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Trinidad López C, De La Fuente Aguado J, Oca Pernas R, Delgado Sánchez-Gracián C, Santos Armentia E, Vaamonde Liste A, Prada González R, Souto Bayarri M. Evaluation of response to conventional chemotherapy and radiotherapy by perfusion computed tomography in non-small cell lung cancer (NSCLC). Eur Radiol Exp 2019; 3:23. [PMID: 31197486 PMCID: PMC6565789 DOI: 10.1186/s41747-019-0101-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 05/02/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND To evaluate changes in perfusion computed tomography (PCT) parameters induced by treatment with conventional chemotherapy (CCT) alone or with CCT and radiation therapy (RT) in patients with non-small cell lung cancer (NSCLC) and to determine whether these changes correlate with response as defined by the response evaluation criteria in solid tumours version 1.1 (RECIST-1.1). METHODS Fifty-three patients with a histological diagnosis of NSCLC prospectively underwent PCT of the whole tumour, before/after CCT or before/after CCT and RT. Blood flow (BF), blood volume (BV), permeability (PMB), and mean transit time (MTT) were compared before and after treatment and with the response as defined by RECIST-1.1. The relationship between changes in the perfusion parameters and in tumour size was also evaluated. RESULTS PCT parameters decreased after treatment, significantly for BV (p = 0.002) and MTT (p = 0.027). The 30 patients with partial response had a significant decrease of 21% for BV (p = 0.006) and 17% for MTT (p = 0.031). A non-significant decrease in all perfusion parameters was found in patients with stable disease (p > 0.137). In patients with progressive disease, MTT decreased by 10% (p = 0.465) and the other parameters did not significantly vary (p > 0.809). No significant correlation was found between changes in size and PCT parameters (p > 0.145). CONCLUSIONS Treatment of NSCLC with platinum derivatives, with or without RT, induces changes in PCT parameters. Partial response is associated with a significant decrease in BV and MTT, attributable to the effect of the treatment on tumour vascularisation.
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Affiliation(s)
- Carmen Trinidad López
- Department of Radiology, POVISA Hospital, 5 Salamanca st, 36208, Vigo, Pontevedra, Spain.
| | | | - Roque Oca Pernas
- Department of Radiology, Osatek, Urduliz Hospital, Vizcaya, Spain
| | | | - Eloisa Santos Armentia
- Department of Radiology, POVISA Hospital, 5 Salamanca st, 36208, Vigo, Pontevedra, Spain
| | - Antonio Vaamonde Liste
- Department of Statistics and Operational Research, Faculty of Economic and Business Sciences, Vigo University Spain, Vigo, Spain
| | - Raquel Prada González
- Department of Radiology, POVISA Hospital, 5 Salamanca st, 36208, Vigo, Pontevedra, Spain
| | - Miguel Souto Bayarri
- Department of Radiology, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
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Yoshida Y, Manaka T, Nitadori JI, Shinozaki-Ushiku A, Doke T, Saito T, Sato J, Miyaji T, Yamaguchi T, Oyama H, Fukayama M, Nakajima Y, Nakajima J. A comparison between 2- and 3-dimensional approaches to solid component measurement as radiological criteria for sublobar resection in lung adenocarcinoma ≤ 2 cm in size. Surg Today 2019; 49:828-835. [PMID: 30968225 DOI: 10.1007/s00595-019-01806-9] [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: 01/31/2019] [Accepted: 03/20/2019] [Indexed: 01/15/2023]
Abstract
PURPOSE We compared three-dimensional (3D) and two-dimensional (2D) measurements of the solid component to determine radiological criteria for sublobar resection of lung adenocarcinoma ≤ 2 cm in size. METHODS We included 233 surgical cases. The maximum size of the solid component for 3D measurement was calculated by delineating the solid component on successive axial images and reconstructing the 3D surface model. RESULTS The predictive performance for adenocarcinoma in situ (n = 43) and minimally invasive adenocarcinoma (n = 77) were equivalent to areas under the curve of 0.871 and 0.857 for 2D and 3D measurements (p = 0.229), respectively. A solid component of 5 mm had a prognostic impact on both measurements ( ≤ 5 mm versus > 5 mm; p = 0.003 for 2D and p = 0.002 for 3D, log-rank test). Survival rates at 5 years were 94.7-96.9% following lobectomy and sublobar resection among patients with a solid component ≤ 5 mm in size. Sublobar resection resulted in worse survival rates, with declines at 5 years of 15.8% on 2D and 11.5% on 3D measurements, than lobectomy in patients with a solid component > 5 mm in size. CONCLUSIONS A solid component ≤ 5 mm in size is an appropriate criterion for sublobar resection for both measurements. In addition, 2D measurement is justified because of its simple implementation.
