1
|
Fatima J, Fatima E, Mehmood F, Ishtiaq I, Khan MA, Khurshid HMS, Kashif M. Comprehensive Analysis of Oral Squamous Cell Carcinomas: Clinical, Epidemiological, and Histopathological Insights With a Focus on Prognostic Factors and Survival Time. Cureus 2024; 16:e54394. [PMID: 38505442 PMCID: PMC10949903 DOI: 10.7759/cureus.54394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Oral squamous cell carcinoma (OSCC) is one of the most common malignancies in the head and neck region. Particularly, high incidence rates are observed in South and Southeast Asia, attributed to the widespread use of the carcinogenic areca nut. This study aimed to investigate the clinical, epidemiological, and histopathological features of OSCC, identify prognostic factors impacting disease-free survival, and determine a post-diagnosis disease-free survival time of OSCC patients. METHODOLOGY Employing a descriptive cross-sectional design, the study conducted a thorough examination of the clinical, epidemiological, and histopathological aspects of OSCC among patients seeking care at a tertiary healthcare facility. Participants were personally interviewed if available, while information for unreachable or deceased individuals was extracted from archival patient records in the Oral and Maxillofacial Surgery Department, Bakhtawar Amin Medical and Dental College, Multan, Pakistan. Data analysis was performed with a significance level set at p ≤ 0.05. RESULTS The mean age of the patients was 54.16 ± 11.1, with a notable concentration in the 41 years and above age group, indicating a significant prevalence of OSCC in this population. The data revealed a gender bias toward males, and a substantial proportion of patients, particularly those aged 41 years and above, had unfortunately passed away. Statistical analysis using the Fisher exact test showed a significant association between age groups and patients' current living status (p-value < 0.05). CONCLUSION Histopathologically, moderately differentiated OSCC was the most frequently encountered grade, and surgery emerged as the predominant treatment modality. The majority of patients studied had a survival period of three years or less, emphasizing the need for further exploration of factors influencing prognosis and treatment outcomes in OSCC.
Collapse
Affiliation(s)
- Jia Fatima
- Oral and Maxillofacial Surgery, Bakhtawar Amin Medical and Dental College, Multan, PAK
| | - Ehda Fatima
- Oral and Maxillofacial Surgery, Bakhtawar Amin Medical and Dental College, Multan, PAK
| | - Fatima Mehmood
- Oral and Maxillofacial Surgery, Bakhtawar Amin Medical and Dental College, Multan, PAK
| | - Iman Ishtiaq
- Oral and Maxillofacial Surgery, Bakhtawar Amin Medical and Dental College, Multan, PAK
| | - Muhammad Athar Khan
- Oral and Maxillofacial Surgery, Bakhtawar Amin Medical and Dental College, Multan, PAK
| | | | - Muhammad Kashif
- Oral Pathology, Bakhtawar Amin Medical and Dental College, Multan, PAK
| |
Collapse
|
2
|
Shah D, Gehani A, Mahajan A, Chakrabarty N. Advanced Techniques in Head and Neck Cancer Imaging: Guide to Precision Cancer Management. Crit Rev Oncog 2023; 28:45-62. [PMID: 37830215 DOI: 10.1615/critrevoncog.2023047799] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
Precision treatment requires precision imaging. With the advent of various advanced techniques in head and neck cancer treatment, imaging has become an integral part of the multidisciplinary approach to head and neck cancer care from diagnosis to staging and also plays a vital role in response evaluation in various tumors. Conventional anatomic imaging (CT scan, MRI, ultrasound) remains basic and focuses on defining the anatomical extent of the disease and its spread. Accurate assessment of the biological behavior of tumors, including tumor cellularity, growth, and response evaluation, is evolving with recent advances in molecular, functional, and hybrid/multiplex imaging. Integration of these various advanced diagnostic imaging and nonimaging methods aids understanding of cancer pathophysiology and provides a more comprehensive evaluation in this era of precision treatment. Here we discuss the current status of various advanced imaging techniques and their applications in head and neck cancer imaging.
Collapse
Affiliation(s)
- Diva Shah
- Senior Consultant Radiologist, Department of Radiodiagnosis, HCG Cancer Centre, Ahmedabad, 380060, Gujarat, India
| | - Anisha Gehani
- Department of Radiology and Imaging Sciences, Tata Medical Centre, New Town, WB 700160, India
| | - Abhishek Mahajan
- Department of Radiology, The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, L7 8YA, United Kingdom
| | - Nivedita Chakrabarty
- Department of Radiodiagnosis, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), 400012, Mumbai, India
| |
Collapse
|
3
|
Magnetic Fields and Cancer: Epidemiology, Cellular Biology, and Theranostics. Int J Mol Sci 2022; 23:ijms23031339. [PMID: 35163262 PMCID: PMC8835851 DOI: 10.3390/ijms23031339] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/22/2022] [Accepted: 01/22/2022] [Indexed: 02/08/2023] Open
Abstract
Humans are exposed to a complex mix of man-made electric and magnetic fields (MFs) at many different frequencies, at home and at work. Epidemiological studies indicate that there is a positive relationship between residential/domestic and occupational exposure to extremely low frequency electromagnetic fields and some types of cancer, although some other studies indicate no relationship. In this review, after an introduction on the MF definition and a description of natural/anthropogenic sources, the epidemiology of residential/domestic and occupational exposure to MFs and cancer is reviewed, with reference to leukemia, brain, and breast cancer. The in vivo and in vitro effects of MFs on cancer are reviewed considering both human and animal cells, with particular reference to the involvement of reactive oxygen species (ROS). MF application on cancer diagnostic and therapy (theranostic) are also reviewed by describing the use of different magnetic resonance imaging (MRI) applications for the detection of several cancers. Finally, the use of magnetic nanoparticles is described in terms of treatment of cancer by nanomedical applications for the precise delivery of anticancer drugs, nanosurgery by magnetomechanic methods, and selective killing of cancer cells by magnetic hyperthermia. The supplementary tables provide quantitative data and methodologies in epidemiological and cell biology studies. Although scientists do not generally agree that there is a cause-effect relationship between exposure to MF and cancer, MFs might not be the direct cause of cancer but may contribute to produce ROS and generate oxidative stress, which could trigger or enhance the expression of oncogenes.
Collapse
|
4
|
Bruckmann NM, Kirchner J, Morawitz J, Umutlu L, Herrmann K, Bittner AK, Hoffmann O, Mohrmann S, Ingenwerth M, Schaarschmidt BM, Li Y, Stang A, Antoch G, Sawicki LM, Buchbender C. Prospective comparison of CT and 18F-FDG PET/MRI in N and M staging of primary breast cancer patients: Initial results. PLoS One 2021; 16:e0260804. [PMID: 34855886 PMCID: PMC8638872 DOI: 10.1371/journal.pone.0260804] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/18/2021] [Indexed: 01/10/2023] Open
Abstract
Objectives To compare the diagnostic accuracy of contrast-enhanced thoraco-abdominal computed tomography and whole-body 18F-FDG PET/MRI in N and M staging in newly diagnosed, histopathological proven breast cancer. Material and methods A total of 80 consecutive women with newly diagnosed and histopathologically confirmed breast cancer were enrolled in this prospective study. Following inclusion criteria had to be fulfilled: (1) newly diagnosed, treatment-naive T2-tumor or higher T-stage or (2) newly diagnosed, treatment-naive triple-negative tumor of every size or (3) newly diagnosed, treatment-naive tumor with molecular high risk (T1c, Ki67 >14%, HER2neu over-expression, G3). All patients underwent a thoraco-abdominal ceCT and a whole-body 18F-FDG PET/MRI. All datasets were evaluated by two experienced radiologists in hybrid imaging regarding suspect lesion count, localization, categorization and diagnostic confidence. Images were interpreted in random order with a reading gap of at least 4 weeks to avoid recognition bias. Histopathological results as well as follow-up imaging served as reference standard. Differences in staging accuracy were assessed using Mc Nemars chi2 test. Results CT rated the N stage correctly in 64 of 80 (80%, 95% CI:70.0–87.3) patients with a sensitivity of 61.5% (CI:45.9–75.1), a specificity of 97.6% (CI:87.4–99.6), a PPV of 96% (CI:80.5–99.3), and a NPV of 72.7% (CI:59.8–82.7). Compared to this, 18F-FDG PET/MRI determined the N stage correctly in 71 of 80 (88.75%, CI:80.0–94.0) patients with a sensitivity of 82.1% (CI:67.3–91.0), a specificity of 95.1% (CI:83.9–98.7), a PPV of 94.1% (CI:80.9–98.4) and a NPV of 84.8% (CI:71.8–92.4). Differences in sensitivities were statistically significant (difference 20.6%, CI:-0.02–40.9; p = 0.008). Distant metastases were present in 7/80 patients (8.75%). 18 F-FDG PET/MRI detected all of the histopathological proven metastases without any false-positive findings, while 3 patients with bone metastases were missed in CT (sensitivity 57.1%, specificity 95.9%). Additionally, CT presented false-positive findings in 3 patients. Conclusion 18F-FDG PET/MRI has a high diagnostic potential and outperforms CT in assessing the N and M stage in patients with primary breast cancer.
Collapse
Affiliation(s)
- Nils Martin Bruckmann
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany
| | - Julian Kirchner
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany
- * E-mail:
| | - Janna Morawitz
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ann-Kathrin Bittner
- Department Gynecology and Obstetrics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Oliver Hoffmann
- Department Gynecology and Obstetrics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Svjetlana Mohrmann
- Department of Gynecology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany
| | - Marc Ingenwerth
- Institute of Pathology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen and the German Cancer Consortium (DKTK), Essen, Germany
| | - Benedikt M. Schaarschmidt
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Yan Li
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Andreas Stang
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany
| | - Lino M. Sawicki
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany
| | - Christian Buchbender
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany
| |
Collapse
|
5
|
Li Y, Su X, Yao F, Wu T, Peng J, Yang A. Comparison of the value of ultrasound and enhanced magnetic resonance imaging in judging cervical lymph node metastasis in patients with oral cancer. Bull Cancer 2021; 108:1085-1090. [PMID: 34782121 DOI: 10.1016/j.bulcan.2021.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 05/17/2021] [Accepted: 09/02/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Oral cancer is the twelfth largest malignant tumor in the world. Oral cancer is prone to lymph node metastasis in the early stages of the disease, and lymph node metastasis will directly affect the treatment and survival rate. Therefore, whether the lymph node metastasis can be accurately evaluated is of great significance to the treatment and prognosis of patients. OBJECTIVE The diagnostic efficacy of three methods of preoperative ultrasound, enhanced magnetic resonance (enhanced MR), and ultrasound combined with enhanced MR on cervical lymph node metastasis of oral cancer were compared. MATERIALS AND METHODS A retrospective analysis of 399 cases of oral cancer completed by head and neck surgery at Cancer Center of Sun Yat-sen University, China. In all cases, the maxillofacial and neck enhanced MR and cervical lymph node ultrasound examinations were performed before surgery, and imaging diagnosis was made for cervical lymph node metastasis and compared with pathology. All judgment results were statistically processed using the chi-square test. RESULTS Compared with the above three methods, the diagnostic efficiency of ultrasound alone is better, and the diagnostic efficiency of enhanced MR combined ultrasound is not significantly better than that of ultrasound alone. There are differences in the diagnostic efficacy of the three inspection methods in different clinical sub-periods, all of which are better for the diagnosis of stage I. For patients with stage I, II, and III, there were no differences between the three examination methods. However, for stage IV patients,the diagnostic efficiency of ultrasound alone is better. For patients with stage N0, there was no difference in diagnostic efficacy between the three methods. For the assessment of lymph nodes in the I-III region, there are differences between the three methods of examination: the diagnostic efficiency of ultrasound alone is better, and enhanced MR combined ultrasound is not significantly better than ultrasound alone. For the evaluation of lymph nodes in the IV-VII region, there was no difference in diagnostic efficacy between the three methods. CONCLUSION According to the clinical characteristics and prognosis of patients with oral cancer, although enhanced MR can better evaluate the tumor, ultrasound may be considered as the preferred imaging method for cervical lymph node metastasis. SIGNIFICANCE Accurate assessment and proper and timely treatment of lymph node metastasis can help improve the survival rate of patients.
