear Medicine, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.,German Cancer Consortium (DKTK), partner site Munich; and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - C Belka
- German Cancer Consortium (DKTK), partner site Munich; and German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
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Performing clinical 18F-FDG-PET/MRI of the mediastinum optimising a dedicated, patient-friendly protocol. Nucl Med Commun 2019; 40:815-826. [PMID: 31169592 DOI: 10.1097/mnm.0000000000001035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To construct a mediastinal-specific fluorine-18-fluorodeoxyglucose (F-FDG)-PET/MR protocol with high-quality MRI of minimal acquisition-time and comparable diagnostic value to F-FDG-PET/computed tomography (CT). MATERIALS AND METHODS Fifteen healthy participants received PET/MRI and 10 patients with mediastinal tumours (eight non-small-cell lung, two oesophageal cancer) received F-FDG-PET/MRI immediately after F-FDG-PET/CT. Sequences volume interpolated breath-hold examination (T1-VIBE) and Half-Fourier acquisition single-shot turbo spin echo (T2-HASTE) were optimised by varying the parameters: breath-hold (BH, end-expiration), fat suppression (spectral adiabatic inversion recovery), and ECG-triggering (ECG, end-diastole). Image quality (IQ) of each sequence-variation was qualitatively scored by medical experts and quantitatively assessed by calculating signal-to-noise ratios, contrast relative to muscle, standardized-uptake-value, and tumour-to-blood ratios. Patient comfort was evaluated on patients' experience. Diagnostic accuracy of F-FDG-PET/MRI was compared to F-FDG-PET/CT, in reference to histopathology/cytopathology. RESULTS ECG-triggered T1-VIBE images showed the highest signal-to-noise ratio (P < 0.01) and the largest contrast between mediastinal soft-tissues, regardless of BH or free-breathing acquisition. IQ of ECG-triggered T1-VIBE scans in BH were scored qualitatively highest with good reader agreement (κ = 0.62). IQ of T2-HASTE was not significantly affected by BH acquisition (P > 0.9). Qualitative IQ of T1-VIBE and T2-HASTE declined after spectral adiabatic inversion recovery fat-suppression. All patients could maintain BH at end-expiration and reported no discomfort. Diagnostic performance of F-FDG-PET/MR was not significantly different from F-FDG-PET/CT with comparable staging, standardized-uptake-values, and tumour-to-blood ratios. However, T-status was more often over-staged on F-FDG-PET/CT, while N-status was more frequently under-staged on F-FDG-PET/MR. CONCLUSION ECG-triggered T1-VIBE sequences acquired during short, multiple BHs are recommended for mediastinal imaging using F-FDG-PET/MR. With dedicated protocols, F-FDG-PET/MRI will be useful in thoracic oncology and aid in diagnostic evaluation and tailored treatment decision-making.
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27
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Martin O, Schaarschmidt BM, Kirchner J, Suntharalingam S, Grueneisen J, Demircioglu A, Heusch P, Quick HH, Forsting M, Antoch G, Herrmann K, Umutlu L. PET/MRI Versus PET/CT for Whole-Body Staging: Results from a Single-Center Observational Study on 1,003 Sequential Examinations. J Nucl Med 2019; 61:1131-1136. [DOI: 10.2967/jnumed.119.233940] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 12/02/2019] [Indexed: 12/31/2022] Open
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28
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Ferrone C, Goyal L, Qadan M, Gervais D, Sahani DV, Zhu AX, Hong TS, Blaszkowsky LS, Tanabe KK, Vangel M, Amorim BJ, Wo JY, Mahmood U, Pandharipande PV, Catana C, Duenas VP, Collazo YQ, Canamaque LG, Domachevsky L, Bernstine HH, Groshar D, Shih TTF, Li Y, Herrmann K, Umutlu L, Rosen BR, Catalano OA. Management implications of fluorodeoxyglucose positron emission tomography/magnetic resonance in untreated intrahepatic cholangiocarcinoma. Eur J Nucl Med Mol Imaging 2019; 47:1871-1884. [PMID: 31705172 DOI: 10.1007/s00259-019-04558-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 09/25/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE Intrahepatic cholangiocarcinoma (ICC) is associated with a poor prognosis with surgical resection offering the best chance for long-term survival and potential cure. However, in up to 36% of patients who undergo surgery, more extensive disease is found at time of operation requiring cancellation of surgery. PET/MR is a novel hybrid technology that might improve local and whole-body staging in ICC patients, potentially influencing clinical management. This study was aimed to investigate the possible management implications of PET/MR, relative to conventional imaging, in patients affected by untreated intrahepatic cholangiocarcinoma. METHODS Retrospective review of the clinicopathologic features