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Mihailović J, Roganović J, Starčević I, Nikolić I, Prvulović Bunović N, Nikin Z. Diagnostic Performance of F-18 FDG PET/CT in the Detection of Recurrent Colorectal Cancer: Correlation with Biochemical Markers and Conventional Imaging Modalities. J Clin Med 2024; 13:3602. [PMID: 38930131 PMCID: PMC11204678 DOI: 10.3390/jcm13123602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/05/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
Background/Objectives: Although the role of PET/CT imaging is well established in oncology, its diagnostic value in routine monitoring for recurrent colorectal cancer (CRC) is still controversial. The aim was to evaluate the diagnostic value of F-18 FDG PET/CT in detecting recurrent CRC in correlation with CEA, CA 19-9 levels, and conventional imaging modalities (CIM). Methods: Between 2009 and 2023, a retrospective study was performed including 134 CRC patients referred for PET/CT imaging on the suspicion of recurrence, based on elevated CEA and/or CA 19-9 and/or equivocal CIM findings. According to our institution's Tumor Board CRC protocol, after the initial treatment, which was dependent on the TNM stage (neoadjuvant therapy, primary resection, or adjuvant treatment), patients underwent a standard 5-year surveillance including CEA and CA 19-9 measurements, CIM, and colonoscopy, every six months. The statistics, including univariate and multivariate analyses were conducted using the IBM SPSS 20.0 statistical software. p-values < 0.05 were considered statistically significant. Results: Recurrent CRC was confirmed in 54/134 (40.3%) patients with elevated tumor markers. PET/CT showed high diagnostic performance in detecting recurrent CRC with sensitivity, specificity, PPV, NPV, and accuracy of 94.4%, 82.5%, 78.5%, 95.7%, and 87.3%, respectively. The CEA showed a high sensitivity of 98.1% but both low specificity and accuracy of 15% and 48.5%, respectively. The sensitivity, specificity, and accuracy for CA 19-9 and CIM for diagnosis of CRC recurrence were 44.4%, 67.5%, 58.2%, and 51.9%, 98.8%, 79.9%, respectively. The AUC for PET/CT, elevated CEA levels, CIM, and elevated CA 19-9 levels was 0.885 (95% CI: 0.824-0.946; p < 0.001), 0.844 (95% CI: 0.772-0.916; p < 0.001), 0.753 (95% CI: 0.612-0.844; p < 0.001), and 0.547 (95% CI: 0.442-0.652; p = 0.358), respectively. Univariate analysis showed that both PET/CT and CIM positive results were highly associated with CRC recurrence (p < 0.001 and p < 0.001, respectively). At the same time, gender, mucinous tumor type, presence of initial lymph node metastasis (N+), and presence of initial distant metastasis (M+) had no significance (p = 0.211, p = 0.158, p = 0.583, and p = 0.201, respectively). Our multivariate analysis showed that independent predictors for CRC recurrence are positive PET/CT scans (p < 0.001), positive CIM results (p = 0.001), and elevated CA 19-9 levels (p = 0.023). Although CA 19-9 was not detected as a statistically significant predictor in the univariate analysis (p = 0.358), in a multivariate analysis it was recognized as a significant predicting factor in detecting the CRC recurrence (p = 0.023). Conclusions: F-18 FDG PET/CT showed high diagnostic efficacy in CRC recurrence detection, in correlation with CEA levels, CA 19-9 levels, and CIM. This imaging modality should be routinely integrated into the post-operative follow-op in patients with elevated tumor markers.
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Affiliation(s)
- Jasna Mihailović
- Department of Nuclear Medicine, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia;
- Division of Nuclear Medicine, Oncology Institute of Vojvodina, Put dr Goldmana 4, 21204 Sremska Kamenica, Serbia; (J.R.); (I.S.)
| | - Jelena Roganović
- Division of Nuclear Medicine, Oncology Institute of Vojvodina, Put dr Goldmana 4, 21204 Sremska Kamenica, Serbia; (J.R.); (I.S.)
| | - Ivana Starčević
- Division of Nuclear Medicine, Oncology Institute of Vojvodina, Put dr Goldmana 4, 21204 Sremska Kamenica, Serbia; (J.R.); (I.S.)
