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Zhang Y, Hu Y, Zhao S, Huang R. The Utility of 18F-FDG-PET-CT Metabolic Parameters in Evaluating the Primary Tumor Aggressiveness and Lymph Node Metastasis of Nasopharyngeal Carcinoma. Clin Med Insights Oncol 2024; 18:11795549231225419. [PMID: 38322667 PMCID: PMC10845995 DOI: 10.1177/11795549231225419] [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: 05/31/2023] [Accepted: 12/17/2023] [Indexed: 02/08/2024] Open
Abstract
Background Following changes in primary tumor (T) and lymph node (N) staging for nasopharyngeal carcinoma (NPC) in the Eighth Edition AJCC Cancer Staging Manual, simplification of T staging has been proposed. However, a limited range of 2-deoxy-2-[fluorine-18] fluoro-D-glucose positron emission tomography-computed tomography (18F-FDG PET-CT) metabolic parameters has been investigated. Therefore, we aimed to evaluate the primary tumor invasiveness and the lymph node metastasis (LNM) of NPC from a metabolic perspective. Methods A total of 435 NPC patients underwent 18F-FDG PET/CT before treatment were retrospectively examined. The primary endpoint was differences in standard uptake value (SUV), lean body mass-normalized SUV (SUL), body surface area-normalized SUV (SUS), glucose-normalized SUV (GN), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and glucose-normalized total lesion glycolysis (GNTLG) of primary tumors and LNM between different T and N stages. The metabolic parameters associated with T and N staging were identified. Results There were significant differences between all parameters relative to the primary tumor but no significant differences in any parameter relative to the LNM and T stages. Higher mean values of TGNmax, TGNmean, TSUVpeak, and TSUSmax were associated with advanced T stages. Higher mean values of all the LNM parameters were associated with more advanced N stages. Only primary tumor metabolic tumor volume (TMTV), TSUVpeak, TSULmax, and TSUSmax showed a significant positive association with T staging, while lymph node metabolic tumor volume (LNMTV) and TSUSmax were significantly positive in N staging. Conclusions Our findings suggest that metabolic parameters are useful indicators of tumor invasiveness and LNM based on the Eighth Edition manual. Compared with volume-dependent parameters, TGNmax, TGNmean, TSUVpeak, and TSUSmax may be better indicators of local tumor aggressiveness. SUSmax of the primary tumor was associated with LNM. In addition to SUVmax, other metabolic parameters (eg, SULmax, SUSmax, GNmax, and GNmean) could evaluate tumor aggressiveness and LNM better.
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Affiliation(s)
- Yun Zhang
- Department of PET/CT Center, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Yuxiao Hu
- Department of PET/CT Center, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Shuang Zhao
- Department of PET/CT Center, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Rong Huang
- Department of PET/CT Center, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
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2
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Guo R, Xue S, Hu J, Sari H, Mingels C, Zeimpekis K, Prenosil G, Wang Y, Zhang Y, Viscione M, Sznitman R, Rominger A, Li B, Shi K. Using domain knowledge for robust and generalizable deep learning-based CT-free PET attenuation and scatter correction. Nat Commun 2022; 13:5882. [PMID: 36202816 PMCID: PMC9537165 DOI: 10.1038/s41467-022-33562-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022] Open
Abstract
Despite the potential of deep learning (DL)-based methods in substituting CT-based PET attenuation and scatter correction for CT-free PET imaging, a critical bottleneck is their limited capability in handling large heterogeneity of tracers and scanners of PET imaging. This study employs a simple way to integrate domain knowledge in DL for CT-free PET imaging. In contrast to conventional direct DL methods, we simplify the complex problem by a domain decomposition so that the learning of anatomy-dependent attenuation correction can be achieved robustly in a low-frequency domain while the original anatomy-independent high-frequency texture can be preserved during the processing. Even with the training from one tracer on one scanner, the effectiveness and robustness of our proposed approach are confirmed in tests of various external imaging tracers on different scanners. The robust, generalizable, and transparent DL development may enhance the potential of clinical translation. Deep learning-based methods have been proposed to substitute CT-based PET attenuation and scatter correction to achieve CT-free PET imaging. Here, the authors present a simple way to integrate domain knowledge in deep learning for CT-free PET imaging.
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Affiliation(s)
- Rui Guo
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Ruijin Center, Shanghai, China
| | - Song Xue
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jiaxi Hu
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Hasan Sari
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Clemens Mingels
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Konstantinos Zeimpekis
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - George Prenosil
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Yue Wang
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Ruijin Center, Shanghai, China
| | - Yu Zhang
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Ruijin Center, Shanghai, China
| | - Marco Viscione
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Raphael Sznitman
- ARTORG Center, University of Bern, Bern, Switzerland.,Center of Artificial Intelligence in Medicine (CAIM), University of Bern, Bern, Switzerland
| | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Biao Li
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Ruijin Center, Shanghai, China.
| | - Kuangyu Shi
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Center of Artificial Intelligence in Medicine (CAIM), University of Bern, Bern, Switzerland.,Computer Aided Medical Procedures and Augmented Reality, Institute of Informatics I16, Technical University of Munich, Munich, Germany
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3
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Liu Y, Wang Y, Zhang W. Scoring system and a simple nomogram for predicting radioiodine refractory differentiated thyroid cancer: a retrospective study. EJNMMI Res 2022; 12:45. [PMID: 35904608 PMCID: PMC9338217 DOI: 10.1186/s13550-022-00917-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background Differentiated thyroid carcinoma (DTC) originates from abnormal follicular cells and accounts for approximately 90–95% of thyroid malignancies. The diagnosis of radioiodine refractory DTC (RR-DTC) is based on clinical evolution and iodine uptake characteristics rather than pathological characteristics. Thus, it takes a long time to become apparent, and the definition of RR-DTC covers multiple aspects. We aimed to analyze the clinical and molecular imaging characteristics of patients with RR-DTC and identify independent predictors to develop an RR-DTC scoring system and a simple nomogram for predicting the probability of RR-DTC. We reviewed the data of 404 patients with metastatic DTC who underwent both post-RAI WB therapy scintigraphy and 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography. Data on the clinical features and molecular characteristics of RR-DTC and non-RR-DTC cases were obtained from medical records. We screened for predictors using univariate analyses, obtained independent predictors through multivariate analyses, and then established a scoring system and a simple nomogram for predicting RR-DTC according to the corresponding odds ratio (OR) values. Results Diagnosis at age ≥ 48 years (OR, 1.037; 95% confidence interval [CI], 1.007–1.069), recurrence between the operation and iodine-131 treatment (OR, 7.362; 95% CI 2.388–22.698), uptake of 18F-FDG (OR, 39.534; 95% CI 18.590–84.076), and the metastasis site (OR, 4.365; 95% CI 1.593–11.965) were highly independently associated with RR-DTC. We established a scoring system for predicting RR-DTC, showing that the area under the receiver operating characteristic curve (AUC) with a cutoff value of 10 points (AUC = 0.898) had a higher discernibility than any other single independent predictor. The risk factors of RR-DTC in nomogram modeling include diagnosis at age ≥ 48 years, recurrence between the operation and iodine-131 treatment, uptake of 18F-FDG, and the site of metastasis. The concordance index (c-Index) of the nomogram was 0.9. Conclusions We demonstrated that a predictive model based on four factors has a good ability to predict RR-DTC. An index score ≥ 10 points was found to be the optimal index point for predicting RR-DTC. Moreover, this nomogram model has good predictive ability and stability. This model may help establish an active surveillance or appropriate treatment strategy for RR-DTC cases.