of 37 patients with iCCC, who underwent PET/MR between September 2015 and August 2018, was performed to investigate the management implications that PET/MR had exerted on the affected patients, relative to conventional imaging. RESULTS Of the 37 patients enrolled, median age 63.5 years, 20 (54%) were female. The same day PET/CT was performed in 26 patients. All patients were iCCC-treatment-naïve. Conventional imaging obtained as part of routine clinical care demonstrated early-stage resectable disease for 15 patients and advanced stage disease beyond the scope of surgical resection for 22. PET/MR modified the clinical management of 11/37 (29.7%) patients: for 5 patients (13.5%), the operation was cancelled due to identification of additional disease, while 4 "inoperable" patients (10.8%) underwent an operation. An additional 2 patients (5.4%) had a significant change in their operative plan based on PET/MR. CONCLUSIONS When compared with standard imaging, PET/MR significantly influenced the treatment plan in 29.7% of patients with iCCC. TRIAL REGISTRATION 2018P001334.
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Affiliation(s)
- Cristina Ferrone
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Boston, MA, 02114, USA
| | - Lipika Goyal
- Department of Oncology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Boston, MA, 02114, USA
| | - Motaz Qadan
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Boston, MA, 02114, USA
| | - Debra Gervais
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, WHT 270, 55 Fruit St., Boston, MA, 02114, USA
| | - Dushyant V Sahani
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, WHT 270, 55 Fruit St., Boston, MA, 02114, USA
| | - Andrew X Zhu
- Department of Oncology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Boston, MA, 02114, USA
| | - Theodore S Hong
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Boston, MA, 02114, USA
| | - Lawrence S Blaszkowsky
- Department of Oncology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Boston, MA, 02114, USA.,Department of Oncology, Newton-Wellesley Hospital, 2114 Washington St., Newton, MA, 02462, USA
| | - Kenneth K Tanabe
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Boston, MA, 02114, USA
| | - Mark Vangel
- Department of Biostatics, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Boston, MA, 02114, USA
| | - Barbara J Amorim
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, WHT 270, 55 Fruit St., Boston, MA, 02114, USA.,Division of Nuclear Medicine, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Jennifer Y Wo
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Boston, MA, 02114, USA
| | - Umar Mahmood
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, WHT 270, 55 Fruit St., Boston, MA, 02114, USA.,Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, 149 13th, Charlestown, MA, 02129, USA
| | - Pari V Pandharipande
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, WHT 270, 55 Fruit St., Boston, MA, 02114, USA
| | - Ciprian Catana
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, 149 13th, Charlestown, MA, 02129, USA
| | - Virginia P Duenas
- Department of Nuclear Medicine and Radiology, Hospital HM Puerta del Sur, Avda Carlos V 70, 28938, Madrid, Spain
| | - Yolanda Q Collazo
- Department of Surgery, Hospital HM Sanchinarro, Avda Carlos V 70, 28938, Madrid, Spain
| | - Lina G Canamaque
- Department of Nuclear Medicine and Radiology, Hospital HM Puerta del Sur, Avda Carlos V 70, 28938, Madrid, Spain
| | - Liran Domachevsky
- Department of Radiology and Nuclear Medicine, Assuta Medical Center, HaBarzel St. 20, Tel Aviv-Yafo, Israel
| | - Hanna H Bernstine
- Department of Radiology and Nuclear Medicine, Assuta Medical Center, HaBarzel St. 20, Tel Aviv-Yafo, Israel
| | - David Groshar
- Department of Radiology and Nuclear Medicine, Assuta Medical Center, HaBarzel St. 20, Tel Aviv-Yafo, Israel
| | - Tiffany Tsing-Fang Shih
- Department of Medical Imaging and Radiology, National Taiwan University College of Medicine and Hospital, No. 7, Chung-Shan South Rd., Taipei, 10016, Taiwan
| | - Yan Li
- Department of Radiology, Universitatsklinikum, Essen University, Hufelandstraße 55, 45147, Essen, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, Universitatsklinikum, Essen University, Hufelandstraße 55, 45147, Essen, Germany
| | - Lale Umutlu
- Department of Radiology, Universitatsklinikum, Essen University, Hufelandstraße 55, 45147, Essen, Germany
| | - Bruce R Rosen
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, 149 13th, Charlestown, MA, 02129, USA
| | - Onofrio A Catalano
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, WHT 270, 55 Fruit St., Boston, MA, 02114, USA. .,Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, 149 13th, Charlestown, MA, 02129, USA. .,Department of Radiology, University of Naples "Parthenope", Via Acton 38, 80131, Naples, Italy.
