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Shangguan C, Yang C, Shi Z, Miao Y, Hai W, Shen Y, Qu Q, Li B, Mi J. 68Ga-FAPI-04 Positron Emission Tomography Distinguishes Malignancy From 18F-FDG-Avid Colorectal Lesions. Int J Radiat Oncol Biol Phys 2024; 118:285-294. [PMID: 37634891 DOI: 10.1016/j.ijrobp.2023.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 07/18/2023] [Accepted: 08/08/2023] [Indexed: 08/29/2023]
Abstract
PURPOSE Lesions with a high uptake of 18F-fluorodeoxyglucose (18F-FDG) on positron emission tomography-computed tomography (PET-CT) can be benign and malignant. New radiotracers, such as the gallium 68 (68Ga)-labeled fibroblast activation protein inhibitor 4 (FAPI-04), could be used to diagnose colorectal carcinoma. This study aimed to evaluate the efficacy of 68Ga-FAPI-04 PET in differentiating benign from malignant 18F-FDG-avid colorectal lesions. METHODS AND MATERIALS An azoxymethane/dextran sodium sulfate (AOM/DSS)-induced rat colorectal tumor model was developed. Double-tracer 68Ga-FAPI-04 and 18F-FDG PET-CT were applied in the rat model and 22 patients. The PET-CT data were analyzed with enteroscopy, histopathologic observations, immunohistochemistry (IHC) staining, and radioautography results. One hundred seventy-two patients with pathologically confirmed colorectal lesions were enrolled in FAP IHC staining. RESULTS We found that 68Ga-FAPI-04 PET-CT imaging accurately distinguished the malignant from benign inflammatory lesions in an AOM/DSS-induced rat colorectal tumor model. Of 22 patients with gastric cancer but without colorectal carcinoma, 8 had 18F-FDG uptake in the colorectum, but 68Ga-FAPI-04 PET was negative in these sites. An inflammatory lesion or adenoma did not interfere with 68Ga-FAPI-04 PET imaging. Among the 18F-FDG-avid colorectal lesions, 80 of 94 pathologically malignant lesions (85.1%) were FAP-positive, and only 16 of the 78 premalignant or benign lesions (20.5%) had a weak 68Ga-FAPI-04 uptake. CONCLUSIONS 68Ga-FAPI-04 PET-CT could be used to distinguish between benign and malignant 18F-FDG-avid colorectal lesions.
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Affiliation(s)
- Chengfang Shangguan
- Department of Oncology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chen Yang
- Department of Otolaryngology & Head and Neck Surgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhaopeng Shi
- Basic Medical Institute, Key Laboratory of Cell Differentiation and Apoptosis of Chinese Ministry of Education, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Miao
- Department of Nuclear Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wangxi Hai
- Department of Nuclear Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Shen
- Research Center for Experimental Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing Qu
- Department of Oncology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Biao Li
- Department of Nuclear Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Jun Mi
- Basic Medical Institute, Key Laboratory of Cell Differentiation and Apoptosis of Chinese Ministry of Education, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Nuclear Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Classification and Segmentation Algorithm in Benign and Malignant Pulmonary Nodules under Different CT Reconstruction. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:3490463. [PMID: 35495882 PMCID: PMC9050279 DOI: 10.1155/2022/3490463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/01/2022] [Accepted: 04/08/2022] [Indexed: 11/17/2022]
Abstract
Methods The imaging data of 55 patients with chest CT plain scan in the Xuancheng People's Hospital were collected retrospectively. The data of each patient included lung window reconstruction, mediastinum reconstruction, and bone window reconstruction. The depth neural network and 3D convolution neural network were used to construct the model and train the classification and segmentation algorithm. The pathological results were the gold standard for benign and malignant pulmonary nodules. The classification and segmentation algorithms under three CT reconstruction algorithms were compared and analyzed by analysis of variance. Results Under the three CT reconstruction algorithms, the classification accuracy of pulmonary nodule density types was 98.2%, 96.4%, and 94.5%, respectively. The Dice coefficients of all nodule segmentation were 80.32% ± 5.91%, 79.83% ± 6.12%, and 80.17% ± 5.89%, respectively. The diagnostic accuracy between benign and malignant pulmonary nodules under different reconstruction algorithms was 98.2%, 96.4%, and 94.5%, respectively. There was no significant difference in the classification accuracy, Dice coefficients, and diagnostic accuracy of pulmonary nodules under three different reconstruction algorithms (all P > 0.05). Conclusion The depth neural network algorithm combined with 3D convolution neural network has a good efficiency in identifying benign and malignant pulmonary nodules under different CT reconstruction classification and segmentation algorithms.
