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Zou Y, Zhu S, Kong Y, Feng C, Wang R, Lei L, Zhao Y, Chang L, Chen L. Precision matters: the value of PET/CT and PET/MRI in the clinical management of cervical cancer. Strahlenther Onkol 2024:10.1007/s00066-024-02294-8. [PMID: 39331065 DOI: 10.1007/s00066-024-02294-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 08/01/2024] [Indexed: 09/28/2024]
Abstract
The incidence of cervical cancer has been increasing recently, becoming an essential factor threatening patients' health. Positron emission computed tomography (PET/CT) and positron emission tomography/magnetic resonance imaging (PET/MRI) are multimodal molecular imaging methods that combine functional imaging (PET) and anatomical imaging (CT) with MRI fusion technology. They play an important role in the clinical management of patients with cervical cancer. Precision radiotherapy refers to the use of advanced intensive modulated radiotherapy (IMRT) to give different doses of radiation to different treatment areas to achieve the purpose of killing tumors and protecting normal tissues to the greatest extent. At present, pelvic target delineation is mostly based on CT and MRI, but these mostly provide anatomical morphological information, which is difficult to show the internal metabolism of tumors. PET/CT and PET/MRI combine information on biological function, metabolism and anatomical structure, thereby more accurately distinguishing the boundaries between tumor and non-tumor tissues and playing a positive guiding role in improving radiotherapy planning (RTP) for cervical cancer and evaluating treatment effect.
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Affiliation(s)
- Yulin Zou
- Department of Radiation Oncology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Tumor Hospital, 650118, Kunming, Yunnan, China
| | - Sijin Zhu
- Department of Radiation Oncology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Tumor Hospital, 650118, Kunming, Yunnan, China
| | - Yinwu Kong
- Department of Radiation Oncology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Tumor Hospital, 650118, Kunming, Yunnan, China
| | - Chengtao Feng
- Department of PET/CT Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, No. 519 Kunzhou Road, Xishan District, 650118, Kunming, Yunnan, China
| | - Ru Wang
- Department of Radiation Oncology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Tumor Hospital, 650118, Kunming, Yunnan, China
| | - Linping Lei
- Department of Radiation Oncology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Tumor Hospital, 650118, Kunming, Yunnan, China
| | - Yaomin Zhao
- Department of Radiation Oncology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Tumor Hospital, 650118, Kunming, Yunnan, China
| | - Li Chang
- Department of Radiation Oncology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Tumor Hospital, 650118, Kunming, Yunnan, China.
| | - Long Chen
- Department of PET/CT Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, No. 519 Kunzhou Road, Xishan District, 650118, Kunming, Yunnan, China.
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Yap WK, Hsu KH, Wang TH, Lin CH, Kang CJ, Huang SM, Lin HC, Hung TM, Chang KP, Tsai TY. The prognostic value of lymph node to primary tumor standardized uptake value ratio in cancer patients: a meta-analysis. Ann Nucl Med 2024; 38:607-618. [PMID: 38724805 DOI: 10.1007/s12149-024-01933-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 04/16/2024] [Indexed: 07/28/2024]
Abstract
OBJECTIVE The lymph node to primary tumor standardized uptake value ratio (NTR) is an innovative parameter derived from positron emission tomography/computed tomography (PET/CT) scans that captures the intricate relationship between primary tumors and associated lymph nodes. This meta-analysis aimed to investigate the prognostic value of NTR in cancer patients. METHODS A systematic search of PubMed, Cochrane, and Embase databases was conducted to identify studies investigating the association between NTR and survival outcomes in cancer patients. The pooled adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were calculated using a random-effects model. RESULTS Twelve studies comprising a total of 2037 patients were included in the meta-analysis. Elevated NTR was significantly associated with worse overall survival aHR (2.21, 95% CI 1.63 to 2.99), disease-free survival aHR (3.27, 95% CI 2.12 to 5.05), and distant metastasis-free survival aHR (2.07, 95% CI 1.55 to 2.78) in cancer patients. Subgroup analyses by cancer type showed consistent results across various malignancies, including head and neck squamous cell carcinoma, endometrial carcinoma, lung cancer, breast cancer, and nasopharyngeal carcinoma. CONCLUSIONS This meta-analysis provides evidence for a significant association between elevated NTR and worse survival outcomes in cancer patients. Elevated NTR may serve as a useful prognostic biomarker for cancer patients and could potentially be used to guide treatment decisions and monitor disease progression. Future studies should aim to validate these findings in larger and more diverse patient populations and investigate the underlying mechanisms for the observed association between NTR and survival outcomes.
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Affiliation(s)
- Wing-Keen Yap
- Proton and Radiation Therapy Center, Department of Radiation Oncology, Chang Gung Memorial Hospital-Linkou Medical Center, Chang Gung University, Taoyuan, 333423, Taiwan
| | - Ken-Hao Hsu
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, No. 5, Fu-Hsing St. Kwei-Shan, Taoyuan, 333423, Taiwan
| | - Ting-Hao Wang
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, No. 5, Fu-Hsing St. Kwei-Shan, Taoyuan, 333423, Taiwan
| | - Chia-Hsin Lin
- Proton and Radiation Therapy Center, Department of Radiation Oncology, Chang Gung Memorial Hospital-Linkou Medical Center, Chang Gung University, Taoyuan, 333423, Taiwan
| | - Chung-Jan Kang
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, No. 5, Fu-Hsing St. Kwei-Shan, Taoyuan, 333423, Taiwan
| | - Shih-Ming Huang
- Department of Radiation Oncology, Keelung Chang Gung Memorial Hospital, Keelung, 204, Taiwan
| | - Huan-Chun Lin
- Department of Nuclear Medicine, Chang Gung Memorial Hospital, Linkou Medical Center, Tao-Yuan, Taiwan
| | - Tsung-Min Hung
- Proton and Radiation Therapy Center, Department of Radiation Oncology, Chang Gung Memorial Hospital-Linkou Medical Center, Chang Gung University, Taoyuan, 333423, Taiwan
| | - Kai-Ping Chang
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, No. 5, Fu-Hsing St. Kwei-Shan, Taoyuan, 333423, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, 333323, Taiwan
| | - Tsung-You Tsai
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, No. 5, Fu-Hsing St. Kwei-Shan, Taoyuan, 333423, Taiwan.