| | - Ivan Nikolić
- Department of Internal Medicine, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia;
- Clinic for Medical Oncology, Oncology Institute of Vojvodina, Put dr Goldmana 4, 21204 Sremska Kamenica, Serbia
| | - Nataša Prvulović Bunović
- Department of Nuclear Medicine, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia;
- Centre for Diagnostic Imaging, Oncology Institute of Vojvodina, Put dr Goldmana 4, 21204 Sremska Kamenica, Serbia
| | - Zoran Nikin
- Department for Pathoanatomical Diagnostics, Oncology Institute of Vojvodina, Put dr Goldmana 4, 21204 Sremska Kamenica, Serbia;
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Meng J, Zhao H, Liu Y, Chen D, Hacker M, Wei Y, Li X, Zhang X, Kreissl MC. Assessment of cardiac tumors by 18F-FDG PET/CT imaging: Histological correlation and clinical outcomes. J Nucl Cardiol 2021; 28:2233-2243. [PMID: 31933156 DOI: 10.1007/s12350-019-02022-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 12/15/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND To evaluate the diagnostic value of 18F-FDG PET/CT in distinguishing benign versus malignant cardiac tumors as well as to assess its prognostic value. METHODS We analyzed 38 patients with cardiac tumors who underwent 18F-FDG PET/CT and followed for median 8.5 ± 12.5 months. SUVmax and TBRmax (maximum tumor-to-background ratio) by receiver-operating characteristic (ROC) curve analysis were used to obtain threshold for the diagnosis of malignancy as defined by histology (n = 38). Survival was assessed and correlated with the dignity of the lesions and PET parameters. RESULTS Optimal cut-off values indicating malignancy were as follows: SUVmax = 3.44, with 100% sensitivity and 92.9% specificity, and TBRmax = 1.55, with 95.8% sensitivity and 92.9% specificity. A significant difference of 18F-FDG uptake was observed between primary benign (n = 14, SUVmax = 2.35 ± 1.31, TBRmax = 1.05 ± 0.50) compared to primary malignant cardiac tumors (n = 11, SUVmax = 8.90 ± 4.23, TBRmax = 3.82 ± 1.44) as well as cardiac metastases and lymphoma (n = 13, SUVmax = 14.37 ± 8.05, TBRmax = 6.19 ± 3.38) (all P < .001). Survival rate was significantly lower in patients with malignant as compared to benign cardiac tumors (P < .05). Regression analysis revealed that the lesion dignity determined by the cut-off value of SUVmax was an independent predictor for death in patients with cardiac tumors (P < .05). CONCLUSION 18F-FDG uptake in cardiac tumors can differentiate between benign and malignant cardiac tumors and predicts survival.
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Affiliation(s)
- Jingjing Meng
- Department of Nuclear Medicine, Laboratory for Molecular Imaging, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, 100029, China
| | - Honglei Zhao
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yongmin Liu
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Dong Chen
- Department of Pathology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Währinger Gürthel 18-20, Floor 3L, 1090, Vienna, Austria
| | - Yongxiang Wei
- Department of Nuclear Medicine, Laboratory for Molecular Imaging, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, 100029, China
| | - Xiang Li
- Department of Nuclear Medicine, Laboratory for Molecular Imaging, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, 100029, China
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Währinger Gürthel 18-20, Floor 3L, 1090, Vienna, Austria
| | - Xiaoli Zhang
- Department of Nuclear Medicine, Laboratory for Molecular Imaging, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, 100029, China.
| | - Michael C Kreissl
- Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
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Luis de Redín I, Expósito F, Agüeros M, Collantes M, Peñuelas I, Allemandi D, Llabot JM, Calvo A, Irache JM. In vivo efficacy of bevacizumab-loaded albumin nanoparticles in the treatment of colorectal cancer. Drug Deliv Transl Res 2021; 10:635-645. [PMID: 32040774 DOI: 10.1007/s13346-020-00722-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Bevacizumab (as other monoclonal antibodies) has now become a mainstay in the treatment of several cancers in spite of some limitations, including poor tumour penetration and the development of resistance mechanisms. Its nanoencapsulation may be an adequate strategy to minimize these problems. The aim of this work was to evaluate the efficacy of bevacizumab-loaded nanoparticles (B-NP-PEG) on a xenograft model of human colorectal cancer. For this purpose, human serum albumin nanoparticles were prepared by coacervation, then coated with poly(ethylene glycol) and freeze-dried. B-NP-PEG displayed a mean size of about 300 nm and a bevacizumab loading of approximately 145 μg/mg. An in vivo study was conducted in the HT-29 xenograft model of colorectal cancer. Both, free and nanoencapsulated bevacizumab, induced a similar reduction in the tumour growth rate of about 50%, when compared to controls. By microPET imaging analysis, B-NP-PEG was found to be a more effective treatment in decreasing the glycolysis and metabolic tumour volume than free bevacizumab, suggesting higher efficacy. These results correlated well with the capability of B-NP-PEG to increase about fourfold the levels of intratumour bevacizumab, compared with the conventional formulation. In parallel, B-NP-PEG displayed six-times lower amounts of bevacizumab in blood than the aqueous formulation of the antibody, suggesting a lower incidence of potential undesirable side effects. In summary, albumin-based nanoparticles may be adequate carriers to promote the delivery of monoclonal antibodies (i.e. bevacizumab) to tumour tissues. Graphical abstract.