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Affiliation(s)
- Ye Liu
- Department of Nuclear Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.,Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yuhua Wang
- Department of Nuclear Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.,Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wanchun Zhang
- Department of Nuclear Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China. .,Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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4
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Borgheresi A, De Muzio F, Agostini A, Ottaviani L, Bruno A, Granata V, Fusco R, Danti G, Flammia F, Grassi R, Grassi F, Bruno F, Palumbo P, Barile A, Miele V, Giovagnoni A. Lymph Nodes Evaluation in Rectal Cancer: Where Do We Stand and Future Perspective. J Clin Med 2022; 11:2599. [PMID: 35566723 PMCID: PMC9104021 DOI: 10.3390/jcm11092599] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/25/2022] [Accepted: 05/03/2022] [Indexed: 12/12/2022] Open
Abstract
The assessment of nodal involvement in patients with rectal cancer (RC) is fundamental in disease management. Magnetic Resonance Imaging (MRI) is routinely used for local and nodal staging of RC by using morphological criteria. The actual dimensional and morphological criteria for nodal assessment present several limitations in terms of sensitivity and specificity. For these reasons, several different techniques, such as Diffusion Weighted Imaging (DWI), Intravoxel Incoherent Motion (IVIM), Diffusion Kurtosis Imaging (DKI), and Dynamic Contrast Enhancement (DCE) in MRI have been introduced but still not fully validated. Positron Emission Tomography (PET)/CT plays a pivotal role in the assessment of LNs; more recently PET/MRI has been introduced. The advantages and limitations of these imaging modalities will be provided in this narrative review. The second part of the review includes experimental techniques, such as iron-oxide particles (SPIO), and dual-energy CT (DECT). Radiomics analysis is an active field of research, and the evidence about LNs in RC will be discussed. The review also discusses the different recommendations between the European and North American guidelines for the evaluation of LNs in RC, from anatomical considerations to structured reporting.
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Affiliation(s)
- Alessandra Borgheresi
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60121 Ancona, Italy; (A.B.); (A.A.); (A.B.); (A.G.)
| | - Federica De Muzio
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy;
| | - Andrea Agostini
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60121 Ancona, Italy; (A.B.); (A.A.); (A.B.); (A.G.)
- Department of Radiological Sciences, University Hospital Ospedali Riuniti, 60126 Ancona, Italy;
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy; (G.D.); (R.G.); (F.G.); (F.B.); (P.P.); (V.M.)
| | - Letizia Ottaviani
- Department of Radiological Sciences, University Hospital Ospedali Riuniti, 60126 Ancona, Italy;
| | - Alessandra Bruno
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60121 Ancona, Italy; (A.B.); (A.A.); (A.B.); (A.G.)
| | - Vincenza Granata
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale IRCCS di Napoli, 80131 Naples, Italy;
| | - Roberta Fusco
- Medical Oncology Division, Igea SpA, 80013 Napoli, Italy
| | - Ginevra Danti
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy; (G.D.); (R.G.); (F.G.); (F.B.); (P.P.); (V.M.)
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, Italy;
| | - Federica Flammia
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, Italy;
| | - Roberta Grassi
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy; (G.D.); (R.G.); (F.G.); (F.B.); (P.P.); (V.M.)
- Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, 80128 Naples, Italy
| | - Francesca Grassi
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy; (G.D.); (R.G.); (F.G.); (F.B.); (P.P.); (V.M.)
- Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, 80128 Naples, Italy
| | - Federico Bruno
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy; (G.D.); (R.G.); (F.G.); (F.B.); (P.P.); (V.M.)
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Pierpaolo Palumbo
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy; (G.D.); (R.G.); (F.G.); (F.B.); (P.P.); (V.M.)
- Abruzzo Health Unit 1, Department of Diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, 67100 L’Aquila, Italy
| | - Antonio Barile
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Vittorio Miele
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy; (G.D.); (R.G.); (F.G.); (F.B.); (P.P.); (V.M.)
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, Italy;
| | - Andrea Giovagnoni
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60121 Ancona, Italy; (A.B.); (A.A.); (A.B.); (A.G.)
- Department of Radiological Sciences, University Hospital Ospedali Riuniti, 60126 Ancona, Italy;
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Gherghe M, Lazar AM, Mutuleanu MD, Stanciu AE, Martin S. Radiomics Analysis of [18F]FDG PET/CT Thyroid Incidentalomas: How Can It Improve Patients’ Clinical Management? A Systematic Review from the Literature. Diagnostics (Basel) 2022; 12:diagnostics12020471. [PMID: 35204561 PMCID: PMC8870948 DOI: 10.3390/diagnostics12020471] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/07/2022] [Accepted: 02/09/2022] [Indexed: 01/01/2023] Open
Abstract
Background: We performed a systematic review of the literature to provide an overview of the application of PET-based radiomics of [18F]FDG-avid thyroid incidentalomas and to discuss the additional value of PET volumetric parameters and radiomic features over clinical data. Methods: The most relevant databases were explored using an algorithm constructed based on a combination of terms related to our subject and English-language articles published until October 2021 were considered. Among the 247 identified articles, 19 studies were screened for eligibility and 11 met the criteria, with 4 studies including radiomics analyses. Results: We summarized the available literature based on a study of PET volumetric parameters and radiomics. Ten articles provided accurate details about volumetric parameters and their prospective value in tumour assessment. We included the data provided by these articles in a sub-analysis, but could not obtain statistically relevant results. Four publications analyzed the diagnostic potential of radiomics and the possibility of creating precise predictive models, their corresponding quality score being assessed. Conclusions: The use of PET volumetric parameters and radiomics analysis in patients with [18F]FDG-avid thyroid incidentalomas outlines a great prospect in diagnosis and stratification of patients with malignant nodules and may represent a way of limiting the need for unnecessary invasive procedures; however, further studies need to be performed for a standardization of the method.