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Divisi D, Rinaldi M, Necozione S, Curcio C, Rea F, Zaraca F, De Vico A, Zaccagna G, Di Leonardo G, Crisci R. Is It Possible to Establish a Reliable Correlation between Maximum Standardized Uptake Value of 18-Fluorine Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and Histological Types of Non-Small Cell Lung Cancer? Analysis of the Italian VATS Group Database. Diagnostics (Basel) 2021; 11:diagnostics11101901. [PMID: 34679600 PMCID: PMC8534503 DOI: 10.3390/diagnostics11101901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 10/08/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Although positron emission tomography/computed tomography, often integrated with 2-deoxy-2-[fluorine-18] fluorine-D-glucose (18F-FDG-PET/CT), is fundamental in the assessment of lung cancer, the relationship between metabolic avidity of different histotypes and maximum standardized uptake value (SUVmax) has not yet been thoroughly investigated. The aim of the study is to establish a reliable correlation between Suvmax and histology in non-small cell lung cancer (NSCLC), in order to facilitate patient management. METHODS We retrospectively assessed the data about lung cancer patients entered in the Italian Registry of VATS Group from January 2014 to October 2019, after establishing the eligibility criteria of the study. In total, 8139 patients undergoing VATS lobectomy were enrolled: 3260 females and 4879 males. The relationship between SUVmax and tumor size was also analyzed. RESULTS The mean values of SUVmax in the most frequent types of lung cancer were as follows: (a) 4.88 ± 3.82 for preinvasive adenocarcinoma; (b) 5.49 ± 4.10 for minimally invasive adenocarcinoma; (c) 5.87 ± 4.18 for invasive adenocarcinoma; and (d) 8.85 ± 6.70 for squamous cell carcinoma. Processing these data, we displayed a statistically difference (p < 0.000001) of FDG avidity between adenocarcinoma and squamous cell carcinoma. Moreover, by classifying patients into five groups based on tumor diameter and after evaluating the SUVmax value for each group, we noted a statistical correlation (p < 0.000001) between size and FDG uptake, also confirmed by the post hoc analysis. CONCLUSIONS There is a correlation between SUVmax, histopathology outcomes and tumor size in NSCLC. Further clinical trials should be performed in order to confirm our data.
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Affiliation(s)
- Duilio Divisi
- Thoracic Surgery Unit, Department of Life, Health & Environmental Sciences, University of L’Aquila, “Giuseppe Mazzini” Hospital, Piazza Italia 1, 64100 Teramo, Italy; (M.R.); (A.D.V.); (G.Z.); (G.D.L.); (R.C.)
- Correspondence: or ; Tel.: +39-0861-42-94-82; Fax: +39-0861-42-94-78
| | - Marta Rinaldi
- Thoracic Surgery Unit, Department of Life, Health & Environmental Sciences, University of L’Aquila, “Giuseppe Mazzini” Hospital, Piazza Italia 1, 64100 Teramo, Italy; (M.R.); (A.D.V.); (G.Z.); (G.D.L.); (R.C.)
| | - Stefano Necozione
- Department of Internal Medicine and Public Health, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Carlo Curcio
- Division of Thoracic Surgery, Monaldi Hospital, 80131 Naples, Italy;
| | - Federico Rea
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova City Hospital, 35100 Padova, Italy;
| | - Francesco Zaraca
- Department of Vascular and Thoracic Surgery, Central Hospital, 39100 Bolzano, Italy;
| | - Andrea De Vico
- Thoracic Surgery Unit, Department of Life, Health & Environmental Sciences, University of L’Aquila, “Giuseppe Mazzini” Hospital, Piazza Italia 1, 64100 Teramo, Italy; (M.R.); (A.D.V.); (G.Z.); (G.D.L.); (R.C.)
| | - Gino Zaccagna
- Thoracic Surgery Unit, Department of Life, Health & Environmental Sciences, University of L’Aquila, “Giuseppe Mazzini” Hospital, Piazza Italia 1, 64100 Teramo, Italy; (M.R.); (A.D.V.); (G.Z.); (G.D.L.); (R.C.)