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Affiliation(s)
- Inés Luis de Redín
- Department of Chemistry and Pharmaceutical Technology, NANO-VAC Research Group, University of Navarra, Pamplona, Spain
| | - Francisco Expósito
- Department of Pathology, Anatomy and Physiology, School of Medicine, IDISNA and Program in Solid Tumors and Biomarkers, Center for Applied Medical Research (CIMA), CIBERONC, ISC-III, University of Navarra, Pamplona, Spain
| | - Maite Agüeros
- Department of Chemistry and Pharmaceutical Technology, NANO-VAC Research Group, University of Navarra, Pamplona, Spain
| | - María Collantes
- Radiopharmacy, Radionanopharmacology and Translational Molecular Imaging Research Group, Clínica Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Iván Peñuelas
- Radiopharmacy, Radionanopharmacology and Translational Molecular Imaging Research Group, Clínica Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Daniel Allemandi
- UNITEFA-CONICET, Department of Pharmacy, Faculty of Chemical Sciences (FCQ-UNC), National University of Córdoba, Córdoba, Argentina
| | - Juan M Llabot
- UNITEFA-CONICET, Department of Pharmacy, Faculty of Chemical Sciences (FCQ-UNC), National University of Córdoba, Córdoba, Argentina
| | - Alfonso Calvo
- Department of Pathology, Anatomy and Physiology, School of Medicine, IDISNA and Program in Solid Tumors and Biomarkers, Center for Applied Medical Research (CIMA), CIBERONC, ISC-III, University of Navarra, Pamplona, Spain
| | - Juan M Irache
- Department of Chemistry and Pharmaceutical Technology, NANO-VAC Research Group, University of Navarra, Pamplona, Spain.
- Department of Pharmacy and Pharmaceutical Technology, University of Navarra, C/ Irunlarrea, 1, 31008, Pamplona, Spain.
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Lee ST, Muralidharan V, Tebbutt N, Wong P, Fang C, Liu Z, Gan H, Sachinidis J, Pathmaraj K, Christophi C, Scott AM. Prevalence of hypoxia and correlation with glycolytic metabolism and angiogenic biomarkers in metastatic colorectal carcinoma. Eur J Nucl Med Mol Imaging 2021; 48:1585-1592. [PMID: 33125527 DOI: 10.1007/s00259-020-05074-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 10/12/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Hypoxia is associated with aggressive tumour behaviour and can influence response to systemic therapy and radiotherapy. The prevalence of hypoxia in metastatic colorectal cancer is poorly understood, and the relationship of hypoxia to patient outcomes has not been clearly established. The aims of the study were to evaluate hypoxia in metastatic colorectal cancer with [18F]Fluoromisonidazole ([18F]FMISO PET) and correlate these findings with glycolytic metabolism ([18F]FDG PET) and angiogenic blood biomarkers and patient outcomes. METHODS Patients with metastatic colorectal cancer received routine staging investigations and both [18F] FMISO PET and [18F] FDG PET scans. Correlative blood specimens were also obtained at the time of the [18F] FMISO PET scan. Patient follow-up was performed to establish progression-free survival. RESULTS A total of 40 patients were recruited into the trial. [18F]FMISO and [18F]FDG PET scans showed a significant correlation of SUVmax (p = 0.003). A significant correlation of progression-free survival and [18F] FMISO TNR (p = 0.02) and overall survival with [18F]FMISO TNR (p = 0.003) and [18F]FDG TGV (p = 0.02) was observed. Serum levels of osteopontin, but not VEGF, correlated with [18F] FMISO and [18F]FDG PET scan parameters. CONCLUSION [18F]FMISO PET uptake in metastatic colorectal cancer significantly correlates with glycolytic metabolism and is predictive of progression-free and overall survival. These findings have implications for the assessment and treatment of metastatic colorectal cancer patients with novel therapies which affect tumour angiogenesis and hypoxia.