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Affiliation(s)
- Mirela Gherghe
- Nuclear Medicine Department, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania; (M.G.); (M.-D.M.)
- Nuclear Medicine Department, Institute of Oncology “Profesor Doctor Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Alexandra Maria Lazar
- Nuclear Medicine Department, Institute of Oncology “Profesor Doctor Alexandru Trestioreanu”, 022328 Bucharest, Romania
- Correspondence:
| | - Mario-Demian Mutuleanu
- Nuclear Medicine Department, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania; (M.G.); (M.-D.M.)
- Nuclear Medicine Department, Institute of Oncology “Profesor Doctor Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Adina Elena Stanciu
- Carcinogenesis and Molecular Biology Department, Institute of Oncology “Profesor Doctor Alexandru Trestioreanu”, 022328 Bucharest, Romania;
| | - Sorina Martin
- Endocrinology Department, Elias Emergency University Clinic Hospital, 011461 Bucharest, Romania;
- Endocrinology Department, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania
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6
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Xue XQ, Wang B, Yu WJ, Zhang FF, Niu R, Shao XL, Shi YM, Yang YS, Wang JF, Li XF, Wang YT. Relationship between total lesion glycolysis of primary lesions based on 18F-FDG PET/CT and lymph node metastasis in gastric adenocarcinoma: a cross-sectional preliminary study. Nucl Med Commun 2022; 43:114-121. [PMID: 34406147 DOI: 10.1097/mnm.0000000000001475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES We explored the relationship between lymph node metastasis (LNM) and total lesion glycolysis (TLG) of primary lesions determined by 18fluoro-2-deoxyglucose PET/computed tomography (18F-FDG PET/CT) in patients with gastric adenocarcinoma, and evaluated the independent effect of this association. METHODS This retrospective study included 106 gastric adenocarcinoma patients who were examined by preoperative 18F-FDG PET/CT imaging between April 2016 and April 2020. We measured TLG of primary gastric lesions and evaluated its association with LNM. Multivariate logistic regression and a two-piece-wise linear regression were performed to evaluate the relationship between TLG of primary lesions and LNM. RESULTS Of the 106 patients, 75 cases (71%) had LNM and 31 cases (29%) did not have LNM. Univariate analyses revealed that a per-SD increase in TLG was independently associated with LNM [odds ratio (OR) = 2.37; 95% confidence interval (CI), 1.42-3.98; P = 0.0010]. After full adjustment of confounding factors, multivariate analyses exhibited that TLG of primary lesions was still significantly associated with LNM (OR per-SD: 2.20; 95% CI, 1.16-4.19; P = 0.0164). Generalized additive model indicated a nonlinear relationship and saturation effect between TLG of primary lesions and LNM. When TLG of primary lesions was <23.2, TLG was significantly correlated with LNM (OR = 1.26; 95% CI, 1.07-1.48; P = 0.0053), whereas when TLG of primary lesions was ≥ 23.2, the probability of LNM was greater than 60%, gradually reached saturation effect, as high as 80% or more. CONCLUSIONS In this preliminary study, there were saturation and segmentation effects between TLG of primary lesions determined by preoperative 18F-FDG PET/CT and LNM. When TLG of primary lesions was ≥ 23.2, the probability of LNM was greater than 60%, gradually reached saturation effect, as high as 80% or more. TLG of primary lesions is helpful in the preoperative diagnosis of LNM in patients with gastric adenocarcinoma.
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Affiliation(s)
- Xiu-Qing Xue
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou
- Department of Nuclear Medicine, The First People's Hospital of Yancheng City, Yancheng
- Department of Nuclear Medicine, Yancheng First Hospital, Affiliated Hospital of Nanjing University Medical School
| | - Bing Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou
| | - Wen-Ji Yu
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou
| | - Fei-Fei Zhang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou
| | - Rong Niu
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou
| | - Xiao-Liang Shao
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou
| | - Yun-Mei Shi
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou
| | - Yan-Song Yang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou
| | - Jian-Feng Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou
| | - Xiao-Feng Li
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou
| | - Yue-Tao Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou
- Department of Nuclear Medicine, Changzhou Key Laboratory of Molecular Imaging, Changzhou, Jiangsu, China
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7
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Scappaticcio L, Piccardo A, Treglia G, Poller DN, Trimboli P. The dilemma of 18F-FDG PET/CT thyroid incidentaloma: what we should expect from FNA. A systematic review and meta-analysis. Endocrine 2021; 73:540-549. [PMID: 33761104 PMCID: PMC8325664 DOI: 10.1007/s12020-021-02683-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 03/05/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE 18F-FDG thyroid incidentaloma (TI) occurs in ~2% of PET/CT examinations with a cancer prevalence of up to 35-40%. Guidelines recommend fine-needle aspiration cytology (FNA) if a focal 18F-FDG TI corresponds to a sonographic nodule >1 cm. The aim of this systematic review and meta-analysis was to provide evidence-based data on the diagnostic distribution of 18F-FDG TIs in the six Bethesda systems for reporting thyroid cytopathology (BETHESDA) subcategories. METHODS Original studies reporting 18F-FDG TIs and cytologically classified according to BETHESDA were included. Six separate meta-analyses were performed to obtain the pooled prevalence (95% confidence interval, 95% CI) of 18F-FDG TIs in the six BETHESDA subcategories. RESULTS Fifteen studies were finally included. Nine studies were from Asian/Eastern and six from Western countries. FNA data according to BETHESDA was available in 2304 cases. The pooled prevalence of 18F-FDG TIs according to BETHESDA was BETHESDA I 10% (6-14), BETHESDA II 45% (37-53), BETHESDA III 8% (3-13), BETHESDA IV 8% (5-12), BETHESDA V 6% (4-9), BETHESDA VI 19% (13-25). A significantly different prevalence was found in the BETHESDA IV between Asian/Eastern (2%) and Western (19%) studies. CONCLUSION Two-thirds of focal 18F-FDG TIs undergoing FNA have either malignant (BETHESDA VI) or benign (BETHESDA II) cytology while a minority will have indeterminate (BETHESDA III or IV) FNA results. Significant differences between Asian/Eastern and Western studies are also present in the prevalence of indeterminate FNA results.