| | - Gabriella Di Leonardo
- Thoracic Surgery Unit, Department of Life, Health & Environmental Sciences, University of L’Aquila, “Giuseppe Mazzini” Hospital, Piazza Italia 1, 64100 Teramo, Italy; (M.R.); (A.D.V.); (G.Z.); (G.D.L.); (R.C.)
| | - Roberto Crisci
- Thoracic Surgery Unit, Department of Life, Health & Environmental Sciences, University of L’Aquila, “Giuseppe Mazzini” Hospital, Piazza Italia 1, 64100 Teramo, Italy; (M.R.); (A.D.V.); (G.Z.); (G.D.L.); (R.C.)
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Kousgaard SJ, Gade M, Petersen LJ, Thorlacius-Ussing O. Incidental detection of colorectal lesions on 18 F-FDG-PET/CT is associated with high proportion of malignancy: A study in 549 patients. Endosc Int Open 2020; 8:E1725-E1731. [PMID: 33269303 PMCID: PMC7671755 DOI: 10.1055/a-1266-3308] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 08/18/2020] [Indexed: 02/06/2023] Open
Abstract
Background and study aims Further diagnostics of incidental colorectal lesions on 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is questionable. Therefore, we aimed to evaluate the clinical importance of incidentally detected colorectal lesions on FDG-PET/CT. Patients and methods In the North Denmark Region, a retrospective study was performed among 19,987 patients who had an FDG-PET/CT from January 2006 to December 2015. Among these patients, we identified patients with a colonoscopy within 12 months from the PET/CT scan and a description of incidental colorectal PET-avid lesions on the PET/CT. PET findings were compared with colonoscopy-detected lesions and eventually histopathology. Results Incidental PET-avid lesions were observed in 549 patients. Colonoscopy revealed lesions in 457 (83 %), among whom 338 patients had a final histopathological diagnosis. Malignant and premalignant lesions were found in 297 patients (54 % among patients with a PET-avid lesion). The lesions were cancer in 76 patients and adenoma in 221 patients of whom 30 had high-grade and 191 low-grade adenomas. The findings changed patient management in 166 cases (30 % of all patients with a PET-avid lesion). A colonoscopy-based surveillance program was initiated for 80 % of patients with high-grade adenoma. No patients with PET-avid lesions but normal colonoscopy developed colorectal cancer during 3 years of observation (median observation time 7 years). Conclusions Incidental colorectal FDG uptake was infrequently observed, but when present, it was associated with a high rate of malignant or premalignant lesions. Our results indicate that patients with incidental colorectal FDG uptake should be referred to diagnostic work-up including colonoscopy.
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Affiliation(s)
- Sabrina Just Kousgaard
- Department of Gastrointestinal Surgery and Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Michael Gade
- Department of Nuclear Medicine, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Lars Jelstrup Petersen
- Department of Nuclear Medicine, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Ole Thorlacius-Ussing
- Department of Gastrointestinal Surgery and Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Zhang R, Tian P, Chen B, Zhou Y, Li W. Predicting Lung Cancer Risk of Incidental Solid and Subsolid Pulmonary Nodules in Different Sizes. Cancer Manag Res 2020; 12:8057-8066. [PMID: 32943938 PMCID: PMC7481308 DOI: 10.2147/cmar.s256719] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 08/13/2020] [Indexed: 02/05/2023] Open
Abstract
Objective Malignancy prediction models for pulmonary nodules are most accurate when used within nodules similar to those in which they were developed. This study was to establish models that respectively predict malignancy risk of incidental solid and subsolid pulmonary nodules of different size. Materials and Methods This retrospective study enrolled patients with 5-30 mm pulmonary nodules who had a histopathologic diagnosis of benign or malignant. The median time to lung cancer diagnosis was 25 days. Four training/validation datasets were assembled based on nodule texture and size: subsolid nodules (SSNs) ≤15 mm, SSNs between 15 and 30 mm, solid nodules ≤15 mm and those between 15 and 30 mm. Univariate logistic regression was used to identify potential predictors, and multivariate analysis was used to build four models. Results The study identified 1008 benign and 1813 malignant nodules from a single hospital, and by random selection 1008 malignant nodules were enrolled for further analysis. There was a much higher malignancy rate among SSNs than solid nodules (rate, 75% vs 39%, P<0.001). Four distinguishing models were respectively developed and the areas under the curve (AUC) in training sets and validation sets were 0.83 (0.78-0.88) and 0.70 (0.61-0.80) for SSNs ≤15 mm, 0.84 (0.74-0.93) and 0.72 (0.57-0.87) for SSNs between 15 and 30 mm, 0.82 (0.77-0.87) and 0.71 (0.61-0.80) for solid nodules ≤15 mm, 0.82 (0.79-0.85) and 0.81 (0.76-0.86) for solid nodules between 15 and 30 mm. Each model showed good calibration and potential clinical applications. Different independent predictors were identified for solid nodules and SSNs of different size. Conclusion We developed four models to help characterize subsolid and solid pulmonary nodules of different sizes. The established models may provide decision-making information for thoracic radiologists and clinicians.
