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Menendez-Santos M, Gonzalez-Baerga C, Taher D, Waters R, Virarkar M, Bhosale P. Endometrial Cancer: 2023 Revised FIGO Staging System and the Role of Imaging. Cancers (Basel) 2024; 16:1869. [PMID: 38791948 PMCID: PMC11119523 DOI: 10.3390/cancers16101869] [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: 03/25/2024] [Revised: 05/02/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
The FIGO endometrial cancer staging system recently released updated guidance based on clinical evidence gathered after the previous version was published in 2009. Different imaging modalities are beneficial across various stages of endometrial cancer (EC) management. Additionally, ongoing research studies are aimed at improving imaging in EC. Gynecological cancer is a crucial element in the practice of a body radiologist. With a new staging system in place, it is important to address the role of radiology in the EC diagnostic pathway. This article is a comprehensive review of the changes made to the FIGO endometrial cancer staging system and the impact of imaging in the staging of this disease.
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Affiliation(s)
- Manuel Menendez-Santos
- Department of Radiology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL 32209, USA; (C.G.-B.); (M.V.)
| | - Carlos Gonzalez-Baerga
- Department of Radiology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL 32209, USA; (C.G.-B.); (M.V.)
| | - Daoud Taher
- Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (D.T.); (R.W.); (P.B.)
| | - Rebecca Waters
- Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (D.T.); (R.W.); (P.B.)
| | - Mayur Virarkar
- Department of Radiology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL 32209, USA; (C.G.-B.); (M.V.)
| | - Priya Bhosale
- Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (D.T.); (R.W.); (P.B.)
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Li X, Lv X, Quan Z, Han T, Tang Y, Liu Y, Wang M, Li G, Ye J, Wang J, Lan X, Zhang X, Li M, Liu S, Kang F, Wang J. Surgical evidence-based comparison of [ 68Ga]Ga-FAPI-04 PET and MRI-DWI for assisting debulking surgery in ovarian cancer patients. Eur J Nucl Med Mol Imaging 2024; 51:1773-1785. [PMID: 38197954 DOI: 10.1007/s00259-023-06582-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/22/2023] [Indexed: 01/11/2024]
Abstract
PURPOSE Imaging assessment of abdominopelvic tumor burden is crucial for debulking surgery decision in ovarian cancer patients. This study aims to compare the efficiency of [68Ga]Ga-FAPI-04 FAPI PET and MRI-DWI in the preoperative evaluation and its potential impact to debulking surgery decision. METHODS Thirty-six patients with suspected/confirmed ovarian cancer were enrolled and underwent integrated [68Ga]Ga-FAPI-04 PET/MRI. Nineteen patients (15 stage III-IV and 4 I-II stage) who underwent debulking surgery were involved in the diagnostic efficiency analysis. The images of [68Ga]Ga-FAPI-04 PET and MRI-DWI were visually analyzed respectively. Immunohistochemistry on FAP was performed in metastatic lesions to investigate the radiological missing of [68Ga]Ga-FAPI-04 PET as well as its different performance in primary debulking surgery (PDS) and interval debulking surgery (IDS) patients. Potential imaging impact on management was also studied in 35 confirmed ovarian cancer patients. RESULTS [68Ga]Ga-FAPI-04 PET displayed higher sensitivity (76.8% vs.59.9%), higher accuracy (84.9% vs. 80.7%), and lower missing rate (23.2% vs. 40.1%) than MRI-DWI in detecting abdominopelvic metastasis. The diagnostic superiority of [68Ga]Ga-FAPI-04 PET is more obvious in PDS patients but diminished in IDS patients. [68Ga]Ga-FAPI-04 PET outperformed MRI-DWI in 70.8% abdominopelvic regions (17/24), which contained seven key regions that impact the resectability and surgical complexity. MRI-DWI hold advantage in the peritoneal surface of the bladder and the central tendon of the diaphragm. Of the contradictory judgments between the two modalities (14.9%), [68Ga]Ga-FAPI-04 PET correctly identified more lesions, particularly in PDS patients (73.8%). In addition, FAP expression was independent of lesion size and decreased in IDS patients. [68Ga]Ga-FAPI-04 PET changed 42% of surgical planning that was previously based on MRI-DWI. CONCLUSION [68Ga]Ga-FAPI-04 PET is more efficient in assisting debulking surgery in ovarian cancer patients than MRI-DWI. Integrated [68Ga]Ga-FAPI-04 PET/MR imaging is a potential method for planning debulking surgery in ovarian cancer patients.
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Affiliation(s)
- Xiang Li
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Xiaohui Lv
- Department of Gynaecology and Obstetrics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Zhiyong Quan
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Tingting Han
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Yongqiang Tang
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Ying Liu
- Department of Gynaecology and Obstetrics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Mengxin Wang
- Department of Gynaecology and Obstetrics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Guiyu Li
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Jiajun Ye
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Jingyi Wang
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Xiaoli Lan
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Xiao Zhang
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Mengting Li
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Shujuan Liu
- Department of Gynaecology and Obstetrics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China.
| | - Fei Kang
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China.
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China.
| | - Jing Wang
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China.
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China.
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Chen Y, Sun Z, Cai S, Hu Y, Jiang R, Xiang L, Zang R. Supragastric lesser sac: an insidious site for surgical exploration during the debulking surgery in advanced ovarian cancer. J Gynecol Oncol 2024; 35:e25. [PMID: 38130134 PMCID: PMC11107271 DOI: 10.3802/jgo.2024.35.e25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 09/08/2023] [Accepted: 11/26/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE Metastases in the supragastric lesser sac (SGLS) are not only occult but are also barriers to complete resection of ovarian cancer. We describe a cohort of patients with SGLS disease undergoing debulking surgery. METHODS We identified all patients who underwent evaluation and eventual resection of SGLS disease as part of cytoreductive surgery for stage IIIC-IVB high-grade epithelial ovarian cancer at our institution from January 2018 to August 2022. RESULTS Thirty-three of 286 patients (11.5%) underwent resection of SGLS disease. Metastases in the SGLS were identified by preoperative imaging in 4 of 33 patients (12.1%). The median peritoneal cancer index score was 22 (range, 9-33). Through surgical exploration, metastases were frequently seen in the right diaphragm (100%), hepatorenal recess (97%), lesser omentum (81.8%), left diaphragm (78.8%), supracolic omentum (75.8%), anterior transverse mesocolon (72.7%), splenic hilum (63.6%), ligamentum teres hepatis (60.6%), and gallbladder fossa (51.5%). The lesser omentum was normal in 6 of 33 (18.2%) patients, despite metastases within the SGLS. A total of 54.5% of patients underwent complex surgery (surgical complexity scores; median, 8; range, 3-14). Complete resections were achieved in 19 (57.6%) patients. No complications were related to the resection of SGLS disease. The median length of progression-free survival was 24.8 months (95% confidence interval=16.6-32.9). CONCLUSION Metastases to the SGLS are not uncommon in advanced ovarian cancer, particularly those with widely disseminated disease. Disease in this recess is rarely identified by preoperative imaging and deserves systematic surgical exploration to attain complete cytoreduction.
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Affiliation(s)
- Yulian Chen
- Ovarian Cancer Program, Department of Gynecologic Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zhuozhen Sun
- Ovarian Cancer Program, Department of Gynecologic Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Songqi Cai
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yan Hu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Rong Jiang
- Ovarian Cancer Program, Department of Gynecologic Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Libing Xiang
- Ovarian Cancer Program, Department of Gynecologic Oncology, Zhongshan Hospital, Fudan University, Shanghai, China.
| | - Rongyu Zang
- Ovarian Cancer Program, Department of Gynecologic Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
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Tsili AC, Alexiou G, Tzoumpa M, Siempis T, Argyropoulou MI. Imaging of Peritoneal Metastases in Ovarian Cancer Using MDCT, MRI, and FDG PET/CT: A Systematic Review and Meta-Analysis. Cancers (Basel) 2024; 16:1467. [PMID: 38672549 PMCID: PMC11048266 DOI: 10.3390/cancers16081467] [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: 02/07/2024] [Revised: 04/05/2024] [Accepted: 04/06/2024] [Indexed: 04/28/2024] Open
Abstract
This review aims to compare the diagnostic performance of multidetector CT (MDCT), MRI, including diffusion-weighted imaging, and FDG PET/CT in the detection of peritoneal metastases (PMs) in ovarian cancer (OC). A comprehensive search was performed for articles published from 2000 to February 2023. The inclusion criteria were the following: diagnosis/suspicion of PMs in patients with ovarian/fallopian/primary peritoneal cancer; initial staging or suspicion of recurrence; MDCT, MRI and/or FDG PET/CT performed for the detection of PMs; population of at least 10 patients; surgical results, histopathologic analysis, and/or radiologic follow-up, used as reference standard; and per-patient and per-region data and data for calculating sensitivity and specificity reported. In total, 33 studies were assessed, including 487 women with OC and PMs. On a per-patient basis, MRI (p = 0.03) and FDG PET/CT (p < 0.01) had higher sensitivity compared to MDCT. MRI and PET/CT had comparable sensitivities (p = 0.84). On a per-lesion analysis, no differences in sensitivity estimates were noted between MDCT and MRI (p = 0.25), MDCT and FDG PET/CT (p = 0.68), and MRI and FDG PET/CT (p = 0.35). Based on our results, FDG PET/CT and MRI are the preferred imaging modalities for the detection of PMs in OC. However, the value of FDG PET/CT and MRI compared to MDCT needs to be determined. Future research to address the limitations of the existing studies and the need for standardization and to explore the cost-effectiveness of the three imaging modalities is required.
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Affiliation(s)
- Athina C. Tsili
- Department of Clinical Radiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, University Campus, 45110 Ioannina, Greece; (M.T.); (M.I.A.)
| | - George Alexiou
- Department of Neurosurgery, Faculty of Medicine, School of Health Sciences, University of Ioannina, University Campus, 45110 Ioannina, Greece;
| | - Martha Tzoumpa
- Department of Clinical Radiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, University Campus, 45110 Ioannina, Greece; (M.T.); (M.I.A.)
| | - Timoleon Siempis
- ENT Department, Ulster Hospital, Upper Newtownards Rd., Dundonald, Belfast BT16 1RH, UK;
| | - Maria I. Argyropoulou
- Department of Clinical Radiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, University Campus, 45110 Ioannina, Greece; (M.T.); (M.I.A.)
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Zhang K, Abdoli N, Gilley P, Sadri Y, Chen X, Thai TC, Dockery L, Moore K, Mannel RS, Qiu Y. Developing a novel image marker to predict the clinical outcome of neoadjuvant chemotherapy (NACT) for ovarian cancer patients. Comput Biol Med 2024; 172:108240. [PMID: 38460312 DOI: 10.1016/j.compbiomed.2024.108240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 02/13/2024] [Accepted: 02/26/2024] [Indexed: 03/11/2024]
Abstract
OBJECTIVE Neoadjuvant chemotherapy (NACT) is one kind of treatment for advanced stage ovarian cancer patients. However, due to the nature of tumor heterogeneity, the clinical outcomes to NACT vary significantly among different subgroups. Partial responses to NACT may lead to suboptimal debulking surgery, which will result in adverse prognosis. To address this clinical challenge, the purpose of this study is to develop a novel image marker to achieve high accuracy prognosis prediction of NACT at an early stage. METHODS For this purpose, we first computed a total of 1373 radiomics features to quantify the tumor characteristics, which can be grouped into three categories: geometric, intensity, and texture features. Second, all these features were optimized by principal component analysis algorithm to generate a compact and informative feature cluster. This cluster was used as input for developing and optimizing support vector machine (SVM) based classifiers, which indicated the likelihood of receiving suboptimal cytoreduction after the NACT treatment. Two different kernels for SVM algorithm were explored and compared. A total of 42 ovarian cancer cases were retrospectively collected to validate the scheme. A nested leave-one-out cross-validation framework was adopted for model performance assessment. RESULTS The results demonstrated that the model with a Gaussian radial basis function kernel SVM yielded an AUC (area under the ROC [receiver characteristic operation] curve) of 0.806 ± 0.078. Meanwhile, this model achieved overall accuracy (ACC) of 83.3%, positive predictive value (PPV) of 81.8%, and negative predictive value (NPV) of 83.9%. CONCLUSION This study provides meaningful information for the development of radiomics based image markers in NACT treatment outcome prediction.
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Affiliation(s)
- Ke Zhang
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK, USA, 73019; School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK, USA, 73019
| | - Neman Abdoli
- School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK, USA, 73019
| | - Patrik Gilley
- School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK, USA, 73019
| | - Youkabed Sadri
- School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK, USA, 73019
| | - Xuxin Chen
- School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK, USA, 73019
| | - Theresa C Thai
- Department of Radiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA, 73104
| | - Lauren Dockery
- Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA, 73104
| | - Kathleen Moore
- Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA, 73104
| | - Robert S Mannel
- Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA, 73104
| | - Yuchen Qiu
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK, USA, 73019; School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK, USA, 73019.
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Qiu N, Zhang Z, Wei X, Xu C, Jia X, Wang K, Chen Y, Wang S, Su R, Cen B, Shen Y, Chen C, Liu Y, Xu X. Peritoneal Gene Transfection of Tumor Necrosis Factor-Related Apoptosis-Inducing Ligand for Tumor Surveillance and Prophylaxis. NANO LETTERS 2023; 23:7859-7868. [PMID: 37433066 DOI: 10.1021/acs.nanolett.3c01568] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
Peritoneal metastasis is very common in gastrointestinal, reproductive, and genitourinary tract cancers in late stages or postsurgery, causing poor prognosis, so effective and nontoxic prophylactic strategies against peritoneal metastasis are highly imperative. Herein, we demonstrate the first gene transfection as a nontoxic prophylaxis preventing peritoneal metastasis or operative metastatic dissemination. Lipopolyplexes of TNF-related-apoptosis-inducing-ligand (TRAIL) transfected peritonea and macrophages to express TRAIL for over 15 days. The expressed TRAIL selectively induced tumor cell apoptosis while exempting normal tissue, providing long-term tumor surveillance. Therefore, tumor cells inoculated in the pretransfected peritoneal cavity quickly underwent apoptosis and, thus, barely formed tumor nodules, significantly prolonging the mouse survival time compared with chemotherapy prophylaxis. Furthermore, lipopolyplex transfection showed no sign of toxicity. Therefore, this peritoneal TRAIL-transfection is an effective and safe prophylaxis, preventing peritoneal metastasis.