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Affiliation(s)
- Lorenzo Scappaticcio
- Unit of Endocrinology and Metabolic Diseases, University of Campania 'L. Vanvitelli'', Naples, Italy.
| | | | - Giorgio Treglia
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Clinic of Nuclear Medicine and Molecular Imaging, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Health Technology Assessment Unit, Academic Education, Research and Innovation Area, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - David N Poller
- Departments of Cytology & Pathology, Queen Alexandra Hospital, Portsmouth, UK
- UCL Cancer Institute, 72 Huntley St., Bloomsbury, London, WC1E 6DD, UK
| | - Pierpaolo Trimboli
- Clinic for Endocrinology and Diabetology, Lugano Regional Hospital, Ente Ospedaliero Cantonale, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
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8
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Erdoğan M, Korkmaz H, Torus B, Avcı M, Boylubay ŞM, Çiriş M, Yıldız M, Şengül SS. The Role of Metabolic Volumetric Parameters in Predicting Malignancy in Incidental Thyroid Nodules Detected in 18F-FDG PET/CT Scans. Mol Imaging Radionucl Ther 2021; 30:86-92. [PMID: 34082507 PMCID: PMC8185484 DOI: 10.4274/mirt.galenos.2021.75983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Objectives The metabolic activities of tumors can be calculated volumetrically during positron emission tomography/computed tomography (PET/CT) imaging using metabolic tumor volume (MTV) and total lesion glycolysis (TLG). This study aimed to evaluate the roles of MTV and TLG in predicting the malignancy risk of incidental thyroid nodules detected by PET/CT imaging. Methods Active metabolic areas of each section were manually drawn by region of interest to calculate the MTV of nodules, and all obtained values were then summed. TLG, the product of mean standardized uptake value and MTV, was calculated by multiplying two values. All participants underwent thyroid ultrasonography imaging. All nodules were divided into risk classes according to the European Thyroid Image Reporting and Data System (EU-TIRADS) that was developed by the European Thyroid Association. The American Thyroid Association Guidelines were used to determine which thyroid nodules would undergo thyroid fine-needle biopsy (FNAB). Results were classified according to the Bethesda scoring system. Results TLG levels were significantly higher in malignant or malignant-suspicious nodules than in benign nodules (p=0.013). Although MTV levels were high in malignant or malignant-suspicious nodules than in benign and non-diagnostic nodules, it was statistically insignificant at limit values (p=0.079). Areas under curve (AUC) were 0.726 (p=0.005) and AUC: 0.668 (p=0.039) for TLG and MTV, respectively. The 2.3 g cut-off value of TLG has a sensitivity of 85.7% and specificity of 59.0%. The 1.7 mL cut-off value of MTV has a sensitivity of 78.6% and specificity of 60.4%. Conclusion We believe that TLG evaluation will be useful in predicting high-risk malignancy or malignancy suspicion based on EU-TIRADS risk classification of incidental thyroid nodules detected in PET/CT images. We believe that unnecessary thyroid FNABs can be avoided for thyroid incidental nodules if such relation and cut-off values are determined and that it will be useful in hastening the operation of the necessary patients.
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Affiliation(s)
- Mehmet Erdoğan
- Süleyman Demirel University Faculty of Medicine, Department of Nuclear Medicine, Isparta, Turkey
| | - Hakan Korkmaz
- Süleyman Demirel University Faculty of Medicine, Department of Endocrinology and Metabolism, Isparta, Turkey
| | - Bora Torus
- Süleyman Demirel University Faculty of Medicine, Department of Endocrinology and Metabolism, Isparta, Turkey
| | - Mustafa Avcı
- Süleyman Demirel University Faculty of Medicine, Department of Nuclear Medicine, Isparta, Turkey
| | - Şerife Mehtap Boylubay
- Süleyman Demirel University Faculty of Medicine, Department of Endocrinology and Metabolism, Isparta, Turkey
| | - Metin Çiriş
- Süleyman Demirel University Faculty of Medicine, Department of Pathology, Isparta, Turkey
| | - Mustafa Yıldız
- Süleyman Demirel University Faculty of Medicine, Department of Nuclear Medicine, Isparta, Turkey
| | - Sevim Süreyya Şengül
- Süleyman Demirel University Faculty of Medicine, Department of Nuclear Medicine, Isparta, Turkey
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Araz M, Soydal Ç, Özkan E, Akkuş P, Nak D, Küçük NÖ, Kır KM. Role of Thyroglobulin Doubling Time in Differentiated Thyroid Cancer and Its Relationship with Demographic-Histopathologic Risk Factors and 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Parameters. Cancer Biother Radiopharm 2020; 36:425-432. [PMID: 32379488 DOI: 10.1089/cbr.2019.3203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Aim of this study was to investigate the relationship between thyroglobulin doubling time (TgDT) and basal risk factors and metabolic parameters derived from 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in differentiated thyroid cancer (DTC). Materials and Methods: An analysis of 95 DTC patients who had rising serum thyroglobulin (Tg) levels under levothyroxine (LT4) suppression after radioiodine therapy was made. TgDT was calculated for 28/95 patients. The relationship between TgDT and basal demographic and histopathologic risk factors, preablative Tg, and antithyroglobulin antibody (ATg) levels and metabolic parameters was analyzed. Results: In 28 patients (15M, 13F, mean age: 52.6 ± 17.6) that TgDT could be calculated, 18F-FDG PET/CT was positive in 12 patients. Median TgDT was lower in 18F-FDG PET/CT positive patients compared to the negative cases (p < 0.05). Patients with skeletal metastasis or local recurrence had a shorter DT compared to the patients with lung metastasis. TgDT was correlated with peak standardized uptake value (SUVpeak) (p < 0.05). Maximum standardized uptake value (SUVmax) was correlated with tumor size (p < 0.05) and mean standardized uptake value (SUVmean) with tumor size and vascular invasion (p < 0.05). Median SUVmax and SUVmean were higher in follicular cancer or poor histological variants of papillary DTC compared to papillary cancer classical variant patients Conclusion: TgDT may be predictive of a positive 18F-FDG PET/CT in DTC. Skeletal metastasis and local recurrence are related to shorter TgDT. Greater tumor size, vascular invasion, and follicular cancer or poor variants of papillary carcinoma are related with higher SUVmax and SUVmean. Larger scale studies are needed to confirm results and to calculate a possible cutoff of TgDT for a positive 18F-FDG PET/CT study.