Collapse
Affiliation(s)
- Yixuan Li
- Sun Yat-sen University Cancer Center, Department of Head and Neck Surgery, 51, Dongfeng Dong Road, Guangzhou, 510060, China; State key laboratory of Oncology in South China, Guangzhou, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Xuan Su
- Sun Yat-sen University Cancer Center, Department of Head and Neck Surgery, 51, Dongfeng Dong Road, Guangzhou, 510060, China; State key laboratory of Oncology in South China, Guangzhou, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Fan Yao
- Sun Yat-sen University Cancer Center, Department of Head and Neck Surgery, 51, Dongfeng Dong Road, Guangzhou, 510060, China; State key laboratory of Oncology in South China, Guangzhou, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Tong Wu
- Sun Yat-sen University Cancer Center, Department of Head and Neck Surgery, 51, Dongfeng Dong Road, Guangzhou, 510060, China; State key laboratory of Oncology in South China, Guangzhou, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Jin Peng
- Sun Yat-sen University Cancer Center, Department of Head and Neck Surgery, 51, Dongfeng Dong Road, Guangzhou, 510060, China; State key laboratory of Oncology in South China, Guangzhou, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Ankui Yang
- Sun Yat-sen University Cancer Center, Department of Head and Neck Surgery, 51, Dongfeng Dong Road, Guangzhou, 510060, China; State key laboratory of Oncology in South China, Guangzhou, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
| |
Collapse
|
6
|
Diagnostic Accuracy of Combined PET/CT with MRI, 18F-FDG PET/MRI, and 18F-FDG PET/CT in Patients with Oropharyngeal and Hypopharyngeal Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis. CONTRAST MEDIA & MOLECULAR IMAGING 2021; 2021:6653117. [PMID: 34007251 PMCID: PMC8099512 DOI: 10.1155/2021/6653117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 04/03/2021] [Accepted: 04/19/2021] [Indexed: 01/06/2023]
Abstract
Introduction The aim of this paper is to compare the diagnostic accuracy of PET/CT, PET/MRI, and the combination of PET/CT and MRI for detecting synchronous cancer and distant metastasis in patients with oropharyngeal and hypopharyngeal squamous cell carcinomas (OHSCC). Method A large and growing body of literature has been conducted using the Preferred Reporting Items for Systematic Reviews (PRISMA). The researchers collected all accessible literature existing through Cochrane Library (John Wiley & Sons) electronic databases, Embase (Elsevier), PubMed (U.S. National Library of Medicine), Scopus, and Google Scholar up to June 2020. Analyses were conducted using Stata version 12.0 (StataCorp LP). Results A total of nine studies consisting of 1166 patients were included. The pooled sensitivity of combined PET/CT with MRI, 18F-FDG PET/MRI, and 18F-FDG PET/CT was 0.92, 0.80, and 0.79, respectively, and the corresponding specificities were 0.93, 0.91, and 0.88. The overall prevalence of distant metastases and synchronous cancer in patients with oropharyngeal and hypopharyngeal squamous cell carcinomas was 9.2% and 11.8%, respectively, with the esophagus (4.6%) being the most common site of synchronous cancer. The most common sites of distant metastases were lung (3%), bone (1.2%), and distant lymph nodes (1.2%), respectively. Conclusion Our study showed an approximately similar diagnostic performance for PET/CT, PET/MRI, and the combination of PET/CT and MRI for metastasis assessment in advanced oropharyngeal and hypopharyngeal squamous cell carcinomas.
Collapse
|
7
|
Bruckmann NM, Sawicki LM, Kirchner J, Martin O, Umutlu L, Herrmann K, Fendler W, Bittner AK, Hoffmann O, Mohrmann S, Dietzel F, Ingenwerth M, Schaarschmidt BM, Li Y, Kowall B, Stang A, Antoch G, Buchbender C. Prospective evaluation of whole-body MRI and 18F-FDG PET/MRI in N and M staging of primary breast cancer patients. Eur J Nucl Med Mol Imaging 2020; 47:2816-2825. [PMID: 32333068 PMCID: PMC7567721 DOI: 10.1007/s00259-020-04801-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 03/30/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To evaluate and compare the diagnostic potential of whole-body MRI and whole-body 18F-FDG PET/MRI for N and M staging in newly diagnosed, histopathologically proven breast cancer. MATERIAL AND METHODS A total of 104 patients (age 53.4 ± 12.5) with newly diagnosed, histopathologically proven breast cancer were enrolled in this study prospectively. All patients underwent a whole-body 18F-FDG PET/MRI. MRI and 18F-FDG PET/MRI datasets were evaluated separately regarding lesion count, lesion localization, and lesion characterization (malignant/benign) as well as the diagnostic confidence (5-point ordinal scale, 1-5). The N and M stages were assessed according to the eighth edition of the American Joint Committee on Cancer staging manual in MRI datasets alone and in 18F-FDG PET/MRI datasets, respectively. In the majority of lesions histopathology served as the reference standard. The remaining lesions were followed-up by imaging and clinical examination. Separately for nodal-positive and nodal-negative women, a McNemar chi2 test was performed to compare sensitivity and specificity of the N and M stages between 18F-FDG PET/MRI and MRI. Differences in diagnostic confidence scores were assessed by Wilcoxon signed rank test. RESULTS MRI determined the N stage correctly in 78 of 104 (75%) patients with a sensitivity of 62.3% (95% CI: 0.48-0.75), a specificity of 88.2% (95% CI: 0.76-0.96), a PPV (positive predictive value) of 84.6% % (95% CI: 69.5-0.94), and a NPV (negative predictive value) of 69.2% (95% CI: 0.57-0.8). Corresponding results for 18F-FDG PET/MRI were 87/104 (83.7%), 75.5% (95% CI: 0.62-0.86), 92.2% (0.81-0.98), 90% (0.78-0.97), and 78.3% (0.66-0.88), showing a significantly better sensitivity of 18F-FDG PET/MRI determining malignant lymph nodes (p = 0.008). The M stage was identified correctly in MRI and 18F-FDG PET/MRI in 100 of 104 patients (96.2%). Both modalities correctly staged all 7 patients with distant metastases, leading to false-positive findings in 4 patients in each modality (3.8%). In a lesion-based analysis, 18F-FDG PET/MRI showed a significantly better performance in correctly determining malignant lesions (85.8% vs. 67.1%, difference 18.7% (95% CI: 0.13-0.26), p < 0.0001) and offered a superior diagnostic confidence compared with MRI alone (4.1 ± 0.7 vs. 3.4 ± 0.7, p < 0.0001). CONCLUSION 18F-FDG PET/MRI has a better diagnostic accuracy for N staging in primary breast cancer patients and provides a significantly higher diagnostic confidence in lesion characterization than MRI alone. But both modalities bear the risk to overestimate the M stage.
Collapse
Affiliation(s)
- Nils Martin Bruckmann
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Dusseldorf, Germany
| | - Lino M Sawicki
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Dusseldorf, Germany
| | - Julian Kirchner
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Dusseldorf, Germany.
| | - Ole Martin
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Dusseldorf, Germany
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Wolfgang Fendler
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ann-Kathrin Bittner
- Department Gynecology and Obstetrics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Oliver Hoffmann
- Department Gynecology and Obstetrics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Svjetlana Mohrmann
- Department of Gynecology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany
| | - Frederic Dietzel
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Dusseldorf, Germany
| | - Marc Ingenwerth
- Institute of Pathology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK), Essen, Germany
| | - Benedikt M Schaarschmidt
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Yan Li
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Bernd Kowall
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, Germany
| | - Andreas Stang
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, Germany
| | - Gerald Antoch
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Dusseldorf, Germany
| | - Christian Buchbender
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, Dusseldorf, Germany
| |
Collapse
|
8
|
Comparison of diagnostic accuracy between [ 18F]FDG PET/MRI and contrast-enhanced MRI in T staging for oral tongue cancer. Ann Nucl Med 2020; 34:952-959. [PMID: 33040312 DOI: 10.1007/s12149-020-01526-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 09/09/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Integrated PET/MRI with [18F]FDG is advantageous in that it enables simultaneous PET and MR imaging with higher soft-tissue contrast, multiplanar image acquisition, and functional imaging capability without using fat suppression and gadolinium-based contrast agents (GBCAs). The aims of this study were to demonstrate the feasibility of [18F]FDG PET/MRI for assessing the extent of the primary tumor (T) in oral tongue cancer (OTC) based on the 8th edition of American Joint Committee on Cancer (AJCC) cancer staging system, and to compare the diagnostic accuracy between [18F]FDG PET/MRI and contrast-enhanced MRI (ceMRI). METHODS 18 patients with biopsy-proven operable OTC underwent preoperative regional [18F]FDG PET/MRI and ceMRI within 2 weeks. For [18F]FDG PET/MRI, rainbow-colored PET images were overlaid on the corresponding MR images. Tumor size and the depth of invasion (DOI) were visually measured on [18F]FDG PET/MRI and ceMRI. The size, DOI, and clinical T stage were evaluated using the final surgical pathology as the reference. RESULTS Of the 18 OTCs, one was not detected by ceMRI due to metal artifacts from an artificial denture, and another due to superficial type (pathological DOI = 0 mm). Tumor sizes measured by ceMRI and [18F]FDG PET/MRI had significant positive correlations with the pathological size (r = 0.80 and r = 0.90, respectively), and DOIs measured by ceMRI and [18F]FDG PET/MRI had significant positive correlations with the pathological DOI (r = 0.74 and r = 0.64, respectively). The means ± SD of size (mm) were 20.4 ± 9.1, 22.9 ± 10.9, and 26.2 ± 10.0, and those of DOI (mm) were 7.1 ± 2.5, 6.9 ± 2.2, and 5.8 ± 3.2 for ceMRI, [18F]FDG PET/MRI, and pathology, respectively. A significant difference was observed in tumor size between ceMRI and pathology (p < 0.05), whereas no significant differences were observed between any other sizes, DOIs, or T stages. The accuracy for T status was 72% (13/18 including 2 undetectable cases) for ceMRI and 89% (16/18) for [18F]FDG PET/MRI. CONCLUSIONS Although shallow DOIs are often overestimated, regional [18F]FDG PET/MRI without fat suppression and gadolinium enhancement is comparable to and may be substituted for ceMRI in preoperative T staging for OTC patients, reducing metal artifacts and avoiding the adverse effects of GBCAs.
Collapse
|
9
|
Abstract
Oncologic imaging has been a major focus of clinical research on PET/MR over the last 10 years. Studies so far have shown that PET/MR with 18F-Fluorodeoxyglucose (FDG) overall provides a similar accuracy for tumor staging as FDG PET/CT. The effective radiation dose of whole-body FDG PET/MR is more than 50% lower than for FDG PET/CT, making PET/MR particularly attractive for imaging of children. However, the longer acquisition times and higher costs have so far limited broader clinical use of PET/MR technology for whole-body staging. With the currently available technology, PET/MR appears more promising for locoregional staging of diseases for which MR is the anatomical imaging modality of choice. These include brain tumors, head and neck cancers, gynecologic malignancies, and prostate cancer. For instance, PET imaging with ligands of prostate-specific membrane antigen, combined with multi-parametric MR, appears promising for detection of prostate cancer and differentiation from benign prostate pathologies as well as for detection of local recurrences. The combination of functional parameters from MR, such as apparent diffusion coefficients, and molecular parameters from PET, such as receptor densities or metabolic rates, is feasible in clinical studies, but clinical applications for this multimodal and multi-parametric imaging approach still need to be defined.
Collapse
|
10
|
Hu LH, Zhang WB, Yu Y, Peng X. Accuracy of multimodal image fusion for oral and maxillofacial tumors: A revised evaluation method and its application. J Craniomaxillofac Surg 2020; 48:741-750. [PMID: 32536539 DOI: 10.1016/j.jcms.2020.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 05/14/2020] [Accepted: 05/28/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To develop a revised evaluation method for accuracy of multimodal image fusion for oral and maxillofacial tumors and explore its application for comparing the accuracy of three commonly used fusion algorithms, automatic fusion, manual fusion, and registration point-based fusion. MATERIALS AND METHODS Image sets of patients with oral and maxillofacial tumor were fused using the iPlan 3.0 navigation system. Fusion accuracy included two aspects: (1) overall fusion accuracy: represented by the mean value of the coordinate differences along the x-, y-, and z- axes (Δx, Δy, and Δz), mean deviation (MD), and root mean square (RMS) of six pairs of landmarks on the two image sets; (2) tumor volume fusion accuracy: represented by Fusion Index (FI), which was calculated based on the volume of tumor delineated on the two image sets. RESULTS Eighteen pairs of image sets of 17 patients were enrolled in this study. The Δx and Δy values for the three algorithms were less than 1.5 mm. The Δz values for automatic fusion, manual fusion and registration point-based fusion was 1.049 mm, 1.864 mm and 1.254 mm. The MD for automatic fusion, manual fusion and registration point-based fusion was 1.978 mm, 2.788 mm and 1.926 mm. Significant differences existed in Δz for manual fusion and that for automatic fusion (P = 0.058), in MD for manual fusion and that for automatic fusion (P = 0.087), and in MD for manual fusion and that for registration point-based fusion (P = 0.069). The FI for automatic fusion, manual fusion, and registration point-based fusion was 0.594, 0.520, and 0.549; the inter-algorithm differences were not significant (P = 0.290). CONCLUSION The automatic fusion and the registration point-based fusion were more accurate than manual fusion, and therefore were recommended to be used in multimodal image fusion for oral and maxillofacial tumors.