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Affiliation(s)
- Nasha Qiu
- The Center for Integrated Oncology and Precision Medicine, Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
- Zhejiang University School of Medicine, Hangzhou 310058, China
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, China
- Zhejiang Key Laboratory of Smart Biomaterials and College of Chemical and Biological Engineering, Zhejiang Univeristy, Hangzhou 310027, China
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety and CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing 100090, China
| | - Zhen Zhang
- Zhejiang Longcharm Bio-tech Pharma Co., Ltd. Hangzhou 310027, China
| | - Xuyong Wei
- The Center for Integrated Oncology and Precision Medicine, Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
- Zhejiang University School of Medicine, Hangzhou 310058, China
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Chang Xu
- The Center for Integrated Oncology and Precision Medicine, Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
- Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Xiaolong Jia
- Department of Urology, The First Affiliated Hospital of Ningbo University, Ningbo 315010, China
| | - Kai Wang
- The Center for Integrated Oncology and Precision Medicine, Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
- Zhejiang University School of Medicine, Hangzhou 310058, China
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Yunqi Chen
- The Center for Integrated Oncology and Precision Medicine, Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Shuai Wang
- The Center for Integrated Oncology and Precision Medicine, Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
- Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Renyi Su
- The Center for Integrated Oncology and Precision Medicine, Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
- Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Beini Cen
- The Center for Integrated Oncology and Precision Medicine, Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Youqing Shen
- Zhejiang Key Laboratory of Smart Biomaterials and College of Chemical and Biological Engineering, Zhejiang Univeristy, Hangzhou 310027, China
| | - Chunying Chen
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety and CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing 100090, China
| | - Yanpeng Liu
- The Center for Integrated Oncology and Precision Medicine, Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Xiao Xu
- The Center for Integrated Oncology and Precision Medicine, Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
- Zhejiang University School of Medicine, Hangzhou 310058, China
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, China
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Wang X, Fu J, Jiang C, Liao X, Chen Y, Jia T, Chen G, Feng X. Specific and Long-Term Luminescent Monitoring of Hydrogen Peroxide in Tumor Metastasis. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2023; 35:e2210948. [PMID: 36848628 DOI: 10.1002/adma.202210948] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/06/2023] [Indexed: 05/19/2023]
Abstract
Luminescent monitoring of endogenous hydrogen peroxide (H2 O2 ) in tumors is conducive to understanding metastasis and developing novel therapeutics. The clinical transformation is obstructed by the limited light penetration depth, toxicity of nano-probes, and lack of long-term monitoring modes of up to days or months. New monitoring modes are introduced via specific probes and implantable devices, which can achieve real-time monitoring with a readout frequency of 0.01 s or long-term monitoring for months to years. Near-infrared dye-sensitized upconversion nanoparticles (UCNPs) are fabricated as the luminescent probes, and the specificity to reactive oxygen species is subtly regulated by the self-assembled monolayers on the surfaces of UCNPs. Combined with the passive implanted system, a 20-day monitoring of H2 O2 in the rat model of ovarian cancer with peritoneal metastasis is achieved, in which the limited light penetration depth and toxicity of nano-probes are circumvented. The developed monitoring modes show great potential in accelerating the clinical transformation of nano-probes and biochemical detection methods.
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Affiliation(s)
- Xindong Wang
- Center for Flexible Electronics Technology, Tsinghua University, No. 30 Shuangqing Road, Beijing, 100084, P. R. China
- MIIT Key Laboratory of Critical Materials Technology for New Energy Conversion and Storage, School of Chemistry and Chemical Engineering & Key Laboratory of Micro-systems and Micro-structures, Ministry of Education, Harbin Institute of Technology, No. 92 Xidazhi Street, Harbin, 150001, P. R. China
- Institute of Flexible Electronics Technology of THU, No. 906, YaTai Road, Jiaxing, 314006, P. R. China
- Jiaxing Key Laboratory of Flexible Electronics based Intelligent Sensing and Advanced Manufacturing Technology, Jiaxing, 314006, P. R. China
| | - Ji Fu
- Institute of Flexible Electronics Technology of THU, No. 906, YaTai Road, Jiaxing, 314006, P. R. China
| | - Chang Jiang
- MIIT Key Laboratory of Critical Materials Technology for New Energy Conversion and Storage, School of Chemistry and Chemical Engineering & Key Laboratory of Micro-systems and Micro-structures, Ministry of Education, Harbin Institute of Technology, No. 92 Xidazhi Street, Harbin, 150001, P. R. China
| | - Xiaohui Liao
- Institute of Flexible Electronics Technology of THU, No. 906, YaTai Road, Jiaxing, 314006, P. R. China
| | - Yiju Chen
- Institute of Flexible Electronics Technology of THU, No. 906, YaTai Road, Jiaxing, 314006, P. R. China
| | - Tao Jia
- MIIT Key Laboratory of Critical Materials Technology for New Energy Conversion and Storage, School of Chemistry and Chemical Engineering & Key Laboratory of Micro-systems and Micro-structures, Ministry of Education, Harbin Institute of Technology, No. 92 Xidazhi Street, Harbin, 150001, P. R. China
| | - Guanying Chen
- MIIT Key Laboratory of Critical Materials Technology for New Energy Conversion and Storage, School of Chemistry and Chemical Engineering & Key Laboratory of Micro-systems and Micro-structures, Ministry of Education, Harbin Institute of Technology, No. 92 Xidazhi Street, Harbin, 150001, P. R. China
| | - Xue Feng
- Center for Flexible Electronics Technology, Tsinghua University, No. 30 Shuangqing Road, Beijing, 100084, P. R. China
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Jusufi M, Piso P, Zorger N. [Peritoneal carcinomatosis secondary to CUP syndrome : Diagnosis and indications for multimodal treatment]. RADIOLOGIE (HEIDELBERG, GERMANY) 2023; 63:371-380. [PMID: 37022459 DOI: 10.1007/s00117-023-01140-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 04/07/2023]
Abstract
CLINICAL PROBLEM Peritoneal carcinomatosis secondary to cancer of unknown primary (CUP) syndrome is a rare entity for which there are no uniform treatment recommendations or guidelines. The median survival time is 3 months. DIAGNOSIS Computed tomography (CT), magnetic resonance imaging (MRI), and 18F‑FDG positron emission tomography (PET)/CT are valid imaging modalities for the detection of peritoneal carcinomatosis. The sensitivity of all techniques is highest for large, macronodular peritoneal carcinomatosis manifestations. A limitation of all imaging techniques is limited and small-nodular peritoneal carcinomatosis. Also, peritoneal metastasis in the small bowel mesentery or diaphragmatic domes can only be visualized with low sensitivity. Therefore, exploratory laparoscopy should be considered as the next diagnostic step. In half of these cases an unnecessary laparotomy can be avoided, because the laparoscopy revealed diffuse, small-nodule involvement of the small bowel wall and thus an irresectable situation. TREATMENT In selected patients, performing complete cytoreduction followed by hyperthermic intra-abdominal chemotherapy (HIPEC) is a good therapeutic option. Therefore, the identification of the extent of peritoneal tumor manifestation as accurately as possible is important for the definition of the increasingly complex oncological therapy strategies.
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Affiliation(s)
- M Jusufi
- Allgemein- und Viszeralchirurgie, Department für Chirurgie, Klinik für Gastrointestinale und Kolorektale Chirurgie, Asklepios Klinik Barmbek, Rübenkamp 220, 22307, Hamburg, Deutschland.
| | - P Piso
- Allgemein- und Viszeralchirurgie, Krankenhaus Barmherzige Brüder Regensburg, Regensburg, Deutschland
| | - N Zorger
- Radiologie, Neuroradiologie und Nuklearmedizin, Krankenhaus Barmherzige Brüder Regensburg, Regensburg, Deutschland
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9
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Reijonen M, Holopainen E, Arponen O, Könönen M, Vanninen R, Anttila M, Sallinen H, Rinta-Kiikka I, Lindgren A. Neoadjuvant chemotherapy induces an elevation of tumour apparent diffusion coefficient values in patients with ovarian cancer. BMC Cancer 2023; 23:299. [PMID: 37005578 PMCID: PMC10068179 DOI: 10.1186/s12885-023-10760-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 03/21/2023] [Indexed: 04/04/2023] Open
Abstract
OBJECTIVES Multiparametric magnetic resonance imaging (mMRI) is the modality of choice in the imaging of ovarian cancer (OC). We aimed to investigate the feasibility of different types of regions of interest (ROIs) in the measurement of apparent diffusion coefficient (ADC) values of diffusion-weighted imaging in OC patients treated with neoadjuvant chemotherapy (NACT). METHODS We retrospectively enrolled 23 consecutive patients with advanced OC who had undergone NACT and mMRI. Seventeen of them had been imaged before and after NACT. Two observers independently measured the ADC values in both ovaries and in the metastatic mass by drawing on a single slice of (1) freehand large ROIs (L-ROIs) covering the solid parts of the whole tumour and (2) three small round ROIs (S-ROIs). The side of the primary ovarian tumour was defined. We evaluated the interobserver reproducibility and statistical significance of the change in tumoural pre- and post-NACT ADC values. Each patient's disease was defined as platinum-sensitive, semi-sensitive, or resistant. The patients were deemed either responders or non-responders. RESULTS The interobserver reproducibility of the L-ROI and S-ROI measurements ranged from good to excellent (ICC range: 0.71-0.99). The mean ADC values were significantly higher after NACT in the primary tumour (L-ROI p < 0.001, S-ROIs p < 0.01), and the increase after NACT was associated with sensitivity to platinum-based chemotherapy. The changes in the ADC values of the omental mass were associated with a response to NACT. CONCLUSION The mean ADC values of the primary tumour increased significantly after NACT in the OC patients, and the amount of increase in omental mass was associated with the response to platinum-based NACT. Our study indicates that quantitative analysis of ADC values with a single slice and a whole tumour ROI placement is a reproducible method that has a potential role in the evaluation of NACT response in patients with OC. TRIAL REGISTRATION Retrospectively registered (institutional permission code: 5302501; date of the permission: 31.7.2020).
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Affiliation(s)
- Milja Reijonen
- Department of Radiology, Tampere University Hospital, Tampere, Finland.
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland.
| | - Erikka Holopainen
- Department of Radiology, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine, School of Medicine, Clinical Radiology, University of Eastern Finland, Kuopio, Finland
| | - Otso Arponen
- Department of Radiology, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
| | - Mervi Könönen
- Department of Radiology, Kuopio University Hospital, Kuopio, Finland
- Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland
| | - Ritva Vanninen
- Department of Radiology, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine, School of Medicine, Clinical Radiology, University of Eastern Finland, Kuopio, Finland
| | - Maarit Anttila
- Department of Gynaecology and Obstetrics, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine, School of Medicine, Obstetrics and Gynaecology, University of Eastern Finland, Kuopio, Finland
| | - Hanna Sallinen
- Department of Gynaecology and Obstetrics, Kuopio University Hospital, Kuopio, Finland
| | - Irina Rinta-Kiikka
- Department of Radiology, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
| | - Auni Lindgren
- Department of Gynaecology and Obstetrics, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine, School of Medicine, Obstetrics and Gynaecology, University of Eastern Finland, Kuopio, Finland
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10
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MAP4K4 promotes ovarian cancer metastasis through diminishing ADAM10-dependent N-cadherin cleavage. Oncogene 2023; 42:1438-1452. [PMID: 36922678 PMCID: PMC10154218 DOI: 10.1038/s41388-023-02650-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 03/18/2023]
Abstract
Peritoneal metastasis is a key feature of advanced ovarian cancer, but the critical protein required for ovarian cancer metastasis and progression is yet to be defined. Thus, an unbiased high throughput and in-depth study is warranted to unmask the mechanism. Transcriptomic sequencing of paired primary ovarian tumors and metastases unveiled that MAP4K4, a serine/threonine kinase belongs to the Ste20 family of kinases, was highly expressed in metastatic sites. Increased MAP4K4 expression in metastasis was further validated in other independent patients, with higher MAP4K4 expression associated with poorer survival, higher level of CA125 and more advanced FIGO stage. Down regulation of MAP4K4 inhibited cancer cell adhesion, migration, and invasion. Notably, MAP4K4 was found to stabilize N-cadherin. Further results showed that MAP4K4 mediated phosphorylation of ADAM10 at Ser436 results in suppression of N-cadherin cleavage by ADAM10, leading to N-cadherin stabilization. Pharmacologic inhibition of MAP4K4 abrogated peritoneal metastases. Overall, our data reveal MAP4K4 as a significant promoter in ovarian cancer metastasis. Targeting MAP4K4 may be a potential therapeutic approach for ovarian cancer patients.
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11
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Kose S. Role of Computed Tomography in the Evaluation of Peritoneal Carcinomatosis. J Belg Soc Radiol 2023; 107:27. [PMID: 37064170 PMCID: PMC10103720 DOI: 10.5334/jbsr.2921] [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] [Received: 09/06/2022] [Accepted: 02/23/2023] [Indexed: 04/18/2023] Open
Abstract
Peritoneal carcinomatosis (PC) refers to metastatic spread of tumor into the peritoneal cavity. Earlier, PC was thought to be associated with grave clinical outcome. However, various advances in treatment options including cytoreductive surgery and heated intraperitoneal chemotherapy or early post-operative chemotherapy can prolong survival of patients with peritoneal carcinomatosis. These treatment options are associated with high morbidity and mortality. The purpose of this article is to acquaint the radiologist about various appearances of peritoneal carcinomatosis in order to help clinicians in selecting candidates for surgery and avoid unnecessary potentially debilitating surgeries in patients with unresectable PC.
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Affiliation(s)
- Snehal Kose
- All India Institute of Medical Sciences, New Delhi, IN
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12
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Pat JJ, Rothnie KKM, Kolomainen D, Sundaresan M, Zhang J, Liyanage SH. CT review of ovarian fibrothecoma. Br J Radiol 2022; 95:20210790. [PMID: 35451310 PMCID: PMC10162058 DOI: 10.1259/bjr.20210790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective: The aim of this study was to investigate the CT imaging characteristics of ovarian fibrothecoma which may aid in the differentiation from early stage epithelial tumours. Methods: Comparison of 36 patients (41 lesions) with pathologically proven ovarian fibrothecoma tumours and 36 (52 lesions) serous papillary carcinomas (SPCs) lesions. We noted their laterality, size, density, calcifications, Hounsfield units (HUs) and introduced a novel HU comparison technique with the psoas muscle or the uterus. Patients’ clinical findings such as ascites, pleural effusion, carbohydrate antigen-125 levels, and lymphadenopathy findings were also included. Results: Average age was 67.8 and 66 across the fibrothecoma and SPC cohort respectively. Fibrothecoma tumours had diameters ranging from 24 to 207 mm (Median: 94 mm). 80.6% of the fibrothecoma cohort had ascites which was comparable to the 72.2% in the SPC cohort. 70.7% of fibrothecoma tumour favour a purely to predominantly solid structural configuration (p < 0.001). The average HU value for the fibrothecoma solid component was 44 ± 11.7 contrasting the SPC HU value of 66.8 ± 15. The psoas:tumour mass ratio demonstrated a median of 0.7, whereas SPCs shows a median of 1.1 (p < 0.001). Conclusion: Suspicion of ovarian fibrothecoma should be considered through interrogation of their structural density configuration, low psoas to mass HU ratio and a presence of ascites. Advances in knowledge: CT imaging can be a useful tool in diagnosing fibrothecoma tumours and subsequently reducing oncogynaecological tertiary centre referrals, financial burden and patient operative morbidity and mortality.
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Affiliation(s)
| | | | | | | | - Jufen Zhang
- Anglia Ruskin University, Cambridge, United Kingdom
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13
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Maiti M, Kikuchi K, Athul KK, Kaur A, Bhuniya S. β-Galactosidase-activated theranostic for hepatic carcinoma therapy and imaging. Chem Commun (Camb) 2022; 58:6413-6416. [PMID: 35543438 DOI: 10.1039/d2cc01825j] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
A β-galactosidase activatable fluorescent turn-on theranostic Gal-CGem exhibits gemcitabine release specifically in β-galactosidase overexpressing hepatic carcinoma cells. The cytotoxicity of Gal-CGem in cancer cells is achieved through the apoptotic cell death pathway. Overall, Gal-CGem is a new frontline prodrug in cancer therapy that has provided antineoplastic information through fluorescence imaging.