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Mayerhoefer ME, Prosch H, Beer L, Tamandl D, Beyer T, Hoeller C, Berzaczy D, Raderer M, Preusser M, Hochmair M, Kiesewetter B, Scheuba C, Ba-Ssalamah A, Karanikas G, Kesselbacher J, Prager G, Dieckmann K, Polterauer S, Weber M, Rausch I, Brauner B, Eidherr H, Wadsak W, Haug AR. PET/MRI versus PET/CT in oncology: a prospective single-center study of 330 examinations focusing on implications for patient management and cost considerations. Eur J Nucl Med Mol Imaging 2019; 47:51-60. [PMID: 31410538 PMCID: PMC6885019 DOI: 10.1007/s00259-019-04452-y] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 07/18/2019] [Indexed: 12/18/2022]
Abstract
Purpose PET/MRI has recently been introduced into clinical practice. We prospectively investigated the clinical impact of PET/MRI compared with PET/CT, in a mixed population of cancer patients, and performed an economic evaluation of PET/MRI. Methods Cancer patients referred for routine staging or follow-up by PET/CT underwent consecutive PET/CT and PET/MRI, using single applications of [18F]FDG, [68Ga]Ga-DOTANOC, or [18F]FDOPA, depending on tumor histology. PET/MRI and PET/CT were rated separately, and lesions were assessed per anatomic region; based on regions, per-examination and per-patient accuracies were determined. A simulated, multidisciplinary team meeting served as reference standard and determined whether differences between PET/CT and PET/MRI affected patient management. The McNemar tests were used to compare accuracies, and incremental cost-effectiveness ratios (ICERs) for PET/MRI were calculated. Results Two hundred sixty-three patients (330 same-day PET/CT and PET/MRI examinations) were included. PET/MRI was accurate in 319/330 examinations and PET/CT in 277/330 examinations; the respective accuracies of 97.3% and 83.9% differed significantly (P < 0.001). The additional findings on PET/MRI—mainly liver and brain metastases—had implications for patient management in 21/263 patients (8.0%). The per-examination cost was 596.97 EUR for PET/MRI and 405.95 EUR for PET/CT. ICERs for PET/MRI were 14.26 EUR per percent of diagnostic accuracy and 23.88 EUR per percent of correctly managed patients. Conclusions PET/MRI enables more appropriate management than PET/CT in a nonnegligible fraction of cancer patients. Since the per-examination cost is about 50% higher for PET/MRI than for PET/CT, a histology-based triage of patients to either PET/MRI or PET/CT may be meaningful.
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Affiliation(s)
- Marius E Mayerhoefer
- Department of Biomedical Imaging and Image-guided Therapy, Division of General and Pediatric Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. .,Department of Radiology, Memorial Sloan Kettering Cancer Center New York, New York City, NY, USA.