Collapse
Affiliation(s)
- Lei-Hao Hu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Beijing 100081, China.
| | - Wen-Bo Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Beijing 100081, China.
| | - Yao Yu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Beijing 100081, China.
| | - Xin Peng
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Beijing 100081, China.
| |
Collapse
|
11
|
Nieberler M, Stimmer H, Rasthofer D, Nentwig K, Weirich G, Wolff KD. Defining secure surgical bone margins in head and neck squamous cell carcinomas: The diagnostic impact of intraoperative cytological assessment of bone resection margins compared with preoperative imaging. Oral Oncol 2020; 102:104579. [PMID: 32062159 DOI: 10.1016/j.oraloncology.2020.104579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 01/09/2020] [Accepted: 01/20/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Imaging provides crucial staging information for treatment planning of head and neck squamous cell carcinomas (HNSCCs). Despite technical progress in imaging techniques, defining the extent of bone involvement preoperatively remains challenging and requires intraoperative information to control for adequate resection. The intraoperative cytological assessment of the bone resection margins (ICAB) provides information whether bone is infiltrated by carcinoma. The aim of this study was to assess the diagnostic value of preoperative imaging compared with ICAB in order to achieve carcinoma-free bone margins. MATERIALS AND METHODS 108 HNSCC patients underwent preoperative computed tomography (CT), magnetic resonance imaging (MRI) and orthopantomogram (OPG) for staging and surgical planning. Curative resection was planned based on imaging. Intraoperatively, the resection margins were controlled by ICAB. The diagnostic value of preoperative imaging and ICAB was assessed with reference to the histological findings. RESULTS CT showed a sensitivity of 89.7%, specificity of 63.0%, positive predictive value (PPV) of 85.9%, and negative predictive value (NPV) of 70.8%. MRI revealed a sensitivity of 45.5%, specificity of 66.7%, PPV of 71.4% and NPV of 40.0%. OPG-imaging had a sensitivity of 64.7%, specificity of 76.2%, PPV of 81.5%, NPV 57.1%. In comparison, ICAB provided a sensitivity of 78.6%, specificity of 95.7%, PPV 73.3%, and NPV 96.7%. The accuracy was 82.1%, 52.9%, 69.0%, and 93.5% for CT, MRI, OPG, and ICAB, respectively. CONCLUSION Preoperative imaging lacks accuracy in defining adequate bone resection margins, compared with ICAB. ICAB supports preoperative imaging and intraoperative frozen sections to improve bone margin control.
Collapse
Affiliation(s)
- Markus Nieberler
- Department of Oral and Maxillofacial Surgery, Hospital rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81679 Munich, Germany.
| | - Herbert Stimmer
- Department of Radiology, Hospital rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81679 Munich, Germany
| | - Daniela Rasthofer
- Department of Oral and Maxillofacial Surgery, Hospital rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81679 Munich, Germany
| | - Katharina Nentwig
- Department of Oral and Maxillofacial Surgery, Hospital rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81679 Munich, Germany
| | - Gregor Weirich
- Institute of Pathology, Technische Universität München, Trogerstr. 18, 81675 Munich, Germany
| | - Klaus-Dietrich Wolff
- Department of Oral and Maxillofacial Surgery, Hospital rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81679 Munich, Germany
| |
Collapse
|
12
|
Hohenstein NA, Chan JW, Wu SY, Tahir P, Yom SS. Diagnosis, Staging, Radiation Treatment Response Assessment, and Outcome Prognostication of Head and Neck Cancers Using PET Imaging. PET Clin 2020; 15:65-75. [DOI: 10.1016/j.cpet.2019.08.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
13
|
Ye J, Luo J, Xu S, Wu W. One-slice CT image based kernelized radiomics model for the prediction of low/mid-grade and high-grade HNSCC. Comput Med Imaging Graph 2019; 80:101675. [PMID: 31945637 DOI: 10.1016/j.compmedimag.2019.101675] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 10/18/2019] [Accepted: 10/24/2019] [Indexed: 01/02/2023]
Abstract
An accurate grade prediction can help to appropriate treatment strategy and effective diagnosis to Head and neck squamous cell carcinoma (HNSCC). Radiomics has been studied for the prediction of carcinoma characteristics in medical images. The success of previous researches in radiomics is attributed to the availability of annotated all-slice medical images. However, it is very challenging to annotate all slices, as annotating biomedical images is not only tedious, laborious, and time consuming, but also demanding of costly, specialty-oriented skills, which are not easily accessible. To address this problem, this paper presents a model to integrate radiomics and kernelized dimension reduction into a single framework, which maps handcrafted radiomics features to a kernelized space where they are linearly separable and then reduces the dimension of features through principal component analysis. Three methods including baseline radiomics models, proposed kernelized model and convolutional neural network (CNN) model were compared in experiments. Results suggested proposed kernelized model best fit in one-slice data. We reached AUC of 95.91 % on self-made one-slice dataset, 67.33 % in predicting localregional recurrence on H&N dataset and 64.33 % on H&N1 dataset. While all other models were <76 %, <65 %, and <62 %. Though CNN model reached an incredible performance when predicting distant metastasis on H&N (AUC 0.88), model faced serious problem of overfitting in small datasets. When changing all-slice data to one-slice on both H&N and H&N1, proposed model suffered less loss on AUC (<1.3 %) than any other models (>3 %). These proved our proposed model is efficient to deal with the one-slice problem and makes using one-slice data to reduce annotation cost practical. This is attributed to the several advantages derived from the proposed kernelized radiomics model, including (1) the prior radiomics features reduced the demanding of huge amount of data and avoided overfitting; (2) the kernelized method mined the potential information contributed to predict; (3) generating principal components in kernelized features reduced redundant features.
Collapse
Affiliation(s)
- Junyong Ye
- Key Laboratory of Optoelectronic Technology and Systems of the Ministry of Education, Chongqing University, Shapingba, Chongqing, China.
| | - Jin Luo
- Key Laboratory of Optoelectronic Technology and Systems of the Ministry of Education, Chongqing University, Shapingba, Chongqing, China
| | - Shengsheng Xu
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenli Wu
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| |
Collapse
|
14
|
Ryan JL, Aaron VD, Sims JB. PET/MRI vs PET/CT in Head and Neck Imaging: When, Why, and How? Semin Ultrasound CT MR 2019; 40:376-390. [PMID: 31635765 DOI: 10.1053/j.sult.2019.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The increasing availability of hybrid PET/MRI systems has led to a breadth of new publications and opportunities for use of PET/MRI. While PET/CT has been a valuable tool for oncologic staging, including head and neck malignancy, there are several theoretical and practical advantages a PET/MRI system would have over PET/CT in head and neck imaging. This review article discusses the established role of PET/CT, early evidence for the role of PET/MRI, and protocol considerations for both PET/CT and PET/MRI as they apply to head and neck imaging.
Collapse
Affiliation(s)
- Joshua L Ryan
- Indiana University School of Medicine, Indianapolis, IN.
| | | | - Justin B Sims
- Indiana University School of Medicine, Indianapolis, IN
| |
Collapse
|
15
|
Integrated versus separate reading of F-18 FDG-PET/CT and MRI for abdominal malignancies – effect on staging outcomes and diagnostic confidence. Eur Radiol 2019; 29:6900-6910. [DOI: 10.1007/s00330-019-06253-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 04/04/2019] [Accepted: 04/25/2019] [Indexed: 12/11/2022]
|
16
|
Hayashi K, Kikuchi M, Imai Y, Yamashita D, Hino M, Ito K, Shimizu K, Harada H, Shinohara S. Clinical Value of Fused PET/MRI for Surgical Planning in Patients With Oral/Oropharyngeal Carcinoma. Laryngoscope 2019; 130:367-374. [DOI: 10.1002/lary.27911] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 01/31/2019] [Accepted: 02/13/2019] [Indexed: 12/24/2022]
Affiliation(s)
- Kazuki Hayashi
- Department of Otolaryngology–Head and Neck SurgeryKokura Memorial Hospital Kokura Japan
| | - Masahiro Kikuchi
- Department of Otolaryngology–Head and Neck SurgeryGraduate School of Medicine, Kyoto University Kyoto Japan
| | - Yukihiro Imai
- Department of PathologyKakogawa Central City Hospital Kakogawa Japan
| | - Daisuke Yamashita
- Department of PathologyKobe City Medical Center General Hospital Kobe Japan
| | - Megumu Hino
- Department of RadiologyKobe City Medical Center General Hospital Kobe Japan
| | - Kyo Ito
- Department of RadiologyOsaka Red Cross Hospital Osaka Japan
| | - Keiji Shimizu
- Department of Radiological TechnologyKobe City Medical Center General Hospital Kobe Japan
| | - Hiroyuki Harada
- Department of Otolaryngology–Head and Neck SurgeryKitano Hospital Osaka Japan
| | - Shogo Shinohara
- Department of Head and Neck SurgeryKobe City Medical Center General Hospital Kobe Japan
| |
Collapse
|
17
|
Seeburg DP, Baer AH, Aygun N. Imaging of Patients with Head and Neck Cancer. Oral Maxillofac Surg Clin North Am 2018; 30:421-433. [DOI: 10.1016/j.coms.2018.06.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
|
18
|
Magnetic resonance imaging based radiomics signature for the preoperative discrimination of stage I-II and III-IV head and neck squamous cell carcinoma. Eur J Radiol 2018; 106:1-6. [PMID: 30150029 DOI: 10.1016/j.ejrad.2018.07.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 05/08/2018] [Accepted: 07/02/2018] [Indexed: 11/23/2022]
Abstract
PURPOSE This study aimed to investigate the predictive ability of magnetic resonance imaging (MRI) based radiomics signature for the preoperative staging in HNSCC. METHODS This study involved127 consecutive patients (training cohort: n = 85; testing cohort, n = 42) with stage I-IV HNSCC. A total of 970 radiomics features were extracted from T2-weighted (T2W) (n = 485) and contrast-enhanced T1-weighted (ceT1W) (n = 485) MRI for each case. Radiomics signatures were constructed with least absolute shrinkage and selection operator (LASSO) logistic regression. Associations between radiomics signatures and HNSCC staging were explored. Areas under the receiver operating characteristic curve (AUC) and classification performance of radiomics signatures were determined and compared with those of the visual assessment. RESULTS Ten features from T2W images, six from ceT1W images, and six from combined T2W and ceT1W images were selected by LASSO logistic regression. The three radiomics signatures of stage III-IV HNSCC were significantly higher than that for stage I-II in both cohorts (all P < 0.05). The radiomics signatures from ceT1W and combined images performed well in the discrimination of stage I-II and III-IV HNSCC, with AUCs of 0.828 and 0.850 in the training cohort, and AUCs of 0.853 and 0.849 in the testing cohort. Based on the cut-off value of the training cohort, the radiomics signature from combined images achieved best classification performance in both cohorts, with accuracies of 0.788 and 0.857, sensitivities of 0.836 and 0.885, and specificities of 0.700 and 0.813. Significant differences in accuracy and sensitivity were found between the radiomics signature from combined images and the visual assessment of the radiologists in the training cohort. CONCLUSION Radiomics signature based on MRI could discriminate stage I-II from stage III-IV HNSCC, which may serve as a complementary tool for preoperative staging.