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Affiliation(s)
- Yukihiro Yoshida
- Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Toshiki Manaka
- Department of Bioengineering, The University of Tokyo Graduate School of Engineering, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Jun-Ichi Nitadori
- Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Aya Shinozaki-Ushiku
- Department of Pathology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Takehito Doke
- Department of Bioengineering, The University of Tokyo Graduate School of Engineering, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Toki Saito
- Department of Clinical Information Engineering, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Jiro Sato
- Department of Radiology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Takuhiro Yamaguchi
- Department of Clinical Trial Data Management, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroshi Oyama
- Department of Clinical Information Engineering, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Masashi Fukayama
- Department of Pathology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yoshikazu Nakajima
- Department of Bioengineering, The University of Tokyo Graduate School of Engineering, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Jun Nakajima
- Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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Radiation Therapy in Non-small-Cell Lung Cancer. Radiat Oncol 2019. [DOI: 10.1007/978-3-319-52619-5_34-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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4
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Trinidad López C, Souto Bayarri M, Oca Pernas R, Delgado Sánchez-Gracián C, González Vázquez M, Vaamonde Liste A, Tardáguila De La Fuente G, De La Fuente Aguado J. Characteristics of computed tomography perfusion parameters in non-small-cell-lung-cancer and its relationship to histology, size, stage an treatment response. Clin Imaging 2018; 50:5-12. [DOI: 10.1016/j.clinimag.2017.12.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 10/27/2017] [Accepted: 12/01/2017] [Indexed: 11/29/2022]
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Clustering approach to identify intratumour heterogeneity combining FDG PET and diffusion-weighted MRI in lung adenocarcinoma. Eur Radiol 2018; 29:468-475. [PMID: 29922931 DOI: 10.1007/s00330-018-5590-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/13/2018] [Accepted: 06/04/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Malignant tumours consist of biologically heterogeneous components; identifying and stratifying those various subregions is an important research topic. We aimed to show the effectiveness of an intratumour partitioning method using clustering to identify highly aggressive tumour subregions, determining prognosis based on pre-treatment PET and DWI in stage IV lung adenocarcinoma. METHODS Eighteen patients who underwent both baseline PET and DWI were recruited. Pre-treatment imaging of SUV and ADC values were used to form intensity vectors within manually specified ROIs. We applied k-means clustering to intensity vectors to yield distinct subregions, then chose the subregion that best matched the criteria for high SUV and low ADC to identify tumour subregions with high aggressiveness. We stratified patients into high- and low-risk groups based on subregion volume with high aggressiveness and conducted survival analyses. This approach is referred to as the partitioning approach. For comparison, we computed tumour subregions with high aggressiveness without clustering and repeated the described procedure; this is referred to as the voxel-wise approach. RESULTS The partitioning approach led to high-risk (median SUVmax = 14.25 and median ADC = 1.26x10-3 mm2/s) and low-risk (median SUVmax = 14.64 and median ADC = 1.09x10-3 mm2/s) subgroups. Our partitioning approach identified significant differences in survival between high- and low-risk subgroups (hazard ratio, 4.062, 95% confidence interval, 1.21 - 13.58, p-value: 0.035). The voxel-wise approach did not identify significant differences in survival between high- and low-risk subgroups (p-value: 0.325). CONCLUSION Our partitioning approach identified intratumour subregions that were predictors of survival. KEY POINTS • Multimodal imaging of PET and DWI is useful for assessing intratumour heterogeneity. • Data-driven clustering identified subregions which might be highly aggressive for lung adenocarcinoma. • The data-driven partitioning results might be predictors of survival.
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Jiménez-Bonilla JF, Quirce R, Martínez-Rodríguez I, De Arcocha-Torres M, Carril JM, Banzo I. The Role of PET/CT Molecular Imaging in the Diagnosis of Recurrence and Surveillance of Patients Treated for Non-Small Cell Lung Cancer. Diagnostics (Basel) 2016; 6:diagnostics6040036. [PMID: 27706025 PMCID: PMC5192511 DOI: 10.3390/diagnostics6040036] [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: 05/04/2016] [Revised: 09/08/2016] [Accepted: 09/22/2016] [Indexed: 12/28/2022] Open
Abstract
Non-small cell lung cancer (NSCLC) is the leading cause of cancer mortality worldwide and its prognosis remains poor. Molecular imaging with 18F-FDG PET/CT can metabolically characterize the nature of lesions as benign or malignant, allowing a better staging at the diagnosis of this kind of patient. This advantage can also be applied in the re-staging due to the suspicion of recurrent disease. Many patients have a recurrence of the disease, including surgically treated patients. In the current context, with new personalized oncological treatments, the surveillance for recurrence and its accurate diagnosis are crucial to improve their survival. In this paper, we revise the current knowledge about the clinical and molecular factors related to the recurrent disease. In the context of new, promising, available personalized treatments, the role of molecular imaging with PET/CT and 18F-FDG and non-18F-FDG radiotracers in the follow-up of NSCLC-treated patients is especially attractive and interesting.