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Affiliation(s)
- Mine Araz
- Nuclear Medicine Department, Ankara University Medical School, Ankara, Turkey
| | - Çiğdem Soydal
- Nuclear Medicine Department, Ankara University Medical School, Ankara, Turkey
| | - Elgin Özkan
- Nuclear Medicine Department, Ankara University Medical School, Ankara, Turkey
| | - Pınar Akkuş
- Nuclear Medicine Department, Ankara University Medical School, Ankara, Turkey
| | - Demet Nak
- Nuclear Medicine Department, Ankara University Medical School, Ankara, Turkey
| | - N Özlem Küçük
- Nuclear Medicine Department, Ankara University Medical School, Ankara, Turkey
| | - K Metin Kır
- Nuclear Medicine Department, Ankara University Medical School, Ankara, Turkey
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10
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Xu C, Li X, Shi Y, Wang B, Sun H. Combinative evaluation of primary tumor and lymph nodes to predict pelvic lymphatic metastasis in cervical cancer: an integrated PET-IVIM MRI study. Cancer Imaging 2020; 20:21. [PMID: 32143736 PMCID: PMC7060657 DOI: 10.1186/s40644-020-00298-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 02/28/2020] [Indexed: 12/18/2022] Open
Abstract
Background The aim of this study was to evaluate the value of combining pelvic lymph node and tumor characteristics on positron emission tomography-intravoxel incoherent motion magnetic resonance (PET-IVIM MR) imaging for predicting lymph node metastasis in patients with cervical cancer, especially in those with negative lymph nodes on PET. Methods The medical records of 95 patients with cervical cancer who underwent surgical resection with pelvic lymph node dissection were evaluated. The patients were divided into negative and positive groups according to postoperative pathologic lymph node diagnosis, and comparisons of the PET and IVIM-derived parameters between the two groups were performed. Univariate and multivariate analyses were performed to construct a predictive model of lymph node metastasis. Results For all patients, tumor SUVmax, TLG, Dmin, PET and MRI for lymph node diagnosis showed significant differences between patients with and without confirmed lymph node metastasis. Univariate and multivariate logistic analysis showed that the combination of tumor TLG, Dmin and PET for lymph node diagnosis had the strongest predictive value (AUC 0.913, p < 0.001). For patients with PET-negative lymph nodes, SUVmax, SUVmean, MTV, TLG, and Dmin showed significant between-group differences, and univariate and multivariate logistic analysis showed that TLG had the strongest predictive value. Conclusions The combination of tumorTLG, Dmin and PET for lymph node diagnosis is a powerful prognostic factor for all patients. TLG has the best predictive performance in patients with PET negative lymph nodes.
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Affiliation(s)
- Chen Xu
- Department of Radiology, Shengjing Hospital of China Medical University, Sanhao Street No36, Heping District, Shenyang, Liaoning, PR China, 110004.,Liaoning Provincial Key Laboratory of Medical Imaging, Sanhao Street No36, Heping District, Shenyang, 110004, Liaoning, China
| | - Xiaoran Li
- Department of Radiology, Shengjing Hospital of China Medical University, Sanhao Street No36, Heping District, Shenyang, Liaoning, PR China, 110004
| | - Yanchi Shi
- Department of Radiology, Shengjing Hospital of China Medical University, Sanhao Street No36, Heping District, Shenyang, Liaoning, PR China, 110004
| | - Bo Wang
- Department of Radiology, Shengjing Hospital of China Medical University, Sanhao Street No36, Heping District, Shenyang, Liaoning, PR China, 110004
| | - Hongzan Sun
- Department of Radiology, Shengjing Hospital of China Medical University, Sanhao Street No36, Heping District, Shenyang, Liaoning, PR China, 110004. .,Liaoning Provincial Key Laboratory of Medical Imaging, Sanhao Street No36, Heping District, Shenyang, 110004, Liaoning, China.
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11
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Prognostic value of 18F-FDG PET/CT parameters and histopathologic variables in head and neck cancer. Braz J Otorhinolaryngol 2019; 87:452-456. [PMID: 31899125 PMCID: PMC9422361 DOI: 10.1016/j.bjorl.2019.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 10/28/2019] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION 18F-fluorodeoxyglucose positron emission tomography/computed tomography parameters such as; maximum standardized uptake values, standard metabolic tumor volume and otal lesion glycosis are important prognostic biomarkers in cancers. OBJECTIVE To investigate the prognostic value of these parameters in patients with head and neck cancers. METHODS We performed a retrospective study including 47 patients with head and neck cancer who underwent18F-fluorodeoxyglucose positron emission tomography/computed tomography prior to treatment. Standard metabolic tumor volume, otal lesion glycosis and standardized uptake were measured for each patient. The prognostic value of quantitative 18F-fluorodeoxyglucose positron emission tomography/computed tomography parameters and clinicopathologic variables on disease free survival and overall survival were analyzed. RESULTS The median (range) standard metabolic tumor volume and otal lesion glycosis and standardized uptake were 7.63cm3 (0.6-34.3), 68.9g (2.58-524.5g), 13.89 (4.89-33.03g/mL), respectively. Lymph node metastases and tumour differentiation were significant variables for disease free survival and overall survival, however, all 18F-fluorodeoxyglucose positron emission tomography/computed tomography parameters were not associated with disease- free survival and overall survival. CONCLUSION Pretreatment quantities positron emission tomography parameters did not predict survival in head and neck cancer.
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12
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Maturo A, Tromba L, De Anna L, Carbotta G, Livadoti G, Donello C, Falbo F, Galiffa G, Esposito A, Biancucci A, Carbotta S. Incidental thyroid carcinomas. A retrospective study. G Chir 2019; 38:94-101. [PMID: 28691675 DOI: 10.11138/gchir/2017.38.2.094] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
AIM The aim of the present study is to report our series of incidental thyroid carcinomas in the last 15 years and their follow-up, discussing therapeutics indications and surgical choices. PATIENTS AND METHODS We have considered 1793 patients operated on Surgical Sciences Department of "Sapienza" University of Rome from January 1, 2001 to December 31, 2015. The study was conducted on 83 totally thyroidectomized patients with a real incidental thyroid carcinoma, by clinical, laboratory and instrumental controls. Whole-body scan was the most important test in postoperative evaluation. RESULTS In our series, the incidence of incidental carcinomas was 4.62%. Compared to the total number of cancer patients, the percentage is 21,9%. In 15.66% of cases there was multifocality and in 7.23% also bilaterality. Regarding the histological type, in all cases they were papillary carcinoma. The size of the neoplastic lesions ranged from a minimum of 3 to a maximum of 10 mm. Whole-body scan revealed lymph node metastasis in 57.69% of patients. DISCUSSION Comparing these data with our previous studies we have seen a significant increase in incidence of incidental thyroid carcinomas over the years. Our therapeutical choice is total thyroidectomy and complection thyroidectomy after lobectomy, because of a relevant percentage of multifocality and/or bilaterality of these tumors. Many Authors on the contrary prefer a more conservative approach invoking the good prognosis of these tumors. The 57.69% of lymph node metastasis at postoperative whole-body scan comfort us in our setting. CONCLUSION Incidental thyroid carcinomas are not uncommon. We consider only tumors until 1 cm in diameter. Multifocality and bilaterality are often present such as occult lymph node metastasis. Our therapeutical choice is total thyroidectomy in order to conduct a proper follow-up.