Collapse
|
19
|
Improved detection rates and treatment planning of head and neck cancer using dual-layer spectral CT. Eur Radiol 2018; 28:4925-4931. [DOI: 10.1007/s00330-018-5511-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 04/17/2018] [Accepted: 04/20/2018] [Indexed: 12/19/2022]
|
20
|
Kamei R, Watanabe Y, Sagiyama K, Isoda T, Togao O, Honda H. Optimal monochromatic color combinations for fusion imaging of FDG-PET and diffusion-weighted MR images. Ann Nucl Med 2018; 32:437-445. [PMID: 29797001 DOI: 10.1007/s12149-018-1263-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 05/17/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the optimal monochromatic color combination for fusion imaging of FDG-PET and diffusion-weighted MR images (DW) regarding lesion conspicuity of each image. METHODS Six linear monochromatic color-maps of red, blue, green, cyan, magenta, and yellow were assigned to each of the FDG-PET and DW images. Total perceptual color differences of the lesions were calculated based on the lightness and chromaticity measured with the photometer. Visual lesion conspicuity was also compared among the PET-only, DW-only and PET-DW-double positive portions with mean conspicuity scores. Statistical analysis was performed with a one-way analysis of variance and Spearman's rank correlation coefficient. RESULTS Among all the 12 possible monochromatic color-map combinations, the 3 combinations of red/cyan, magenta/green, and red/green produced the highest conspicuity scores. Total color differences between PET-positive and double-positive portions correlated with conspicuity scores (ρ = 0.2933, p < 0.005). Lightness differences showed a significant negative correlation with conspicuity scores between the PET-only and DWI-only positive portions. Chromaticity differences showed a marginally significant correlation with conspicuity scores between DWI-positive and double-positive portions. CONCLUSIONS Monochromatic color combinations can facilitate the visual evaluation of FDG-uptake and diffusivity as well as registration accuracy on the FDG-PET/DW fusion images, when red- and green-colored elements are assigned to FDG-PET and DW images, respectively.
Collapse
Affiliation(s)
- Ryotaro Kamei
- Department of Clinical Radiology, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yuji Watanabe
- Department of Molecular Imaging and Diagnosis, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Koji Sagiyama
- Department of Clinical Radiology, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Takuro Isoda
- Department of Clinical Radiology, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Osamu Togao
- Department of Clinical Radiology, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Hiroshi Honda
- Department of Clinical Radiology, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| |
Collapse
|
21
|
Queiroz MA, Barbosa FDG, Buchpiguel CA, Cerri GG. Positron emission tomography/magnetic resonance imaging (PET/MRI): An update and initial experience at HC-FMUSP. ACTA ACUST UNITED AC 2018; 64:71-84. [PMID: 29561945 DOI: 10.1590/1806-9282.64.01.71] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 08/17/2017] [Indexed: 01/16/2023]
Abstract
The new technology of PET/MRI is a prototype of hybrid imaging, allowing for the combination of molecular data from PET scanning and morphofunctional information derived from MRI scanning. Recent advances regarding the technical aspects of this device, especially after the development of MRI-compatible silicon photomultipliers of PET, permitted an increase in the diagnostic performance of PET/MRI translated into dose reduction and higher imaging quality. Among several clinical applications, PET/MRI gains ground initially in oncology, where MRI per se plays an essential role in the assessment of primary tumors (which is limited in the case of PET/CT), including prostate, rectal and gynecological tumors. On the other hand, the evaluation of the lungs remains an enigma although new MRI sequences are being designed to overcome this. More clinical indications of PET/MRI are seen in the fields of neurology, cardiology and inflammatory processes, and the use of PET/MRI also opens perspectives for pediatric populations as it involves very low radiation exposure. Our review aimed to highlight the current indications of PET/MRI and discuss the challenges and perspectives of PET/MRI at HC-FMUSP.
Collapse
Affiliation(s)
- Marcelo A Queiroz
- Institute of Radiology (InRad), Hospital das Clínicas da Faculdade de Medicina da USP (HC-FMUSP), São Paulo, SP, Brazil.,Service of Medical Imaging, Hospital Sírio-Libanês, São Paulo, SP, Brazil
| | | | - Carlos Alberto Buchpiguel
- Institute of Radiology (InRad), Hospital das Clínicas da Faculdade de Medicina da USP (HC-FMUSP), São Paulo, SP, Brazil.,Service of Medical Imaging, Hospital Sírio-Libanês, São Paulo, SP, Brazil
| | - Giovanni Guido Cerri
- Institute of Radiology (InRad), Hospital das Clínicas da Faculdade de Medicina da USP (HC-FMUSP), São Paulo, SP, Brazil.,Service of Medical Imaging, Hospital Sírio-Libanês, São Paulo, SP, Brazil
| |
Collapse
|
22
|
Li N, Jie MM, Yang M, Tang L, Chen SY, Sun XM, Tang B, Yang SM. Magnetic Gold Nanoparticle-Labeled Heparanase Monoclonal Antibody and its Subsequent Application for Tumor Magnetic Resonance Imaging. NANOSCALE RESEARCH LETTERS 2018; 13:106. [PMID: 29671088 PMCID: PMC5906410 DOI: 10.1186/s11671-018-2518-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 04/05/2018] [Indexed: 05/03/2023]
Abstract
Heparanase (HPA) is ubiquitously expressed in various metastatic malignant tumors; previous studies have demonstrated that HPA was a potential tumor-associated antigen (TAA) for tumor immunotherapy. We sought to evaluate the feasibility of HPA as a common TAA for magnetic resonance imaging (MRI) of tumor metastasis and its potential application in tumor molecular imaging. We prepared a targeted probe based on magnetic gold nanoparticles coupled with an anti-HPA antibody for the specific detection of HPA by MRI. The specificity of the targeted probe was validated in vitro by incubation of the probe with various tumor cells, and the probe was able to selectively detect HPA (+) cells. We found the probes displayed significantly reduced signal intensity in several tumor cells, and the signal intensity decreased significantly after the targeted probe was injected in tumor-bearing nude mice. In the study, we demonstrated that the HPA&GoldMag probe had excellent physical and chemical properties and immune activities and could specifically target many tumor cell tissues both in vitro and in vivo. This may provide an experimental base for molecular imaging of tumor highly expressing heparanase using HPA mAbs.
Collapse
Affiliation(s)
- Ning Li
- Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, 400030 China
- Department of Gastroenterology, Institute of Surgery research, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, 400042 China
| | - Meng-Meng Jie
- Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, 400030 China
| | - Min Yang
- Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, 400030 China
| | - Li Tang
- Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, 400030 China
| | - Si-Yuan Chen
- Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, 400030 China
| | - Xue-Mei Sun
- Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, 400030 China
| | - Bo Tang
- Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, 400030 China
| | - Shi-Ming Yang
- Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, 400030 China
| |
Collapse
|
23
|
García-Escudero R, Segrelles C, Dueñas M, Pombo M, Ballestín C, Alonso-Riaño M, Nenclares P, Álvarez-Rodríguez R, Sánchez-Aniceto G, Ruíz-Alonso A, López-Cedrún JL, Paramio JM, Lorz C. Overexpression of PIK3CA in head and neck squamous cell carcinoma is associated with poor outcome and activation of the YAP pathway. Oral Oncol 2018; 79:55-63. [PMID: 29598951 DOI: 10.1016/j.oraloncology.2018.02.014] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 01/22/2018] [Accepted: 02/16/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Phosphatidylinositol 3-kinase catalytic subunit alpha (PIK3CA) is commonly altered in many human tumors, leading to the activation of p110α enzymatic activity that stimulates growth factor-independent cell growth. PIK3CA alterations such as mutation, gene amplification and overexpression are common in head and neck squamous cell carcinoma (HNSCC) and. We aim to explore how these alterations and clinical outcome are associated, as well as the molecular mechanisms involved. MATERIAL AND METHODS Mutation and copy-number variation in PIK3CA, and whole-genome expression profiles, were analyzed in primary HNSCC tumors from The Cancer Genome Atlas (TCGA) cohort (n = 243). The results were validated in an independent cohort form the University Hospital of A Coruña (UHAC, n = 62). Expression of the PIK3CA gene protein product (PI3K p110α) and nuclear YAP were assessed in tissue microarrays in a cohort from the University Hospital 12 de Octubre (UH12O, n = 91). RESULTS Only high expression of the PIK3CA gene was associated with poor clinical outcome. The study of gene expression, transcription factor and protein signatures suggested that the activation of the Hippo-YAP pathway, involved in organ size, stem cell maintenance and tumorigenesis, could underlie tumor progression in PI3KCA overexpressing tumors. Tissue arrays showed that PI3K p110α levels correlated with YAP nuclear localization in HNSCC tumors. CONCLUSIONS High expression of PIK3CA in HNSCC primary tumors identifies patients at high risk for recurrence. In these tumors, progression could rely on the Hippo-YAP pathway instead of the canonical Akt/mTOR pathway. This observation could have important implications in the therapeutic options for patients.
Collapse
Affiliation(s)
- Ramón García-Escudero
- Molecular Oncology Unit, CIEMAT (ed 70A), Ave Complutense 40, 28040 Madrid, Spain; Molecular Oncology, University Hospital 12 de Octubre, Research Institute, 12 de Octubre i+12, Ave Córdoba s/n, 28041 Madrid, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Spain; Institute of Oncology Research (IOR), and Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.
| | - Carmen Segrelles
- Molecular Oncology Unit, CIEMAT (ed 70A), Ave Complutense 40, 28040 Madrid, Spain; Molecular Oncology, University Hospital 12 de Octubre, Research Institute, 12 de Octubre i+12, Ave Córdoba s/n, 28041 Madrid, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Spain
| | - Marta Dueñas
- Molecular Oncology Unit, CIEMAT (ed 70A), Ave Complutense 40, 28040 Madrid, Spain; Molecular Oncology, University Hospital 12 de Octubre, Research Institute, 12 de Octubre i+12, Ave Córdoba s/n, 28041 Madrid, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Spain
| | - María Pombo
- Department of Maxillofacial Surgery, University Hospital of A Coruña, As Xubias, 84, 15006 A Coruña, Spain
| | - Claudio Ballestín
- Department of Pathology, University Hospital 12 de Octubre, Ave Córdoba s/n, 28041 Madrid, Spain
| | - Marina Alonso-Riaño
- Department of Pathology, University Hospital 12 de Octubre, Ave Córdoba s/n, 28041 Madrid, Spain
| | - Pablo Nenclares
- Department of Radiation Oncology, University Hospital 12 de Octubre, Ave Córdoba s/n, 28041 Madrid, Spain
| | | | - Gregorio Sánchez-Aniceto
- Department of Maxillofacial Surgery, University Hospital 12 de Octubre, Ave Córdoba s/n, 28041 Madrid, Spain
| | - Ana Ruíz-Alonso
- Department of Radiation Oncology, University Hospital 12 de Octubre, Ave Córdoba s/n, 28041 Madrid, Spain
| | - José Luis López-Cedrún
- Department of Maxillofacial Surgery, University Hospital of A Coruña, As Xubias, 84, 15006 A Coruña, Spain
| | - Jesús M Paramio
- Molecular Oncology Unit, CIEMAT (ed 70A), Ave Complutense 40, 28040 Madrid, Spain; Molecular Oncology, University Hospital 12 de Octubre, Research Institute, 12 de Octubre i+12, Ave Córdoba s/n, 28041 Madrid, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Spain
| | - Corina Lorz
- Molecular Oncology Unit, CIEMAT (ed 70A), Ave Complutense 40, 28040 Madrid, Spain; Molecular Oncology, University Hospital 12 de Octubre, Research Institute, 12 de Octubre i+12, Ave Córdoba s/n, 28041 Madrid, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Spain.
| |
Collapse
|
24
|
Khanmohammadi R, Mir F, Baniebrahimi G, Mirzaei H. Oral tumors in children: Diagnosis and management. J Cell Biochem 2017; 119:2474-2483. [DOI: 10.1002/jcb.26316] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 08/02/2017] [Indexed: 02/05/2023]
Affiliation(s)
- Razieh Khanmohammadi
- Department of Pediatric Dentistry, School of DentistryTehran University of Medical SciencesTehranIran
| | - Fatemeh Mir
- Department of Pediatric Dentistry, School of DentistryZahedan University of Medical SciencesZahedanIran
| | - Ghazaleh Baniebrahimi
- Department of Pediatric Dentistry, School of DentistryTehran University of Medical SciencesTehranIran
| | - Hamed Mirzaei
- Department of Medical Biotechnology, School of Advanced Technologies in MedicineTehran University of Medical SciencesTehranIran
| |
Collapse
|
25
|
An Evaluation of the Benefits of Simultaneous Acquisition on PET/MR Coregistration in Head/Neck Imaging. JOURNAL OF HEALTHCARE ENGINEERING 2017; 2017:2634389. [PMID: 29065582 PMCID: PMC5539939 DOI: 10.1155/2017/2634389] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 05/02/2017] [Accepted: 05/16/2017] [Indexed: 11/17/2022]
Abstract
Coregistration of multimodal diagnostic images is crucial for qualitative and quantitative multiparametric analysis. While retrospective coregistration is computationally intense and could be inaccurate, hybrid PET/MR scanners allow acquiring implicitly coregistered images. Aim of this study is to assess the performance of state-of-the-art coregistration methods applied to PET and MR acquired as single modalities, comparing the results with the implicitly coregistration of a hybrid PET/MR, in complex anatomical regions such as head/neck (HN). A dataset consisting of PET/CT and PET/MR subsequently acquired in twenty-three patients was considered: performance of rigid (RR) and deformable (DR) registration obtained by a commercial software and an open-source registration package was evaluated. Registration accuracy was qualitatively assessed in terms of visual alignment of anatomical structures and qualitatively measured by the Dice scores computed on segmented tumors in PET and MRI. The resulting scores highlighted that hybrid PET/MR showed higher registration accuracy than retrospectively coregistered images, because of an overall misalignment after RR, unrealistic deformations and volume variations after DR. DR revealed superior performance compared to RR due to complex nonrigid movements of HN district. Moreover, simultaneous PET/MR offers unique datasets serving as ground truth for the improvement and validation of coregistration algorithms, if acquired with PET/CT.