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Affiliation(s)
- Rui Zhang
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Panwen Tian
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.,Department of Lung Cancer Treatment Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Bojiang Chen
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Yongzhao Zhou
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Weimin Li
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
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Theodorakis L, Loudos G, Prassopoulos V, Kappas C, Tsougos I, Georgoulias P. PET Counting Response Variability Depending on Tumor Location, Activity, and Patient Obesity: A Feasibility Study of Solitary Pulmonary Nodule Using Monte Carlo. IEEE TRANSACTIONS ON MEDICAL IMAGING 2019; 38:1763-1774. [PMID: 30629497 DOI: 10.1109/tmi.2019.2891578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We aim to investigate the counting response variations of positron emission tomography (PET) scanners with different detector configurations in the presence of solitary pulmonary nodule (SPN). Using experimentally validated Monte Carlo simulations, the counting performance of four different scanner models with varying tumor activity, location, and patient obesity is represented using a noise equivalent count rate (NECR). NECR is a well-established quantitative metric which has positive correlation with clinically perceived image quality. The combined effect of tumor displacement and increased activity shows a linear ascending trend for NECR with slope ranges of (12.5-18.2)*10-3 (kBq/cm3)-1 for three-ring (3R) scanners and (15.3-21.5)*10-3 (kBq/cm3)-1 for four-ring (4R). The trend for the combined effect of tumor displacement and patient obesity is exponential decay with 3R configurations weakly dependent on the patient obesity if the tumor is located at the center of the field of view with exponent's range of (6.6-33.8)*10-2cm-1. The dependence is stronger for 4R scanners (9.6-38.5)*10-2cm-1. The analysis indicates that quantitative PET data from the same SPN patient possibly examined in different time points (e.g., during staging or for the evaluation of treatment response) are affected by the different detector configurations and need to be normalized with patient weight, activity, and tumor location to reduce unwanted bias of the diagnosis. This paper provides also with a proof of concept for the ability of properly tuned simulations to provide additional insights into the counting response variability especially in tumor types where often borderline decisions have to be made regarding their characterization.
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Erdoğan O, İsmi O, Arpacı RB, Vayısoğlu Y, Özcan C. False-Positive Laryngeal FDG Uptake During PET/CT Imaging: Reinke's Edema. Turk Arch Otorhinolaryngol 2018; 56:114-116. [PMID: 30197811 DOI: 10.5152/tao.2018.3123] [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: 12/24/2017] [Accepted: 02/13/2018] [Indexed: 11/22/2022] Open
Abstract
Positron emission tomography/computed tomography (PET/CT) is frequently used for diagnosing, staging, and following-up various malignancy types because it provides information on the site and metabolic activity of the tumor. Fluorodeoxyglucose (FDG) uptake by the normal laryngeal tissue is symmetric and low, whereas that under some non-malignant conditions of the larynx, such as vocal cord paralysis and Teflon granuloma, is asymmetrically increased. We reported the first case of histologically proven Reinke's edema causing false-positive laryngeal FDG uptake on PET/CT imaging. A clinician must be aware of these rare benign lesions in the case of increased FDG uptake, and histopathological investigation is mandatory to rule out malignancy for suspicious cases.