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Affiliation(s)
- S T Lee
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia.
- Tumour Targeting Laboratory, Olivia Newton-John Cancer Research Institute, Austin Health, Melbourne, Australia.
- School of Cancer Medicine, La Trobe University, Melbourne, Australia.
- Department of Medicine, The University of Melbourne, Austin Health, Melbourne, Australia.
| | - V Muralidharan
- Department of Surgery, Austin Health, Melbourne, Australia
- Department of Surgery, The University of Melbourne, Austin Health, Melbourne, Australia
| | - N Tebbutt
- Department of Surgery, The University of Melbourne, Austin Health, Melbourne, Australia
- Department of Medical Oncology, Austin Health, Melbourne, Australia
| | - P Wong
- Department of Surgery, Austin Health, Melbourne, Australia
| | - C Fang
- Tumour Targeting Laboratory, Olivia Newton-John Cancer Research Institute, Austin Health, Melbourne, Australia
| | - Z Liu
- Tumour Targeting Laboratory, Olivia Newton-John Cancer Research Institute, Austin Health, Melbourne, Australia
| | - H Gan
- Tumour Targeting Laboratory, Olivia Newton-John Cancer Research Institute, Austin Health, Melbourne, Australia
- School of Cancer Medicine, La Trobe University, Melbourne, Australia
- Department of Medical Oncology, Austin Health, Melbourne, Australia
| | - J Sachinidis
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia
| | - K Pathmaraj
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia
| | - C Christophi
- Department of Surgery, Austin Health, Melbourne, Australia
- Department of Surgery, The University of Melbourne, Austin Health, Melbourne, Australia
| | - A M Scott
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia
- Tumour Targeting Laboratory, Olivia Newton-John Cancer Research Institute, Austin Health, Melbourne, Australia
- School of Cancer Medicine, La Trobe University, Melbourne, Australia
- Department of Medicine, The University of Melbourne, Austin Health, Melbourne, Australia
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5
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Ragheb SR, Sharara SM. Can PET/CT detect recurrence in post-operative colorectal carcinoma patients with elevated CEA level? THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2020. [DOI: 10.1186/s43055-020-00170-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
PET is considered to be the most sensitive and specific modality for the detection of recurrent colorectal cancer. This study is to assess the role of F18-FDG PET/CT in post-operative assessment in a patient with colorectal cancer with elevated CEA level to rule out local recurrence and/or metastasis and hence guiding the clinician to the proper management strategy.
Results
This study was performed on 45 patients who underwent surgical resection of the colon and/or rectal cancer; they were referred for PET/CT assessment at least 3 months after surgical resection. F18-FDG PET/CT sensitivity and specificity in detecting the recurrence and/or metastasis were 96.9 % and 83.3%, respectively. The positive predictive value was 94.2% while the negative predictive value was 90%.
Conclusion
For post-operative detection of loco-regional recurrence and metastasis in patients with colorectal cancer and elevated CEA level, 18F-FDG PET/CT can be considered as an efficient diagnostic imaging tool due to its high sensitivity and specificity which extensively affect further management.
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6
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Abstract
International colon cancer guidelines suggest F-FDG PET/CT in a few circumstances: (1) at disease presentation in case of suspected or proven metastatic synchronous adenocarcinoma; (2) in the workup of recurrent colon cancer with metachronous metastases documented by CT, MRI, or biopsy and in case of serial CEA elevation with negative colonoscopy and negative CT; and (3) in case of contraindication to iodine- and gadolinium-based contrast agents. However, review of the literature has shown that PET/CT can also be used in other scenarios with significant levels of diagnostic advantage. This review aims to emphasize differences between guidelines and scientific literature for the use of PET/CT in colon cancer.
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7
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The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Rectal Cancer. Dis Colon Rectum 2020; 63:1191-1222. [PMID: 33216491 DOI: 10.1097/dcr.0000000000001762] [Citation(s) in RCA: 152] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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8
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Abstract
Neuroblastoma is one of the most common pediatric malignant tumors. Functional imaging plays an important role in the diagnosis, staging, and therapy response monitoring of neuroblastoma. Although metaiodobenzylguanidine scan with single-photon emission computed tomography/computed tomography remains the mainstay in functional imaging of the neuroblastomas, PET/CT has begun to show increased utility in this clinical setting.