Collapse
|
26
|
Lopez R, Gantet P, Salabert AS, Julian A, Hitzel A, Herbault-Barres B, Fontan C, Alshehri S, Payoux P. Prospective comparison of 18F-NaF PET/CT versus 18F-FDG PET/CT imaging in mandibular extension of head and neck squamous cell carcinoma with dedicated analysis software and validation with surgical specimen. A preliminary study. J Craniomaxillofac Surg 2017; 45:1486-1492. [PMID: 28764952 DOI: 10.1016/j.jcms.2017.06.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 06/08/2017] [Accepted: 06/30/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The aim of this study is to propose a new method to quantify radioactivity with PET/CT imaging in mandibular extension in head and neck squamous cell carcinoma (HNSCC), using innovative software, and to compare results with microscopic surgical specimens. PATIENTS AND METHODS This prospective study enrolled 15 patients who underwent 18F-NaF and 18F-FDG PET/CT. We compared the delineations of bone invasions obtained with 18F-NaF PET/CT and 18F-FDG PET/CT with the results of histopathological analysis of mandibular resections (from right and left bone borders). A method for visualization and quantification of PET images was developed. RESULTS For all patients, a significant difference (p = 0.032 for right limits and p = 0.011 for left limits) was observed between 18F-FDG PET/CT imaging and histopathology results, and no significant difference (p = 0.88 for right limits and p = 0.55 for left limits) was observed between 18F-NaF PET/CT imaging and histopathology results. The right limits were less than 10 mm in 93% of patients, and the left limits were less than 10 mm in 86% of patients. CONCLUSIONS The dedicated software enabled the objective delineation of radioactivity within the bone. We can confirm that 18F-NaF is a precise and specific bone marker for the assessment of intraosseous mandibular extensions of head and neck cancers. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, III.
Collapse
Affiliation(s)
- Raphael Lopez
- University of Toulouse, UPS, F-31062 Toulouse Cedex 04, France; Toulouse NeuroImaging Center, ToNIC, UMR 1214, F-31059 Toulouse, France; Plastic and Maxillo-facial Surgery Department, Pierre Paul Riquet Hospital, Place du Dr Baylac, F-31059 Toulouse Cedex 9, France.
| | - Pierre Gantet
- University of Toulouse, UPS, F-31062 Toulouse Cedex 04, France; Nuclear Medicine Department, Pierre Paul Riquet Hospital, Place du Dr Baylac, F-31059 Toulouse Cedex 9, France
| | - Anne Sophie Salabert
- University of Toulouse, UPS, F-31062 Toulouse Cedex 04, France; Toulouse NeuroImaging Center, ToNIC, UMR 1214, F-31059 Toulouse, France; Radiopharmacy Department, Pierre Paul Riquet Hospital, Place du Dr Baylac, F-31059 Toulouse Cedex 9, France
| | - Anne Julian
- Nuclear Medicine Department, Pierre Paul Riquet Hospital, Place du Dr Baylac, F-31059 Toulouse Cedex 9, France
| | - Anne Hitzel
- University of Toulouse, UPS, F-31062 Toulouse Cedex 04, France; Nuclear Medicine Department, Pierre Paul Riquet Hospital, Place du Dr Baylac, F-31059 Toulouse Cedex 9, France
| | - Beatrice Herbault-Barres
- Anatomopathology Department, Pierre Paul Riquet Hospital, Place du Dr Baylac, F-31059 Toulouse Cedex 9, France
| | - Charlotte Fontan
- University of Toulouse, UPS, F-31062 Toulouse Cedex 04, France; Toulouse NeuroImaging Center, ToNIC, UMR 1214, F-31059 Toulouse, France; Radiopharmacy Department, Pierre Paul Riquet Hospital, Place du Dr Baylac, F-31059 Toulouse Cedex 9, France
| | - Sarah Alshehri
- Otolaryngology Department, King Khalid University, College of Medicine, Saudi Arabia
| | - Pierre Payoux
- University of Toulouse, UPS, F-31062 Toulouse Cedex 04, France; Toulouse NeuroImaging Center, ToNIC, UMR 1214, F-31059 Toulouse, France; Nuclear Medicine Department, Pierre Paul Riquet Hospital, Place du Dr Baylac, F-31059 Toulouse Cedex 9, France
| |
Collapse
|
27
|
Keshavarzi M, Darijani M, Momeni F, Moradi P, Ebrahimnejad H, Masoudifar A, Mirzaei H. Molecular Imaging and Oral Cancer Diagnosis and Therapy. J Cell Biochem 2017; 118:3055-3060. [PMID: 28390191 DOI: 10.1002/jcb.26042] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 04/06/2017] [Indexed: 12/31/2022]
Abstract
Oral cancer is known as one of relatively common type of cancer worldwide. Despite the easy access of the oral cavity to examination, oral tumors are diagnosed in more advanced stages of the disease. Imaging techniques have been recently emerged as non-invasive approaches to detect molecular and cellular changes in living cells and organisms. These techniques such as computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) could help physicians to screen patients with oral tumors particularly oral squamous cell carcinoma (OSCC) in early stage of the disease. In this review, we discuss that early detection and diagnosis of oral tumors through using more robust and precise imaging techniques and a variety of cellular/molecular biomarkers not only could lead to more effective and less aggressive form of treatment for the disease but also could improve survival rates and lower treatment costs. J. Cell. Biochem. 118: 3055-3060, 2017. © 2017 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Maryam Keshavarzi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mansoreh Darijani
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Momeni
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Pouya Moradi
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hamed Ebrahimnejad
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - Aria Masoudifar
- Department of Molecular Biotechnology, Royan Institute for Biotechnology, Cell Science Research Center, ACECR, Isfahan, Iran
| | - Hamed Mirzaei
- Department of Medical Biotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
28
|
|
29
|
Comparative characteristics of quantitative indexes for 18F-FDG uptake and metabolic volume in sequentially obtained PET/MRI and PET/CT. Nucl Med Commun 2017; 38:333-339. [DOI: 10.1097/mnm.0000000000000655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|
30
|
Ahn SH, Hong HJ, Kwon SY, Kwon KH, Roh JL, Ryu J, Park JH, Baek SK, Lee GH, Lee SY, Lee JC, Chung MK, Joo YH, Ji YB, Hah JH, Kwon M, Park YM, Song CM, Shin SC, Ryu CH, Lee DY, Lee YC, Chang JW, Jeong HM, Cho JK, Cha W, Chun BJ, Choi IJ, Choi HG, Lee KD. Guidelines for the Surgical Management of Laryngeal Cancer: Korean Society of Thyroid-Head and Neck Surgery. Clin Exp Otorhinolaryngol 2017; 10:1-43. [PMID: 28043099 PMCID: PMC5327593 DOI: 10.21053/ceo.2016.01389] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 10/24/2016] [Indexed: 01/08/2023] Open
Abstract
Korean Society of Thyroid-Head and Neck Surgery appointed a Task Force to develop clinical practice guidelines for the surgical treatment of laryngeal cancer. This Task Force conducted a systematic search of the EMBASE, MEDLINE, Cochrane Library, and KoreaMed databases to identify relevant articles, using search terms selected according to the key questions. Evidence-based recommendations were then created on the basis of these articles. An external expert review and Delphi questionnaire were applied to reach consensus regarding the recommendations. The resulting guidelines focus on the surgical treatment of laryngeal cancer with the assumption that surgery is the selected treatment modality after a multidisciplinary discussion in any context. These guidelines do not, therefore, address non-surgical treatment such as radiation therapy or chemotherapy. The committee developed 62 evidence-based recommendations in 32 categories intended to assist clinicians during management of patients with laryngeal cancer and patients with laryngeal cancer, and counselors and health policy-makers.
Collapse
Affiliation(s)
- Korean Society of Thyroid-Head and Neck Surgery Guideline Task Force
- Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Catholic Kwandong University College of Medicine, Incheon, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Hallym University College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, University of Ulsan College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, National Cancer Center, Goyang, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Chosun University College of Medicine, Gwangju, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Korea Cancer Center Hospital, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Pusan National University School of Medicine, Busan, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Gyeongsang National University School of Medicine, Jinju, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Daejin Medical Center, Bundang Jesaeng Hospital, Seongnam, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Wonkwang University School of Medicine, Iksan, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Inje University College of Medicine, Busan, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Seonam University College of Medicine, Goyang, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Kosin University College of Medicine, Busan, Korea
| | - Soon-Hyun Ahn
- Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hyun Jun Hong
- Department of Otorhinolaryngology Head and Neck Surgery, Catholic Kwandong University College of Medicine, Incheon, Korea
| | - Soon Young Kwon
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Kee Hwan Kwon
- Department of Otorhinolaryngology Head and Neck Surgery, Hallym University College of Medicine, Seoul, Korea
| | - Jong-Lyel Roh
- Department of Otorhinolaryngology Head and Neck Surgery, University of Ulsan College of Medicine, Seoul, Korea
| | - Junsun Ryu
- Department of Otorhinolaryngology Head and Neck Surgery, National Cancer Center, Goyang, Korea
| | - Jun Hee Park
- Department of Otorhinolaryngology Head and Neck Surgery, Chosun University College of Medicine, Gwangju, Korea
| | - Seung-Kuk Baek
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Guk Haeng Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Korea Cancer Center Hospital, Seoul, Korea
| | - Sei Young Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jin Choon Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Pusan National University School of Medicine, Busan, Korea
| | - Man Ki Chung
- Department of Otorhinolaryngology Head and Neck Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Hoon Joo
- Department of Otorhinolaryngology Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong Bae Ji
- Department of Otorhinolaryngology Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Jeong Hun Hah
- Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Minsu Kwon
- Department of Otorhinolaryngology Head and Neck Surgery, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Young Min Park
- Department of Otorhinolaryngology Head and Neck Surgery, Daejin Medical Center, Bundang Jesaeng Hospital, Seongnam, Korea
| | - Chang Myeon Song
- Department of Otorhinolaryngology Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Sung-Chan Shin
- Department of Otorhinolaryngology Head and Neck Surgery, Pusan National University School of Medicine, Busan, Korea
| | - Chang Hwan Ryu
- Department of Otorhinolaryngology Head and Neck Surgery, National Cancer Center, Goyang, Korea
| | - Doh Young Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Young Chan Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jae Won Chang
- Department of Otorhinolaryngology Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea
| | - Ha Min Jeong
- Department of Otorhinolaryngology Head and Neck Surgery, Wonkwang University School of Medicine, Iksan, Korea
| | - Jae-Keun Cho
- Department of Otorhinolaryngology Head and Neck Surgery, Inje University College of Medicine, Busan, Korea
| | - Wonjae Cha
- Department of Otorhinolaryngology Head and Neck Surgery, Pusan National University School of Medicine, Busan, Korea
| | - Byung Joon Chun
- Department of Otorhinolaryngology Head and Neck Surgery, Seonam University College of Medicine, Goyang, Korea
| | - Ik Joon Choi
- Department of Otorhinolaryngology Head and Neck Surgery, Korea Cancer Center Hospital, Seoul, Korea
| | - Hyo Geun Choi
- Department of Otorhinolaryngology Head and Neck Surgery, Hallym University College of Medicine, Seoul, Korea
| | - Kang Dae Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Kosin University College of Medicine, Busan, Korea
| |
Collapse
|
31
|
Wang K, Mullins BT, Falchook AD, Lian J, He K, Shen D, Dance M, Lin W, Sills TM, Das SK, Huang BY, Chera BS. Evaluation of PET/MRI for Tumor Volume Delineation for Head and Neck Cancer. Front Oncol 2017; 7:8. [PMID: 28168166 PMCID: PMC5253486 DOI: 10.3389/fonc.2017.00008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 01/09/2017] [Indexed: 12/20/2022] Open
Abstract
Introduction Computed tomography (CT), combined positron emitted tomography and CT (PET/CT), and magnetic resonance imaging (MRI) are commonly used in head and neck radiation planning. Hybrid PET/MRI has garnered attention for potential added value in cancer staging and treatment planning. Herein, we compare PET/MRI vs. planning CT for head and neck cancer gross tumor volume (GTV) delineation. Material and methods We prospectively enrolled patients with head and neck cancer treated with definitive chemoradiation to 60–70 Gy using IMRT. We performed pretreatment contrast-enhanced planning CT and gadolinium-enhanced PET/MRI. Primary and nodal volumes were delineated on planning CT (GTV-CT) prospectively before treatment and PET/MRI (GTV-PET/MRI) retrospectively after treatment. GTV-PET/MRI was compared to GTV-CT using separate rigid registrations for each tumor volume. The Dice similarity coefficient (DSC) metric evaluating spatial overlap and modified Hausdorff distance (mHD) evaluating mean orthogonal distance difference were calculated. Minimum dose to 95% of GTVs (D95) was compared. Results Eleven patients were evaluable (10 oropharynx, 1 larynx). Nine patients had evaluable primary tumor GTVs and seven patients had evaluable nodal GTVs. Mean primary GTV-CT and GTV-PET/MRI size were 13.2 and 14.3 cc, with mean intersection 8.7 cc, DSC 0.63, and mHD 1.6 mm. D95 was 65.3 Gy for primary GTV-CT vs. 65.2 Gy for primary GTV-PET/MRI. Mean nodal GTV-CT and GTV-PET/MRI size were 19.0 and 23.0 cc, with mean intersection 14.4 cc, DSC 0.69, and mHD 2.3 mm. D95 was 62.3 Gy for both nodal GTV-CT and GTV-PET/MRI. Conclusion In this series of patients with head and neck (primarily oropharynx) cancer, PET/MRI and CT-GTVs had similar volumes (though there were individual cases with larger differences) with overall small discrepancies in spatial overlap, small mean orthogonal distance differences, and similar radiation doses.