| | - Helmut Prosch
- Department of Biomedical Imaging and Image-guided Therapy, Division of General and Pediatric Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Lucian Beer
- Department of Biomedical Imaging and Image-guided Therapy, Division of General and Pediatric Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Dietmar Tamandl
- Department of Biomedical Imaging and Image-guided Therapy, Division of General and Pediatric Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Thomas Beyer
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Christoph Hoeller
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Dominik Berzaczy
- Department of Biomedical Imaging and Image-guided Therapy, Division of General and Pediatric Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Markus Raderer
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | - Matthias Preusser
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | - Maximilian Hochmair
- Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria
| | - Barbara Kiesewetter
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | - Christian Scheuba
- Department of Surgery, Division of General Surgery, Medical University of Vienna, Vienna, Austria
| | - Ahmed Ba-Ssalamah
- Department of Biomedical Imaging and Image-guided Therapy, Division of General and Pediatric Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Georgios Karanikas
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - Julia Kesselbacher
- Department of Biomedical Imaging and Image-guided Therapy, Division of General and Pediatric Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Gerald Prager
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | - Karin Dieckmann
- Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
| | - Stephan Polterauer
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Michael Weber
- Department of Biomedical Imaging and Image-guided Therapy, Division of General and Pediatric Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Ivo Rausch
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Bernhard Brauner
- Siemens Healthineers, Siemens Healthcare Diagnostics GmbH, Vienna, Austria
| | - Harald Eidherr
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Wadsak
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria.,Center for Biomarker Research in Medicine-CBmed, Graz, Austria
| | - Alexander R Haug
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
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Integrated versus separate reading of F-18 FDG-PET/CT and MRI for abdominal malignancies – effect on staging outcomes and diagnostic confidence. Eur Radiol 2019; 29:6900-6910. [DOI: 10.1007/s00330-019-06253-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 04/04/2019] [Accepted: 04/25/2019] [Indexed: 12/11/2022]
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Use of Magnetic Resonance Imaging for N-Staging in Patients with Non-Small Cell Lung Cancer. A Systematic Review. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.arbr.2018.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Kirchner J, Sawicki LM, Nensa F, Schaarschmidt BM, Reis H, Ingenwerth M, Bogner S, Aigner C, Buchbender C, Umutlu L, Antoch G, Herrmann K, Heusch P. Prospective comparison of 18F-FDG PET/MRI and 18F-FDG PET/CT for thoracic staging of non-small cell lung cancer. Eur J Nucl Med Mol Imaging 2018; 46:437-445. [PMID: 30074073 DOI: 10.1007/s00259-018-4109-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 07/23/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To compare the diagnostic performance of 18F-FDG PET/MRI and 18F-FDG PET/CT for primary and locoregional lymph node staging in non-small cell lung cancer (NSCLC). METHODS In this prospective study, a total of 84 patients (51 men, 33 women, mean age 62.5 ± 9.1 years) with histopathologically confirmed NSCLC underwent 18F-FDG PET/CT followed by 18F-FDG PET/MRI in a single injection protocol. Two readers independently assessed T and N staging in separate sessions according to the seventh edition of the American Joint Committee on Cancer staging manual for 18F-FDG PET/CT and 18F-FDG PET/MRI, respectively. Histopathology as a reference standard was available for N staging in all 84 patients and for T staging in 39 patients. Differences in staging accuracy were assessed by McNemars chi2 test. The maximum standardized uptake value (SUVmax) and longitudinal diameters of primary tumors were correlated using Pearson's coefficients. RESULTS T stage was categorized concordantly in 18F-FDG PET/MRI and 18F-FDG PET/CT in 38 of 39 (97.4%) patients. Herein, 18F-FDG PET/CT and 18F-FDG PET/MRI correctly determined the T stage in 92.3 and 89.7% of patients, respectively. N stage was categorized concordantly in 83 of 84 patients (98.8%). 18F-FDG PET/CT correctly determined the N stage in 78 of 84 patients (92.9%), while 18F-FDG PET/MRI correctly determined the N stage in 77 of 84 patients (91.7%). Differences between 18F-FDG PET/CT and 18F-FDG PET/MRI in T and N staging accuracy were not statistically significant (p > 0.5, each). Tumor size and SUVmax measurements derived from both imaging modalities exhibited excellent correlation (r = 0.963 and r = 0.901, respectively). CONCLUSION 18F-FDG PET/MRI and 18F-FDG PET/CT show an equivalently high diagnostic performance for T and N staging in patients suffering from NSCLC.