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PET in Gastrointestinal, Pancreatic, and Liver Cancers. Clin Nucl Med 2020. [DOI: 10.1007/978-3-030-39457-8_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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10
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Rocha KBF, Oliveira CN, Azevedo ÍM, Macedo RD, Medeiros AC. Effect of Arrabidaea chica extract against chemically induced breast cancer in animal model. Acta Cir Bras 2019; 34:e201901001. [PMID: 31826147 PMCID: PMC6907885 DOI: 10.1590/s0102-865020190100000001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 09/17/2019] [Indexed: 12/17/2022] Open
Abstract
Purpose: To examine the effects of Arrabidaa chica
(Bignoniacea) extract, a native plant of the Amazon
known as crajiru, on a 7,12-dimethyl-1,2-benzanthracene (DMBA)-induced
breast cancer model in Wistar rats. Methods: We compared the response of breast cancer to the oral administration of
A. chica extract (ACE) for 16 weeks, associated or not
with vincristine. Groups: normal control; DMBA (50mg/kg v.o,) without
treatment; DMBA+ACE (300 mg/kg); DMBA+vincristine. 500μg/kg injected i.p;
DMBA+ACE+Vincristine 250μg/kg i.p. Imaging by microPET and fluorescence,
biochemistry, oxidative stress, hematology and histopathology were used to
validate the treatments. Results: All animals survived. A gradual weight gain in all groups was observed, with
no significant difference (p>0.05). The oral administration of ACE and
ACE+vincristine 50% significantly reduced breast tumors incidence examined
with PET-18FDG and fluorescence (p<0.001). Significant reduction of serum
transaminases, oxidative stress and hematological toxicity were observed in
these groups. Antioxidant enzyme levels in breast tissue were significantly
higher compared to the DMBA and DMBA+vincristine groups. Conclusion: These results demonstrate for the first time that ACE positively influences
the treatment of DMBA-induced breast cancer in animal model, inducing a
reduction in oxidative stress and chemotherapy toxicity, meaning that ACE
may have clinical implication in further studies.
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Affiliation(s)
- Keyla Borges Ferreira Rocha
- Fellow PhD degree, Postgraduate Program in Health Sciences, Universidade Federal do Rio Grande do Norte (UFRN), Natal-RN, Brazil. Technical procedures, acquisition of data, statistics analysis, critical revision
| | - Cláudia Nunes Oliveira
- Fellow PhD degree, Postgraduate Program in Health Sciences, Universidade Federal do Rio Grande do Norte (UFRN), Natal-RN, Brazil. Technical procedures, acquisition of data, statistics analysis, critical revision
| | - Ítalo Medeiros Azevedo
- Fellow PhD degree, Postgraduate Program in Health Sciences, Universidade Federal do Rio Grande do Norte (UFRN), Natal-RN, Brazil. Technical procedures, acquisition of data, statistics analysis, critical revision
| | - Robson de Macedo
- Fellow PhD degree, Postgraduate Program in Health Sciences, Universidade Federal do Rio Grande do Norte (UFRN), Natal-RN, Brazil. Technical procedures, acquisition of data, statistics analysis, critical revision
| | - Aldo Cunha Medeiros
- PhD, Full Professor, Nucleus of Experimental Surgery, UFRN, Natal-RN, Brazil. Conception, design, intellectual and scientific content of the study, critical revision, final approval
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11
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Yang X, Lovell JF, Zhang Y. Ingestible Contrast Agents for Gastrointestinal Imaging. Chembiochem 2019; 20:462-473. [PMID: 30421487 DOI: 10.1002/cbic.201800589] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Indexed: 12/17/2022]
Abstract
Gastrointestinal (GI) ailments cover a wide variety of diseases involving the esophagus, stomach, small intestine, large intestine, and rectum. They bring about many inconveniences in daily life in chronic diseases and can even be life threatening in acute cases. Rapid and safe detection approaches are essential for early diagnosis and timely management. Contrast agents for GI imaging can enhance contrast to distinguish abnormal lesions from normal structures. Computed tomography and magnetic resonance imaging are two important diagnostic tools for the evaluation of GI conditions. This review mainly involves several common GI diseases, including inflammatory diseases, intestinal tumors, diarrhea, constipation, and gastroesophageal reflux diseases. Selected contrast agents, such as barium sulfate, iodine-based agents, gadolinium-based agents, and others, are summarized. Going forward, continued endeavors are being made to develop more emerging contrast agents for other imaging modalities.