Collapse
Affiliation(s)
- Kyle Wang
- Department of Radiation Oncology, University of North Carolina Hospitals , Chapel Hill, NC , USA
| | - Brandon T Mullins
- Department of Radiation Oncology, University of North Carolina Hospitals , Chapel Hill, NC , USA
| | - Aaron D Falchook
- Department of Radiation Oncology, University of North Carolina Hospitals , Chapel Hill, NC , USA
| | - Jun Lian
- Department of Radiation Oncology, University of North Carolina Hospitals , Chapel Hill, NC , USA
| | - Kelei He
- State Key Laboratory for Novel Software Technology, Nanjing University , Nanjing , China
| | - Dinggang Shen
- Department of Radiology, University of North Carolina Hospitals , Chapel Hill, NC , USA
| | - Michael Dance
- Department of Radiation Oncology, University of North Carolina Hospitals , Chapel Hill, NC , USA
| | - Weili Lin
- Department of Radiology, University of North Carolina Hospitals , Chapel Hill, NC , USA
| | - Tiffany M Sills
- Department of Radiology, University of North Carolina Hospitals , Chapel Hill, NC , USA
| | - Shiva K Das
- Department of Radiation Oncology, University of North Carolina Hospitals , Chapel Hill, NC , USA
| | - Benjamin Y Huang
- Department of Radiology, University of North Carolina Hospitals , Chapel Hill, NC , USA
| | - Bhishamjit S Chera
- Department of Radiation Oncology, University of North Carolina Hospitals , Chapel Hill, NC , USA
| |
Collapse
|
32
|
Sekine T, de Galiza Barbosa F, Kuhn FP, Burger IA, Stolzmann P, Huber GF, Kollias SS, von Schulthess GK, Veit-Haibach P, Huellner MW. PET+MR versus PET/CT in the initial staging of head and neck cancer, using a trimodality PET/CT+MR system. Clin Imaging 2017; 42:232-239. [PMID: 28129606 DOI: 10.1016/j.clinimag.2017.01.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 12/19/2016] [Accepted: 01/10/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare the diagnostic accuracy of PET+MR with PET/CT in the initial staging of head and neck cancer. MATERIALS AND METHODS Contrast-enhanced PET/CT+MR was performed in 27 patients with newly diagnosed head and neck cancer. PET/CT and PET+MR were evaluated separately, and the TNM stage and factors influencing treatment were assessed. RESULTS The TNM staging by PET+MR was comparable to PET/CT (T: p=0.331, N: p=0.453, M: p=0.034). The sensitivity/specificity/accuracy of treatment-influencing factors by PET/CT and PET+MR were 0.68/0.99/0.97, and 1.00/1.00/0.99, respectively. CONCLUSIONS Whole-body staging with PET+MR yields at least equal diagnostic accuracy as PET/CT in head and neck cancer.
Collapse
Affiliation(s)
- Tetsuro Sekine
- Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Switzerland; Department of Radiology, Nippon Medical School, Tokyo, Japan.
| | | | - Felix P Kuhn
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Switzerland; Clinic of Neuroradiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Irene A Burger
- Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Switzerland
| | - Paul Stolzmann
- Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Switzerland; Clinic of Neuroradiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Gerhard F Huber
- Department of Otorhinolaryngology, University Hospital Zurich, University of Zurich, Switzerland
| | - Spyros S Kollias
- Clinic of Neuroradiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Gustav K von Schulthess
- Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Switzerland
| | - Patrick Veit-Haibach
- Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Switzerland; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Martin W Huellner
- Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Switzerland
| |
Collapse
|
33
|
Cacicedo J, Navarro A, Del Hoyo O, Gomez-Iturriaga A, Alongi F, Medina JA, Elicin O, Skanjeti A, Giammarile F, Bilbao P, Casquero F, de Bari B, Dal Pra A. Role of fluorine-18 fluorodeoxyglucose PET/CT in head and neck oncology: the point of view of the radiation oncologist. Br J Radiol 2016; 89:20160217. [PMID: 27416996 DOI: 10.1259/bjr.20160217] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Squamous cell carcinoma is the most common malignant tumour of the head and neck. The initial TNM staging, the evaluation of the tumour response during treatment, and the long-term surveillance are crucial moments in the approach to head and neck squamous cell carcinoma (HNSCC). Thus, at each of these moments, the choice of the best diagnostic tool providing the more precise and larger information is crucial. Positron emission tomography with fluorine-18 fludeoxyglucose integrated with CT (18F-FDG-PET/CT) rapidly gained clinical acceptance, and it has become an important imaging tool in routine clinical oncology. However, controversial data are currently available, for example, on the role of 18F-FDG-PET/CT imaging during radiotherapy planning, the prognostic value or its real clinical impact on treatment decisions. In this article, the role of 18F-FDG-PET/CT imaging in HNSCC during pre-treatment staging, radiotherapy planning, treatment response assessment, prognosis and follow-up is reviewed focusing on current evidence and controversial issues. A proposal on how to integrate 18F-FDG-PET/CT in daily clinical practice is also described.
Collapse
Affiliation(s)
- Jon Cacicedo
- 1 Radiation Oncology Department, Cruces University Hospital/Biocruces Health Research Institute, Barakaldo, Spain.,2 Grupo Español de Oncología Radioterápica en Cabeza y Cuello (GEORCC)
| | - Arturo Navarro
- 3 Radiation Oncology Department, Hospital Duran i Reynals (ICO) Avda, Gran Via de L´Hospitalet, Hospitalet de Llobregat, Barcelona, Spain
| | - Olga Del Hoyo
- 1 Radiation Oncology Department, Cruces University Hospital/Biocruces Health Research Institute, Barakaldo, Spain
| | - Alfonso Gomez-Iturriaga
- 1 Radiation Oncology Department, Cruces University Hospital/Biocruces Health Research Institute, Barakaldo, Spain
| | - Filippo Alongi
- 4 Radiation Oncology Department, Sacro Cuore-Don Calabria Hospital, Verona, Italy
| | - Jose A Medina
- 2 Grupo Español de Oncología Radioterápica en Cabeza y Cuello (GEORCC).,5 Radiation Oncology Department, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - Olgun Elicin
- 6 Radiation Oncology Department, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Andrea Skanjeti
- 7 Nuclear Medicine Department, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Francesco Giammarile
- 7 Nuclear Medicine Department, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Pedro Bilbao
- 1 Radiation Oncology Department, Cruces University Hospital/Biocruces Health Research Institute, Barakaldo, Spain
| | - Francisco Casquero
- 1 Radiation Oncology Department, Cruces University Hospital/Biocruces Health Research Institute, Barakaldo, Spain
| | - Berardino de Bari
- 8 fESTRO Radiation Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Alan Dal Pra
- 6 Radiation Oncology Department, Inselspital, Bern University Hospital, Bern, Switzerland
| |
Collapse
|
34
|
Kreppel M, Nazarli P, Grandoch A, Safi AF, Zirk M, Nickenig HJ, Scheer M, Rothamel D, Hellmich M, Zöller JE. Clinical and histopathological staging in oral squamous cell carcinoma - Comparison of the prognostic significance. Oral Oncol 2016; 60:68-73. [PMID: 27531875 DOI: 10.1016/j.oraloncology.2016.07.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 07/02/2016] [Accepted: 07/04/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND In oral cancer the prognostic significance of clinical staging (cTNM) is regarded inferior to histopathologic staging (pTNM) after surgery. This is mainly due to the point that the quality of the cTNM strongly depends on the clinical and radiological examination techniques applied and the physician's experience. The aim of this study was to evaluate the prognostic quality of cTNM and pTNM in a single center cohort. METHODS This retrospective study included 392 patients with treatment-naive oral squamous cell carcinoma (OSCC). All patients received primary surgery including a neck dissection. According to tumor stage and histopathologic risk factors patients received adjuvant radiotherapy (RT) or radiochemotherapy (RCT). Prognostic factors were identified in univariate analysis by using the log rank test and in multivariate analysis through Cox regression. RESULTS Clinical and histopathologic staging showed concordance in 62% for the primary tumor and 59% for cN- and pN-classification. In 58% of the cases of discordance the primary tumor was overstaged. In case of discordance of metastatic spread to the cervical lymph nodes, lymph node involvement showed overstaging in 78%. In univariate analysis cT-, cN-, cT- and pT-classification had a significant impact (p<0.05) on overall survival (OS). In multivariate analysis only pT- and pN-classification had a significant impact on OS. CONCLUSION Despite advances and modern radiologic techniques, pTNM has a higher prognostic quality than cTNM. Discordance between clinical and histopathologic staging was observed in up to 40%. When discordance was observed overstaging for clinical T-stage and clinical N-stage was more likely than understaging.