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Affiliation(s)
- Mrinmoy Maiti
- Department of Science, Amrita School of Engineering, Amrita Viswa Vidyapeetham, Coimbatore, India, 641112
| | - Kai Kikuchi
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, NSW 2006, Australia. .,The University of Sydney Nano Institute, The University of Sydney, NSW 2006, Australia
| | - K K Athul
- Centre for Interdisciplinary Sciences, JIS Institute of Advanced Studies and Research, JIS University, Arch Waterfront, GP Block, Sector V, Kolkata, India, 700091.
| | - Amandeep Kaur
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, NSW 2006, Australia. .,The University of Sydney Nano Institute, The University of Sydney, NSW 2006, Australia
| | - Sankarprasad Bhuniya
- Centre for Interdisciplinary Sciences, JIS Institute of Advanced Studies and Research, JIS University, Arch Waterfront, GP Block, Sector V, Kolkata, India, 700091.
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14
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Morland D, Jallerat P, Brixi H, Cadiot G, Papathanassiou D, Deguelte S. Performances of 18F-FDOPA PET/CT in the Preoperative Evaluation of the Peritoneal Cancer Index in Small Intestine Neuroendocrine Tumors. Clin Nucl Med 2022; 47:294-298. [PMID: 35067541 DOI: 10.1097/rlu.0000000000004057] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE Peritoneal carcinomatosis (PC) concerns up to 30% of patients with a neuroendocrine tumor (NET), especially of the small intestine. Aggressive management of carcinomatosis seems to be justified, especially with regard to possible mechanical complications. 18F-FDOPA PET/CT is known to be the most sensitive imaging modality for the detection of small bowel NET metastases, yet its performance in the detection of PC is not well studied. The main objective of our study is to evaluate the performances of preoperative 18F-FDOPA PET/CT in the prediction of surgical peritoneal cancer index. METHODS All patients referred to our center for an 18F-FDOPA PET/CT from October 2017 to January 2021 were retrospectively screened. Images were analyzed by a blinded nuclear medicine physician, and peritoneal abnormalities were reported to comply with the surgical peritoneal cancer index standard. Per patient analysis and per region analysis were then conducted. RESULTS Thirty-three patients were included; 6 patients (35 regions) presented a peritoneal carcinosis. Peritoneal Carcinomatosis Index (PCI) estimated on 18F-FDOPA PET/CT was significantly and strongly correlated to surgical PCI (r = 0.96, P < 0.001). Patient-based sensitivity, specificity, negative predictive value, and positive predictive value for 18F-FDOPA PET/CT were 100%, 93%, 100%, and 75%, respectively. The agreement between 18F-FDOPA and surgery regarding PC was excellent (Cohen κ = 0.82 on per patient analysis, 0.74 on per region analysis). CONCLUSIONS A preoperative estimation of PCI is achievable based on 18F-FDOPA PET/CT for small intestine NET and could allow to optimize surgical procedures and patient selection.
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Affiliation(s)
| | | | - Hedia Brixi
- Hépatogastroentérologie, Hôpital Robert Debré, CHU de Reims
| | | | | | - Sophie Deguelte
- Chirurgie Digestive et Endocrinienne, Hôpital Robert Debré, CHU de Reims, Reims, France
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15
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The role of computed tomography in the assessment of tumour extent and the risk of residual disease after upfront surgery in advanced ovarian cancer (AOC). Arch Gynecol Obstet 2022; 306:1235-1243. [PMID: 35235024 PMCID: PMC9470643 DOI: 10.1007/s00404-022-06466-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 02/15/2022] [Indexed: 11/28/2022]
Abstract
Purpose Epithelial ovarian cancer is usually diagnosed in the advanced stages. To choose the best therapeutic approach, an accurate preoperative assessment of the tumour extent is crucial. This study aimed to determine whether the peritoneal cancer index (PCI), the amount of ascites, and the presence of cardiophrenic nodes (CPLNs) visualized by computed tomography (CT) can assess the tumour extent (S-PCI) and residual disease (RD) for advanced ovarian cancer (AOC) patients treated with upfront surgery. Methods In total, 118 AOC cases were included between January 2016 and December 2018 at Skåne University Hospital, Lund, Sweden. Linear regression and interclass correlation (ICC) analyses were used to determine the relationship between CT-PCI and S-PCI. The patients were stratified in complete cytoreductive surgery (CCS) with no RD or to non-CCS with RD of any size. The amount of ascites on CT (CT-ascites), CA-125 and the presence of radiological enlarged CPLNs (CT-CPLN) were analysed to evaluate their impact on estimating RD. Results CT-PCI correlated well with S-PCI (0.397; 95% CI 0.252–0.541; p < 0.001). The risk of RD was also related to CT-PCI (OR 1.069 (1.009–1.131), p < 0.023) with a cut-off of 21 for CT-PCI (0.715, p = 0.000). The sensitivity, specificity, positive predictive value and negative predictive value were 58.5, 70.3, 52.2 and 75.4%, respectively. CT-ascites above 1000 ml predicted RD (OR 3.510 (1.298–9.491) p < 0.013). Conclusion CT is a reliable tool to assess the extent of the disease in advanced ovarian cancer. Higher CT-PCI scores and large volumes of ascites estimated on CT predicted RD of any size.
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16
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Gan J, Herzog J, Smith DA, Vos D, Kikano E, Tirumani SH, Ramaiya NH. Primary peritoneal serous carcinoma: a primer for radiologists. Clin Imaging 2021; 83:56-64. [PMID: 34974267 DOI: 10.1016/j.clinimag.2021.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 11/14/2021] [Accepted: 12/07/2021] [Indexed: 11/16/2022]
Abstract
Primary peritoneal serous carcinoma (PPSC) is a rare primary peritoneal tumor characterized by a unique range of clinical features and imaging findings. Though it shares many clinical, histologic, and imaging features with serous ovarian carcinoma, it remains a distinct clinical entity. Although less common than its primary ovarian counterpart, PPSC is characterized by a prognosis that is often equally poor with presentations common in late stages of disease. Key imaging modalities used in the evaluation of PPSC include ultrasound, CT, MRI, and PET/CT. For radiologists, an understanding of the pertinent imaging findings, pathologic correlations, and clinical features of PPSC is essential for arriving at the correct diagnosis and guiding the subsequent appropriate management of this complex malignancy.
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Affiliation(s)
- Jonathan Gan
- Case Western Reserve University, School of Medicine, 9501 Euclid Ave, Cleveland, OH 44106, United States of America
| | - Jackson Herzog
- Department of Radiology, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH 44106, United States of America
| | - Daniel A Smith
- Department of Radiology, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH 44106, United States of America.
| | - Derek Vos
- Case Western Reserve University, School of Medicine, 9501 Euclid Ave, Cleveland, OH 44106, United States of America
| | - Elias Kikano
- Department of Radiology, Brigham & Women's Hospital, 75 Francis St, Boston, MA 02115, United States of America
| | - Sree H Tirumani
- Department of Radiology, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH 44106, United States of America
| | - Nikhil H Ramaiya
- Department of Radiology, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH 44106, United States of America
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17
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Moro F, Bertoldo V, Avesani G, Moruzzi MC, Mascilini F, Bolomini G, Caliolo G, Esposito R, Moroni R, Zannoni GF, Fagotti A, Manfredi R, Scambia G, Testa AC. Fusion imaging in preoperative assessment of extent of disease in patients with advanced ovarian cancer: feasibility and agreement with laparoscopic findings. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2021; 58:916-925. [PMID: 33847427 DOI: 10.1002/uog.23650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/19/2021] [Accepted: 03/30/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Fusion imaging is an emerging technique that combines real-time ultrasound examination with images acquired previously using other modalities, such as computed tomography (CT), magnetic resonance imaging and positron emission tomography. The primary aim of this study was to evaluate the feasibility of fusion imaging in patients with suspicion of ovarian or peritoneal cancer. Secondary aims were: to compare the agreement of findings on fusion imaging, CT alone and ultrasound imaging alone with laparoscopic findings, in the assessment of extent of intra-abdominal disease; and to evaluate the time required for the fusion imaging technique. METHODS Patients with clinical and/or radiographic suspicion of advanced ovarian or peritoneal cancer who were candidates for surgery were enrolled prospectively between December 2019 and September 2020. All patients underwent a CT scan and ultrasound and fusion imaging to evaluate the presence or absence of the following abdominal-cancer features according to the laparoscopy-based scoring model (predictive index value (PIV)): supracolic omental disease, visceral carcinomatosis on the liver, lesser omental carcinomatosis and/or visceral carcinomatosis on the lesser curvature of the stomach and/or spleen, involvement of the paracolic gutter(s) and/or anterior abdominal wall, involvement of the diaphragm and visceral carcinomatosis on the small and/or large bowel (regardless of rectosigmoid involvement). The feasibility of the fusion examination in these patients was evaluated. Agreement of each imaging method (ultrasound, CT and fusion imaging) with laparoscopy (considered as reference standard) was calculated using Cohen's kappa coefficient. RESULTS Fifty-two patients were enrolled into the study. Fusion imaging was feasible in 51 (98%) of these patients (in one patient, it was not possible for technical reasons). Two patients were excluded because laparoscopy was not performed, leaving 49 women in the final analysis. Kappa values for CT, ultrasound and fusion imaging, using laparoscopy as the reference standard, in assessing the PIV parameters were, respectively: 0.781, 0.845 and 0.896 for the great omentum; 0.329, 0.608 and 0.847 for the liver surface; 0.472, 0.549 and 0.756 for the lesser omentum and/or stomach and/or spleen; 0.385, 0.588 and 0.795 for the paracolic gutter(s) and/or anterior abdominal wall; 0.385, 0.497 and 0.657 for the diaphragm; and 0.336, 0.410 and 0.469 for the bowel. The median time needed to perform the fusion examination was 20 (range, 10-40) min. CONCLUSION Fusion of CT images and real-time ultrasound imaging is feasible in patients with suspicion of ovarian or peritoneal cancer and improves the agreement with surgical findings when compared with ultrasound or CT scan alone. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- F Moro
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - V Bertoldo
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - G Avesani
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - M C Moruzzi
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - F Mascilini
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - G Bolomini
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - G Caliolo
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - R Esposito
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
| | - R Moroni
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Direzione Scientifica, Rome, Italy
| | - G F Zannoni
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Istituto di Anatomia Patologica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Fagotti
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Dipartimento Scienze della Vita e di Sanità Pubblica, Rome, Italy
| | - R Manfredi
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Scambia
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Dipartimento Scienze della Vita e di Sanità Pubblica, Rome, Italy
| | - A C Testa
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Rome, Italy
- Università Cattolica del Sacro Cuore, Dipartimento Scienze della Vita e di Sanità Pubblica, Rome, Italy
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18
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Iyoshi S, Yoshihara M, Nakamura K, Sugiyama M, Koya Y, Kitami K, Uno K, Mogi K, Tano S, Tomita H, Kajiwara K, Taki M, Yamaguchi S, Nawa A, Kajiyama H. Pro-tumoral behavior of omental adipocyte-derived fibroblasts in tumor microenvironment at the metastatic site of ovarian cancer. Int J Cancer 2021; 149:1961-1972. [PMID: 34469585 DOI: 10.1002/ijc.33770] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 07/08/2021] [Accepted: 08/06/2021] [Indexed: 12/16/2022]
Abstract
Adipocyte-rich omentum offers "good soil" for disseminating ovarian cancer (OvCa), contributing to therapeutic difficulty. However, little is understood about the association between adipocytes and tumor growth at peritoneal dissemination site. Herein, we report the induction of adipocyte dedifferentiation by OvCa cells and pro-tumorigenic effects of resulted adipocyte-derived fibroblasts. We confirmed that malignant ascites promoted the dedifferentiation of the primary human adipocytes obtained from surgical omental specimen into omental adipocyte-derived fibroblast (O-ADF) that possess both mesenchymal stem cell and myofibroblast-like features. This promotion of dedifferentiation by malignant ascites was blocked by addition of Wnt signaling inhibitor. The effects of dedifferentiated adipocytes in proliferation and migration of OvCa cells were analyzed with in vitro coculturing experimental models and in vivo mice model, and we demonstrated that OvCa cell lines showed enhanced proliferative characteristics, as well as increased migratory abilities upon coculturing with O-ADF. Additionally, exogenous transforming growth factor-β1 augmented desmoplastic morphological change of O-ADF, leading to higher proliferative ability. Our results suggest that OvCa cells promote dedifferentiation of peritoneal adipocytes by activating Wnt/β-catenin signaling, and generated O-ADFs exhibit pro-tumoral hallmarks.
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Affiliation(s)
- Shohei Iyoshi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Spemann Graduate School of Biology and Medicine, University of Freiburg, Freiburg, Germany
| | - Masato Yoshihara
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kae Nakamura
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Center for Low-Temperature Plasma Sciences, Nagoya University, Nagoya, Japan
| | - Mai Sugiyama
- Bell Research Center, Department of Obstetrics and Gynecology Collaborative Research, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshihiro Koya
- Bell Research Center, Department of Obstetrics and Gynecology Collaborative Research, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuhisa Kitami
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kaname Uno
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Division of Clinical Genetics, Department of Laboratory Medicine, Lund University Graduate School of Medicine, Lund, Sweden
| | - Kazumasa Mogi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sho Tano
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroyuki Tomita
- Department of Tumor Pathology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Keiji Kajiwara
- Department of Chemistry, Graduate School of Science, Nagoya University, Nagoya, Japan
| | - Masayasu Taki
- Institute of Transformative Bio-Molecules, Nagoya University, Nagoya, Japan
| | - Shigehiro Yamaguchi
- Department of Chemistry, Graduate School of Science, Nagoya University, Nagoya, Japan.,Institute of Transformative Bio-Molecules, Nagoya University, Nagoya, Japan
| | - Akihiro Nawa
- Bell Research Center, Department of Obstetrics and Gynecology Collaborative Research, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Tsili AC, Naka C, Argyropoulou MI. Multidetector computed tomography in diagnosing peritoneal metastases in ovarian carcinoma. Acta Radiol 2021; 62:1696-1706. [PMID: 33334121 DOI: 10.1177/0284185120980006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Multidetector computed tomography (MDCT) of the abdomen is currently the imaging examination of choice for the staging and follow-up of ovarian carcinoma (OC). Peritoneal metastases (PMs) represent the most common pathway for the metastatic spread of OC. MDCT scanners, due to several advantages-including increased volume coverage, reduced scanning time, acquisition of thin slices and creation of multiplanar reformations, and three-dimensional reconstructions-provide useful information regarding the early and accurate detection of PMs. Detailed mapping of peritoneal carcinomatosis is feasible, with improved detection of sub-centimeter peritoneal implants and thorough evaluation of curved peritoneal surfaces.
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Affiliation(s)
- Athina C Tsili
- Department of Clinical Radiology, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Christina Naka
- Department of Clinical Radiology, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Maria I Argyropoulou
- Department of Clinical Radiology, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece
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20
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Sahin H, Akdogan AI, Smith J, Zawaideh JP, Addley H. Serous borderline ovarian tumours: an extensive review on MR imaging features. Br J Radiol 2021; 94:20210116. [PMID: 34111956 DOI: 10.1259/bjr.20210116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Serous borderline ovarian tumours (SBOTs) are an intermediate group of neoplasms, which have features between benign and malignant ovarian tumours and for which, fertility-sparing surgery can be offered. MRI in imaging of SBOTs is, therefore, crucial in raising the possibility of the diagnosis, in order to present the patient with the most appropriate treatment options. There are characteristic MRI features that SBOTs demonstrate. In addition, recent advanced techniques, and further classification into subtypes within the borderline group have been developed. The aim of this article is to review the MRI features of SBOT and provide the reporter with an awareness of the imaging tips and tricks in the differential diagnosis of SBOT.