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Affiliation(s)
- Xingyue Yang
- School of Chemical Engineering and Technology, Tianjin University, Tianjin, 301636, China
| | - Jonathan F Lovell
- Department of Biomedical Engineering, State University of New York at Buffalo, Buffalo, NY, 14260, USA
| | - Yumiao Zhang
- School of Chemical Engineering and Technology, Tianjin University, Tianjin, 301636, China
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12
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The significant value of predicting prognosis in patients with colorectal cancer using 18F-FDG PET metabolic parameters of primary tumors and hematological parameters. Ann Nucl Med 2018; 33:32-38. [PMID: 30218280 DOI: 10.1007/s12149-018-1299-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 09/09/2018] [Indexed: 02/08/2023]
Abstract
OBJECTS The purpose was to evaluate the correlation of the pre-treatment hematological parameters with metabolic parameters of primary tumor in baseline 18F-FDG PET/CT in patients with colorectal cancer (CRC) and estimate the prognostic value of both. METHODS We retrospectively investigated 231 patients with CRC who underwent baseline 18F-FDG PET/CT. Routine blood sampling was tested in the same term. PET parameters in term of hematological parameters and pathological characteristics of primary tumor were compared. Kaplan-Meier survival analysis was performed in the patients without distant metastasis. The differences of disease-free survival between groups were compared by log-rank tests. RESULTS Neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) were significantly correlated with all the metabolic parameters including maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and tumor lesion glycolysis (TLG). The patients with NLR > 3 had higher MTV (24.82 ± 18.16 vs 19.06 ± 13.30, P = 0.039) and TLG (219.04 ± 186.94 vs 166.45 ± 146.39, P = 0.047) than those whose NLR ≤ 3. NLR in those patients with distant metastasis was significantly higher than those without distant metastasis (P = 0.018) while LMR in those patients with distant metastasis was significantly lower than those without distant metastasis (P = 0.032). Survival analysis showed that those patients with low MTV (P = 0.015), low NLR (P = 0.008) and high LMR (P = 0.027) revealed significant survival benefit. CONCLUSIONS There was a significant association between the pre-treatment hematological parameters and metabolic parameters of baseline 18F-FDG PET/CT in the patients with CRC. It might be helpful in those patients with high NLR and low LMR to undergo 18F-FDG PET/CT to detect distant metastasis and predict prognosis.
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13
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Woff E, Hendlisz A, Ameye L, Garcia C, Kamoun T, Guiot T, Paesmans M, Flamen P. Validation of Metabolically Active Tumor Volume and Total Lesion Glycolysis as 18F-FDG PET/CT–derived Prognostic Biomarkers in Chemorefractory Metastatic Colorectal Cancer. J Nucl Med 2018; 60:178-184. [DOI: 10.2967/jnumed.118.210161] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 06/11/2018] [Indexed: 12/15/2022] Open
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García-Figueiras R, Baleato-González S, Padhani AR, Luna-Alcalá A, Marhuenda A, Vilanova JC, Osorio-Vázquez I, Martínez-de-Alegría A, Gómez-Caamaño A. Advanced Imaging Techniques in Evaluation of Colorectal Cancer. Radiographics 2018; 38:740-765. [PMID: 29676964 DOI: 10.1148/rg.2018170044] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Imaging techniques are clinical decision-making tools in the evaluation of patients with colorectal cancer (CRC). The aim of this article is to discuss the potential of recent advances in imaging for diagnosis, prognosis, therapy planning, and assessment of response to treatment of CRC. Recent developments and new clinical applications of conventional imaging techniques such as virtual colonoscopy, dual-energy spectral computed tomography, elastography, advanced computing techniques (including volumetric rendering techniques and machine learning), magnetic resonance (MR) imaging-based magnetization transfer, and new liver imaging techniques, which may offer additional clinical information in patients with CRC, are summarized. In addition, the clinical value of functional and molecular imaging techniques such as diffusion-weighted MR imaging, dynamic contrast material-enhanced imaging, blood oxygen level-dependent imaging, lymphography with contrast agents, positron emission tomography with different radiotracers, and MR spectroscopy is reviewed, and the advantages and disadvantages of these modalities are evaluated. Finally, the future role of imaging-based analysis of tumor heterogeneity and multiparametric imaging, the development of radiomics and radiogenomics, and future challenges for imaging of patients with CRC are discussed. Online supplemental material is available for this article. ©RSNA, 2018.