Collapse
Affiliation(s)
- Matthias Kreppel
- Department for Oral and Cranio-Maxillo and Facial Plastic Surgery, University of Cologne, Germany; Center for Integrated Oncology (CIO) Cologne-Bonn, Germany.
| | - Parvin Nazarli
- Department for Oral and Cranio-Maxillo and Facial Plastic Surgery, University of Cologne, Germany; Center for Integrated Oncology (CIO) Cologne-Bonn, Germany
| | - Andrea Grandoch
- Department for Oral and Cranio-Maxillo and Facial Plastic Surgery, University of Cologne, Germany; Center for Integrated Oncology (CIO) Cologne-Bonn, Germany
| | - Ali-Farid Safi
- Department for Oral and Cranio-Maxillo and Facial Plastic Surgery, University of Cologne, Germany; Center for Integrated Oncology (CIO) Cologne-Bonn, Germany
| | - Matthias Zirk
- Department for Oral and Cranio-Maxillo and Facial Plastic Surgery, University of Cologne, Germany; Center for Integrated Oncology (CIO) Cologne-Bonn, Germany
| | - Hans-Joachim Nickenig
- Department for Oral and Cranio-Maxillo and Facial Plastic Surgery, University of Cologne, Germany; Center for Integrated Oncology (CIO) Cologne-Bonn, Germany
| | | | - Daniel Rothamel
- Department for Oral and Cranio-Maxillo and Facial Plastic Surgery, University of Cologne, Germany; Center for Integrated Oncology (CIO) Cologne-Bonn, Germany
| | - Martin Hellmich
- Department for Medical Statistics, Informatics and Epidemiology, University of Cologne, Germany
| | - Joachim E Zöller
- Department for Oral and Cranio-Maxillo and Facial Plastic Surgery, University of Cologne, Germany; Center for Integrated Oncology (CIO) Cologne-Bonn, Germany
| |
Collapse
|
35
|
Shen G, Hu S, Liu B, Kuang A. Diagnostic Performance of Whole-Body PET/MRI for Detecting Malignancies in Cancer Patients: A Meta-Analysis. PLoS One 2016; 11:e0154497. [PMID: 27124545 PMCID: PMC4849712 DOI: 10.1371/journal.pone.0154497] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 04/14/2016] [Indexed: 02/05/2023] Open
Abstract
Background As an evolving imaging modality, PET/MRI is preliminarily applied in clinical practice. The aim of this study was to assess the diagnostic performance of PET/MRI for tumor staging in patients with various types of cancer. Methods Relevant articles about PET/MRI for cancer staging were systematically searched in PubMed, EMBASE, EBSCO and the Cochrane Library. Two researchers independently selected studies, extracted data and assessed the methodological quality using the QUADAS tool. The pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (PLR), and negative likelihood ratio (NLR) were calculated per patient and per lesion. The summary receiver-operating characteristic (SROC) curves were also constructed, and the area under the curve (AUC) and Q* estimates were obtained. Results A total of 38 studies that involved 753 patients and 4234 lesions met the inclusion criteria. On a per-patient level, the pooled sensitivity and specificity with 95% confidence intervals (CIs) were 0.93 (0.90–0.95) and 0.92 (0.89–0.95), respectively. On a per-lesion level, the corresponding estimates were 0.90 (0.88–0.92) and 0.95 (0.94–0.96), respectively. The pooled PLR, NLR and DOR estimates were 6.67 (4.83–9.19), 0.12 (0.07–0.21) and 75.08 (42.10–133.91) per patient and 10.91 (6.79–17.54), 0.13 (0.08–0.19) and 102.53 (59.74–175.97) per lesion, respectively. Conclusion According to our results, PET/MRI has excellent diagnostic potential for the overall detection of malignancies in cancer patients. Large, multicenter and prospective studies with standard scanning protocols are required to evaluate the diagnostic value of PET/MRI for individual cancer types.
Collapse
Affiliation(s)
- Guohua Shen
- Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, Sichuan, 610041, People’s Republic of China
| | - Shuang Hu
- Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, Sichuan, 610041, People’s Republic of China
| | - Bin Liu
- Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, Sichuan, 610041, People’s Republic of China
| | - Anren Kuang
- Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, Sichuan, 610041, People’s Republic of China
- * E-mail:
| |
Collapse
|
36
|
Kwon HW, Becker AK, Goo JM, Cheon GJ. FDG Whole-Body PET/MRI in Oncology: a Systematic Review. Nucl Med Mol Imaging 2016; 51:22-31. [PMID: 28250855 DOI: 10.1007/s13139-016-0411-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 03/01/2016] [Accepted: 03/16/2016] [Indexed: 01/14/2023] Open
Abstract
The recent advance in hybrid imaging techniques enables offering simultaneous positron emission tomography (PET)/magnetic resonance imaging (MRI) in various clinical fields. 18F-fluorodeoxyglucose (FDG) PET has been widely used for diagnosis and evaluation of oncologic patients. The growing evidence from research and clinical experiences demonstrated that PET/MRI with FDG can provide comparable or superior diagnostic performance more than conventional radiological imaging such as computed tomography (CT), MRI or PET/CT in various cancers. Combined analysis using structural information and functional/molecular information of tumors can draw additional diagnostic information based on PET/MRI. Further studies including determination of the diagnostic efficacy, optimizing the examination protocol, and analysis of the hybrid imaging results is necessary for extending the FDG PET/MRI application in clinical oncology.
Collapse
Affiliation(s)
- Hyun Woo Kwon
- Department of Nuclear Medicine, Soonchunhyang University Hospital, Cheonan, South Korea
| | | | - Jin Mo Goo
- Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea
| | - Gi Jeong Cheon
- Department of Nuclear Medicine, Seoul National University College of Medicine, 101 Daehang-ro, Jongno-gu, Seoul, 03080 Republic of Korea
| |
Collapse
|
37
|
Abstract
One early application of PET/MRI in clinical practice may be the imaging of head and neck cancers. This is because the morphologic imaging modalities, CT and MR, are recognized as similarly effective tools in cross-sectional oncological imaging of the head and neck. The addition of PET with FDG is believed to enhance the accuracy of both modalities to a similar degree. However, there are a few specific scenarios in head and neck cancer imaging where MR is thought to provide an edge over CT, including perineural spread of tumors and the infiltration of important anatomical landmarks, such as the prevertebral fascia and great vessel walls. Here, hybrid PET/MR might provide higher diagnostic certainty than PET/CT or a separate acquisition of PET/CT and MR. Another advantage of MR is the availability of several functional techniques. Although some of them might enhance the imaging of head and neck cancer with PET/MR, other functional techniques actually might prove dispensable in the presence of PET. In this overview, we discuss current trends and potential clinical applications of PET/MR in the imaging of head and neck cancers, including clinical protocols. We also discuss potential benefits of implementing functional MR techniques into hybrid PET/MRI of head and neck cancers.
Collapse
Affiliation(s)
- Marcelo A Queiroz
- Research and Education Institute, Hospital Sirio-Libanes, Sao Paulo, Brazil; Department of Radiology, Cancer Institute, Hospital das Clinicas/University of Sao Paulo, Sao Paulo, Brazil
| | - Martin W Huellner
- Research and Education Institute, Hospital Sirio-Libanes, Sao Paulo, Brazil; Department of Medical Radiology, Divisions of Nuclear Medicine and Neuroradiology,University Hospital Zurich/University of Zurich, Zurich, Switzerland.
| |
Collapse
|
38
|
Indeterminate Findings on Oncologic PET/CT: What Difference Does PET/MRI Make? Nucl Med Mol Imaging 2016; 50:292-299. [PMID: 27994684 DOI: 10.1007/s13139-016-0405-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 01/28/2016] [Accepted: 02/04/2016] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Positron emission tomography/computed tomography (PET/CT) with 2-deoxy-2-[18F]fluoro-D-glucose (FDG) has become the standard of care for the initial staging and subsequent treatment response assessment of many different malignancies. Despite this success, PET/CT is often supplemented by MRI to improve assessment of local tumor invasion and to facilitate detection of lesions in organs with high background FDG uptake. Consequently, PET/MRI has the potential to expand the clinical value of PET examinations by increasing reader certainty and reducing the need for subsequent imaging. This study evaluates the ability of FDG-PET/MRI to clarify findings initially deemed indeterminate on clinical FDG-PET/CT studies. METHODS A total of 190 oncology patients underwent whole-body PET/CT, immediately followed by PET/MRI utilizing the same FDG administration. Each PET/CT was interpreted by our institution's nuclear medicine service as a standard-of-care clinical examination. Review of these PET/CT reports identified 31 patients (16 %) with indeterminate findings. Two readers evaluated all 31 PET/CT studies, followed by the corresponding PET/MRI studies. A consensus was reached for each case, and changes in interpretation directly resulting from PET/MRI review were recorded. Interpretations were then correlated with follow-up imaging, pathology results, and other diagnostic studies. RESULTS In 18 of 31 cases with indeterminate findings on PET/CT, PET/MRI resulted in a more definitive interpretation by facilitating the differentiation of infection/inflammation from malignancy (15/18), the accurate localization of FDG-avid lesions (2/18), and the characterization of incidental non-FDG-avid solid organ lesions (1/18). Explanations for improved reader certainty with PET/MRI included the superior soft tissue contrast of MRI and the ability to assess cellular density with diffusion-weighted imaging. The majority (12/18) of such cases had an appropriate standard of reference; in all 12 cases, the definitive PET/MRI interpretation proved correct. These 12 patients underwent six additional diagnostic studies to clarify the initial indeterminate PET/CT findings. In the remaining 13 of 31 cases with indeterminate findings on both PET/CT and PET/MRI, common reasons for uncertainty included the inability to distinguish reactive from malignant lymphadenopathy (4/13) and local recurrence from treatment effect (2/13). CONCLUSIONS Indeterminate PET/CT findings can result in equivocal reads and additional diagnostic studies. PET/MRI may reduce the rate of indeterminate findings by facilitating better tumor staging, FDG activity localization, and lesion characterization. In our study, PET/MRI resulted in more definitive imaging interpretations with high accuracy. PET/MRI also showed potential in reducing the number of additional diagnostic studies prompted by PET/CT findings. Our results suggest that whole-body PET/MRI provides certain diagnostic advantages over PET/CT, promotes more definitive imaging interpretations, and may improve the overall clinical utility of PET.
Collapse
|
39
|
Fraum TJ, Fowler KJ, McConathy J. Conspicuity of FDG-Avid Osseous Lesions on PET/MRI Versus PET/CT: a Quantitative and Visual Analysis. Nucl Med Mol Imaging 2016; 50:228-39. [PMID: 27540427 DOI: 10.1007/s13139-016-0403-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 01/14/2016] [Accepted: 02/02/2016] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Because standard MRI-based attenuation correction (AC) does not account for the attenuation of photons by cortical bone, PET/MRI may have reduced sensitivity for FDG-avid focal bone lesions (FFBLs). This study evaluates whether MRI-based AC compromises detection of FFBLs, by comparing their conspicuity both quantitatively and qualitatively on PET/MRI versus PET/CT. METHODS One hundred ninety general oncology patients underwent whole-body PET/CT followed by whole-body PET/MRI, utilizing the same FDG dose. Thirteen patients with a total of 50 FFBLs were identified. Using automated contouring software, a volumetric contour was generated for each FFBL. Adjacent regions of normal background bone (BB) were selected manually. For each contour, SUV-max and SUV-mean were determined. Lesion-to-background SUV ratios served as quantitative metrics of conspicuity. Additionally, two blinded readers evaluated the relative conspicuity of FFBLs on PET images derived from MRI-based AC versus CT-based AC. Visibility of an anatomic correlate for FFBLs on the corresponding CT and MR images was also assessed. RESULTS SUV-mean was lower on PET/MRI for both FFBLs (-6.5 %, p = 0.009) and BB (-20.5 %, p < 0.001). SUV-max was lower on PET/MRI for BB (-14.2 %, p = 0.002) but not for FFBLs (-6.2 %, p = 0.068). The ratio of FFBL SUV-mean to BB SUV-mean was higher for PET/MRI (+29.5 %, p < 0.001). Forty of 50 lesions (80 %) were visually deemed to be of equal or greater conspicuity on PET images derived from PET/MRI. Thirty-five of 50 FFBLs (70 %) had CT correlates, while 40/50 FFBLs (80 %) had a correlate on at least one MRI sequence. The mean interval from tracer administration to imaging was longer (p < 0.001) for PET/MRI (127 v. 62 min). CONCLUSIONS Both FFBLs and BB had lower mean SUVs on PET/MRI than PET/CT. This finding was likely in part due to differences in the handling of cortical bone by MRI-based AC versus CT-based AC. Despite this systematic bias, FFBLs had greater conspicuity on PET/MRI, both qualitatively and quantitatively. This difference was likely due to the longer tracer uptake times for PET/MRI, which allowed for more tracer accumulation by FFBLs and more tracer washout from BB. Our results suggest that whole-body PET/MRI and PET/CT provide comparable sensitivity for detection of FDG-avid focal bone lesions.
Collapse
Affiliation(s)
- Tyler J Fraum
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Campus Box 8131, 510 S. Kingshighway Blvd., Saint Louis, MO 63110 USA
| | - Kathryn J Fowler
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Campus Box 8131, 510 S. Kingshighway Blvd., Saint Louis, MO 63110 USA
| | - Jonathan McConathy
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Campus Box 8131, 510 S. Kingshighway Blvd., Saint Louis, MO 63110 USA
| |
Collapse
|
40
|
Sawicki LM, Grueneisen J, Schaarschmidt BM, Buchbender C, Nagarajah J, Umutlu L, Antoch G, Kinner S. Evaluation of 18 F-FDG PET/MRI, 18 F-FDG PET/CT, MRI, and CT in whole-body staging of recurrent breast cancer. Eur J Radiol 2016; 85:459-65. [DOI: 10.1016/j.ejrad.2015.12.010] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 12/09/2015] [Accepted: 12/14/2015] [Indexed: 10/22/2022]
|
41
|
Fraum TJ, Fowler KJ, McConathy J. PET/MRI: Emerging Clinical Applications in Oncology. Acad Radiol 2016; 23:220-36. [PMID: 26521689 DOI: 10.1016/j.acra.2015.09.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 08/08/2015] [Accepted: 09/27/2015] [Indexed: 01/09/2023]
Abstract
Positron emission tomography (PET), commonly performed in conjunction with computed tomography (CT), has revolutionized oncologic imaging. PET/CT has become the standard of care for the initial staging and assessment of treatment response for many different malignancies. Despite this success, PET/CT is often supplemented by magnetic resonance imaging (MRI), which offers superior soft-tissue contrast and a means of assessing cellular density with diffusion-weighted imaging. Consequently, PET/MRI, the newest clinical hybrid imaging modality, has the potential to provide added value over PET/CT or MRI alone. The purpose of this article is to provide a comprehensive review of the current body of literature pertaining to the clinical performance of PET/MRI, with the aim of summarizing current evidence and identifying gaps in knowledge to direct clinical expansion and future research. Multiple example cases are also provided to illustrate the central findings of these publications.