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Kong FF, Pan GS, Ni MS, Du CR, Hu CS, Ying HM. Prognostic value of lymph node-to-primary tumor ratio of PET standardized uptake value for nasopharyngeal carcinoma: a recursive partitioning risk stratification analysis. Ther Adv Med Oncol 2024; 16:17588359241233235. [PMID: 38379851 PMCID: PMC10878206 DOI: 10.1177/17588359241233235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 01/26/2024] [Indexed: 02/22/2024] Open
Abstract
Background Induction chemotherapy (IC) combined with concurrent chemoradiotherapy has become the standard treatment for locoregionally advanced nasopharyngeal carcinoma (LA-NPC). Data on the prognostic value of the lymph node-to-primary tumor ratio (NTR) of positron emission tomography (PET) standardized uptake value (SUV) for patients treated with IC were limited. Objectives To evaluate the prognostic value of the SUV NTR for patients with LA-NPC treated with IC. Design In all, 467 patients with pretreatment 18F-fluorodeoxyglucose PET/computed tomography (CT) scans between September 2017 and November 2020 were retrospectively reviewed. Methods The receiver operating characteristic (ROC) analysis was used to determine the optimal cut-off value of SUV NTR. Kaplan-Meier method was used to evaluate survival rates. The recursive partitioning analysis (RPA) was performed to construct a risk stratification model. Results The optimal cutoff value of SUV NTR was 0.74. Multivariate analyses showed that SUV NTR and overall stage were independent predictors for distant metastasis-free survival (DMFS) and regional recurrent-free survival (RRFS). Therefore, an RPA model based on the endpoint of DMFS was generated and categorized the patients into three distinct risk groups: RPA I (low risk: SUV NTR < 0.74 and stage III), RPA II (medium risk: SUV NTR < 0.74 and stage IVa, or SUV NTR ⩾ 0.74 and stage III), and RPA III (high risk: SUV NTR ⩾ 0.74 and stage IVa), with a 3-year DMFS of 98.9%, 93.4%, and 84.2%, respectively. ROC analysis showed that the RPA model had superior predictive efficacy than the SUV NTR or overall stage alone. Conclusion SUV NTR was an independent prognosticator for distant metastasis and regional recurrence in locoregionally advanced NPC. The RPA risk stratification model based on SUV NTR provides improved DMFS and RRFS prediction over the eighth edition of the TNM (Tumor Node Metastasis) staging system.
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Affiliation(s)
- Fang-Fang Kong
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Clinical Research Center for Radiation Oncology, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
| | - Guang-Sen Pan
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Clinical Research Center for Radiation Oncology, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
| | - Meng-Shan Ni
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Clinical Research Center for Radiation Oncology, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
| | - Cheng-Run Du
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Clinical Research Center for Radiation Oncology, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
| | - Chao-Su Hu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, 270 Dong’an Road, Shanghai 20032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Clinical Research Center for Radiation Oncology, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
| | - Hong-Mei Ying
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, 270 Dong’an Road, Shanghai 20032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Clinical Research Center for Radiation Oncology, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
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Baudouin R, Calvo-Henriquez C, Mayo-Yanez M, Iannella G, Maniaci A, Lechien JR. The importance of 24-h hypopharyngeal-esophageal impedance-pH monitoring for the treatment of laryngopharyngeal reflux. Eur Arch Otorhinolaryngol 2022; 279:5481-5482. [PMID: 36006517 DOI: 10.1007/s00405-022-07623-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/16/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Robin Baudouin
- Department of Otolaryngoly-Head Neck Surgery, Foch Hospital, University of Paris Saclay, Paris, France. .,Research Committee of Young-Otolaryngologists of the International Federation of Otorhinolaryngological Societies (YO-IFOS), Paris, France.
| | - Christian Calvo-Henriquez
- Research Committee of Young-Otolaryngologists of the International Federation of Otorhinolaryngological Societies (YO-IFOS), Paris, France.,Department of Otorhinolaryngology-Head and Neck Surgery, Complexo Hospitalario Universitario Santiago de Compostela (CHUS), Santiago de Compostela, Galicia, Spain
| | - Miguel Mayo-Yanez
- Research Committee of Young-Otolaryngologists of the International Federation of Otorhinolaryngological Societies (YO-IFOS), Paris, France.,Department of Otorhinolaryngology-Head and Neck Surgery, Complexo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Galicia, Spain
| | - Giannicola Iannella
- Research Committee of Young-Otolaryngologists of the International Federation of Otorhinolaryngological Societies (YO-IFOS), Paris, France.,Department of Otolaryngoly-Head Neck Surgery, Sapienza University of Rome, Rome, Italy
| | - Antonino Maniaci
- Research Committee of Young-Otolaryngologists of the International Federation of Otorhinolaryngological Societies (YO-IFOS), Paris, France.,ENT Section, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Jerome R Lechien
- Department of Otolaryngoly-Head Neck Surgery, Foch Hospital, University of Paris Saclay, Paris, France.,Research Committee of Young-Otolaryngologists of the International Federation of Otorhinolaryngological Societies (YO-IFOS), Paris, France.,Department of Otolaryngology, Elsan Polyclinic of Poitiers, Poitiers, France
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