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Affiliation(s)
- Roberto García-Figueiras
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Sandra Baleato-González
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Anwar R Padhani
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Antonio Luna-Alcalá
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Ana Marhuenda
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Joan C Vilanova
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Iria Osorio-Vázquez
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Anxo Martínez-de-Alegría
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
| | - Antonio Gómez-Caamaño
- From the Departments of Radiology (R.G.F., S.B.G., I.O.V., A.M.d.A.) and Radiation Oncology (A.G.C.), Hospital Clínico Universitario de Santiago de Compostela, Choupana s/n, 15706 Santiago de Compostela, Spain; Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, Middlesex, England (A.R.P.); Health Time, Jaén, Spain (A.L.A.); Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio (A.L.A.); Department of Radiology, IVO (Instituto Valenciano de Oncología), Valencia, Spain (A.M.); and Department of Radiology, Clínica Girona and IDI, Girona, Spain (J.C.V.)
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15
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Ince S, Okuyucu K, Hancerliogulları O, Alagoz E, San H, Arslan N. Clinical Significance of Fluorine-18-fluorodeoxyglucose Positron Emission Tomography/computed Tomography in the Follow-up of Colorectal Cancer: Searching off Approaches Increasing Specificity for Detection of Recurrence. Radiol Oncol 2017; 51:378-385. [PMID: 29333115 PMCID: PMC5765313 DOI: 10.1515/raon-2017-0045] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 09/10/2017] [Indexed: 12/12/2022] Open
Abstract
Background Nearly 40% of colorectal cancer (CRC) recurs within 2 years after resection of primary tumor. Imaging with fluorine-18-fluorodeoxyglucose (l8F-FDG) positron emission tomography/computed tomography (PET/CT) is the most recent modality and often applied for the evaluation of metastatic spread during the follow-up period. Our goal was to study the diagnostic importance of 18F-FDG-PET/CT data of maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG) and the difference of SUVmax on dual-time imaging in CRC. Patients and methods We examined the SUVmax value of lesions on control or restaging 18F-FDG-PET/CT of 53 CRC patients. All lesions with increased SUVmax values were confirmed by colonoscopy or histopathology. We compared PET/CT results with conventional imaging modalities (CT, MRI) and tumor markers (carbohydrate antigen 19-9 [Ca 19-9], carcinoembryonic antigen [CEA]). Results Mean SUVmax was 6.9 ± 5.6 in benign group, 12.7 ± 6.1 in malignant group. Mean TLG values of malignant group and benign group were 401 and 148, respectively. 18F-FDG-PET/CT was truely positive in 48% of patients with normal Ca 19-9 or CEA levels and truely negative in 10% of cases with elevated Ca 19-9 or CEA. CT or MRI detected suspicious malignancy in 32% of the patients and 18F-FDG-PET/CT was truely negative in 35% of these cases. We found the most important and striking statistical difference of TLG value between the groups with benign and recurrent disease. Conclusions Although SUVmax is a strong metabolic parameter (p = 0.008), TLG seems to be the best predictor in recurrence of CRC (p = 0.001); both are increasing the specificity of 18F-FDG-PET/CT.