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Affiliation(s)
- Julian Kirchner
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, D-40225, Dusseldorf, Germany.
| | - Lino M Sawicki
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, D-40225, Dusseldorf, Germany
| | - Felix Nensa
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147, Essen, Germany
| | - Benedikt M Schaarschmidt
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, D-40225, Dusseldorf, Germany
| | - Henning Reis
- Institute of Pathology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) Essen, D-45147, Essen, Germany
| | - Marc Ingenwerth
- Institute of Pathology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) Essen, D-45147, Essen, Germany
| | - Simon Bogner
- Department of Medical Oncology, University Hospital Essen, West German Cancer Center, University of Duisburg-Essen, D-45122, Essen, Germany
| | - Clemens Aigner
- Department of Thoracic Surgery and Surgical Endoscopy, University Hospital Essen, Ruhrlandklinik, University of Duisburg-Essen, D-45147, Essen, Germany
| | - Christian Buchbender
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, D-40225, Dusseldorf, Germany
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147, Essen, Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, D-40225, Dusseldorf, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, D-45147, Essen, Germany
| | - Philipp Heusch
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, D-40225, Dusseldorf, Germany
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Brea TP, Raviña AR, Villamor JMC, Gómez AG, de Alegría AM, Valdés L. Use of Magnetic Resonance Imaging for N-Staging in Patients with Non-Small Cell Lung Cancer. A Systematic Review. Arch Bronconeumol 2018; 55:9-16. [PMID: 29803524 DOI: 10.1016/j.arbres.2018.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 02/09/2018] [Accepted: 03/12/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The aim of this study is to assess the diagnostic value of the magnetic resonance imaging (MRI) in differentiating metastasic from non-metastatic lymph nodes in NSCLC patients compared with computed tomography (CT) and fluorodeoxyglucose (FDG) - positron emission tomography (PET) or both combined. METHODS Twenty-three studies (19 studies and 4 meta-analysis) with sample size ranging between 22 and 250 patients were included in this analysis. MRI, regardless of the sequence obtained, where used for the evaluation of N-staging of NSCLC. Histopathology results and clinical or imaging follow-up were used as the reference standard. Studies were excluded if the sample size was less than 20 cases, if less than 10 lymph nodes assessment were presented or studies where standard reference was not used. Papers not reporting sufficient data were also excluded. RESULTS As compared to CT and PET, MRI demonstrated a higher sensitivity, specificity and diagnostic accuracy in the diagnosis of metastatic or non-metastatic lymph nodes in N-staging in NSCLC patients. No study considered MRI inferior than conventional techniques (CT, PET or PET/CT). Other outstanding results of this review are fewer false positives with MRI in comparison with PET, their superiority over PET/CT to detect non-resectable lung cancer, to diagnosing infiltration of adjacent structures or brain metastasis and detecting small nodules. CONCLUSION MRI has shown at least similar or better results in diagnostic accuracy to differentiate metastatic from non-metastatic mediastinal lymph nodes. This suggests that MRI could play a significant role in mediastinal NSCLC staging.
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Affiliation(s)
- Tara Pereiro Brea
- University Hospital Complex, Pneumology Service, Santiago de Compostela, Spain.
| | - Alberto Ruano Raviña
- Medicine School. University of Santiago. Area of Preventive Medicine and Public Health, Santiago de Compostela, Spain; CIBER of Epidemiology and Public Health. CIBERESP, Madrid, Spain
| | | | - Antonio Golpe Gómez
- University Hospital Complex, Pneumology Service, Santiago de Compostela, Spain
| | | | - Luís Valdés
- University Hospital Complex, Pneumology Service, Santiago de Compostela, Spain; Interdisciplinary Group of Research in Pneumology, Institute of Sanitary Investigations in Santiago (IDIS), Santiago de Compostela, Spain
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Rami-Porta R, Call S, Dooms C, Obiols C, Sánchez M, Travis WD, Vollmer I. Lung cancer staging: a concise update. Eur Respir J 2018; 51:13993003.00190-2018. [PMID: 29700105 DOI: 10.1183/13993003.00190-2018] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 04/04/2018] [Indexed: 12/13/2022]
Abstract
Diagnosis and clinical staging of lung cancer are fundamental to planning therapy. The techniques for clinical staging, i.e anatomic and metabolic imaging, endoscopies and minimally invasive surgical procedures, should be performed sequentially and with an increasing degree of invasiveness. Intraoperative staging, assessing the magnitude of the primary tumour, the involved structures, and the loco-regional lymphatic spread by means of systematic nodal dissection, is essential in order to achieve a complete resection. In resected tumours, pathological staging, with the systematic study of the resected specimens, is the strongest prognostic indicator and is essential to make further decisions on therapy. In the present decade, the guidelines on lung cancer staging of the American College of Chest Physicians and the European Society of Thoracic Surgeons are based on the best available evidence and are widely followed. Recent advances in the classification of the adenocarcinoma of the lung, with the definition of adenocarcinoma in situ, minimally invasive adenocarcinoma and lepidic predominant adenocarcinoma, and the publication of the eighth edition of the tumour, node and metastasis classification of lung cancer, have to be integrated into the staging process. The present review complements the latest guidelines on lung cancer staging by providing an update of all these issues.