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Affiliation(s)
- Hilal Sahin
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Cambridge, UK.,Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, UK.,Department of Radiology, Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Asli Irmak Akdogan
- Department of Radiology, Ataturk Training and Research Hospital, Katip Celebi University, Izmir, Turkey
| | - Janette Smith
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Jeries Paolo Zawaideh
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Helen Addley
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, UK.,Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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21
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Ai Y, Zhang J, Jin J, Zhang J, Zhu H, Jin X. Preoperative Prediction of Metastasis for Ovarian Cancer Based on Computed Tomography Radiomics Features and Clinical Factors. Front Oncol 2021; 11:610742. [PMID: 34178617 PMCID: PMC8222738 DOI: 10.3389/fonc.2021.610742] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 04/28/2021] [Indexed: 11/17/2022] Open
Abstract
Background There is urgent need for an accurate preoperative prediction of metastatic status to optimize treatment for patients with ovarian cancer (OC). The feasibility of predicting the metastatic status based on radiomics features from preoperative computed tomography (CT) images alone or combined with clinical factors were investigated. Methods A total of 101 OC patients who underwent primary debulking surgery were enrolled. Radiomics features were extracted from the tumor volumes contoured on CT images with LIFEx package. Mann-Whitney U tests, least absolute shrinkage selection operator (LASSO), and Ridge Regression were applied to select features and to build prediction models. Univariate and regression analysis were applied to select clinical factors for metastatic prediction. The performance of models generated with radiomics features alone, clinical factors, and combined factors were evaluated and compared. Results Nine radiomics features were screened out from 184 extracted features to classify patients with and without metastasis. Age and cancer antigen 125 (CA125) were the two clinical factors that were associated with metastasis. The area under curves (AUCs) for the radiomics signature, clinical factors model, and combined model were 0.82 (95% CI, 0.66-0.98; sensitivity = 0.90, specificity = 0.70), 0.83 (95% CI, 0.67-0.95; sensitivity = 0.71, specificity = 0.8), and 0.86 (95% CI, 0.72-0.99, sensitivity = 0.81, specificity = 0.8), respectively. Conclusions Radiomics features alone or radiomics features combined with clinical factors are feasible and accurate enough to predict the metastatic status for OC patients.
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Affiliation(s)
- Yao Ai
- Department of Radiotherapy Center, The 1st Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jindi Zhang
- Department of Gynecology, The 1st Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Juebin Jin
- Department of Medical Engineering, The 1st Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ji Zhang
- Department of Radiotherapy Center, The 1st Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Haiyan Zhu
- Department of Gynecology, The 1st Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Department of Gynecology, Shanghai First Maternal and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiance Jin
- Department of Radiotherapy Center, The 1st Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of Basic Medical Science, Wenzhou Medical University, Wenzhou, China
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22
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Radiomics based on multisequence magnetic resonance imaging for the preoperative prediction of peritoneal metastasis in ovarian cancer. Eur Radiol 2021; 31:8438-8446. [PMID: 33948702 DOI: 10.1007/s00330-021-08004-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/29/2021] [Accepted: 04/20/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To develop a radiomics signature based on multisequence magnetic resonance imaging (MRI) to preoperatively predict peritoneal metastasis (PM) in ovarian cancer (OC). METHODS Eighty-nine patients with OC were divided into a training cohort including patients (n = 54) with a single lesion and a validation cohort including patients (n = 35) with bilateral lesions. Radiomics features were extracted from the T2-weighted images (T2WIs), fat-suppressed T2WIs, multi-b-value diffusion-weighted images (DWIs), and corresponding parametric maps. A radiomics signature and nomogram incorporating the radiomics signature and clinical predictors were developed and validated on the training and validation cohorts, respectively. RESULTS The radiomics signature generated by 6 selected features showed a favorable discriminatory ability to predict PM in OC with an area under the curve (AUC) of 0.963 in the training cohort and an AUC of 0.928 in the validation cohort. The nomogram, comprising the radiomics signature, pelvic fluid, and CA-125 level, showed more favorable discrimination with an AUC of 0.969 in the training cohort and 0.944 in the validation cohort. Net reclassification index with values of 0.548 in the training cohort and 0.500 in the validation cohort. CONCLUSION Radiomics signature based on multisequence MRI serves as an effective quantitative approach to predict PM in OC patients. A nomogram of radiomics signature and clinical predictors could further improve the prediction ability of PM in patients with OC. KEY POINTS • Multisequence MRI-based radiomics showed a favorable discriminatory ability to predict PM in OC. • The nomogram incorporating the radiomics signature and clinical predictors was clinically useful to preoperatively predict PM in patients with OC.
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23
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Jin J, Zhu H, Zhang J, Ai Y, Zhang J, Teng Y, Xie C, Jin X. Multiple U-Net-Based Automatic Segmentations and Radiomics Feature Stability on Ultrasound Images for Patients With Ovarian Cancer. Front Oncol 2021; 10:614201. [PMID: 33680934 PMCID: PMC7930567 DOI: 10.3389/fonc.2020.614201] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/29/2020] [Indexed: 12/21/2022] Open
Abstract
Few studies have reported the reproducibility and stability of ultrasound (US) images based radiomics features obtained from automatic segmentation in oncology. The purpose of this study is to study the accuracy of automatic segmentation algorithms based on multiple U-net models and their effects on radiomics features from US images for patients with ovarian cancer. A total of 469 US images from 127 patients were collected and randomly divided into three groups: training sets (353 images), validation sets (23 images), and test sets (93 images) for automatic segmentation models building. Manual segmentation of target volumes was delineated as ground truth. Automatic segmentations were conducted with U-net, U-net++, U-net with Resnet as the backbone (U-net with Resnet), and CE-Net. A python 3.7.0 and package Pyradiomics 2.2.0 were used to extract radiomic features from the segmented target volumes. The accuracy of automatic segmentations was evaluated by Jaccard similarity coefficient (JSC), dice similarity coefficient (DSC), and average surface distance (ASD). The reliability of radiomics features were evaluated by Pearson correlation and intraclass correlation coefficients (ICC). CE-Net and U-net with Resnet outperformed U-net and U-net++ in accuracy performance by achieving a DSC, JSC, and ASD of 0.87, 0.79, 8.54, and 0.86, 0.78, 10.00, respectively. A total of 97 features were extracted from the delineated target volumes. The average Pearson correlation was 0.86 (95% CI, 0.83–0.89), 0.87 (95% CI, 0.84–0.90), 0.88 (95% CI, 0.86–0.91), and 0.90 (95% CI, 0.88–0.92) for U-net++, U-net, U-net with Resnet, and CE-Net, respectively. The average ICC was 0.84 (95% CI, 0.81–0.87), 0.85 (95% CI, 0.82–0.88), 0.88 (95% CI, 0.85–0.90), and 0.89 (95% CI, 0.86–0.91) for U-net++, U-net, U-net with Resnet, and CE-Net, respectively. CE-Net based segmentation achieved the best radiomics reliability. In conclusion, U-net based automatic segmentation was accurate enough to delineate the target volumes on US images for patients with ovarian cancer. Radiomics features extracted from automatic segmented targets showed good reproducibility and for reliability further radiomics investigations.
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Affiliation(s)
- Juebin Jin
- Department of Medical Engineering, Wenzhou Medical University First Affiliated Hospital, Wenzhou, China
| | - Haiyan Zhu
- Department of Gynecology, Shanghai First Maternal and Infant Hospital, Tongji University School of Medicine, Shanghai, China.,Department of Gynecology, Wenzhou Medical University First Affiliated Hospital, Wenzhou, China
| | - Jindi Zhang
- Department of Gynecology, Wenzhou Medical University First Affiliated Hospital, Wenzhou, China
| | - Yao Ai
- Department of Radiotherapy Center, Wenzhou Medical University First Affiliated Hospital, Wenzhou, China
| | - Ji Zhang
- Department of Radiotherapy Center, Wenzhou Medical University First Affiliated Hospital, Wenzhou, China
| | - Yinyan Teng
- Department of Ultrasound Imaging, Wenzhou Medical University First Affiliated Hospital, Wenzhou, China
| | - Congying Xie
- Department of Radiotherapy Center, Wenzhou Medical University First Affiliated Hospital, Wenzhou, China.,Department of Radiation and Medical Oncology, Wenzhou Medical University Second Affiliated Hospital, Wenzhou, China
| | - Xiance Jin
- Department of Radiotherapy Center, Wenzhou Medical University First Affiliated Hospital, Wenzhou, China
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24
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Wang SB, He H, Xv DD, She B, Lu RC, Yang ZH, Shi H, Xie R. Visual PET/CT scoring of mesenteric fdg uptake to differentiate between tuberculous peritonitis and peritoneal carcinomatosis. ACTA ACUST UNITED AC 2020; 26:523-530. [PMID: 32558647 DOI: 10.5152/dir.2020.20088] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE We aimed to differentiate tuberculous peritonitis (TBP) from peritoneal carcinomatosis (PC) using a visual positron-emission tomography/computed tomography (PET/CT) scoring system based on mesenteric fluorodeoxyglucose (FDG) uptake. METHODS PET/CT scans from 31 patients with TBP and 92 patients with PC were retrospectively reviewed. A visual PET/CT scoring system for mesenteric FDG uptake was used according to the following characteristics: FDG uptake intensity (low = 0, moderate = 1, high = 2), FDG uptake deposits (uniform = 0, irregular = 1, ascitic = 2), FDG uptake focality (diffuse = 0, segmental = 1, focal = 2), nodularity on the corresponding CT (nonnodular = 0, micronodular = 1, macronodular = 2) and mesenteric lymphadenopathy (absent = 0, lymphadenopathy without FDG uptake = 1, lymphadenopathy with FDG uptake = 2). The FDG uptake intensity, deposits, focality, nodularity and mesenteric lymphadenopathy scores between TBP and PC were compared using chi-square tests. The diagnostic performance of this scoring system for differentiating TBP from PC was analyzed using a receiver operating characteristic (ROC) curve. P < 0.05 was considered statistically significant. RESULTS Twenty-four patients with TBP (77.4%) and 56 patients with PC (60.9%) had mesenteric FDG uptake (P = 0.095) and were included for evaluation with the visual PET/CT scoring system. PC lesions scored higher than TBP lesions in FDG uptake deposits (P < 0.001), focality (P < 0.001) and nodularity (P < 0.001). No significant differences were observed between PC and TBP lesions in FDG uptake intensity (P = 0.396) and lymphadenopathy (P = 0.074). The total score that combined deposits, focality and nodularity had significant value for differentiating TBP from PC (area under the curve (AUC) = 0.869, P < 0.001), and a cutoff > 1 had a sensitivity (the accuracy for diagnosis of PC) of 80.4% and a specificity (the accuracy for diagnosis of TBP) of 75.0%. CONCLUSION A visual PET/CT scoring system based on mesenteric FDG uptake performed well in differentiating between TBP and PC.
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Affiliation(s)
- Shao-Bo Wang
- Yunnan Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, China;PET/CT center, First People's Hospital of Yunnan Province, Kunming, China
| | - Hong He
- PET/CT center, First People's Hospital of Yunnan Province, Kunming, China
| | - Dong-Dong Xv
- PET/CT center, First People's Hospital of Yunnan Province, Kunming, China
| | - Bo She
- PET/CT center, First People's Hospital of Yunnan Province, Kunming, China
| | - Ren-Cai Lu
- PET/CT center, First People's Hospital of Yunnan Province, Kunming, China
| | - Zhao-Hui Yang
- Yunnan Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, China
| | - Hong Shi
- Yunnan Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, China
| | - Ran Xie
- PET-CT Center, Yunnan Cancer Hospital, Kunming, China
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de Muynck LDAN, Gaarenstroom KN, Sier CFM, van Duijvenvoorde M, Bosse T, Mieog JSD, de Kroon CD, Vahrmeijer AL, Peters ITA. Novel Molecular Targets for Tumor-Specific Imaging of Epithelial Ovarian Cancer Metastases. Cancers (Basel) 2020; 12:cancers12061562. [PMID: 32545676 PMCID: PMC7352913 DOI: 10.3390/cancers12061562] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/22/2020] [Accepted: 06/09/2020] [Indexed: 01/01/2023] Open
Abstract
In epithelial ovarian cancer (EOC), the strongest prognostic factor is the completeness of surgery. Intraoperative molecular imaging that targets cell-surface proteins on tumor cells may guide surgeons to detect metastases otherwise not visible to the naked eye. Previously, we identified 29% more metastatic lesions during cytoreductive surgery using OTL-38, a fluorescent tracer targeting folate receptor-α (FRα). Unfortunately, eleven out of thirteen fluorescent lymph nodes were tumor negative. The current study evaluates the suitability of five biomarkers (EGFR, VEGF-A, L1CAM, integrin αvβ6 and EpCAM) as alternative targets for molecular imaging of EOC metastases and included FRα as a reference. Immunohistochemistry was performed on paraffin-embedded tissue sections of primary ovarian tumors, omental, peritoneal and lymph node metastases from 84 EOC patients. Tumor-negative tissue specimens from these patients were included as controls. EGFR, VEGF-A and L1CAM were highly expressed in tumor-negative tissue, whereas αvβ6 showed heterogeneous expression in metastases. The expression of EpCAM was most comparable to FRα in metastatic lesions and completely absent in the lymph nodes that were false-positively illuminated with OTL-38 in our previous study. Hence, EpCAM seems to be a promising novel target for intraoperative imaging and may contribute to a more reliable detection of true metastatic EOC lesions.
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Affiliation(s)
- Lysanne D. A. N. de Muynck
- Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (L.D.A.N.d.M.); (C.F.M.S.); (J.S.D.M.); (A.L.V.)
| | - Katja N. Gaarenstroom
- Department of Gynecology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (K.N.G.); (M.v.D.); (C.D.d.K.)
| | - Cornelis F. M. Sier
- Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (L.D.A.N.d.M.); (C.F.M.S.); (J.S.D.M.); (A.L.V.)
| | - Maurice van Duijvenvoorde
- Department of Gynecology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (K.N.G.); (M.v.D.); (C.D.d.K.)
| | - Tjalling Bosse
- Department of Pathology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands;
| | - J. Sven D. Mieog
- Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (L.D.A.N.d.M.); (C.F.M.S.); (J.S.D.M.); (A.L.V.)
| | - Cornelis D. de Kroon
- Department of Gynecology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (K.N.G.); (M.v.D.); (C.D.d.K.)
| | - Alexander L. Vahrmeijer
- Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (L.D.A.N.d.M.); (C.F.M.S.); (J.S.D.M.); (A.L.V.)
| | - Inge T. A. Peters
- Department of Gynecology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (K.N.G.); (M.v.D.); (C.D.d.K.)