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Affiliation(s)
- Osman Erdoğan
- Department of Otorhinolaryngology, Mersin University School of Medicine, Mersin, Turkey
| | - Onur İsmi
- Department of Otorhinolaryngology, Mersin University School of Medicine, Mersin, Turkey
| | | | - Yusuf Vayısoğlu
- Department of Otorhinolaryngology, Mersin University School of Medicine, Mersin, Turkey
| | - Cengiz Özcan
- Department of Otorhinolaryngology, Mersin University School of Medicine, Mersin, Turkey
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Divisi D, Barone M, Bertolaccini L, Zaccagna G, Gabriele F, Crisci R. Diagnostic performance of fluorine-18 fluorodeoxyglucose positron emission tomography in the management of solitary pulmonary nodule: a meta-analysis. J Thorac Dis 2018; 10:S779-S789. [PMID: 29780624 DOI: 10.21037/jtd.2017.12.126] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background In the setting of solitary pulmonary nodules (SPNs), fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) is considered a useful non-invasive diagnostic tool though false positive (FP) and false negative (FN) results affects accuracy due to different conditions, such as inflammatory diseases or low-uptake neoplasms. Aim of this study is to evaluate overall diagnostic performance of 18F-FDG-PET/CT for malignant pulmonary nodules. Methods A computerized research, including published articles from 2012 and 2017, was carried out. 18F-FDG-PET/CT overall sensitivity (Se), specificity (Spe), positive likelihood ratio (PLR), negative likelihood ratio (NLR), positive predictive value (PPV), negative predictive value (NPV), diagnostic index and odds ratio were pooled. No selection-bias were found according to asymmetry test. Results A total of twelve studies were included in the meta-analysis. The pooled Se, Spe, PLR, NLR, PPV, NPV and accuracy index (AI) with relative 95% confidence intervals (CI) were 0.819 (95% CI: 0.794-0.843), 0.624 (95% CI: 0.582-0.665), 2.190 (95% CI: 1.950-2.440), 0.290 (95% CI: 0.250-0.330), 0.802 (95% CI: 0.783-0.819), 0.652 (95% CI: 0.618-0.684) and 0.649 (95% CI: 0.625-0.673), respectively. The diagnostic odds ratio (DOR) was 7.049 with a relative 95% CI between 5.550 and 8.944. Conclusions The results suggest 18F-FDG-PET/CT has good diagnostic accuracy in SPNs evaluation; but, it should not be considered as a discriminatory test rather than a method to be included in a clinical and diagnostic pathway.
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Affiliation(s)
- Duilio Divisi
- Thoracic Surgery Unit, University of L'Aquila, "G. Mazzini" Hospital, Teramo Italy
| | - Mirko Barone
- Thoracic Surgery Unit, University of L'Aquila, "G. Mazzini" Hospital, Teramo Italy
| | | | - Gino Zaccagna
- Thoracic Surgery Unit, University of L'Aquila, "G. Mazzini" Hospital, Teramo Italy
| | - Francesca Gabriele
- Thoracic Surgery Unit, University of L'Aquila, "G. Mazzini" Hospital, Teramo Italy
| | - Roberto Crisci
- Thoracic Surgery Unit, University of L'Aquila, "G. Mazzini" Hospital, Teramo Italy
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Divisi D, Barone M, Crisci R. Current role of standardized uptake value max-derived ratios in N2 fluorine-18 fluorodeoxyglucose positron-emission tomography non-small cell lung cancer. J Thorac Dis 2018; 10:503-507. [PMID: 29600085 DOI: 10.21037/jtd.2017.11.137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Mediastinal staging is a crucial moment in management of non-small cell lung cancer (NSCLC) patients. In integrated pathways, 18-fluorine fluorodeoxyglucose positron-emission tomography (18F-FDG-PET/CT) is an indispensable imaging resource with its peculiarities and its limitations. A critical review of work up protocols would certainly help to standardize procedures with important reflections also on the diagnostic value of this examination. In this regard, new semi-quantitative and semi-qualitative indexes have been proposed with the aim of increasing the accuracy of 18F-FDG-PET/CT in mediastinal lymph node staging. These latter, such as SUVn/t and SUV indexes, seem to overcome the problem of spatial resolution and discrimination of malignancy by endorsing a new predictive and prognostic role.
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Affiliation(s)
- Duilio Divisi
- Department of Thoracic Surgery, University of L'Aquila, "G. Mazzini" Hospital, Teramo, Italy
| | - Mirko Barone
- Department of Thoracic Surgery, University of L'Aquila, "G. Mazzini" Hospital, Teramo, Italy
| | - Roberto Crisci
- Department of Thoracic Surgery, University of L'Aquila, "G. Mazzini" Hospital, Teramo, Italy
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