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Affiliation(s)
- Ramón Rami-Porta
- Dept of Thoracic Surgery, Hospital Universitari Mutua Terrassa, University of Barcelona, Barcelona, Spain.,Network of Centres for Biomedical Research in Respiratory Diseases (CIBERES) Lung Cancer Group, Barcelona, Spain
| | - Sergi Call
- Dept of Thoracic Surgery, Hospital Universitari Mutua Terrassa, University of Barcelona, Barcelona, Spain.,Dept of Morphological Sciences, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Christophe Dooms
- Dept of Respiratory Diseases, University Hospitals, KU Leuven, Leuven, Belgium
| | - Carme Obiols
- Dept of Thoracic Surgery, Hospital Universitari Mutua Terrassa, University of Barcelona, Barcelona, Spain
| | - Marcelo Sánchez
- Centre of Imaging Diagnosis, Radiology Dept, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - William D Travis
- Dept of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ivan Vollmer
- Centre of Imaging Diagnosis, Radiology Dept, Hospital Clínic, University of Barcelona, Barcelona, Spain
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Zaccagna F, Grist JT, Deen SS, Woitek R, Lechermann LMT, McLean MA, Basu B, Gallagher FA. Hyperpolarized carbon-13 magnetic resonance spectroscopic imaging: a clinical tool for studying tumour metabolism. Br J Radiol 2018; 91:20170688. [PMID: 29293376 PMCID: PMC6190784 DOI: 10.1259/bjr.20170688] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 12/13/2017] [Accepted: 12/19/2017] [Indexed: 01/09/2023] Open
Abstract
Glucose metabolism in tumours is reprogrammed away from oxidative metabolism, even in the presence of oxygen. Non-invasive imaging techniques can probe these alterations in cancer metabolism providing tools to detect tumours and their response to therapy. Although Positron Emission Tomography with (18F)2-fluoro-2-deoxy-D-glucose (18F-FDG PET) is an established clinical tool to probe cancer metabolism, it has poor spatial resolution and soft tissue contrast, utilizes ionizing radiation and only probes glucose uptake and phosphorylation and not further downstream metabolism. Magnetic Resonance Spectroscopy (MRS) has the capability to non-invasively detect and distinguish molecules within tissue but has low sensitivity and can only detect selected nuclei. Dynamic Nuclear Polarization (DNP) is a technique which greatly increases the signal-to-noise ratio (SNR) achieved with MR by significantly increasing nuclear spin polarization and this method has now been translated into human imaging. This review provides a brief overview of this process, also termed Hyperpolarized Carbon-13 Magnetic Resonance Spectroscopic Imaging (HP 13C-MRSI), its applications in preclinical imaging, an outline of the current human trials that are ongoing, as well as future potential applications in oncology.