- Correspondence: ; Tel.: +31-715262845
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Kleinmanns K, Fosse V, Davidson B, de Jalón EG, Tenstad O, Bjørge L, McCormack E. CD24-targeted intraoperative fluorescence image-guided surgery leads to improved cytoreduction of ovarian cancer in a preclinical orthotopic surgical model. EBioMedicine 2020; 56:102783. [PMID: 32454402 PMCID: PMC7248677 DOI: 10.1016/j.ebiom.2020.102783] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/03/2020] [Accepted: 04/21/2020] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND The completeness of resection is a key prognostic indicator in patients with ovarian cancer, and the application of tumour-targeted fluorescence image-guided surgery (FIGS) has led to improved detection of peritoneal metastases during cytoreductive surgery. CD24 is highly expressed in ovarian cancer and has been shown to be a suitable biomarker for tumour-targeted imaging. METHODS CD24 expression was investigated in cell lines and heterogenous patient-derived xenograft (PDX) tumour samples of high-grade serous ovarian carcinoma (HGSOC). After conjugation of the monoclonal antibody CD24 to the NIR dye Alexa Fluor 750 and the evaluation of the optimal pharmacological parameters (OV-90, n = 21), orthotopic HGSOC metastatic xenografts (OV-90, n = 16) underwent cytoreductive surgery with real-time feedback. The impact of intraoperative CD24-targeted fluorescence guidance was compared to white light and palpation alone, and the recurrence of disease was monitored post-operatively (OV-90, n = 12). CD24-AF750 was further evaluated in four clinically annotated orthotopic PDX models of metastatic HGSOC, to validate the translational potential for intraoperative guidance. FINDINGS CD24-targeted intraoperative NIR FIGS significantly (47•3%) improved tumour detection and resection, and reduced the post-operative tumour burden compared to standard white-light surgery in orthotopic HGSOC xenografts. CD24-AF750 allowed identification of minuscule tumour lesions which were undetectable with the naked eye in four HGSOC PDX. INTERPRETATION CD24-targeted FIGS has translational potential as an aid to improve debulking surgery of ovarian cancer. FUNDING This study was supported by the H2020 program MSCA-ITN [675743], Helse Vest RHF, and Helse Bergen HF [911809, 911852, 912171, 240222, 911974, HV1269], as well as by The Norwegian Cancer Society [182735], and The Research Council of Norway through its Centres of excellence funding scheme [223250, 262652].
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Affiliation(s)
- Katrin Kleinmanns
- Center for Cancer Biomarkers, CCBIO, Department of Clinical Science, University of Bergen, Jonas Lies vei 91B, 5021 Bergen, Norway
| | - Vibeke Fosse
- Center for Cancer Biomarkers, CCBIO, Department of Clinical Science, University of Bergen, Jonas Lies vei 91B, 5021 Bergen, Norway; Department of Radiology, Erasmus Medical Centre, 3000 CA Rotterdam, the Netherlands
| | - Ben Davidson
- Department of Pathology, Oslo University Hospital, Norwegian Radium Hospital, 0310 Oslo, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, 0316 Oslo, Norway
| | - Elvira García de Jalón
- Center for Cancer Biomarkers, CCBIO, Department of Clinical Science, University of Bergen, Jonas Lies vei 91B, 5021 Bergen, Norway; Department of Chemistry and Centre for Pharmacy, University of Bergen, Allégaten 41, 5007 Bergen, Norway
| | - Olav Tenstad
- Department of Biomedicine, University of Bergen, Jonas Lies vei 91B, 5021 Bergen, Norway
| | - Line Bjørge
- Center for Cancer Biomarkers, CCBIO, Department of Clinical Science, University of Bergen, Jonas Lies vei 91B, 5021 Bergen, Norway; Department of Obstetrics and Gyneacology, Haukeland University Hospital, 5021 Bergen, Norway
| | - Emmet McCormack
- Center for Cancer Biomarkers, CCBIO, Department of Clinical Science, University of Bergen, Jonas Lies vei 91B, 5021 Bergen, Norway.
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Gu B, Xia L, Ge H, Liu S. Preoperative PET/CT score can predict complete resection in advanced epithelial ovarian cancer: a prospective study. Quant Imaging Med Surg 2020; 10:743-753. [PMID: 32269933 DOI: 10.21037/qims.2020.02.19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background To assess the ability of preoperative positron emission tomography/computed tomography (PET/CT) scans to predict postoperative residual disease in advanced epithelial ovarian cancer (AEOC). Methods Thirty-one women with suspected AEOC were enrolled in our prospective study before surgery from July 2016 to December 2017. Complete resection was determined as no residual disease (R0) after surgery. A PET/CT scan was obtained within 2 weeks before surgery in our hospital. The PET score was the sum of each score of the radiological criteria from Suidan's model. The correlations between the PET score and tumor burden and surgical complexity were evaluated by Pearson correlation analysis. T-test or Fisher's exact test was used to compare differences in the variables between the complete and incomplete resection groups. Receiver operating characteristic (ROC) curve analysis was performed to assess the accuracy of the PET score for predicting complete postoperative resection. Results The median [range] of PET score was 2 [0-8], and the PET score in 20 (65%) patients was less than 3. Complete resection was achieved in 11 (35.5%) patients after surgery, including 10 (90.91%) with low PET scores and only 1 (9.09%) with a high score. The PET score had a significant positive correlation with tumor burden [Eisenkop: r=0.603, P<0.001; peritoneal cancer index (PCI): r=0.522, P=0.003] but not with surgery complexity (Aletti: r=0.291, P=0.113). Patients with lower PET scores (P=0.046) and tumor burdens (Eisenkop: P=0.013; PCI: P=0.012) had higher rates of complete resection. The PET score and tumor burden were effective for predicting complete resection. The AUCPET, AUCEisenkop, and AUCPCI were 0.797 (95% CI: 0.633-0.961, P=0.01), 0.847 (95% CI: 0.707-0.988, P=0.003), and 0.811 (95% CI: 0.653-0.969, P=0.007), respectively. However, surgery complexity was not useful for assessing complete resection. Conclusions The preoperative PET score can noninvasively reflect tumor burden and helps predict complete resection after surgery in AEOC patients.
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Affiliation(s)
- Bingxin Gu
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.,Center for Biomedical Imaging, Fudan University, Shanghai 200032, China.,Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai 200032, China
| | - Lingfang Xia
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.,Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Huijuan Ge
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.,Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Shuai Liu
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.,Center for Biomedical Imaging, Fudan University, Shanghai 200032, China.,Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai 200032, China
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28
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Chen J, Liu S, Tang Y, Zhang X, Cao M, Xiao Z, Ren M, Chen T. Diagnostic performance of CT for differentiating peritoneal tuberculosis from peritoneal carcinomatosis: a systematic review and meta-analysis. Clin Radiol 2020; 75:396.e7-396.e14. [PMID: 32081347 DOI: 10.1016/j.crad.2019.12.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 12/12/2019] [Indexed: 01/01/2023]
Abstract
AIM To undertake a systematic review and meta-analysis of the diagnostic performance of CT for differentiating peritoneal tuberculosis (PTB) from peritoneal carcinomatosis (PC). MATERIAL AND METHODS PubMed, Embase, the Web of Science, and the Cochrane Library were searched for papers published before 23 July 2019. The methodological quality of the studies was analysed. Overlapping descriptors used in different studies to denote the same image finding were subsumed under a single CT feature. Sensitivity, specificity, and positive and negative likelihood ratios were pooled. A summary receiver operating characteristic curve (sROC) was constructed and the area under the curve (AUC) of the included studies was calculated when possible. RESULTS Six studies were included and 17 CT features were analysed. The pooled sensitivity and specificity of smooth peritoneal thickening were 59% (95% CI: 52-66%) and 84% (95% CI: 79-88%), respectively. The AUC of smooth peritoneal thickening was 0.83. Omentum line/rim, lymph node necrosis or calcification, and mesenteric macro nodules had a pooled specificity ranging from 95% to 100% and a pooled sensitivity ranging from 12% to 67%. The other 12 signs had a pooled sensitivity ranging from 21% to 79% and a pooled specificity ranging from 19% to 81%. Omentum involvement (cake-like pattern) showed a threshold-effect, so only the AUC (=0.70) was calculated. CONCLUSIONS Smooth peritoneal thickening shows fairly good diagnostic accuracy, while omentum rim/line, lymph nodes necrosis or calcification, mesenteric macro nodules have good specificity but limited sensitivity. The informative features summarised in this study may aid clinical practice and future studies.
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Affiliation(s)
- J Chen
- Department of Radiology, Zhongshan Affiliated Hospital, Guangzhou University of Chinese Medicine, Zhongshan, 528400, PR China.
| | - S Liu
- Department of Radiology, Zhongshan Affiliated Hospital, Guangzhou University of Chinese Medicine, Zhongshan, 528400, PR China
| | - Y Tang
- Department of Radiology, Zhongshan Affiliated Hospital, Guangzhou University of Chinese Medicine, Zhongshan, 528400, PR China
| | - X Zhang
- Department of Radiology, Zhongshan Affiliated Hospital, Guangzhou University of Chinese Medicine, Zhongshan, 528400, PR China
| | - M Cao
- Department of Radiology, Zhongshan Affiliated Hospital, Guangzhou University of Chinese Medicine, Zhongshan, 528400, PR China
| | - Z Xiao
- Department of Radiology, Zhongshan Affiliated Hospital, Guangzhou University of Chinese Medicine, Zhongshan, 528400, PR China
| | - M Ren
- Department of Radiology, Zhongshan Affiliated Hospital, Guangzhou University of Chinese Medicine, Zhongshan, 528400, PR China
| | - T Chen
- Department of Radiology, Zhongshan Affiliated Hospital, Guangzhou University of Chinese Medicine, Zhongshan, 528400, PR China
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Rizzo S, De Piano F, Buscarino V, Pagan E, Bagnardi V, Zanagnolo V, Colombo N, Maggioni A, Del Grande M, Del Grande F, Bellomi M, Aletti G. Pre-operative evaluation of epithelial ovarian cancer patients: Role of whole body diffusion weighted imaging MR and CT scans in the selection of patients suitable for primary debulking surgery. A single-centre study. Eur J Radiol 2019; 123:108786. [PMID: 31862634 DOI: 10.1016/j.ejrad.2019.108786] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 12/05/2019] [Accepted: 12/06/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE to evaluate the accuracy of Whole Body MRI including Diffusion-Weighted Imaging sequences (WB DWI MR) in the assessment of sites of disease in epithelial ovarian cancer (EOC), in comparison to CT; to evaluate whether a clinical-radiological score may predict suboptimal cytoreductive surgery. METHODS patients with suspected EOC who underwent pre-operative WB DWI MR were included; CT scans were recorded. Data recorded included: age, staging, dates of examinations and surgery; tumour markers; sites of disease at imaging scans and at surgery. For calculation of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of WB DWI MR and CT, surgical evaluation represented the gold standard. The accuracy of WB DWI MR and CT was compared. The association between clinical and radiological criteria with sub-optimal cytoreduction was tested to identify a final model to predict sub-optimal cytoreduction. RESULTS 92 patients were included; 77/92 (83.7 %) were optimally cytoreduced. Sixty-six CT and 92 MR examinations were evaluated. WB DWI MR showed overall higher accuracy than CT in assessing all sites, but it performed significantly better than CT specifically for involvement of mesentery, lumbo-aortic lymph nodes, pelvis, large bowel, sigmoid-rectum. The predicting score for suboptimal cytoreduction included: mesenteric carcinomatosis; mesenteric retraction; large bowel carcinomatosis. CONCLUSIONS In pre-operative evaluation of EOC patients, WB DW MRI is accurate for assessment of multiple sites and it is significantly more accurate than CT for specific unresectable sites. In our series, significant sites of disease for suboptimal cytoreduction were mesenteric carcinomatosis, mesenteric retraction and large bowel carcinomatosis.
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Affiliation(s)
- Stefania Rizzo
- Clinica di Radiologia EOC, Istituto di Imaging della Svizzera Italiana (IIMSI), Via Tesserete, 46- 6900, Lugano, Switzerland.
| | - Francesca De Piano
- Università degli Studi di Milano, Postgraduation School in Radiodiagnostics, Via Festa del Perdono, 7, 20122, Milan, Italy
| | - Valentina Buscarino
- Department of Radiology, ASLVC, corso Mario Abbiate 21, 13100, Vercelli, Italy
| | - Eleonora Pagan
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Via Bicocca degli Arcimboldi 8, 20126, Milan, Italy
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Via Bicocca degli Arcimboldi 8, 20126, Milan, Italy
| | - Vanna Zanagnolo
- Department of Gynecologic Oncology, IEO European Institute of Oncology, IRCCS via Ripamonti 435, 20141 Milan, Italy
| | - Nicoletta Colombo
- Department of Gynecologic Oncology, IEO European Institute of Oncology, IRCCS via Ripamonti 435, 20141 Milan, Italy; Department of Medicine and Surgery, University of Milan-Bicocca, Italy
| | - Angelo Maggioni
- Department of Gynecologic Oncology, IEO European Institute of Oncology, IRCCS via Ripamonti 435, 20141 Milan, Italy
| | - Maria Del Grande
- Oncology Institute of Southern Switzerland, San Giovanni Hospital, 6500, Bellinzona, Switzerland
| | - Filippo Del Grande
- Clinica di Radiologia EOC, Istituto di Imaging della Svizzera Italiana (IIMSI), Via Tesserete, 46- 6900, Lugano, Switzerland
| | - Massimo Bellomi
- Department of Radiology, IEO European Institute of Oncology IRCCS, via Ripamonti 435, 20141 Milan, Italy; Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy
| | - Giovanni Aletti
- Clinica di Radiologia EOC, Istituto di Imaging della Svizzera Italiana (IIMSI), Via Tesserete, 46- 6900, Lugano, Switzerland; Department of Radiology, IEO European Institute of Oncology IRCCS, via Ripamonti 435, 20141 Milan, Italy
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Kemppainen J, Hynninen J, Virtanen J, Seppänen M. PET/CT for Evaluation of Ovarian Cancer. Semin Nucl Med 2019; 49:484-492. [DOI: 10.1053/j.semnuclmed.2019.06.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Ceppi L, Bardhan NM, Na Y, Siegel A, Rajan N, Fruscio R, Del Carmen MG, Belcher AM, Birrer MJ. Real-Time Single-Walled Carbon Nanotube-Based Fluorescence Imaging Improves Survival after Debulking Surgery in an Ovarian Cancer Model. ACS NANO 2019; 13:5356-5365. [PMID: 31009198 DOI: 10.1021/acsnano.8b09829] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Improved cytoreductive surgery for advanced stage ovarian cancer (OC) represents a critical challenge in the treatment of the disease. Optimal debulking reaching no evidence of macroscopic disease is the primary surgical end point with a demonstrated survival advantage. Targeted molecule-based fluorescence imaging offers complete tumor resection down to the microscopic scale. We used a custom-built reflectance/fluorescence imaging system with an orthotopic OC mouse model to both quantify tumor detectability and evaluate the effect of fluorescence image-guided surgery on post-operative survival. The contrast agent is an intraperitoneal injectable nanomolecular probe, composed of single-walled carbon nanotubes, coupled to an M13 bacteriophage carrying a modified peptide binding to the SPARC protein, an extracellular protein overexpressed in OC. The imaging system is capable of detecting a second near-infrared window fluorescence (1000-1700 nm) and can display real-time video imagery to guide intraoperative tumor debulking. We observed high microscopic tumor detection with a pixel-limited resolution of 200 μm. Moreover, in a survival-surgery orthotopic OC mouse model, we demonstrated an increased survival benefit for animals treated with fluorescence image-guided surgical resection compared to standard surgery.