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Affiliation(s)
- Julio Francisco Jiménez-Bonilla
- Nuclear Medicine Department, University Hospital Marqués de Valdecilla, Molecular Imaging IDIVAL, University of Cantabria, 39008 Santander, Spain.
| | - Remedios Quirce
- Nuclear Medicine Department, University Hospital Marqués de Valdecilla, Molecular Imaging IDIVAL, University of Cantabria, 39008 Santander, Spain.
| | - I Martínez-Rodríguez
- Nuclear Medicine Department, University Hospital Marqués de Valdecilla, Molecular Imaging IDIVAL, University of Cantabria, 39008 Santander, Spain.
| | - María De Arcocha-Torres
- Nuclear Medicine Department, University Hospital Marqués de Valdecilla, Molecular Imaging IDIVAL, University of Cantabria, 39008 Santander, Spain.
| | - José Manuel Carril
- Nuclear Medicine Department, University Hospital Marqués de Valdecilla, Molecular Imaging IDIVAL, University of Cantabria, 39008 Santander, Spain.
| | - Ignacio Banzo
- Nuclear Medicine Department, University Hospital Marqués de Valdecilla, Molecular Imaging IDIVAL, University of Cantabria, 39008 Santander, Spain.
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Fifty Years of Technological Innovation: Potential and Limitations of Current Technologies in Abdominal Magnetic Resonance Imaging and Computed Tomography. Invest Radiol 2016; 50:584-93. [PMID: 26039773 DOI: 10.1097/rli.0000000000000173] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Magnetic resonance imaging (MRI) has become an important modality for the diagnosis of intra-abdominal pathology. Hardware and pulse sequence developments have made it possible to derive not only morphologic but also functional information related to organ perfusion (dynamic contrast-enhanced MRI), oxygen saturation (blood oxygen level dependent), tissue cellularity (diffusion-weighted imaging), and tissue composition (spectroscopy). These techniques enable a more specific assessment of pathologic lesions and organ functionality. Magnetic resonance imaging has thus transitioned from a purely morphologic examination to a modality from which image-based disease biomarkers can be derived. This fits well with several emerging trends in radiology, such as the need to accurately assess response to costly treatment strategies and the need to improve lesion characterization to potentially avoid biopsy. Meanwhile, the cost-effectiveness, availability, and robustness of computed tomography (CT) ensure its place as the current workhorse for clinical imaging. Although the lower soft tissue contrast of CT relative to MRI is a long-standing limitation, other disadvantages such as ionizing radiation exposure have become a matter of public concern. Nevertheless, recent technical developments such as dual-energy CT or dynamic volume perfusion CT also provide more functional imaging beyond morphology.The aim of this article was to review and discuss the most important recent technical developments in abdominal MRI and state-of-the-art CT, with an eye toward the future, providing examples of their clinical utility for the evaluation of hepatic and renal pathologies.
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Lubner SJ, Mullvain J, Perlman S, Pishvaian M, Mortimer J, Oliver K, Heideman J, Hall L, Weichert J, Liu G. A Phase 1, Multi-Center, Open-Label, Dose-Escalation Study of 131I-CLR1404 in Subjects with Relapsed or Refractory Advanced Solid Malignancies. Cancer Invest 2015; 33:483-9. [PMID: 26536061 DOI: 10.3109/07357907.2015.1081691] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study explores the imaging and therapeutic properties of a novel radiopharmaceutical, (131)I-CLR1404. Phase 1a data demonstrated safety and tumor localization by SPECT-CT. This 1b study assessed safety, imaging characteristics, and possible antineoplastic properties and provided further proof-of-concept of phospholipid ether analogues' retention within tumors. A total of 10 patients received (131)I-CLR1404 in an adaptive dose-escalation design. Imaging characteristics were consistent with prior studies, showing tumor uptake in primary tumors and metastases. At doses of 31.25 mCi/m(2) and greater, DLTs were thrombocytopenia and neutropenia. Disease-specific studies are underway to identify cancers most likely to benefit from (131)I-CLR1404 monotherapy.
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Affiliation(s)
- Sam Joseph Lubner
- a University of Wisconsin Carbone Cancer Center , Madison , WI , USA
| | | | - Scott Perlman
- a University of Wisconsin Carbone Cancer Center , Madison , WI , USA
| | - Michael Pishvaian
- b Georgetown University Medical Center , Lombardi Cancer Center, Washington, DC , USA
| | - Joanne Mortimer
- c City of Hope Comprehensive Cancer Center , Duarte , CA , USA
| | | | - Jennifer Heideman
- a University of Wisconsin Carbone Cancer Center , Madison , WI , USA
| | - Lance Hall
- a University of Wisconsin Carbone Cancer Center , Madison , WI , USA
| | - Jamey Weichert
- a University of Wisconsin Carbone Cancer Center , Madison , WI , USA.,d Cellectar Biosciences , Madison , WI , USA
| | - Glenn Liu
- a University of Wisconsin Carbone Cancer Center , Madison , WI , USA
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