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Affiliation(s)
- Fulvio Zaccagna
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - James T Grist
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Surrin S Deen
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Ramona Woitek
- Department of Radiology, University of Cambridge, Cambridge, UK
| | | | - Mary A McLean
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Bristi Basu
- Department of Oncology, University of Cambridge, Cambridge, UK
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Impact of Computer-Aided CT and PET Analysis on Non-invasive T Staging in Patients with Lung Cancer and Atelectasis. Mol Imaging Biol 2018; 20:1044-1052. [PMID: 29679299 DOI: 10.1007/s11307-018-1196-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE Tumor delineation within an atelectasis in lung cancer patients is not always accurate. When T staging is done by integrated 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG)-positron emission tomography (PET)/X-ray computer tomography (CT), tumors of neuroendocrine differentiation and slowly growing tumors can present with reduced FDG uptake, thus aggravating an exact T staging. In order to further exhaust information derived from [18F]FDG-PET/CT, we evaluated the impact of CT density and maximum standardized uptake value (SUVmax) for the classification of different tumor subtypes within a surrounding atelectasis, as well as possible cutoff values for the differentiation between the primary tumor and atelectatic lung tissue. PROCEDURES Seventy-two patients with histologically proven lung cancer and adjacent atelectasis were investigated. Non-contrast-enhanced [18F]FDG-PET/CT was performed within 2 weeks before surgery/biopsy. Boundaries of the primary within the atelectasis were determined visually on the basis of [18F]FDG uptake; CT density was quantified manually within each primary and each atelectasis. RESULTS CT density of the primary (36.4 Hounsfield units (HU) ± 6.2) was significantly higher compared to that of atelectatic lung (24.3 HU ± 8.3; p < 0.01), irrespective of the histological subtype. The discrimination between different malignant tumors using density analysis failed. SUVmax was increased in squamous cell carcinomas compared to adenocarcinomas. Irrespective of the malignant subtype, a possible cutoff value of 24 HU may help to exclude the presence of a primary in lesions below 24 HU, whereas a density above a threshold of 40 HU can help to exclude atelectatic lung. CONCLUSION Density measurements in patients with lung cancer and surrounding atelectasis may help to delineate the primary tumor, irrespective of the specific lung cancer subtype. This could improve T staging and radiation treatment planning (RTP) without additional application of a contrast agent in CT, or an additional magnetic resonance imaging (MRI), even in cases of lung tumors of neuroendocrine differentiation or in slowly growing tumors with less avidity to [18F]FDG.
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Ehman EC, Johnson GB, Villanueva-Meyer JE, Cha S, Leynes AP, Larson PEZ, Hope TA. PET/MRI: Where might it replace PET/CT? J Magn Reson Imaging 2017; 46:1247-1262. [PMID: 28370695 PMCID: PMC5623147 DOI: 10.1002/jmri.25711] [Citation(s) in RCA: 148] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 03/06/2017] [Indexed: 12/13/2022] Open
Abstract
Simultaneous positron emission tomography and MRI (PET/MRI) is a technology that combines the anatomic and quantitative strengths of MR imaging with physiologic information obtained from PET. PET and computed tomography (PET/CT) performed in a single scanning session is an established technology already in widespread and accepted use worldwide. Given the higher cost and complexity of operating and interpreting the studies obtained on a PET/MRI system, there has been question as to which patients would benefit most from imaging with PET/MRI versus PET/CT. In this article, we compare PET/MRI with PET/CT, detail the applications for which PET/MRI has shown promise and discuss impediments to future adoption. It is our hope that future work will prove the benefit of PET/MRI to specific groups of patients, initially those in which PET/CT and MRI are already performed, leveraging simultaneity and allowing for greater degrees of multiparametric evaluation. LEVEL OF EVIDENCE 5 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2017;46:1247-1262.
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Affiliation(s)
- Eric C. Ehman
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Soonmee Cha
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Andrew Palmera Leynes
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Peder Eric Zufall Larson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Thomas A. Hope
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
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Seith F, Schmidt H, Gatidis S, Bezrukov I, Schraml C, Pfannenberg C, la Fougère C, Nikolaou K, Schwenzer N. SUV-quantification of physiological lung tissue in an integrated PET/MR-system: Impact of lung density and bone tissue. PLoS One 2017; 12:e0177856. [PMID: 28562622 PMCID: PMC5451041 DOI: 10.1371/journal.pone.0177856] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 05/04/2017] [Indexed: 11/18/2022] Open
Abstract
Purpose The aim of the study was to investigate the influence of lung density changes as well as bone proximity on the attenuation correction of lung standardized uptake values (SUVs). Methods and materials 15 patients with mostly oncologic diseases were examined in 18F-FDG-PET/CT and subsequently in a fully integrated PET/MR scanner. From each PET dataset acquired in PET/MR, four different PET reconstructions were computed using different attenuation maps (μ-maps): i) CT-based μ-map (gold standard); ii) CT-based μ-map in which the linear attenuation coefficients (LAC) of the lung tissue was replaced by the lung LAC from the MR-based segmentation method; iii) based on reconstruction ii), the LAC of bone structures was additionally replaced with the LAC from the MR-based segmentation method; iv) the vendor-provided MR-based μ-map (segmentation-based method). Those steps were performed using MATLAB. CT Hounsfield units (HU) and SUVmean was acquired in different levels and regions of the lung. Relative differences between the differently corrected PETs were computed. Results Compared to the gold standard, reconstruction ii), iii) and iv) led to a relative underestimation of SUV in the posterior regions of -9.0%, -13.4% and -14.0%, respectively. Anterior and middle regions were less affected with an overestimation of about 6–8% in reconstructions ii)–iv). Conclusion It could be shown that both, differences in lung density and the vicinity of bone tissue in the μ-map may have an influence on SUV, mostly affecting the posterior lung regions.