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Affiliation(s)
- Lorenzo Ceppi
- Center for Cancer Research, The Gillette Center for Gynecologic Oncology , Massachusetts General Hospital, Harvard Medical School , Boston , Massachusetts 02114 , United States
- Department of Medicine and Surgery , University of Milan-Bicocca , 20126 Milan , Italy
| | - Neelkanth M Bardhan
- Department of Materials Science and Engineering , Massachusetts Institute of Technology , Cambridge , Massachusetts 02139 , United States
- The David H. Koch Institute for Integrative Cancer Research , Massachusetts Institute of Technology , Cambridge , Massachusetts 02142 , United States
- Department of Biological Engineering , Massachusetts Institute of Technology , Cambridge , Massachusetts 02139 , United States
| | - YoungJeong Na
- Center for Cancer Research, The Gillette Center for Gynecologic Oncology , Massachusetts General Hospital, Harvard Medical School , Boston , Massachusetts 02114 , United States
| | - Andrew Siegel
- Massachusetts Institute of Technology , Cambridge , Massachusetts 02139 , United States
| | - Nandini Rajan
- Massachusetts Institute of Technology , Cambridge , Massachusetts 02139 , United States
| | - Robert Fruscio
- Department of Medicine and Surgery , University of Milan-Bicocca , 20126 Milan , Italy
| | - Marcela G Del Carmen
- Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology , Massachusetts General Hospital, Harvard Medical School , Boston , Massachusetts 02114 , United States
| | - Angela M Belcher
- Department of Materials Science and Engineering , Massachusetts Institute of Technology , Cambridge , Massachusetts 02139 , United States
- The David H. Koch Institute for Integrative Cancer Research , Massachusetts Institute of Technology , Cambridge , Massachusetts 02142 , United States
- Department of Biological Engineering , Massachusetts Institute of Technology , Cambridge , Massachusetts 02139 , United States
| | - Michael J Birrer
- Center for Cancer Research, The Gillette Center for Gynecologic Oncology , Massachusetts General Hospital, Harvard Medical School , Boston , Massachusetts 02114 , United States
- O'Neal Comprehensive Cancer Center, Division of Hematology-Oncology , University of Alabama at Birmingham , Birmingham , Alabama 35294 , United States
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Sebastian A, Thomas A, Varghese G, Yadav B, Chandy R, Peedicayil A. Outcome of Bowel Resection in Women with Advanced Ovarian Carcinoma. Indian J Surg Oncol 2018; 9:511-518. [PMID: 30538381 DOI: 10.1007/s13193-018-0790-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 07/13/2018] [Indexed: 12/20/2022] Open
Abstract
To evaluate the mortality and morbidity related to bowel resection in women with advanced ovarian carcinoma. Retrospective case series of 47 women with stage III and IV carcinoma ovary who underwent bowel resection, over the period of 5 years from Jan 2011 to Dec 2015. The risk factors for perioperative morbidity and death were determined by regression analysis. The disease free and overall survival were determined by Kaplan-Meier plots. In this cohort, 64% (30/47) had primary debulking, 21% (10/47) had interval debulking, and 15% (7/47) had secondary debulking. The mean period of follow-up was 23 months (1 to 45 months). There were no anastomotic leaks. The commonest morbidities were relaparotomy (8.5%), surgical site infection (12%), and paralytic ileus (19%). The overall morbidity was 42.6% (20/47). The 30-day mortality was 4.2% (2/47). The recurrence rate was 51% (20/47). The overall mortality from ovarian cancer in this cohort was 40% (19/47) during the follow-up period. Stage and histology seemed to be important risk factors for morbidity. Low BMI and sub-optimal debulking were significant risk factors for recurrence and death in univariate analysis. Bowel resection, in optimally selected cases of advanced carcinoma ovary, is often required for optimal cytoreduction. It carries a reasonable peri-operative mortality and morbidity and improves overall survival.
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Affiliation(s)
- Ajit Sebastian
- 1Department of Gynaecologic Oncology, CMC Hospital, Vellore, 632004 India
| | - Anitha Thomas
- 1Department of Gynaecologic Oncology, CMC Hospital, Vellore, 632004 India
| | - Gigi Varghese
- 2Department of Colorectal Surgery, CMC Hospital, Vellore, 632004 India
| | - Bijesh Yadav
- 3Department of Biostatistics, CMC Hospital, Vellore, 632004 India
| | - Rachel Chandy
- 1Department of Gynaecologic Oncology, CMC Hospital, Vellore, 632004 India
| | - Abraham Peedicayil
- 1Department of Gynaecologic Oncology, CMC Hospital, Vellore, 632004 India
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Zargari A, Du Y, Heidari M, Thai TC, Gunderson CC, Moore K, Mannel RS, Liu H, Zheng B, Qiu Y. Prediction of chemotherapy response in ovarian cancer patients using a new clustered quantitative image marker. Phys Med Biol 2018; 63:155020. [PMID: 30010611 DOI: 10.1088/1361-6560/aad3ab] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This study aimed to investigate the feasibility of integrating image features computed from both spatial and frequency domain to better describe the tumor heterogeneity for precise prediction of tumor response to postsurgical chemotherapy in patients with advanced-stage ovarian cancer. A computer-aided scheme was applied to first compute 133 features from five categories namely, shape and density, fast Fourier transform, discrete cosine transform (DCT), wavelet, and gray level difference method. An optimal feature cluster was then determined by the scheme using the particle swarm optimization algorithm aiming to achieve an enhanced discrimination power that was unattainable with the single features. The scheme was tested using a balanced dataset (responders and non-responders defined using 6 month PFS) retrospectively collected from 120 ovarian cancer patients. By evaluating the performance of the individual features among the five categories, the DCT features achieved the highest predicting accuracy than the features in other groups. By comparison, a quantitative image marker generated from the optimal feature cluster yielded the area under ROC curve (AUC) of 0.86, while the top performing single feature only had an AUC of 0.74. Furthermore, it was observed that the features computed from the frequency domain were as important as those computed from the spatial domain. In conclusion, this study demonstrates the potential of our proposed new quantitative image marker fused with the features computed from both spatial and frequency domain for a reliable prediction of tumor response to postsurgical chemotherapy.
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Affiliation(s)
- Abolfazl Zargari
- School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK 73019, United States of America. These authors contributed equally to this work
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An H, Lee E, Chiu K, Chang C. The emerging roles of functional imaging in ovarian cancer with peritoneal carcinomatosis. Clin Radiol 2018; 73:597-609. [DOI: 10.1016/j.crad.2018.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 03/09/2018] [Indexed: 12/22/2022]
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deSouza NM, Liu Y, Chiti A, Oprea-Lager D, Gebhart G, Van Beers BE, Herrmann K, Lecouvet FE. Strategies and technical challenges for imaging oligometastatic disease: Recommendations from the European Organisation for Research and Treatment of Cancer imaging group. Eur J Cancer 2018; 91:153-163. [DOI: 10.1016/j.ejca.2017.12.012] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 12/07/2017] [Indexed: 02/06/2023]
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Guo HL, He L, Zhu YC, Wu K, Yuan F. Comparison between multi-slice spiral CT and magnetic resonance imaging in the diagnosis of peritoneal metastasis in primary ovarian carcinoma. Onco Targets Ther 2018. [PMID: 29535533 PMCID: PMC5836691 DOI: 10.2147/ott.s147700] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The advent of disease evaluation by means of multi-slice spiral computed tomography (MSCT) and magnetic resonance imaging (MRI) represents a continually emerging role in the evaluation of various diseases; however, its role is yet to be adequately defined. Thus, the aim of the study was to compare the diagnostic value of MSCT and MRI in the diagnosis of peritoneal metastasis in primary ovarian carcinoma. Between January 2013 and December 2015, MSCT or MRI data were collected from 42 patients who had been previously diagnosed with peritoneal metastasis of ovarian carcinoma at the First Affiliated Hospital of Kunming Medical University. The tumor location, size, edge, and shape were all evaluated independently by three qualified imaging physicians using a double-blind method to confirm whether the patients were indeed suffering from peritoneal metastasis, as well as to rank the metastatic lesions recorded on a five-point scale. It was hypothesized that MRI and MSCT were comparable in the evaluation of ovarian carcinoma. Therefore, a receiver operating characteristics (ROC) curve was used to analyze the results and also to directly compare the respective diagnostic values of MSCT and MRI. In total, 165 metastatic lesions were confirmed by means of surgical operation. MSCT revealed 131 metastatic lesions, while MRI confirmed 154 metastatic lesions. The metastatic sites were primarily located on the subphrenic, epiploon, and gastrocolic ligaments and were further confirmed by either MRI or CT. In regard to MSCT, the most common site of underdiagnoses was in the vicinity of the uterus-rectum-fossa. MRI displayed a high detection rate in every site. The omission diagnostic rate of MSCT and MRI were 20.61% and 6.67%, respectively, while the accuracy rates were 79.39% and 93.33%, respectively. The obtained results revealed that the MSCT value of area under the ROC curve was smaller than that for MRI. Our findings provided evidence asserting that MRI, in comparison to MSCT, was more accurate in diagnosing peritoneal metastasis in patients with ovarian carcinoma.
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Affiliation(s)
- Hong-Lei Guo
- Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University, Kunming, People's Republic of China
| | - Ling He
- Department of Radiology, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, People's Republic of China
| | - Yan-Cui Zhu
- Intensive Care Unit, The First Affiliated Hospital of Kunming Medical University, Kunming, People's Republic of China
| | - Kun Wu
- Department of Hematology, The First Affiliated Hospital of Kunming Medical University, Kunming, People's Republic of China
| | - Feng Yuan
- Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University, Kunming, People's Republic of China
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Danala G, Thai T, Gunderson CC, Moxley KM, Moore K, Mannel RS, Liu H, Zheng B, Qiu Y. Applying Quantitative CT Image Feature Analysis to Predict Response of Ovarian Cancer Patients to Chemotherapy. Acad Radiol 2017; 24:1233-1239. [PMID: 28554551 PMCID: PMC5875685 DOI: 10.1016/j.acra.2017.04.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 04/03/2017] [Accepted: 04/03/2017] [Indexed: 12/19/2022]
Abstract
RATIONALE AND OBJECTIVES The study aimed to investigate the role of applying quantitative image features computed from computed tomography (CT) images for early prediction of tumor response to chemotherapy in the clinical trials for treating ovarian cancer patients. MATERIALS AND METHODS A dataset involving 91 patients was retrospectively assembled. Each patient had two sets of pre- and post-therapy CT images. A computer-aided detection scheme was applied to segment metastatic tumors previously tracked by radiologists on CT images and computed image features. Two initial feature pools were built using image features computed from pre-therapy CT images only and image feature difference computed from both pre- and post-therapy images. A feature selection method was applied to select optimal features, and an equal-weighted fusion method was used to generate a new quantitative imaging marker from each pool to predict 6-month progression-free survival. The prediction accuracy between quantitative imaging markers and the Response Evaluation Criteria in Solid Tumors (RECIST) criteria was also compared. RESULTS The highest areas under the receiver operating characteristic curve are 0.684 ± 0.056 and 0.771 ± 0.050 when using a single image feature computed from pre-therapy CT images and feature difference computed from pre- and post-therapy CT images, respectively. Using two corresponding fusion-based image markers, the areas under the receiver operating characteristic curve significantly increased to 0.810 ± 0.045 and 0.829 ± 0.043 (P < 0.05), respectively. Overall prediction accuracy levels are 71.4%, 80.2%, and 74.7% when using two imaging markers and RECIST, respectively. CONCLUSIONS This study demonstrated the feasibility of predicting patients' response to chemotherapy using quantitative imaging markers computed from pre-therapy CT images. However, using image feature difference computed between pre- and post-therapy CT images yielded higher prediction accuracy.
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Affiliation(s)
- Gopichandh Danala
- School of Electrical and Computer Engineering, University of Oklahoma, 101 David L. Boren Blvd, Norman, OK 73019
| | - Theresa Thai
- Health Science Center of University of Oklahoma, Oklahoma City, Oklahoma
| | | | - Katherine M Moxley
- Health Science Center of University of Oklahoma, Oklahoma City, Oklahoma
| | - Kathleen Moore
- Health Science Center of University of Oklahoma, Oklahoma City, Oklahoma
| | - Robert S Mannel
- Health Science Center of University of Oklahoma, Oklahoma City, Oklahoma
| | - Hong Liu
- School of Electrical and Computer Engineering, University of Oklahoma, 101 David L. Boren Blvd, Norman, OK 73019
| | - Bin Zheng
- School of Electrical and Computer Engineering, University of Oklahoma, 101 David L. Boren Blvd, Norman, OK 73019
| | - Yuchen Qiu
- School of Electrical and Computer Engineering, University of Oklahoma, 101 David L. Boren Blvd, Norman, OK 73019.
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Abstract
[fluorine-18]-fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG PET CT) has increasing clinical applications supplementing conventional TVUS, CT and MRI imaging in assessing ovarian, cervical and endometrial cancer. The published literature on the applications of 18F-FDG PET CT shows its use can have significant impact on patient management by improving staging of the cancers, influencing patient selection for treatment and in detecting early recurrent disease. However, the increasing clinical use of PET CT does not always align with the guidelines, recommendations or expert opinion in the use of PET CT. This article summarizes the existing evidence base for the established clinical applications and the emerging roles for 18F-FDG PET CT in the common gynaecological malignancies.
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Affiliation(s)
- Priya Narayanan
- 1 Department of Imaging, University College Hospital NHS Trust, London, UK
| | - Anju Sahdev
- 2 Department of Imaging, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
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Jiang D, Im HJ, Sun H, Valdovinos HF, England CG, Ehlerding EB, Nickles RJ, Lee DS, Cho SY, Huang P, Cai W. Radiolabeled pertuzumab for imaging of human epidermal growth factor receptor 2 expression in ovarian cancer. Eur J Nucl Med Mol Imaging 2017; 44:1296-1305. [PMID: 28265738 PMCID: PMC5471126 DOI: 10.1007/s00259-017-3663-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 02/21/2017] [Indexed: 12/12/2022]
Abstract
PURPOSE Human epidermal growth factor receptor 2 (HER2) is over-expressed in over 30% of ovarian cancer cases, playing an essential role in tumorigenesis and metastasis. Non-invasive imaging of HER2 is of great interest for physicians as a mean to better detect and monitor the progression of ovarian cancer. In this study, HER2 was assessed as a biomarker for ovarian cancer imaging using 64Cu-labeled pertuzumab for immunoPET imaging. METHODS HER2 expression and binding were examined in three ovarian cancer cell lines (SKOV3, OVCAR3, Caov3) using in vitro techniques, including western blot and saturation binding assays. PET imaging and biodistribution studies in subcutaneous models of ovarian cancer were performed for non-invasive in vivo evaluation of HER2 expression. Additionally, orthotopic models were employed to further validate the imaging capability of 64Cu-NOTA-pertuzumab. RESULTS HER2 expression was highest in SKOV3 cells, while OVCAR3 and Caov3 displayed lower HER2 expression. 64Cu-NOTA-pertuzumab showed high specificity for HER2 (Ka = 3.1 ± 0.6 nM) in SKOV3. In subcutaneous tumors, PET imaging revealed tumor uptake of 41.8 ± 3.8, 10.5 ± 3.9, and 12.1 ± 2.3%ID/g at 48 h post-injection for SKOV3, OVCAR3, and Caov3, respectively (n = 3). In orthotopic models, PET imaging with 64Cu-NOTA-pertuzumab allowed for rapid and clear delineation of both primary and small peritoneal metastases in HER2-expressing ovarian cancer. CONCLUSIONS 64Cu-NOTA-pertuzumab is an effective PET tracer for the non-invasive imaging of HER2 expression in vivo, rendering it a potential tracer for treatment monitoring and improved patient stratification.