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Affiliation(s)
- Semra Ince
- Department of Nuclear Medicine, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Kursat Okuyucu
- Department of Nuclear Medicine, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Oguz Hancerliogulları
- Department of General Surgery, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Engin Alagoz
- Department of Nuclear Medicine, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Huseyin San
- Department of Nuclear Medicine, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Nuri Arslan
- Department of Nuclear Medicine, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey
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16
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Clinicopathological analysis and risk factors of advanced colorectal neoplasms incidentally detected by 18F-FDG PET-CT. Eur J Gastroenterol Hepatol 2017; 29:407-413. [PMID: 27926665 DOI: 10.1097/meg.0000000000000808] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND As the clinical use of fluorine-18-fluorodeoxyglucose PET-computed tomography (F-FDG PET-CT) has increased, the incidental finding of F-FDG uptake with subsequent diagnosis of advanced neoplasm at colorectum has increased. The aim of this study is to analyze the characteristics and risk factors of advanced colorectal neoplasm incidentally detected by F-FDG PET-CT. PATIENTS AND METHODS Patients who underwent colonoscopy because of an incidental finding of F-FDG uptake at the colorectum from January 2006 to January 2015 at Yeungnam University Hospital were reviewed retrospectively. Advanced neoplasm was defined as adenoma of at least 10 mm, adenoma with serrated or villous component, high-grade dysplasia, and adenocarcinoma. RESULTS Of the 19 798 candidates, 180 patients with incidental colorectal F-FDG uptake were included in this study. The indications of PET-CT were metastasis work-up, health screening, and others. The male to female ratio was 1.6 : 1 and the mean age was 62.7±11.4 years. A total of 156 lesions were detected in the colorectum and 86 (47.8%) were diagnosed as advanced neoplasms. Of the 86 patients with advanced neoplasms, 34 (39.5%) underwent an operation, 34 (39.5%) underwent endoscopic resection, and 18 (20.9%) underwent chemotherapy or conservative treatments. In univariate analysis, age of 62.5 years or older, carcinoembryonic antigen (CEA) of at least 3.4 ng/ml, maximum standardized uptake value (SUVmax) of at least 8.0, hypertension, F-FDG uptake on the rectosigmoid, and PET-CT for metastasis work-up showed a significant association with advanced neoplasm. In multivariate analysis, CEA (P=0.028), SUVmax (P<0.001) and an indication of PET-CT for metastasis work-up (P=0.008) were independent predictors of advanced neoplasm. CONCLUSION Colonoscopy should be recommended in case of F-FDG uptake at the colorectum, particularly in patients with CEA of at least 3.4 ng/ml, SUVmax of at least 8.0, or metastasis work-up of malignancy.
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17
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A rare case of rectal carcinoma and prostate carcinoma with coexistent Paget’s disease mimicking bone metastases in both 18F-FDG and 68Ga PSMA PET/CT. Eur J Nucl Med Mol Imaging 2016; 44:173. [DOI: 10.1007/s00259-016-3529-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 09/16/2016] [Indexed: 12/20/2022]
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18
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Lu CZ, Cao SS, Wang W, Liu J, Fu N, Lu F. Usefulness of PET/CT in the diagnosis of recurrent or metastasized differentiated thyroid carcinoma. Oncol Lett 2016; 11:2420-2423. [PMID: 27073490 PMCID: PMC4812582 DOI: 10.3892/ol.2016.4229] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 02/15/2016] [Indexed: 02/07/2023] Open
Abstract
The aim of the present study was to determine the usefulness of the positron emission tomography/computed tomography (PET/CT) with 18F-fluorodeoxyglucose (FDG) in the detection of recurrence or metastasization of differentiated thyroid carcinoma (DTC) in patients with abnormal thyroglobulin levels and negative findings on the 131I-diagnostic whole-body scanning (dWBS). Fifteen patients with DTC, abnormal thyroglobulin levels, and negative 131I-dWBS findings were scanned using the 18F-FDG PET/CT. Positive diagnosis was based on postoperative histologic findings, and clinical and imaging follow-up results obtained in the subsequent 6 months. In addition, preoperative and postoperative thyroglobulin levels were compared. Using the findings of 18F-FDG PET/CT and data on confirmed positive diagnosis, sensitivity and positive predictive value (PPV) were calculated. Sensitivity and PPV of PET/CT in detecting recurrence or metastasisization of DTC were 93.30 and 91.40%, respectively. Furthermore, postoperative thyroglobulin levels were markedly lower compared to the preoperative levels (respectively, 4.67±1.71 vs. 58.53±18.34 ng/ml; p<0.05). PET/CT scan with 18F-FDG is an informative technique for the detection of recurrent or metastasized DTC in patients with abnormal thyroglobulin levels and negative 131I-dWBS findings.
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Affiliation(s)
- Cun-Zhi Lu
- Department of Nuclear Medicine, Xuzhou Central Hospital, Xuzhou, Jiangsu 221009, P.R. China
| | - Su-Sheng Cao
- Department of Thyroid Surgery, Xuzhou Central Hospital, Xuzhou, Jiangsu 221009, P.R. China
| | - Wei Wang
- Department of Thyroid Surgery, Xuzhou Central Hospital, Xuzhou, Jiangsu 221009, P.R. China
| | - Jun Liu
- Department of Thyroid Surgery, Xuzhou Central Hospital, Xuzhou, Jiangsu 221009, P.R. China
| | - Ning Fu
- Department of Nuclear Medicine, Xuzhou Central Hospital, Xuzhou, Jiangsu 221009, P.R. China
| | - Feng Lu
- Department of Nuclear Medicine, Xuzhou Central Hospital, Xuzhou, Jiangsu 221009, P.R. China
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