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Affiliation(s)
- Ferdinand Seith
- Diagnostic and Interventional Radiology, Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, Tuebingen, Germany
| | - Holger Schmidt
- Diagnostic and Interventional Radiology, Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, Tuebingen, Germany
- * E-mail:
| | - Sergios Gatidis
- Diagnostic and Interventional Radiology, Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, Tuebingen, Germany
| | - Ilja Bezrukov
- Preclinical Imaging and Radiopharmacy, Laboratory for Preclinical Imaging and Imaging Technology of the Werner Siemens Foundation, Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, Tuebingen, Germany
- Max Planck Institute for Intelligent Systems, Spemannstr. 38, Tuebingen, Germany
| | - Christina Schraml
- Diagnostic and Interventional Radiology, Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, Tuebingen, Germany
| | - Christina Pfannenberg
- Diagnostic and Interventional Radiology, Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, Tuebingen, Germany
| | - Christian la Fougère
- Nuclear Medicine, Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, Tuebingen, Germany
| | - Konstantin Nikolaou
- Diagnostic and Interventional Radiology, Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, Tuebingen, Germany
| | - Nina Schwenzer
- Diagnostic and Interventional Radiology, Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, Tuebingen, Germany
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Huang YS, Chen JLY, Hsu FM, Huang JY, Ko WC, Chen YC, Jaw FS, Yen RF, Chang YC. Response assessment of stereotactic body radiation therapy using dynamic contrast-enhanced integrated MR-PET in non-small cell lung cancer patients. J Magn Reson Imaging 2017; 47:191-199. [DOI: 10.1002/jmri.25758] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 04/20/2017] [Indexed: 12/21/2022] Open
Affiliation(s)
- Yu-Sen Huang
- Institute of Biomedical Engineering; College of Medicine and College of Engineering, National Taiwan University; Taipei Taiwan
- Department of Medical Imaging; National Taiwan University, Hospital and National Taiwan, University College of Medicine; Taipei Taiwan
- Department of Medical Imaging; National Taiwan University Hospital; Yun-Lin Branch Yun-Lin Taiwan
| | - Jenny Ling-Yu Chen
- Institute of Biomedical Engineering; College of Medicine and College of Engineering, National Taiwan University; Taipei Taiwan
- Department of Oncology; National Taiwan University, Hospital and National Taiwan University College of Medicine; Taipei Taiwan
- Department of Radiation Oncology; National Taiwan University Hospital; Hsin-Chu Branch Hsin-Chu Taiwan
| | - Feng-Ming Hsu
- Department of Oncology; National Taiwan University, Hospital and National Taiwan University College of Medicine; Taipei Taiwan
| | - Jei-Yie Huang
- Department of Nuclear Medicine; National Taiwan University, Hospital and National Taiwan, University College of Medicine; Taipei Taiwan
| | - Wei-Chun Ko
- Department of Medical Imaging; National Taiwan University, Hospital and National Taiwan, University College of Medicine; Taipei Taiwan
| | - Yi-Chang Chen
- Department of Medical Imaging; National Taiwan University, Hospital and National Taiwan, University College of Medicine; Taipei Taiwan
| | - Fu-Shan Jaw
- Institute of Biomedical Engineering; College of Medicine and College of Engineering, National Taiwan University; Taipei Taiwan
| | - Ruoh-Fang Yen
- Department of Nuclear Medicine; National Taiwan University, Hospital and National Taiwan, University College of Medicine; Taipei Taiwan
| | - Yeun-Chung Chang
- Department of Medical Imaging; National Taiwan University, Hospital and National Taiwan, University College of Medicine; Taipei Taiwan
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