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MESH Headings
- Animals
- Antibodies, Monoclonal, Humanized/chemistry
- Antibodies, Monoclonal, Humanized/metabolism
- Antibodies, Monoclonal, Humanized/pharmacokinetics
- Cell Line, Tumor
- Cell Transformation, Neoplastic
- Copper Radioisotopes
- Female
- Gene Expression Regulation, Neoplastic
- Heterocyclic Compounds, 1-Ring/chemistry
- Humans
- Isotope Labeling
- Mice
- Ovarian Neoplasms/diagnostic imaging
- Ovarian Neoplasms/metabolism
- Ovarian Neoplasms/pathology
- Positron-Emission Tomography/methods
- Radiometry
- Receptor, ErbB-2/metabolism
- Tissue Distribution
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Affiliation(s)
- Dawei Jiang
- Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University, Shenzhen, 518060, China
- Department of Radiology, University of Wisconsin - Madison, Room 7137, 1111 Highland Ave, Madison, WI, 53705-2275, USA
| | - Hyung-Jun Im
- Department of Radiology, University of Wisconsin - Madison, Room 7137, 1111 Highland Ave, Madison, WI, 53705-2275, USA
- Graduate School of Convergence Science and Technology, Seoul National University, Seoul, 08826, Republic of Korea
| | - Haiyan Sun
- Department of Radiology, University of Wisconsin - Madison, Room 7137, 1111 Highland Ave, Madison, WI, 53705-2275, USA
| | - Hector F Valdovinos
- Department of Medical Physics, University of Wisconsin - Madison, Madison, WI, 53705, USA
| | - Christopher G England
- Department of Medical Physics, University of Wisconsin - Madison, Madison, WI, 53705, USA
| | - Emily B Ehlerding
- Department of Medical Physics, University of Wisconsin - Madison, Madison, WI, 53705, USA
| | - Robert J Nickles
- Department of Medical Physics, University of Wisconsin - Madison, Madison, WI, 53705, USA
| | - Dong Soo Lee
- Graduate School of Convergence Science and Technology, Seoul National University, Seoul, 08826, Republic of Korea
| | - Steve Y Cho
- Department of Radiology, University of Wisconsin - Madison, Room 7137, 1111 Highland Ave, Madison, WI, 53705-2275, USA
| | - Peng Huang
- Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University, Shenzhen, 518060, China.
| | - Weibo Cai
- Department of Radiology, University of Wisconsin - Madison, Room 7137, 1111 Highland Ave, Madison, WI, 53705-2275, USA.
- Department of Medical Physics, University of Wisconsin - Madison, Madison, WI, 53705, USA.
- University of Wisconsin Carbone Cancer Center, Madison, WI, 53705, USA.
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Yogo T, Umezawa K, Kamiya M, Hino R, Urano Y. Development of an Activatable Fluorescent Probe for Prostate Cancer Imaging. Bioconjug Chem 2017; 28:2069-2076. [DOI: 10.1021/acs.bioconjchem.7b00233] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
| | | | - Mako Kamiya
- PRESTO, Japan Science and Technology Agency, 4-1-8 Honcho, Kawaguchi, Saitama 332-0012, Japan
| | - Rumi Hino
- Department
of Sports and Health Science, Daito Bunka University, 560 Iwadono, Higashimathuyama, Saitama 355-8501, Japan
| | - Yasuteru Urano
- AMED-CREST, Japan Agency for Medical Research and Development, 1-7-1 Otemachi, Chiyoda-ku, Tokyo 100-0004, Japan
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41
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Diagnostic value of whole body diffusion-weighted MRI compared to computed tomography for pre-operative assessment of patients suspected for ovarian cancer. Eur J Cancer 2017; 83:88-98. [PMID: 28734146 DOI: 10.1016/j.ejca.2017.06.010] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 05/29/2017] [Accepted: 06/11/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND Despite excellent per-lesion performance for peritoneal staging, the additional clinical value of diffusion-weighted magnetic resonance imaging (DWI/MRI) compared to computed tomography (CT) remains to be established in ovarian cancer. Our purpose was to evaluate whole body (WB)-DWI/MRI for diagnosis, staging and operability assessment of patients suspected for ovarian cancer compared to CT. METHODS One hundred and sixty-one patients suspected for ovarian carcinoma underwent 3 T WB-DWI/MRI and contrast-enhanced CT. WB-DWI/MRI and CT were compared for confirmation of the malignant nature and primary origin of the ovarian mass, Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) staging and prediction of incomplete resection using institutional operability criteria. Interobserver agreement between two readers was determined for WB-DWI/MRI and CT. RESULTS WB-DWI/MRI showed a significantly higher accuracy than CT (93 versus 82%, p = 0.001) to confirm the malignant nature of the ovarian mass and correctly identified 26 of 32 (81%) cancers of non-ovarian origin compared to 10/32 (31%) for CT (p < 0.001). WB-DWI/MRI assigned more ovarian carcinoma patients to the correct FIGO stage (82/94, 87%) compared with CT (33/94, 35%). For prediction of incomplete resection, WB-DWI/MRI showed significantly higher sensitivity (94 versus 66%), specificity (97.7 versus 77.3%) and accuracy (95.7 versus 71.3%) compared to CT (p < 0.001). Interobserver agreement was almost perfect (κ = 0.90) for WB-DWI/MRI and moderate (κ = 0.52) for CT for prediction of incomplete resection. CONCLUSIONS WB-DWI/MRI was superior to CT for primary tumour characterisation, staging and prediction of incomplete resection in patients suspected for ovarian cancer.
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Madore WJ, De Montigny E, Deschênes A, Benboujja F, Leduc M, Mes-Masson AM, Provencher DM, Rahimi K, Boudoux C, Godbout N. Morphologic three-dimensional scanning of fallopian tubes to assist ovarian cancer diagnosis. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:76012. [PMID: 28727868 DOI: 10.1117/1.jbo.22.7.076012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 06/29/2017] [Indexed: 05/11/2023]
Abstract
The majority of high-grade serous ovarian cancers is now believed to originate in the fallopian tubes. Therefore, current practices include the pathological examination of excised fallopian tubes. Detection of tumors in the fallopian tubes using current clinical approaches remains difficult but is of critical importance to achieve accurate staging and diagnosis. Here, we present an intraoperative imaging system for the detection of human fallopian tube lesions. The system is based on optical coherence tomography (OCT) to access subepithelial tissue architecture. To demonstrate that OCT could identify lesions, we analyzed 180 OCT volumes taken from five different ovarian lesions and from healthy fallopian tubes, and compared them to standard pathological review. We demonstrated that qualitative features could be matched to pathological conditions. We then determined the feasibility of intraluminal imaging of intact human fallopian tubes by building a dedicated endoscopic single-fiber OCT probe to access the mucosal layer inside freshly excised specimens from five patients undergoing prophylactic surgeries. The probe insertion into the lumen acquired images over the entire length of the tubes without damaging the mucosa, providing the first OCT images of intact human fallopian tubes.
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Affiliation(s)
- Wendy-Julie Madore
- École Polytechnique Montréal, Centre d'Optique, Photonique et Lasers (COPL), Montreal, CanadabCentre de recherche du Centre hospitalier de l'Université (CRCHUM), Cancer and Imaging and Engineering Departments, Montreal, CanadacInstitut du cancer de Montréal, Montreal, Canada
| | - Etienne De Montigny
- École Polytechnique Montréal, Centre d'Optique, Photonique et Lasers (COPL), Montreal, CanadabCentre de recherche du Centre hospitalier de l'Université (CRCHUM), Cancer and Imaging and Engineering Departments, Montreal, Canada
| | - Andréanne Deschênes
- École Polytechnique Montréal, Centre d'Optique, Photonique et Lasers (COPL), Montreal, Canada
| | - Fouzi Benboujja
- École Polytechnique Montréal, Centre d'Optique, Photonique et Lasers (COPL), Montreal, Canada
| | - Mikaël Leduc
- École Polytechnique Montréal, Centre d'Optique, Photonique et Lasers (COPL), Montreal, Canada
| | - Anne-Marie Mes-Masson
- Centre de recherche du Centre hospitalier de l'Université (CRCHUM), Cancer and Imaging and Engineering Departments, Montreal, CanadacInstitut du cancer de Montréal, Montreal, CanadadUniversité de Montréal, Department of Medicine, Montreal, Canada
| | - Diane M Provencher
- Centre de recherche du Centre hospitalier de l'Université (CRCHUM), Cancer and Imaging and Engineering Departments, Montreal, CanadacInstitut du cancer de Montréal, Montreal, CanadaeUniversité de Montréal, Division of Gynecologic Oncology, Montreal, Canada
| | - Kurosh Rahimi
- Centre de recherche du Centre hospitalier de l'Université (CRCHUM), Cancer and Imaging and Engineering Departments, Montreal, CanadacInstitut du cancer de Montréal, Montreal, Canada
| | - Caroline Boudoux
- École Polytechnique Montréal, Centre d'Optique, Photonique et Lasers (COPL), Montreal, Canada
| | - Nicolas Godbout
- École Polytechnique Montréal, Centre d'Optique, Photonique et Lasers (COPL), Montreal, Canada
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Liu M, Guo H, Liu H, Zhang Z, Chi C, Hui H, Dong D, Hu Z, Tian J. In vivo pentamodal tomographic imaging for small animals. BIOMEDICAL OPTICS EXPRESS 2017; 8:1356-1371. [PMID: 28663833 PMCID: PMC5480548 DOI: 10.1364/boe.8.001356] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 01/24/2017] [Accepted: 01/27/2017] [Indexed: 05/05/2023]
Abstract
Multimodality molecular imaging emerges as a powerful strategy for correlating multimodal information. We developed a pentamodal imaging system which can perform positron emission tomography, bioluminescence tomography, fluorescence molecular tomography, Cerenkov luminescence tomography and X-ray computed tomography successively. Performance of sub-systems corresponding to different modalities were characterized. In vivo multimodal imaging of an orthotopic hepatocellular carcinoma xenograft mouse model was performed, and acquired multimodal images were fused. The feasibility of pentamodal tomographic imaging system was successfully validated with the imaging application on the mouse model. The ability of integrating anatomical, metabolic, and pharmacokinetic information promises applications of multimodality molecular imaging in precise medicine.
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Affiliation(s)
- Muhan Liu
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education & School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710071, China
- Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
- Contributed equally
| | - Hongbo Guo
- Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
- School of Information Sciences and Technology, Northwest University, Xi'an, 710069, China
- Contributed equally
| | - Hongbo Liu
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education & School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710071, China
- Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
| | - Zeyu Zhang
- Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
| | - Chongwei Chi
- Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
| | - Hui Hui
- Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
| | - Di Dong
- Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
| | - Zhenhua Hu
- Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
- The State Key Laboratory of Management and Control of Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
| | - Jie Tian
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education & School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710071, China
- Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
- The State Key Laboratory of Management and Control of Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
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Tourell MC, Shokoohmand A, Landgraf M, Holzapfel NP, Poh PSP, Loessner D, Momot KI. The distribution of the apparent diffusion coefficient as an indicator of the response to chemotherapeutics in ovarian tumour xenografts. Sci Rep 2017; 7:42905. [PMID: 28220831 PMCID: PMC5318900 DOI: 10.1038/srep42905] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 01/12/2017] [Indexed: 12/17/2022] Open
Abstract
Diffusion-weighted magnetic resonance imaging (DW-MRI) was used to evaluate the effects of single-agent and combination treatment regimens in a spheroid-based animal model of ovarian cancer. Ovarian tumour xenografts grown in non-obese diabetic/severe-combined-immunodeficiency (NOD/SCID) mice were treated with carboplatin or paclitaxel, or combination carboplatin/paclitaxel chemotherapy regimens. After 4 weeks of treatment, tumours were extracted and underwent DW-MRI, mechanical testing, immunohistochemical and gene expression analyses. The distribution of the apparent diffusion coefficient (ADC) exhibited an upward shift as a result of each treatment regimen. The 99-th percentile of the ADC distribution (“maximum ADC”) exhibited a strong correlation with the tumour size (r2 = 0.90) and with the inverse of the elastic modulus (r2 = 0.96). Single-agent paclitaxel (n = 5) and combination carboplatin/paclitaxel (n = 2) treatment regimens were more effective in inducing changes in regions of higher cell density than single-agent carboplatin (n = 3) or the no-treatment control (n = 5). The maximum ADC was a good indicator of treatment-induced cell death and changes in the extracellular matrix (ECM). Comparative analysis of the tumours’ ADC distribution, mechanical properties and ECM constituents provides insights into the molecular and cellular response of the ovarian tumour xenografts to chemotherapy. Increased sample sizes are recommended for future studies. We propose experimental approaches to evaluation of the timeline of the tumour’s response to treatment.
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Affiliation(s)
- Monique C Tourell
- Queensland University of Technology (QUT), Brisbane, Queensland (QLD), Australia
| | - Ali Shokoohmand
- Queensland University of Technology (QUT), Brisbane, Queensland (QLD), Australia.,Australian Prostate Cancer Research Centre - Queensland, Translational Research Institute, Brisbane, QLD, Australia
| | - Marietta Landgraf
- Queensland University of Technology (QUT), Brisbane, Queensland (QLD), Australia
| | - Nina P Holzapfel
- Queensland University of Technology (QUT), Brisbane, Queensland (QLD), Australia
| | - Patrina S P Poh
- Experimental Trauma Surgery, Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Daniela Loessner
- Queensland University of Technology (QUT), Brisbane, Queensland (QLD), Australia
| | - Konstantin I Momot
- Queensland University of Technology (QUT), Brisbane, Queensland (QLD), Australia
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Sundaram KM, Zhang Y, Mitra AK, Kouadio JLK, Gwin K, Kossiakoff AA, Roman BB, Lengyel E, Piccirilli JA. Prolactin Receptor-Mediated Internalization of Imaging Agents Detects Epithelial Ovarian Cancer with Enhanced Sensitivity and Specificity. Cancer Res 2017; 77:1684-1696. [PMID: 28202518 DOI: 10.1158/0008-5472.can-16-1454] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 12/02/2016] [Accepted: 12/21/2016] [Indexed: 01/24/2023]
Abstract
Poor prognosis of ovarian cancer, the deadliest of the gynecologic malignancies, reflects major limitations associated with detection and diagnosis. Current methods lack high sensitivity to detect small tumors and high specificity to distinguish malignant from benign tissue, both impeding diagnosis of early and metastatic cancer stages and leading to costly and invasive surgeries. Tissue microarray analysis revealed that >98% of ovarian cancers express the prolactin receptor (PRLR), forming the basis of a new molecular imaging strategy. We fused human placental lactogen (hPL), a specific and tight binding PRLR ligand, to magnetic resonance imaging (gadolinium) and near-infrared fluorescence imaging agents. Both in tissue culture and in mouse models, these imaging bioconjugates underwent selective internalization into ovarian cancer cells via PRLR-mediated endocytosis. Compared with current clinical MRI techniques, this targeted approach yielded both enhanced signal-to-noise ratio from accumulation of signal via selective internalization and improved specificity conferred by PRLR upregulation in malignant ovarian cancer. These features endow PRLR-targeted imaging with the potential to transform ovarian cancer detection. Cancer Res; 77(7); 1684-96. ©2017 AACR.