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13
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Kim SH, Song BI, Kim BW, Kim HW, Won KS, Bae SU, Jeong WK, Baek SK. Predictive Value of [ 18F]FDG PET/CT for Lymph Node Metastasis in Rectal Cancer. Sci Rep 2019; 9:4979. [PMID: 30899056 PMCID: PMC6428820 DOI: 10.1038/s41598-019-41422-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 03/08/2019] [Indexed: 12/12/2022] Open
Abstract
[18F]Fluorodeoxyglucose ([18F]FDG) Positron emission tomography/computed tomography (PET/CT) is commonly used for rectal cancer staging, but improved diagnostic methods for nodal metastases are needed. We aimed to evaluate whether the combination model of the metabolic tumor volume of primary tumor (T_MTV) and maximum standardized uptake value of lymph node (N_SUVmax) on pretreatment [18F]FDG PET/CT could improve nodal metastases prediction in rectal cancer. We enrolled a total of 166 rectal cancer patients who underwent pretreatment [18F]FDG PET/CT and surgical resection without neoadjuvant treatment between January 2009 and August 2016. Visual and semiquantitative PET/CT parameters were obtained. Associations between clinicopathological, PET/CT-derived variables and nodal metastases were evaluated by logistic regression analysis. Nodal metastases were confirmed histologically in 68 of the 166 patients (41%). Uni- and multivariate analyses demonstrated T_MTV and N_SUVmax were independent predictive factors for nodal metastases. The c-statistics of the combination model was 0.806 (Standard Error, 0.034; 95% Confidence Interval, 0.737-0.863), which showed significant improvement compared to T_MTV (0.698, P = 0.0002) or N_SUVmax (0.720, P = 0.0008) alone. T_MTV and N_SUVmax are independently correlated with nodal metastases. Furthermore, the combination model showed improved performance for risk prediction; thus, [18F]FDG PET/CT might have a role in rectal cancer staging and treatment planning.
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Affiliation(s)
- Sung Hoon Kim
- Department of Nuclear Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Bong-Il Song
- Department of Nuclear Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
| | - Beong Woo Kim
- Department of Nuclear Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Hae Won Kim
- Department of Nuclear Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Kyoung Sook Won
- Department of Nuclear Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Sung Uk Bae
- Department of Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Woon Kyung Jeong
- Department of Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Seong Kyu Baek
- Department of Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
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14
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Dejima H, Kuroda H, Oya Y, Sakakura N, Inaba Y, Tamaki T, Yatabe Y, Sakao Y. Evaluation of lobar lymph node metastasis in non-small cell lung carcinoma using modified total lesion glycolysis. J Thorac Dis 2019; 10:6932-6941. [PMID: 30746239 DOI: 10.21037/jtd.2018.11.40] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Volumetric parameters based on 3-dimensional reconstruction have recently been introduced for cancer staging. We aimed to improve the ability to diagnose hilar lymph node metastasis in patients with non-small cell lung cancer. Methods We evaluated 142 patients with non-small cell lung cancer who underwent right upper lobectomy and radical lymph node dissection. Metastatic involvement of right upper lobar lymph nodes was assessed using high-resolution computed tomography (HRCT) and 18F-2-floro-2-deoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT). Results On receiver operating characteristic (ROC) curve analysis, the area under the curves (AUC) for short axis, maximum of standardized uptake value (SUVmax), total lesion glycolysis (TLG) and modified TLG (mTLG) were 0.79, 0.77, 0.76, and 0.87, respectively. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of mTLG, using the optimal cut off value (2.45), for diagnosis of lobar lymph node metastasis were 71%, 88%, 44%, and 96%, respectively. Hilar asymmetric uptake (HAU) of FDG was larger in true-positive cases than in false-negative cases (P<0.01). Furthermore, the size of metastatic foci in the lymph node was smaller in false-negative cases (P=0.012). Conclusions Modified TLG is a good parameter to diagnose metastatic right upper lobar lymph nodes. Micrometastasis in the lymph node is difficult to predict using the current diagnostic method. However, more careful evaluation is required in patients with symmetric FDG accumulation at hilar region because hilar lymph nodes respond to various causes such as benign pulmonary diseases.