Collapse
|
42
|
Stecco A, Ciolfi S, Buemi F, Cassarà A, Sacchetti GM, Brambilla M, Carriero A. Combined multimodal co-registration of PET/CT and MRI images increases diagnostic accuracy in squamous cell carcinoma staging. Radiol Med 2016; 121:502-9. [DOI: 10.1007/s11547-015-0617-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 12/13/2015] [Indexed: 12/17/2022]
|
43
|
Sarrión Pérez MG, Bagán JV, Jiménez Y, Margaix M, Marzal C. Utility of imaging techniques in the diagnosis of oral cancer. J Craniomaxillofac Surg 2015; 43:1880-94. [DOI: 10.1016/j.jcms.2015.07.037] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 07/05/2015] [Accepted: 07/30/2015] [Indexed: 02/07/2023] Open
|
44
|
Covello M, Cavaliere C, Aiello M, Cianelli MS, Mesolella M, Iorio B, Rossi A, Nicolai E. Simultaneous PET/MR head-neck cancer imaging: Preliminary clinical experience and multiparametric evaluation. Eur J Radiol 2015; 84:1269-76. [PMID: 25958189 DOI: 10.1016/j.ejrad.2015.04.010] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 03/26/2015] [Accepted: 04/11/2015] [Indexed: 12/26/2022]
Abstract
PURPOSE To evaluate the role of simultaneous hybrid PET/MR imaging and to correlate metabolic PET data with morpho-functional parameters derived by MRI in patients with head-neck cancer. METHODS Forty-four patients, with histologically confirmed head and neck malignancy (22 primary tumors and 22 follow-up) were studied. Patients initially received a clinical exam and endoscopy with direct biopsy. Next patients underwent whole body PET/CT followed by PET/MR of the head/neck region. PET and MRI studies were separately evaluated by two blinded groups (both included one radiologist and one nuclear physician) in order to define the presence or absence of lesions/recurrences. Regions of interest (ROIs) analysis was conducted on the primary lesion at the level of maximum size on metabolic (SUV and MTV), diffusion (ADC) and perfusion (K(trans), Ve, kep and iAUC) parameters. RESULTS PET/MR examinations were successfully performed on all 44 patients. Agreement between the two blinded groups was found in anatomic allocation of lesions by PET/MR (Primary tumors: Cohen's kappa 0.93; FOLLOW-UP Cohen's kappa 0.89). There was a significant correlation between CT-SUV measures and MR (e.g., CT-SUV VOI vs. MR-SUV VOI ρ=0.97, p<0.001 for the entire sample). There was also significant positive correlations between the ROI area, SUV measures, and the metabolic parameters (SUV and MTV) obtained during both PET/CT and PET/MR. A significant negative correlation was observed between ADC and K(trans) values in the primary tumors. In addition, a significant negative correlation existed between MR SUV and ADC in recurrent tumors. CONCLUSION Our study demonstrates the feasibility of PET/MR imaging for primary tumors and recurrent tumors evaluations of head/neck malignant lesions. When assessing HNC, PET/MR allows simultaneous collection of multiparametric metabolic and functional data. This technique therefore allows for a more complete characterization of malignant lesions.
Collapse
Affiliation(s)
- M Covello
- IRCCS SDN, Via E. Gianturco, 111-113 - 80143, Naples, Italy.
| | - C Cavaliere
- IRCCS SDN, Via E. Gianturco, 111-113 - 80143, Naples, Italy
| | - M Aiello
- IRCCS SDN, Via E. Gianturco, 111-113 - 80143, Naples, Italy
| | - M S Cianelli
- IRCCS SDN, Via E. Gianturco, 111-113 - 80143, Naples, Italy
| | - M Mesolella
- Department of Otorhinolaryngoiatry, Federico II University, Naples, Italy
| | - B Iorio
- Department of Otorhinolaryngoiatry, Federico II University, Naples, Italy
| | - A Rossi
- IRCCS SDN, Via E. Gianturco, 111-113 - 80143, Naples, Italy
| | - E Nicolai
- IRCCS SDN, Via E. Gianturco, 111-113 - 80143, Naples, Italy
| |
Collapse
|
45
|
|
46
|
Chen W, Zhang C, Zhang S, Liang L, Zhang B, Liu C, Zhang Z, Liang C. Application value of MRI combined with positron emission tomography (PET)/CT in diagnosis and preoperative staging of tongue squamous cell carcinoma. J Med Imaging Radiat Oncol 2015; 59:170-8. [PMID: 25753588 DOI: 10.1111/1754-9485.12282] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Accepted: 12/26/2014] [Indexed: 11/29/2022]
Abstract
INTRODUCTION This study aimed to compare and analyse the findings of tongue squamous cell carcinoma (TSCC) on MRI and positron emission tomography (PET)/CT and explore the diagnostic utility of combined MRI-PET/CT in the diagnosis and preoperative staging of TSCC. METHODS A prospective analysis of MRI and PET/CT data in 18 TSCC cases was performed. Cases were comprehensively staged on MRI and PET/CT preoperatively according to American Joint Committee on Cancer (AJCC) staging criteria and confirmed by pathological results. RESULTS The highest and lowest sensitivities of preoperative AJCC staging I-IV using MRI alone, PET/CT alone and combined MRI-PET/CT were 100.0%, 100.0% and 100.0% (stage II) and 50.4%, 55.6% and 55.6% (stage I), respectively. The highest specificities were 100.0%, 100.0% and 100.0% (stage II), and the highest correct rates were 100.0%, 96.5% and 100.0% (stage II). Compared with the postoperative pathological staging, preoperative staging showed no significant difference for stages I-II and IV (P > 0.05); however, stage III showed a significant difference (P < 0.05). When combined MRI-PET/CT was compared with MRI alone in the accuracy of preoperative TSCC staging, there was no significant difference for stages I-III (P > 0.05), but there was a significant difference for stage IV (P < 0.05). CONCLUSIONS Combined MRI and PET/CT could serve as an important tool for the accurate diagnosis and preoperative staging of TSCC and could improve the accuracy of preoperative TSCC staging.
Collapse
Affiliation(s)
- Wenbo Chen
- Department of Radiology, Guangdong Academy of Medical Sciences, Guangdong General Hospital, Guangzhou, Guangdong, China; Graduate College, Southern Medical University, Guangzhou, Guangdong, China
| | | | | | | | | | | | | | | |
Collapse
|
47
|
Sun R, Tang X, Yang Y, Zhang C. (18)FDG-PET/CT for the detection of regional nodal metastasis in patients with head and neck cancer: a meta-analysis. Oral Oncol 2015; 51:314-20. [PMID: 25619735 DOI: 10.1016/j.oraloncology.2015.01.004] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Revised: 01/03/2015] [Accepted: 01/05/2015] [Indexed: 11/28/2022]
Abstract
We performed a meta-analysis to evaluate the role of (18)FDG-PET/CT for detection of regional nodal metastasis in patients with head and neck cancer (HNC). Studies about (18)FDG-PET/CT were systematically searched in the MEDLINE and EMBASE databases. The Stata software was used to obtain pooled estimates of sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio for (18)FDG-PET/CT. We also compared the performance of (18)FDG-PET/CT with that of conventional imaging (CT, MRI, and CT/MRI) by analyzing studies that had also used conventional imaging on the same patients. 24 articles bulled all inclusion criteria (1270 patients). The pooled per-patient, per-neck-side, and per-neck-level sensitivities/specificities for (18)FDG-PET/CT were 0.91/0.87, 0.84/0.83, and 0.80/0.96, respectively. Across 13 studies (3460 neck levels) with per-neck-level data, the sensitivity and specificity of PET-CT were 0.84 and 0.96, and of conventional imaging were 0.63 and 0.96, respectively. (18)FDG-PET/CT has good diagnostic performance for the detection of regional nodal metastasis in HNC patients. Compared with conventional imaging, (18)FDG-PET/CT may have higher per-neck-level sensitivity.
Collapse
Affiliation(s)
- Rong Sun
- Department of Physical Examination, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Xinye Tang
- Departments of Otolaryngology, Children's Hospital of Chongqing Medical University, Chongqing 400016, China; Pediatric Research Institute of Chongqing Medical University, Chongqing 400016, China; National Key Disciplinary Areas of Pediatrics, Ministry of Education, Chongqing 400016, China.
| | - Yang Yang
- Departments of Otolaryngology, Children's Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Cheng Zhang
- Departments of Otolaryngology, Children's Hospital of Chongqing Medical University, Chongqing 400016, China
| |
Collapse
|
48
|
Loeffelbein DJ, Souvatzoglou M, Wankerl V, Dinges J, Ritschl LM, Mücke T, Pickhard A, Eiber M, Schwaiger M, Beer AJ. Diagnostic value of retrospective PET-MRI fusion in head-and-neck cancer. BMC Cancer 2014; 14:846. [PMID: 25407100 PMCID: PMC4252007 DOI: 10.1186/1471-2407-14-846] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 10/31/2014] [Indexed: 12/03/2022] Open
Abstract
Background To assess the diagnostic value of retrospective PET-MRI fusion and to compare
the results with side-by-side analysis and single modality use of PET and of MRI
alone for locoregional tumour and nodal staging of head-and-neck cancer. Methods Thirty-three patients with head-and-neck cancer underwent preoperative
contrast-enhanced MRI and PET/CT for staging. The diagnostic data of MRI, PET,
side-by-side analysis of MRI and PET images and retrospective PET-MRI fusion were
systematically analysed for tumour and lymph node staging using receiver operating
characteristic (ROC) analysis. The results were correlated to the
histopathological evaluation. Results The overall sensitivity/specificity for tumour staging for MRI, PET,
side-by-side analysis and retrospective PET-MRI fusion was 79%/66%, 82%/100%,
86%/100% and 89%/100%, respectively. The overall sensitivity/specificity for nodal
staging on a patient basis for MRI, PET, side-by-side analysis and PET-MRI fusion
was 94%/64%, 94%/91%, 94%/82% and 94%/82%, respectively. MRI, PET, side-by-side
analysis and retrospective image fusion were associated with correct
diagnosis/over-staging/under-staging of N-staging in 70.4%/18.5%/11.1%,
81.5%/7.4%/11.1%, 81.5%/11.1%/7.4% and 81.5%/11.1%/7.4%, respectively. ROC analysis showed no significant differences in tumor detection between the
investigated methods. The Area Under the Curve (AUC) for MRI, PET, side-by-side
analysis and retrospective PET-MRI fusion were 0.667/0.667/0.702/0.708
(p > 0.05). The most reliable technique in detection of cervical lymph node
metastases was PET imaging (AUC: 0.95), followed by side-by-side analysis and
retrospective image fusion technique (AUC: 0.941), which however, was not
significantly better then the MRI (AUC 0.935; p > 0.05). Conclusions We found a beneficial use of multimodal imaging, compared with MRI or PET
imaging alone, particular in individual cases of recurrent tumour disease.
Side-by-side analysis and retrospective image fusion analysis did not perform
significantly differently.
Collapse
Affiliation(s)
- Denys J Loeffelbein
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Ismaningerstr, 22, D-82675 München, Germany.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Lymph Node Disease and Advanced Head and Neck Imaging: A Review of the 2013 Literature. CURRENT RADIOLOGY REPORTS 2014. [DOI: 10.1007/s40134-014-0058-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
50
|
PET/CT for Head and Neck Squamous Cell Cancer—Uses and Updates for Radiologists. CURRENT RADIOLOGY REPORTS 2014. [DOI: 10.1007/s40134-014-0047-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|