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Affiliation(s)
- Karthik M Sundaram
- Department of Biochemistry & Molecular Biology, and Chemistry, The University of Chicago, Chicago, Illinois
| | - Yilin Zhang
- Department of Obstetrics and Gynecology/Section of Gynecologic Oncology, The University of Chicago, Chicago, Illinois
| | - Anirban K Mitra
- Department of Obstetrics and Gynecology/Section of Gynecologic Oncology, The University of Chicago, Chicago, Illinois
| | - Jean-Louis K Kouadio
- Department of Biochemistry & Molecular Biology, and Chemistry, The University of Chicago, Chicago, Illinois
| | - Katja Gwin
- Department of Pathology, The University of Chicago, Chicago, Illinois
| | - Anthony A Kossiakoff
- Department of Biochemistry & Molecular Biology, and Chemistry, The University of Chicago, Chicago, Illinois
| | - Brian B Roman
- Department of Radiology, The University of Chicago, Chicago, Illinois
| | - Ernst Lengyel
- Department of Obstetrics and Gynecology/Section of Gynecologic Oncology, The University of Chicago, Chicago, Illinois.
| | - Joseph A Piccirilli
- Department of Biochemistry & Molecular Biology, and Chemistry, The University of Chicago, Chicago, Illinois.
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46
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Wang SB, Ji YH, Wu HB, Wang QS, Zhou WL, Lv L, Shou T, Hu J. PET/CT for differentiating between tuberculous peritonitis and peritoneal carcinomatosis: The parietal peritoneum. Medicine (Baltimore) 2017; 96:e5867. [PMID: 28079823 PMCID: PMC5266185 DOI: 10.1097/md.0000000000005867] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES Tuberculous peritonitis (TBP) mimics peritoneal carcinomatosis (PC). We aimed to investigate the discriminative use of PET/CT findings in the parietal peritoneum. MATERIALS AND METHODS Parietal peritoneal PET/CT findings from 76 patients with TBP (n = 25) and PC (n = 51) were retrospectively reviewed. The lesion locations were noted as right subdiaphragmatic, left subdiaphragmatic, right paracolic gutters, left paracolic gutters, and pelvic regions. The distribution characteristic consisted of a dominant distribution in the pelvic and/or right subdiaphragmatic region (susceptible area for peritoneal implantation, SAPI) (SAPI distribution), a dominant distribution in the remaining regions (less-susceptible area for peritoneal implantation, LSAPI) (LSAPI distribution), or a uniform distribution. PET morphological patterns were classified as F18-fluorodeoxyglucose (F-FDG) uptake in a long beaded line (string-of-beads F-FDG uptake) or in a cluster (clustered F-FDG uptake) or focal F-FDG uptake. CT patterns included smooth uniform thickening, irregular thickening, or nodules. RESULTS More common findings in the parietal peritoneum corresponding to TBP as opposed to PC were (a) ≥4 involved regions (80.0% vs 19.6%), (b) uniform distribution (72.0% vs 5.9%), (c) string-of-beads F-FDG uptake (76.0% vs 7.8%), and (d) smooth uniform thickening (60.0% vs 7.8%) (all P < 0.001), whereas more frequent findings in PC compared with TBP were (a) SAPI distribution (78.4% vs 28.0%), (b) clustered F-FDG uptake (56.9% vs 20.0%), (c) focal F-FDG uptake (21.6% vs 4.0%), (d) irregular thickening (51.0% vs 12.0%), and (e) nodules (21.6% vs 4.0%) (P < 0.001, P < 0.05, P > 0.05, P < 0.05, P > 0.05, respectively). CONCLUSION Our data show that PET/CT findings in the parietal peritoneum are useful for differentiating between TBP and PC.
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Affiliation(s)
- Shao-Bo Wang
- PET/CT Center, the First People's Hospital of Yunnan Province, Kunming
- NanFang PET Center, Nanfang Hospital, Southern Medical University, Guangzhou
| | - Yun-Hai Ji
- PET/CT Center, the First People's Hospital of Yunnan Province, Kunming
| | - Hu-Bing Wu
- NanFang PET Center, Nanfang Hospital, Southern Medical University, Guangzhou
| | - Quan-Shi Wang
- NanFang PET Center, Nanfang Hospital, Southern Medical University, Guangzhou
| | - Wen-Lan Zhou
- NanFang PET Center, Nanfang Hospital, Southern Medical University, Guangzhou
| | | | - Tao Shou
- Department of Medical Oncology, The First People's Hospital of Yunnan Province, Kunming, China
| | - Jing Hu
- Department of Medical Oncology, The First People's Hospital of Yunnan Province, Kunming, China
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Mahajan A, Sable NP, Popat PB, Bhargava P, Gangadhar K, Thakur MH, Arya S. Magnetic Resonance Imaging of Gynecological Malignancies: Role in Personalized Management. Semin Ultrasound CT MR 2016; 38:231-268. [PMID: 28705370 DOI: 10.1053/j.sult.2016.11.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Gynecological malignancies are a leading cause of mortality and morbidity in women and pose a significant health problem around the world. Currently used staging systems for management of gynecological malignancies have unresolved issues, the most important being recommendations on the use of imaging. Although not mandatory as per the International Federation of Gynecology and Obstetrics recommendations, preoperative cross-sectional imaging is strongly recommended for adequate and optimal management of patients with gynecological malignancies. Standardized disease-specific magnetic resonance imaging protocols help assess disease spread accurately and avoid pitfalls. Multiparametric imaging holds promise as a roadmap to personalized management in gynecological malignancies. In this review, we will highlight the role of magnetic resonance imaging in cervical, endometrial, and ovarian carcinomas.
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Affiliation(s)
- Abhishek Mahajan
- Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, India
| | - Nilesh P Sable
- Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, India
| | - Palak B Popat
- Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, India
| | - Puneet Bhargava
- Department of Radiology, University of Washington School of Medicine, Seattle, WA
| | - Kiran Gangadhar
- Department of Radiology, University of Washington School of Medicine, Seattle, WA
| | | | - Supreeta Arya
- Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, India.
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Penet MF, Krishnamachary B, Wildes F, Mironchik Y, Mezzanzanica D, Podo F, de Reggi M, Gharib B, Bhujwalla ZM. Effect of Pantethine on Ovarian Tumor Progression and Choline Metabolism. Front Oncol 2016; 6:244. [PMID: 27900284 PMCID: PMC5110532 DOI: 10.3389/fonc.2016.00244] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 11/02/2016] [Indexed: 01/21/2023] Open
Abstract
Epithelial ovarian cancer remains the leading cause of death from gynecologic malignancy among women in developed countries. New therapeutic strategies evaluated with relevant preclinical models are urgently needed to improve survival rates. Here, we have assessed the effect of pantethine on tumor growth and metabolism using magnetic resonance imaging and high-resolution proton magnetic resonance spectroscopy (MRS) in a model of ovarian cancer. To evaluate treatment strategies, it is important to use models that closely mimic tumor growth in humans. Therefore, we used an orthotopic model of ovarian cancer where a piece of tumor tissue, derived from an ovarian tumor xenograft, is engrafted directly onto the ovary of female mice, to maintain the tumor physiological environment. Treatment with pantethine, the precursor of vitamin B5 and active moiety of coenzyme A, was started when tumors were ~100 mm3 and consisted of a daily i.p. injection of 750 mg/kg in saline. Under these conditions, no side effects were observed. High-resolution 1H MRS was performed on treated and control tumor extracts. A dual-phase extraction method based on methanol/chloroform/water was used to obtain lipid and water-soluble fractions from the tumors. We also investigated effects on metastases and ascites formation. Pantethine treatment resulted in slower tumor progression, decreased levels of phosphocholine and phosphatidylcholine, and reduced metastases and ascites occurrence. In conclusion, pantethine represents a novel potential, well-tolerated, therapeutic tool in patients with ovarian cancer. Further in vivo preclinical studies are needed to confirm the beneficial role of pantethine and to better understand its mechanism of action.
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Affiliation(s)
- Marie-France Penet
- JHU ICMIC Program, Russell H. Morgan, Division of Cancer Imaging Research, Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Balaji Krishnamachary
- JHU ICMIC Program, Russell H. Morgan, Division of Cancer Imaging Research, Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine , Baltimore, MD , USA
| | - Flonne Wildes
- JHU ICMIC Program, Russell H. Morgan, Division of Cancer Imaging Research, Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine , Baltimore, MD , USA
| | - Yelena Mironchik
- JHU ICMIC Program, Russell H. Morgan, Division of Cancer Imaging Research, Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine , Baltimore, MD , USA
| | - Delia Mezzanzanica
- Unit of Molecular Therapies, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori , Milan , Italy
| | - Franca Podo
- Section of Molecular and Cellular Imaging, Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità , Rome , Italy
| | - Max de Reggi
- Neurobiology of Cellular Interactions and Neurophysiopathology (NICN), Aix Marseille Univ, CNRS , Marseille , France
| | - Bouchra Gharib
- Neurobiology of Cellular Interactions and Neurophysiopathology (NICN), Aix Marseille Univ, CNRS , Marseille , France
| | - Zaver M Bhujwalla
- JHU ICMIC Program, Russell H. Morgan, Division of Cancer Imaging Research, Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Michielsen KLM, Vergote I, Dresen R, Op de Beeck K, Vanslembrouck R, Amant F, Leunen K, Moerman P, Fieuws S, De Keyzer F, Vandecaveye V. Whole-body diffusion-weighted magnetic resonance imaging in the diagnosis of recurrent ovarian cancer: a clinical feasibility study. Br J Radiol 2016; 89:20160468. [PMID: 27585490 DOI: 10.1259/bjr.20160468] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To assess the clinical feasibility of whole-body diffusion-weighted MRI (WB-DWI/MRI) for diagnosis and prediction of complete tumour resection in patients with suspected recurrent ovarian cancer. METHODS 51 females clinically suspected for ovarian cancer recurrence underwent 3-T WB-DWI/MRI in addition to contrast-enhanced CT. WB-DWI/MRI was assessed for detection of tumour recurrence, prediction of tumour extent and complete resection compared with CT. Tumour presence was confirmed by pathology obtained by surgery or biopsy, or by imaging follow-up. RESULTS WB-DWI/MRI showed 94% accuracy for detecting ovarian cancer recurrence, compared with 78% for CT (p = 0.008). WB-DWI/MRI showed better sensitivity [% (95% confidence interval)] than CT for detecting involvement of surgically critical tumour sites including mesenteric root infiltration [92 (62-100) vs 31 (10-61)], small bowel [93 (64-100) vs 21 (6-51)], colon carcinomatosis [91 (57-100) vs 27 (7-61)] and unresectable distant metastases [90 (54-99) vs 20 (4-56)]. WB-DWI/MRI correctly predicted complete resection in 33 of 35 (94%) patients eligible for salvage surgery compared with 17 of 35 (49%) for CT (p < 0.001). CONCLUSION WB-DWI/MRI allowed better detection of ovarian cancer recurrence and better prediction of complete resection than CT. Advances in knowledge: WB-DWI/MRI could assist in optimizing treatment planning for recurrent ovarian cancer, particularly by improving patient selection for salvage surgery, thus giving eligible patients the highest chance on prolonged survival and refraining patients who would not benefit from extensive surgery reducing related morbidity and mortality.
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Affiliation(s)
| | - Ignace Vergote
- 2 Department of Obstetrics and Gynaecology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Raphaëla Dresen
- 1 Department of Imaging and Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Katya Op de Beeck
- 1 Department of Imaging and Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Ragna Vanslembrouck
- 1 Department of Imaging and Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Frédéric Amant
- 2 Department of Obstetrics and Gynaecology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium.,3 Belgium and Center Gynaecological Oncology Amsterdam (CGOA), Antoni van Leeuwenhoek, Amsterdam, Netherlands
| | - Karin Leunen
- 2 Department of Obstetrics and Gynaecology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Philippe Moerman
- 1 Department of Imaging and Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Steffen Fieuws
- 4 Department of Public Health and Primary Care, University Hospitals Leuven, Leuven, Belgium
| | - Frederik De Keyzer
- 1 Department of Imaging and Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Vincent Vandecaveye
- 1 Department of Imaging and Pathology, University Hospitals Leuven, Leuven, Belgium
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Qiu Y, Tan M, McMeekin S, Thai T, Ding K, Moore K, Liu H, Zheng B. Early prediction of clinical benefit of treating ovarian cancer using quantitative CT image feature analysis. Acta Radiol 2016; 57:1149-55. [PMID: 26663390 PMCID: PMC5150882 DOI: 10.1177/0284185115620947] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 10/28/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND In current clinical trials of treating ovarian cancer patients, how to accurately predict patients' response to the chemotherapy at an early stage remains an important and unsolved challenge. PURPOSE To investigate feasibility of applying a new quantitative image analysis method for predicting early response of ovarian cancer patients to chemotherapy in clinical trials. MATERIAL AND METHODS A dataset of 30 patients was retrospectively selected in this study, among which 12 were responders with 6-month progression-free survival (PFS) and 18 were non-responders. A computer-aided detection scheme was developed to segment tumors depicted on two sets of CT images acquired pre-treatment and 4-6 weeks post treatment. The scheme computed changes of three image features related to the tumor volume, density, and density variance. We analyzed performance of using each image feature and applying a decision tree to predict patients' 6-month PFS. The prediction accuracy of using quantitative image features was also compared with the clinical record based on the Response Evaluation Criteria in Solid Tumors (RECIST) guideline. RESULTS The areas under receiver operating characteristic curve (AUC) were 0.773 ± 0.086, 0.680 ± 0.109, and 0.668 ± 0.101, when using each of three features, respectively. AUC value increased to 0.831 ± 0.078 when combining these features together. The decision-tree classifier achieved a higher predicting accuracy (76.7%) than using RECIST guideline (60.0%). CONCLUSION This study demonstrated the potential of using a quantitative image feature analysis method to improve accuracy of predicting early response of ovarian cancer patients to the chemotherapy in clinical trials.
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Affiliation(s)
- Yuchen Qiu
- School of Electrical and Computer Engineering, University of Oklahoma, Norman, Oklahoma, USA
| | - Maxine Tan
- School of Electrical and Computer Engineering, University of Oklahoma, Norman, Oklahoma, USA
| | - Scott McMeekin
- Health Science Center of University of Oklahoma, Oklahoma City, Oklahoma, USA
| | - Theresa Thai
- Health Science Center of University of Oklahoma, Oklahoma City, Oklahoma, USA
| | - Kai Ding
- Health Science Center of University of Oklahoma, Oklahoma City, Oklahoma, USA
| | - Kathleen Moore
- Health Science Center of University of Oklahoma, Oklahoma City, Oklahoma, USA
| | - Hong Liu
- School of Electrical and Computer Engineering, University of Oklahoma, Norman, Oklahoma, USA
| | - Bin Zheng
- School of Electrical and Computer Engineering, University of Oklahoma, Norman, Oklahoma, USA
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