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Affiliation(s)
- Hitoshi Dejima
- Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.,Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Hiroaki Kuroda
- Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yuko Oya
- Department of Thoracic Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Noriaki Sakakura
- Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yoshitaka Inaba
- Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Tsuneo Tamaki
- Nagoya Radiological Diagnosis Foundation, Nagoya, Japan
| | - Yasushi Yatabe
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yukinori Sakao
- Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
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15
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Li K, Sun H, Guo Q. Combinative evaluation of primary tumor and lymph nodes in predicting pelvic lymphatic metastasis in early-stage cervical cancer: A multiparametric PET-CT study. Eur J Radiol 2019; 113:153-157. [PMID: 30927941 DOI: 10.1016/j.ejrad.2019.02.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 09/17/2018] [Accepted: 02/12/2019] [Indexed: 01/27/2023]
Abstract
PURPOSE The purpose of this study is to investigate the value of combining tumor and pelvic lymph node (PLN) characteristics on PET-CT in predicting PLN metastasis of patients with early-stage cervical cancer, specifically to further reduce the false-negative cases of diagnosis. METHODS The [18F] FDG PET-CT imaging data of 394 patients who were newly diagnosed with cervical cancer (FIGO stage, Ia-IIa) were retrospectively studied. We measured size, total lesion glycolysis (TLG) of tumor, metabolic tumor volume (MTV), maximum and mean standardized uptake value (SUVmax, SUVmean) of tumor and lymph node (LN). Diagnostic efficiency was evaluated using receiver operator characteristic (ROC) curve. We also investigated additional CT diagnosis information in PET-negative cases. RESULTS Our results indicated both lymph node and tumor parameters were independent risk factors for lymphatic metastasis in early-stage cervical cancer. The diagnosis based on above meaningful parameters, we name it 'combination diagnosis', offered significantly higher predictive value than that based on SUV measurement alone, which the values of AUC were 0.842 and 0.784 respectively (P < 0.05). In PET-negative cases, we also found that tumor TLG, suspicious LN in lymphatic drainage pathway, long/short axis of LN ≤ 2, heterogeneity of LN significantly associated with PLN metastasis. ROC analysis showed combination diagnosis of all these parameters above produced an AUC value of 0.859 (P < 0.05, 95% CI, 0.811-0.899), which was significantly higher than either using tumor TLG alone (AUC = 0.622, Z = 3.919, P < 0.05) or indices derived from CT alone (AUC = 0.727, 0.668, 0.695. Z = 3.620, 5.356, 3.696, P < 0.05). CONCLUSIONS We proposed a combination diagnosis method that can better predict PLN metastasis for patients with early-stage cervical cancer. In PET-negative cases, combination diagnosis of TLG of tumor and CT indicators also produced improved prediction by reducing false-negative cases of diagnosis. This combination diagnosis approach has significant implications in cervical cancer patient management and treatment planning.
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Affiliation(s)
- Kexin Li
- Department of Radiology, Shengjing Hospital of China Medical University, Sanhao Street No36, Heping District, Shenyang, Liaoning, 110004, PR China
| | - Hongzan Sun
- Department of Radiology, Shengjing Hospital of China Medical University, Sanhao Street No36, Heping District, Shenyang, Liaoning, 110004, PR China.
| | - Qiyong Guo
- Department of Radiology, Shengjing Hospital of China Medical University, Sanhao Street No36, Heping District, Shenyang, Liaoning, 110004, PR China
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Nakajo M, Jinguji M, Shinaji T, Tani A, Nakabeppu Y, Nakajo M, Nakajo A, Natsugoe S, Yoshiura T. 18F-FDG-PET/CT features of primary tumours for predicting the risk of recurrence in thyroid cancer after total thyroidectomy: potential usefulness of combination of the SUV-related, volumetric, and heterogeneous texture parameters. Br J Radiol 2018; 92:20180620. [PMID: 30273012 DOI: 10.1259/bjr.20180620] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE: This retrospective study examined whether the primary tumour 18F-FDG uptake features could predict the high-risk of recurrence in differentiated thyroid cancer (DTC) patients. METHODS: The enrolled 114 DTC patients underwent preoperative 18F-FDG-PET/CT. SUVmax, SUVmean, metabolic tumour volume (MTV), total lesion glycolysis (TLG) and 6 texture parameters were obtained. Because the texture features can be confounded by the tumour volume effects, 18F-FDG-avid tumour patients were divided into two groups (tumours with MTV ≤ 10.0 cm3 and >10.0 cm3). Diagnostic performance for predicting the high-risk was evaluated by the area under the curve (AUC) by the ROC curve analysis. RESULTS: Eighty eight 18F-FDG-avid tumours revealed more advanced-risk classification (p = 0.015 → 0.02) than 26 18F-FDG-nonavid tumours, which yielded no high-risk patients. In the 44 MTV > 10.0 cm3 18F-FDG-avid tumour patients, 8 high-risk patients revealed significantly higher SUVmax, SUVmean, MTV, TLG, intensity variability and size-zone variability, and lower zone percentage than 36 non-high-risk patients (p < 0.001-0.016). Their AUC (diagnostic accuracy) ranged between 0.77 (66%) and 0.92 (91%). When each parameter was scored as 0 (negative for high-risk) or 1 (positive for high-risk) according to each threshold criterion, and the 7 parameter summed score ≥5 was defined as high-risk, the accuracy was 93.2% (AUC: 0.98) in the MTV > 10.0 cm3 18F-FDG-avid tumour patients. CONCLUSION: For primary MTV > 10.0 cm3 18F-FDG-avid DTCs, the combined use of SUV-related, volumetric, and texture parameters may be more useful to identify high-risk patients than the individual parameters. ADVANCES IN KNOWLEDGE: Combined use of SUV-related, volumetric, and texture parameters may be useful to identify high-risk DTC patients.
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Affiliation(s)
- Masatoyo Nakajo
- 1 Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka , Kagoshima , Japan
| | - Megumi Jinguji
- 1 Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka , Kagoshima , Japan
| | - Tetsuya Shinaji
- 2 Department of Nuclear Medicine, University of Würzburg, Oberdürrbacher Str , Würzburg , Germany
| | - Atsushi Tani
- 1 Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka , Kagoshima , Japan
| | - Yoshiaki Nakabeppu
- 3 Department of Radiology, Kagoshima City Hospital,Uearata , Kagoshima , Japan
| | - Masayuki Nakajo
- 4 Department of Radiology, Nanpuh Hospital, Nagata , Kagoshima , Japan
| | - Akihiro Nakajo
- 5 Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka , Kagoshima , Japan
| | - Shoji Natsugoe
- 5 Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka , Kagoshima , Japan
| | - Takashi Yoshiura
- 1 Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka , Kagoshima , Japan
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Takeuchi S, Shiga T, Hirata K, Taguchi J, Magota K, Ariga S, Gouda T, Ohhara Y, Homma R, Shimizu Y, Kinoshita I, Tsuji Y, Homma A, Iijima H, Tamaki N, Dosaka-Akita H. Early prediction of lenvatinib treatment efficacy by using 18F-FDG PET/CT in patients with unresectable or advanced thyroid carcinoma that is refractory to radioiodine treatment: a protocol for a non-randomized single-arm multicenter observational study. BMJ Open 2018; 8:e021001. [PMID: 30166292 PMCID: PMC6119439 DOI: 10.1136/bmjopen-2017-021001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Lenvatinib, an oral molecular targeted drug, is used to treat patients with unresectable or advanced thyroid carcinoma that is refractory to radioiodine treatment. Effective methods for evaluating molecular targeted drugs are a critical unmet need owing to their expensive costs and unique adverse events. The aim of this study is to determine whether 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT at 1 week after commencing lenvatinib can predict treatment outcomes. DESIGN AND METHODS This study is planned as a non-randomised single-arm multicentre study; patients with pathologically confirmed differentiated thyroid carcinoma (DTC) with lesions that are refractory to radioiodine treatment are eligible. The main exclusion criteria are medullary or anaplastic carcinoma, prior treatment with chemotherapy, poor general condition and thromboembolism-requiring treatment. Patients to be included in the study will be treated with lenvatinib and undergo FDG-PET/CT examination twice: before and 1 week after the initiation of treatment. Contrast-enhanced CT, the gold standard for evaluation, will be performed at least 4 weeks after the initiation of treatment. The primary objective is to evaluate the ability of the lesion maximum standard uptake value for FDG PET/CT performed 1 week after the initiation of treatment to predict outcomes compared with the response evaluation obtained via contrast-enhanced CT performed at least 4 weeks after the initiation of treatment. ETHICS AND DISSEMINATION This study is conducted in accordance with the Declaration of Helsinki and has received ethical approval from the institutional review board of the Hokkaido University Hospital (approval number: 015-402). The results of this study will be disseminated through a presentation at a conference and the publication of the data in a peer-reviewed journal. The study will be implemented and reported in line with the SPIRIT statement. TRIAL REGISTRATION NUMBER UMIN000022592.
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Affiliation(s)
- Satoshi Takeuchi
- Department of Medical Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Tohru Shiga
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Kenji Hirata
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Jun Taguchi
- Department of Medical Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Keiichi Magota
- Department of Radiology, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Shin Ariga
- Department of Medical Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Tomohiro Gouda
- Department of Medical Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yoshihito Ohhara
- Department of Medical Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Rio Homma
- Department of Medical Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yasushi Shimizu
- Department of Medical Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Ichiro Kinoshita
- Department of Medical Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yasushi Tsuji
- Department of of Medical Oncology, Tonan Hospital, Sapporo, Hokkaido, Japan
| | - Akihiro Homma
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Hiroaki Iijima
- Clinical Research and Medical Innovation Center, Hokkaido University Hospital, Sapporo, Japan
| | - Nagara Tamaki
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Hirotoshi Dosaka-Akita
- Department of Medical Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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18
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Lin FI, Gonzalez EM, Kummar S, Do K, Shih J, Adler S, Kurdziel KA, Ton A, Turkbey B, Jacobs PM, Bhattacharyya S, Chen AP, Collins JM, Doroshow JH, Choyke PL, Lindenberg ML. Utility of 18F-fluoroestradiol ( 18F-FES) PET/CT imaging as a pharmacodynamic marker in patients with refractory estrogen receptor-positive solid tumors receiving Z-endoxifen therapy. Eur J Nucl Med Mol Imaging 2017; 44:500-508. [PMID: 27872957 PMCID: PMC7886184 DOI: 10.1007/s00259-016-3561-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 10/25/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND Z-endoxifen is the most potent of the metabolites of tamoxifen, and has the potential to be more effective than tamoxifen because it bypasses potential drug resistance mechanisms attributable to patient variability in the expression of the hepatic microsomal enzyme CYP2D6. 18F-FES is a positron emission tomography (PET) imaging agent which selectively binds to estrogen receptor alpha (ER-α) and has been used for non-invasive in vivo assessment of ER activity in tumors. This study utilizes 18F-FES PET imaging as a pharmacodynamic biomarker in patients with ER+ tumors treated with Z-endoxifen. METHODS Fifteen patients were recruited from a parent therapeutic trial of Z-endoxifen and underwent imaging with 18F-FES PET at baseline. Eight had positive lesions on the baseline scan and underwent follow-up imaging with 18F-FES 1-5 days post administration of Z-endoxifen. RESULTS Statistically significant changes (p = 0.0078) in standard uptake value (SUV)-Max were observed between the baseline and follow-up scans as early as 1 day post drug administration. CONCLUSION F-FES PET imaging could serve as a pharmacodynamic biomarker for patients treated with ER-directed therapy.
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Affiliation(s)
- Frank I Lin
- Cancer Imaging Program, National Cancer Institute, NIH, Bethesda, MD, USA.
- Molecular Imaging Program, National Cancer Institute, Bethesda, MD, USA.
| | - E M Gonzalez
- Molecular Imaging Program, National Cancer Institute, Bethesda, MD, USA
| | - S Kummar
- Division of Cancer Treatment and Diagnosis and Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - K Do
- Division of Cancer Treatment and Diagnosis and Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - J Shih
- Biometric Research Program, National Cancer Institute, NIH, Bethesda, MD, USA
| | - S Adler
- Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research, Inc., NCI Campus at Frederick, Frederick, MD, 21702, USA
| | - K A Kurdziel
- Molecular Imaging Program, National Cancer Institute, Bethesda, MD, USA
| | - A Ton
- Molecular Imaging Program, National Cancer Institute, Bethesda, MD, USA
| | - B Turkbey
- Molecular Imaging Program, National Cancer Institute, Bethesda, MD, USA
| | - P M Jacobs
- Cancer Imaging Program, National Cancer Institute, NIH, Bethesda, MD, USA
| | - S Bhattacharyya
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Frederick, MD, USA
| | - A P Chen
- Early Clinical Trials Development Program, DCTD, National Cancer Institute, Bethesda, MD, USA
| | - J M Collins
- Division of Cancer Treatment and Diagnosis and Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - J H Doroshow
- Division of Cancer Treatment and Diagnosis and Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - P L Choyke
- Molecular Imaging Program, National Cancer Institute, Bethesda, MD, USA
| | - M L Lindenberg
- Molecular Imaging Program, National Cancer Institute, Bethesda, MD, USA
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19
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Araz M, Çayır D. 18F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography for Other Thyroid Cancers: Medullary, Anaplastic, Lymphoma and So Forth. Mol Imaging Radionucl Ther 2017; 26:1-8. [PMID: 28291004 PMCID: PMC5350500 DOI: 10.4274/mirt.60783] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Positron emission tomography/computed tomography (PET/CT) with 18F-fluorodeoxyglucose (FDG) is used in staging, restaging, and evaluation of therapy response in many cancers as well as differentiated thyroid carcinomas especially in non-iodine avid variants. Its potential in less frequent thyroid tumors like medullary, anaplastic thyroid cancers, thyroid lymphoma and metastatic tumors of the thyroid however, is not well established yet. The aim of this review is to provide an overview on the recent applications and indications of 18F-FDG PET/CT in these tumors and to focus on the controversies in the clinical setting.
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Affiliation(s)
- Mine Araz
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Clinic of Nuclear Medicine, Ankara, Turkey Phone: +90 532 666 73 13 E-mail:
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